Key result
Live registration of TEE and fluoroscopy images demonstrated probe tracking errors below 0.6 mm and 0.2°, a 2-D RMS registration error of 1.5 mm, and a tracking failure rate below 1%.
A novel fiducial-based TEE-fluoroscopy registration system for TAVI provides highly accurate probe tracking with errors below 0.6 mm and a failure rate under 1% without requiring additional hardware.
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Supports feasibility of accurate TEE-fluoroscopy fusion without added hardware; leaves open clinical efficacy in TAVI procedures.
Transcatheter aortic valve implantation is a minimally invasive alternative to open-heart surgery for aortic stenosis in which a stent-based bioprosthetic valve is delivered into the heart on a catheter. Limited visualization during this procedure can lead to severe complications. Improved visualization can be provided by live registration of transesophageal echo (TEE) and fluoroscopy images intraoperatively. Since the TEE probe is always visible in the fluoroscopy image, it is possible to track it using fiducial-based single-perspective pose estimation. In this study, inherent probe tracking performance was assessed, and TEE to fluoroscopy registration accuracy and robustness were evaluated. Results demonstrated probe tracking errors of below 0.6 mm and 0.2°, a 2-D RMS registration error of 1.5 mm, and a tracking failure rate of below 1%. In addition to providing live registration and better accuracy and robustness compared to existing TEE probe tracking methods, this system is designed to be suitable for clinical use. It is fully automatic, requires no additional operating room hardware, does not require intraoperative calibration, maintains existing procedure and imaging workflow without modification, and can be implemented in all cardiac centers at extremely low cost.
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Lang et al. (2012) studied Aortic stenosis. Live registration of transesophageal echo (TEE) and fluoroscopy images vs. Existing TEE probe tracking methods was evaluated on Probe tracking performance, TEE to fluoroscopy registration accuracy and robustness. Live registration of TEE and fluoroscopy images demonstrated probe tracking errors below 0.6 mm and 0.2°, a 2-D RMS registration error of 1.5 mm, and a tracking failure rate below 1%.
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