In Vivo Demonstration of Photoacoustic Image Guidance and Robotic Visual Servoing for Cardiac Catheter-Based Interventions
In Vivo Demonstration of Photoacoustic Image Guidance and Robotic Visual Servoing for Cardiac Catheter-Based Interventions
复制标题
DOI：
10.1109/tmi.2019.2939568
复制
发表时间：
2020-04-01
影响因子：
10.6
通讯作者：
Bell, Muyinatu A. Lediju
中科院分区：
文献类型：
--
作者：
Graham, Michelle;Assis, Fabrizio;Bell, Muyinatu A. Lediju
心脏介入手术通常是在透视引导下进行的，使患者和操作员都暴露在电离辐射中。为了减少这种辐射暴露的风险，我们正在探索使用光声成像和机器人视觉伺服来进行心脏导管可视化和手术指导。在将光纤插入心脏导管后，在两只活体猪身上进行了心导管术，以从纤维-导管对的尖端产生光声信号。使用光声成像和机器人视觉伺服的组合来可视化和保持导管尖端的恒定视野，以便将导管通过股静脉或颈静脉引导到心脏。透视为导管尖端位置的一维验证提供了初步的地面真实估计，这些估计使用基于3D电磁的心脏标测系统作为基本真实进行了改进。一维和三维均方根误差分别为0.25~2.28 mm和1.24~1.54 mm。导管尖端还可在心脏内的三个位置显示：(1)在右心房内，(2)与右室流出道接触，(3)在右室内。切除心脏组织的激光区域进行组织病理学分析，结果显示，尽管在光纤尖端使用2.98mJ/脉冲(379.2 mJ/cm(2)通量)，但没有激光相关的组织损伤。此外，在观察导管尖端与心内膜组织接触前后的光声信号对比度有19分贝的差异，这对于心脏介入手术(如心脏射频消融术)中的接触确认是有希望的。这些结果还有望通过提供深度信息和增强导管尖端在血管内和心脏跳动中的位置的可视化来使用光声成像来指导心脏干预。
Cardiac interventional procedures are often performed under fluoroscopic guidance, exposing both the patient and operators to ionizing radiation. To reduce this risk of radiation exposure, we are exploring the use of photoacoustic imaging paired with robotic visual servoing for cardiac catheter visualization and surgical guidance. A cardiac catheterization procedure was performed on two in vivo swine after inserting an optical fiber into the cardiac catheter to produce photoacoustic signals from the tip of the fiber-catheter pair. A combination of photoacoustic imaging and robotic visual servoing was employed to visualize and maintain constant sight of the catheter tip in order to guide the catheter through the femoral or jugular vein, toward the heart. Fluoroscopy provided initial ground truth estimates for 1D validation of the catheter tip positions, and these estimates were refined using a 3D electromagnetic-based cardiac mapping system as the ground truth. The 1D and 3D root mean square errors ranged 0.25-2.28 mm and 1.24-1.54 mm, respectively. The catheter tip was additionally visualized at three locations within the heart: (1) inside the right atrium, (2) in contact with the right ventricular outflow tract, and (3) inside the right ventricle. Lasered regions of cardiac tissue were resected for histopathological analysis, which revealed no laser-related tissue damage, despite the use of 2.98 mJ per pulse at the fiber tip (379.2 mJ/cm(2) fluence). In addition, there was a 19 dB difference in photoacoustic signal contrast when visualizing the catheter tip pre- and post-endocardial tissue contact, which is promising for contact confirmation during cardiac interventional procedures (e.g., cardiac radiofrequency ablation). These results are additionally promising for the use of photoacoustic imaging to guide cardiac interventions by providing depth information and enhanced visualization of catheter tip locations within blood vessels and within the beating heart.