3D Stress echocardiography: a novel application based on registration of real-time 3D ultrasound images

Abstract

Stress echocardiography is a common clinical procedure to diagnose myocardial ishemia by comparing myocardial wall motion in pre- and post-stress ultrasound images. Complicated imaging protocol, incomplete data, and misaligned pre- and post-stress images, however, are known limitations of conventional stress echocardiography. We have proposed here a new stress testing procedure that uses real-time three-dimensional (3D) ultrasound in place of conventional ultrasound and termed the new procedure “3D stress echocardiography.” Real-time 3D ultrasound is an emerging modality capable of imaging a beating heart in its entirety in the time of one cardiac cycle without requiring gating. The proposed 3D stress echocardiography addresses the limitations of complicated imaging protocol and incomplete data by collecting volumetric data rapidly. The problem of misaligned image sectors is solved by registering pre- and post-stress 3D images. We have described here our mutual information-based image registration and interactive 3D image visualization methods that are key engineering developments to enable performing 3D stress echocardiography. These methods were customized to meet the specific needs of 3D stress echocardiography. The preliminary results of the study are encouraging. Image registration used in conjunction with real-time 3D ultrasound offers the potential to simplify stress echocardiography and improve its diagnostic accuracy.