A new method of three-dimensional coronary artery reconstruction from X-ray angiography: Validation against a virtual phantom and multislice computed tomography

Objective: To develop and implement a method for three-dimensional (3D) reconstruction of coronary arteries from conventional monoplane angiograms. Background: 3D reconstruction of conventional coronary angiograms is a promising imaging modality for both diagnostic and interventional purposes. Methods: Our method combines image enhancement, automatic edge detection, an iterative method to reconstruct the centerline of the artery and reconstruction of the diameter of the vessel by taking into consideration foreshortening effects. The X-Ray-based 3D coronary trees were compared against phantom data from a virtual arterial tree projected into two planes as well as computed tomography (CT)-based coronary artery reconstructions in patients subjected to coronary angiography. Results: Comparison against the phantom arterial tree demonstrated perfect agreement with the developed algorithm. Visual comparison against the CT-based reconstruction was performed in the 3D space, in terms of the direction angle along the centerline length of the left anterior descending and circum-flex arteries relative to the main stem, and location and take-off angle of sample bifurcation branches from the main coronary arteries. Only minimal differences were detected between the two methods. Inter- and intraobserver variability of our method was low (intra-class correlation coefficients > 0.8). Conclusion: The developed method for coronary artery reconstruction from conventional angiography images provides the geometry of coronary arteries in the 3D space.