title: Automatic intra-operative generation of geometric left atrium/pulmonary vein models from rotational X-ray angiography.
abstract: Pre-procedural imaging with cardiac CT or MR has become popular for guiding complex electrophysiology procedures such as those used for atrial fibrillation ablation therapy. Electroanatomical mapping and ablation within the left atrium and pulmonary veins (LAPV) is facilitated using such data, however the pre-procedural anatomy can be quite different from that at the time of intervention. Recently, a method for intra-procedural LAPV imaging has been developed based on contrast-enhanced 3-D rotational X-ray angiography (3-D RA). These intraprocedural data now create a compelling need for rapid and automated extraction of the LAPV geometry for catheter guidance. We present a new approach to automatic intra-procedural generation of LAPV surfaces from 3-D RA volumes. Using model-based segmentation, our technique is robust to imaging noise and artifacts typical of 3-D RA imaging, strongly minimizes the user interaction time required for segmentation, and eliminates inter-subject variability. Our findings in 33 patients indicate that intra-procedural LAPV surface models accurately represent the anatomy at the time of intervention and are comparable to pre-procedural models derived from CTA or MRA.
authors.affiliation: Philips Research Laboratories, X-Ray Imaging Systems, Weisshausstrasse 2, D-52066 Aachen, Germany. carsten.meyer@philips.com
authors.forename: Carsten
authors.initials: C
authors.lastname: Meyer
authors.forename: Robert
authors.initials: R
authors.lastname: Manzke
authors.forename: Jochen
authors.initials: J
authors.lastname: Peters
authors.forename: Olivier
authors.initials: O
authors.lastname: Ecabert
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kneser
authors.forename: Vivek Y
authors.initials: VY
authors.lastname: Reddy
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Chan
authors.forename: Jürgen
authors.initials: J
authors.lastname: Weese
mesh_terms: D000465:Algorithms; D000792:Angiography / Q000379:methods*; D003198:Computer Simulation; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000601:surgery; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012399:Rotation; D012680:Sensitivity and Specificity