Abstract
Side branches in the atherosclerotic lesion region are important as they highly influence the treatment strategy selection and optimization. Moreover, they are reliable landmarks for image registration. By providing high resolution delineation of coronary morphology, intravascular optical coherence tomography (IVOCT) has been increasingly used for side branch analysis. This paper presents a fully automated method to detect side branches in IVOCT images, which relies on precise segmentation of the imaging catheter, the protective sheath, the guide wire and the lumen. 25 in-vivo data sets were used for validation. The intraclass correlation coefficient between the algorithmic results and manual delineations for the imaging catheter, the protective sheath and the lumen contour positions was 0.997, 0.949 and 0.974, respectively. All the guide wires were detected correctly and the Dice's coefficient of the shadow regions behind the guide wire was 0.97. 94.0% of 82 side branches were detected with 5.0% false positives and the Dice's coefficient of the side branch size was 0.85. In conclusion, the presented method has been demonstrated to be accurate and robust for side branch analysis.
Highlights
Despite decades of progress in understanding the development of coronary artery disease (CAD), it remains the most common cause of death in the world
Polar intravascular optical coherence tomography (IVOCT) images are pre-processed in four steps: (1) first, the imaging catheter is segmented and removed, so it will not affect the step; (2) the guide wire is detected by analyzing the intensity profile of every scan-line; (3) after guide wire masking, the protective sheath is segmented for image correction and masking purposes; and in the end (4) the lumen contour is detected for lumen center calculation and guide wire shadow fixing
As IVOCT contributes to clinical researchers and cardiologists by providing a better understanding of the in-vivo artery situation, there are increasing demands of side branch analysis in IVOCT images
Summary
Despite decades of progress in understanding the development of coronary artery disease (CAD), it remains the most common cause of death in the world. Percutaneous coronary intervention (PCI) with stenting is widely performed to open narrowed coronary arteries and to restore the oxygen-rich blood supply to the myocardium. Without a single preferred approach, a bifurcation lesion should be analyzed prior to the PCI to plan the interventional strategy, because bifurcation stenting often suffers from higher risks of acute and chronic complications such as acute thrombosis or late restenosis [1,2,3]. Like coronary angiography (CA) and intravascular ultrasound (IVUS), has been used for side branch analysis [7,8,9,10,11]. Current approaches require the combination of multiple imaging modalities to assess lesion characteristics, analyze the blood flow and optimize stent placement with respect to optimal stent selection, deployment and expansion since every modality has its limitations. For image registration in the same or different modalities, side branches are reliable landmarks [12, 13]
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