Cardiac Gated 2D Imaging Overlay for Interventional Navigation
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Solution Overview
Problem
Current image-guided interventional procedures in cardiac electrophysiology face inaccuracies due to the registration and fusion of distinct imaging modalities, which can lead to significant radiation exposure and lengthy procedure times, especially during radiofrequency ablation and pacemaker placement, where precise navigation is crucial without the use of contrast agents.
Innovation Solution
The method involves acquiring and recording a sequence of 2D live images from the same projection angle, synchronized with cardiac and respiratory cycles, to generate a dynamically enriched 2D reconstruction of the patient's cardiovascular anatomy, allowing for real-time navigation and overlaying of the interventional instrument's motion stages, thereby reducing the need for preoperative 3D reconstructions and minimizing radiation exposure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If distinct imaging modalities are used for preoperative 3D reconstruction and intraoperative 2D fluoroscopy, then comprehensive anatomical information is obtained, but registration inaccuracies and procedure complexity increase
Solution Approach 1:
The patent merges preoperative 3D anatomical information with intraoperative 2D fluoroscopy into a single integrated fluoroscopic image display. The 3D anatomical structures (coronary vessels, cardiac chambers) are overlaid directly onto the 2D fluoroscopic images in real-time, eliminating the need for separate imaging modalities and complex registration procedures while maintaining complete anatomical information.
Solution Approach 2:
The system provides multi-functionality by combining diagnostic angiography, interventional guidance, and 3D anatomical visualization into a single fluoroscopic imaging system. This universal approach allows the same system to perform both 2D real-time imaging and 3D anatomical reconstruction without requiring separate specialized equipment.
2Reliability
If contrast agents are injected for real-time X-ray imaging, then coronary arteries and cardiac chambers are visualized, but radiation exposure and procedure cost increase
Solution Approach 1:
The system performs preliminary 3D anatomical reconstruction from preoperative CT or MRI data before the interventional procedure begins. This pre-acquired anatomical information is then integrated with intraoperative fluoroscopy, allowing reduced contrast agent injection volumes and lower radiation exposure during the actual intervention since the anatomical framework is already established.
3Measurement precision
If high radiation exposure is used for diagnostic angiography, then high-quality images of coronary arteries are obtained, but patient and physician radiation dose increase
Solution Approach 1:
The system applies partial action by using low-dose fluoroscopic imaging for real-time guidance during interventions, supplemented by preoperative high-quality 3D anatomical data from CT or MRI. This allows diagnostic and interventional imaging to be performed at lower radiation doses while maintaining sufficient image quality through the integration of pre-acquired high-resolution anatomical information.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enhances the accuracy of image-guided interventions by providing a precise, real-time 2D view of the anatomy aligned with fluoroscopy, reducing radiation exposure and procedure time, and eliminating the need for expensive localized interventional tools and contrast agents.
Implementation Method 1
a point X-ray source that projects an X-ray beam through the patient and onto a large-area detector
Implementation Method 2
a large-area detector, the latter being used for converting the generated 2D image to electrical signals for display on a monitor
Data Source
AI summary
The present invention refers to the field of cardiac electrophysiology (EP) and, more specifically, to image-guided radio frequency ablation and pacemaker placement procedures. For those procedures, it is proposed to display the overlaid 2D navigation motions of an interventional tool intraoperatively obtained from the same projection angle for tracking navigation motions of an interventional tool during an image-guided intervention procedure while being navigated through a patient's bifurcated coronary vessel or cardiac chambers anatomy in order to guide e.g. a cardiovascular catheter to a target structure or lesion in a cardiac vessel segment of the patient's coronary venous tree or to a region of interest within the myocard. In such a way, a dynamically enriched 2D reconstruction of the patient's anatomy is obtained while moving the interventional instrument. By applying a cardiac and/or respiratory gating technique, it can be provided that the 2D live images are acquired during the same phases of the patient's cardiac and/or respiratory cycles. Compared to prior-art solutions which are based on a registration and fusion of image data independently acquired by two distinct imaging modalities, the accuracy of the two-dimensionally reconstructed anatomy is significantly enhanced.