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3D fusion of intravascular ultrasound and coronary computed tomography for in-vivo wall shear stress analysis: a feasibility study

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Abstract

Wall shear stress, the force per area acting on the lumen wall due to the blood flow, is an important biomechanical parameter in the localization and progression of atherosclerosis. To calculate shear stress and relate it to atherosclerosis, a 3D description of the lumen and vessel wall is required. We present a framework to obtain the 3D reconstruction of human coronary arteries by the fusion of intravascular ultrasound (IVUS) and coronary computed tomography angiography (CT). We imaged 23 patients with IVUS and CT. The images from both modalities were registered for 35 arteries, using bifurcations as landmarks. The IVUS images together with IVUS derived lumen and wall contours were positioned on the 3D centerline, which was derived from CT. The resulting 3D lumen and wall contours were transformed to a surface for calculation of shear stress and plaque thickness. We applied variations in selection of landmarks and investigated whether these variations influenced the relation between shear stress and plaque thickness. Fusion was successfully achieved in 31 of the 35 arteries. The average length of the fused segments was 36.4 ± 15.7 mm. The length in IVUS and CT of the fused parts correlated excellently (R 2 = 0.98). Both for a mildly diseased and a very diseased coronary artery, shear stress was calculated and related to plaque thickness. Variations in the selection of the landmarks for these two arteries did not affect the relationship between shear stress and plaque thickness. This new framework can therefore successfully be applied for shear stress analysis in human coronary arteries.

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Abbreviations

CT:

Computed tomography

IVUS:

Intravascular ultrasound

WSS:

Wall shear stress

PT:

Plaque thickness

LAD:

Left coronary artery

RCA:

Right coronary artery

LCX:

Left circumflex artery

95% CI:

95% Confidence interval

MPR:

Multiplanar reformat

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Authors and Affiliations

  1. Department of Biomedical Engineering, Erasmus MC, Biomechanics Laboratory Ee2322, PO Box 2040, 3000 CA, Rotterdam, The Netherlands

    Alina G. van der Giessen, Frank J. H. Gijsen, Harald C. Groen, Antonius F. W. van der Steen & Jolanda J. Wentzel

  2. Department of Radiology, Erasmus MC, Rotterdam, The Netherlands

    Michiel Schaap, Theo van Walsum, Nico R. Mollet, Wiro J. Niessen & Pim J. de Feyter

  3. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    Jouke Dijkstra

  4. Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands

    Pim J. de Feyter

  5. Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands

    Alina G. van der Giessen & Frans N. van de Vosse

  6. The Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands

    Antonius F. W. van der Steen

  7. Department of Medical Informatics, Erasmus MC, Rotterdam, The Netherlands

    Michiel Schaap, Theo van Walsum & Wiro J. Niessen

  8. Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands

    Wiro J. Niessen

Authors
  1. Alina G. van der Giessen
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  2. Michiel Schaap
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  3. Frank J. H. Gijsen
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  4. Harald C. Groen
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  5. Theo van Walsum
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  8. Frans N. van de Vosse
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  9. Wiro J. Niessen
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  10. Pim J. de Feyter
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  11. Antonius F. W. van der Steen
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  12. Jolanda J. Wentzel
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Corresponding author

Correspondence to Frank J. H. Gijsen.

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10554_2009_9546_MOESM1_ESM.avi

Movie: Fused IVUS and CT for diseased artery. The movie shows two panels, with on the left cross-sectional CT images of the diseased artery and on the right the corresponding IVUS images. The lumen (pink) and wall (blue) contours of IVUS are depicted in the CT cross-sections (AVI 8,963 kb)

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van der Giessen, A.G., Schaap, M., Gijsen, F.J.H. et al. 3D fusion of intravascular ultrasound and coronary computed tomography for in-vivo wall shear stress analysis: a feasibility study. Int J Cardiovasc Imaging 26, 781–796 (2010). https://doi.org/10.1007/s10554-009-9546-y

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  • DOI: https://doi.org/10.1007/s10554-009-9546-y

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