3D reconstruction of coronary anatomy using invasive imaging modalities: Methods, applications and challenges

Coronary artery disease (CAD) is the most common cause of death in the developed world. To reduce cardiac morbidity and mortality an effort was made over the last 30 years to develop new invasive diagnostic techniques, which would permit more accurate evaluation of luminal dimensions and quantification of atheroma burden. However, a significant limitation of these approaches is the two dimensional representation of vessel morphology and pathology which does not allow detailed assessment of coronary geometry and complete evaluation of the severity and complexity of a lesion. To address these limitations several methodologies have been developed for the three dimensional (3D) reconstruction of coronary anatomy. These approaches relied either on one imaging technique (i.e., coronary angiography, intravascular ultrasound, optical coherence tomography) or on the combination of different modalities. In this review chapter we describe the available 3D reconstruction approaches; we analyze the advantages and the limitations of each technique, and discuss their potential value in clinical practice and in the study of atherosclerosis.