Pre-procedural image data,
such as CT or MR,
can provide valuable information during interventional treatment.
Fusion of this multi-modal image data into the live fluoroscopy image can aid accurate neuronavigation.
In case of angiographic multi-modal data,
contrast agent usage can be reduced during the intervention.
For AVM treatment,
pre-procedural MR can be used to localize arterial feeders and drainage veins of the AVM,
and fistula during the intervention.
The learning objectives comprise the steps leading to accurate fusion of multi-modal image data,...
Traditional roadmapping is based on the superimposition of digital subtraction angiography (DSA) and the live fluoroscopy images.
The DSA technique has been developed in the 1930's,
and has first been used in interventional treatment in the 1960's.
The DSA images show the vessel lumen filled with iodinated contrast medium,
while the fluoroscopy images show the current location of the endovascular devices.
It provides the vascular context to the real-time fluoroscopy and therefore helps to lowers the risk of inadvertent events,
while lowering the use of...
Imaging findings OR Procedure details
The pre-procedural multi-modal data in DICOM format is imported into the interventional workstation from a PACS or disc.
a cone-beam CT (optionally contrast enhanced) is acquired with the C-arm system,
see movie below.
The cone-beam CT is co-registered with the multi-modal data,
using a semi-automatic approach,
by selecting the overlay tool on the 3D workstation.
A coarse manual initialization in axial,
coronal and sagittal viewing direction is performed by the operator.
Then the fine co-registration can be performed by the software,
In this poster the steps that need to be taken to perform multi-modality 3D roadmapping have been explained.
The fused visualization may be used to improve the localization of arterial feeders and drainage veins of the AVM (see figures 5 and 9),
contrast medium induced nephropathy (CIN) has been reported to occur in approximately 10%–30% of patients with preexisting renal insufficiency [6-9].
for those patients image guidance based on previously acquired CTA orMRA data fusion with fluoroscopy (see...
Moret J: Overlying fluoroscopy and preacquired CT angiography for road-mapping in cerebral angiography,
et al.: 3D roadmap in neuroangiography: technique and clinical interest.
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Kim JH: Feasibility and Usefulness of 3D Roadmap in Vascular Intervention: Clinical Application in Non-Neurological Field,
van de Haar P,
Babic D: Validation of 3D...