Dongkue Kim1, Sangsoo Park2, Myung Ho Jeong3, Jeha Ryu4. 1. School of Mechanical Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea. 2. Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea. 3. The Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea. 4. School of Mechanical Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea. ryu@gist.ac.kr.
Abstract
PURPOSE: In percutaneous coronary intervention (PCI), cardiologists must study two different X-ray image sources: a fluoroscopic image and an angiogram. Manipulating a guidewire while alternately monitoring the two separate images on separate screens requires a deep understanding of the anatomy of coronary vessels and substantial training. We propose 2D/2D spatiotemporal image registration of the two images in a single image in order to provide cardiologists with enhanced visual guidance in PCI. METHODS: The proposed 2D/2D spatiotemporal registration method uses a cross-correlation of two ECG series in each image to temporally synchronize two separate images and register an angiographic image onto the fluoroscopic image. A guidewire centerline is then extracted from the fluoroscopic image in real time, and the alignment of the centerline with vessel outlines of the chosen angiographic image is optimized using the iterative closest point algorithm for spatial registration. RESULTS: A proof-of-concept evaluation with a phantom coronary vessel model with engineering students showed an error reduction rate greater than 74% on wrong insertion to nontarget branches compared to the non-registration method and more than 47% reduction in the task completion time in performing guidewire manipulation for very difficult tasks. Evaluation with a small number of experienced doctors shows a potentially significant reduction in both task completion time and error rate for difficult tasks. The total registration time with real procedure X-ray (angiographic and fluoroscopic) images takes [Formula: see text] 60 ms, which is within the fluoroscopic image acquisition rate of 15 Hz. CONCLUSIONS: By providing cardiologists with better visual guidance in PCI, the proposed spatiotemporal image registration method is shown to be useful in advancing the guidewire to the coronary vessel branches, especially those difficult to insert into.
PURPOSE: In percutaneous coronary intervention (PCI), cardiologists must study two different X-ray image sources: a fluoroscopic image and an angiogram. Manipulating a guidewire while alternately monitoring the two separate images on separate screens requires a deep understanding of the anatomy of coronary vessels and substantial training. We propose 2D/2D spatiotemporal image registration of the two images in a single image in order to provide cardiologists with enhanced visual guidance in PCI. METHODS: The proposed 2D/2D spatiotemporal registration method uses a cross-correlation of two ECG series in each image to temporally synchronize two separate images and register an angiographic image onto the fluoroscopic image. A guidewire centerline is then extracted from the fluoroscopic image in real time, and the alignment of the centerline with vessel outlines of the chosen angiographic image is optimized using the iterative closest point algorithm for spatial registration. RESULTS: A proof-of-concept evaluation with a phantom coronary vessel model with engineering students showed an error reduction rate greater than 74% on wrong insertion to nontarget branches compared to the non-registration method and more than 47% reduction in the task completion time in performing guidewire manipulation for very difficult tasks. Evaluation with a small number of experienced doctors shows a potentially significant reduction in both task completion time and error rate for difficult tasks. The total registration time with real procedure X-ray (angiographic and fluoroscopic) images takes [Formula: see text] 60 ms, which is within the fluoroscopic image acquisition rate of 15 Hz. CONCLUSIONS: By providing cardiologists with better visual guidance in PCI, the proposed spatiotemporal image registration method is shown to be useful in advancing the guidewire to the coronary vessel branches, especially those difficult to insert into.
Authors: Coert T Metz; Michiel Schaap; Stefan Klein; Lisan A Neefjes; Ermanno Capuano; Carl Schultz; Robert Jan van Geuns; Patrick W Serruys; Theo van Walsum; Wiro J Niessen Journal: Med Image Comput Comput Assist Interv Date: 2009
Authors: N Baka; C T Metz; C Schultz; L Neefjes; R J van Geuns; B P F Lelieveldt; W J Niessen; T van Walsum; M de Bruijne Journal: Med Image Anal Date: 2013-03-27 Impact factor: 8.545
Authors: Coert T Metz; Michiel Schaap; Stefan Klein; Nora Baka; Lisan A Neefjes; Carl J Schultz; Wiro J Niessen; Theo van Walsum Journal: IEEE Trans Med Imaging Date: 2013-02-06 Impact factor: 10.048