INTRAVASCULAR IMAGING (U LANDMESSER, SECTION EDITOR) Three-Dimensional Fourier-Domain Optical Coherence Tomography Imaging: Advantages and Future Development Daniel Chamié & David Prabhu & Zhao Wang & Hiram Bezerra & Andrejs Erglis & David L. Wilson & Andrew M. Rollins & Marco A. Costa Published online: 3 June 2012 # Springer Science+Business Media, LLC 2012 Abstract Traditionally, intravascular imaging methods dis- play the coronary anatomy in two dimensions, through a series of consecutive cross-sectional tomographic images. The physician is then required to mentally reassemble these images in order to visualize the vascular anatomy and all its complex interactions. The ability to depict the vascular structure with its actual spatial appearance, in three dimen- sions, is a powerful way to provide an easy, objective, and comprehensive overview of its complex and dynamic anat- omy. However, three-dimensional (3D) application of intra- vascular imaging has been plagued by lack of enough resolution, frequent presence of imaging and motion arti- facts and need for extensive image post-processing. Fourier- Domain OCT (FD-OCT) allows high-resolution (10– 15 μm) visualization of the intracoronary environment with faster pullback speeds and image acquisition rates in com- parison to IVUS and the previous generation time-domain OCT. These features have recently attracted attention to the potential of FD-OCT in generating high-quality 3D images of intravascular anatomies, with lesser artifacts. The present manuscript discusses the current status and some potential clinical applications of 3D FD-OCT imaging. Some techni- cal aspects, limitations, and future perspectives are also briefly discussed. Keywords 3-dimensional . FD-OCT . Intravascular imaging . Bifurcation . Fibrous cap . Stent fracture Introduction Intravascular imaging methods such as intravascular ultra- sound (IVUS) and more recently optical coherence tomog- raphy (OCT) have highly contributed to our understanding of atherosclerosis and the pathophysiology of coronary ar- tery disease as well as to the advancement of interventional techniques and devices. However, these imaging modalities display the coronary anatomy in two dimensions, through a series of consecutive cross-sectional tomographic images. The physician is then required to mentally reassemble these images in order to visualize the vascular anatomy and all its complex interactions, a process that may be highly influ- enced by subjectivity and level of experience of the observer with the imaging method. The ability to depict the vascular structure with its actual spatial appearance, in three dimensions, is a powerful way to provide an easy, objective, and compre- hensive overview of its complex and dynamic anatomy. Previous works with three-dimensional (3D) reconstruc- tions of IVUS images have been plagued by the frequent presence of imaging artifacts, limited axial resolution and need of extensive post-processing of two-dimensional (2D) cross-sectional images, preventing its widespread clinical application [1, 2]. Intravascular OCT’s unrivalled axial resolution (10– 15 μm) coupled with faster Fourier-Domain OCT (FD- D. Chamié : H. Bezerra : M. A. Costa (*) Division of Cardiology, Harrington Heart & Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve School of Medicine, 11,100 Euclid Avenue, Lakeside 3001, Cleveland, OH 44106, USA e-mail: marco.costa@uhhospitals.org D. Prabhu : Z. Wang : D. L. Wilson : A. M. Rollins Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA A. Erglis Latvian Center of Cardiology, Paul Stradins Clinical Hospital, Riga, Latvia Curr Cardiovasc Imaging Rep (2012) 5:221–230 DOI 10.1007/s12410-012-9145-5