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22 March 2007Augmenting CT cardiac roadmaps with segmented streaming ultrasound
Static X-ray computed tomography (CT) volumes are often used as anatomic roadmaps during catheter-based cardiac
interventions performed under X-ray fluoroscopy guidance. These CT volumes provide a high-resolution depiction of
soft-tissue structures, but at only a single point within the cardiac and respiratory cycles. Augmenting these static CT
roadmaps with segmented myocardial borders extracted from live ultrasound (US) provides intra-operative access to
real-time dynamic information about the cardiac anatomy. In this work, using a customized segmentation method based
on a 3D active mesh, endocardial borders of the left ventricle were extracted from US image streams (4D data sets) at a
frame rate of approximately 5 frames per second. The coordinate systems for CT and US modalities were registered
using rigid body registration based on manually selected landmarks, and the segmented endocardial surfaces were
overlaid onto the CT volume. The root-mean squared fiducial registration error was 3.80 mm. The accuracy of the
segmentation was quantitatively evaluated in phantom and human volunteer studies via comparison with manual
tracings on 9 randomly selected frames using a finite-element model (the US image resolutions of the phantom and
volunteer data were 1.3 x 1.1 x 1.3 mm and 0.70 x 0.82 x 0.77 mm, respectively). This comparison yielded 3.70±2.5
mm (approximately 3 pixels) root-mean squared error (RMSE) in a phantom study and 2.58±1.58 mm (approximately 3
pixels) RMSE in a clinical study. The combination of static anatomical roadmap volumes and dynamic intra-operative
anatomic information will enable better guidance and feedback for image-guided minimally invasive cardiac
interventions.
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Qi Duan, Guy Shechter, Luis F. Gutiérrez, Douglas Stanton, Lyubomir Zagorchev, Andrew F. Laine, Daniel R. Elgort, "Augmenting CT cardiac roadmaps with segmented streaming ultrasound," Proc. SPIE 6509, Medical Imaging 2007: Visualization and Image-Guided Procedures, 65090V (22 March 2007); https://doi.org/10.1117/12.711431