13 May 2015 Parametric ultrasound and fluoroscopy image fusion for guidance of left ventricle lead placement in cardiac resynchronization therapy
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Abstract
Recent studies show that the response rate to cardiac resynchronization therapy (CRT) could be improved if the left ventricle (LV) is paced at the site of the latest mechanical activation, but away from the myocardial scar. A prototype system for CRT lead placement guidance that combines LV functional information from ultrasound with live x-ray fluoroscopy was developed. Two mean anatomical models, each containing LV epi-, LV endo- and right ventricle endocardial surfaces, were computed from a database of 33 heart failure patients as a substitute for a patient-specific model. The sphericity index was used to divide the observed population into two groups. The distance between the mean and the patient-specific models was determined using a signed distance field metric (reported in mm). The average error values for LV epicardium were −0.4±4.6 and for LV endocardium were −0.3±4.4. The validity of using average LV models for a CRT procedure was tested by simulating coronary vein selection in a group of 15 CRT candidates. The probability of selecting the same coronary branch, when basing the selection on the average model compared to a patient-specific model, was estimated to be 95.3±2.9%. This was found to be clinically acceptable.
© 2015 Society of Photo-Optical Instrumentation Engineers (SPIE)
Aleksandar Babic, Hans Henrik Odland, Olivier Gérard, Eigil Samset, "Parametric ultrasound and fluoroscopy image fusion for guidance of left ventricle lead placement in cardiac resynchronization therapy," Journal of Medical Imaging 2(2), 025001 (13 May 2015). https://doi.org/10.1117/1.JMI.2.2.025001 . Submission:
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