title: Three-dimensional image fusion of CTA and angiography for real-time guidance during neurointerventional procedures.
abstract: OBJECTIVE
  To evaluate the accuracy of three-dimensional (3D) images from two modalities-CT angiography (CTA) and digital subtraction angiography (DSA). Additionally, to explore the value of using preprocedural CTA for real-time guidance during neurointerventional procedures.
  
  
  METHODS
  25 patients with CTA-confirmed cerebral arterial lesions were enrolled. For 12 of these patients, 3D DSA images of the contrast medium-enhanced target vessel were acquired during the intervention and registered with the preprocedurally acquired CTA images for evaluation of the accuracy of image fusion, focusing on the target vessel and the lesion. For the other 13 patients, a low-dose non-contrast 3D angiographic scan was performed. The preprocedurally acquired CTA image was then registered with the coordinate of angiography and overlaid onto the live fluoroscopic image to provide interventional guidance.
  
  
  RESULTS
  Based on visual inspection by two experienced physicians and quantitative evaluation, excellent accuracy in the 3D registration of the CTA and DSA was achieved for all 12 patients examined. Additionally, CTA could be used successfully to guide the interventional procedures, including both diagnostic DSA and stent treatment. The radiation dose and contrast medium use were compared with those used by conventional interventional procedures and both were found to be significantly reduced.
  
  
  CONCLUSIONS
  3D CTA and angiographic image fusion was approved as highly accurate for neurovasculature. Additionally, using the fusion technique to guide interventional procedures enhanced the workflow, and required much less radiation exposure and contrast medium use, thus helping to reduce potential risks and increase treatment safety.
authors.affiliation: Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing, China.
authors.forename: Qiang
authors.identifier: http://orcid.org/0000-0002-7781-485X
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Siemens Ltd China, Healthcare Sector, Beijing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Hebei Cangzhou Cang Xian hospital, Cangzhou, Hebei, China.
authors.forename: Yiqi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing, China.
authors.forename: Hao
authors.identifier: http://orcid.org/0000-0001-9775-7250
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing, China.
authors.forename: Tonghui
authors.identifier: http://orcid.org/0000-0001-5226-6482
authors.initials: T
authors.lastname: Shan
authors.affiliation: Siemens Ltd China, Healthcare Sector, Beijing, China.
authors.forename: Jingfeng
authors.identifier: http://orcid.org/0000-0001-7713-745X
authors.initials: J
authors.lastname: Han
authors.affiliation: Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing, China.
authors.forename: Wenlong
authors.initials: W
authors.lastname: Pan
authors.affiliation: Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing, China.
authors.forename: Chuanqi
authors.identifier: http://orcid.org/0000-0002-7484-6688
authors.initials: C
authors.lastname: Gu
authors.affiliation: Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing, China.
authors.forename: Ruxiang
authors.initials: R
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods* / Q000592:standards; D002533:Cerebral Angiography / Q000379:methods / Q000592:standards; D000072226:Computed Tomography Angiography / Q000379:methods* / Q000592:standards; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods* / Q000592:standards; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods* / Q000592:standards; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards
chemical_list: D003287:Contrast Media
keywords: Angiography; CT Angiography; Intervention