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用于图像引导心脏消融治疗监测的病变建模、特征描述及可视化

Lesion modeling, characterization, and visualization for image-guided cardiac ablation therapy monitoring.

作者信息

Linte Cristian A, Camp Jon J, Rettmann Maryam E, Haemmerich Dieter, Aktas Mehmet K, Huang David T, Packer Douglas L, Holmes David R

机构信息

Rochester Institute of Technology, Biomedical Engineering and Chester F. Carlson Center for Imaging Science, Rochester, New York, United States.

Mayo Clinic, Biomedical Imaging Resource, Rochester, Minnesota, United States.

出版信息

J Med Imaging (Bellingham). 2018 Apr;5(2):021218. doi: 10.1117/1.JMI.5.2.021218. Epub 2018 Mar 1.

Abstract

In spite of significant efforts to improve image-guided ablation therapy, a large number of patients undergoing ablation therapy to treat cardiac arrhythmic conditions require repeat procedures. The delivery of insufficient thermal dose is a significant contributor to incomplete tissue ablation, in turn leading to the arrhythmia recurrence. Ongoing research efforts aim to better characterize and visualize RF delivery to monitor the induced tissue damage during therapy. Here, we propose a method that entails modeling and visualization of the lesions in real-time. The described image-based ablation model relies on classical heat transfer principles to estimate tissue temperature in response to the ablation parameters, tissue properties, and duration. The ablation lesion quality, geometry, and overall progression are quantified on a voxel-by-voxel basis according to each voxel's cumulative temperature and time exposure. The model was evaluated both numerically under different parameter conditions, as well as experimentally, using bovine tissue samples undergoing clinically relevant ablation protocols. The studies demonstrated less than 5°C difference between the model-predicted and experimentally measured end-ablation temperatures. The model predicted lesion patterns were within 0.5 to 1 mm from the observed lesion patterns, suggesting sufficiently accurate modeling of the ablation lesions. Lastly, our proposed method enables therapy delivery feedback with no significant workflow latency. This study suggests that the proposed technique provides reasonably accurate and sufficiently fast visualizations of the delivered ablation lesions.

摘要

尽管在改进图像引导消融治疗方面付出了巨大努力,但大量接受消融治疗以治疗心律失常疾病的患者仍需要重复手术。热剂量不足是导致组织消融不完全的一个重要因素,进而导致心律失常复发。正在进行的研究旨在更好地表征和可视化射频传递,以监测治疗过程中引起的组织损伤。在此,我们提出一种方法,该方法需要对病变进行实时建模和可视化。所描述的基于图像的消融模型依靠经典传热原理,根据消融参数、组织特性和持续时间来估计组织温度。根据每个体素的累积温度和时间暴露情况,逐体素地对消融病变质量、几何形状和整体进展进行量化。该模型在不同参数条件下进行了数值评估,并使用接受临床相关消融方案的牛组织样本进行了实验评估。研究表明,模型预测的消融结束时温度与实验测量值之间的差异小于5°C。模型预测的病变模式与观察到的病变模式相差在0.5至1毫米以内,这表明对消融病变的建模足够准确。最后,我们提出的方法能够提供治疗反馈,且工作流程延迟不显著。这项研究表明,所提出的技术能够对所传递的消融病变进行合理准确且足够快速的可视化。

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Cardiac Lesion Mapping In Vivo Using Intracardiac Myocardial Elastography.利用心内心肌弹性成像技术进行活体心脏损伤定位。
IEEE Trans Ultrason Ferroelectr Freq Control. 2018 Jan;65(1):14-20. doi: 10.1109/TUFFC.2017.2768301.
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Proc SPIE Int Soc Opt Eng. 2015 Feb 21;9415. doi: 10.1117/12.2083122. Epub 2015 Mar 18.
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