Intracoronary ultrasound plaque volume quantification

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Abstract
An intracoronary ultrasound (ICUS) methodology for quantitative volumetric analysis of coronary atheroma was developed and validated. Sources of errors associated with volumetric ICUS were studied using computer simulations. These issues were addressed experimentally by implementing a data acquisition scheme to acquire calibrated, cardiac gated 3D data. A semi-automated segmentation scheme was developed to compute the plaque area which is enclosed between the luminal boundary and the media-adventitia interface. Volumetric validations were performed on phantoms resembling stenotic arteries. Multiple pull-backs were performed on the phantoms to assess reproducibility. Clinical applicability was assessed by quantifying plaque volumes in 4 patients before and after directional coronary atherectomy. It was found that ICUS has the accuracy and reproducibility required for performing quantitative volumetric analysis of coronary atheroma. Such volumetric analysis will help determine mechanisms of interventions and provide critical data needed for regression and restenosis trials.