Suivi temporel 3D de vaisseaux coronaires dans les projections rayons X

International audienceFusing pre-operative CT angiography with per-operative an-giographic and fluoroscopic images is considered by physicians as a potentially useful tool for improved guidance. To be adopted, this tool requires the development of tracking methods adapted to the deformations of the arteries caused by the cardiac motion. Here, we propose a 3D/2D temporal tracking of one coronary vessel, based on a spline deformation, using pairings with a controlled 2D stretching or contraction along the paired curves and a preservation of the length of the 3D curve. Experiments were conducted on a database of 10 vessels from 5 distinct patients, with dedicated metrics assessing both the global registration and the local coherency of the position along the vessel. The proposed results demonstrate the efficiency of the proposed method, with an average standard deviation of 2 mm for the localization of landmarks

Recalage préservant la topologie des vaisseaux: application à la cardiologie interventionnelle

In percutaneous coronary interventions, integrating into the live fluoroscopic image vessel calcifications and occlusion information that are revealed in the pre-operative Computed Tomography Angiography can greatly improve guidance of the clinician. Fusing pre- and intra-operative information into a single space aims at taking advantage of two complementary modalities and requires a step of registration that must provide good alignment and relevant correspondences between them. Most of the existing 3D/2D vessel registration algorithms do not take into account the particular topology of the vasculature to be matched, resulting into pairings that may be topologically inconsistent along the vasculature.A first contribution consisted in a registration framework dedicated to curve matching, denoted the Iterative Closest Curve (ICC). Its main feature is to preserve the topological consistency along curves by taking advantage of the Frechet distance that not only computes the distance between two curves but also builds ordered pairings along them. A second contribution is a pairing procedure designed for the matching of a vascular tree structure that endorses its particular topology and that can easily take advantage of the ICC-framework. Centerlines of the 3D tree are matched to curves extracted from the 2D vascular graph while preserving the connectivity at 3D bifurcations. The matching criterion used to build the pairings takes into account the geometric distance and the resemblance between curves both based on a global formulation using the Frechet distance.To evaluate our approach we run experiments on a database composed of 63 clinical cases, measuring accuracy on real conditions and robustness with respect to a simulated displacement. Quantitative results have been obtained using two complementary measures that aim at assessing the results both geometrically and topologically, and quantify the resulting alignment error as well as the pairing error. The proposed method exhibits good results both in terms of pairing and alignment and demonstrates to be low sensitive to the rotations to be compensated (up to 30 degrees).Cette thèse s’inscrit dans le cadre de la cardiologie interventionnelle. Intégrer des informations telles que la position des calcifications ainsi que la taille et forme d’une occlusion dans les images fluoroscopiques constituerait un bénéfice pour le praticien. Ces informations, invisibles dans les images rayons-X pendant la procédure, sont présentes au sein du scanner CT préopératoire. La fusion de cette modalité avec la fluoroscopie apporterait une aide précieuse au guidage temps réel des outils interventionnels en bénéficiant des informations fournies par le CT. Cette fusion requiert une étape de recalage qui vise à aligner au mieux les deux modalités et fournir des correspondances pertinentes entre elles. La plupart des algorithmes de recalage 3D/2D de vaisseaux rencontrent des difficultés à construire des appariements anatomiquement pertinents, essentiellement à cause du manque de cohérence topologique le long du réseau vasculaire.Afin de résoudre ce problème, nous proposons dans cette thèse un cadre générique pour le recalage de structures curvilinéaires. L’algorithme qui en découle préserve la structure des courbes appariées. Les artères coronaires pouvant être représentées par un ensemble de courbes arrangées en arbre, nous proposons aussi une procédure d’appariement qui respecte cette structure. Le recalage d’un arbre 3D sur un graphe 2D est ainsi réalisé en assurant la préservation des connectivités aux bifurcations. Le choix de l’appariement est basé sur un critère prenant en compte la distance géométrique ainsi que la ressemblance entre courbes. Ce critère est évalué grâce à une forme modifiée de la distance de Fréchet.Une base de données de 63 cas cliniques a été utilisée à travers différentes expériences afin de prouver la robustesse et la précision de notre approche. Nous avons proposé deux mesures complémentaires visant à quantifier la qualité de l’alignement d’une part et des appariements engendrés d’autre part. La méthode proposée se montre précise pour les alignements de la projection du modèle CT et des artères coronaires observées dans les images angiographiques. De plus, les appariements obtenus sont anatomiquement pertinents et lálgorithme a prouvé sa robustesse face aux perturbations de la position initiale. Nous attribuons cette robustesse à la qualité des appariements construits au fur et à mesure des itérations

IVUS – UBPCL(I)

Treballs Finals de Grau d'Enginyeria Informàtica, Facultat de Matemàtiques, Universitat de Barcelona, Any: 2013, Director: Petia RadevaEn los últimos años la medicina ha avanzado a una velocidad vertiginosa, en parte por nuevos descubrimientos y en parte causado por la evolución tecnológica. Esto hace que se presenten nuevos problemas, ya que ahora somos capaces de extraer gran cantidad de información, pero nos encontramos delante de un gran muro que hay que sortear. Este muro es la dificultad de tratar y obtener resultados de este volumen ingente de información. En nuestro caso, la tecnología IVUS ha supuesto un gran avance para la detección y el tratamiento de enfermedades de las arterias coronarias (EAC), pero también ha supuesto un reto cómo obtener la información, ya que, gracias a la tecnología IVUS tenemos que lidiar con una gran cantidad de imágenes. El objetivo de nuestro proyecto es crear una herramienta que ayude al profesional a tratar y procesar toda la información de la manera más cómoda y rápida posible para poder obtener el mejor resultado y diagnosticar o tratar al paciente

Examination of myocardial electrophysiology using novel panoramic optical mapping techniques

Optical mapping of voltage signals has revolutionised the field and study of cardiac electrophysiology by providing the means to visualise changes in electrical activity at a high temporal and spatial resolution from the cellular to the whole heart level under both normal and disease conditions. The aim of this thesis was to develop a novel method of panoramic optical mapping using a single camera and to study myocardial electrophysiology in isolated Langendorff-perfused rabbit hearts. First, proper procedures for selection, filtering and analysis of the optical data recorded from the panoramic optical mapping system were established. This work was followed by extensive characterisation of the electrical activity across the epicardial surface of the preparation investigating time and heart dependent effects. In an initial study, features of epicardial electrophysiology were examined as the temperature of the heart was reduced below physiological values. This manoeuvre was chosen to mimic the temperatures experienced during various levels of hypothermia in vivo, a condition known to promote arrhythmias. The facility for panoramic optical mapping allowed the extent of changes in conduction timing and pattern of ventricular activation and repolarisation to be assessed. In the main experimental section, changes in epicardial electrical activity were assessed under various pacing conditions in both normal hearts and in a rabbit model of chronic MI. In these experiments, there was significant changes in the pattern of electrical activation corresponding with the changes in pacing regime. These experiments demonstrated a negative correlation between activation time and APD, which was not maintained during ventricular pacing. This suggests that activation pattern is not the sole determinant of action potential duration in intact hearts. Lastly, a realistic 3D computational model of the rabbit left ventricle was developed to simulate the passive and active mechanical properties of the heart. The aim of this model was to infer further information from the experimental optical mapping studies. In future, it would be feasible to gain insight into the electrical and mechanical performance of the heart by simulating experimental pacing conditions in the model