title: Interventional heart wall motion analysis with cardiac C-arm CT systems.
abstract: Today, quantitative analysis of three-dimensional (3D) dynamics of the left ventricle (LV) cannot be performed directly in the catheter lab using a current angiographic C-arm system, which is the workhorse imaging modality for cardiac interventions. Therefore, myocardial wall analysis is completely based on the 2D angiographic images or pre-interventional 3D/4D imaging. In this paper, we present a complete framework to study the ventricular wall motion in 4D (3D+t) directly in the catheter lab. From the acquired 2D projection images, a dynamic 3D surface model of the LV is generated, which is then used to detect ventricular dyssynchrony. Different quantitative features to evaluate LV dynamics known from other modalities (ultrasound, magnetic resonance imaging) are transferred to the C-arm CT data. We use the ejection fraction, the systolic dyssynchrony index a 3D fractional shortening and the phase to maximal contraction (ϕi, max) to determine an indicator of LV dyssynchrony and to discriminate regionally pathological from normal myocardium. The proposed analysis tool was evaluated on simulated phantom LV data with and without pathological wall dysfunctions. The LV data used is publicly available online at https://conrad.stanford.edu/data/heart. In addition, the presented framework was tested on eight clinical patient data sets. The first clinical results demonstrate promising performance of the proposed analysis tool and encourage the application of the presented framework to a larger study in clinical practice.
authors.affiliation: Department of Computer Science, Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Martensstr. 3, D-91058 Erlangen, Germany. Erlangen Graduate School in Advanced Optical Technologies (SAOT), Paul-Gordan-Str. 6, D-91052 Erlangen, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Müller
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Maier
authors.forename: Yefeng
authors.initials: Y
authors.lastname: Zheng
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Günter
authors.initials: G
authors.lastname: Lauritsch
authors.forename: Chris
authors.initials: C
authors.lastname: Schwemmer
authors.forename: Christopher
authors.initials: C
authors.lastname: Rohkohl
authors.forename: Joachim
authors.initials: J
authors.lastname: Hornegger
authors.forename: Rebecca
authors.initials: R
authors.lastname: Fahrig
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000379:methods*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D009068:Movement; D019047:Phantoms, Imaging
references.citation: IEEE Trans Med Imaging. 2008 Nov;27(11):1668-81
references.pmid: 18955181
references.citation: J Am Soc Echocardiogr. 2008 Nov;21(11):1229-35
references.pmid: 18848431
references.citation: Prog Biophys Mol Biol. 1988;52(2):101-64
references.pmid: 3076684
references.citation: Med Phys. 2008 Aug;35(8):3800-8
references.pmid: 18777939
references.citation: Med Image Comput Comput Assist Interv. 2013;16(Pt 3):90-7
references.pmid: 24505748
references.citation: IEEE Trans Med Imaging. 2009 Nov;28(11):1836-49
references.pmid: 19884068
references.citation: Phys Med Biol. 2012 May 21;57(10):2953-68
references.pmid: 22517030
references.citation: Med Phys. 2010 Mar;37(3):1093-109
references.pmid: 20384245
references.citation: IEEE Trans Med Imaging. 2006 Jul;25(7):922-34
references.pmid: 16827492
references.citation: Circulation. 2002 Jan 29;105(4):539-42
references.pmid: 11815441
references.citation: Eur Heart J. 1985 Aug;6(8):647-55
references.pmid: 4054134
references.citation: Ann Biomed Eng. 2005 Jul;33(7):912-9
references.pmid: 16060531
references.citation: Acad Radiol. 2012 Apr;19(4):395-405
references.pmid: 22225726
references.citation: Br J Radiol. 2012 Jul;85(1015):e343-7
references.pmid: 22745212
references.citation: Circulation. 2005 Aug 16;112(7):992-1000
references.pmid: 16087800
references.citation: Med Image Comput Comput Assist Interv. 2011;14(Pt 3):471-8
references.pmid: 22003733
references.citation: J Am Coll Cardiol. 2004 Aug 18;44(4):878-86
references.pmid: 15312875
references.citation: Phys Med Biol. 2012 Oct 7;57(19):6193-210
references.pmid: 22975431
references.citation: Circulation. 1981 Apr;63(4):752-60
references.pmid: 7471329
references.citation: IEEE Trans Med Imaging. 2006 Aug;25(8):1087-100
references.pmid: 16895001
references.citation: IEEE Trans Med Imaging. 2002 Jul;21(7):773-85
references.pmid: 12374315
references.citation: Med Phys. 2013 Mar;40(3):031107
references.pmid: 23464287
references.citation: Med Phys. 2013 Nov;40(11):111914
references.pmid: 24320447