Automated determination of optimal angiographic viewing angles for coronary artery bifurcations from CTA data

Pieter H. Kitslaar; Henk A. Marquering; Wouter J. Jukema; Gerhard Koning; Maarten Nieber; Albert M. Vossepoel; Jeroen J. Bax; Johan H. C. Reiber

doi:10.1117/12.770255

17 March 2008 Automated determination of optimal angiographic viewing angles for coronary artery bifurcations from CTA data

Pieter H. Kitslaar, Henk A. Marquering, Wouter J. Jukema, Gerhard Koning, Maarten Nieber, Albert M. Vossepoel, Jeroen J. Bax, Johan H. C. Reiber

Author Affiliations +

Proceedings Volume 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling; 69181J (2008) https://doi.org/10.1117/12.770255
Event: Medical Imaging, 2008, San Diego, California, United States

Abstract

For optimal diagnosis and treatment of lesions at coronary artery bifurcations using x-ray angiography, it is of utmost importance to determine proper angiographic viewing angles. Due to the increasing use of CTA as a first line diagnostic tool, 3D CTA data is more frequently available before x-ray angiographic procedures take place. Motivated by this, we propose to use available CTA data for the determination of patient specific optimal x-ray viewing angles. A semi-automatic iterative region growing scheme is developed for the segmentation of the coronary arterial tree. From the segmented arterial tree, a complete hierarchical surface and centerline representation, including bifurcation points, is automatically obtained. The optimal viewing angle for a selected bifurcation is determined as the view rendering the least amount of foreshortening and vessel overlap. For 83 bifurcation areas, viewing angles were automatically determined. The sensitivity of the method to patient positioning in the x-ray system was also studied. Next, the automatically determined angels were both quantitatively and qualitatively compared with angles determined by two experts. The method was found not to be sensitive to the positioning of the patient in the angiographic x-ray system. In 95% of the cases our method produced a clinically usable view (mean score of 8.4 out of 10) as compared to 98% for the experts (mean score of 8.7). Our method produced angiographic views with significantly less foreshortening (mean difference of 10 percentage points) than the angiographic views set by the experts.

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Pieter H. Kitslaar, Henk A. Marquering, Wouter J. Jukema, Gerhard Koning, Maarten Nieber, Albert M. Vossepoel, Jeroen J. Bax, and Johan H. C. Reiber "Automated determination of optimal angiographic viewing angles for coronary artery bifurcations from CTA data", Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling, 69181J (17 March 2008); https://doi.org/10.1117/12.770255

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