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Proceedings Paper

Interactive visualization for scar transmurality in cardiac resynchronization therapy
Author(s): Sabrina Reiml; Daniel Toth; Maria Panayiotou; Bernhard Fahn; Rashed Karim; Jonathan M. Behar; Christopher A. Rinaldi; Reza Razavi; Kawal S. Rhode; Alexander Brost; Peter Mountney
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Paper Abstract

Heart failure is a serious disease affecting about 23 million people worldwide. Cardiac resynchronization therapy is used to treat patients suffering from symptomatic heart failure. However, 30% to 50% of patients have limited clinical benefit. One of the main causes is suboptimal placement of the left ventricular lead. Pacing in areas of myocardial scar correlates with poor clinical outcomes. Therefore precise knowledge of the individual patient’s scar characteristics is critical for delivering tailored treatments capable of improving response rates. Current research methods for scar assessment either map information to an alternative non-anatomical coordinate system or they use the image coordinate system but lose critical information about scar extent and scar distribution. This paper proposes two interactive methods for visualizing relevant scar information. A 2-D slice based approach with a scar mask overlaid on a 16 segment heart model and a 3-D layered mesh visualization which allows physicians to scroll through layers of scar from endocardium to epicardium. These complementary methods enable physicians to evaluate scar location and transmurality during planning and guidance. Six physicians evaluated the proposed system by identifying target regions for lead placement. With the proposed method more target regions could be identified.

Paper Details

Date Published: 18 March 2016
PDF: 8 pages
Proc. SPIE 9786, Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling, 97862S (18 March 2016); doi: 10.1117/12.2214737
Show Author Affiliations
Sabrina Reiml, Siemens Healthcare (Germany)
Daniel Toth, Siemens Healthcare (United Kingdom)
King's College London (United Kingdom)
Maria Panayiotou, King's College London (United Kingdom)
Bernhard Fahn, Siemens Healthcare (Austria)
Rashed Karim, King's College London (United Kingdom)
Jonathan M. Behar, King's College London (United Kingdom)
Guy's and St Thomas' NHS Foundation Trust (United Kingdom)
Christopher A. Rinaldi, King's College London (United Kingdom)
Guy's and St Thomas' NHS Foundation Trust (United Kingdom)
Reza Razavi, King's College London (United Kingdom)
Kawal S. Rhode, King's College London (United Kingdom)
Alexander Brost, Siemens Healthcare (Germany)
Peter Mountney, Siemens Healthcare (United Kingdom)

Published in SPIE Proceedings Vol. 9786:
Medical Imaging 2016: Image-Guided Procedures, Robotic Interventions, and Modeling
Robert J. Webster III; Ziv R. Yaniv, Editor(s)

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