PROCEEDINGS ARTICLE | February 17, 2012
Proc. SPIE. 8316, Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling
KEYWORDS: Information fusion, Blood, Magnetic resonance imaging, Image processing, Ions, Arteries, Image enhancement, Associative arrays, Gadolinium, 3D image processing
Catheter ablation is an important option to treat ventricular tachycardias (VT). Scar-related VT is among the most
difficult to treat, because myocardial scar, which is the underlying arrhythmogenic substrate, is patient-specific and
often highly complex. The scar image from preprocedural late gadolinium enhancement magnetic resonance
imaging (LGE- MRI) can provide high-resolution substrate information and, if integrated at the early stage of the
procedure, can largely facilitate the procedure with image guidance. In clinical practice, however, early MRI
integration is difficult because available integration tools rely on matching the MRI surface mesh and
electroanatomical mapping (EAM) points, which is only possible after extensive EAM has been performed.
In this paper, we propose to use a priori information on patient posture and a multi-sequence MRI integration
framework to achieve accurate MRI integration that can be accomplished at an early stage of the procedure. From
the MRI sequences, the left ventricular (LV) geometry, myocardial scar characteristics, and an anatomical landmark
indicating the origin of the left main coronary artery are obtained preprocedurally using image processing techniques.
Thereby the integration can be realized at the beginning of the procedure after acquiring a single mapping point. The
integration method has been evaluated postprocedurally in terms of LV shape match and actual scar match.
Compared to the iterative closest point (ICP) method that uses high-intensity mapping (225±49 points), our method
using one mapping point reached a mean point-to-surface distance of 5.09±1.09 mm (vs. 3.85±0.60 mm, p<0.05),
and scar correlation of -0.51±0.14 (vs. -0.50±0.14, p=NS).
