Skip to main content
Top
Published in: International Journal of Computer Assisted Radiology and Surgery 9/2015

Open Access 01-09-2015 | Original Article

Quantification of fibrous cap thickness in intracoronary optical coherence tomography with a contour segmentation method based on dynamic programming

Authors: Guillaume Zahnd, Antonios Karanasos, Gijs van Soest, Evelyn Regar, Wiro Niessen, Frank Gijsen, Theo van Walsum

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 9/2015

Login to get access

Abstract

Objectives

Fibrous cap thickness is the most critical component of plaque stability. Therefore, in vivo quantification of cap thickness could yield valuable information for estimating the risk of plaque rupture. In the context of preoperative planning and perioperative decision making, intracoronary optical coherence tomography imaging can provide a very detailed characterization of the arterial wall structure. However, visual interpretation of the images is laborious, subject to variability, and therefore not always sufficiently reliable for immediate decision of treatment.

Methods

A novel semiautomatic segmentation method to quantify coronary fibrous cap thickness in optical coherence tomography is introduced. To cope with the most challenging issue when estimating cap thickness (namely the diffuse appearance of the anatomical abluminal interface to be detected), the proposed method is based on a robust dynamic programming framework using a geometrical a priori. To determine the optimal parameter settings, a training phase was conducted on 10 patients.

Results

Validated on a dataset of 179 images from 21 patients, the present framework could successfully extract the fibrous cap contours. When assessing minimal cap thickness, segmentation results from the proposed method were in good agreement with the reference tracings performed by a medical expert (mean absolute error and standard deviation of \(22\,\pm \,18\,\upmu \hbox {m},\hbox { R}\,=\,.73\)) and were similar to inter-observer reproducibility (\(21\,\pm \,19\,\upmu \hbox {m}\), R = .74), while being significantly faster and fully reproducible.

Conclusion

The proposed framework demonstrated promising performances and could potentially be used for online identification of high-risk plaques.
Footnotes
1
Please note that in the remaining of this manuscript, any reference to segmentation contour and all results are related to the original automatic contours (i.e., non manually corrected), except when explicitly specified.
 
Literature
2.
go back to reference Bezerra HG, Costa MA, Guagliumi G, Rollins AM, Simon DI (2009) Intracoronary optical coherence tomography: a comprehensive review. J Am Coll Cardiol Cardiovasc Interv 2(11):1035–1046CrossRef Bezerra HG, Costa MA, Guagliumi G, Rollins AM, Simon DI (2009) Intracoronary optical coherence tomography: a comprehensive review. J Am Coll Cardiol Cardiovasc Interv 2(11):1035–1046CrossRef
3.
go back to reference Brezinski ME (2002) Optical coherence tomography for identifying unstable coronary plaque. Int J Cardiol 102(2):154–165 Brezinski ME (2002) Optical coherence tomography for identifying unstable coronary plaque. Int J Cardiol 102(2):154–165
4.
go back to reference Burke AP, Farb A, Malcom GT, Liang YH, Smialek J, Virmani R (1997) Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. New Engl J Med 336(18):1276–1282CrossRefPubMed Burke AP, Farb A, Malcom GT, Liang YH, Smialek J, Virmani R (1997) Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. New Engl J Med 336(18):1276–1282CrossRefPubMed
5.
go back to reference Celi S, Berti S (2014) In-vivo segmentation and quantification of coronary lesions by optical coherence tomography images for a lesion type definition and stenosis grading. Med Image Anal 18(7):1157–1168CrossRefPubMed Celi S, Berti S (2014) In-vivo segmentation and quantification of coronary lesions by optical coherence tomography images for a lesion type definition and stenosis grading. Med Image Anal 18(7):1157–1168CrossRefPubMed
6.
go back to reference Cohen L (2006) Minimal paths and fast marching methods for image analysis. In: Paragios N, Chen Y, Faugeras O (eds) Handbook of mathematical models in computer vision. Springer, pp 97–111 Cohen L (2006) Minimal paths and fast marching methods for image analysis. In: Paragios N, Chen Y, Faugeras O (eds) Handbook of mathematical models in computer vision. Springer, pp 97–111
7.
go back to reference Karanasos A, Ligthart J, Witberg K, Toutouzas K, Daemen J, van Soest G, Gnanadesigan M, van Geuns RJ, de Jaegere P, Regar E (2013) Association of neointimal morphology by optical coherence tomography with rupture of neoatherosclerotic plaque very late after coronary stent implantation. SPIE Conf Proc. doi:10.1117/12.2006331 Karanasos A, Ligthart J, Witberg K, Toutouzas K, Daemen J, van Soest G, Gnanadesigan M, van Geuns RJ, de Jaegere P, Regar E (2013) Association of neointimal morphology by optical coherence tomography with rupture of neoatherosclerotic plaque very late after coronary stent implantation. SPIE Conf Proc. doi:10.​1117/​12.​2006331
8.
go back to reference Karanasos A, Simsek C, Gnanadesigan M, van Ditzhuijzen NS, Freire R, Dijkstra J, Tu S, van Mieghem N, van Soest G, de Jaegere P, Serruys PW, Zijlstra F, van Geuns RJ, Regar E (2014) Oct assessment of the long-term vascular healing response 5 years after everolimus-eluting bioresorbable vascular scaffold. J Am Coll Cardiol 64(22):2343–2356CrossRefPubMed Karanasos A, Simsek C, Gnanadesigan M, van Ditzhuijzen NS, Freire R, Dijkstra J, Tu S, van Mieghem N, van Soest G, de Jaegere P, Serruys PW, Zijlstra F, van Geuns RJ, Regar E (2014) Oct assessment of the long-term vascular healing response 5 years after everolimus-eluting bioresorbable vascular scaffold. J Am Coll Cardiol 64(22):2343–2356CrossRefPubMed
9.
go back to reference Kubo T, Imanishi T, Takarada S, Kuroi A, Ueno S, Yamano T, Tanimoto T, Matsuo Y, Masho T, Kitabata H, Tsuda K, Tomobuchi Y, Akasaka T (2007) Assessment of culprit lesion morphology in acute myocardial infarction: ability of optical coherence tomography compared with intravascular ultrasound and coronary angioscopy. J Am Coll Cardiol 50(10):933–939CrossRefPubMed Kubo T, Imanishi T, Takarada S, Kuroi A, Ueno S, Yamano T, Tanimoto T, Matsuo Y, Masho T, Kitabata H, Tsuda K, Tomobuchi Y, Akasaka T (2007) Assessment of culprit lesion morphology in acute myocardial infarction: ability of optical coherence tomography compared with intravascular ultrasound and coronary angioscopy. J Am Coll Cardiol 50(10):933–939CrossRefPubMed
10.
go back to reference Kume T, Akasaka T, Kawamoto T, Okura H, Watanabe N, Toyota E, Neishi Y, Sukmawan R, Sadahira Y, Yoshida K (2006) Measurement of the thickness of the fibrous cap by optical coherence tomography. Am Heart J 152(4):755e1–755e4CrossRef Kume T, Akasaka T, Kawamoto T, Okura H, Watanabe N, Toyota E, Neishi Y, Sukmawan R, Sadahira Y, Yoshida K (2006) Measurement of the thickness of the fibrous cap by optical coherence tomography. Am Heart J 152(4):755e1–755e4CrossRef
11.
go back to reference Narula J, Nakano M, Virmani R, Kolodgie FD, Petersen R, Newcomb R, Malik S, Fuster V, Finn AV (2013) Histopathologic characteristics of atherosclerotic coronary disease and implications of the findings for the invasive and noninvasive detection of vulnerable plaques. J Am Coll Cardiol 61(10):1041–1051PubMedCentralCrossRefPubMed Narula J, Nakano M, Virmani R, Kolodgie FD, Petersen R, Newcomb R, Malik S, Fuster V, Finn AV (2013) Histopathologic characteristics of atherosclerotic coronary disease and implications of the findings for the invasive and noninvasive detection of vulnerable plaques. J Am Coll Cardiol 61(10):1041–1051PubMedCentralCrossRefPubMed
12.
go back to reference van Soest G, Goderie T, Regar E, Koljenovic S, van Leenders GLJH, Gonzalo N, van Noorden S, Okamura T, Bouma BE, Tearney GJ, Serruys PW, van der Steen AFW (2010) Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging. J Biomed Opt 15:011105-1 van Soest G, Goderie T, Regar E, Koljenovic S, van Leenders GLJH, Gonzalo N, van Noorden S, Okamura T, Bouma BE, Tearney GJ, Serruys PW, van der Steen AFW (2010) Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging. J Biomed Opt 15:011105-1
13.
go back to reference Stone GW, Maehara A, Lansky AJ (2011) A prospective natural-history study of coronary atherosclerosis. New Engl J Med 364(3):226–235CrossRefPubMed Stone GW, Maehara A, Lansky AJ (2011) A prospective natural-history study of coronary atherosclerosis. New Engl J Med 364(3):226–235CrossRefPubMed
14.
go back to reference Tearney GJ, Regar E, Akasaka T et al (2012) Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies. J Am Coll Cardiol 59(12):1058–1072CrossRefPubMed Tearney GJ, Regar E, Akasaka T et al (2012) Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies. J Am Coll Cardiol 59(12):1058–1072CrossRefPubMed
15.
go back to reference Toutouzas K, Karanasos A, Tsiamis E, Riga M, Drakopoulou M, Synetos A, Papanikolaou A, Tsioufis C, Androulakis A, Stefanadi E, Tousoulis D, Stefanadis C (2011) New insights by optical coherence tomography into the differences and similarities of culprit ruptured plaque morphology in non-ST-elevation myocardial infarction and ST-elevation myocardial infarction. Am Heart J 161(6):1192–1199CrossRefPubMed Toutouzas K, Karanasos A, Tsiamis E, Riga M, Drakopoulou M, Synetos A, Papanikolaou A, Tsioufis C, Androulakis A, Stefanadi E, Tousoulis D, Stefanadis C (2011) New insights by optical coherence tomography into the differences and similarities of culprit ruptured plaque morphology in non-ST-elevation myocardial infarction and ST-elevation myocardial infarction. Am Heart J 161(6):1192–1199CrossRefPubMed
16.
go back to reference Ughi GJ, Steigerwald K, Adriaenssens T, Desmet W, Guagliumi G, Joner M, D’hooge J (2013) Automatic characterization of neointimal tissue by intravascular optical coherence tomography. J Biomed Opt 19:021104CrossRef Ughi GJ, Steigerwald K, Adriaenssens T, Desmet W, Guagliumi G, Joner M, D’hooge J (2013) Automatic characterization of neointimal tissue by intravascular optical coherence tomography. J Biomed Opt 19:021104CrossRef
17.
go back to reference Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20(5):1262–1275CrossRefPubMed Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM (2000) Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 20(5):1262–1275CrossRefPubMed
18.
go back to reference Wang T, Wieser W, Springeling G, Beurskens R, Lancee CT, Pfeiffer T, van der Steen AFW, Huber R, van Soest G (2013) Intravascular optical coherence tomography imaging at 3200 frames per second. Opt lett 38(10):1715–1717CrossRefPubMed Wang T, Wieser W, Springeling G, Beurskens R, Lancee CT, Pfeiffer T, van der Steen AFW, Huber R, van Soest G (2013) Intravascular optical coherence tomography imaging at 3200 frames per second. Opt lett 38(10):1715–1717CrossRefPubMed
19.
go back to reference Wang Z, Chamie D, Bezerra HG, Yamamoto H, Kanovsky J, Wilson DL, Costa MA, Rollins AM (2012) Volumetric quantification of fibrous caps using intravascular optical coherence tomography. Biomed Opt Express 3:1413–1426PubMedCentralCrossRefPubMed Wang Z, Chamie D, Bezerra HG, Yamamoto H, Kanovsky J, Wilson DL, Costa MA, Rollins AM (2012) Volumetric quantification of fibrous caps using intravascular optical coherence tomography. Biomed Opt Express 3:1413–1426PubMedCentralCrossRefPubMed
20.
go back to reference Xu C, Schmitt JM, Carlier SG, Virmani R (2008) Characterization of atherosclerosis plaques by measuring both backscattering and attenuation coefficients in optical coherence tomography. J Biomed Opt 13:034003CrossRefPubMed Xu C, Schmitt JM, Carlier SG, Virmani R (2008) Characterization of atherosclerosis plaques by measuring both backscattering and attenuation coefficients in optical coherence tomography. J Biomed Opt 13:034003CrossRefPubMed
21.
go back to reference Yonetsu T, Kakuta T, Lee T, Takahashi K, Kawaguchi N, Yamamoto G, Koura K, Hishikari K, Iesaka Y, Fujiwara H, Isobe M (2011) In vivo critical fibrous cap thickness for rupture-prone coronary plaques assessed by optical coherence tomography. Eur Heart J 32(10):1251–1259CrossRefPubMed Yonetsu T, Kakuta T, Lee T, Takahashi K, Kawaguchi N, Yamamoto G, Koura K, Hishikari K, Iesaka Y, Fujiwara H, Isobe M (2011) In vivo critical fibrous cap thickness for rupture-prone coronary plaques assessed by optical coherence tomography. Eur Heart J 32(10):1251–1259CrossRefPubMed
22.
go back to reference Zahnd G, Karanasos A, van Soest G, Regar E, Niessen WJ, Gijsen FJH, van Walsum T (2014) Fully automated detection of healthy wall sections in intracoronary optical coherence tomography. In: MICCAI CVII-STENT Workshop. Springer, Berlin, Heidelberg (in press) Zahnd G, Karanasos A, van Soest G, Regar E, Niessen WJ, Gijsen FJH, van Walsum T (2014) Fully automated detection of healthy wall sections in intracoronary optical coherence tomography. In: MICCAI CVII-STENT Workshop. Springer, Berlin, Heidelberg (in press)
23.
go back to reference Zahnd G, Karanasos A, van Soest G, Regar E, Niessen WJ, Gijsen FJH, van Walsum T (2014) Semi-automated quantification of fibrous cap thickness in intracoronary optical coherence tomography. International conference on information processing in computer-assisted interventions p 78–89 Zahnd G, Karanasos A, van Soest G, Regar E, Niessen WJ, Gijsen FJH, van Walsum T (2014) Semi-automated quantification of fibrous cap thickness in intracoronary optical coherence tomography. International conference on information processing in computer-assisted interventions p 78–89
24.
go back to reference Zahnd G, Orkisz M, Sérusclat A, Moulin P, Vray D (2013) Simultaneous extraction of carotid artery intima-media interfaces in ultrasound images: assessment of wall thickness temporal variation during the cardiac cycle. Int J Comput Assist Radiol Surg 9(4):645–658CrossRef Zahnd G, Orkisz M, Sérusclat A, Moulin P, Vray D (2013) Simultaneous extraction of carotid artery intima-media interfaces in ultrasound images: assessment of wall thickness temporal variation during the cardiac cycle. Int J Comput Assist Radiol Surg 9(4):645–658CrossRef
Metadata
Title
Quantification of fibrous cap thickness in intracoronary optical coherence tomography with a contour segmentation method based on dynamic programming
Authors
Guillaume Zahnd
Antonios Karanasos
Gijs van Soest
Evelyn Regar
Wiro Niessen
Frank Gijsen
Theo van Walsum
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 9/2015
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-015-1164-7

Other articles of this Issue 9/2015

International Journal of Computer Assisted Radiology and Surgery 9/2015 Go to the issue