Application of XMR 2D-3D Registration to Cardiac Interventional Guidance

Rhode, Kawal; Hill, Derek L. G.; Edwards, Philip; Hipwell, John H.; Rueckert, Daniel; Sanchez-Ortiz, Gerardo I.; Hegde, Sanjeet; Rahunathan, Vithuran; Razavi, Reza

doi:10.1007/978-3-540-39899-8_37

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…We have previously described the validation of a novel XMR registration technique [12][13] that is applicable to the sliding table XMR configuration. A registration technique has also been described for fixed table configuration [14].…”

Section: Xmr Registration Techniquementioning

confidence: 99%

“…The strategy of our approach is to perform the procedure using x-ray guidance with pre-and post-procedure MR imaging to determine patient cardiac anatomy and wall motion. Using an XMR registration technique that we have previously developed [12][13], we aimed to combine the MR images with the x-ray images to provide an integrated representation of the patient that can be used for interventional guidance. Furthermore, we aimed to simulate myocardial electrical depolarisation and contraction using electromechanical models of the myocardium and our integrated representation of the patient anatomical, electrical, and motion data.…”

Section: Aimsmentioning

confidence: 99%

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XMR guided cardiac electrophysiology study and radio frequency ablation

et al. 2004

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Introduction: XMR systems are a new type of interventional facility in which patients can be rapidly transferred between x-ray and MR systems on a floating table. We have previously developed a technique to register MR and x-ray images obtained from such systems. We are carrying out a programme of XMR guided cardiac electrophysiology study (EPS) and radio frequency ablation (RFA). Aim: The aim of our work was to apply our registration technology to XMR guided EPS/RFA in order to integrate anatomical, electrophysiological and motion information. This would assist in guidance and allow us to validate and refine electromechanical models. Method: Registration of the imaging modalities was achieved by a combination of system calibration and real-time optical tracking. Patients were initially imaged using MR imaging. An SSFP volume scan of the heart was acquired for anatomical information, followed by tagged scans for motion information. The patients were then transferred to the x-ray system. Tracked biplane x-ray images were acquired while electrical measurements were made from catheters placed in the heart. The relationship between the MR and x-ray images was determined. The MR volume scan of the heart was segmented and the tagged scans were analysed using a nonrigid registration algorithm to compute motion. The position of catheters was reconstructed within the MR cardiac anatomy. The anatomical, electrophysiological, and motion information were displayed in the same coordinate system. Simulations of electrical depolarisation and contraction were performed using electromechanical models of the myocardium. Results: We present results for 2 initial cases. For patient 1, a contact mapping system was used for the EPS and for patient 2, a noncontact mapping system was used. Conclusions: Our XMR registration technique allows the integration of anatomical, electrophysiological, and motion information for patients undergoing EPS/RFA. This integrated approach has assisted in interventional guidance and has been used to validate electromechanical models of the myocardium.

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Section: Xmr Registration Techniquementioning

confidence: 99%

Section: Aimsmentioning

confidence: 99%

XMR guided cardiac electrophysiology study and radio frequency ablation

et al. 2004

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A system for real-time XMR guided cardiovascular intervention

Rhode

Sermesant

Brogan

et al. 2005

IEEE Trans. Med. Imaging

157

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The hybrid magnetic resonance (MR)/X-ray suite (XMR) is a recently introduced imaging solution that provides new possibilities for guidance of cardiovascular catheterization procedures. We have previously described and validated a technique based on optical tracking to register MR and X-ray images obtained from the sliding table XMR configuration. The aim of our recent work was to extend our technique by providing an improved calibration stage, real-time guidance during cardiovascular catheterization procedures, and further off-line analysis for mapping cardiac electrical data to patient anatomy. Specially designed optical trackers and a dedicated calibration object have resulted in a single calibration step that can be efficiently checked and updated before each procedure. An X-ray distortion model has been implemented that allows for distortion correction for arbitrary c-arm orientations. During procedures, the guidance system provides a real-time combined MR/X-ray image display consisting of live X-ray images with registered recently acquired MR derived anatomy. It is also possible to reconstruct the location of catheters seen during X-ray imaging in the MR derived patient anatomy. We have applied our registration technique to 13 cardiovascular catheterization procedures. Our system has been used for the real-time guidance of ten radiofrequency ablations and one aortic stent implantation. We demonstrate the real-time guidance using two exemplar cases. In a further two cases we show how off-line analysis of registered image data, acquired during electrophysiology study procedures, has been used to map cardiac electrical measurements to patient anatomy for two different types of mapping catheters. The cardiologists that have used the guidance system suggest that real-time XMR guidance could have substantial value in difficult interventional and electrophysiological procedures, potentially reducing procedure time and delivered radiation dose. Also, the ability to map measured electrical data to patient specific anatomy provides improved visualization and a path to investigation of cardiac electromechanical models.

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Application of XMR 2D-3D Registration to Cardiac Interventional Guidance

Cited by 2 publications

References 8 publications

XMR guided cardiac electrophysiology study and radio frequency ablation

XMR guided cardiac electrophysiology study and radio frequency ablation

A system for real-time XMR guided cardiovascular intervention

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