ANGIOCARE: An automated system for fast three-dimensional coronary reconstruction by integrating angiographic and intracoronary ultrasound data

Objectives: The development of an automated, user-friendly system (ANGIOCARE), for rapid three-dimensional (3D) coronary reconstruction, integrating angiographic and, intracoronary ultrasound (ICUS) data. Methods: Biplane angiographic and ICUS sequence images are imported into the system where a prevalidated method is used for coronary reconstruction. This incorporates extraction of the catheter path from two end-diastolic X-ray images and detection of regions of interest (lumen, outer vessel wall) in the ICUS sequence by an automated border detection algorithm. The detected borders are placed perpendicular to the catheter path and established algorithms used to estimate their absolute orientation. The resulting 3D object is imported into an advanced visualization module with which the operator can interact, examine plaque distribution (depicted as a color coded map) and assess plaque burden by virtual endoscopy. Results: Data from 19 patients (27 vessels) undergoing biplane angiography and ICUS were examined. The reconstructed vessels were 21.3-80.2 mm long. The mean difference was 0.9 +/- 2.9% between the plaque volumes measured using linear 3D ICUS analysis and the volumes, estimated by taking into account the curvature of the vessel. The time required to reconstruct a luminal narrowing of 25 mm was approximately 10 min. Conclusion: The ANGIOCARE system provides rapid coronary reconstruction allowing the operator accurately to estimate the length of the lesion and determine plaque distribution and volume. (C) 2008 Wiley-Liss, Inc.