Low-Dose Tomosynthetic Interventional System For Quantitative Cardiac Imaging

用于定量心脏成像的低剂量断层合成介入系统

• 批准号: 8239054
• 负责人: Michael A Speidel
• 金额: $ 62.63万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-02-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8239054
• 关键词: Ablation; Anatomy; Angiography; Animal Model; Arrhythmia; Atrial Fibrillation; Caliber; Calibration; Cardiac; Cardiac ablation; Cardiology; Cataract; Catheters; Clinical; Coronary; Coronary Arteriosclerosis; Coronary Vessels; Country; Devices; Diagnostic radiologic examination; Digital X-Ray; Dimensions; Dose; Exposure to; Fluoroscopy; Funding; Goals; Image; Imagery; Imaging Device; Injury; Intervention; Laboratories; Left atrial structure; Life; Malignant Neoplasms; Maps; Measurement; Medical Staff; Morbidity - disease rate; Noise; Outcome; Patients; Positioning Attribute; Procedures; Radiation; Radiation Injuries; Relative (related person); Research; Research Proposals; Resolution; Risk; Roentgen Rays; Savings; Scanning; Signal Transduction; Skin; Societies; Stents; Surface; System; Techniques; Technology; Testing; Therapeutic; Three-Dimensional Imaging; Time; United States National Institutes of Health; Work; X-Ray Computed Tomography; base; coronary angioplasty; detector; digital; heart visualization; human subject; improved; mortality; novel; novel therapeutics; patient safety; rapid diagnosis; reconstruction; tool

DESCRIPTION (provided by applicant): X-ray fluoroscopy provides a combination of real-time imaging, high spatial resolution, ease of use, and device compatibility that is essential for rapid diagnosis of coronary artery disease and catheter guidance during fluoroscopically-guided interventional (FGI) procedures. Although the millions of FGI procedures performed in the U.S. each year undeniably improve and save lives, these procedures entail a radiation burden on both the patient and the medical staff who perform them. Radiation risks include serious skin injury, cataracts, and cancer. Unfortunately, there is limited room for improvement in the dose efficiency of conventional x-ray systems. The 2D projection format of conventional fluoroscopy also fails to provide the 3D device and anatomic information needed for modern catheter ablation procedures. The goal of this project is to develop a novel inverse-geometry x-ray fluoroscopic system that will dramatically reduce x-ray dose to patient and staff, while simultaneously providing real-time 3D catheter guidance. The Scanning-Beam Digital X-ray (SBDX) system is a low-dose fluoroscopic/fluorographic system that performs 30 frame/sec imaging using low-scatter inverse-geometry scanning. Previous NIH-funded research enabled the construction of an advanced SBDX system capable of reducing patient entrance skin dose to 15% of a conventional dose while maintaining 100% of conventional image signal-to-noise ratio. This research also yielded two new interventional techniques that exploit the unique SBDX real-time, multiplane, tomosynthetic reconstructor: frame-by-frame 3D catheter tip tracking and calibration-free 3D vessel analysis for device sizing. This new proposal will advance SBDX into the interventional laboratory through three projects. First, a human subjects study will be performed to compare SBDX and conventional x-ray dose, image quality, and interventional device sizing accuracy. Second, a procedure-room system for 3D catheter tracking and cardiac visualization will be constructed and validated in an animal model of ablation in the left atrium. Third, the ability to perform SBDX computed tomography in the interventional room will be developed, in order to provide 3D cardiac maps for ablation procedures without the need for a separate, pre-procedure CT scan. Reducing x-ray dose in the cardiac cath lab is critical to maximizing the safety of patient and staff. Real-time three-dimensional imaging capability is needed for many modern interventional procedures. The successful conclusion of this research will be a low dose x-ray fluoroscopic system which provides clinical image quality, novel therapeutic tools, and 3D imaging capability in a single interventional laboratory. PUBLIC HEALTH RELEVANCE: Coronary artery disease and cardiac arrhythmia are significant causes of morbidity and mortality in our society. Over 1,000,000 coronary angioplasties and 200,000 catheter ablation procedures for the treatment of atrial fibrillation are performed annually in our country, saving many lives and improving the quality of many more. Successful completion of this work will provide therapeutic tools which improve the outcomes of these procedures, while dramatically lowering the radiation exposure to the patient and medical staff.

描述（由申请人提供）：X 射线透视结合了实时成像、高空间分辨率、易用性和设备兼容性，这对于快速诊断冠状动脉疾病和在透视引导介入 (FGI) 过程中进行导管引导至关重要。尽管美国每年进行的数百万例 FGI 手术无疑改善并挽救了生命，但这些手术给患者和实施这些手术的医务人员带来了辐射负担。辐射风险包括严重的皮肤损伤、白内障和癌症。不幸的是，传统 X 射线系统的剂量效率的改进空间有限。传统荧光透视的 2D 投影格式也无法提供现代导管消融手术所需的 3D 设备和解剖信息。该项目的目标是开发一种新型逆几何 X 射线透视系统，该系统将显着减少患者和工作人员的 X 射线剂量，同时提供实时 3D 导管引导。扫描光束数字 X 射线 (SBDX) 系统是一种低剂量荧光透视/荧光照相系统，使用低散射逆几何扫描执行 30 帧/秒成像。之前 NIH 资助的研究构建了先进的 SBDX 系统，能够将患者进入皮肤的剂量减少至常规剂量的 15%，同时保持 100% 的常规图像信噪比。这项研究还产生了两种新的介入技术，利用独特的 SBDX 实时、多平面、断层合成重建器：逐帧 3D 导管尖端跟踪和用于设备尺寸调整的免校准 3D 血管分析。这项新提案将通过三个项目将 SBDX 推进介入实验室。首先，将进行一项人体研究，以比较 SBDX 和传统 X 射线剂量、图像质量和介入设备尺寸准确性。其次，将构建用于 3D 导管跟踪和心脏可视化的手术室系统，并在左心房消融动物模型中进行验证。第三，将开发在介入室进行 SBDX 计算机断层扫描的能力，以便为消融手术提供 3D 心脏图，而无需单独的手术前 CT 扫描。减少心导管实验室中的 X 射线剂量对于最大限度地提高患者和工作人员的安全至关重要。许多现代介入手术都需要实时三维成像能力。这项研究的成功结论将是低剂量 X 射线透视系统，该系统可在单个介入实验室中提供临床图像质量、新颖的治疗工具和 3D 成像能力。 公共卫生相关性：冠状动脉疾病和心律失常是我们社会发病和死亡的重要原因。我国每年进行超过 1,000,000 例冠状动脉成形术和 200,000 例用于治疗心房颤动的导管消融手术，挽救了许多生命并提高了更多人的质量。这项工作的成功完成将提供改善这些手术结果的治疗工具，同时显着降低患者和医务人员的辐射暴露。