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Simone Balocco, Francesco Ciompi, Juan Rigla, Xavier Carrillo, J. Mauri, & Petia Radeva. (2019). Assessment of intracoronary stent location and extension in intravascular ultrasound sequences. MEDPHYS - Medical Physics, 46(2), 484–493.
Abstract: PURPOSE:
An intraluminal coronary stent is a metal scaffold deployed in a stenotic artery during percutaneous coronary intervention (PCI). In order to have an effective deployment, a stent should be optimally placed with regard to anatomical structures such as bifurcations and stenoses. Intravascular ultrasound (IVUS) is a catheter-based imaging technique generally used for PCI guiding and assessing the correct placement of the stent. A novel approach that automatically detects the boundaries and the position of the stent along the IVUS pullback is presented. Such a technique aims at optimizing the stent deployment.
METHODS:
The method requires the identification of the stable frames of the sequence and the reliable detection of stent struts. Using these data, a measure of likelihood for a frame to contain a stent is computed. Then, a robust binary representation of the presence of the stent in the pullback is obtained applying an iterative and multiscale quantization of the signal to symbols using the Symbolic Aggregate approXimation algorithm.
RESULTS:
The technique was extensively validated on a set of 103 IVUS of sequences of in vivo coronary arteries containing metallic and bioabsorbable stents acquired through an international multicentric collaboration across five clinical centers. The method was able to detect the stent position with an overall F-measure of 86.4%, a Jaccard index score of 75% and a mean distance of 2.5 mm from manually annotated stent boundaries, and in bioabsorbable stents with an overall F-measure of 88.6%, a Jaccard score of 77.7 and a mean distance of 1.5 mm from manually annotated stent boundaries. Additionally, a map indicating the distance between the lumen and the stent along the pullback is created in order to show the angular sectors of the sequence in which the malapposition is present.
CONCLUSIONS:
Results obtained comparing the automatic results vs the manual annotation of two observers shows that the method approaches the interobserver variability. Similar performances are obtained on both metallic and bioabsorbable stents, showing the flexibility and robustness of the method.
Keywords: IVUS; malapposition; stent; ultrasound
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Sumit K. Banchhor, Narendra D. Londhe, Tadashi Araki, Luca Saba, Petia Radeva, Narendra N. Khanna, et al. (2018). Calcium detection, its quantification, and grayscale morphology-based risk stratification using machine learning in multimodality big data coronary and carotid scans: A review. CBM - Computers in Biology and Medicine, 101, 184–198.
Abstract: Purpose of review
Atherosclerosis is the leading cause of cardiovascular disease (CVD) and stroke. Typically, atherosclerotic calcium is found during the mature stage of the atherosclerosis disease. It is therefore often a challenge to identify and quantify the calcium. This is due to the presence of multiple components of plaque buildup in the arterial walls. The American College of Cardiology/American Heart Association guidelines point to the importance of calcium in the coronary and carotid arteries and further recommend its quantification for the prevention of heart disease. It is therefore essential to stratify the CVD risk of the patient into low- and high-risk bins.
Recent finding
Calcium formation in the artery walls is multifocal in nature with sizes at the micrometer level. Thus, its detection requires high-resolution imaging. Clinical experience has shown that even though optical coherence tomography offers better resolution, intravascular ultrasound still remains an important imaging modality for coronary wall imaging. For a computer-based analysis system to be complete, it must be scientifically and clinically validated. This study presents a state-of-the-art review (condensation of 152 publications after examining 200 articles) covering the methods for calcium detection and its quantification for coronary and carotid arteries, the pros and cons of these methods, and the risk stratification strategies. The review also presents different kinds of statistical models and gold standard solutions for the evaluation of software systems useful for calcium detection and quantification. Finally, the review concludes with a possible vision for designing the next-generation system for better clinical outcomes.
Keywords: Heart disease; Stroke; Atherosclerosis; Intravascular; Coronary; Carotid; Calcium; Morphology; Risk stratification
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Xavier Perez Sala, Fernando De la Torre, Laura Igual, Sergio Escalera, & Cecilio Angulo. (2017). Subspace Procrustes Analysis. IJCV - International Journal of Computer Vision, 121(3), 327–343.
Abstract: Procrustes Analysis (PA) has been a popular technique to align and build 2-D statistical models of shapes. Given a set of 2-D shapes PA is applied to remove rigid transformations. Then, a non-rigid 2-D model is computed by modeling (e.g., PCA) the residual. Although PA has been widely used, it has several limitations for modeling 2-D shapes: occluded landmarks and missing data can result in local minima solutions, and there is no guarantee that the 2-D shapes provide a uniform sampling of the 3-D space of rotations for the object. To address previous issues, this paper proposes Subspace PA (SPA). Given several
instances of a 3-D object, SPA computes the mean and a 2-D subspace that can simultaneously model all rigid and non-rigid deformations of the 3-D object. We propose a discrete (DSPA) and continuous (CSPA) formulation for SPA, assuming that 3-D samples of an object are provided. DSPA extends the traditional PA, and produces unbiased 2-D models by uniformly sampling different views of the 3-D object. CSPA provides a continuous approach to uniformly sample the space of 3-D rotations, being more efficient in space and time. Experiments using SPA to learn 2-D models of bodies from motion capture data illustrate the benefits of our approach.
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Laura Igual, Xavier Perez Sala, Sergio Escalera, Cecilio Angulo, & Fernando De la Torre. (2014). Continuous Generalized Procrustes Analysis. PR - Pattern Recognition, 47(2), 659–671.
Abstract: PR4883, PII: S0031-3203(13)00327-0
Two-dimensional shape models have been successfully applied to solve many problems in computer vision, such as object tracking, recognition, and segmentation. Typically, 2D shape models are learned from a discrete set of image landmarks (corresponding to projection of 3D points of an object), after applying Generalized Procustes Analysis (GPA) to remove 2D rigid transformations. However, the
standard GPA process suffers from three main limitations. Firstly, the 2D training samples do not necessarily cover a uniform sampling of all the 3D transformations of an object. This can bias the estimate of the shape model. Secondly, it can be computationally expensive to learn the shape model by sampling 3D transformations. Thirdly, standard GPA methods use only one reference shape, which can might be insufficient to capture large structural variability of some objects.
To address these drawbacks, this paper proposes continuous generalized Procrustes analysis (CGPA).
CGPA uses a continuous formulation that avoids the need to generate 2D projections from all the rigid 3D transformations. It builds an efficient (in space and time) non-biased 2D shape model from a set of 3D model of objects. A major challenge in CGPA is the need to integrate over the space of 3D rotations, especially when the rotations are parameterized with Euler angles. To address this problem, we introduce the use of the Haar measure. Finally, we extended CGPA to incorporate several reference shapes. Experimental results on synthetic and real experiments show the benefits of CGPA over GPA.
Keywords: Procrustes analysis; 2D shape model; Continuous approach
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Simone Balocco, Carlo Gatta, Marina Alberti, Xavier Carrillo, Juan Rigla, & Petia Radeva. (2012). Relation between plaque type, plaque thickness, blood shear stress and plaque stress in coronary arteries assessed by X-ray Angiography and Intravascular Ultrasound. MEDPHYS - Medical Physics, 39(12), 7430–7445.
Abstract: PMID 23231293
PURPOSE:
Atheromatic plaque progression is affected, among others phenomena, by biomechanical, biochemical, and physiological factors. In this paper, the authors introduce a novel framework able to provide both morphological (vessel radius, plaque thickness, and type) and biomechanical (wall shear stress and Von Mises stress) indices of coronary arteries.
METHODS:
First, the approach reconstructs the three-dimensional morphology of the vessel from intravascular ultrasound (IVUS) and Angiographic sequences, requiring minimal user interaction. Then, a computational pipeline allows to automatically assess fluid-dynamic and mechanical indices. Ten coronary arteries are analyzed illustrating the capabilities of the tool and confirming previous technical and clinical observations.
RESULTS:
The relations between the arterial indices obtained by IVUS measurement and simulations have been quantitatively analyzed along the whole surface of the artery, extending the analysis of the coronary arteries shown in previous state of the art studies. Additionally, for the first time in the literature, the framework allows the computation of the membrane stresses using a simplified mechanical model of the arterial wall.
CONCLUSIONS:
Circumferentially (within a given frame), statistical analysis shows an inverse relation between the wall shear stress and the plaque thickness. At the global level (comparing a frame within the entire vessel), it is observed that heavy plaque accumulations are in general calcified and are located in the areas of the vessel having high wall shear stress. Finally, in their experiments the inverse proportionality between fluid and structural stresses is observed.
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