In vivo comparison of arterial lumen dimensions assessed by co-registered three-dimensional (3D) quantitative coronary angiography, intravascular ultrasound and optical coherence tomography

Abstract

This study sought to compare lumen dimensions as assessed by 3D quantitative coronary angiography (QCA) and by intravascular ultrasound (IVUS) or optical coherence tomography (OCT), and to assess the association of the discrepancy with vessel curvature. Coronary lumen dimensions often show discrepancies when assessed by X-ray angiography and by IVUS or OCT. One source of error concerns a possible mismatch in the selection of corresponding regions for the comparison. Therefore, we developed a novel, real-time co-registration approach to guarantee the point-to-point correspondence between the X-ray, IVUS and OCT images. A total of 74 patients with indication for cardiac catheterization were retrospectively included. Lumen morphometry was performed by 3D QCA and IVUS or OCT. For quantitative analysis, a novel, dedicated approach for co-registration and lumen detection was employed allowing for assessment of lumen size at multiple positions along the vessel. Vessel curvature was automatically calculated from the 3D arterial vessel centerline. Comparison of 3D QCA and IVUS was performed in 519 distinct positions in 40 vessels. Correlations were r = 0.761, r = 0.790, and r = 0.799 for short diameter (SD), long diameter (LD), and area, respectively. Lumen sizes were larger by IVUS (P < 0.001): SD, 2.51 ± 0.58 mm versus 2.34 ± 0.56 mm; LD, 3.02 ± 0.62 mm versus 2.63 ± 0.58 mm; Area, 6.29 ± 2.77 mm2 versus 5.08 ± 2.34 mm2. Comparison of 3D QCA and OCT was performed in 541 distinct positions in 40 vessels. Correlations were r = 0.880, r = 0.881, and r = 0.897 for SD, LD, and area, respectively. Lumen sizes were larger by OCT (P < 0.001): SD, 2.70 ± 0.65 mm versus 2.57 ± 0.61 mm; LD, 3.11 ± 0.72 mm versus 2.80 ± 0.62 mm; Area 7.01 ± 3.28 mm2 versus 5.93 ± 2.66 mm2. The vessel-based discrepancy between 3D QCA and IVUS or OCT long diameters increased with increasing vessel curvature. In conclusion, our comparison of co-registered 3D QCA and invasive imaging data suggests a bias towards larger lumen dimensions by IVUS and by OCT, which was more pronounced in larger and tortuous vessels.

Advances in three-dimensional coronary imaging and computational fluid dynamics

“…Their findings were again confirmed by Bourantas et al [19], who showed stronger correlation between 3D-QCA and intravascular ultrasound (IVUS) in lumen dimensions (r = 0.8) than 2D assessed %DS (r = 0.34). Ultimately, the greatest advantage of 3D-QCA may be that it offers improved assessment of the absolute lumen dimensions including length, diameter, tortuosity, and optimal views [20,21] and not just %DS.…”

Bioresorbable Vascular Scaffolds for the Treatment of Chronic Total Occlusions

“…Appropriate lesion preparation based on these evaluation could facilitate adequate expansion of BVS. Furthermore, there are some discrepancies of vessel sizing between angiography and imaging modalities such as IVUS and OCT. 22,23 Precise vessel sizing is mandatory for device selection because BVS has limitation of overexpansion. 24 In our study, following meticulous lesion preparation involving additional rotational atherectomy in 3 cases, BVS were successfully delivered and deployed in all of the 65 cases.…”

Reconstruction of coronary arteries from X-ray angiography: A review

“…Fusion of X-ray coronary angiography with IVUS or OCT is also desirable since these imaging modalities are known to provide cross-sectional morphological information about the stenosis and plaque characteristics (Bruining et al, 2009). This type of fusion employs 3D reconstruction of coronary artery centreline and complements it with the surface information from IVUS/OCT (Figure 3) (Bruining et al, 2009;Tu et al, 2012).…”