Quantitative Cardiovascular Image Analysis: Current Status and what are Realistic Expectations for the Future?

Cardiology is typically an image oriented specialty. Single still images, but much more so dynamic and increasingly three-dimensional image sequences, play a major role in clinical decision making and clinical research trials. Of major interest is always the state of the coronary arteries and of the left ventricular function. In this chapter an overview is given of the various quantitative approaches using automated edge detection techniques which have been developed in our departments to: 1) assess the severity of disease of coronary obstructions from x-ray arteriography and intravascular ultrasound; and 2) assess the global and regional left ventricular function from x-ray angiography, echocardiography and magnetic resonance (MR) imaging. Also, the possibilities of MR flow velocity mapping are presented. In addition, for each modality and application a short description is given of the future developments and expectations. Finally, it is recognized that the automated combination of the data from the different imaging modalities (i.e. image fusion) will be a topic of major research in the future. As a current and practical example, the image fusion of biplane x-ray arteriography and 3D intravascular ultrasound is discussed.