IMAGE BASED MANAGEMENT OF ATRIAL FIBRILLATION

这个子项目是许多利用资源的研究子项目之一 由NIH/NCRR资助的中心拨款提供。子项目的主要支持 而子项目的主要调查员可能是由其他来源提供的， 包括其它NIH来源。 列出的子项目总成本可能 代表子项目使用的中心基础设施的估计数量， 而不是由NCRR赠款提供给子项目或子项目工作人员的直接资金。 背景资料： 心房颤动（AF）是一种增加中风风险的电生理状态 和死亡率，并降低老年人口的生活质量。当前最佳的 评估AF进展和监测干预成功的方法是通过 一种基于侵入性心内导管的电标测程序。Marrouche博士和 CARMA团队最近发表的研究结果表明， 他们开发的方法可以提供一种非侵入性的方法来评估临床 支持AF的组织基质的特性，以及检测AF的方法。 消融治疗引起的心房组织变化。 基本原理： DBP的首要技术目标是支持筛查、管理 治疗和维护的人与心房颤动的一系列计算 工具.这些工具将对疾病的所有阶段都很有用， 使用简单高效，并将整合患者特定所需的所有任务 将管理整合到一个工作流程中。 问题： 纤维化消融前评价的全部基础是基于分割和 量化延迟增强MRI的细微特征，这一过程将需要 创新的图像处理和分析实现。CARMA团队已经 Seg 3D的日常使用，并驱动它包含的许多功能。当前迫切 还需要更多的能力，使步骤需要大量的人工评估和 具体的医疗经验至少可以半自动化。虽然Seg 3D 简化了处理时间，每个案件都需要进行文件转换， 延迟和错误的可能性增加。 设计与方法： 本DBP的基本原理和程序目标如下：（1）开发软件工具 用于AF患者图像的配准和分割， MRI在房颤患者治疗中的应用;（2）开发和 确认用于消融前定量分析的算法和相关软件 纤维化和消融后水肿和瘢痕;（3）为 来自心脏和呼吸运动的位置误差及其 对MRI引导消融期间用于心脏实时成像的MR图像的影响; （4）开发和评估综合可视化方案和软件， 实时MRI引导的AF消融。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Background: Atrial fibrillation (AF) is an electrophysiological condition that increases the risk of stroke and mortality and diminishes the quality of life for aging populations. The best current method to evaluate the progression of AF and monitor the success of interventions is via an invasive intracardiac catheter-based electrical mapping procedure. Dr. Marrouche and the CARMA team have published recent findings indicating that the MRI image acquisition methods they have developed may provide a non-invasivie means to evaluate clinical characteristics of the tissue substrate that supports AF, as well as methods to detect changes in atrial tissue that result from ablation therapy. Rationale: The overarching technical goal of this DBP is to support the screening, management, treatment, and maintenance of people with atrial fibrillation with a range of computational tools. These tools will be useful for all stages of the disease and its treatment, will be simple and efficient to use, and will integrate all the tasks required for patient specific management into a single workflow. Questions: The entire basis for pre-ablation evaluation of fibrosis is based on segmentation and quantification of subtle features of delayed enhancement MRI, a process that will require innovative image processing and analysis to achieve. The CARMA team already makes daily use of Seg3D and drives many of the features that it contains. There is a pressing need for still more capabilities so that steps requiring considerable manual evaluation and specific medical experience can become at least semi-automated. Although Seg3D has streamlined the processing time, each case requires a file conversion, which introduces delays and increased chances of error. Design & Methods: The rationale and procedural goals of this DBP are as follows: (1) To develop software tools for the registration and segmentation of images from AF patients to be applied across all segments of the use of MRI in the management of AF patients; (2) To develop and validate algorithms and associated software for the quantitative analysis of pre-ablation fibrosis and post-ablation edema and scar; (3) To create compensation approaches for errors in position from heart and respiratory motion and their impact on MR images for use in real-time imaging of the heart during MRI guided ablation; and (4) To develop and evaluate integrated visualization schemes and software for use in real-time MRI guided AF ablation.