Navigation and positioning aids for intracoronary interventions

Percutaneous Transluminal Coronary Angioplasty is currently the preferred method for treatment of coronary artery disease in vivo. X-ray images of the coronary arteries filled with a radio-opaque contrast dye are acquired to localise the lesion. One of these images is displayed on a monitor and will serve as roadmap to navigate the interventional instruments under constant x-ray surveillance. The interventional images are displayed in real-time on a second monitor next to the roadmap monitor. It depends on the physician's ability to correlate the images on both monitors and estimate the actual position of the guidewire within the vessel tree in order to steer it further. The navigation task is hindered by the constant movement of the heart within the chest cavity and the static nature of the angiographic roadmap. The main goal of this work is to present a novel image registration framework to enable navigation and positioning aids for cardiac catheterisation procedures to reduce interventional time. This task is accomplished by enhancing the visualisation of the procedure by means of overlaying onto each interventional frame a roadmap that exhibits the coronary vessels in a similar position and with a similar shape, and by fusing information acquired from Intravascular Ultrasound (IVUS). To this end, we characterise each acquired frame by a heart state vector, which main components are respiration state and heart contraction state. The latter is calculated from the ECG signal, and we propose and evaluate a multimodality similarity measure based on mutual information to measure the respiration state from the image content. With these two characteristic parameters, each image can be represented in a two-dimensional graph where nearby points represent images that show the heart in a similar state and position. Furthermore, methods to refine the registration of the vessels visible in the roadmap and the instrument visible in the interventional frames by respiration compensation and accurate device to vessel registration are proposed. A flexible software architecture is developed to ease transfer from research activities to a clinical setting and test the real-time performance of these algorithms. To aid accurate positioning, we present a novel multimodality application to fuse IVUS and projection x-ray images. IVUS images are related to their acquisition locations in the diagnostic angiograms or to instrument positions during the intervention by means of respiration compensation and accurate device to vessel registration. A reconstruction algorithm of the three-dimensional pullback path for projection x-ray sequences is also proposed. The two-dimensional registration algorithm for IVUS and angiography is tested in a heart phantom.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2009

Author dc:creator

• Martín-Leung, Bárbara

Contributors dc:contributor

• Aach, Til

• info:eu-repo/classification/ddc/004
• Registrierung <Bildverarbeitung>
• Bildverarbeitung
• Koronarographie
• Perkutane transluminale koronare Angioplastie
• Informatik
• image registration
• image processing
• angiography
• intracoronary interventions
• Percutanerous Transluminal Coronary Angioplasty

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

eng

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113594%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A51287