Validation of a Novel System for Co-Registration of Coronary Angiographic and Intravascular Ultrasound Imaging

• Published in: Cardiovascular revascularization medicine Vol. 20; no. 9; pp. 775 - 781
• Main Authors: Houissa, Khalil, Ryan, Nicola, Escaned, Javier, Cruden, Nick L., Uren, Neal, Slots, Tristan, Kayaert, Peter, Carlier, Stéphane G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2019
• Subjects: OCT; SD; CAD; PCI; ECG; 2-D; IVUS; 3-D; QCA
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2018.10.024

Intravascular ultrasound (IVUS) is a useful adjunct to guide percutaneous coronary intervention (PCI). Correlating IVUS images with angiographic findings can be challenging. We evaluated the utility of a novel co-registration system for IVUS and coronary angiography. A 3-D virtual catheter trajectory was constructed from separate angiographic imaging runs using bespoke software. Intravascular ultrasound images were obtained using a commercially available mechanical rotational transducer with motorized pullback. Co-registration of ultrasound and angiographic images was then performed retrospectively based on the length of pullback, the 3-D trajectory and the start position of the catheter. Validation was performed in a spherical phantom model and in vivo in the coronary circulation of patients undergoing coronary angiography and intravascular imaging for clinical purposes. 111 paired angiographic and IVUS runs were performed in 3 phantom models. The differences between the reference length and the length measured on the 3D reconstructed path was −0.01 ± 0.40 mm. Intra-observer variability was 0.4%. We enrolled 25 patients in 3 European hospitals and performed 35 co-registration attempts with an 86% success rate. 71 landmarks were selected by the first operator, 68 by the second. Differences between angiographic and IVUS landmarks were −0.22 ± 0.72 mm and 0.05 ± 1.01 mm, respectively. Inter-observer variability was 0.23 ± 0.63 mm. We present a novel method for the co-registration of IVUS and coronary angiographic images. This system performed well in a phantom model and using images obtained from the human coronary circulation. Innovation, intravascular ultrasound, other technique •Correlating IVUS images with angiographic findings can be challenging.•We evaluated the utility of a novel co-registration system for IVUS and coronary angiography.•A 3-D virtual catheter trajectory was constructed from separate angiographic imaging runs using bespoke software.•IVUS images were co-registered to angiographic images based on the length of pullback, the 3-D trajectory and the start position of the catheter.•Validation was performed in a spherical phantom model and in vivo in patients undergoing clinically indicated coronary angiography and IVUS.