KEYWORDS: Near infrared spectroscopy, Optical coherence tomography, Light sources, Arteries, 3D image processing, In vivo imaging, Imaging technologies, Reliability, Data acquisition, Spectral calibration
Intravascular optical coherence tomography (OCT) is a high-resolution catheter-based imaging method that provides three-dimensional microscopic images of coronary artery in vivo, facilitating coronary artery disease treatment decisions based on detailed morphology. Near-infrared spectroscopy (NIRS) has proven to be a powerful tool for identification of lipid-rich plaques inside the coronary walls. We have recently demonstrated a dual-modality intravascular imaging technology that integrates OCT and NIRS into one imaging catheter using a two-fiber arrangement and a custom-made dual-channel fiber rotary junction. It therefore enables simultaneous acquisition of microstructural and composition information at 100 frames/second for improved diagnosis of coronary lesions.
The dual-modality OCT-NIRS system employs a single wavelength-swept light source for both OCT and NIRS modalities. It subsequently uses a high-speed photoreceiver to detect the NIRS spectrum in the time domain. Although use of one light source greatly simplifies the system configuration, such light source exhibits pulse-to-pulse wavelength and intensity variation due to mechanical scanning of the wavelength. This can be in particular problematic for NIRS modality and sacrifices the reliability of the acquired spectra. In order to address this challenge, here we developed a robust data acquisition and processing method that compensates for the spectral variations of the wavelength-swept light source. The proposed method extracts the properties of the light source, i.e., variation period and amplitude from a reference spectrum and subsequently calibrates the NIRS datasets. We have applied this method on datasets obtained from cadaver human coronary arteries using a polygon-scanning (1230-1350nm) OCT system, operating at 100,000 sweeps per second. The results suggest that our algorithm accurately and robustly compensates the spectral variations and visualizes the dual-modality OCT-NIRS images. These findings are therefore crucial for the practical application and clinical translation of dual-modality intravascular OCT-NIRS imaging when the same swept sources are used for both OCT and spectroscopy.
Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for assessing vessel healing after stent implantation due to its unique axial resolution <20 μm . The amount of neointimal coverage is an important parameter. In addition, the characterization of neointimal tissue maturity is also of importance for an accurate analysis, especially in the case of drug-eluting and bioresorbable stent devices. Previous studies indicated that well-organized mature neointimal tissue appears as a high-intensity, smooth, and homogeneous region in IVOCT images, while lower-intensity signal areas might correspond to immature tissue mainly composed of acellular material. A new method for automatic neointimal tissue characterization, based on statistical texture analysis and a supervised classification technique, is presented. Algorithm training and validation were obtained through the use of 53 IVOCT images supported by histology data from atherosclerotic New Zealand White rabbits. A pixel-wise classification accuracy of 87% and a two-dimensional region–based analysis accuracy of 92% (with sensitivity and specificity of 91% and 93%, respectively) were found, suggesting that a reliable automatic characterization of neointimal tissue was achieved. This may potentially expand the clinical value of IVOCT in assessing the completeness of stent healing and speed up the current analysis methodologies (which are, due to their time- and energy-consuming character, not suitable for application in large clinical trials and clinical practice), potentially allowing for a wider use of IVOCT technology.
KEYWORDS: Image registration, In vivo imaging, Data modeling, 3D modeling, Image segmentation, Optical coherence tomography, In vitro testing, Algorithm development, 3D image processing, Visualization
Intravascular optical coherence tomography (IV-OCT) is a catheter-based high-resolution imaging technique able to visualize the inner wall of the coronary arteries and implanted devices in vivo with an axial resolution below 20 μm. IV-OCT is being used in several clinical trials aiming to quantify the vessel response to stent implantation over time. However, stent analysis is currently performed manually and corresponding images taken at different time points are matched through a very labor-intensive and subjective procedure. We present an automated method for the spatial registration of IV-OCT datasets. Stent struts are segmented through consecutive images and three-dimensional models of the stents are created for both datasets to be registered. The two models are initially roughly registered through an automatic initialization procedure and an iterative closest point algorithm is subsequently applied for a more precise registration. To correct for nonuniform rotational distortions (NURDs) and other potential acquisition artifacts, the registration is consecutively refined on a local level. The algorithm was first validated by using an in vitro experimental setup based on a polyvinyl-alcohol gel tubular phantom. Subsequently, an in vivo validation was obtained by exploiting stable vessel landmarks. The mean registration error in vitro was quantified to be 0.14 mm in the longitudinal axis and 7.3-deg mean rotation error. In vivo validation resulted in 0.23 mm in the longitudinal axis and 10.1-deg rotation error. These results indicate that the proposed methodology can be used for automatic registration of in vivo IV-OCT datasets. Such a tool will be indispensable for larger studies on vessel healing pathophysiology and reaction to stent implantation. As such, it will be valuable in testing the performance of new generations of intracoronary devices and new therapeutic drugs.
KEYWORDS: Image registration, Data modeling, 3D modeling, Optical coherence tomography, In vivo imaging, Image segmentation, Data acquisition, In vitro testing, 3D image processing, Visualization
In the last decade a large number of new intracoronary devices (i.e. drug-eluting stents, DES) have been developed to
reduce the risks related to bare metal stent (BMS) implantation. The use of this new generation of DES has been shown
to substantially reduce, compared with BMS, the occurrence of restenosis and recurrent ischemia that would necessitate a
second revascularization procedure. Nevertheless, safety issues on the use of DES persist and full understanding of
mechanisms of adverse clinical events is still a matter of concern and debate. Intravascular Optical Coherence
Tomography (IV-OCT) is an imaging technique able to visualize the microstructure of blood vessels with an axial
resolution <20 μm. Due to its very high spatial resolution, it enables detailed in-vivo assessment of implanted
devices and vessel wall. Currently, the aim of several major clinical trials is to observe and quantify the vessel
response to DES implantation over time. However, image analysis is currently performed manually and corresponding
images, belonging to different IV-OCT acquisitions, can only be matched through a very labor intensive and subjective
procedure.
The aim of this study is to develop and validate a new methodology for the automatic registration of IV-OCT datasets
on an image level. Hereto, we propose a landmark based rigid registration method exploiting the metallic stent
framework as a feature. Such a tool would provide a better understanding of the behavior of different intracoronary
devices in-vivo, giving unique insights about vessel pathophysiology and performance of new generation of
intracoronary devices and different drugs.
Intra-vascular Optical Coherence Tomography (IV-OCT) is an appropriate imaging modality for the evaluation of stent
struts apposition and coverage in the coronary arteries. Most often, image analysis is performed by a time-consuming
manual contour tracing process. Recently, we proposed an algorithm for fully automated lumen morphology and
individual stent struts apposition/coverage quantification. In this manuscript further developments allowing for automatic
segmentation of the stent contour are presented. As such, quantification of in-stent area, malapposition cross-sectional
area (i.e. the area representing the space from the stent surface to the vessel wall) and coverage cross-sectional area (i.e.
the area of the tissue covering the stent surface) are automatically obtained. Volumetric measurements of malapposition
and coverage are then achieved through the analysis of equally-spaced consecutive IV-OCT cross-sectional images. In
addition, uncovered and malapposed struts are automatically clustered through consecutive slices according to their
three-dimensional spatial position. Finally, properties of each cluster (e.g. malapposition/coverage volumes and struts
spatial location and distribution) are quantified allowing for a volumetric analysis of the implanted device.
Validation of the algorithm was obtained taking as a reference manual measurements performed by an expert
cardiologist. 102 in-vivo images, taken at random from 8 different patients, were both automatically and manually
analyzed quantifying lumen and stent area. High Pearson's correlation coefficients (Rarea = 0.99) and Bland-Altman
statistics, showing no significant bias and good limits of agreement, proved that the presented algorithm provides a
robust and fast tool to automatically estimate apposition and coverage of stent through an entire in-vivo IV-OCT
pullback. Such a tool will be important for the integration of this technology in clinical routine and large clinical trials.
Several studies have proven that intra-vascular OCT is an appropriate imaging modality able to evaluate stent strut
apposition and coverage in coronary arteries. Currently image processing is performed manually resulting in a very time
consuming and labor intensive procedure.
We propose an algorithm for fully automatic individual stent strut apposition and coverage analysis in coronary arteries.
The vessel lumen and stent strut are automatically detected and segmented through analysis of the intensity profiles of
the A-scan lines. From these data, apposition and coverage can then be estimated automatically. The algorithm was
validated using manual measurement (performed by two trained cardiologists) as a reference. 108 images were taken at
random from in-vivo pullbacks from 9 different patient presenting 'real-life' situations (i.e. blood residual, small luminal
objects and artifacts). High Pearson's correlation coefficients were found (R = 0.96 - 0.95) between the automated and
manual measurements while Bland-Altman statistics showed no significant bias with good limits of agreement. As such,
it was shown that the presented algorithm provides a robust and a fast tool to automatically estimate apposition and
coverage of stent struts in in-vivo pullbacks. This will be important for the integration of this technology in clinical
routine and large clinical trials.
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