Real-time visualization of coronary interventions using VRML

Medical visualization is a rapidly developing field with many application areas spanning from visualization of anatomy to surgery planning, to understanding of disease processes. With increasing computer speed, medical visualization is becoming more real-time. In this paper, we present a novel application of real-time three-dimensional visualization of coronary arteries during catheter interventions that combines image information from two complementary sources: biplane X-ray contrast angiography and intravascular ultrasound (IVUS). After identification of the three-dimensional characteristics of the intravascular ultrasound pullback sequence, vessel geometry and vessel wall images are combined into a single visualization using semi-automated analysis of a corresponding pair of biplane angiography images. Visualization data are represented using the Virtual Reality Modeling Language (VRML), the code for which is automatically generated by our angiography/IVUS image processing and analysis software system. Selection of the VRML approach facilitates real-time 3-D visualization with an ability of over-the-network image processing and dissemination of results. The visualization specifics are easily modifiable in near real time to consider the immediate requirements of the end-user, the cardiologist who performs the coronary intervention.