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Proceedings Paper

MRI evaluation of RF ablation scarring for atrial fibrillation treatment
Author(s): Yuri Ishihara M.D.; Reza Nazafat; John V. Wylie M.D.; Marius G. Linguraru; Mark E. Josephson M.D.; Robert D. Howe; Warren J. Manning M.D.; Dana C. Peters
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Paper Abstract

This study presents a multi-modality image registration method that evaluates left atrial scarring after radiofrequency (RF) ablation for pulmonary vein (PV) isolation. Our group has recently developed a delayed enhancement magnetic resonance imaging (DE-MRI) method with the potential to visualize and monitor non-invasively post-ablation scarring in the left atrium and the PV ostia. We wished to compare the 3D configuration of scarring in the DE-MRI image and the ablation points recorded by electroanatomical mapping (EAM) system, hypothesizing that scarring detected by DE-MRI overlaps with ablation points recorded by the EAM system used in the procedure. Methods and Results: Three data sets, DE-MRI images and pulmonary vein MR angiography (PV-MRA) images, and EAM data (CARTO-XP, Biosense-Webster, Inc., Diamond Bar, CA) from a patient who underwent PV ablation, were used for the multi-modal image registration. Contrast-enhanced MR imaging was performed 38 days after the ablation procedure. PV-MRA and DE-MRI were fused by intensity-based rigid registration. Scar tissue was extracted from the DE-MRI images using multiple threshold values. EAM data was further fused with segmented PV-MRA by the iterative closest point algorithm (ICP). After registration, the distance from PV-MRA to the scar was 2.6 ± 2.1 mm, and from ablation points to the surface of the scar was 2.5 ± 2.3 mm. The fused image demonstrates the 3D relationship between the PV ostia, the scar and the EAM recording of ablation points. Conclusion: Multimodal data fusion indicated that the scar tissue lesion after PV isolation showed good overlap with the ablation points.

Paper Details

Date Published: 21 March 2007
PDF: 12 pages
Proc. SPIE 6509, Medical Imaging 2007: Visualization and Image-Guided Procedures, 65090Q (21 March 2007); doi: 10.1117/12.710323
Show Author Affiliations
Yuri Ishihara M.D., Harvard Univ. (United States)
Reza Nazafat, Harvard Medical School (United States)
John V. Wylie M.D., Harvard Medical School (United States)
Marius G. Linguraru, Harvard Univ. (United States)
Mark E. Josephson M.D., Harvard Medical School (United States)
Robert D. Howe, Harvard Univ. (United States)
Warren J. Manning M.D., Harvard Medical School (United States)
Dana C. Peters, Harvard Medical School (United States)

Published in SPIE Proceedings Vol. 6509:
Medical Imaging 2007: Visualization and Image-Guided Procedures
Kevin R. Cleary; Michael I. Miga, Editor(s)

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