Semiautomatic Estimation of Device Size for Left Atrial Appendage Occlusion in 3-D TEE Images

• Tipo: Artigo em Revista Científica Internacional
• Data: 2019-05

Autores

Pedro Morais (Autor) Outra; João L. Vilaça (Autor) Outra; Sandro Queirós (Autor) Outra; Pieter De Meester (Autor) Outra; Werner Budts (Autor) Outra; João Manuel R. S. Tavares (Autor) FEUP; Jan D'hooge (Autor) Outra

Revista

Título: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control

Vol. 66 Nº 5

Páginas: 922-929

ISSN: 0885-3010

Editora: IEEE

Indexação

ISI Web of Knowledge - 0 Citações

ISI Web of Science

Scopus - 1 Citação

Classificação Científica

CORDIS: Ciências Tecnológicas

FOS: Ciências médicas e da saúde

Outras Informações

ID Authenticus: P-00Q-JXA

DOI: 10.1109/tuffc.2019.2903886

Abstract (EN): Left atrial appendage (LAA) occlusion is used to reduce the risk of thromboembolism in patients with non-valvular atrial fibrillation by obstructing the LAA through a percutaneously delivered device. Nonetheless, correct device sizing is complex, requiring the manual estimation of different measurements in preprocedural/periprocedural images, which is tedious and time-consuming and with high interobserver and intraobserver variability. In this paper, a semiautomatic solution to estimate the required relevant clinical measurements is described. This solution starts with the 3-D segmentation of the LAA in 3-D transesophageal echocardiographic images, using a constant blind-ended model initialized through a manually defined spline. Then, the segmented LAA surface is aligned with a set of templates, i.e., 3-D surfaces plus relevant measurement planes (manually defined by one observer), transferring the latter to the unknown situation. Specifically, the alignment is performed in three consecutive steps, namely: 1) rigid alignment using the LAA clipping plane position; 2) orientation compensation using the circumflex artery location; and 3) anatomical refinement through a weighted iterative closest point algorithm. The novel solution was evaluated in a clinical database with 20 volumetric TEE images. Two experiments were set up to assess: 1) the sensitivity of the model's parameters and 2) the accuracy of the proposed solution for the estimation of the clinical measurements. Measurement levels manually identified by two observers were used as ground truth. The proposed solution obtained results comparable to the interobserver variability, presenting narrower limits of agreement for all measurements. Moreover, this solution proved to be fast, taking nearly 40 s (manual analysis took 3 min) to estimate the relevant measurements while being robust to the variation of the model's parameters. Overall, the proposed solution showed its potential for fast and robust estimation of the clinical measurements for occluding device selection, proving its added value for clinical practice.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 8