Integration of Three-Dimensional Scar Maps for Ventricular Tachycardia Ablation With Positron Emission Tomography-Computed Tomography
Integration of Three-Dimensional Scar Maps for Ventricular Tachycardia Ablation With Positron Emission Tomography-Computed Tomography
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DOI：
10.1016/j.jcmg.2007.10.001
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发表时间：
2008-01-01
影响因子：
14
通讯作者：
Shorofsky, Stephen
中科院分区：
文献类型：
--
作者：
Dickfeld, Timm;Lei, Peng;Shorofsky, Stephen
本研究旨在评估从正电子发射断层扫描（PET）/计算机断层扫描（CT）混合成像获得三维（3D）瘢痕图的可行性，并将其整合到临床标测系统中以辅助室性心动过速（VT）消融。然而，目前的“金标准”的电压映射是有限的，它无法准确地描述一个复杂的三维疤痕形态，其不完善的空间分辨率，并延长processtimes.METHODS 14例患者进行PET/CT多模态成像前室性心动过速消融术。我们使用PET/CT衍生的瘢痕图，通过17段分析和表面重建来表征心肌瘢痕。结果电压图与PET/CT瘢痕图具有良好的相关性（r = 0.89; r < 0.05）。此外，3D代谢瘢痕图准确显示了心内膜和心外膜表面，并且可以成功整合，配准误差为3.7 +/- 0.7 mm。
OBJECTIVES This study sought to assess the feasibility of deriving 3-dimensional (3D) scar maps from positron emission tomography (PET)/computed tomography (CT) hybrid imaging and to integrate those into clinical mapping systems to assist in ventricular tachycardia (VT) ablations.BACKGROUND Ablation strategies for nonidiopathic VT are increasingly based on the anatomic information of the scar and its border zone. However, the current "gold standard" of voltage mapping is limited by its inability to accurately describe a complex 3D scar morphology, its imperfect spatial resolution, and prolonged procedure times.METHODS Fourteen patients underwent PET/CT multimodality imaging before the VT ablation. We used PET/CT-derived scar maps to characterize myocardial scar using a 17-segment analysis and surface reconstruction. In 10 patients, reconstructed 3D metabolic scar maps were integrated into a clinical mapping system and compared with high-resolution voltage maps.RESULTS A good correlation was found between the voltage maps and PET/CT-derived scar maps (r = 0.89; r < 0.05). In addition, 3D metabolic scar maps accurately displayed endocardial and epicardial surface and could be successfully integrated with a registration error of 3.7 +/- 0.7 mm. A combination of visual alignment and surface registration was most accurate for myocardial scar accounting for