3-D reconstruction of coronary arterial tree to optimize angiographic visualization

Due to vessel overlap and foreshortening, multiple projections are necessar y to adequately evaluate the coronary tree with arteriography, Catheter-bas ed interventions can only be optimally performed when these visualization p roblems are successfully solved. The traditional method provides multiple s elected views in which overlap and foreshortening are subjectively minimize d based on two dimensional (2-D) projections. A pair of images acquired fro m routine angiographic study at arbitrary orientation using a single-plane imaging system were chosen far three-dimensional (3-D) reconstruction. Afte r the arterial segment of interest (e.g., a single coronary stenosis or bif urcation lesion) was selected, a set of gantry angulations minimizing segme nt foreshortening was calculated. Multiple computer-generated projection im ages with minimized segment foreshortening were then used to choose views w ith minimal overlapped vessels relative to the segment of interest. The opt imized views could then be utilized to guide subsequent angiographic acquis ition and interpretation. Over 800 cases of coronary arterial trees have be en reconstructed, in which more than 40 cases were performed in room during cardiac catheterization. The accuracy of 3-D length measurement was confir med to be within an average root-mean-square (rms) 3.5% error using eight d ifferent pairs of angiograms of an intracoronary guidewire of 105-mm length with eight radiopaque markers of 15-mm interdistance. The accuracy of simi larity between the additional computer-generated projections versus the act ual acquired views was demonstrated with the average rms errors of 3.09 mm and 3.13 mm in 20 LCA and 20 RCA cases, respectively. The projections of th e reconstructed patient-specific 3-D coronary tree model can be utilized fo r planning optimal clinical views: minimal overlap and foreshortening, The assessment of lesion length and diameter narrowing can be optimized in both interventional cases and studies of disease progression and regression.