# A novel framework for fully automated co-registration of intravascular ultrasound and optical coherence tomography imaging data

**Authors:** Xingwei He, Kit Mills Bransby, Ahmet Emir Ulutas, Thamil Kumaran, Nathan Angelo Lecaros Yap, Gonul Zeren, Hesong Zeng, Yao-Jun Zhang, Ryota Kakizaki, Yasushi Ueki, Jonas Häner, George C M Siontis, Sylvain Losdat, Andreas Baumbach, James Moon, Anthony Mathur, Ryo Torii, Jouke Dijkstra, Qianni Zhang, Lorenz Räber, Christos V Bourantas

PMC · DOI: 10.1093/ehjdh/ztag007 · European Heart Journal. Digital Health · 2026-01-16

## TL;DR

A deep-learning framework automates the alignment of two heart imaging techniques with accuracy and speed comparable to experts.

## Contribution

A novel deep-learning framework for fully automated co-registration of IVUS and OCT imaging data is introduced.

## Key findings

- The DL framework achieved high concordance with experts for longitudinal and circumferential co-registration.
- The Williams Index showed performance comparable to analysts for both alignment types.
- The DL pipeline processed vessel imaging data in under 90 seconds.

## Abstract

To develop a deep-learning (DL) framework that enables fully automated longitudinal and circumferential co-registration of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) images.

Data from 230 patients (714 vessels) with acute myocardial infarction that underwent near-infrared spectroscopy IVUS and OCT imaging in their non-infarct related vessels were analysed. Experts annotated the lumen borders (61 655 IVUS and 62 334 OCT frames), the side branches and the calcific tissue (10 000 IVUS and 10 000 OCT frames each). This information was used to train DL models that extracted these features that were then used by a dynamic time warping algorithm to co-registered longitudinally the IVUS and OCT images. The circumferential registration of IVUS and OCT was performed through a rotation cost matrix and dynamic programming. On a test set of 22 patients (77 vessels), the DL method showed high concordance with the expert analysts for the longitudinal and circumferential co-registration of the two datasets (concordance correlation coefficient >0.99 and >0.90, respectively). The Williams Index was 0.96 for longitudinal and 0.97 for circumferential alignment, indicating a comparable performance of the proposed framework to the analysts. The time needed for the DL pipeline to process imaging data from a vessel was <90 s.

A fully automated, DL-based framework for IVUS–OCT co-registration demonstrated both speed and accuracy, with performance comparable to that of expert analysts. These features enable its application in research using large-scale data incorporating multimodality imaging.

Graphical Abstract

## Linked entities

- **Diseases:** acute myocardial infarction (MONDO:0004781)

## Full-text entities

- **Diseases:** calcification (MESH:D002114), DL (MESH:D007859), thrombus (MESH:D013927), atherosclerosis (MESH:D050197), Ischemic Cardiovascular Disease (MESH:D002318), AMI (MESH:D009203), infarct (MESH:D007238), coronary artery disease (MESH:D003324), necrotic (MESH:D009336), tissue (MESH:D017695)
- **Chemicals:** alirocumab (MESH:C571059), SZ202401 (-), nitroglycerin (MESH:D005996), lipid (MESH:D008055), calcium (MESH:D002118)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12933311/full.md

## References

38 references — full list in the complete paper: https://tomesphere.com/paper/PMC12933311/full.md

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Source: https://tomesphere.com/paper/PMC12933311