title: Toward computer-assisted image-guided congenital heart defect repair: an initial phantom analysis.
abstract: OBJECTIVE
  Radiation exposure in interventional cardiology is an important consideration, due to risk of cancer and other morbidity to the patient and clinical staff. Cardiac catheterizations rely heavily on fluoroscopic imaging exposing both patient and clinician to ionizing radiation. An image-guided surgery system capable of facilitating cardiac catheterizations was developed and tested to evaluate dose reduction.
  
  
  METHODS
  Several electromagnetically tracked tools were constructed specifically a 7-Fr catheter with five 5-degree-of-freedom magnetic seeds. Catheter guidance was accomplished using our image guidance system Kit for Navigation by Image-Focused Exploration and fluoroscopy alone. A cardiac phantom was designed and 3D printed to validate the image guidance procedure. In mock procedures, an expert clinician guided and deployed an occluder across the septal defect of the phantom heart.
  
  
  RESULTS
  The image guidance method resulted in a dose of 1.26 mSv of radiation dose per procedure, while traditional guidance resulted in a dose of 3.33 mSv. Average overall dose savings for the image-guided method was nearly 2.07 mSv or 62 %.
  
  
  CONCLUSIONS
  The work showed significant ([Formula: see text]) decrease in radiation dose with use of image guidance methods at the expense of a modest increase in procedure time. This study lays the groundwork for further exploration of image guidance applications in pediatric cardiology.
authors.affiliation: , 301 Rhodes Research Center, Clemson, SC, 29634-0905, USA. robodoc@clemson.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Kwartowitz
authors.affiliation: , 301 Rhodes Research Center, Clemson, SC, 29634-0905, USA.
authors.forename: Fuad N
authors.initials: FN
authors.lastname: Mefleh
authors.affiliation: , 301 Rhodes Research Center, Clemson, SC, 29634-0905, USA.
authors.forename: G Hamilton
authors.initials: GH
authors.lastname: Baker
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005471:Fluoroscopy / Q000379:methods*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: Catheterization; Dose sparing; Fluoroscopy; Image-guided surgery; Pediatric cardiology; Phantom procedures