Document Detail


Registration of three-dimensional left atrial computed tomographic images with projection images obtained using fluoroscopy.
MedLine Citation:
PMID:  16344405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Anatomic structures such as the left atrium and the pulmonary veins (PVs) are not delineated by fluoroscopy because there is no contrast differentiation between them and the surrounding anatomy. Representation of an anatomic structure via a 3D model obtained from computed tomography (CT) imaging and subsequent projection of these images over the fluoroscopy system may help in navigation of the mapping and ablation catheter to the appropriate sites during electrophysiology procedures. METHODS AND RESULTS: In this feasibility study, in vitro experiments were performed with a plastic heart model (phantom) with 2 catheters or radiopaque platinum beads placed in the phantom at the time of CT imaging and fluoroscopy. Subsequently, 20 consecutive patients underwent contrast-enhanced, ECG-gated CT scanning. Left atrial volumes were generated from the reconstructed data at &75% of the R-R interval during the cardiac cycle. Similarly, the superior vena cava and the coronary sinus were also reconstructed from these images. During the electrophysiology procedure, digital records (cine sequences) were obtained. Using predetermined algorithms, both the phantom model and the patients' 3D left atrial models derived from the CT were registered with projection images of fluoroscopy. Registration was performed with a transformation that linked the superior vena cava and the coronary sinus from the CT model with a catheter placed inside the coronary sinus via the superior vena cava. Registration was successfully accomplished with the plastic phantom and in all 20 patients. Registration accuracy was assessed in the phantom by assessing the overlapping beads seen both in the CT and the fluoroscopy images. The mean registration error was 1.4 mm (range 0.9 to 2.3 mm). Accuracy of the registered images was assessed in patients with recordings from a basket catheter placed sequentially in the superior PVs and by injecting contrast into the PVs to assess overlapping of contrast-filled PVs with the corresponding vessels on the registered images. The images could be calibrated quite accurately. Any rotational error, which was usually minor, could be corrected by rotating the images as needed. CONCLUSIONS: Registration of 3D models of the left atrium and PVs with fluoroscopic images of the same is feasible and could enable appropriate navigation and localization of the mapping and ablation catheter during procedures such as atrial fibrillation ablation.
Authors:
Jasbir Sra; David Krum; Angela Malloy; Melissa Vass; Barry Belanger; Elisabeth Soubelet; Regis Vaillant; Masood Akhtar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  112     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-13     Completed Date:  2006-02-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3763-8     Citation Subset:  AIM; IM    
Affiliation:
Electrophysiology Laboratories, St. Luke's and Aurora Sinai Medical Centers, University of Wisconsin Medical School-Milwaukee Clinical Campus, Milwaukee, WI, USA. bdanek@hrtcare.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Contrast Media
Diagnostic Imaging / methods*
Electrocardiography
Electrophysiologic Techniques, Cardiac
Feasibility Studies
Fluoroscopy / methods
Heart Atria / anatomy & histology*
Heart Catheterization / methods
Humans
Image Interpretation, Computer-Assisted / methods
Imaging, Three-Dimensional / methods
Male
Middle Aged
Models, Cardiovascular*
Phantoms, Imaging
Tomography, X-Ray Computed / methods
Chemical
Reg. No./Substance:
0/Contrast Media
Comments/Corrections
Comment In:
Circulation. 2005 Dec 13;112(24):3677-9   [PMID:  16344399 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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