Document Detail

Centerline tracking for quantification of reverse structural remodeling of the pulmonary veins following cardiac ablation therapy.
MedLine Citation:
PMID:  22889735     Owner:  NLM     Status:  MEDLINE    
RATIONALE AND OBJECTIVES: Patients with atrial fibrillation undergo structural remodeling resulting in increased pulmonary vein sizes. Studies have demonstrated that these changes are reversible following successful ablation therapy. To date, analyses of pulmonary vein structure have focused on measurements at the pulmonary vein ostia, and the full extent of reverse remodeling along the length of the pulmonary veins has not yet been fully characterized.
MATERIALS AND METHODS: An automated, three-dimensional method is proposed that quantifies pulmonary vein geometry starting at the ostia and extending several centimeters into the veins. A centerline is tracked along the length of the pulmonary vein, and orthogonal planes are computed along the curve. The method was validated against manual measurements on each of the four pulmonary veins for 10 subjects. The proposed methodology was used to analyze the pulmonary veins in 21 patients undergoing cardiac ablation therapy with preoperative and postoperative computed tomographic scans.
RESULTS: Validation results demonstrated that the automated measurements closely followed the manual measurements, with an overall mean difference of 11.50 mm(2). Significant differences in cross-sectional area at the two time points were observed at all pulmonary vein ostia and extending for 2.0 cm (excluding the 0.5-cm interval) into the left inferior pulmonary vein, 3.5 cm into the left superior pulmonary vein, and 2.0 cm into the right superior pulmonary vein.
CONCLUSIONS: Quantitative analysis along the length of the pulmonary veins can be accomplished using centerline tracking and measurements from orthogonal planes along the curve. The patient study demonstrated that reverse structural remodeling following ablation therapy occurs not only at the ostia but for several centimeters extending into the pulmonary veins.
Maryam E Rettmann; Mia S Gunawan; David R Holmes; Jerome F Breen; Douglas L Packer; Richard A Robb;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-08-11
Journal Detail:
Title:  Academic radiology     Volume:  19     ISSN:  1878-4046     ISO Abbreviation:  Acad Radiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-02     Completed Date:  2013-03-18     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  9440159     Medline TA:  Acad Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1332-44     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.
Biomedical Imaging Resource, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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MeSH Terms
Atrial Fibrillation / radiography*,  surgery*
Heart Conduction System / radiography,  surgery
Imaging, Three-Dimensional / methods
Pattern Recognition, Automated / methods*
Pulmonary Veins / radiography*,  surgery*
Radiographic Image Enhancement / methods
Radiographic Image Interpretation, Computer-Assisted / methods*
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Grant Support
Tristram Bahnson / ; Steven Bailin / ; Anil Bhandari / ; John Day / ; John Hummel / ; Neil Kay / ; Kerry Lee / ; Douglas Packer / ; David Wilber /

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