Circulation: Fully automatic 3D software shows promise in cath lab
A fully automatic 3D reconstruction software has compared favorably to 2D x-ray images in the cath lab, while also contributing new clinical information about patients' coronary anatomy, according to a feasibility study reported Jan. 26 online in Circulation: Cardiovascular Interventions.
Still in the early stages of testing, the authors suggested that 3D images may allow cardiologists to quickly assess the length, branching pattern and angles of coronary arteries and any blockages. They explained that a recently developed method to create 3D images of the coronary arteries uses x-ray projection images acquired during a 180-degree C-arm rotation and continuous contrast injection followed by ECG-gated iterative reconstruction.
"Coronary interventions may be improved by having a realistic 3D image of the coronary artery tree," said senior author John. D. Carroll, MD, professor of medicine and director of interventional cardiology at the University of Colorado in Aurora, Colo.
Currently, physicians take multiple 2D x-ray images from different views. The authors reported that the new software, which uses existing x-ray systems, could reduce the need for multiple x-rays, thus decreasing patients' exposure to radiation and contrast dye and cutting the time physicians spend analyzing the images.
In the study, Carroll and colleagues compared the standard 2D images to automatically generated, computer-reconstructed 3D images of 23 patients.
Researchers compared the reconstructed 3D volumetric images with the 2D angiographic projection images to ascertain overall image quality and lesion visibility, as well as quantitative analyses.
According to Carroll and colleagues, the majority of the 3D volume images (66 percent) were rated as having high image quality and provided the physician with additional clinical information such as complete visualization of bifurcations and unobtainable views of the coronary tree. True-positive lesion detection rates were high (90 to 100 percent), whereas false-positive detection rates were low (0 to 8.1 percent).
Also, the authors reported 3D quantitative coronary analysis showed significant similarity with 2D quantitative coronary analysis in terms of lumen diameters and provided vessel segment length free from the errors of foreshortening.
"This is the first in-human use," Carroll said. "The next step is to test it in multiple centers around the world. In addition, we'll formally test it to see the impact on clinical care. The bottom line is that this is very exciting technology that holds great promise."
Researchers concluded that there "is a clear workflow advantage to the fully automatic generation of the 3D reconstruction, especially for PCI guidance."
Philips Healthcare funded the study.
Still in the early stages of testing, the authors suggested that 3D images may allow cardiologists to quickly assess the length, branching pattern and angles of coronary arteries and any blockages. They explained that a recently developed method to create 3D images of the coronary arteries uses x-ray projection images acquired during a 180-degree C-arm rotation and continuous contrast injection followed by ECG-gated iterative reconstruction.
"Coronary interventions may be improved by having a realistic 3D image of the coronary artery tree," said senior author John. D. Carroll, MD, professor of medicine and director of interventional cardiology at the University of Colorado in Aurora, Colo.
Currently, physicians take multiple 2D x-ray images from different views. The authors reported that the new software, which uses existing x-ray systems, could reduce the need for multiple x-rays, thus decreasing patients' exposure to radiation and contrast dye and cutting the time physicians spend analyzing the images.
In the study, Carroll and colleagues compared the standard 2D images to automatically generated, computer-reconstructed 3D images of 23 patients.
Researchers compared the reconstructed 3D volumetric images with the 2D angiographic projection images to ascertain overall image quality and lesion visibility, as well as quantitative analyses.
According to Carroll and colleagues, the majority of the 3D volume images (66 percent) were rated as having high image quality and provided the physician with additional clinical information such as complete visualization of bifurcations and unobtainable views of the coronary tree. True-positive lesion detection rates were high (90 to 100 percent), whereas false-positive detection rates were low (0 to 8.1 percent).
Also, the authors reported 3D quantitative coronary analysis showed significant similarity with 2D quantitative coronary analysis in terms of lumen diameters and provided vessel segment length free from the errors of foreshortening.
"This is the first in-human use," Carroll said. "The next step is to test it in multiple centers around the world. In addition, we'll formally test it to see the impact on clinical care. The bottom line is that this is very exciting technology that holds great promise."
Researchers concluded that there "is a clear workflow advantage to the fully automatic generation of the 3D reconstruction, especially for PCI guidance."
Philips Healthcare funded the study.