Cardiac CT system and method for planning atrial fibrillation intervention

• US 7,565,190 B2
• Filed: 05/09/2003
• Issued: 07/21/2009
• Est. Priority Date: 05/09/2003
• Status: Active Grant

• Current Assignee: APN Health, LLC, GE Medical Systems Global Technology Company LLC (GE Healthcare Technologies, Inc.)
• Original Assignee: GE Medical Systems Global Technology Company LLC (GE Healthcare Technologies, Inc.), Jasbir S. Sra
• Inventors: Thomson, Helen, Sra, Jasbir S., Okerlund, Darin R.
• Primary Examiner(s): Casler; Brian
• Assistant Examiner(s): RAMIREZ, JOHN FERNANDO
• Application Number:
  US10/249,812
• Publication Number:
  US 20040225331A1
• Time in Patent Office: 2,265 Days
• Field of Search: 600/427, 600/374, 600/407, 600/424, 600425-428, 600/410, 600/523, 606/41, 128/920, 128/922, 382/128, 382/130, 382/131
• US Class Current: 600/426
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/543 involving acquisition triggered by a physiological signal
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method for planning atrial fibrillation (AF) intervention for a patient includes obtaining acquisition data from a medical imaging system, and generating a 3D model of the left atrium and pulmonary veins of the patient. One or more left atrial anatomical landmarks are identified on the 3D model, and saved views of the 3D model are registered on an interventional system. One or more of the registered saved views are visualized with the interventional system.

Claims

1. A method for planning atrial fibrillation (AF) ablation for a patient, the method comprising:

obtaining cardiac acquisition data from a medical imaging system;

generating from the acquisition data a cardiac 3D model including the left atrium, left circumflex artery, coronary arteries and pulmonary veins of the patient;

identifying one or more left atrial (LA) and pulmonary vein (PV) anatomical landmarks on said 3D model and inserting geometric markers therein corresponding to selected ones of said anatomical landmarks;

generating from the 3D model graphs or plots of muscle thickness in and around the PV ostium;

performing vessel tracking segmentation of the coronary arteries;

identifying areas of the left atrium and pulmonary veins within a determined proximity with respect to the left circumflex artery;

creating a translucent 3D rendering of the LA and PVs along with and in contrast to an opaque rendering of the coronary arteries, and highlighting areas of the LA in proximity of the left circumflex artery (LCx);

determining from the graphs or plots of muscle thickness and the LCx proximity data levels of ablation to be applied to a given area of one or more LA and PV surfaces to avoid excessive ablation in those areas of the LA in proximity to the LCx;

wherein the 3D model, translucent rendering, opaque rendering, highlighting, muscle thickness graphs or plots, and LCx proximity data are useful to assist an electrophysiologist to decide how much radiofrequency ablation energy to use at different cardiac locations in a subsequent interventional procedure where the 3D model by using the geometric markers is registerable with a projection image on an interventional system to improve the efficiency of the subsequent interventional procedure and reduce the risk of complications.

2. The method of claim 1, wherein said obtaining acquisition data is implemented with protocols directed for imaging the left atrium and pulmonary veins.

3. The method of claim 2, further comprising utilizing post processing software to process said acquisition data so as to generate immersible views of the left atrium and pulmonary veins.

4. The method of claim 3, wherein said 3D model and said immersible views are visualized through a display screen associated with said interventional system.

5. The method of claim 1, wherein said obtaining acquisition data is EKG gated.

6. A method for planning atrial fibrillation (AF) ablation for a patient, the method comprising:

obtaining cardiac acquisition data from a medical imaging system using a protocol directed toward the left atrium and pulmonary veins;

segmenting said acquisition data using a 3D protocol so as to visualize the left atrium and pulmonary veins;

generating a 3D model of the left atrium, coronary arteries and pulmonary veins of the patient;

identifying one or more left atrial (LA) and pulmonary vein (PV) anatomical landmarks on said 3D model and inserting geometric markers therein corresponding to selected ones of said anatomical landmarks;

generating from the 3D model graphs or plots of muscle thickness in and around the PV ostium;

performing vessel tracking segmentation of the coronary arteries;

identifying areas of the left atrium and pulmonary veins within a determined proximity with respect to the left circumflex artery;

creating a translucent 3D rendering of the LA and PVs along with and in contrast to an opaque rendering of the coronary arteries, and highlighting areas of the LA in proximity of the left circumflex artery (LCx);

determining from the graphs or plots of muscle thickness and the LCx proximity data levels of ablation to be applied to a given area of one or more LA and PV surfaces to avoid excessive ablation in those areas of the LA in proximity to the LCx;

wherein the 3D model, translucent rendering, opaque rendering, highlighting, muscle thickness graphs or plots, and LCx proximity data are useful to assist an electrophysiologist to decide how much radiofrequency ablation energy to use at different cardiac locations in a subsequent interventional procedure where the 3D model by using the geometric markers is registerable with a projection image on an interventional system to improve the efficiency of the subsequent interventional procedure and reduce the risk of complications.

7. The method of claim 6, further comprising utilizing post processing software to process said acquisition data so as to generate immersible views of the left atrium and pulmonary veins.

8. The method of claim 7, wherein said 3D model and said immersible views are visualized through a display screen associated with said interventional system.

9. The method of claim 6, wherein said obtaining acquisition data is EKG gated.

10. The method of claim 6, wherein said levels of ablation are identified through areas of spectral coloring included in a 3D map.

11. The method of claim 6, wherein said medical imaging system is one of a computed tomography system, a magnetic resonance imaging system and an ultrasound system.

12. A method for planning atrial fibrillation (AF) ablation for a patient, the method comprising:

obtaining acquisition data from a cardiac computed tomography (CT) imaging system using a protocol directed toward the left atrium and pulmonary veins;

segmenting said acquisition data using a 3D protocol so as to visualize the left atrium and pulmonary veins;

generating a 3D model of the left atrium, coronary arteries and pulmonary veins of the patient;

identifying one or more left atrial (LA) and pulmonary vein (PV) anatomical landmarks on said 3D model and inserting geometric markers therein corresponding to selected ones of said anatomical landmarks;

generating from the 3D model graphs or plots of muscle thickness in and around the PV ostium;

performing vessel tracking segmentation of the coronary arteries;

identifying areas of the left atrium and pulmonary veins within a determined proximity with respect to the left circumflex artery;

creating a translucent 3D rendering of the LA and PVs along with and in contrast to an opaque rendering of the coronary arteries, and highlighting areas of the LA in proximity of the left circumflex artery (LCx);

determining from the graphs or plots of muscle thickness and the LCx proximity data levels of ablation to be applied to a given area of one or more LA and PV surfaces to avoid excessive ablation in those areas of the LA in proximity to the LCx;

wherein the 3D model, translucent rendering, opaque rendering, highlighting, muscle thickness graphs or plots, and LCx proximity data are useful to assist an electrophysiologist to decide how much radiofrequency ablation energy to use at different cardiac locations in a subsequent interventional procedure where the 3D model by using the geometric markers is registerable with a projection image on a fluoroscopy system to improve the efficiency of the subsequent interventional procedure and reduce the risk of complications.

13. The method of claim 12 further comprising utilizing post processing software to process said acquisition data so as to generate immersible views of the left atrium and pulmonary veins.

14. The method of claim 13, wherein said 3D model and said immersible views are visualized through a display screen associated with said fluoroscopy system.

15. The method of claim 12, wherein said obtaining acquisition data is EKG gated.

16. The method of claim 12, wherein said levels of ablation are identified through areas of spectral coloring included in a 3D map.