title: Surface flattening of the human left atrium and proof-of-concept clinical applications.
abstract: Surface flattening in medical imaging has seen widespread use in neurology and more recently in cardiology to describe the left ventricle using the bull's-eye plot. The method is particularly useful to standardize the display of functional information derived from medical imaging and catheter-based measurements. We hypothesized that a similar approach could be possible for the more complex shape of the left atrium (LA) and that the surface flattening could be useful for the management of patients with atrial fibrillation (AF). We implemented an existing surface mesh parameterization approach to flatten and unfold 3D LA models. Mapping errors going from 2D to 3D and the inverse were investigated both qualitatively and quantitatively using synthetic data of regular shapes and computer tomography scans of an anthropomorphic phantom. Testing of the approach was carried out using data from 14 patients undergoing ablation treatment for AF. 3D LA meshes were obtained from magnetic resonance imaging and electroanatomical mapping systems. These were unfolded using the developed approach and used to demonstrate proof-of-concept applications, such as the display of scar information, electrical information and catheter position. The work carried out shows that the unfolding of complex cardiac structures, such as the LA, is feasible and has several potential clinical uses for the management of patients with AF.
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK. Electronic address: rashed.karim@kcl.ac.uk.
authors.forename: Rashed
authors.initials: R
authors.lastname: Karim
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK.
authors.forename: YingLiang
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK.
authors.forename: Munjung
authors.initials: M
authors.lastname: Jang
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK.
authors.forename: R James
authors.initials: RJ
authors.lastname: Housden
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK; Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, UK.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Williams
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK; Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, UK.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Centre for Robotics Research, Department of Informatics, King's College London, SE1 7EH, UK.
authors.forename: Asghar
authors.initials: A
authors.lastname: Ataollahi
authors.affiliation: Centre for Robotics Research, Department of Informatics, King's College London, SE1 7EH, UK.
authors.forename: Kaspar
authors.initials: K
authors.lastname: Althoefer
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK; Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, UK.
authors.forename: C Aldo
authors.initials: CA
authors.lastname: Rinaldi
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK; Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, UK.
authors.forename: Reza
authors.initials: R
authors.lastname: Razavi
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK; Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London SE1 7EH, UK.
authors.forename: Mark D
authors.initials: MD
authors.lastname: O'Neill
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK.
authors.forename: Tobias
authors.initials: T
authors.lastname: Schaeftter
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, SE1 7EH, UK.
authors.forename: Kawal S
authors.initials: KS
authors.lastname: Rhode
mesh_terms: D000465:Algorithms; D001281:Atrial Fibrillation / Q000473:pathology* / Q000601:surgery*; D003198:Computer Simulation; D005260:Female; D006325:Heart Atria; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013499:Surface Properties; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: Atrial fibrillation; Catheter ablation planning and navigation; Left atrial surface parameterization; Lesion visualization; Surface flattening