An augmented reality system for image guidance of transcatheter procedures for structural heart disease

• Published in: PloS one 2019-07, Vol.14 (7), p.e0219174-e0219174
• Main Authors: Liu, Jun, Al'Aref, Subhi J, Singh, Gurpreet, Caprio, Alexandre, Moghadam, Amir Ali Amiri, Jang, Sun-Joo, Wong, S Chiu, Min, James K, Dunham, Simon, Mosadegh, Bobak
• Format: Article
• Language: English
• Subjects: Augmented Reality; Biology and Life Sciences; Bone surgery; Cardiac Catheterization - instrumentation; Cardiac Catheterization - methods; Cardiac Surgical Procedures - instrumentation; Cardiac Surgical Procedures - methods; Cardiovascular disease; Cardiovascular diseases; Care and treatment; CAT scans; Catheters; Computed tomography; Computer applications; Coronary artery disease; Depth perception; Diagnostic imaging; Engineering and Technology; Fiducial Markers; Fluoroscopic imaging; Fluoroscopy; Fluoroscopy - instrumentation; Fluoroscopy - methods; Fourier Analysis; Fourier transforms; Heart; Heart - anatomy & histology; Heart - diagnostic imaging; Heart catheterization; Heart diseases; Hospitals; Humans; Image acquisition; Imaging, Three-Dimensional - instrumentation; Imaging, Three-Dimensional - methods; Medical imaging; Medical imaging equipment; Medical instruments; Medicine; Medicine and Health Sciences; Methods; Models, Anatomic; Orientation; Orientation behavior; Otology; Patient Care Planning; Phantoms, Imaging; Preoperative Care - methods; Printing, Three-Dimensional; Registration; Research and Analysis Methods; Space perception; Spine; Spine - diagnostic imaging; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Technology application; Three dimensional models; Three dimensional printing; Three-dimensional imaging; Tomography, X-Ray Computed; Visual stimuli; Visualization
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0219174

The primary mode of visualization during transcatheter procedures for structrural heart disease is fluoroscopy, which suffers from low contrast and lacks any depth perception, thus limiting the ability of an interventionalist to position a catheter accurately. This paper describes a new image guidance system by utilizing augmented reality to provide a 3D visual environment and quantitative feedback of the catheter's position within the heart of the patient. The real-time 3D position of the catheter is acquired via two fluoroscopic images taken at different angles, and a patient-specific 3D heart rendering is produced pre-operatively from a CT scan. The spine acts as a fiduciary land marker, allowing the position and orientation of the catheter within the heart to be fully registered. The automated registration method is based on Fourier transformation, and has a high success rate (100%), low registration error (0.42 mm), and clinically acceptable computational cost (1.22 second). The 3D renderings are displayed and updated on the augmented reality device (i.e., Microsoft HoloLens), which can provide pre-set views of various angles of the heart using voice-command. This new image-guidance system with augmented reality provides a better visualization to interventionalists and potentially assists them in understanding of complicated cases. Furthermore, this system coupled with the developed 3D printed models can serve as a training tool for the next generation of cardiac interventionalists.