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Proceedings Paper

Multi-sequence magnetic resonance imaging integration framework for image-guided catheter ablation of scar-related ventricular tachycardia
Author(s): Qian Tao; Julien Milles; Carine van Huls van Taxis; Johan H. C. Reiber; Katja Zeppenfeld; Rob J. van der Geest
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Paper Abstract

Catheter ablation is an important option to treat ventricular tachycardias (VT). Scar-related VT is among the most difficult to treat, because myocardial scar, which is the underlying arrhythmogenic substrate, is patient-specific and often highly complex. The scar image from preprocedural late gadolinium enhancement magnetic resonance imaging (LGE- MRI) can provide high-resolution substrate information and, if integrated at the early stage of the procedure, can largely facilitate the procedure with image guidance. In clinical practice, however, early MRI integration is difficult because available integration tools rely on matching the MRI surface mesh and electroanatomical mapping (EAM) points, which is only possible after extensive EAM has been performed. In this paper, we propose to use a priori information on patient posture and a multi-sequence MRI integration framework to achieve accurate MRI integration that can be accomplished at an early stage of the procedure. From the MRI sequences, the left ventricular (LV) geometry, myocardial scar characteristics, and an anatomical landmark indicating the origin of the left main coronary artery are obtained preprocedurally using image processing techniques. Thereby the integration can be realized at the beginning of the procedure after acquiring a single mapping point. The integration method has been evaluated postprocedurally in terms of LV shape match and actual scar match. Compared to the iterative closest point (ICP) method that uses high-intensity mapping (225±49 points), our method using one mapping point reached a mean point-to-surface distance of 5.09±1.09 mm (vs. 3.85±0.60 mm, p<0.05), and scar correlation of -0.51±0.14 (vs. -0.50±0.14, p=NS).

Paper Details

Date Published: 17 February 2012
PDF: 7 pages
Proc. SPIE 8316, Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling, 831616 (17 February 2012); doi: 10.1117/12.910699
Show Author Affiliations
Qian Tao, Leiden Univ. Medical Ctr. (Netherlands)
Julien Milles, Leiden Univ. Medical Ctr. (Netherlands)
Carine van Huls van Taxis, Leiden Univ. Medical Ctr. (Netherlands)
Johan H. C. Reiber, Leiden Univ. Medical Ctr. (Netherlands)
Katja Zeppenfeld, Leiden Univ. Medical Ctr. (Netherlands)
Rob J. van der Geest, Leiden Univ. Medical Ctr. (Netherlands)

Published in SPIE Proceedings Vol. 8316:
Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling
David R. Holmes III; Kenneth H. Wong, Editor(s)

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