Retrospective image‐based gating of intracoronary ultrasound images for improved quantitative analysis: The intelligate method

Winter, S.A. de; Hamers, Ronald; Degertekin, M; Tanabe, Kengo; Lemos, Pedro A.; Serruys, Patrick W.; Roelandt, Jos R.T.C.; Bruining, Nico

doi:10.1002/ccd.10693

Cited by 74 publications

(48 citation statements)

References 18 publications

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“…To obtain a smooth appearance of the vessel wall structures in the longitudinal views, the Intelligate image-based gating method was applied. 25,26 The primary IVUS outcome is the change in percent atheroma volume (PAV), 9,27 calculated as PAVϭ[⌺(EEM CSA Ϫ LUMEN CSA )/⌺EEM CSA ]ϫ100, where EEM CSA is the external elastic membrane cross-sectional area (CSA) and LUMEN CSA is the luminal cross-sectional area. A secondary IVUS outcome is the change in normalized total atheroma volume (TAV N ), calculated as the product of the mean atheroma area and the median segment length in the entire population, as follows:…”

Section: Ivus Outcomesmentioning

confidence: 99%

Effect of Rosiglitazone on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease

et al. 2010

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the APPROACH Study GroupBackground-Rosiglitazone has several properties that may affect progression of atherosclerosis. The Assessment on the Prevention of Progression by Rosiglitazone on Atherosclerosis in Diabetes Patients With Cardiovascular History (APPROACH) study was undertaken to determine the effect of the thiazolidinedione rosiglitazone on coronary atherosclerosis as assessed by intravascular ultrasound compared with the sulfonylurea glipizide. Methods and Results-This was a randomized, double-blind, controlled 18-month study in 672 patients aged 30 to 80 years with established type 2 diabetes mellitus treated by lifestyle, 1 oral agent, or submaximal doses of 2 oral agents who had at least 1 atherosclerotic plaque with 10% to 50% luminal narrowing in a coronary artery that had not undergone intervention during a clinically indicated coronary angiography or percutaneous coronary intervention. The primary outcome was change in percent atheroma volume in the longest and least angulated epicardial coronary artery that had not undergone intervention. Secondary outcomes included change in normalized total atheroma volume and change in total atheroma volume in the most diseased baseline 10-mm segment. Rosiglitazone did not significantly reduce the primary outcome of percent atheroma volume compared with glipizide (Ϫ0.64%; 95% confidence interval, Ϫ1.46 to 0.17; Pϭ0.12). The secondary outcome of normalized total atheroma volume was significantly reduced by rosiglitazone compared with glipizide (Ϫ5.1 mm 3 ; 95% confidence interval, Ϫ10.0 to Ϫ0.3; Pϭ0.04); however, no significant difference between groups was observed for the change in total atheroma volume within the most diseased baseline 10-mm segment (Ϫ1.7 mm 3 ; 95% confidence interval, Ϫ3.9 to 0.5; Pϭ0.13). Conclusions-Rosiglitazone did not significantly decrease the primary end point of progression of coronary atherosclerosis more than glipizide in patients with type 2 diabetes mellitus and coronary atherosclerosis. Clinical Trial Registration-http://www.clinicaltrials.gov.

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Section: Ivus Outcomesmentioning

confidence: 99%

Effect of Rosiglitazone on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease

et al. 2010

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“…ICUS studies that are not acquired ECG-gated [8], are retrospectively image-based gated with the IntelliGate ® [13,14] method before QCU analysis. This allows accurate QCU results in anatomically correctly displayed segments.…”

Section: Methodsmentioning

confidence: 99%

“…A Gaussian low-pass filter is applied to each cross section to smooth the effect of natural intensity fluctuations caused by the texture of that specific tissue. This ensures that echogenicity measurements focus on the identification of regions instead of individual pixels.ICUS studies that are not acquired ECG-gated [8], are retrospectively image-based gated with the IntelliGate ® [13,14] method before QCU analysis. This allows accurate QCU results in anatomically correctly displayed segments.…”

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confidence: 99%

Computer assisted three-dimensional plaque characterization in intracoronary ultrasound studies

Winter

Heller

Hamers

et al. 2003

Computers in Cardiology, 2003

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IntroductionIntracoronary ultrasound (ICUS) is used as a tomographic imaging technique to visualize the vessel wall morphology and to identify atherosclerotic plaque [1]. To examine a selected coronary vessel segment an ICUS imaging catheter is pulled back through the coronary artery, meanwhile acquiring a series of cross sectional images. Three-dimensional (3D) reconstruction of the segment and contour tracing in the ICUS images facilitate subsequent quantitative coronary ultrasound (QCU) analysis and qualifies ICUS to be used in clinical trials to evaluate the results of novel catheter-based interventional techniques as well as pharmaceutical treatments [2].Knowledge of plaque composition is a valuable clinical parameter to assess information on plaque formation, progression and rupture [3] and plays an important role in gaining insight in the processes underlying events of sudden cardiac death [4]. Studies that compared histology to intravascular ultrasound learned that different structures correspond to different video-densities in the images; structures that appear white indicating high echogenicity, mainly consist of dense fibrous or calcific tissue. The darker, echolucent or hypoechogenic areas contain larger amounts of loose fibrous or smooth, muscle-rich tissue and thrombotic or necrotic elements [5]. Based on this idea, video-densitometry can be used for plaque characterization [7].Manual classification of tissue in the ICUS images for an entire 3D segment is very time-consuming, and potentially error prone. The analyst has to judge the high number of ICUS images (typically 1500 images per minute pullback acquired at a speed of 0.5 mm/s) in a consistent way, which may result in large inter-and intraobserver variability. Moreover, the human eye can discriminate only about 32 levels of grey, while the ultrasound images can contain 256 levels. Computerassisted grey level interpretation (labelling) and measurement in an entire 3D segment can overcome these problems. Therefore we developed a method, based on video-densitometry, that can automatically label plaque tissue and quantify each labelled type in an existing ICUS pullback. This paper describes this method and shows how the results are presented and visualized in the new research tool. MethodsICUS pullbacks can be stored either on S-VHS videotape, or digitally on CD-ROM. Images originating from standard PAL S-VHS tapes are first de-interlaced to remove the effect of having duplicate images in one image frame. A Gaussian low-pass filter is applied to each cross section to smooth the effect of natural intensity fluctuations caused by the texture of that specific tissue. This ensures that echogenicity measurements focus on the identification of regions instead of individual pixels.ICUS studies that are not acquired ECG-gated [8], are retrospectively image-based gated with the IntelliGate ® [13,14] method before QCU analysis. This allows accurate QCU results in anatomically correctly displayed segments. ECG -gating synchronizes the acquisition o...

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“…[12][13][14][15] Of note, a low frame rate does not allow accurate detection of near end-diastolic frames and cannot be processed by the Intelligate algorithm. Therefore, IVUS data acquired with a 30-MHz catheter and attached to a Clearview console were retrospectively corrected before further analyses.…”

Section: Ivus Echogenicity Analysismentioning

confidence: 99%

Long-Term (>10 Years) Clinical Outcomes of First-in-Human Biodegradable Poly- l -Lactic Acid Coronary Stents

et al. 2012

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Background-The purpose of this study was to evaluate the long-term safety of the Igaki-Tamai stent, the first-in-human fully biodegradable coronary stent made of poly-l-lactic acid. Methods and Results-Between September 1998 and April 2000, 50 patients with 63 lesions were treated electively with 84 Igaki-Tamai stents. Overall clinical follow-up (Ͼ10 years) of major adverse cardiac events and rates of scaffold thrombosis was analyzed together with the results of angiography and intravascular ultrasound. Major adverse cardiac events included all-cause death, nonfatal myocardial infarction, and target lesion revascularization/target vessel revascularization. During the overall clinical follow-up period (121Ϯ17 months), 2 patients were lost to follow-up. There were 1 cardiac death, 6 noncardiac deaths, and 4 myocardial infarctions. Survival rates free of all-cause death, cardiac death, and major adverse cardiac events at 10 years were 87%, 98%, and 50%, respectively. The cumulative rates of target lesion revascularization (target vessel revascularization) were 16% (16%) at 1 year, 18% (22%) at 5 years, and 28% (38%) at 10 years. Two definite scaffold thromboses (1 subacute, 1 very late) were recorded. The latter case was related to a sirolimus-eluting stent, which was implanted for a lesion proximal to an Igaki-Tamai stent. From the analysis of intravascular ultrasound data, the stent struts mostly disappeared within 3 years. The external elastic membrane area and stent area did not change. Conclusion-Acceptable major adverse cardiac events and scaffold thrombosis rates without stent recoil and vessel remodeling suggested the long-term safety of the Igaki-Tamai stent. (Circulation. 2012;125:2343-2352.)

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Retrospective image‐based gating of intracoronary ultrasound images for improved quantitative analysis: The intelligate method

Cited by 74 publications

References 18 publications

Effect of Rosiglitazone on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease

Effect of Rosiglitazone on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease

Computer assisted three-dimensional plaque characterization in intracoronary ultrasound studies

Long-Term (>10 Years) Clinical Outcomes of First-in-Human Biodegradable Poly- l -Lactic Acid Coronary Stents

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