1 CLINICAL RESEARCH EuroIntervention 2014;10-online publish-ahead-of-print June 2014 DOI: 10.4244/EIJY14M06_11 © Europa Digital & Publishing 2014. All rights reserved. *Corresponding author: Department of Cardiology, Medical School, University of Ioannina, PO Box 1186, GR 451 10 Ioannina, Greece. E-mail: lmihalis@cc.uoi.gr Anatomically correct three-dimensional coronary artery reconstruction using frequency domain optical coherence tomographic and angiographic data: head-to-head comparison with intravascular ultrasound for endothelial shear stress assessment in humans Michail I. Papafaklis 1,2 , MD, PhD; Christos V. Bourantas 3 , MD, PhD; Taishi Yonetsu 4 , MD; Rocco Vergallo 4 , MD; Anna Kotsia 2 , MD; Shimpei Nakatani 3 , MD; Lampros S. Lakkas 2 , MD; Lambros S. Athanasiou 5 , BSc; Katerina K. Naka 2 , MD, PhD; Dimitrios I. Fotiadis 5 , PhD; Charles L. Feldman 1 , ScD; Peter H. Stone 1 , MD; Patrick W. Serruys 3 , MD, PhD; Ik-Kyung Jang 4 , MD, PhD; Lampros K. Michalis 2 *, MD, MRCP 1. Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 2. Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece; 3. Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands; 4. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 5. Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece M.I. Papafaklis and C.V. Bourantas contributed equally to this manuscript. GUEST EDITOR: Peter Barlis, MBBS, MPH, PhD, FCSANZ, FACC, FRSA, FRACP, FESC; Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia Abstract Aims: To develop a methodology that permits accurate 3-dimensional (3D) reconstruction from FD-OCT and angiographic data enabling reliable evaluation of the ESS distribution, and to compare the FD-OCT-derived models against the established models based on angiography/IVUS. Methods and results: Fifteen patients (17 coronary arteries) who underwent angiography, FD-OCT and IVUS examination during the same procedure were studied. The FD-OCT and IVUS lumen borders were placed onto the 3D luminal centreline derived from angiographic data. Three-dimensional geometry algo- rithms and anatomical landmarks were used to estimate the orientation of the borders appropriately. ESS was calculated using computational fluid dynamics. In 188 corresponding consecutive 3-mm segments, FD-OCT- and IVUS-derived models were highly correlated for lumen area (r=0.96) and local ESS (r=0.89) measure- ments. FD-OCT-based 3D reconstructions had a high diagnostic accuracy for detecting regions exposed to proatherogenic low ESS identified on the IVUS-based 3D models, considered as the gold standard (receiver operator characteristic area under the curve: 94.9%). Conclusions: FD-OCT-based 3D coronary reconstruction provides anatomically correct models and permits reliable ESS computation. ESS assessment in combination with the superior definition of plaque character- istics by FD-OCT is expected to provide valuable insights into the effect of the haemodynamic environment on the development and destabilisation of high-risk plaques. KEYWORDS • angiography • endothelial shear stress • intravascular ultrasound • optical coherence tomography • three-dimensional reconstruction