3D Rotational Coronary X-Ray Angiography On Track for Clinical Use

As medical imaging is rapidly moving toward 3D visualization, angiographies are about to follow suit. A new technique, that uses a rotating X-ray machine, reconstructs images taken from different angles into a volumetric view of the vascular lumen. The initial study using a sole human subject now paves way to see if the technique is actually useful in a more substantial clinical trial.
From the study abstract in Circulation: Cardiovascular Interventions:

A recently developed method to create 3D images of the coronary arteries uses x-ray projection images acquired during a 180° C-arm rotation and continuous contrast injection followed by ECG-gated iterative reconstruction. This method shows promise for providing high-quality 3D reconstructions of the coronary arteries with no user interaction but requires clinical evaluation.
The reconstruction strategy was evaluated by comparing the reconstructed 3D volumetric images with the 2D angiographic projection images from the same 23 patients to ascertain overall image quality, lesion visibility, and a comparison of 3D quantitative coronary analysis with 2D quantitative coronary analysis. The majority of the resulting 3D volume images were rated as having high image quality (66%) and provided the physician with additional clinical information such as complete visualization of bifurcations and unobtainable views of the coronary tree. True-positive lesion detection rates were high (90 to 100%), whereas false-positive detection rates were low (0 to 8.1%). Finally, 3D quantitative coronary analysis showed significant similarity with 2D quantitative coronary analysis in terms of lumen diameters and provided vessel segment length free from the errors of foreshortening.
Fully automated reconstruction of rotational coronary x-ray angiograms is feasible, produces 3D volumetric images that overcome some of the limitations of standard 2D angiography, and is ready for further implementation and study in the clinical environment.

Abstract in Circulation: Cardiovascular Interventions: Clinical Feasibility of a Fully Automated 3D Reconstruction of Rotational Coronary X-Ray Angiograms
Aerican Heart Association press statement: New software provides 3-D views of arteries in catheterization lab…
Image credit: Lisbon Center for Images in Science and Art