Accuracy considerations in image-guided cardiac interventions: Experience and lessons learned

Cristian A. Linte, Pencilla Lang, Maryam E. Rettmann, Daniel S. Cho, David R. Holmes, Richard A. Robb, Terry M. Peters

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Motivation Medical imaging and its application in interventional guidance has revolutionized the development of minimally invasive surgical procedures leading to reduced patient trauma, fewer risks, and shorter recovery times. However, a frequently posed question with regard to an image guidance system is "how accurate is it?" On one hand, the accuracy challenge can be posed in terms of the tolerable clinical error associated with the procedure; on the other hand, accuracy is bound by the limitations of the system's components, including modeling, patient registration, and surgical instrument tracking, all of which ultimately impact the overall targeting capabilities of the system. Methods While these processes are not unique to any interventional specialty, this paper discusses them in the context of two different cardiac image guidance platforms: a modelenhanced ultrasound platform for intracardiac interventions and a prototype system for advanced visualization in imageguided cardiac ablation therapy. Results Pre-operative modeling techniques involving manual, semi-automatic and registration-based segmentation are discussed. The performance and limitations of clinically feasible approaches for patient registration evaluated both in the laboratory and in the operating room are presented. Our experience with two different magnetic tracking systems for instrument and ultrasound transducer localization is reported. Ultimately, the overall accuracy of the systems is discussed based on both in vitro and preliminary in vivo experience. Conclusion While clinical accuracy is specific to a particular patient and procedure and vastly dependent on the surgeon's experience, the system's engineering limitations are critical to determine whether the clinical requirements can be met.

Original languageEnglish (US)
Pages (from-to)13-25
Number of pages13
JournalInternational Journal of Computer Assisted Radiology and Surgery
Volume7
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • Clinical and engineering accuracy considerations
  • Medical imaging and modeling
  • Minimally invasive cardiac interventions
  • Registration
  • Surgical tracking

ASJC Scopus subject areas

  • Surgery
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging
  • Computer Vision and Pattern Recognition
  • Health Informatics
  • Computer Science Applications
  • Computer Graphics and Computer-Aided Design

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