Florent Lalys1, Ketty Favre2, Alexandre Villena3, Vincent Durrmann2, Mathieu Colleaux2, Antoine Lucas3,4,5, Adrien Kaladji3,4,5. 1. Therenva, 35000, Rennes, France. florent.lalys@therenva.com. 2. Therenva, 35000, Rennes, France. 3. Department of Cardiothoracic and Vascular Surgery, CHU Rennes, 35033, Rennes, France. 4. INSERM, U1099, 35000, Rennes, France. 5. Signal and Image Processing Laboratory (LTSI), University Rennes 1, 35000, Rennes, France.
Abstract
PURPOSE: Interventional endovascular treatment has become the first line of management in the treatment of peripheral artery disease (PAD). However, contrast and radiation exposure continue to limit the feasibility of these procedures. This paper presents a novel hybrid image fusion system for endovascular intervention of PAD. We present two different roadmapping methods from intra- and pre-interventional imaging that can be used either simultaneously or independently, constituting the navigation system. METHODS: The navigation system is decomposed into several steps that can be entirely integrated within the procedure workflow without modifying it to benefit from the roadmapping. First, a 2D panorama of the entire peripheral artery system is automatically created based on a sequence of stepping fluoroscopic images acquired during the intra-interventional diagnosis phase. During the interventional phase, the live image can be synchronized on the panorama to form the basis of the image fusion system. Two types of augmented information are then integrated. First, an angiography panorama is proposed to avoid contrast media re-injection. Information exploiting the pre-interventional computed tomography angiography (CTA) is also brought to the surgeon by means of semiautomatic 3D/2D registration on the 2D panorama. Each step of the workflow was independently validated. RESULTS: Experiments for both the 2D panorama creation and the synchronization processes showed very accurate results (errors of 1.24 and [Formula: see text] mm, respectively), similarly to the registration on the 3D CTA (errors of [Formula: see text] mm), with minimal user interaction and very low computation time. First results of an on-going clinical study highlighted its major clinical added value on intraoperative parameters. CONCLUSION: No image fusion system has been proposed yet for endovascular procedures of PAD in lower extremities. More globally, such a navigation system, combining image fusion from different 2D and 3D image sources, is novel in the field of endovascular procedures.
PURPOSE: Interventional endovascular treatment has become the first line of management in the treatment of peripheral artery disease (PAD). However, contrast and radiation exposure continue to limit the feasibility of these procedures. This paper presents a novel hybrid image fusion system for endovascular intervention of PAD. We present two different roadmapping methods from intra- and pre-interventional imaging that can be used either simultaneously or independently, constituting the navigation system. METHODS: The navigation system is decomposed into several steps that can be entirely integrated within the procedure workflow without modifying it to benefit from the roadmapping. First, a 2D panorama of the entire peripheral artery system is automatically created based on a sequence of stepping fluoroscopic images acquired during the intra-interventional diagnosis phase. During the interventional phase, the live image can be synchronized on the panorama to form the basis of the image fusion system. Two types of augmented information are then integrated. First, an angiography panorama is proposed to avoid contrast media re-injection. Information exploiting the pre-interventional computed tomography angiography (CTA) is also brought to the surgeon by means of semiautomatic 3D/2D registration on the 2D panorama. Each step of the workflow was independently validated. RESULTS: Experiments for both the 2D panorama creation and the synchronization processes showed very accurate results (errors of 1.24 and [Formula: see text] mm, respectively), similarly to the registration on the 3D CTA (errors of [Formula: see text] mm), with minimal user interaction and very low computation time. First results of an on-going clinical study highlighted its major clinical added value on intraoperative parameters. CONCLUSION: No image fusion system has been proposed yet for endovascular procedures of PAD in lower extremities. More globally, such a navigation system, combining image fusion from different 2D and 3D image sources, is novel in the field of endovascular procedures.
Authors: Amish N Raval; Parag V Karmarkar; Michael A Guttman; Cengizhan Ozturk; Smita Sampath; Ranil DeSilva; Ronnier J Aviles; Minnan Xu; Victor J Wright; William H Schenke; Ozgur Kocaturk; Alexander J Dick; Venkatesh K Raman; Ergin Atalar; Elliot R McVeigh; Robert J Lederman Journal: Circulation Date: 2006-02-20 Impact factor: 29.690
Authors: Andrew J Klein; Michael T Tomkowiak; Karl K Vigen; Timothy A Hacker; Michael A Speidel; Michael S Vanlysel; Nehal Shah; Amish N Raval Journal: Catheter Cardiovasc Interv Date: 2012-10-24 Impact factor: 2.692