Electro-anatomical Fusion for Guiding EP Procedures and Patient Specific Modelling.

我们研究项目的主要目标是开发使用医学图像和计算机的技术，以帮助医生改善对某些类型的长期心脏问题患者的治疗。医生不仅可以使用X射线和磁共振成像（MRI）等医学成像来观察身体内部以检测疾病，还可以使用成像来指导疾病的治疗。我们的项目特别关注心律不齐患者的治疗，称为心律失常。这是一个常见的问题，影响了3%-5%的40岁以上的人，并使这些患者面临严重问题的风险增加，如中风。许多名人，如托尼·布莱尔和亚历克斯·弗格森，都患有心律失常。医生通常用药物治疗这些病人，试图防止心律失常。病人必须在他们的余生中服用这些药丸，因为这不是一种治疗方法。此外，与任何药物一样，患者可能难以忍受不必要的副作用。最近，医生们正在使用一种新技术来治疗这些病人。心律不齐被认为是由心脏本身的异常区域引起的。有可能破坏这些区域，因此，通过在心脏内施加称为消融的小烧伤来治愈问题。医生们使用被称为导管的电线，通过腿部的血管插入心脏，在没有实际切开病人的情况下实施这些烧伤。这些新技术很有前途，但不如医生们所希望的那样成功。对于某些类型的疾病，30%至40%的患者在消融后没有好转。医生使用X射线图像来帮助他们看到身体内部，以便他们可以将导管放置在心脏中的正确位置。X射线具有很强的穿透力，很容易穿透人体。然而，导管阻挡X射线，使得它们在X射线照片中与患者身体看起来不同。因此，医生可以很容易地看到导管，但不能在X光照片上看到患者的心脏。据认为，这些心律失常治疗不成功的一个原因是医生不能清楚地看到病人的心脏。另一个原因是，X射线只是病人的二维阴影，并没有给出任何关于深度的信息。另一方面，MRI和X射线CT成像能够制作心脏的三维图像，而不需要任何有害的X射线。在我们的项目中，我们的目标是允许医生使用来自MR或CT成像的心脏三维图像来帮助将导管放置在心脏内。我们的技术将MR或CT图像与X线图像相结合，使心律失常患者的治疗更容易。我们将专注于这两种不同类型的图像的准确组合。我们还将心脏内部的电测量与此图像信息叠加。这种集成的图像和电信息可以用于构建模拟心脏的计算机化模型。正如工程师可以在桥梁或飞机实际建造之前创建计算机模型一样，我们也将创建人类心脏的计算机模型。以前已经创建了心脏模型，但我们将为每个患者定制模型，我们将能够使用治疗期间的测量结果进行测试。在这个项目中，我们将使用这些模型来帮助医生在实际对患者进行治疗之前制定治疗计划。

The broad aim of our research project is to develop techniques that use medical images and computers to help doctors to improve the treatment of patients with certain types of long-term heart problems. Doctors can not only use medical imaging, such as x-ray and magnetic resonance imaging (MRI), to look inside the body to detect disease but can also use imaging to guide the treatment of disease. Our project specifically concerns the treatment of patients with an irregular heartbeat, called an arrhythmia. This is a common problem affecting 3-5% of people that are over 40 years old and puts these patients at an increased risk of serious problems, such as stroke. Many famous people, such as Tony Blair and Alex Ferguson, have suffered from arrhythmias. Doctors commonly treat these patients with pills that try to prevent the arrhythmia. The patients must take the pills for the rest of their lives since this is not a cure. Moreover, as with any medication, there are unwanted side effects that can be difficult for the patient to tolerate. More recently, doctors are using a new technique to try to cure these patients. The irregular heart rhythm is thought to be caused by abnormal areas within the heart itself. It is possible to destroy these areas, and therefore, to cure the problem by applying a small burn within the heart called an ablation. Doctors apply these burns without actually cutting the patient open by using wires called catheters that are inserted through blood vessels in the legs and threaded up into the heart. These new techniques are very promising, but are less successful than Doctors would like. For some types of disease, between 30% and 40% of patients are no better after the ablation. Doctors use x-ray images to help them see inside the body so that they can place the catheters in the correct position in the heart. X-rays are very penetrating and pass through the body easily. However, the catheters block the x-rays so that they appear different to the patient's body in the x-ray pictures. Therefore, the doctors can see the catheters easily but cannot see the patient's heart on the x-ray pictures. It is thought that one reason that these arrhythmia treatments are unsuccessful is that the doctor cannot see the patient's heart clearly. Another reason, is that the x-rays are only two dimensional shadows of the patient, and don't give any information about depth. MRI and x-ray CT imaging on the other hand has the ability to make three-dimensional pictures of the heart without the need for any harmful x-rays. In our project we aim to allow doctors to use the three-dimensional images of the heart from MR or CT imaging to help to place the catheter inside the heart. Our technique combines MR or CT pictures with x-ray pictures to allow easier treatment of patients with arrhythmias. We will focus on accurate combination of these two different types of images. We will also overlay electrical measurements made inside the heart with this image information. This integrated image and electrical information can be used to build a computerized model that simulates the heart. Just as engineers can create a computer model of a bridge or aeroplane before it is actually built, so we will create a computer model of the human heart. Heart models have been created before, but we will generate models customized to each individual patient, which we will be able to test using measurement made during the treatments. In this project we will use these models to help doctors plan treatments before actually carrying them out on patients.