Exposure reduction by optimization of the imaging toolchain in pulmonary vein isolation

Viggiano, Alessandro; Potter, Tom J R De; Celentano, Egidio; Stefan, L.; Peytchev, P.; Geelen, P.

doi:10.1093/eurheartj/eht308.p2344

Cited by 4 publications

(2 citation statements)

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“…Dose–area product (DAP) rate is a figure of merit used to compare absorbed doses in real medical imaging 67 . DAP rate of around 2.5 Gy air cm 2 h −1 is estimated for perovskite detector in interventional cardiology with X-rays continuously on for capturing an image (entrance area of 100 cm 2 ) of the human body, at least an order of magnitude better than that offered by state-of-the-art commercial medical radiographic systems 68,69 . The resolution of X-ray image reached 10 lp mm −1 , which is comparable to those of the best CZT X-ray detectors and CsI(Tl) scintillator detectors as shown in Table 1, and is still lower than α-Se flat panel imagers 70 .…”

Section: Advance In the Development Of Perovskite X-ray Imaging Detecmentioning

confidence: 99%

Halide lead perovskites for ionizing radiation detection

2019

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Halide lead perovskites have attracted increasing attention in recent years for ionizing radiation detection due to their strong stopping power, defect-tolerance, large mobility-lifetime (μτ) product, tunable bandgap and simple single crystal growth from low-cost solution processes. In this review, we start with the requirement of material properties for high performance ionizing radiation detection based on direct detection mechanisms for applications in X-ray imaging and γ-ray energy spectroscopy. By comparing the performances of halide perovskites radiation detectors with current state-of-the-art ionizing radiation detectors, we show the promising features and challenges of halide perovskites as promising radiation detectors.

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Section: Advance In the Development Of Perovskite X-ray Imaging Detecmentioning

confidence: 99%

Halide lead perovskites for ionizing radiation detection

2019

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“…Compared with CT, patient radiation exposure is reduced and can be brought to levels well below accepted values for interventional procedures. 10 A workflow based on imaging in the EP lab allows logistic independence from other departments, making 'on the spot' decision trees possible. In addition, cost benefits are reasonable to expect as the incremental cost of performing a single 3DRA amounts to contrast agent and a pigtail catheter.…”

Section: Three-dimensional Rotational Angiography As Computed Tomogramentioning

confidence: 99%

Three-dimensional Rotational Angiography as a Periprocedural Imaging Tool in Atrial Fibrillation Ablation

Potter

Bardhaj

Viggiano

et al. 2014

Arrhythm Electrophysiol Rev

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Percutaneous catheter treatment for atrial fibrillation (AF) has seen an exponential uptake since the first cases were published exactly two decades ago.1 Evolving over different approaches and treatment strategies, current standard of care consists of pulmonary vein isolation (PVI) through radiofrequency (RF) or other energy sources. While this treatment has been shown to be superior to pharmacological treatment in the setting of paroxysmal AF, considerable variation in reported outcomes exists.2,3 Part of this variation is attributed to the aforementioned change in strategies over time -a clear evolution exists from electrophysiology (EP)-guided (and anatomically rather straightforward) approaches such as trigger elimination inside the pulmonary veins (PVs) to more empirical creation of circular lesions around the PVs.3 This latter approach eliminates challenges such as trigger identification and reduces safety concerns such as PV stenosis, but introduces new complexities that are mostly related to catheter positioning in the complex three-dimensional (3D) space of the left atrium (LA).One of the peculiarities of catheter manipulation in the LA is the usefulness, or rather lack of usefulness, of basic two-dimensional (2D) fluoroscopy. Unlike conventional procedures (e.g. right atrial or ventricular manipulation), fluoroscopy landmarks for AF ablation are few and far between. On top of that, safe and successful PVI requires precise energy delivery at crucial complex 3D structures, such as the left superior PV left atrial appendage transition. In order to achieve this goal, several tools have been developed that either help the operator understand anatomy, facilitate 3D catheter navigation or decrease radiation exposure; and ideally combine several of these useful features. 4-7 Rotational AngiographyThree-dimensional rotational angiography (3DRA) is an innovative method that allows reconstruction of tomographic slices of a volume of interest in a manner similar to computed tomography (CT), using single-plane radiographic equipment. 8,9 The reconstructed 3D models can be used instead of conventional CT or magnetic resonance imaging (MRI) to complement non-fluoroscopic navigation systems, or can be overlaid on 2D fluoroscopic images. In contrast to CT/MRI this technology allows near realtime 3D imaging that is acquired during an ongoing ablation procedure, thereby avoiding volume mismatch due to changes in volume status, rhythm or even table geometry (influencing chest geometry). Not only does 3DRA offer advantages in terms of accuracy over pre-procedural imaging, it also has important benefits from a logistics and cost-effectiveness perspective. Table 1 lists the impact of 3DRA in different clinical scenarios, explained below. Table 2 lists the impact of different workflow options for 3DRA. Three-dimensional Rotational Angiography as Computed Tomography SubstituteAt its core, 3DRA is a technology that produces CT-like tomography slices.These slices can be used to perform measurements or -more commonly for EP pr...

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Perovskite Materials in Biomedical Applications

Gong

2020

Materials Horizons: From Nature to Nanomaterials

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Exposure reduction by optimization of the imaging toolchain in pulmonary vein isolation

Cited by 4 publications

References 0 publications

Halide lead perovskites for ionizing radiation detection

Halide lead perovskites for ionizing radiation detection

Three-dimensional Rotational Angiography as a Periprocedural Imaging Tool in Atrial Fibrillation Ablation

Perovskite Materials in Biomedical Applications

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