Gerardo Tibamoso-Pedraza1, Sarah Amouri2, Victor Molina3, Iñaki Navarro3, Marie-Josée Raboisson3, Joaquim Miró3, Chantale Lapierre3, Sylvie Ratté2, Luc Duong2. 1. Interventional Imaging Lab, Department of Software and IT Engineering, École de technologie supérieure, 1100, Notre-Dame West, Montréal, H3C 1K3, Québec, Canada. gerardo.tibamoso-pedraza.1@etsmtl.net. 2. Interventional Imaging Lab, Department of Software and IT Engineering, École de technologie supérieure, 1100, Notre-Dame West, Montréal, H3C 1K3, Québec, Canada. 3. Cardiology, Department of Pediatrics, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, H3T 1C5, Québec, Canada.
Abstract
PURPOSE: Transesophageal echocardiography (TEE) is the preferred imaging modality in a hybrid procedure used to close ventricular septal defects (VSDs). However, the limited field of view of TEE hinders the maneuvering of surgical instruments inside the beating heart. This study evaluates the accuracy of a method that aims to support navigation guidance in the hybrid procedure. METHODS: A cardiologist maneuvered a needle to puncture the patient's heart and to access a VSD, guided by information displayed in a virtual environment. The information displayed included a model of the patient's heart and a virtual needle that reproduced the position and orientation of the real needle in real time. The physical and the virtual worlds were calibrated with a landmark registration and an iterative closest point algorithms, using an electromagnetic measurement system (EMS). For experiments, we developed a setup that included heart phantoms representing the patient's heart. RESULTS: Experimental results from two pediatric cases studied suggested that the information provided for guidance was accurate enough when the landmark registration algorithm was fed with coordinates of seven points clearly identified on the surfaces of the physical and virtual hearts. Indeed, with a registration error of 2.28 mm RMS, it was possible to successfully access two VSDs (6.2 mm and 6.3 mm in diameter) in all the attempts with a needle (5 attempts) and a guidewire (7 attempts). CONCLUSION: We found that information provided in a virtual environment facilitates guidance in the hybrid procedure for VSD closure. A clear identification of anatomical details in the heart surfaces is key to the accuracy of the procedure.
PURPOSE: Transesophageal echocardiography (TEE) is the preferred imaging modality in a hybrid procedure used to close ventricular septal defects (VSDs). However, the limited field of view of TEE hinders the maneuvering of surgical instruments inside the beating heart. This study evaluates the accuracy of a method that aims to support navigation guidance in the hybrid procedure. METHODS: A cardiologist maneuvered a needle to puncture the patient's heart and to access a VSD, guided by information displayed in a virtual environment. The information displayed included a model of the patient's heart and a virtual needle that reproduced the position and orientation of the real needle in real time. The physical and the virtual worlds were calibrated with a landmark registration and an iterative closest point algorithms, using an electromagnetic measurement system (EMS). For experiments, we developed a setup that included heart phantoms representing the patient's heart. RESULTS: Experimental results from two pediatric cases studied suggested that the information provided for guidance was accurate enough when the landmark registration algorithm was fed with coordinates of seven points clearly identified on the surfaces of the physical and virtual hearts. Indeed, with a registration error of 2.28 mm RMS, it was possible to successfully access two VSDs (6.2 mm and 6.3 mm in diameter) in all the attempts with a needle (5 attempts) and a guidewire (7 attempts). CONCLUSION: We found that information provided in a virtual environment facilitates guidance in the hybrid procedure for VSD closure. A clear identification of anatomical details in the heart surfaces is key to the accuracy of the procedure.
Authors: Pedro Morais; João Manuel R S Tavares; Sandro Queirós; Fernando Veloso; Jan D'hooge; João L Vilaça Journal: Med Phys Date: 2017-10-09 Impact factor: 4.071
Authors: John T Moore; Michael W A Chu; Bob Kiaii; Daniel Bainbridge; Gerard Guiraudon; Chris Wedlake; Maria Currie; Martin Rajchl; Rajni V Patel; Terry M Peters Journal: IEEE Trans Biomed Eng Date: 2012-10-03 Impact factor: 4.538