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Proceedings Paper

Automated determination of optimal angiographic viewing angles for coronary artery bifurcations from CTA data
Author(s): Pieter H. Kitslaar; Henk A. Marquering; Wouter J. Jukema; Gerhard Koning; Maarten Nieber; Albert M. Vossepoel; Jeroen J. Bax; Johan H. C. Reiber
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Paper 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.

Paper Details

Date Published: 17 March 2008
PDF: 10 pages
Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling, 69181J (17 March 2008); doi: 10.1117/12.770255
Show Author Affiliations
Pieter H. Kitslaar, Leiden Univ. Medical Ctr. (Netherlands)
Henk A. Marquering, Leiden Univ. Medical Ctr. (Netherlands)
Wouter J. Jukema, Leiden Univ. Medical Ctr. (Netherlands)
Gerhard Koning, Leiden Univ. Medical Ctr. (Netherlands)
Maarten Nieber, Leiden Univ. Medical Ctr. (Netherlands)
Albert M. Vossepoel, Delft Univ. of Technology (Netherlands)
Jeroen J. Bax, Leiden Univ. Medical Ctr. (Netherlands)
Johan H. C. Reiber, Leiden Univ. Medical Ctr. (Netherlands)


Published in SPIE Proceedings Vol. 6918:
Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling
Michael I. Miga; Kevin Robert Cleary, Editor(s)

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