Int J Comput Assist Radiol Surg - Optimized viewing angles for cardiac electrophysiology ablation procedures.

Tópicos

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Resumo

RPOSE: Catheter ablation is a common treatment option for atrial fibrillation (AF). Interventional C-arm X-ray systems are used for guiding AF procedures, employing standard view positions. Since the projection angles are not adapted to the individual patient anatomy, standard projections do not necessarily offer the best views of important anatomical structures. Using a pre-procedural 3D data set acquired with MRI or CT, suitable ablation sites (lines) can be identified in advance so an ablation plan can be superimposed on fluoroscopic images to guide the procedure.METHODS: A method was developed to estimate optimized projection views for biplane X-ray C-arm systems based on planning data for AF ablation procedures. The estimated viewing angles were compared to standard angulations using an objective quality metric, the length of the planned ablation line as seen under X-ray. This method was tested using 35 clinical datasets annotated with planned ablation lines for ipsilateral pulmonary vein isolation.RESULTS: The optimized views computed using the new method yielded 28 % less foreshortening of pre-planned ablation lines on average. In one case, anatomy-based view calculation lead to a 69 % reduction in foreshortening.CONCLUSION: The commonly used standard views provide reasonable a priori choices, and some improvement is possible by switching among common angulations depending on the treatment region. Further gains are possible by using anatomy-optimized biplane C-arm angulations.

Resumo Limpo

rpose cathet ablat common treatment option atrial fibril af intervent carm xray system use guid af procedur employ standard view posit sinc project angl adapt individu patient anatomi standard project necessarili offer best view import anatom structur use preprocedur d data set acquir mri ct suitabl ablat site line can identifi advanc ablat plan can superimpos fluoroscop imag guid proceduremethod method develop estim optim project view biplan xray carm system base plan data af ablat procedur estim view angl compar standard angul use object qualiti metric length plan ablat line seen xray method test use clinic dataset annot plan ablat line ipsilater pulmonari vein isolationresult optim view comput use new method yield less foreshorten preplan ablat line averag one case anatomybas view calcul lead reduct foreshorteningconclus common use standard view provid reason priori choic improv possibl switch among common angul depend treatment region gain possibl use anatomyoptim biplan carm angul

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