Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States of America.
Department of Computer Science, Technical University of Munich, Munich, Germany.
PLoS One. 2018 Oct 8;13(10):e0205188. doi: 10.1371/journal.pone.0205188. eCollection 2018.
Visualization of the complex 3D architecture of myocardial scar could improve guidance of radio-frequency ablation in the treatment of ventricular tachycardia (VT). In this study, we sought to develop a framework for 3D holographic visualization of myocardial scar, imaged using late gadolinium enhancement (LGE), on the augmented reality HoloLens. 3D holographic LGE model was built using the high-resolution 3D LGE image. Smooth endo/epicardial surface meshes were generated using Poisson surface reconstruction. For voxel-wise 3D scar model, every scarred voxel was rendered into a cube which carries the actual resolution of the LGE sequence. For surface scar model, scar information was projected on the endocardial surface mesh. Rendered layers were blended with different transparency and color, and visualized on HoloLens. A pilot animal study was performed where 3D holographic visualization of the scar was performed in 5 swines who underwent controlled infarction and electroanatomic mapping to identify VT substrate. 3D holographic visualization enabled assessment of the complex 3D scar architecture with touchless interaction in a sterile environment. Endoscopic view allowed visualization of scar from the ventricular chambers. Upon completion of the animal study, operator and mapping specialist independently completed the perceived usefulness questionnaire in the six-item usefulness scale. Operator and mapping specialist found it useful (usefulness rating: operator, 5.8; mapping specialist, 5.5; 1-7 scale) to have scar information during the intervention. HoloLens 3D LGE provides a true 3D perception of the complex scar architecture with immersive experience to visualize scar in an interactive and interpretable 3D approach, which may facilitate MR-guided VT ablation.
心肌瘢痕的复杂 3D 结构可视化可以改善射频消融治疗室性心动过速 (VT) 的指导。在这项研究中，我们试图开发一种基于增强现实 HoloLens 的心肌瘢痕 3D 全息可视化框架，使用晚期钆增强 (LGE) 进行成像。使用高分辨率 3D LGE 图像构建 3D 全息 LGE 模型。使用泊松曲面重建生成光滑的心内膜/心外膜表面网格。对于体素化 3D 瘢痕模型，将每个瘢痕化体素渲染成一个带有 LGE 序列实际分辨率的立方体。对于表面瘢痕模型，将瘢痕信息投影到心内膜表面网格上。渲染层以不同的透明度和颜色混合，并在 HoloLens 上可视化。进行了一项初步动物研究，在 5 头接受控制性梗死和电解剖标测以识别 VT 底物的猪中进行了瘢痕的 3D 全息可视化。3D 全息可视化允许在无菌环境中进行非接触式交互评估复杂的 3D 瘢痕结构。内窥镜视图允许从心室腔观察瘢痕。动物研究完成后，操作人员和绘图专家分别在六项有用性量表中完成了对感知有用性的问卷调查。操作人员和绘图专家发现，在干预过程中获取瘢痕信息非常有用（有用性评分：操作人员 5.8；绘图专家 5.5；1-7 量表）。HoloLens 3D LGE 以沉浸式体验提供了对复杂瘢痕结构的真实 3D 感知，以交互式和可解释的 3D 方式可视化瘢痕，这可能有助于磁共振引导的 VT 消融。
