title: Image-based view-angle independent cardiorespiratory motion gating and coronary sinus catheter tracking for x-ray-guided cardiac electrophysiology procedures.
abstract: Determination of the cardiorespiratory phase of the heart has numerous applications during cardiac imaging. In this article we propose a novel view-angle independent near-real time cardiorespiratory motion gating and coronary sinus (CS) catheter tracking technique for x-ray fluoroscopy images that are used to guide cardiac electrophysiology procedures. The method is based on learning CS catheter motion using principal component analysis and then applying the derived motion model to unseen images taken at arbitrary projections, using the epipolar constraint. This method is also able to track the CS catheter throughout the x-ray images in any arbitrary subsequent view. We also demonstrate the clinical application of our model on rotational angiography sequences. We validated our technique in normal and very low dose phantom and clinical datasets. For the normal dose clinical images we established average systole, end-expiration and end-inspiration gating success rates of 100%, 85.7%, and 92.3%, respectively. For very low dose applications, the technique was able to track the CS catheter with median errors not exceeding 1 mm for all tracked electrodes. Average gating success rates of 80.3%, 71.4%, and 69.2% were established for the application of the technique on clinical datasets, even with a dose reduction of more than 10 times. In rotational sequences at normal dose, CS tracking median errors were within 1.2 mm for all electrodes, and the gating success rate was 100%, for view angles from RAO 90° to LAO 90°. This view-angle independent technique can extract clinically useful cardiorespiratory motion information using x-ray doses significantly lower than those currently used in clinical practice.
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College London, London SE1 7EH, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Panayiotou
authors.forename: Kawal S
authors.initials: KS
authors.lastname: Rhode
authors.forename: Andrew P
authors.initials: AP
authors.lastname: King
authors.forename: Yingliang
authors.initials: Y
authors.lastname: Ma
authors.forename: Michael
authors.initials: M
authors.lastname: Cooklin
authors.forename: Mark
authors.initials: M
authors.lastname: O'Neill
authors.forename: Jaswinder
authors.initials: J
authors.lastname: Gill
authors.forename: C A
authors.initials: CA
authors.lastname: Rinaldi
authors.forename: R James
authors.initials: RJ
authors.lastname: Housden
mesh_terms: D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D017115:Catheter Ablation; D054326:Coronary Sinus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004594:Electrophysiology; D005471:Fluoroscopy / Q000379:methods; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D009038:Motion; D019047:Phantoms, Imaging; D025341:Principal Component Analysis; D012119:Respiration; D055425:Respiratory-Gated Imaging Techniques / Q000379:methods*; D059629:Signal-To-Noise Ratio; D014965:X-Rays