Novel Three-Dimensional Image Fusion Software to Facilitate Guidance of Complex Cardiac Catheterization

Góreczny, Sebastian; Dryżek, Paweł; Morgan, Gareth J.; Łukaszewski, Maciej; Moll, Jadwiga; Moszura, Tomasz

doi:10.1007/s00246-017-1627-4

Cited by 44 publications

(29 citation statements)

References 18 publications

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“…For infants and children with complex congenital heart disease, every effort is taken to reduce the risks associated with anesthesia induction and therefore the strategy of combined CMR followed by cardiac catheterization under a single sedation procedure is appealing. For the purposes of this study, patients with previous CMR studies had a repeat CMR on the day of the procedure to create the XFM overlay but in many cases adequate XFM overlay can be created from clinically indicated CMR scans acquired before the day of the procedure …”

Section: Discussionmentioning

confidence: 99%

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X‐ray fused with MRI guidance of pre‐selected transcatheter congenital heart disease interventions

Grant

Kanter

Olivieri

et al. 2019

Cathet Cardio Intervent

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Objectives To determine whether X‐ray fused with MRI (XFM) is beneficial for select transcatheter congenital heart disease interventions. Background Complex transcatheter interventions often require three‐dimensional (3D) soft tissue imaging guidance. Fusion imaging with live X‐ray fluoroscopy can potentially improve and simplify procedures. Methods Patients referred for select congenital heart disease interventions were prospectively enrolled. Cardiac MRI data was overlaid on live fluoroscopy for procedural guidance. Likert scale operator assessments of value were recorded. Fluoroscopy time, radiation exposure, contrast dose, and procedure time were compared to matched cases from our institutional experience. Results Forty‐six patients were enrolled. Pre‐catheterization, same day cardiac MRI findings indicated intervention should be deferred in nine patients. XFM‐guided cardiac catheterization was performed in 37 (median age 8.7 years [0.5–63 years]; median weight 28 kg [5.6–110 kg]) with the following prespecified indications: pulmonary artery (PA) stenosis (n = 13), aortic coarctation (n = 12), conduit stenosis/insufficiency (n = 9), and ventricular septal defect (n = 3). Diagnostic catheterization showed intervention was not indicated in 12 additional cases. XFM‐guided intervention was performed in the remaining 25. Fluoroscopy time was shorter for XFM‐guided intervention cases compared to matched controls. There was no significant difference in radiation dose area product, contrast volume, or procedure time. Operator Likert scores indicated XFM provided useful soft tissue guidance in all cases and was never misleading. Conclusions XFM provides operators with meaningful three‐dimensional soft tissue data and reduces fluoroscopy time in select congenital heart disease interventions.

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Section: Discussionmentioning

confidence: 99%

“…For the purposes of this study, patients with previous CMR studies had a repeat CMR on the day of the procedure to create the XFM overlay but in many cases adequate XFM overlay can be created from clinically indicated CMR scans acquired before the day of the procedure. 25…”

Section: Xfm Limitationsmentioning

confidence: 99%

X‐ray fused with MRI guidance of pre‐selected transcatheter congenital heart disease interventions

Grant

Kanter

Olivieri

et al. 2019

Cathet Cardio Intervent

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“…The systems are much more simple, especially for 3DRA. There are newer technologies for use of other modalities such as MRI, CT and transesophageal echo fusion that have been developed, and especially the Siemens system and the Philips VesselNavigator are quite user friendly [45][46][47][48][49][50][51][52][53][54]. Hopefully as we continue to develop programs utilizing these technologies it will make our procedures much simpler for the operator.…”

Section: Sebastian Gorecznymentioning

confidence: 99%

Pros, cons and future perspectives – three questions on three dimensional guidance for cardiac catheterization in congenital heart disease

Góreczny

Krings

Hijazi

et al. 2019

pwki

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Step changes in angiographic imaging are not commonplace. Since the move from analogue to digital and flat detector plates, two-dimensional imaging technology has certainly evolved but not jumped forward. Of all the routine imaging techniques used in cardiology, angiography has been the last modality to embrace the third dimension. Although the development of rotational angiography was initially for the benefit of neuroimaging and fusion of cross sectional datasets was aimed at the treatment of descending aortic pathology, interventional physicians in congenital and structural cardiology have immersed themselves in this technology over the last 10 years. Like many disruptive technologies, its introduction has divided opinion. We aimed to explore the mindset of those in the field of interventional cardiology who are driving imaging forward. These structured interviews recorded during the 21 st Pediatric and Adult Interventional Cardiac Symposium illustrate the challenges and sticking points as well as giving an insight into the direction of travel for three-dimensional imaging and fusion techniques. Covering a wide range of career development, seniority and experience, the interviewees in this article are probably responsible for the majority of the published literature on invasive three-dimensional imaging in congenital heart disease.

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“…In turn, this has led to decreased need for diagnostic angiography which has reduced radiation and contrast exposure as well as procedure time. [2][3][4] Given the improving life expectancy of patients with CHD defects, reducing radiation exposure is becoming an increasingly important consideration, especially as evidence has shown the correlation between radiation exposure and increased carcinoma risk in the adult CHD population. 5 We describe our initial experience performing cardiac catheterisations with the guidance of 3D advanced imaging overlay using the VesselNavigator system (Philips Healthcare, Best, NL).…”

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confidence: 99%

3D advanced imaging overlay with rapid registration in CHD to reduce radiation and assist cardiac catheterisation interventions

et al. 2020

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Novel commercially available software has enabled registration of both CT and MRI images to rapidly fuse with X-ray fluoroscopic imaging. We describe our initial experience performing cardiac catheterisations with the guidance of 3D imaging overlay using the VesselNavigator system (Philips Healthcare, Best, NL). A total of 33 patients with CHD were included in our study. Demographic, advanced imaging, and catheterisation data were collected between 1 December, 2016 and 31 January, 2019. We report successful use of this technology in both diagnostic and interventional cases such as placing stents and percutaneous valves, performing angioplasties, occlusion of collaterals, and guidance for lymphatic interventions. In addition, radiation exposure was markedly decreased when comparing our 10–15-year-old coarctation of the aorta stent angioplasty cohort to cases without the use of overlay technology and the most recently published national radiation dose benchmarks. No complications were encountered due to the application of overlay technology. 3D CT or MRI overlay for CHD intervention with rapid registration is feasible and aids decisions regarding access and planned angiographic angles. Operators found intraprocedural overlay fusion registration using placed vessel guidewires to be more accurate than attempts using bony structures.

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Novel Three-Dimensional Image Fusion Software to Facilitate Guidance of Complex Cardiac Catheterization

Cited by 44 publications

References 18 publications

X‐ray fused with MRI guidance of pre‐selected transcatheter congenital heart disease interventions

X‐ray fused with MRI guidance of pre‐selected transcatheter congenital heart disease interventions

Pros, cons and future perspectives – three questions on three dimensional guidance for cardiac catheterization in congenital heart disease

3D advanced imaging overlay with rapid registration in CHD to reduce radiation and assist cardiac catheterisation interventions

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