Evaluation of the use of multimodality skin markers for the registration of pre-procedure cardiac MR images and intra-procedure x-ray fluoroscopy images for image guided cardiac electrophysiology procedures

Kawal Rhode; Yingliang Ma; Angela Chandrasena; Andrew King; Gang Gao; Phani Chinchapatnam; Maxime Sermesant; David Hawkes; Tobias Schaeffter; Jaswinder Gill; Reza Razavi

doi:10.1117/12.770172

25 March 2008 Evaluation of the use of multimodality skin markers for the registration of pre-procedure cardiac MR images and intra-procedure x-ray fluoroscopy images for image guided cardiac electrophysiology procedures

Kawal Rhode, Yingliang Ma, Angela Chandrasena, Andrew King, Gang Gao, Phani Chinchapatnam, Maxime Sermesant, David Hawkes, Tobias Schaeffter, Jaswinder Gill, Reza Razavi

Author Affiliations +

Proceedings Volume 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling; 69181R (2008) https://doi.org/10.1117/12.770172
Event: Medical Imaging, 2008, San Diego, California, United States

Abstract

This paper presents the evaluation of the use of multimodality skin markers for the registration of cardiac magnetic resonance (MR) image data to x-ray fluoroscopy data for the guidance of cardiac electrophysiology procedures. The approach was validated using a phantom study and 3 patients undergoing pulmonary vein (PV) isolation for the treatment of paroxysmal atrial fibrillation. In the patient study, skin markers were affixed to the patients' chest and used to register pre-procedure cardiac MR image data to intra-procedure fluoroscopy data. Registration errors were assessed using contrast angiograms of the left atrium that were available in 2 out of 3 cases. A clinical expert generated "gold standard" registrations by adjusting the registration manually. Target registration errors (TREs) were computed using points on the PV ostia. Ablation locations were computed using biplane x-ray imaging. Registration errors were further assessed by computing the distances of the ablation points to the registered left atrial surface for all 3 patients. The TREs were 6.0 & 3.1mm for patients 1 & 2. The mean ablation point errors were 6.2, 3.8, & 3.0mm for patients 1, 2, & 3. These results are encouraging in the context of a 5mm clinical accuracy requirement for this type of procedure. We conclude that multimodality skin markers have the potential to provide anatomical image integration for x-ray guided cardiac electrophysiology procedures, especially if coupled with an accurate respiratory motion compensation strategy.

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Kawal Rhode, Yingliang Ma, Angela Chandrasena, Andrew King, Gang Gao, Phani Chinchapatnam, Maxime Sermesant, David Hawkes, Tobias Schaeffter, Jaswinder Gill, and Reza Razavi "Evaluation of the use of multimodality skin markers for the registration of pre-procedure cardiac MR images and intra-procedure x-ray fluoroscopy images for image guided cardiac electrophysiology procedures", Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling, 69181R (25 March 2008); https://doi.org/10.1117/12.770172

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