Automatic Intra-operative Generation of Geometric Left Atrium/Pulmonary Vein Models from Rotational X-Ray Angiography

Authors:
Carsten Meyer;Robert Manzke;Jochen Peters;Olivier Ecabert;Reinhard Kneser;Vivek Y. Reddy;Raymond C. Chan;Jürgen Weese
Affiliations:
Philips Research Laboratories, X-Ray Imaging Systems, Aachen, Germany D-52066;Philips Research North America, Clinical Sites Research, , NY, USA;Philips Research Laboratories, X-Ray Imaging Systems, Aachen, Germany D-52066;Philips Research Laboratories, X-Ray Imaging Systems, Aachen, Germany D-52066;Philips Research Laboratories, X-Ray Imaging Systems, Aachen, Germany D-52066;Experimental Electrophysiology Laboratory, Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, USA;Philips Research North America, Clinical Sites Research, , NY, USA;Philips Research Laboratories, X-Ray Imaging Systems, Aachen, Germany D-52066
Venue:
MICCAI '08 Proceedings of the 11th International Conference on Medical Image Computing and Computer-Assisted Intervention, Part II
Year:
2008

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Abstract

Pre-procedural imaging with cardiac CT or MR has become popular for guiding complex electrophysiology procedures such as those used for atrial fibrillation ablation therapy. Electroanatomical mapping and ablation within the left atrium and pulmonary veins (LAPV) is facilitated using such data, however the pre-procedural anatomy can be quite different from that at the time of intervention. Recently, a method for intra-procedural LAPV imaging has been developed based on contrast-enhanced 3-D rotational X-ray angiography (3-D RA). These intraprocedural data now create a compelling need for rapid and automated extraction of the LAPV geometry for catheter guidance. We present a new approach to automatic intra-procedural generation of LAPV surfaces from 3-D RA volumes. Using model-based segmentation, our technique is robust to imaging noise and artifacts typical of 3-D RA imaging, strongly minimizes the user interaction time required for segmentation, and eliminates inter-subject variability. Our findings in 33 patients indicate that intra-procedural LAPV surface models accurately represent the anatomy at the time of intervention and are comparable to pre-procedural models derived from CTA or MRA.