MRI-based visual and haptic catheter feedback: simulating a novel system's contribution to efficient and safe MRI-guided cardiac electrophysiology procedures
Identifieur interne : 000C08 ( Pmc/Curation ); précédent : 000C07; suivant : 000C09MRI-based visual and haptic catheter feedback: simulating a novel system's contribution to efficient and safe MRI-guided cardiac electrophysiology procedures
Auteurs : Ka-Wai Kwok [États-Unis] ; Yue Chen [États-Unis] ; Thomas Cp Chau [Royaume-Uni] ; Wayne Luk [Royaume-Uni] ; Kent Ronald Nilsson [États-Unis] ; Ehud J. Schmidt [États-Unis] ; Zion T. Tse [États-Unis]Source :
- Journal of Cardiovascular Magnetic Resonance [ 1097-6647 ] ; 2014.
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DOI: 10.1186/1532-429X-16-S1-O50
PubMed: NONE
PubMed Central: 4044231
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Schmidt</name><affiliation wicri:level="1"><nlm:aff id="I4">Radiology, Brigham and Women's Hospital, Harvard, Boston, Massachusetts, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Radiology, Brigham and Women's Hospital, Harvard, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Tse, Zion T" sort="Tse, Zion T" uniqKey="Tse Z" first="Zion T" last="Tse">Zion T. Tse</name><affiliation wicri:level="1"><nlm:aff id="I1">College of Engineering, University of Georgia, Athens, Georgia, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>College of Engineering, University of Georgia, Athens, Georgia</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">4044231</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4044231</idno><idno type="RBID">PMC:4044231</idno><idno type="doi">10.1186/1532-429X-16-S1-O50</idno><idno type="pmid">NONE</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000C08</idno><idno type="wicri:Area/Pmc/Curation">000C08</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">MRI-based visual and haptic catheter feedback: simulating a novel system's contribution to efficient and safe MRI-guided cardiac electrophysiology procedures</title><author><name sortKey="Kwok, Ka Wai" sort="Kwok, Ka Wai" uniqKey="Kwok K" first="Ka-Wai" last="Kwok">Ka-Wai Kwok</name><affiliation wicri:level="1"><nlm:aff id="I1">College of Engineering, University of Georgia, Athens, Georgia, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>College of Engineering, University of Georgia, Athens, Georgia</wicri:regionArea></affiliation></author><author><name sortKey="Chen, Yue" sort="Chen, Yue" uniqKey="Chen Y" first="Yue" last="Chen">Yue Chen</name><affiliation wicri:level="1"><nlm:aff id="I1">College of Engineering, University of Georgia, Athens, Georgia, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>College of Engineering, University of Georgia, Athens, Georgia</wicri:regionArea></affiliation></author><author><name sortKey="Chau, Thomas Cp" sort="Chau, Thomas Cp" uniqKey="Chau T" first="Thomas Cp" last="Chau">Thomas Cp Chau</name><affiliation wicri:level="1"><nlm:aff id="I2">Computing, Imperial College London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Computing, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Luk, Wayne" sort="Luk, Wayne" uniqKey="Luk W" first="Wayne" last="Luk">Wayne Luk</name><affiliation wicri:level="1"><nlm:aff id="I2">Computing, Imperial College London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Computing, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Nilsson, Kent Ronald" sort="Nilsson, Kent Ronald" uniqKey="Nilsson K" first="Kent Ronald" last="Nilsson">Kent Ronald Nilsson</name><affiliation wicri:level="1"><nlm:aff id="I3">Athens Regional Medical Center, University of Georgia, Athens, Georgia, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Athens Regional Medical Center, University of Georgia, Athens, Georgia</wicri:regionArea></affiliation></author><author><name sortKey="Schmidt, Ehud J" sort="Schmidt, Ehud J" uniqKey="Schmidt E" first="Ehud J" last="Schmidt">Ehud J. Schmidt</name><affiliation wicri:level="1"><nlm:aff id="I4">Radiology, Brigham and Women's Hospital, Harvard, Boston, Massachusetts, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Radiology, Brigham and Women's Hospital, Harvard, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Tse, Zion T" sort="Tse, Zion T" uniqKey="Tse Z" first="Zion T" last="Tse">Zion T. Tse</name><affiliation wicri:level="1"><nlm:aff id="I1">College of Engineering, University of Georgia, Athens, Georgia, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>College of Engineering, University of Georgia, Athens, Georgia</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Cardiovascular Magnetic Resonance</title><idno type="ISSN">1097-6647</idno><idno type="eISSN">1532-429X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ce, Saikus" uniqKey="Ce S">Saikus CE</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zth, Tse" uniqKey="Zth T">Tse ZTH</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ej, Schmidt" uniqKey="Ej S">Schmidt EJ</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kw, Kwok" uniqKey="Kw K">Kwok KW</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="abstract" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Cardiovasc Magn Reson</journal-id><journal-id journal-id-type="iso-abbrev">J Cardiovasc Magn Reson</journal-id><journal-title-group><journal-title>Journal of Cardiovascular Magnetic Resonance</journal-title></journal-title-group><issn pub-type="ppub">1097-6647</issn><issn pub-type="epub">1532-429X</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">4044231</article-id><article-id pub-id-type="publisher-id">1532-429X-16-S1-O50</article-id><article-id pub-id-type="doi">10.1186/1532-429X-16-S1-O50</article-id><article-categories><subj-group subj-group-type="heading"><subject>Oral Presentation</subject></subj-group></article-categories><title-group><article-title>MRI-based visual and haptic catheter feedback: simulating a novel system's contribution to efficient and safe MRI-guided cardiac electrophysiology procedures</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Kwok</surname><given-names>Ka-Wai</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib><contrib contrib-type="author" id="A2"><name><surname>Chen</surname><given-names>Yue</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib><contrib contrib-type="author" id="A3"><name><surname>Chau</surname><given-names>Thomas CP</given-names></name><xref ref-type="aff" rid="I2">2</xref></contrib><contrib contrib-type="author" id="A4"><name><surname>Luk</surname><given-names>Wayne</given-names></name><xref ref-type="aff" rid="I2">2</xref></contrib><contrib contrib-type="author" id="A5"><name><surname>Nilsson</surname><given-names>Kent Ronald</given-names></name><xref ref-type="aff" rid="I3">3</xref></contrib><contrib contrib-type="author" id="A6"><name><surname>Schmidt</surname><given-names>Ehud J</given-names></name><xref ref-type="aff" rid="I4">4</xref></contrib><contrib contrib-type="author" id="A7"><name><surname>Tse</surname><given-names>Zion T</given-names></name><xref ref-type="aff" rid="I1">1</xref></contrib></contrib-group><aff id="I1"><label>1</label>College of Engineering, University of Georgia, Athens, Georgia, USA</aff><aff id="I2"><label>2</label>Computing, Imperial College London, London, UK</aff><aff id="I3"><label>3</label>Athens Regional Medical Center, University of Georgia, Athens, Georgia, USA</aff><aff id="I4"><label>4</label>Radiology, Brigham and Women's Hospital, Harvard, Boston, Massachusetts, USA</aff><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>16</day><month>1</month><year>2014</year></pub-date><volume>16</volume><issue>Suppl 1</issue><supplement><named-content content-type="supplement-title">Abstracts of the 17th Annual SCMR Scientific Sessions</named-content><named-content content-type="supplement-sponsor">Publication of this supplement was funded by the Society for Cardiovascular Magnetic Resonance.</named-content></supplement><fpage>O50</fpage><lpage>O50</lpage><permissions><copyright-statement>Copyright © 2014 Kwok et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2014</copyright-year><copyright-holder>Kwok et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><self-uri xlink:href="http://www.jcmr-online.com/content/16/S1/O50"></self-uri><conference><conf-date>16-19 January 2014</conf-date><conf-name>17th Annual SCMR Scientific Sessions</conf-name><conf-loc>New Orleans, LA, USA</conf-loc></conference></article-meta></front><body><sec><title>Background</title><p>MRI-guided Electrophysiology (EP) procedures integrate real-time MRI images with catheter position during Radiofrequency Ablation (RFA) of arrhythmias [<xref ref-type="bibr" rid="B1">1</xref>]. Using simultaneous MR catheter tracking and imaging [<xref ref-type="bibr" rid="B2">2</xref>], this technology can both guide catheter manipulation and provide dynamic assessment of lesion efficacy [<xref ref-type="bibr" rid="B3">3</xref>]. Despite advances in MRI-guided EP, maneuvering catheters to the desired location and ensuring appropriate tissue contact is still challenging inside an MRI due to two issues: (1) inconsistent catheter-tissue contact force (CTCF); and (2) visual-motor disorientation arising from differences between manipulation of the catheter's proximal controlling handle and visualization of the catheter-tissue interface. Both issues can increase the risk of cardiac perforation during catheter manipulation. We hypothesized that a technique based on MR imaging to generate force and vibrotactile alarms, as well as the presentation of a reproducible endoscopic view to the catheter operator, could facilitate precise application of RF energy, thereby increasing efficacy and reducing complications.</p></sec><sec sec-type="methods"><title>Methods</title><p>Catheter position and cardiovascular structure were updated from MR images (Figure <xref ref-type="fig" rid="F1">1a</xref>, upper-right), and the magnitude of CTCF was computed using a graphics processing unit (GPU). A collaborative control strategy, Dynamic Active Constraints (DACs) [<xref ref-type="bibr" rid="B4">4</xref>], then rendered CTCF alarms to the catheter operator (Figure <xref ref-type="fig" rid="F1">1b-c</xref>) in the form of: (i) resistive force against excessive advancement of catheter into tissue beyond the imaging model; and (ii) catheter handle vibratory feedback indicating tissue proximity to the RFA targets. The CTCF alarm signals were generated using MR-conditional pneumatic catheter braking and vibrotactile units placed on the catheter's handle, and operated with a 30psi pressure. A virtual camera view (Figure <xref ref-type="fig" rid="F1">1a</xref>, upper-left) was reconstructed at the catheter tip to provide an endoscopic visualization of the 3-dimensional MRI cardiovascular model. An overview of the complete proposed system is included (Figure <xref ref-type="fig" rid="F2">2a</xref>).</p><fig id="F1" position="float"><label>Figure 1</label><caption><p><bold>(a) Catheter endoscopic view visualizing the left superior pulmonary vein (LSPV) and left interior pulmonary vein (LIPV) with predefined RAF targets (in red)</bold>. The left atrium (LA) model (in blue circle) obtained by a 3-D rendering volume; (b-c) Catheter guidance interface with Catheter-Tissue Contact Force alarms.</p></caption><graphic xlink:href="1532-429X-16-S1-O50-1"></graphic></fig><fig id="F2" position="float"><label>Figure 2</label><caption><p><bold>(a) Simulated System Overview; (b) Performance metrics of a simulated EP RFA procedure performed by ten EP-untrained volunteers</bold>.</p></caption><graphic xlink:href="1532-429X-16-S1-O50-2"></graphic></fig></sec><sec sec-type="results"><title>Results</title><p>Ten volunteers without training in EP procedures were recruited to participate in a simulated RFA procedure to evaluate the performance with and without the proposed endoscopic view and haptic interface. RFA targets were pre-defined at the left pulmonary veins inside a left atrium model reconstructed from the preoperative image data from a cardiac patient (Figure <xref ref-type="fig" rid="F1">1a</xref>). The subjects were allowed to manipulate the catheter so as to locate the virtual catheter tip in the targets, followed by the performance of ablations at multiple locations around the pulmonary vein ostium. Six performance indices with/without the use of the proposed interface are shown in Figure <xref ref-type="fig" rid="F2">2b</xref>. On average, subjects demonstrated a 61.6% (σ = 22%) improvement in terms of RFA accuracy, efficiency and safety.</p></sec><sec sec-type="conclusions"><title>Conclusions</title><p>The proposed image-based catheter haptic guidance and endoscopic view improved RFA procedural time and accuracy, and reduced the risk of perforation.</p></sec></body><back><sec><title>Acknowledgements</title><p>NIH U41-RR019703, R43 HL110427-01, AHA 10SDG261039, EPSRC and Croucher Foundation Fellowship.</p></sec><ref-list><ref id="B1"><mixed-citation publication-type="other"><name><surname>CE</surname><given-names>Saikus</given-names></name><source>JACC Img.'09</source></mixed-citation></ref><ref id="B2"><mixed-citation publication-type="other"><name><surname>ZTH</surname><given-names>Tse</given-names></name><source>ISMRM'12</source></mixed-citation></ref><ref id="B3"><mixed-citation publication-type="other"><name><surname>EJ</surname><given-names>Schmidt</given-names></name><source>Circ.'09 & MRM'13</source></mixed-citation></ref><ref id="B4"><mixed-citation publication-type="other"><name><surname>KW</surname><given-names>Kwok</given-names></name><source>TRO'13</source></mixed-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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