Novel System for Real-Time Integration of 3-D Echocardiography and Fluoroscopy for Image-Guided Cardiac Interventions: Preclinical Validation and Clinical Feasibility Evaluation

Arujuna, Aruna and Housden, R.James and Ma, YingLiang and Rajani, Ronak and Gao, Gang and Nijhof, Niels and Cathier, Pascal and Bullens, Roland and Gijsbers, Geert and Parish, Victoria and Kapetanakis, Stamatis and Hancock, Jane and Rinaldi, C.Aldo and Cooklin, Michael and Gill, Jawinder and Thomas, Martyn and O'Neill, Mark and Razavi, Reza and Rhode, Kawal (2014) Novel System for Real-Time Integration of 3-D Echocardiography and Fluoroscopy for Image-Guided Cardiac Interventions: Preclinical Validation and Clinical Feasibility Evaluation. IEEE Journal of Translational Engineering in Health and Medicine, 2. ISSN 2168-2372

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Abstract

Real-time imaging is required to guide minimally invasive catheter-based cardiac interventions. While transesophageal echocardiography allows for high-quality visualization of cardiac anatomy, X-ray fl�uoroscopy provides excellent visualization of devices. We have developed a novel image fusion system that allows real-time integration of 3-D echocardiography and the X-ray fl�uoroscopy. The system was validated in the following two stages: 1) preclinical to determine function and validate accuracy; and 2) in the clinical setting to assess clinical work�flow feasibility and determine overall system accuracy. In the preclinical phase, the system was assessed using both phantom and porcine experimental studies. Median 2-D projection errors of 4.5 and 3.3 mm were found for the phantom and porcine studies, respectively. The clinical phase focused on extending the use of the system to interventions in patients undergoing either atrial �brillation catheter ablation (CA) or transcatheter aortic valve implantation (TAVI). Eleven patients were studied with nine in the CA group and two in the TAVI group. Successful real-time view synchronization was achieved in all cases with a calculated median distance error of 2.2 mm in the CA group and 3.4 mm in the TAVI group. A standard clinical workfl�ow was established using the image fusion system. These pilot data confi�rm the technical feasibility of accurate real-time echo-�fluoroscopic image overlay in clinical practice, which may be a useful adjunct for real-time guidance during interventional cardiac procedures.

Item Type:	Article
Identification Number:	10.1109/JTEHM.2014.2303799
Dates:	Date Event 2014 Published
Uncontrolled Keywords:	cardiac interventional guidance, image fusion, X-ray fl�uoroscopy, 3D ultrasound, clinical evaluation.
Subjects:	CAH02 - subjects allied to medicine > CAH02-05 - medical sciences > CAH02-05-01 - medical technology CAH11 - computing > CAH11-01 - computing > CAH11-01-01 - computer science
Divisions:	Faculty of Computing, Engineering and the Built Environment Faculty of Computing, Engineering and the Built Environment > College of Computing
Depositing User:	Ian Mcdonald
Date Deposited:	06 Feb 2017 15:30
Last Modified:	22 Mar 2023 12:02
URI:	https://www.open-access.bcu.ac.uk/id/eprint/3863