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International Archives of Photogrammetry and Remote Sensing. Vol. XXXII, Part 5. Hakodate 1998 
3-D CAROTID ARTERY RECONSTRUCTION FROM DUS IMAGES 
KISKINIS D. 9, P. PATIASO , 
A. MEGALOPOULOS 9, E. KOSTOPOULOU , C. GYMNOPOULOS 9), 
V. TSIOUKAS ), D. GEMENTZIS ‘’, A. KOUSOULAKOU ), A. STYLIADIS €? 
(0. Department of Cadastre, Photogrammetry and Cartography, The Aristotle University of Thessaloniki, Greece 
) Department of Vascular Surgery, The Aristotle University of Thessaloniki, Greece 
@ Department of Information Technology, Technological Educational Institute, Thessaloniki, Greece 
(9 Department of Pathology, HIPPOKRATEION General Peripheral Hospital of Thessaloniki, Greece 
©) Department of Neurology, AHEPA General Hospital, Greece 
E-mail: patias@topo.auth.gr 
Commission V, Working Group V/4 
KEY WORDS : 3-D artery reconstruction, medical imaging, CAD modeling 
ABSTRACT : 
Ultrasonographic techniques have long been employed in noninvasive diagnosis of carotid disease. DUS and other 
noninvasive imaging modalities, however, provide only 2-D information regarding the arterial pathology. This 
research concerns the feasibility of non-invasive, photogrammetric and 3-D modelling techniques to form a novel 
tool for the diagnosis and treatment of carotid artery disease. This tool is based on pre- and post-operative DUS 
images as well as on post-operative atherosclerotic plaque specimen. The preliminary results indicate that 
photogrammetric processing of DUS images can lead to modeling, calculations and measurements with excellent 
data accuracy, since the difference is estimated stenosis is only 0.9%. 
1. INTRODUCTION 
Each year more than 300.000 Europeans suffer an 
ischemic stroke. Carotid artery disease is thought to 
contribute 10-15% of new stroke cases each year. 
Ultrasonographic techniques have long been employed in 
noninvasive diagnosis of carotid disease and by now have 
a significant contribution in the safe and cost effective 
identification patients that are potential candidates for 
surgical treatment of severe carotid stenosis. DUS and 
other either invasive or noninvasive imaging modalities 
provide 2-D information regarding the arterial pathology. 
However, intravascular atheromatous pathology is 
certainly a process that is evolving in space, i.e., is a 3- 
dimensional process. Atherosclerotic plaque is an 
abnormal formation that obviously has some volume and 
alters the geometry of the blood vessel lumen in a more 
complex way, rather than just reducing its diameter. 
Across this line of thinking, there are numerous 
parameters inherent to this 3-D approach, that have in 
general been understudied and have the potential to better 
delineate the actual pathologic process and probably 
contribute significant prognostic information regarding a 
more efficacious identification of patients at high risk for 
stroke that will be amenable to surgical intervention. 
2. RESEARCH OBJECTIVE 
Stroke is currently recognized as the third most common 
cause of mortality and the leading cause of disability 
among the developed Western countries. Almost 80% of 
stroke victims are affected by ischemic stroke, which is 
often etiologically related to atherosclerotic disease of the 
carotid arteries. Since attempts to treat ischemic stroke 
have in general been unsuccessful, prevention remains the 
most important means of reducing the dreadful impact of 
stroke on society. 
Over the past five years various well designed and 
conducted studies have conclusively shown that carotid 
endarterectomy (CEA) can be an effective stroke 
preventive modality for selected symptomatic and 
asymptomatic patients with carotid disease. In all these 
studies tightness of carotid stenosis has emerged as the 
most important determinant of the necessity and the 
relative efficacy of the procedure. 
Cerebral angiography has traditionally been considered 
the golden standard technique for the estimation of the 
degree of carotid stenosis although different criteria for 
the determination of its severity were used. However, 
cerebral angiography is an invasive and costly procedure 
which carries a risk for major morbidity and mortality 
that even in experienced hands cannot be reduced below 
1-2%.(Hankey, et.al., 1990) Furthermore, by focusing on 
severity of carotid stenosis as the sole predictor of 
impending ipsilateral stroke, a broader high risk group of 
patients is identified and patients that will never 
experience a stroke are included in it. This is especially 
true for asymptomatic severe carotid stenosis patients 
most of which will have an indolent clinical course. 
Consequently, finer and perhaps qualitative selection 
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