Computer assisted coronary intervention by use of on-line 3D reconstruction and optimal view strategy

Abstract

Abstract. A novel method has been developed for on-line reconstruction of the 3D coronary arterial tree based on a pair of routine angiograms acquired from any two arbitrary viewing angles using a single-plane or biplane imaging system. An arterial segment of interest (e.g., coronary stenosis) is selected on the projection of reconstructed 3D coronary model. Afterwards, the process of optimal view strategy is employed resulting in foreshortening, overlap, and composite maps relative to the selected arterial segment by which any computer-generated projection associated with the gantry orientation can be previewed. By use of the three maps, the views with minimal foreshortening and vessel overlap for the selected arterial segment of interest can be determined to guide subsequent angiogram acquisitions for interventional procedure. More than 200 cases of coronary arterial systems have been reconstructed. A validation confirmed the accuracy of 3D length measurement to within RMS 3.1% error using 8 pairs of angiograms of intra-coronary catheter wire of 105 mm length.

Rotational angiography (RA) and three-dimensional imaging (3-DRA): an available clinical tool

“…The tortuosity of coronary artery segments and intra-cranial vessels present specific challenges in minimizing vessel foreshortening and angiographically separating adjacent structures. Historically, the left main coronary artery is difficult to image because of foreshortening and vessel overlap from the circumflex and left anterior descending arteries (4,5). These difficulties have paved the way for the need to find an optimal technology that in addition to improving our technical abilities, minimizes procedural time, radiation exposure, contrast use and therefore improves procedural outcomes.…”

Coronary Intervention Planning Using Hybrid 3D Reconstruction

“…The view that is chosen to perform the intervention is based on a combination of the amount of foreshortening of the segment of interest and the overlap of other structures [2]. The idea behind using a map is that only those gantry angles are computed that can actually be achieved.…”

“…In order to avoid the 'trial-and-error' approach, several researchers have proposed various methods to construct a three-dimensional surface model of the coronaries using two or three acquisitions from different viewing angles (e.g. [1,2,3,4,5]), generally needing considerable user interaction. As a result, the clinician has the ability to view the entire three-dimensional coronary tree from any angle and to choose the 'optimal working view' without the use of extra radiation or dye.…”

Automatic trinocular 3D reconstruction of coronary artery centerlines from rotational X-ray angiography

“…Three dimensional (3D) reconstruction of the coronary arteries from the angiograms would lead to higher accuracy and reproducibility in the diagnosis and to better precision in the quantification of the severity of the diseases ( [1], [2]). Reconstructing the coronary artery centerlines provides geometrical and topological information that is necessary to compute the optimal orientation of the imager for stenosis characterization ( [3]) or to give an initial point to the computation of the deformation field of the vessels along the cardiac cycle ( [4], [5]). …”