EGG-GATED 3-DIMENSIONAL INTRAVASCULAR ULTRASOUND - FEASIBILITY AND REPRODUCIBILITY OF THE AUTOMATED-ANALYSIS OF CORONARY LUMEN AND ATHEROSCLEROTIC PLAQUE DIMENSIONS IN HUMANS

Background Automated systems for the quantitative analysis of three-di mensional (3D) sets of intravascular ultrasound (IVUS) images have bee n developed to reduce the time required to perform Volumetric analyses , however, 3D image reconstruction by these nongated systems is freque ntly hampered by cyclic artifacts. Methods and Results We used an EGG- gated 3D IVUS image acquisition workstation and a dedicated pullback d evice in atherosclerotic coronary segments of 30 patients to evaluate ii) the feasibility of this approach of image acquisition, (3) the rep roducibility of an automated contour detection algorithm in measuring lumen, external elastic membrane, and plaque+media cross-sectional are as (CSAs) and volumes and the cross-sectional and volumetric plaque+me dia burden, and (3) the agreement between the automated area measureme nts and the results of manual tracing. The gated image acquisition too k 3.9 +/- 1.5 minutes. The length of the segments analyzed was 9.6 to 40.0 mm, with 2.3 +/- 1.5 side branches per segment. The minimum lumen CSA measured 6.4 +/- 1.7 mm(2), and the maximum and average CSA plaqu e+media burden measured 60.5 +/- 10.2% and 46.5 +/- 9.9%, respectively . The automated contour-detection required 34.3 +/- 7.3 minutes per se gment. The differences between these measurements and manual tracing d id not exceed 1.6% (SD < 6.8%). Intraobserver and interobserver differ ences in area measurements (n = 3421; r = .93 to .99) were < 1.6% (SD < 7.2%); intraobserver and interobserver differences in volumetric mea surements (n = 30; r = .99) were < 0.4% (SD < 3.2%). Conclusions EGG-g ated acquisition of 3D IVUS image sets is feasible and permits the app lication of automated contour detection to provide reproducible measur ements of the lumen and atherosclerotic plaque CSA and volume in a rel atively short analysis time.