Usefulness of echocardiographic-fluoroscopic fusion imaging in children with congenital heart disease

Hadeed, Khaled; Hascoët, Sébastien; Karsenty, Clément; Ratsimandresy, Miarisoa; Dulac, Yves; Chausseray, G.; Alacoque, Xavier; Fraisse, Alain; Acar, Philippe

doi:10.1016/j.acvd.2018.03.006

Cited by 28 publications

(14 citation statements)

References 23 publications

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“…This prospective study aims to determine whether XFM guidance is beneficial for prespecified select congenital heart disease interventions. Other groups have explored X‐ray fused with CT, X‐ray fused with 3DRA, and X‐ray fused with ultrasound . Each has potential benefits and drawbacks.…”

Section: Discussionmentioning

confidence: 99%

“…Other groups have explored X-ray fused with CT, X-ray fused with 3DRA, and X-ray fused with ultrasound. 6,[12][13][14][15] Each has potential benefits and drawbacks. CT offers a 3D dataset with better spatial resolution than CMR but exposes the patient to additional radiation, additional contrast and can be difficult to acquire without repeat acquisitions particularly early in experience.…”

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%

Section: Discussionmentioning

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

View full text Add to dashboard Cite

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“…The advantages of EFF imaging are as follows: (a) to improve understanding of anatomical structures imaged by TEE acquisition during the procedure, (b) to quickly understand the relation of the X‐ray fluoroscopy and ultrasound images, (c) to improve communication between the operators of the ultrasound and X‐ray images, and (d) to improve the confidence of positioning the interventional device and guide interventional procedures 11,15−18 . Several medical imaging companies (Philips EchoNavigator ® and Siemens TrueFusion ® ) have developed EFF tools to aid catheter guidance.…”

Section: Introductionmentioning

confidence: 99%

Echocardiography–fluoroscopy fusion imaging: The essential features used in congenital and structural heart disease interventional guidance

et al. 2020

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Increased catheter-based interventions in congenital and structural heart disease require imaging modalities to be oriented in the same visual perspective. The use of echocardiography-fluoroscopy fusion (EFF) imaging has been developed for better characterization of complex anatomy and to facilitate key steps in interventional procedures. This review will detail the technology behind EFF, the differences between the two ultrasound fusion systems, and essential features of EFF imaging in congenital and structural heart disease interventions.

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“…The integration of other imaging modalities during real-time guidance by means of multimodal three-dimensional (3D) image fusion (IF) can address these challenges, combining the strengths of different modalities. With the fusion packages available on commercial XR systems, allowing merging of live XR fluoroscopy with preinterventionally derived patient-specific 3D models [1][2][3][4][5][6], real-time 3D transesophageal echocardiography (TEE) [7,8], or virtual anatomy derived from electroanatomic mapping [9,10], promising results have been shown for the guidance of transvascular catheter interventions, as well as during mapping and ablation of complex arrhythmias. Although IF has been proven advantageous for providing 3D anatomy, reduction of radiation exposure, increasing procedural safety and efficacy, and improved outcome [3,6,[10][11][12], a wide-spread application is hindered by: (1) fusion packages limitation to a single or restricted number of applications and noncompatibility in data transfer between different vendors or even software packages of the same vendor; (2) only basic functionality including 3D volume segmentation, manual registration, and real-time image fusion; (3) static nature of the anatomic models and non-deformable rigid registration, potentially causing overlay inaccuracy; (4) usage of proprietary localization systems, which may significantly increase the costs of the intervention, require additional equipment in the intervention space, and are partly only applicable with dedicated proprietary catheters, limiting the flexibility of catheter choice during the intervention.…”

Section: Introductionmentioning

confidence: 99%

3D-XGuide: open-source X-ray navigation guidance system

et al. 2020

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Purpose With the growing availability and variety of imaging modalities, new methods of intraoperative support have become available for all kinds of interventions. The basic principles of image fusion and image guidance have been widely adopted and are commercialized through a number of platforms. Although multimodal systems have been found to be useful for guiding interventional procedures, they all have their limitations. The integration of more advanced guidance techniques into the product functionality is, however, not easy due to the proprietary solutions of the vendors. Therefore, the purpose of this work is to introduce a software system for image fusion, real-time navigation, and working points documentation during transcatheter interventions performed under X-ray (XR) guidance. Methods An interactive software system for cross-modal registration and image fusion of XR fluoroscopy with CT or MRI-derived anatomic 3D models is implemented using Qt application framework and VTK visualization pipeline. DICOM data can be imported in retrospective mode. Live XR data input is realized by a video capture card application interface. Results The actual software release offers a graphical user interface with basic functionality including data import and handling, calculation of projection geometry and transformations between related coordinate systems, rigid 3D-3D registration, and template matching-based tracking and motion compensation algorithms in 2D and 3D. The link to the actual software release on GitHub including source code and executable is provided to support independent research and development in the field of intervention guidance. Conclusion The introduced system provides a common foundation for the rapid prototyping of new approaches in the field of XR fluoroscopic guidance. As a pure software solution, the developed system is potentially vendor-independent and can be easily extended to be used with the XR systems of different manufacturers.

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Usefulness of echocardiographic-fluoroscopic fusion imaging in children with congenital heart disease

Abstract: The EchoNavigator system is feasible and safe in the guidance of interventional catheterization in children with congenital heart disease; it enables better appreciation of anatomical relationships and improves the confidence of the interventionist.

Cited by 28 publications

References 23 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

Echocardiography–fluoroscopy fusion imaging: The essential features used in congenital and structural heart disease interventional guidance

3D-XGuide: open-source X-ray navigation guidance system

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