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Intravascular Imaging: Current Applications and Research Developments Vasilios D. Tsakanikas University of Ioannina, Greece Dimitrios I. Fotiadis University of Ioannina, Greece Lampros K. Michalis University of Ioannina, Greece Katerina K. Naka University of Ioannina, Greece Christos V. Bourantas Castle Hill Hospital, UK Managing Director: Lindsay Johnston Senior Editorial Director: Heather Probst Book Production Manager: Sean Woznicki Development Manager: Joel Gamon Development Editor: Hannah Abelbeck Acquisitions Editor: Erika Gallagher Typesetters: Lisandro Gonzalez Print Coordinator: Jamie Snavely Cover Design: Nick Newcomer Published in the United States of America by Medical Information Science Reference (an imprint of IGI Global) 701 E. Chocolate Avenue Hershey PA 17033 Tel: 717-533-8845 Fax: 717-533-8661 E-mail: [email protected] Web site: http://www.igi-global.com Copyright © 2012 by IGI Global. All rights reserved. No part of this publication may be reproduced, stored or distributed in any form or by any means, electronic or mechanical, including photocopying, without written permission from the publisher. Product or company names used in this set are for identification purposes only. Inclusion of the names of the products or companies does not indicate a claim of ownership by IGI Global of the trademark or registered trademark. Library of Congress Cataloging-in-Publication Data Intravascular imaging: current applications and research developments / Vasilios D. Tsakanikas ... [et al.], editors. p. ; cm. Includes bibliographical references and index. Summary: “This book presents available intravascular imaging techniques and analyzes their impact in clinical practice and research”--Provided by publisher. ISBN 978-1-61350-095-8 (hardcover) -- ISBN 978-1-61350-096-5 (ebook) -- ISBN 978-1-61350-097-2 (print & perpetual access) I. Tsakanikas, Vasilios D., 1983- [DNLM: 1. Coronary Artery Disease--ultrasonography. 2. Ultrasonography, Interventional--methods. 3. Diagnostic Imaging--methods. WG 300] LC classification not assigned 617.4’1207543--dc23 2011030000 British Cataloguing in Publication Data A Cataloguing in Publication record for this book is available from the British Library. All work contributed to this book is new, previously-unpublished material. The views expressed in this book are those of the authors, but not necessarily of the publisher. Editorial Advisory Board Metin Akay, Arizona State University, USA Angela Hoye, Castle Hill Hospital, UK Jurgen Ligthart, Erasmus Medical Center, The Netherlands Miodrag C. Ostojic, Clinical Center of Serbia, Serbia Obeardan Parodi, Niguarda Ca’ Granda Hospital, Italy Michael R. Rees, Bangor University, UK Christodoulos Stefanadis, University of Athens, Greece Attila Thury, University of Szeged, Hungary Ann C. Tweddel, Castle Hill Hospital, UK List of Reviewers Christos Bourantas, Castle Hill Hospital, UK Dimitrios Fotiadis, University of Ioannina, Greece Michalis Lampros, University of Ioannina, Greece Katerina Naka, University of Ioannina, Greece Michael Papafaklis, Harvard Medical School, USA Obeardan Parodi, Niguarda Ca’ Granda Hospital, Italy Francesco Prati, San Giovanni Hospital, Italy Scot Garg, Erasmus Medical Center, The Netherlands Konstantinos Toutouzas, Athens Medical School, Greece Vasilios Tsakanikas, University of Ioannina, Greece Table of Contents Preface ................................................................................................................................................xvii Section 1 Intravascular Ultrasound Chapter 1 Basic Principles of Image Acquisition ....................................................................................................1 Ourania Katsarou, National and Kapodistrian University of Athens Medical School, Greece Manolis Vavuranakis, National and Kapodistrian University of Athens Medical School, Greece Chapter 2 Intravascular Image Interpretation ........................................................................................................10 Katerina K. Naka, University of Ioannina, Greece Nikolaos D. Papamichael, University of Ioannina, Greece Chapter 3 IVUS Image Processing Methodologies ...............................................................................................36 Antonis A. Sakellarios, University of Ioannina, Greece Christos V. Bourantas, Castle Hill Hospital, UK Lambros S. Athanasiou, University of Ioannina, Greece Dimitrios I. Fotiadis, University of Ioannina, Greece Lampros K. Michalis, University of Ioannina, Greece Chapter 4 Analysis of Radiofrequency Ultrasound Signals: Tissue Characterization with Virtual Histology and Palpography .......................................................................................................55 Attila Thury, Erasmus MC, The Netherlands & University of Szeged, Hungary Héctor M. Garcia-Garcia, Erasmus MC, The Netherlands Evelyn Regar, Erasmus MC, The Netherlands Chapter 5 Implications of Intracoronary Ultrasound Imaging for Clinical Practice .............................................94 Christos V. Bourantas, Castle Hill Hospital, UK Katerina K. Naka, University of Ioannina, Greece Scot Garg, Castle Hill Hospital, UK Farqad M. Alamgir, Castle Hill Hospital, UK Angela Hoye, Castle Hill Hospital, UK Lampros K. Michalis, University of Ioannina, Greece Chapter 6 Research Utility of Intravascular Ultrasound .....................................................................................109 Hector M. Garcia-Garcia, Erasmus MC, The Netherlands Scot Garg, Royal Blackburn Hospital, UK Salvatore Brugaletta, Erasmus MC, The Netherlands Roberto Diletti, Erasmus MC, The Netherlands Eun-Seok Shin, Erasmus MC, The Netherlands & University of Ulsan College of Medicine, Korea Patrick W. Serruys, Erasmus MC, The Netherlands Section 2 Imaging by Angioscopy Chapter 7 Imaging by Angioscopy ......................................................................................................................138 Michael Rees, Bangor University, UK Section 3 Thermography Chapter 8 Thermography: Basic Principles of Data Acquisition ........................................................................148 Konstantinos Toutouzas, Athens Medical School, Greece Maria Drakopoulou, Athens Medical School, Greece Christodoulos Stefanadis, Athens Medical School, Greece Chapter 9 Research and Clinical Utility of Thermography .................................................................................162 Konstantinos Toutouzas, Athens Medical School, Greece Eleftherios Tsiamis, Athens Medical School, Greece Maria Drakopoulou, Athens Medical School, Greece Christodoulos Stefanadis, Athens Medical School, Greece Section 4 Optical Coherence Tomography Chapter 10 Optical Coherence Tomography: Basic Principles of Image Acquisition ...........................................180 Lambros S. Athanasiou, University of Ioannina, Greece Nico Bruining, Erasmus MC, The Netherlands Francesco Prati, San Giovanni Hospital, Italy Dimitris Koutsouris, National Technical University of Athens, Greece Chapter 11 Optical Coherence Tomography: Image Interpretation and Image Processing Methodologies .........194 Simon D. Thackray, Castle Hill Hospital, UK Christos V. Bourantas, Castle Hill Hospital, UK Poay Huan Loh, Castle Hill Hospital, UK Vasilios D. Tsakanikas, University of Ioannina, Greece Dimitrios I. Fotiadis, University of Ioannina, Greece Chapter 12 OCT in the Clinical Practice and Data from Clinical Studies.............................................................209 Francesco Prati, San Giovanni Hospital, Italy & CLI Foundation, Italy Alessandro Di Giorgio, Ferrarotto Hospital, Italy, & ETNA Foundation, Italy Vito Ramazzotti, San Giovanni Hospital, Italy Maria Teresa Mallus, San Giovanni Hospital, Italy Chapter 13 Research Utility of Optical Coherence Tomography ..........................................................................220 Konstantinos Toutouzas, Athens Medical School, Greece Antonios Karanasos, Athens Medical School, Greece Christodoulos Stefanadis, Athens Medical School, Greece Section 5 Intracoronary Near-Infrared Spectroscopy Chapter 14 Intravascular Imaging of Lipid Core Plaque by Near-Infrared Spectroscopy ....................................240 Emmanouil S. Brilakis, Dallas VA Medical Center, USA Stephen T. Sum, InfraReDx, USA Sean P. Madden, InfraReDx, USA James E. Muller, InfraReDx, USA Section 6 Intracardiac Echocardiography Chapter 15 Intracardiac Echocardiography: Procedural Steps and Clinical Application ......................................261 Rajesh K Nair, Rigshospitalet, Denmark Poay Huan Loh, Rigshospitalet, Denmark Lars Sondergaard, Rigshospitalet, Denmark Section 7 Fusion Methodologies Chapter 16 Analysis of the Existing Data Fusion Methodologies for 3D Coronary Imaging ...............................278 Panagiotis Siogkas, University of Ioannina, Greece Dimitrios I. Fotiadis, University of Ioannina, Greece Christos V. Bourantas, Castle Hill Hospital, UK Ann C. Tweddel, Castle Hill Hospital, UK Scot Garg, Royal Blackburn Hospital, UK Lampros K. Michalis, University of Ioannina, Greece Dimitris Koutsouris, National Technical University of Athens, Greece Section 8 Current Status of Vascular Imaging Chapter 17 Current Status of Intravascular Imaging with IVUS and OCT: The Clinical Implications of Intravascular Imaging .....................................................................................................................293 Angela Hoye, Castle Hill Hospital, UK Chapter 18 Current Clinical Status of Vascular Non-Invasive Imaging Methodologies .......................................309 Thanjavur Bragadeesh, University of Hull, UK Ann C. Tweddel, University of Hull, UK Section 9 Intravascular Imaging and Haemodynamics Chapter 19 Intravascular Imaging and Haemodynamics: The Role of Shear Stress in Atherosclerosis and In-Stent Restenosis .......................................................................................................................326 Michail I. Papafaklis, Harvard Medical School, USA & University of Ioannina, Greece Lampros K. Michalis, University of Ioannina, Greece Section 10 Future Trends in Intravascular Imaging Chapter 20 Future Trends in Intravascular Imaging ..............................................................................................350 George Giannoglou, AHEPA University General Hospital, Greece & Aristotle University of Thessaloniki Medical School, Greece Yiannis Chatzizisis, AHEPA University General Hospital, Greece & Aristotle University of Thessaloniki Medical School, Greece Chapter 21 Future Trends in 3D Intravascular Ultrasound (IVUS) Reconstruction .............................................355 George D. Giannoglou, AHEPA University General Hospital, Greece & Aristotle University of Thessaloniki Medical School, Greece Antonios P. Antoniadis, AHEPA University General Hospital, Greece & Aristotle University of Thessaloniki Medical School, Greece Chapter 22 Future Trends in Coronary CT Angiography ......................................................................................360 George Giannoglou, AHEPA University General Hospital, Greece & Aristotle University of Thessaloniki Medical School, Greece Sotirios Katranas, AHEPA University General Hospital, Greece & Aristotle University of Thessaloniki Medical School, Greece Chapter 23 Coronary Plaque Vulnerability: Molecular and Cellular Mechanisms and Novel Imaging Modalities ............................................................................................................367 George D. Giannoglou, AHEPA University General Hospital, Greece & Aristotle University Medical School, Greece Konstantinos C. Koskinas, AHEPA University General Hospital, Greece & Aristotle University Medical School, Greece Compilation of References ...............................................................................................................375 About the Contributors ....................................................................................................................441 Index ...................................................................................................................................................452 Detailed Table of Contents Preface ................................................................................................................................................xvii Section 1 Intravascular Ultrasound Chapter 1 Basic Principles of Image Acquisition ....................................................................................................1 Ourania Katsarou, National and Kapodistrian University of Athens Medical School, Greece Manolis Vavuranakis, National and Kapodistrian University of Athens Medical School, Greece Before proceeding with the clinical and research utility of Intravascular Imaging, it is important to ex- amine in detail the principles that the acquisition of the IVUS signal is based on. This chapter provides an insight into the principles of the IVUS imaging, while describing the image quality factors. Addition- ally, the equipment for IVUS examination is described, and the acquisition and display techniques are detailed. Finally, a brief summary of the limitations of the IVUS signal is attempted. Chapter 2 Intravascular Image Interpretation ........................................................................................................10 Katerina K. Naka, University of Ioannina, Greece Nikolaos D. Papamichael, University of Ioannina, Greece Intravascular ultrasound (IVUS) is an imaging modality often used as a supplement to coronary angiog- raphy and allows accurate assessment of the lumen, vessel wall, and atherosclerotic plaque. A coherent interpretation of the IVUS images requires identification of the image artefacts that emerge during IVUS interrogation and can often be quite difficult. This chapter describes the morphologic appearance of the structures seen in IVUS, presents the morphologic characteristics of the different types of plaque, and summarizes the nomenclature and definitions used during IVUS interpretation. Moreover, it focuses on the quantitative analysis and reports the measurements obtained during IVUS processing. Finally, it presents some of the clinical (e.g. assessment of the extent and severity of a lesion, treatment plan- ning) and research (e.g. evaluation of atherosclerotic progression/regression, transplant vasculopathy, peripheral arterial disease) applications of this modality aiming to highlight its value in the clinical and research arena.

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