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Proceedings Paper

Respiratory motion compensated overlay of surface models from cardiac MR on interventional x-ray fluoroscopy for guidance of cardiac resynchronization therapy procedures
Author(s): R. Manzke; A. Bornstedt; A. Lutz; M. Schenderlein; V. Hombach; L. Binner; V. Rasche
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Paper Abstract

Various multi-center trials have shown that cardiac resynchronization therapy (CRT) is an effective procedure for patients with end-stage drug invariable heart failure (HF). Despite the encouraging results of CRT, at least 30% of patients do not respond to the treatment. Detailed knowledge of the cardiac anatomy (coronary venous tree, left ventricle), functional parameters (i.e. ventricular synchronicity) is supposed to improve CRT patient selection and interventional lead placement for reduction of the number of non-responders. As a pre-interventional imaging modality, cardiac magnetic resonance (CMR) imaging has the potential to provide all relevant information. With functional information from CMR optimal implantation target sites may be better identified. Pre-operative CMR could also help to determine whether useful vein target segments are available for lead placement. Fused with X-ray, the mainstay interventional modality, improved interventional guidance for lead-placement could further help to increase procedure outcome. In this contribution, we present novel and practicable methods for a) pre-operative functional and anatomical imaging of relevant cardiac structures to CRT using CMR, b) 2D-3D registration of CMR anatomy and functional meshes with X-ray vein angiograms and c) real-time capable breathing motion compensation for improved fluoroscopy mesh overlay during the intervention based on right ventricular pacer lead tracking. With these methods, enhanced interventional guidance for left ventricular lead placement is provided.

Paper Details

Date Published: 23 February 2010
PDF: 8 pages
Proc. SPIE 7625, Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling, 762508 (23 February 2010); doi: 10.1117/12.843123
Show Author Affiliations
R. Manzke, Philips Research Europe (Germany)
Univ. Hospital of Ulm (Germany)
A. Bornstedt, Univ. Hospital of Ulm (Germany)
A. Lutz, Univ. Hospital of Ulm (Germany)
M. Schenderlein, Univ. of Ulm (Germany)
V. Hombach, Univ. Hospital of Ulm (Germany)
L. Binner, Univ. Hospital of Ulm (Germany)
V. Rasche, Univ. Hospital of Ulm (Germany)

Published in SPIE Proceedings Vol. 7625:
Medical Imaging 2010: Visualization, Image-Guided Procedures, and Modeling
Kenneth H. Wong; Michael I. Miga, Editor(s)

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