3D-guidance for catheter-based interventions with tessellated heart models for cardiovascular interventions in congenital heart disease (CHD)

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2016

Poster Number:

B-0614

Type:

Scientific Paper

Keywords:

Interventional vascular, Cardiovascular system, Paediatric, Image manipulation / Reconstruction, Cone beam CT, MR-Angiography, Catheters, Computer Applications-3D, Segmentation, Image registration, Congenital, Education and training

Authors:

M. Glöckler, N. Ehret, O. Rompel, S. Dittrich; Erlangen/DE

DOI:

10.1594/ecr2016/B-0614

DOI-Link:

https://dx.doi.org/10.1594/ecr2016/B-0614

Fig. 1: 3D overlay with tessellated heart model, stenting an aortic coarctation,...

Fig. 2: Segmantation with Mimics Medical 18.0, Materialise

Fig. 3: Hollowed 3D heart modell (3-matic Medical 10.0; Materialise)

Fig. 4: Overlay on plan A

Purpose

3D road mapping in catheter-based cardiovascular interventions are very helpful in congenital heart disease, caused by the arbitrary malformed anatomy [1;2]. Segmented and tessellated heart and vascular models (STL models) might overcome the non-standardized VRT-models for 3D guidance in congenital heart disease (CHD). Novel 2D-3D registration may be feasible with an unenhanced biplane fluoroscopy.

Methods and materials

Normal 0 21 false false false DE X-NONE X-NONE In 50 pediatric patients segmentation from routine cardiovascular magnetic resonance imaging (MRI) and computed tomography (CT) was performed. From each segment (cardiac chambers and vessels) of interest a separate mesh was generated with a commercially available software (Mimics Medical 18.0 and 3-matic Medical 10.0, Materialise) For image integration in the live fluoroscopy a prototypic workstation (Monaco Workstation, Siemens healthcare) was used. 3D overlay on fluoroscopy image is displayed on both planes. The trachea was used as...

Results

Accuracy of registration was sufficient in all cases using the trachea as fiducial marker. Quality of segmented and tessellated heart models was rated superior to overlaid VRT images. Accuracy of 2D-3D registration and impact for catheterization was rated as perfect (17%) / essential (11%) or good (83%) / very useful (89%) and always over conventional biplane imaging. Comparative measurements of vessel diameters in conventional VRT-models and tessellated models showed a significant better correlation of STL-models to the gold standard MPR- reconstruction.

Conclusion

Segmented and tessellated heart models can be generated successfully from MRI and CT Biplane 3D Road mapping is feasible 2D-3D registration can be done nearly radiation-free STL-models are more accurate than VRT-models Radiation dose, contrast dye and fluoroscopy time might be reduced Interventionalists develop a more realistic idea of anatomical structures Catheter tubes and stents remain visible due to the fine delineated structure of STL-models

Personal information

Contact: [email protected]

References

1) 1) Glöckler, M, Halbfaß J, Koch A et al. Multimodality 3D-roadmap for cardiovascular interventions in congenital heart disease--a single-center, retrospective analysis of 78 cases. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2013; 82: 436-442 2) Fagan TE, Truong UT, Jone PN et al. Multimodality 3-dimensional image integration for congenital cardiac catheterization. Methodist DeBakey cardiovascular journal 2014; 10: 68-76