True 3-dimensional reconstruction of coronary arteries in patients by fusion of angiography and IVUS (ANGUS) and its quantitative validation

Background-True 3D reconstruction of coronary arteries in patients based on intravascular ultrasound (IVUS) may be achieved by fusing angiographic and IVUS information (ANGUS). The clinical applicability of ANGUS was tested, and its accuracy was evaluated quantitatively. Methods and Results-In 16 patients who were investigated 6 months after ste nt implantation, a sheath-based catheter was used to acquire IVUS images du ring an R-wave-triggered, motorized stepped pullback. First, a Single set o f end-diastolic biplane angiographic images documented the 3D location of t he catheter at the beginning of pullback. From this set, the 3D pullback tr ajectory was predicted. Second, contours of the lumen or stent obtained fro m IVUS were fused with the 3D trajectory. Third, the angular rotation of th e reconstruction was optimized by quantitative matching of the silhouettes of the 3D reconstruction with the actual biplane images. Reconstructions we re obtained in 12 patients. The number of pullback steps, which determines the pullback length, closely agreed with the reconstructed path length (r=0 .99), Geometric measurements in silhouette images of the 3D reconstructions showed high correlation (0.84 to 0.97) with corresponding measurements in the actual biplane angiographic images. Conclusions-With ANGUS, 3D reconstructions of coronary arteries can be succ essfully and accurately obtained in the majority of patients.