Validation of an automated system for luminal and medial-adventitial border detection in three-dimensional intravascular ultrasound

Authors: Klingensmith J.D.¹; Tuzcu E.M.²; Nissen S.E.²; Vince D.G.¹

Source: The International Journal of Cardiac Imaging, Volume 19, Number 2, April 2003 , pp. 93-104(12)

Publisher: Springer

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Abstract:

The precise tomographic assessment of coronary artery disease by intravascular ultrasound (IVUS) is useful in quantitative studies. Such studies require identification of luminal and medial-adventitial (MA) borders in a sequence of IVUS images. We have developed a three-dimensional (3D) active-surface system for border detection that facilitates the analysis of many images with minimal user interaction. To assess the validity of the technique, luminal and MA borders in 529 end-diastolic images from nine coronary arterial segments (58.8 ± 14.2 images per patient) were traced manually by four experienced observers. The computer-detected borders were compared with borders determined by the four observers using a modified Williams' index (WI), the ratio of inter-observer variability to computer-observer variability. While manual tracing required 49.2 ± 12.1 min for analysis, the analysis system identified luminal (R² = 0.92) and MA borders (R² = 0.97) in 13.8 ± 4.0 min, a decrease of 35.4 min (p < 0.000001). The computer minus observer differences in lumen area and MA area were -0.88 ± 0.90 and -0.07 ± 0.63 mm². Therefore, the computer system underestimated both lumen and MA area, but this effect was very small in MA area. The WI values and 95% confidence intervals were 0.98 (0.89,1.06) for luminal border detection and 0.99 (0.95,1.04) for MA border detection. Plaque volume measurements, a common endpoint of clinical trials, also verified the accuracy of the technique (R² = 0.98). The proposed 3D active-surface border detection system provides a faster and less-tedious alternative to manual tracing for assessment of coronary artery anatomy in vivo.

Keywords: intravascular ultrasonography; computer-assisted image analysis; coronary artery disease

Language: English

Document Type: Research article

Affiliations: 1: Department of Biomedical Engineering, Lerner Research Institute, OH 44195, USA 2: Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA

Publication date: 2003-04-01

Validation of an automated system for luminal and medial-adventitial border detection in three-dimensional intravascular ultrasound

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