Semi-automatic contour detection for volumetric quantification of intracoronary ultrasound

Li, W.; Birgelen, Clemens von; Mario, Carlo di; Boersma, Eric; Gussenhoven, Elma J.; Putten, N. van der; Bom, N.

doi:10.1109/cic.1994.470196

Cited by 44 publications

(43 citation statements)

References 7 publications

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“…Lumen, stent boundaries, and external elastic membrane were detected using a minimum cost algorithm, and volumetric quantification was performed. 26,27 Percent volume obstruction was calculated as neointimal volume/stent volumeϫ100. The quantitative ultrasound analysis was performed by the same independent core laboratory.…”

Section: Ivus Analysismentioning

confidence: 99%

TAXUS III Trial

et al. 2003

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Background-The first clinical study of paclitaxel-eluting stent for de novo lesions showed promising results. We performed the TAXUS III trial to evaluate the feasibility and safety of paclitaxel-eluting stent for the treatment of in-stent restenosis (ISR). Methods and Results-The TAXUS III trial was a single-arm, 2-center study that enrolled 28 patients with ISR meeting the criteria of lesion length Յ30 mm, 50% to 99% diameter stenosis, and vessel diameter 3.0 to 3.5 mm. They were treated with one or more TAXUS NIRx paclitaxel-eluting stents. Twenty-five patients completed the angiographic follow-up at 6 months, and 17 of these underwent intravascular ultrasound (IVUS) examination. No subacute stent thrombosis occurred up to 12 months, but there was one late chronic total occlusion, and additional 3 patients showed angiographic restenosis. The mean late loss was 0.54 mm, with neointimal hyperplasia volume of 20.3 mm 3 . The major adverse cardiac event rate was 29% (8 patients; 1 non-Q-wave myocardial infarction, 1 coronary artery bypass grafting, and 6 target lesion revascularization [TLR]). Of the patients with TLR, 1 had restenosis in a bare stent implanted for edge dissection and 2 had restenosis in a gap between 2 paclitaxel-eluting stents. Two patients without angiographic restenosis underwent TLR as a result of the IVUS assessment at follow-up (1 incomplete apposition and 1 insufficient expansion of the stent). Conclusions-Paclitaxel-eluting stent implantation is considered safe and potentially efficacious in the treatment of ISR.IVUS guidance to ensure good stent deployment with complete coverage of target lesion may reduce reintervention.

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Section: Ivus Analysismentioning

confidence: 99%

TAXUS III Trial

et al. 2003

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“…11 This program constructed 2 longitudinal sections from the data set and identified the contours that correspond to the lumen, media, or stent boundaries. Volumetric data were automatically calculated with the following formula: Vϭ⌺ n iϭ1 A i ϫH, where V is volume; A is the area of external elastic membrane, lumen, or plaque in a given cross-sectional ultrasound image; H is slice thickness of the cross section (0.2 mm); and n is the number of digitized cross-sectional images that encompass the volume to be measured.…”

Section: Ivus Image Acquisition Analysis Systemmentioning

confidence: 99%

“…Volumetric data were automatically calculated with the following formula: Vϭ⌺ n iϭ1 A i ϫH, where V is volume; A is the area of external elastic membrane, lumen, or plaque in a given cross-sectional ultrasound image; H is slice thickness of the cross section (0.2 mm); and n is the number of digitized cross-sectional images that encompass the volume to be measured. 11 Offline analyses were performed by 3 independent experienced analysts (K.K., M.C., M.S.) who checked and edited all of the contours of the planar images.…”

Section: Ivus Image Acquisition Analysis Systemmentioning

confidence: 99%

Three-Dimensional Intravascular Ultrasound Assessment of Noninjured Edges of β-Irradiated Coronary Segments

et al. 2000

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Background-The "edge effect," late lumen loss at the margins of the treated segment, has become an important issue in the field of coronary brachytherapy. The aim of the present study was to assess the edge effect in noninjured margins adjacent to the irradiated segments after catheter-based intracoronary ␤-irradiation. Methods and Results-Fifty-three vessels were assessed by means of 3-dimensional intravascular ultrasound after the procedure and at 6-to 8-month follow-up. Fourteen vessels (placebo group) did not receive radiation (sham source), whereas 39 vessels were irradiated. In the irradiated group, 48 edges (5 mm in length) were identified as noninjured, whereas 18 noninjured edges were selected in the placebo group. We compared the volumetric intravascular ultrasound measurements of the noninjured edges of the irradiated vessels with the fully irradiated nonstented segments (IRS, nϭ27) (26-mm segments received the prescribed 100% isodose) and the noninjured edges of the vessels of the placebo patients. The lumen decreased (6 mm 3 ) in the noninjured edges of the irradiated vessels at follow-up (Pϭ0.001). We observed a similar increase in plaque volume in all segments: noninjured edges of the irradiated group (19.6%), noninjured edges of the placebo group (21.5%), and IRS (21.0%). The total vessel volume increased in the IRS in the 3 groups. No edge segment was subject to repeat revascularization. Conclusions-The edge effect occurs in the noninjured margins of radiation source train in both irradiated and placebo patients. Thus, low-dose radiation may not play an important role in this phenomenon, whereas nonmeasurable device injury may be considered a plausible alternative explanation.

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“…16 A Microsoft Windows based contour detection program, developed at the Thoraxcenter, was used for oV line volumetric quantification. 17 Briefly, this program constructed longitudinal sections from the dataset and identified the contours corresponding to the lumen and media boundaries. Intraobserver variability, assessed by analysing IVUS volumetric studies at least three months apart, has been reported-mean (SD): −0.4 (1.1)% and −0.65 (2.66)% in lumen volume, −0.4 (0.6)% and −0.19 (0.67)% in external elastic membrane volume, and −0.3 (1.0)% and −0.95 (2.81)% in plaque volumes using motorised pullback with and without ECG gating, respectively.…”

Section: Three Dimensional Ivus Assessmentmentioning

confidence: 99%

Serial follow up of intramural haematoma associated with lumen compromise after intracoronary intervention

Hong¹

2001

Heart

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Objective-To assess the mechanism of restenosis after balloon angioplasty. Design-Prospective study. Patients-13 patients treated with balloon angioplasty. Interventions-111 coronary subsegments (2 mm each) were analysed after balloon angioplasty and at a six month follow up using three dimensional intravascular ultrasound (IVUS). Main outcome measures-Qualitative and quantitative IVUS analysis. Total vessel (external elastic membrane), plaque, and lumen volume were measured in each 2 mm subsegment. Delta values were calculated (follow up − postprocedure). Remodelling was defined as any (positive or negative) change in total vessel volume. Results-Positive remodelling was observed in 52 subsegments while negative remodelling occurred in 44. Remodelling, plaque type, and dissection were heterogeneously distributed along the coronary segments. Plaque composition was not associated with changes in IVUS indices, whereas dissected subsegments had a greater increase in total vessel volume than those without dissection (1.7 mm 3 v −0.33 mm 3 , p = 0.04). Change in total vessel volume was correlated with changes in lumen (p < 0.05, r = 0.56) and plaque volumes (p < 0.05, r = 0.64). The site with maximum lumen loss was not the same site as the minimum lumen area at follow up in the majority (n = 10) of the vessels. In the multivariate model, residual plaque burden had an influence on negative remodelling (p = 0.001, 95% confidence interval (CI) −0.391 to −0.108), whereas dissection had an eVect on total vessel increase (p = 0.002, 95% CI 1.168 to 4.969). Conclusions-The mechanism of lumen renarrowing after balloon angioplasty appears to be determined by unfavourable remodelling. However, diVerent patterns of remodelling may occur in individual injured coronary segments, which highlights the complexity and influence of local factors in the restenotic process. (Heart 2001;85:73-79)

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Semi-automatic contour detection for volumetric quantification of intracoronary ultrasound

Cited by 44 publications

References 7 publications

TAXUS III Trial

TAXUS III Trial

Three-Dimensional Intravascular Ultrasound Assessment of Noninjured Edges of β-Irradiated Coronary Segments

Serial follow up of intramural haematoma associated with lumen compromise after intracoronary intervention

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