New X-ray imaging modalities and their integration with intravascular imaging and interventions

Abstract

During recent years various techniques emerged providing more detailed images and insights in the cardiovascular system. C-Arm computed tomography is currently introduced in cardiac imaging offering the potential of three dimensional imaging of the coronary arteries, the cardiac chambers, venous system and a variety of anatomic anomalies inside the interventional environment. Furthermore it might enable perfusion imaging during percutaneous coronary intervention (PCI). Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are meanwhile established tools for detailed assessment of the coronary arteries. Their use might further increase with automated tissue characterization, three dimensional reconstruction, integration in angiography systems, and new emerging techniques. Parameters of fluid tissue interactions are important factors in the pathogenesis of atherosclerosis. These parameters can be calculated using computational fluid dynamics based on three dimensional models of the coronary vessels which can be derived from various sources including multislice computed tomography (MSCT), C-Arm CT or 3D reconstructed IVUS or OCT. Their use in the clinical setting has yet to be determined especially with regard to their ability in increasing treatment efficiency and clinical outcome.

Cardiovascular imaging 2010 in the International Journal of Cardiovascular Imaging

“…No data on coronary segmentation were reported. Another C-arm based application was described by Hetterich et al [5]. In this case the C-arm system performs multiple runs around the patient while the ECG is monitored.…”

“…In this case the C-arm system performs multiple runs around the patient while the ECG is monitored. This approach was directed at visualizing the 3D anatomy of the coronary system for improved guidance during complex interventional procedures [5]. …”

ECG-Gated Interventional Cardiac Reconstruction for Non-periodic Motion

“…With the technology of C-arm CT it is possible to reconstruct intraprocedural 3-D images from angiographic projection data [1]. Currently, the major limitation of this technology is its insufficient temporal resolution which limits the visualization of fast moving parts of the heart.…”

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

“…Other hybrid imaging modalities such as intravascular ultrasound (IVUS), optical coherence tomography (OCT) (Hetterich et al, 2010) can be used diagnostically, but require an intervention. Apart from their diagnostic role, these imaging modalities also help clinicians to select between therapeutic options and plan interventional procedures.…”