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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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Simone Balocco, Carlo Gatta, Francesco Ciompi, A. Wahle, Petia Radeva, S. Carlier, et al. (2014). Standardized evaluation methodology and reference database for evaluating IVUS image segmentation. CMIG - Computerized Medical Imaging and Graphics, 38(2), 70–90.
Abstract: This paper describes an evaluation framework that allows a standardized and quantitative comparison of IVUS lumen and media segmentation algorithms. This framework has been introduced at the MICCAI 2011 Computing and Visualization for (Intra)Vascular Imaging (CVII) workshop, comparing the results of eight teams that participated.
We describe the available data-base comprising of multi-center, multi-vendor and multi-frequency IVUS datasets, their acquisition, the creation of the reference standard and the evaluation measures. The approaches address segmentation of the lumen, the media, or both borders; semi- or fully-automatic operation; and 2-D vs. 3-D methodology. Three performance measures for quantitative analysis have
been proposed. The results of the evaluation indicate that segmentation of the vessel lumen and media is possible with an accuracy that is comparable to manual annotation when semi-automatic methods are used, as well as encouraging results can be obtained also in case of fully-automatic segmentation. The analysis performed in this paper also highlights the challenges in IVUS segmentation that remains to be
solved.
Keywords: IVUS (intravascular ultrasound); Evaluation framework; Algorithm comparison; Image segmentation
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Marina Alberti, Simone Balocco, Xavier Carrillo, J. Mauri, & Petia Radeva. (2013). Automatic non-rigid temporal alignment of IVUS sequences: method and quantitative validation. UMB - Ultrasound in Medicine and Biology, 39(9), 1698–712.
Abstract: Clinical studies on atherosclerosis regression/progression performed by intravascular ultrasound analysis would benefit from accurate alignment of sequences of the same patient before and after clinical interventions and at follow-up. In this article, a methodology for automatic alignment of intravascular ultrasound sequences based on the dynamic time warping technique is proposed. The non-rigid alignment is adapted to the specific task by applying it to multidimensional signals describing the morphologic content of the vessel. Moreover, dynamic time warping is embedded into a framework comprising a strategy to address partial overlapping between acquisitions and a term that regularizes non-physiologic temporal compression/expansion of the sequences. Extensive validation is performed on both synthetic and in vivo data. The proposed method reaches alignment errors of approximately 0.43 mm for pairs of sequences acquired during the same intervention phase and 0.77 mm for pairs of sequences acquired at successive intervention stages.
Keywords: Intravascular ultrasound; Dynamic time warping; Non-rigid alignment; Sequence matching; Partial overlapping strategy
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Misael Rosales, Petia Radeva, Oriol Rodriguez-Leor, & Debora Gil. (2009). Modelling of image-catheter motion for 3-D IVUS. MIA - Medical image analysis, 13(1), 91–104.
Abstract: Three-dimensional intravascular ultrasound (IVUS) allows to visualize and obtain volumetric measurements of coronary lesions through an exploration of the cross sections and longitudinal views of arteries. However, the visualization and subsequent morpho-geometric measurements in IVUS longitudinal cuts are subject to distortion caused by periodic image/vessel motion around the IVUS catheter. Usually, to overcome the image motion artifact ECG-gating and image-gated approaches are proposed, leading to slowing the pullback acquisition or disregarding part of IVUS data. In this paper, we argue that the image motion is due to 3-D vessel geometry as well as cardiac dynamics, and propose a dynamic model based on the tracking of an elliptical vessel approximation to recover the rigid transformation and align IVUS images without loosing any IVUS data. We report an extensive validation with synthetic simulated data and in vivo IVUS sequences of 30 patients achieving an average reduction of the image artifact of 97% in synthetic data and 79% in real-data. Our study shows that IVUS alignment improves longitudinal analysis of the IVUS data and is a necessary step towards accurate reconstruction and volumetric measurements of 3-D IVUS.
Keywords: Intravascular ultrasound (IVUS); Motion estimation; Motion decomposition; Fourier
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Tadashi Araki, Sumit K. Banchhor, Narendra D. Londhe, Nobutaka Ikeda, Petia Radeva, Devarshi Shukla, et al. (2016). Reliable and Accurate Calcium Volume Measurement in Coronary Artery Using Intravascular Ultrasound Videos. JMS - Journal of Medical Systems, 40(3), 51:1–51:20.
Abstract: Quantitative assessment of calcified atherosclerotic volume within the coronary artery wall is vital for cardiac interventional procedures. The goal of this study is to automatically measure the calcium volume, given the borders of coronary vessel wall for all the frames of the intravascular ultrasound (IVUS) video. Three soft computing fuzzy classification techniques were adapted namely Fuzzy c-Means (FCM), K-means, and Hidden Markov Random Field (HMRF) for automated segmentation of calcium regions and volume computation. These methods were benchmarked against previously developed threshold-based method. IVUS image data sets (around 30,600 IVUS frames) from 15 patients were collected using 40 MHz IVUS catheter (Atlantis® SR Pro, Boston Scientific®, pullback speed of 0.5 mm/s). Calcium mean volume for FCM, K-means, HMRF and threshold-based method were 37.84 ± 17.38 mm3, 27.79 ± 10.94 mm3, 46.44 ± 19.13 mm3 and 35.92 ± 16.44 mm3 respectively. Cross-correlation, Jaccard Index and Dice Similarity were highest between FCM and threshold-based method: 0.99, 0.92 ± 0.02 and 0.95 + 0.02 respectively. Student’s t-test, z-test and Wilcoxon-test are also performed to demonstrate consistency, reliability and accuracy of the results. Given the vessel wall region, the system reliably and automatically measures the calcium volume in IVUS videos. Further, we validated our system against a trained expert using scoring: K-means showed the best performance with an accuracy of 92.80 %. Out procedure and protocol is along the line with method previously published clinically.
Keywords: Interventional cardiology; Atherosclerosis; Coronary arteries; IVUS; calcium volume; Soft computing; Performance Reliability; Accuracy
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