3D roadmap in neuroangiography: technique and clinical interest

Abstract

We present the first clinical results obtained with a novel technique: the three-dimensional [3D] roadmap. The major difference from the standard 2D digital roadmap technique is that the newly developed 3D roadmap is based on a rotational angiography acquisition technique with the two-dimensional [2D] fluoroscopic image as an overlay. Data required for an accurate superimposition of the previously acquired 3D reconstructed image on the interactively made 2D fluoroscopy image, in real time, are stored in the 3D workstation and constitute the calibration dataset. Both datasets are spatially aligned in real time; thus, the 3D image is accurately superimposed on the 2D fluoroscopic image regardless of any change in C-arm position or magnification. The principal advantage of the described roadmap method is that one contrast injection allows the C-arm to be positioned anywhere in the space and allows alterations in the distance between the x-ray tube and the image intensifier as well as changes in image magnification. In the clinical setting, the 3D roadmap facilitated intravascular neuronavigation with concurrent reduction of procedure time and use of contrast medium.

Real-time respiratory motion tracking: roadmap correction for hepatic artery catheterizations

“…The projection of 3D roadmaps onto 2D fluoroscopy has been already proposed for neuroradiology. 1,2 Studies for clinical evaluation of this method verify the reduction of the injected contrast agent and the procedure time. 1 In liver catheterizations, however, the catheter is mostly displayed outside of the vasculature (Fig.…”

Endovascular Methods for Stem Cell Transplantation

“…Endovascular treatments are continuously providing a third option to open surgical or percutaneous approaches. From the establishment of the Seldinger technique (Seldinger 1953) and the first use of digital subtraction angiography (DSA) (Meaney et al 1980) to the modern interventional lab with 3D road maps (Soderman et al 2005) and CT like capacities of the C-arm (Soderman et al 2008) the path has been long but rapidly progressing. The driving force up until today, that has made the leap ward style of improvements possible, is both rapid developments in computational power and material sciences.…”

Advances in Interventional Neuroimaging

“…2). 2 Therefore, this 3D road map technique has the advantage by using a single injection of contrast medium for the 3D rotational angiogram in which a 3D reconstructed image is superimposed onto the real time 2D fluoroscopic image that allows for free positioning of the C-arm and alterations in the distance between the X-ray tube and the image intensifier. This also allows for changes in image magnification without loss of the 3D vessel road map.…”

“…This also allows for changes in image magnification without loss of the 3D vessel road map. 2 The other clinical application of this 3D road map technique is that intracranial procedures (e.g., coil embolization of cerebral aneurysms routinely performed with biplane digital subtraction angiography) can be performed using a single plane digital subtraction angiography system with this 3D road map capability. 2 The main limitation of this technique for the accurate superimposition of the 3D reconstructed image on the 2D fluoroscopic image is that the patient's head must remain still, which often requires the patient to be under general anesthesia to avoid motion artifact.…”