3-D visualization of acute RF ablation lesions using MRI for the simultaneous determination of the patterns of necrosis and edema.
Catheter ablation using RF energy is a common treatment for atrial arrhythmias. Although this treatment provides a potential cure, currently, there remains a high proportion of patients returning for repeat ablations. Electrophysiologists have little information to verify that a lesion has been created in the myocardium. Temporary electrical block can be created from edema, which will subside. MRI can visualize acute and chronic ablation lesions using delayed-enhancement techniques. However, the ablation patterns cannot be determined from 2-D images alone. Using the combination of T(2)-weighted and delayed-enhancement MRI, ablation lesions can be characterized in terms of necrosis and edema. A novel 3-D visualization technique is presented that projects the image intensity due the lesions onto a 3-D cardiac surface, allowing the complete, simultaneous visualization of the delayed-enhancement and T(2)-weighted ablation patterns. Results show successful visualization of ablation patterns in 18 patients, and an application of this technique is presented in which electroanatomical mapping systems can be validated by overlaying the acquired ablation points onto the cardiac surfaces and assessing the correlation with the lesion maps.
Knowles
Benjamin R
BR
King's College London British Heart Foundation Centre, Division of Imaging Sciences, National Institute for Health Research Biomedical Research Centre, Guy's and St. Thomas' National Health Service Foundation Trust, King's College London, London, SE1 7EH, UK. benjamin.knowles@kcl.ac.uk
Caulfield
Dennis
D
Cooklin
Michael
M
Rinaldi
C Aldo
CA
Gill
Jaswinder
J
Bostock
Julian
J
Razavi
Reza
R
Schaeffter
Tobias
T
Rhode
Kawal S
KS
D000465:Algorithms; D001282:Atrial Flutter / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D004487:Edema / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009336:Necrosis / Q000209:etiology / Q000473:pathology*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome