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: 8403718
• 负责人: Michael A Speidel
• 金额: $ 58.29万
• 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/8403718
• 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

ABSTRACT 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.

抽象的 X 射线透视结合了实时成像、高空间分辨率、易用性和设备 兼容性对于冠状动脉疾病的快速诊断和导管引导至关重要 荧光镜引导介入（FGI）手术。尽管数以百万计的 FGI 手术在 无可否认，美国每年都在改善和拯救生命，但这些程序对双方都造成了辐射负担 患者和执行这些操作的医务人员。辐射风险包括严重的皮肤损伤、白内障和 癌症。遗憾的是，传统 X 射线剂量效率的改进空间有限 系统。传统透视的2D投影格式也无法提供3D设备和 现代导管消融手术所需的解剖信息。该项目的目标是开发一个 新颖的逆几何 X 射线透视系统将大大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。以前的 NIH 资助的研究 构建了先进的 SBDX 系统，能够将患者入口皮肤剂量减少至 15% 传统剂量的同时保持 100% 的传统图像信噪比。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、断层合成技术 重建器：逐帧 3D 导管尖端跟踪和免校准 3D 血管分析，用于确定设备尺寸。 这项新提案将通过三个项目将 SBDX 推进介入实验室。首先，一个人 将进行受试者研究以比较 SBDX 和传统 X 射线剂量、图像质量和 介入设备尺寸的准确性。其次，用于 3D 导管跟踪和心脏检查的手术室系统 将在左心房消融动物模型中构建和验证可视化。三、能力 将开发在介入室进行 SBDX 计算机断层扫描，以提供 3D 用于消融手术的心脏图，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。即时的 许多现代介入手术都需要三维成像能力。成功者 这项研究的结论将是提供临床图像质量的低剂量 X 射线透视系统， 新颖的治疗工具和单一介入实验室的 3D 成像功能。