Abstract
The bioresorbable vascular scaffold (BVS) is a new generation of bioresorbable scaffold (BRS) for the treatment of coronary artery disease. A potential challenge of BVS is malapposition, which may possibly lead to late stent thrombosis. It is therefore important to conduct malapposition analysis right after stenting. Since an intravascular optical coherence tomography (IVOCT) image sequence contains thousands of BVS struts, manual analysis is labor intensive and time consuming. Computer-based automatic analysis is an alternative, but faces some difficulties due to the interference of blood artifacts and the uncertainty of the struts number, position and size. In this paper, we propose a novel framework for a struts malapposition analysis that breaks down the problem into two steps. Firstly, struts are detected by a cascade classifier trained by AdaBoost and a region of interest (ROI) is determined for each strut to completely contain it. Then, strut boundaries are segmented within ROIs through dynamic programming. Based on the segmentation result, malapposition analysis is conducted automatically. Tested on 7 pullbacks labeled by an expert, our method correctly detected 91.5% of 5821 BVS struts with 12.1% false positives. The average segmentation Dice coefficient for correctly detected struts was 0.81. The time consumption for a pullback is 15 sec on average. We conclude that our method is accurate and efficient for BVS strut detection and segmentation, and enables automatic BVS malapposition analysis in IVOCT images.
Highlights
Cardiovascular disease is the world’s NO.1 cause of death in recent years, accounting for 17.3 million deaths per year, a number that is expected to grow to 23.6 million by 2030 [1]
Blue dots refer to detected seed points, and yellow circles refer to the corresponding region of interest (ROI)
We proposed a novel framework for automatic malapposition analysis of bioresorbable vascular scaffold (BVS) struts in intravascular optical coherence tomography (IVOCT) images
Summary
Cardiovascular disease is the world’s NO. cause of death in recent years, accounting for 17.3 million deaths per year, a number that is expected to grow to 23.6 million by 2030 [1]. Coronary stenting is the most common treatment modality for coronary artery disease. Metallic stents face the potential risk of late stent thrombosis [2]. The drug-eluting stent (DES) is a later generation of stent design which can significantly reduce in-stent restenosis [3]. Multiple risk factors become evident 3-6 months after DES implantation [4] and lead to risks of late stent thrombosis in the long term. The third generation of stent is “Bioresorbable Scaffolds (BRS)”, which is seen as one of the most promising type of scaffolds in the long term
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