Transseptal Puncture Guided by CT‐Derived 3D‐Augmented Fluoroscopy

Bourier, Félix; Reents, Tilko; Ammar-Busch, Sonia; Semmler, Verena; Telishevska, Marta; Kottmaier, Marc; Lennerz, Carsten; Grebmer, Christian; Kolb, Christof; Deisenhofer, Isabel; Hessling, Gabriele

doi:10.1111/jce.12885

Cited by 25 publications

(29 citation statements)

References 6 publications

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“…Although no significant differences are expected between the merged contour strategies and our approach in terms of segmentation evaluation metrics (e.g. P2S or Dice), the merged contour approaches are not suitable for novel image-guided minimally invasive interventions focused on atrial wall as presented by (Bourier et al, 2016). A first evaluation of the proposed competitive approach was performed on atrial region segmentation in CT images.…”

Section: Discussionmentioning

confidence: 97%

“…More details about the segmentation can be obtained in (Bourier et al, 2016). In order to identify the atrial body and similarly to the proposed in (Tobon-Gomez et al, 2015), multiple bounding boxes were generated around the pulmonary veins, vena cava and left and right atrial appendage (LAA and RAA).…”

Section: Ground Truth Generationmentioning

confidence: 99%

“…Several authors extracted/isolated multiple contours of the atrial anatomies using different segmentation strategies (Tobon-Gomez et al, 2015), proving the clinical relevance of a correct anatomical and functional assessment of each atrial region for global cardiac function quantification and even for risk stratification (Hoit, 2014;Melenovsky et al, 2014). Moreover, enhanced minimally invasive cardiac interventions were proposed, using electroanatomic mapping techniques (Rolf et al, 2014) or even superimposing pre-operative anatomical atrial surfaces (Bourier et al, 2016), extracted from highly detailed datasets, into intra-operative imaging (e.g. fluoroscopy).…”

Section: Introductionmentioning

confidence: 99%

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A competitive strategy for atrial and aortic tract segmentation based on deformable models

Morais

Vilaça

Queirós

et al. 2017

Medical Image Analysis

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A competitive strategy for atrial and aortic tract segmentation based on deformable models AbstractMultiple strategies have previously been described for atrial region (i.e. atrial bodies and aortic tract) segmentation. Although these techniques have proven their accuracy, inadequate results in the mid atrial walls are common, restricting their application for specific cardiac interventions. In this work, we introduce a novel competitive strategy to perform atrial region segmentation with correct delineation of the thin mid walls, and integrated it into the B-spline Explicit Active Surfaces framework. A double-stage segmentation process is used, which starts with a fast contour growing followed by a refinement stage with local descriptors. Independent functions are used to define each region, being afterward combined to compete for the optimal boundary. The competition locally constrains the surface evolution, prevents overlaps and allows refinement to the walls. Three different scenarios were used to demonstrate the advantages of the proposed approach, through the evaluation of its segmentation accuracy, and its performance for heterogeneous mid walls. Both computed tomography and magnetic resonance imaging datasets were used, presenting results similar to the state-of-the-art methods for both atria and aorta. The competitive strategy showed its superior performance with statistically significant differences against the traditional freeevolution approach in cases with bad image quality or missed atrial/aortic walls. Moreover, only the competitive approach was able to accurately segment the atrial/aortic wall. Overall, the proposed strategy showed to be suitable for atrial region segmentation with a correct segmentation of the mid thin walls, demonstrating its added value with respect to the traditional techniques.

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Section: Discussionmentioning

confidence: 97%

Section: Ground Truth Generationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A competitive strategy for atrial and aortic tract segmentation based on deformable models

Morais

Vilaça

Queirós

et al. 2017

Medical Image Analysis

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“…According to criteria issued by cartography cardiac systems manufacturers [9], the EGM reading can be considered as correct (in terms of catheter contact) when the average strength of the sensor exceeds 5g. Hence, we classified the beats into 3 groups: (a) averaged force in beats 1 and 2 is greater than 5g threshold in both; (b) averaged force in beats 1 and 2 is lower than 5g threshold in both; (c) averaged force is greater than the threshold in one beat but lower in the other.…”

Section: Correlation Analysis On Morphologymentioning

confidence: 99%

A Quantitative Analysis on the Intracardiac Electrogram Contact During Ventricular Tachycardia Ablation

Rivas

Huerta

Sanromán‐Junquera

et al. 2016

2016 Computing in Cardiology Conference (CinC)

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Cardiac arrhythmias are currently treated with ablation procedures, which are guided by X-ray cameras and intracardiac electrograms (EGM) recordings. Recently, the use of catheters with force sensors have been proposed for improving the contact of the sensing catheter over the heart wall, aiming to guarantee the reliability of electrical measurements. Manufacturers of the equipment used for this type of studies have suggested that the catheter has to take a reading above or equal to 5g. We aimed to determine whether the waveform of the EGM can provide us with some information about the good contact conditions of the catheter on the endocardium, by using the recorded force as a gold standard. We first performed a correlation analysis of EGM morphology in terms of the force threshold, and then we made a multivariable analysis based on the Fisher discriminant. The database to be analyzed came from 11 patients (8 males) with mean age of 64.9 years, where 1161 EGM signals were obtained. The EGM set corresponded to the voltage maps of the left ventricle during sinus rhythm. The correlation coefficient between consecutive EGM beats larger and lower than 0.8 in EGM morphology showed similar ratios of averaged force in those beats with larger force (49% vs 46% for force>5g), 29% vs 28% for force<5g. Fisher discriminant analysis yielded error probability larger than 0.3 for the best discrimination case. These previous results show that the EGM morphology seems to have limited information about the catheter contact when scrutinized with simple signal processing methods.

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“…Nevertheless, such approach requires great experience, is very timeconsuming, and frequently results in procedural failures and complications [7,8] . Thus, automated image-fusion strategies were proposed [9,10] . Usually, these strategies start with a segmentation of the target structures, being subsequently fused with the intraprocedural data [9] .…”

Section: Introductionmentioning

confidence: 99%

Automated segmentation of the atrial region and fossa ovalis towards computer-aided planning of inter-atrial wall interventions

Morais

Vilaça

Queirós

et al. 2018

Computer Methods and Programs in Biomedicine

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Transseptal Puncture Guided by CT‐Derived 3D‐Augmented Fluoroscopy

Abstract: Three-dimensional-augmented fluoroscopy is feasible, safe, and easy to apply as guidance for transseptal puncture and demonstrates a high level of accuracy.

Cited by 25 publications

References 6 publications

A competitive strategy for atrial and aortic tract segmentation based on deformable models

A competitive strategy for atrial and aortic tract segmentation based on deformable models

A Quantitative Analysis on the Intracardiac Electrogram Contact During Ventricular Tachycardia Ablation

Automated segmentation of the atrial region and fossa ovalis towards computer-aided planning of inter-atrial wall interventions

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