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Navigation guidance for ventricular septal defect closure in heart phantoms. Int J Comput Assist Radiol Surg 2022; 17:1947-1956. [PMID: 35798998 DOI: 10.1007/s11548-022-02711-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE Transesophageal echocardiography (TEE) is the preferred imaging modality in a hybrid procedure used to close ventricular septal defects (VSDs). However, the limited field of view of TEE hinders the maneuvering of surgical instruments inside the beating heart. This study evaluates the accuracy of a method that aims to support navigation guidance in the hybrid procedure. METHODS A cardiologist maneuvered a needle to puncture the patient's heart and to access a VSD, guided by information displayed in a virtual environment. The information displayed included a model of the patient's heart and a virtual needle that reproduced the position and orientation of the real needle in real time. The physical and the virtual worlds were calibrated with a landmark registration and an iterative closest point algorithms, using an electromagnetic measurement system (EMS). For experiments, we developed a setup that included heart phantoms representing the patient's heart. RESULTS Experimental results from two pediatric cases studied suggested that the information provided for guidance was accurate enough when the landmark registration algorithm was fed with coordinates of seven points clearly identified on the surfaces of the physical and virtual hearts. Indeed, with a registration error of 2.28 mm RMS, it was possible to successfully access two VSDs (6.2 mm and 6.3 mm in diameter) in all the attempts with a needle (5 attempts) and a guidewire (7 attempts). CONCLUSION We found that information provided in a virtual environment facilitates guidance in the hybrid procedure for VSD closure. A clear identification of anatomical details in the heart surfaces is key to the accuracy of the procedure.
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Nisar H, Fakim D, Bainbridge D, Chen ECS, Peters T. 3D localization of vena contracta using Doppler ICE imaging in tricuspid valve interventions. Int J Comput Assist Radiol Surg 2022; 17:1569-1577. [PMID: 35588338 PMCID: PMC9463221 DOI: 10.1007/s11548-022-02660-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/25/2022] [Indexed: 11/27/2022]
Abstract
Purpose Tricuspid valve (TV) interventions face the challenge of imaging the anatomy and tools because of the ‘TEE-unfriendly’ nature of the TV. In edge-to-edge TV repair, a core step is to position the clip perpendicular to the coaptation gap. In this study, we provide a semi-automated method to localize the VC from Doppler intracardiac echo (ICE) imaging in a tracked 3D space, thus providing a pre-mapped location of the coaptation gap to assist device positioning. Methods A magnetically tracked ICE probe with Doppler imaging capabilities is employed in this study for imaging three patient-specific TVs placed in a pulsatile heart phantom. For each of the valves, the ICE probe is positioned to image the maximum regurgitant flow for five cardiac cycles. An algorithm then extracts the regurgitation imaging and computes the exact location of the vena contracta on the image. Results Across the three pathological, patient-specific valves, the average distance error between the detected VC and the ground truth model is \documentclass[12pt]{minimal}
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\begin{document}$$({1.22 \pm 2.00})$$\end{document}(1.22±2.00)mm. For each of the valves, one case represented the outlier where the algorithm misidentified the vena contracta to be near the annulus. In such cases, it is recommended to retake the five-second imaging data. Conclusion This study presented a method for ultrasound-based localization of vena contracta in 3D space. Mapping such anatomical landmarks has the potential to assist with device positioning and to simplify tricuspid valve interventions by providing more contextual information to the interventionalists, thus enhancing their spatial awareness. Additionally, ICE can be used to provide live US and Doppler imaging of the complex TV anatomy throughout the procedure.
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Affiliation(s)
- Hareem Nisar
- Robarts Research Institute, 1151 Richmond St., London, ON, N6A5B7, Canada. .,School of Biomedical Engineering, Western University, 1151 Richmond St, London, ON, N6A3K7, Canada.
| | - Djalal Fakim
- Schulic School of Medicine and Dentistry, Western University, 1151 Richmond St., London, ON, N6A3K7, Canada
| | - Daniel Bainbridge
- Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, 339 Windermere Rd., London, ON, N6A5A5, Canada
| | - Elvis C S Chen
- Robarts Research Institute, 1151 Richmond St., London, ON, N6A5B7, Canada.,School of Biomedical Engineering, Western University, 1151 Richmond St, London, ON, N6A3K7, Canada.,Schulic School of Medicine and Dentistry, Western University, 1151 Richmond St., London, ON, N6A3K7, Canada.,Department of Medical Biophysics, Western University, 1151 Richmond St., London, ON, N6A3K7, Canada
| | - Terry Peters
- Robarts Research Institute, 1151 Richmond St., London, ON, N6A5B7, Canada.,School of Biomedical Engineering, Western University, 1151 Richmond St, London, ON, N6A3K7, Canada.,Schulic School of Medicine and Dentistry, Western University, 1151 Richmond St., London, ON, N6A3K7, Canada.,Department of Medical Biophysics, Western University, 1151 Richmond St., London, ON, N6A3K7, Canada
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Khalil A, Ng SC, Liew YM, Lai KW. An Overview on Image Registration Techniques for Cardiac Diagnosis and Treatment. Cardiol Res Pract 2018; 2018:1437125. [PMID: 30159169 PMCID: PMC6109558 DOI: 10.1155/2018/1437125] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/05/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
Image registration has been used for a wide variety of tasks within cardiovascular imaging. This study aims to provide an overview of the existing image registration methods to assist researchers and impart valuable resource for studying the existing methods or developing new methods and evaluation strategies for cardiac image registration. For the cardiac diagnosis and treatment strategy, image registration and fusion can provide complementary information to the physician by using the integrated image from these two modalities. This review also contains a description of various imaging techniques to provide an appreciation of the problems associated with implementing image registration, particularly for cardiac pathology intervention and treatments.
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Affiliation(s)
- Azira Khalil
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
- Faculty of Science and Technology, Islamic Science University of Malaysia, 71800 Nilai, Negeri Sembilan, Malaysia
| | - Siew-Cheok Ng
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Khin Wee Lai
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Bera D, Raghunathan SB, Chen C, Chen Z, Pertijs MAP, Verweij MD, Daeichin V, Vos HJ, van der Steen AFW, de Jong N, Bosch JG. Multiline 3D beamforming using micro-beamformed datasets for pediatric transesophageal echocardiography. ACTA ACUST UNITED AC 2018; 63:075015. [DOI: 10.1088/1361-6560/aab45e] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Laing J, Moore J, Vassallo R, Bainbridge D, Drangova M, Peters T. Patient-specific cardiac phantom for clinical training and preprocedure surgical planning. J Med Imaging (Bellingham) 2018; 5:021222. [PMID: 29594183 DOI: 10.1117/1.jmi.5.2.021222] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 03/05/2018] [Indexed: 11/14/2022] Open
Abstract
Minimally invasive mitral valve repair procedures including MitraClip® are becoming increasingly common. For cases of complex or diseased anatomy, clinicians may benefit from using a patient-specific cardiac phantom for training, surgical planning, and the validation of devices or techniques. An imaging compatible cardiac phantom was developed to simulate a MitraClip® procedure. The phantom contained a patient-specific cardiac model manufactured using tissue mimicking materials. To evaluate accuracy, the patient-specific model was imaged using computed tomography (CT), segmented, and the resulting point cloud dataset was compared using absolute distance to the original patient data. The result, when comparing the molded model point cloud to the original dataset, resulted in a maximum Euclidean distance error of 7.7 mm, an average error of 0.98 mm, and a standard deviation of 0.91 mm. The phantom was validated using a MitraClip® device to ensure anatomical features and tools are identifiable under image guidance. Patient-specific cardiac phantoms may allow for surgical complications to be accounted for preoperative planning. The information gained by clinicians involved in planning and performing the procedure should lead to shorter procedural times and better outcomes for patients.
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Affiliation(s)
- Justin Laing
- Western University, Department of Biomedical Engineering, London, Ontario, Canada
| | - John Moore
- Robarts Research Institute, London, Ontario, Canada
| | - Reid Vassallo
- Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Daniel Bainbridge
- Western University, Department of Anesthesiology, London, Ontario, Canada
| | - Maria Drangova
- Western University, Department of Biomedical Engineering, London, Ontario, Canada.,Robarts Research Institute, London, Ontario, Canada.,Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Terry Peters
- Western University, Department of Biomedical Engineering, London, Ontario, Canada.,Robarts Research Institute, London, Ontario, Canada.,Western University, Department of Medical Biophysics, London, Ontario, Canada
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