Evaluation of a Real-Time Hybrid Three-Dimensional Echo and X-Ray Imaging System for Guidance of Cardiac Catheterisation Procedures

Housden, James; Arujuna, Aruna; Ma, Yongqiang; Nijhof, Nienke; Gijsbers, G. H. M.; Bullens, Roland; O’Neill, Mark; Cooklin, Michael; Rinaldi, Christopher Aldo; Gill, Jaswinder; Kapetanakis, Stamatis; Hancock, Jane; Thomas, Martyn; Razavi, Reza; Rhode, Kawal

doi:10.1007/978-3-642-33418-4_4

Cited by 20 publications

(21 citation statements)

References 7 publications

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“…A well evaluated direct approach for the fusion of ultrasound with fluoroscopic X-ray was suggested by Gao et al [9] and Housden et al [10]. A TEE probe is detected in the X-ray image and thereby derives the 3D position of the TEE probe relatively to the X-ray detector, which inherently provides a registration of the ultrasound image to the X-ray image.…”

Section: Description Of Purpose and Related Workmentioning

confidence: 99%

Significant acceleration of 2D-3D registration-based fusion of ultrasound and x-ray images by mesh-based DRR rendering

et al. 2013

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For transcatheter-based minimally invasive procedures in structural heart disease ultrasound and X-ray are the two enabling imaging modalities. A live fusion of both real-time modalities can potentially improve the workflow and the catheter navigation by combining the excellent instrument imaging of X-ray with the high-quality soft tissue imaging of ultrasound. A recently published approach to fuse X-ray fluoroscopy with trans-esophageal echo (TEE) registers the ultrasound probe to X-ray images by a 2D-3D registration method which inherently provides a registration of ultrasound images to X-ray images. In this paper, we significantly accelerate the 2D-3D registration method in this context. The main novelty is to generate the projection images (DRR) of the 3D object not via volume ray-casting but instead via a fast rendering of triangular meshes. This is possible, because in the setting for TEE/X-ray fusion the 3D geometry of the ultrasound probe is known in advance and their main components can be described by triangular meshes. We show that the new approach can achieve a speedup factor up to 65 and does not affect the registration accuracy when used in conjunction with the gradient correlation similarity measure. The improvement is independent of the underlying registration optimizer. Based on the results, a TEE/X-ray fusion could be performed with a higher frame rate and a shorter time lag towards real-time registration performance. The approach could potentially accelerate other applications of 2D-3D registrations, e.g. the registration of implant models with X-ray images.Keywords: Mesh-based 2D-3DRegistration, Ultrasound/X-ray Image Fusion, Image Guided Surgery DESCRIPTION OF PURPOSE AND RELATED WORKMore and more procedures in the field of structural heart disease become minimally invasive and catheter-based. This includes for instance trans-catheter aortic valve implantation [1], trans-catheter mitral valve repair [2], closure of atrial septal defects [3], paravalvular leak closure [4] and left atrial appendage occlusion [5]. The drivers for this trend from open-heart surgery to trans-catheter procedures are the availability of new catheter devices and the intra-procedural imaging.Usually these procedures are performed under fluoroscopic X-ray and trans-esophageal echo (TEE). Intra-operatively these modalities are mainly used independently of each other. X-ray imaging is performed by the cardiologist or surgeon at the left or right side of the patient whereas ultrasound imaging is performed by the anesthesiologist at the head side of the patient. An image fusion of both systems could yield a better mutual understanding of the image contents and potentially even allow new kinds of procedures. The images move relatively to each other because the position of the imaging devices is changed by the operator, as well as because of patient, heart and breathing motion. Therefore, there is the demand of an almost real-time update to synchronize the relative position of both images.Several approaches were published fo...

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Section: Description Of Purpose and Related Workmentioning

confidence: 99%

Significant acceleration of 2D-3D registration-based fusion of ultrasound and x-ray images by mesh-based DRR rendering

et al. 2013

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“…The authors also found that cardiorespiratory motion caused projection errors up to 4 mm, and noted that a true real-time algorithm was necessary to overcome these errors. In follow-up work (Housden et al, 2012), the algorithm was implemented on a system that was able to stream echo and XRF data and display both modalities in a common coordinate system.…”

Section: Previous Workmentioning

confidence: 99%

“…Recently, image registration between XRF and TEE has been validated (Housden et al, 2012) and clinically implemented (Philips EchoNavigator). This technology uses image processing to merge the XRF and echo coordinate systems, allowing for image information from both modalities to be fused into a single visualization framework.…”

Section: Introductionmentioning

confidence: 99%

Real-time pose estimation of devices from x-ray images: Application to x-ray/echo registration for cardiac interventions

Hatt

Speidel

Raval

2016

Medical Image Analysis

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In recent years, registration between x-ray fluoroscopy (XRF) and transesophageal echocardiography (TEE) has been rapidly developed, validated, and translated to the clinic as a tool for advanced image guidance of structural heart interventions. This technology relies on accurate pose-estimation of the TEE probe via standard 2D/3D registration methods. It has been shown that latencies caused by slow registrations can result in errors during untracked frames, and a real-time (> 15 hz) tracking algorithm is needed to minimize these errors. This paper presents two novel similarity metrics designed for accurate, robust, and extremely fast pose-estimation of devices from XRF images: Direct Splat Correlation (DSC) and Patch Gradient Correlation (PGC). Both metrics were implemented in CUDA C, and validated on simulated and clinical datasets against prior methods presented in the literature. It was shown that by combining DSC and PGC in a hybrid method (HYB), target registration errors comparable to previously reported methods were achieved, but at much higher speeds and lower failure rates. In simulated datasets, the proposed HYB method achieved a median projected target registration error (pTRE) of 0.33 mm and a mean registration frame-rate of 12.1 hz, while previously published methods produced median pTREs greater than 1.5 mm and mean registration frame-rates less than 4 hz. In clinical datasets, the HYB method achieved a median pTRE of 1.1 mm and a mean registration frame-rate of 20.5 hz, while previously published methods produced median pTREs greater than 1.3 mm and mean registration frame-rates less than 12 hz. The proposed hybrid method also had much lower failure rates than previously published methods.

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“…The image fusion of real-time 3-D echography and ICA for guidance during catheterisation procedures has been demonstrated and it was found clinically useful not only for mitral clip implantation but also for AF ablation and TAVI aortic valve replacement [68]. So far, such hybrid echographic combinations have not emerged into clinical applications for ischemic cardiomyopathy.…”

Section: Other Non-nuclear Hybrid Techniquesmentioning

confidence: 99%

Multimodality Imaging in Ischemic Cardiomyopathy

Prior

Farhad

Müller

2014

Curr Cardiovasc Imaging Rep

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Cardiac multimodality (hybrid) imaging can be obtained from a variety of techniques, such as nuclear medicine with single photon emission computed tomography (SPECT) and positron emission tomography (PET), or radiology with multislice computed tomography (CT), magnetic resonance (MR) and echography. They are typically combined in a side-by-side or fusion mode in order to provide functional and morphological data to better characterise coronary artery disease, with more proven efficacy than when used separately. The gained information is then used to guide revascularisation procedures. We present an up-to-date comprehensive overview of multimodality imaging already in clinical use, as well as a combination of techniques with promising or developing applications.

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Evaluation of a Real-Time Hybrid Three-Dimensional Echo and X-Ray Imaging System for Guidance of Cardiac Catheterisation Procedures

Cited by 20 publications

References 7 publications

Significant acceleration of 2D-3D registration-based fusion of ultrasound and x-ray images by mesh-based DRR rendering

Significant acceleration of 2D-3D registration-based fusion of ultrasound and x-ray images by mesh-based DRR rendering

Real-time pose estimation of devices from x-ray images: Application to x-ray/echo registration for cardiac interventions

Multimodality Imaging in Ischemic Cardiomyopathy

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