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Comparative Study
. 2016 Jan 19:16:9.
doi: 10.1186/s12880-016-0111-6.

Three-dimensional reconstruction of coronary arteries and plaque morphology using CT angiography--comparison and registration with IVUS

Lambros Athanasiou  1 , George Rigas  1 , Antonis I Sakellarios  1 , Themis P Exarchos  1   2 , Panagiotis K Siogkas  1 , Christos V Bourantas  3   4 , Hector M Garcia-Garcia  5 , Pedro A Lemos  6 , Breno A Falcao  6 , Lampros K Michalis  7 , Oberdan Parodi  7 , Federico Vozzi  8 , Dimitrios I Fotiadis  9   10   11
Affiliations
Comparative Study

Three-dimensional reconstruction of coronary arteries and plaque morphology using CT angiography--comparison and registration with IVUS

Lambros Athanasiou et al. BMC Med Imaging. .

Abstract

Background: The aim of this study is to present a new methodology for three-dimensional (3D) reconstruction of coronary arteries and plaque morphology using Computed Tomography Angiography (CTA).

Methods: The methodology is summarized in six stages: 1) pre-processing of the initial raw images, 2) rough estimation of the lumen and outer vessel wall borders and approximation of the vessel's centerline, 3) manual adaptation of plaque parameters, 4) accurate extraction of the luminal centerline, 5) detection of the lumen - outer vessel wall borders and calcium plaque region, and 6) finally 3D surface construction.

Results: The methodology was compared to the estimations of a recently presented Intravascular Ultrasound (IVUS) plaque characterization method. The correlation coefficients for calcium volume, surface area, length and angle vessel were 0.79, 0.86, 0.95 and 0.88, respectively. Additionally, when comparing the inner and outer vessel wall volumes of the reconstructed arteries produced by IVUS and CTA the observed correlation was 0.87 and 0.83, respectively.

Conclusions: The results indicated that the proposed methodology is fast and accurate and thus it is likely in the future to have applications in research and clinical arena.

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Figures

Fig. 1
Fig. 1
The stages of the proposed methodology starting from the initial CTA images and concluding with a full 3D model of inner/outer walls and plaque objects
Fig. 2
Fig. 2
The centerline (blue) of an artery segment with the derivatives (red, purple and green) at each point
Fig. 3
Fig. 3
Centerline smoothing: a rather accurate centerline and the intersection imposed on perpendicular surfaces and b smoothed centerline where no intersections of perpendicular surfaces occurs
Fig. 4
Fig. 4
The radial image correction process on an artificial image a with large offset from the center, b in the first iteration, c in the third iteration and d in the last (fifth) iteration
Fig. 5
Fig. 5
a The original DICOM image. In the red circle is the vessel region detected based on the initial stages of our methodology (stages 1, 2), b The radial image produced taking the RIP image corresponding to the centerline point of the specific vessel region and zero crosses of the RIP image, c The resulting ROI, d The HU profile from the RIP image and the extracted ROI, and e The classified ROI
Fig. 6
Fig. 6
a Region with pixels classified as calcific plaque, and b the corresponding thresholded image where calcified objects are detected
Fig. 7
Fig. 7
a The maximum length of a CTA object and the overlapping volume area with the IVUS object, and b schematic presentation of the inner angle metric used to compare the two objects
Fig. 8
Fig. 8
Bland-Altman (left) and correlation plots (right) for CTA-IVUS 3D objects comparison: a Volume comparison, b Surface area comparison, c Maximum length comparison, and d Inner angle comparison. Correlation plots: the solid line is the line of identity, while the dashed line is the regression line
Fig. 9
Fig. 9
Bland-Altman (left) and correlation plots (right) for CTA and IVUS for the: a lumen volume, b Lumen surface area, c Outer vessel wall volume, d Outer vessel surface area. Correlation plots: the solid line is the line of identity, while the dashed line is the regression line
Fig. 10
Fig. 10
Bland-Altman (left) and correlation plots (right) for Volume intersection 3D objects comparison: a Intersection vs IVUS volume comparison, and b Intersection vs CT volume comparison. Correlation plots: the solid line is the line of identity, while the dashed line is the regression line
Fig. 11
Fig. 11
Lumen and 3D CP objects detected by CTA and IVUS: the gray object corresponds to lumen, the gold object to CPs detected by IVUS and the transparent green object correspond to CP detected by CTA. The volume mismatching between the objects is increased as the distance from the lumen to the plaque voxels is increased
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