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Proceedings Paper

Evaluation of the use of multimodality skin markers for the registration of pre-procedure cardiac MR images and intra-procedure x-ray fluoroscopy images for image guided cardiac electrophysiology procedures
Author(s): Kawal Rhode; Yingliang Ma; Angela Chandrasena; Andrew King; Gang Gao; Phani Chinchapatnam; Maxime Sermesant; David Hawkes; Tobias Schaeffter; Jaswinder Gill; Reza Razavi
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Paper Abstract

This paper presents the evaluation of the use of multimodality skin markers for the registration of cardiac magnetic resonance (MR) image data to x-ray fluoroscopy data for the guidance of cardiac electrophysiology procedures. The approach was validated using a phantom study and 3 patients undergoing pulmonary vein (PV) isolation for the treatment of paroxysmal atrial fibrillation. In the patient study, skin markers were affixed to the patients' chest and used to register pre-procedure cardiac MR image data to intra-procedure fluoroscopy data. Registration errors were assessed using contrast angiograms of the left atrium that were available in 2 out of 3 cases. A clinical expert generated "gold standard" registrations by adjusting the registration manually. Target registration errors (TREs) were computed using points on the PV ostia. Ablation locations were computed using biplane x-ray imaging. Registration errors were further assessed by computing the distances of the ablation points to the registered left atrial surface for all 3 patients. The TREs were 6.0 & 3.1mm for patients 1 & 2. The mean ablation point errors were 6.2, 3.8, & 3.0mm for patients 1, 2, & 3. These results are encouraging in the context of a 5mm clinical accuracy requirement for this type of procedure. We conclude that multimodality skin markers have the potential to provide anatomical image integration for x-ray guided cardiac electrophysiology procedures, especially if coupled with an accurate respiratory motion compensation strategy.

Paper Details

Date Published: 25 March 2008
PDF: 8 pages
Proc. SPIE 6918, Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling, 69181R (25 March 2008); doi: 10.1117/12.770172
Show Author Affiliations
Kawal Rhode, King's College London (United Kingdom)
Yingliang Ma, King's College London (United Kingdom)
Angela Chandrasena, King's College London (United Kingdom)
Andrew King, King's College London (United Kingdom)
Gang Gao, Univ. College London (United Kingdom)
Phani Chinchapatnam, Univ. College London (United Kingdom)
Maxime Sermesant, King's College London (United Kingdom)
David Hawkes, Univ. College London (United Kingdom)
Tobias Schaeffter, King's College London (United Kingdom)
Jaswinder Gill, St. Thomas's Hospital (United Kingdom)
Reza Razavi, King's College London (United Kingdom)

Published in SPIE Proceedings Vol. 6918:
Medical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling
Michael I. Miga; Kevin Robert Cleary, Editor(s)

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