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基于二维-三维配准的标准透视系统的介入数字断层融合摄影术。

Interventional digital tomosynthesis from a standard fluoroscopy system using 2D-3D registration.

机构信息

Biomedical Engineering Dept., King's College London, King's Health Partners, London, UK.

Vascular Surgery Dept., Guys & St Thomas' NHS Foundation Trust, King's Health Partners, London, UK.

出版信息

Med Image Anal. 2015 Jan;19(1):137-48. doi: 10.1016/j.media.2014.10.001. Epub 2014 Oct 16.

Abstract

Interventional fluoroscopy provides guidance in a variety of minimally invasive procedures. However, three-dimensional (3D) clinically relevant information is projected onto a two-dimensional (2D) image which can make image interpretation difficult. Moreover, vasculature visualisation requires the use of iodinated contrast media which is nephrotoxic and is the primary cause of renal complications. In this article, we demonstrate how digital tomosynthesis slices can be produced on standard fluoroscopy equipment by registering the preoperative CT volume and the intraoperative fluoroscopy images using 2D-3D image registration. The proposed method automatically reconstructs patient-anatomy-specific slices and removes clutter resulting from bony anatomy. Such slices could provide additional intraoperative information which cannot be provided by the preoperative CT volume alone, such as the deformed aorta position offering improved guidance precision. Image acquisition would fit with interventional clinical work-flow and would not require a high X-ray dose. Experiments are carried out using one phantom and four clinical datasets. Phantom results showed a 3351% contrast-to-noise improvement compared to standard fluoroscopy. Patient results showed our method enabled visualization of clinically relevant features: outline of the aorta, the aortic bifurcation and some aortic calcifications.

摘要

介入性透视提供了各种微创程序的指导。然而,三维(3D)临床相关信息被投影到二维(2D)图像上,这使得图像解释变得困难。此外,血管可视化需要使用碘造影剂,而碘造影剂具有肾毒性,是导致肾脏并发症的主要原因。在本文中,我们展示了如何通过使用二维-三维图像配准,在标准透视设备上生成数字断层合成切片,将术前 CT 容积和术中透视图像进行配准。该方法可以自动重建患者解剖特有的切片,并去除由骨解剖引起的混杂。这些切片可以提供仅靠术前 CT 容积无法提供的额外术中信息,例如变形的主动脉位置,提供了更高的指导精度。图像采集将符合介入临床工作流程,且不需要高 X 射线剂量。实验使用一个体模和四个临床数据集进行。与标准透视相比,体模结果显示对比度噪声比提高了 3351%。患者结果表明,我们的方法能够可视化临床相关特征:主动脉轮廓、主动脉分叉和一些主动脉钙化。

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