Fusion imaging of computed tomography and 3D echocardiography: Combined assessment of coronary anatomy and myocardial function

Cardiac multimodality imaging offers new opportunities to display composite information not available with any of the imaging modalities alone. We tested the feasibility of fusion of coronary anatomy and left ventricular (LV) function obtained from computed tomography coronary angiography (CTCA) and 3D echocardiography (3DE). Twenty-four patients underwent CTCA and transthoracic 3DE imaging on the same day. CTCA images were processed using custom software to extract the coronary tree. LV endocardial surfaces were obtained from 3DE and co-registered with the coronary tree using a rigid transformation. Three patients (12%) were excluded because of suboptimal CTCA quality. The composite display of coronary arteries and parametric images of regional LV function allowed visual appreciation of the LV functional abnormality secondary to the stenosis when present. Fusion of CT coronary angiography and parametric imaging of LV regional function derived from 3DE is feasible, potentially providing physiologically meaningful and easy-to-interpret combined display of coronary abnormalities and their functional impact.