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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/21602

Title: Multi-phase rotational angiography of the left ventricle to assist ablations: feasibility and accuracy of novel imaging
Authors: Wielandts, Jean-Yves
De Buck, Stijn
Michielsen, Koen
Louw, Ruan
Garweg, Christophe
Nuyts, Johan
Ector, Joris
Maes, Frederik
Heidbuchel, Hein
Issue Date: 2016
Abstract: Aims Interventional left ventricular (LV) procedures integrating static 3D anatomy visualization are subject to mismatch with dynamic catheter movements due to prominent LV motion. We aimed to evaluate the accuracy of a recently developed acquisition and post-processing protocol for low radiation dose LV multi-phase rotational angiography (4DRA) in patients. Methods and results 4DRA image acquisition of the LV was performed as investigational acquisition in patients undergoing left-sided ablation (11 men; BMI = 24.7 +/- 2.5 kg/m(2)). Iodine contrast was injected in the LA, while pacing from the RA at a cycle length of 700 ms. 4DRAacquisition and reconstruction were possible in all 11 studies. Reconstructed images were post-processed using streak artefact reduction algorithms and an interphase registration-based filtering method, increasing contrast-tonoise ratio by a factor 8.2 +/- 2.1. This enabled semi-automatic segmentation, yielding LV models of five equidistant phases per cardiac cycle. For evaluation, off-line 4DRA fluoroscopy registration was performed, and the 4DRA LV contours of the different phases were compared with the contours of five corresponding phases of biplane LV angiography, acquired in identical circumstances. Of the distances between these contours, 95% were,4 mm in both incidences. Effective radiation dose for 4DRA, calculated by patient-specific Monte-Carlo simulation, was 5.1 +/- 1.1 mSv. Conclusion Creation of 4DRA LV models in man is feasible at near-physiological heart rate and with clinically acceptable radiation dose. They showed high accuracy with respect to LV angiography in RAO and LAO. The presented technology not only opens perspectives for full cardiac cycle dynamic anatomical guidance during interventional procedures, but also for 3DRA without need for very rapid pacing.
Notes: [Wielandts, Jean-Yves; Louw, Ruan; Garweg, Christophe; Ector, Joris] Katholieke Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium. [Wielandts, Jean-Yves; De Buck, Stijn; Michielsen, Koen; Nuyts, Johan; Maes, Frederik] Katholieke Univ Leuven, Med Imaging Res Ctr, Herestr 49, Leuven, Belgium. [Wielandts, Jean-Yves; De Buck, Stijn; Michielsen, Koen; Nuyts, Johan; Maes, Frederik] UZ Leuven, Herestr 49, Leuven, Belgium. [De Buck, Stijn; Maes, Frederik] Katholieke Univ Leuven, Med Image Comp, ESAT PSI, Dept Elect Engn, Leuven, Belgium. [Michielsen, Koen; Nuyts, Johan] Katholieke Univ Leuven, Dept Nucl Med & Mol Imaging, Leuven, Belgium. [Maes, Frederik] Katholieke Univ Leuven, iMinds Future Hlth Dept, Leuven, Belgium. [Heidbuchel, Hein] Hasselt Univ, Diepenbeek, Belgium. [Heidbuchel, Hein] Heart Ctr Hasselt, Diepenbeek, Belgium.
URI: http://hdl.handle.net/1942/21602
DOI: 10.1093/ehjci/jev120
ISI #: 000375431800011
ISSN: 2047-2404
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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