Image-Guided Procedures, Robotic Interventions, and Modeling

Parametric ultrasound and fluoroscopy image fusion for guidance of left ventricle lead placement in cardiac resynchronization therapy

[+] Author Affiliations
Aleksandar Babic, Eigil Samset

Center for Cardiological Innovation, Songsvannsveien 9, Oslo 0372, Norway

GE Vingmed Ultrasound AS, Strandpromenaden 45, Horten 3183, Norway

University of Oslo, Department of Informatics, Gaustadalléen 23 B, Oslo 0373, Norway

Hans Henrik Odland

Center for Cardiological Innovation, Songsvannsveien 9, Oslo 0372, Norway

Oslo University Hospital, Department of Cardiology and Pediatrics, P.O. Box 1072, Blindern, Oslo 0316, Norway

Olivier Gérard

GE Vingmed Ultrasound AS, Strandpromenaden 45, Horten 3183, Norway

J. Med. Imag. 2(2), 025001 (May 13, 2015). doi:10.1117/1.JMI.2.2.025001
History: Received January 30, 2015; Accepted April 13, 2015
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Abstract.  Recent studies show that the response rate to cardiac resynchronization therapy (CRT) could be improved if the left ventricle (LV) is paced at the site of the latest mechanical activation, but away from the myocardial scar. A prototype system for CRT lead placement guidance that combines LV functional information from ultrasound with live x-ray fluoroscopy was developed. Two mean anatomical models, each containing LV epi-, LV endo- and right ventricle endocardial surfaces, were computed from a database of 33 heart failure patients as a substitute for a patient-specific model. The sphericity index was used to divide the observed population into two groups. The distance between the mean and the patient-specific models was determined using a signed distance field metric (reported in mm). The average error values for LV epicardium were 0.4±4.6 and for LV endocardium were 0.3±4.4. The validity of using average LV models for a CRT procedure was tested by simulating coronary vein selection in a group of 15 CRT candidates. The probability of selecting the same coronary branch, when basing the selection on the average model compared to a patient-specific model, was estimated to be 95.3±2.9%. This was found to be clinically acceptable.

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© 2015 Society of Photo-Optical Instrumentation Engineers

Citation

Aleksandar Babic ; Hans Henrik Odland ; Olivier Gérard and Eigil Samset
"Parametric ultrasound and fluoroscopy image fusion for guidance of left ventricle lead placement in cardiac resynchronization therapy", J. Med. Imag. 2(2), 025001 (May 13, 2015). ; http://dx.doi.org/10.1117/1.JMI.2.2.025001


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