IVUS-CMS

IntraVascular UltraSound (IVUS) is a catheter-based technique which provides real-time high resolution tomographic images of both the lumen and the arterial wall of a coronary or vascular segment. This is in contrast to x-ray arteriography that provides a shadow image (luminogram) of the contrast-filled lumen.
The conventional manual tracing of the boundaries is very time-consuming and suffers from high intra- and inter-observer variabilities. Therefore, we have developed in close collaboration with the LKEB (Leiden University Medical Center) the analytical software package IVUS-CMS.

The new IVUS-CMS provides quantitative data on lumen, stent and vessel sizes in individual IVUS frames and entire pullback sequences using automated contour detection.

Method

A novel model- and knowledge-guided segmentation technique applied to both the transversal (cross-sectional) and the longitudinal (sagital) views ensures robust and reproducible results, while minimizing user-interaction. The technique uses knowledge about the presence of image artifacts and uses a model of the vessel. It includes the segmentation of the vessel, stent and lumen borders in target, edge and reference segments. In the pre-processing step, the images are corrected for the cardiac motion. In the post-processing step, the manual corrections are propagated in 3D to make user-interactions more efficient. Even multiple pullback runs (e.g., post-intervention and follow-up) can be analyzed simultaneously.

Various studies have demonstrated the superiority of IVUS over the contrast angiogram regarding the diagnostic specificity and sensitivity on the detection of atherosclerotic plaque. The technique is often used to control stent placement and to assess in-stent restenosis. By performing a three-dimensional reconstruction of the pullback sequence, it permits an advanced assessment of the vessel, lumen, and stent morphology.

Developments

The current IVUS research focuses towards knowledge guided interpretation of the IVUS images using multi agent technology. Ongoing research guarantees state-of-the-art IVUS software developments.

Publications

• Dijkstra J, Koning G, Reiber JHC.
  Quantitative measurements in IVUS images.
  Int J of Cardiac Imaging 1999; 15: 513-522
• Dijkstra J, Koning G, Tuinenburg JC, Oemrawsingh PV, Reiber JHC.
  Automated Border Detection in IntraVascular Ultrasound Images for Quantitative Measurements of the Vessel. Lumen and Stent Parameters.
  Computer in Cardiology 2001; Rotterdam, IEEE CS Press: 25-29.
• Koning, G, Dijkstra J, Birgelen C, Tuinenburg JC, Brunette J, Tardiff JC, Oemrawsingh PV, Sieling C, Melsa S, Reiber JHC
  Advanced Contour Detection for Three-Dimensional Intracoronary Ultrasound: A Validation - in-vitro and in-vivo
  Int J Cardiac Imaging 18 (4): 235-248