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Three methods for accurate quantification of plaque volume in coronary arteries
Ruben Medina1, Andreas Wahle, Mark E Olszewski
1Department of Electrical and Computer Engineering, The University of Iowa, Iowa City, IA 52242-1527, USA.
Insights
Accurately quantifying coronary plaque volume is crucial for assessing atherosclerosis. New 3D analysis combining intravascular ultrasound and angiography shows polytope and Watanabe methods are superior to Simpson
Area of Science:
- Cardiovascular Imaging
- Medical Physics
- Biomedical Engineering
Background:
- Coronary atherosclerosis leads to chronic angina and acute coronary syndromes.
- Quantitative assessment tools are vital for tracking disease progression or regression.
- 3D analysis integrating intravascular ultrasound (IVUS) and biplane X-ray angiography offers geometrically accurate coronary vessel representation.
Purpose of the Study:
- To compare the accuracy of three volume quantification methods (polytope, Watanabe, and Simpson's rule) for assessing coronary plaque accumulation.
- To evaluate the performance of these methods in both simulated and in vivo datasets.
Main Methods:
- Developed a 3D analysis methodology by fusing IVUS and biplane X-ray angiography data.
- Employed polytope, Watanabe, and Simpson's rule methods to quantify plaque volume by subdividing vessel space into polyhedral elements.
- Validated methods using 314 computer-generated shapes and seven in vivo coronary arterial datasets.
Main Results:
- All three methods demonstrated high accuracy in computer-generated shapes, with mean errors of 0.138±0.049% (polytope), 0.139±0.049% (Watanabe), and 0.832±0.203% (Simpson's rule).
- Polytope and Watanabe methods were statistically significantly more accurate than Simpson's rule (p < 0.001).
- In vivo testing confirmed polytope and Watanabe methods' superior accuracy, though all methods were sufficient for practical purposes; however, they are not interchangeable.
Conclusions:
- The polytope and Watanabe volume quantification methods offer statistically significant improvements in accuracy over Simpson's rule for coronary plaque assessment.
- While all tested methods provide sufficient accuracy for clinical use, consistency in method selection is crucial for comparative volumetric studies.
- This 3D analysis approach enhances the quantitative assessment of coronary atherosclerotic disease.
Abstract:
The coronary atherosclerotic process evolves to an occlusive disease that causes chronic angina and acute coronary syndromes, such as myocardial infarction and sudden death. An important milestone in the understanding of the atherosclerotic process is the development of tools for quantitative assessment of disease progression or regression. A new methodology to analyze the coronary vessel lumen and plaque morphology in 3-D is based on the fusion of intravascular ultrasound (IVUS) and biplane X-ray angiography, which results in a geometrically correct representation of coronary vessels. A comparison of three volume quantification methods: polytope, Watanabe, and Simpson's rule is reported for quantifying the amount of plaque accumulation. The three methods allow local estimation of plaque volume. To determine volumetric indices, the space between the luminal and adventitial surfaces is first subdivided and then each of the volume elements is considered individually to achieve volume quantification. Polyhedral volume elements are employed and the volume of every element is estimated by each of the three approaches. The volume quantification methods were validated in 314 computer-generated shapes. All three methods are highly accurate, providing a mean error of 0.138 +/- 0.049%, 0.139 +/- 0.049%, and 0.832 +/- 0.203% for the polytope, Watanabe, and Simpson-rule methods, respectively. Nevertheless, the polytope and Watanabe methods are statistically significantly more accurate than the Simpson-rule approach (p < 0.001). The volumetric quantification methods were also tested using seven in vivo coronary arterial datasets from seven patients undergoing coronary angioplasty. While the polytope and Watanabe approaches are statistically significantly more accurate compared to the Simpson's rule method, accuracy of either of the tested method is sufficient for all practical purposes. Yet, the methods are not interchangeable and a single technique should be used in comparative volumetric studies.