Abstract: An apparatus for performing a vascular assessment is disclosed. The apparatus creates a three-dimensional model that is representative of a coronary vessel tree of a patient based on at least two angiographic images. The apparatus estimates first blood flow resistance values for points along at least some vascular segments of the coronary vessel tree using vascular geometrical dimensions of the three-dimensional model. The apparatus also estimates second blood flow resistance values for the points along the at least some vascular segments of the coronary vessel tree using a volume of a crown of the vascular segment downstream from the respective point. The apparatus determines fractional flow reserve (“FFR”) by calculating a ratio of the first blood flow resistance values and the second blood flow resistance values at each of the points along the at least some vascular segments of the coronary vessel tree.

Abstract: An automated measurement device and method for coronary artery disease scoring is disclosed. An example device includes a processor configured to obtain a computerized model of a plurality of vascular segments of a patient and create an unstenosed computerized model from the computerized model by virtually enlarging at least some locations of the vascular segments of the computerized model. The processor also determines vascular state scoring tool (“VSST”) scores based on characteristics of vascular locations along the vascular segments. The processor further determines a severity of stenosis for the vascular locations based on comparisons of first blood flow parameter values at the vascular locations in the computerized model to corresponding second blood flow parameter values at the same vascular locations in the unstenosed computerized model. A user interface of the device displays the severity of stenosis in conjunction with the VSST scores for the vascular locations.

Abstract: Systems and methods for four-dimensional analysis of a patient's coronary arteries and myocardial wall. An example method includes accessing angiographic x-ray images of one or more arteries, with the x-ray images depicting the arteries from respective angles, with each x-ray image being associated with a cardiac phase of cardiac phases, and with the cardiac phases being included in a cardiac cycle. A three-dimensional model of the arteries is generated for each cardiac phase based on a subset of the x-ray images which are associated with the cardiac phase. A four-dimensional representation of the arteries is generated throughout the cardiac cycle based on the three-dimensional models for the cardiac phase. Information associated with the four-dimensional presentation is presented.

Abstract: Automated image analysis used in vascular state modeling. Coronary vasculature in particular is modeled in some embodiments. Methods of “virtual revascularization” of a presently stenotic vasculature are described; useful, for example, as a reference in disease state determinations. Structure and uses of a model which relates records comprising acquired images or other structured data to a vascular tree representation are described.

Abstract: A method and apparatus for vascular assessment are disclosed. The apparatus, in some embodiments, receives, from a medical imaging device, a medical image of a coronary vessel tree of a subject and calculates a plurality of geometric measurements associated with individual portions of a vascular segment of the coronary vessel tree. The apparatus also determines a plurality of resistances associated with the plurality of geometric measurements associated with the individual portions of the vascular segment and determines a plurality of pressure drops across the individual portions of the vascular segment based on the determined resistances and a calculated or estimated blood flow. The apparatus further calculates based on the plurality of pressure drops, a functional index indicative of a presence or an absence of a stenosis within the vascular segment.

Abstract: A method and apparatus for selecting (i) an imaging angle with minimized foreshortening and/or overlap of a target region from an existing angiographic image and/or (ii) selecting an imaging angle for new images so that foreshortening and/or overlap are minimized. A viewing angle cost function is determined that defines optimal viewing angles at least with respect to minimizing foreshortening of the target region. Using the cost function, an image may be selected from among a set of images, which potentially does not match the optimal imaging angle due to the optimal imaging angle having a high cost as a result of overlapping vascular features. The selected image may have an imaging angle that corresponds to a lower cost due to less overlap compared to the optimal imaging angle.

Abstract: An apparatus for synchronizing a three-dimensional model of a patient's coronary arteries with an orientation of a medical imaging device is disclosed. In an example, an apparatus is configured to receive an indication that a three-dimensional model has been rotated. The indication includes a number of degrees of rotation of the three-dimensional model along a roll and/or pitch axis. The processor uses a correlation or transfer function to determine a rotational angulation position of the medical imaging device based on the number of degrees of rotation of the three-dimensional model along the roll and/or pitch axis. The processor transmits a command or instruction to the medical imaging device that is indicative of the desired rotational angulation position, thereby causing the medical imaging device to rotate to the desired position.

Abstract: Methods and systems for manually assisted definition of vascular features are described. In some embodiments, a method provides for editing of vascular paths by enabling a user to drag an erroneously segmented region of a selected vascular path into alignment with a more correctly segmented position that is depicted as a blood vessel in a vascular image. The method may use an energy function, defined as a function of position along the segmentation of the selected blood vessel, to determine how a vascular path is to be moved based on dragging motions provided by the user. In some instances, non-zero regions of the energy function are set based on the position of the selected region.

Abstract: Automated image analysis used in vascular state modeling. Coronary vasculature in particular is modeled in some embodiments. Methods of “virtual revascularization” of a presently stenotic vasculature are described; useful, for example, as a reference in disease state determinations. Structure and uses of a model which relates records comprising acquired images or other structured data to a vascular tree representation are described.

Abstract: A method and apparatus for vascular assessment are disclosed. The apparatus, in some embodiments, receives a plurality of 2-D angiographic images of a portion of a vasculature of a subject, and processes the images to produce a stenotic model over the vasculature. The stenotic model has measurements of the vasculature at one or more locations along vessels of the vasculature. The apparatus, in some embodiments, determines a flow characteristic of the stenotic model and calculates an index indicative of vascular function, based, at least in part, on the flow characteristic in the stenotic model.

Abstract: An automated measurement device and method for coronary artery disease scoring is disclosed. An example device includes a processor configured to obtain a computerized model of a plurality of vascular segments of a patient and create an unstenosed computerized model from the computerized model by virtually enlarging at least some locations of the vascular segments of the computerized model. The processor also determines vascular state scoring tool (“VSST”) scores based on characteristics of vascular locations along the vascular segments. The processor further determines a severity of stenosis for the vascular locations based on comparisons of first blood flow parameter values at the vascular locations in the computerized model to corresponding second blood flow parameter values at the same vascular locations in the unstenosed computerized model. A user interface of the device displays the severity of stenosis in conjunction with the VSST scores for the vascular locations.

Abstract: Systems and methods are described for the compositing together of model-linked vascular data from a plurality of sources, including at least one 2-D angiography image, for display in a frame of reference of the at least one angiography image. In some embodiments, a linking model comprises a data structure configured to link locations of angiographic images to corresponding elements of non-image vascular parameter data. The linking data structure is traversed to obtain a mapping to the frame of reference of one or more of the angiographic images.

Abstract: A method and apparatus for vascular assessment are disclosed. The apparatus, in some embodiments, receives, from a medical imaging device, a medical image of a coronary vessel tree of a subject and calculates a plurality of geometric measurements associated with individual portions of a vascular segment of the coronary vessel tree. The apparatus also determines a plurality of resistances associated with the plurality of geometric measurements associated with the individual portions of the vascular segment and determines a plurality of pressure drops across the individual portions of the vascular segment based on the determined resistances and a calculated or estimated blood flow. The apparatus further calculates based on the plurality of pressure drops, a functional index indicative of a presence or an absence of a stenosis within the vascular segment.

Abstract: A method for vascular assessment is disclosed. The method, in some embodiments, comprises receiving a plurality of 2-D angiographic images of a portion of a vasculature of a subject, and processing the images to produce a stenotic model over the vasculature, the stenotic model having measurements of the vasculature at one or more locations along vessels of the vasculature. The method, in some embodiments, further comprises obtaining a flow characteristic of the stenotic model, and calculating an index indicative of vascular function, based, at least in part, on the flow characteristic in the stenotic model.

Abstract: An automated measurement device and method for coronary artery disease scoring is disclosed. An example device includes a processor configured to obtain a computerized model of a plurality of vascular segments of a patient and create an unstenosed computerized model from the computerized model by virtually enlarging at least some locations of the vascular segments of the computerized model. The processor also determines vascular state scoring tool (“VSST”) scores based on characteristics of vascular locations along the vascular segments. The processor further determines a severity of stenosis for the vascular locations based on comparisons of first blood flow parameter values at the vascular locations in the computerized model to corresponding second blood flow parameter values at the same vascular locations in the unstenosed computerized model. A user interface of the device displays the severity of stenosis in conjunction with the VSST scores for the vascular locations.

Abstract: Methods and systems for manually assisted definition of vascular features are described. In some embodiments, a method provides for editing of vascular paths by enabling a user to drag an erroneously segmented region of a selected vascular path into alignment with a more correctly segmented position that is depicted as a blood vessel in a vascular image. The method may use an energy function, defined as a function of position along the segmentation of the selected blood vessel, to determine how a vascular path is to be moved based on dragging motions provided by the user. In some instances, non-zero regions of the energy function are set based on the position of the selected region.

Abstract: Automated image analysis used in vascular state modeling. Coronary vasculature in particular is modeled in some embodiments. Methods of “virtual revascularization” of a presently stenotic vasculature are described; useful, for example, as a reference in disease state determinations. Structure and uses of a model which relates records comprising acquired images or other structured data to a vascular tree representation are described.

Abstract: A method for real-time vascular modeling and assessment is disclosed. Modeling, in some embodiments, comprises receiving a plurality of 2-D angiographic images of a portion of a vasculature of a subject, and processing the images to automatically detect 2-D features, for example, paths along vascular extents, which are projected into 3-D to determine homologous features among blood vessels and construct 3-D vascular extents and determine other vascular characteristics. Assessment, in some embodiments, comprises processing models selectively different from one another to produce one or more vascular indexes which indicate a diagnostic preference, for example, to perform a medical intervention such as a stent implantation. Speed is achieved, for example, by the method being optimized for determining the effects of a medical intervention. In some embodiments, results are produced quickly enough to allow use of the method to perform PCI within the same catheterization used to perform diagnostic imaging.

Abstract: Systems and methods are described for the compositing together of model-linked vascular data from a plurality of sources, including at least one 2-D angiography image, for display in a frame of reference of the at least one angiography image. In some embodiments, a linking model comprises a data structure configured to link locations of angiographic images to corresponding elements of non-image vascular parameter data. The linking data structure is traversed to obtain a mapping to the frame of reference of one or more of the angiographic images.

Abstract: Methods of and systems for reconstructing a vascular tree shape from vascular segments imaged in a single source 2-D projection image are described. A structuring shape comprising spatial positions of reference anatomical elements is defined, such as vascular segments in the definition of a 3-D surface model corresponding to a surface defined by an anatomical structure such as a body organ (e.g., heart). The 3-D surface model is used to create a 3-D model of anatomical elements (e.g., additional vascular segments of a cardiac vasculature) imaged in a source 2-D projection image, by back-projection to the 3-D surface model. The 3-D surface model is optionally aligned by first aligning the source 2-D projection image to the structuring shape. In some embodiments, the source 2-D projection image is registered to the 3-D surface model through the structuring shape by the source image's initial use in defining the structuring shape.