Dual-Energy Subtraction Angiography for Transcatheter Interventions

用于经导管干预的双能减影血管造影

• 批准号: 9456205
• 负责人: Michael A Speidel
• 金额: $ 18.49万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-26 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9456205
• 关键词: Abdomen; Address; Adopted; Anatomy; Aneurysm; Angiography; Animal Model; Arteriovenous malformation; Blood Vessels; Body Regions; Breathing; Catheters; Cerebrum; Cessation of life; Chest; Clinical; Collaborations; Complex; Development; Devices; Diagnosis; Diagnostic radiologic examination; Digital Subtraction Angiography; Dimensions; Generations; Goals; Head; Healthcare; Hepatic; Hospitalization; Image; Image Enhancement; Imaging Techniques; Imaging technology; Injection of therapeutic agent; Intervention; Iodine; Lung; Masks; Methods; Modeling; Morphologic artifacts; Motion; Patients; Performance; Peripheral; Peripheral Vascular Diseases; Phase; Plant Roots; Procedures; Pulmonary Embolism; Pulmonary artery structure; Pulmonary vessels; Rotation; Scanning; Signal Transduction; Structure; System; Techniques; Three-Dimensional Image; Time; Tissues; Work; arm; base; clinical application; cone-beam computed tomography; contrast enhanced; image guided; interest; lung imaging; novel; phantom model; prototype; reconstruction; stroke treatment; tool; two-dimensional

ABSTRACT Digital subtraction angiography (DSA) is a proven tool for the diagnosis and treatment of cerebral and peripheral vascular diseases, providing 2D and 3D images of complex vascular anatomy without background anatomic clutter. Still, there are classes of interventional procedures in the thorax and abdomen for which DSA is challenging and often not performed, even though vessels of interest may be obscured by anatomic background. In these body regions, motion of background tissues can be difficult to fully control, leading to subtraction artifacts in DSA images which can easily be as large as the vessel signal itself. The overall goal of this project is to eliminate these limitations through the development of mask-free dual-energy DSA. The clinical application addressed is the interventional treatment of pulmonary embolism, which involves both complex 3D pulmonary artery anatomy and challenging catheter device guidance tasks. In the U.S., pulmonary embolism accounts for as many as 100,000 annual deaths and is a growing cause for hospitalization. Catheter-based treatments using x-ray image guidance are being adopted at most centers for pulmonary embolism patients, yet current imaging techniques remain firmly rooted in 2D non-subtracted methods. Dual-energy DSA (DESA) based on fast kV-switching enables the generation of subtraction images from high and low energy projections which are acquired very close in time, and eliminates the traditional mask phase entirely. We hypothesize that DESA will be insensitive to motion of background tissue when compared to conventional time-subtracted DSA, and additionally, DESA will eliminate background clutter present in non-subtracted angiography. The specific aims are to i) implement a fast kV-switching C-arm prototype and develop dual-energy techniques, ii) evaluate the performance of 2D DESA in phantoms, and iii) evaluate 3D DESA in phantoms and in an animal model of pulmonary embolism. Successful completion will establish a new interventional imaging technique for procedures which traditionally suffer from DSA subtraction artifacts. Beyond the pulmonary application, we anticipate these techniques will be extendable to interventions in the abdomen, the head, and in peripheral procedures.

摘要 数字减影血管造影术(DSA)是诊断和治疗脑血管疾病的有效工具。 外周血管疾病，提供没有背景的复杂血管解剖的2D和3D图像 解剖学上的混乱。尽管如此，仍有一些胸部和腹部的介入手术需要DSA 是具有挑战性的，通常不进行手术，即使感兴趣的血管可能被解剖学遮挡 背景资料。在这些身体区域，背景组织的运动可能很难完全控制，导致 减去DSA图像中的伪影，这些伪影可以很容易地与血管信号本身一样大。的总目标是 本项目旨在通过研制无掩膜双能DSA来消除这些限制。临床部 应用于肺栓塞的介入治疗，这涉及到复杂的3D 肺动脉解剖和具有挑战性的导管装置引导任务。在美国，肺栓塞 每年造成多达10万人死亡，并成为越来越多的住院原因。以导管为基础 使用x射线影像引导的治疗方法正被大多数中心用于治疗肺栓塞患者，但 目前的成像技术仍然牢牢扎根于2D非减影方法。双能数字减影血管造影(DESA) 基于快速千伏切换，能够从高能和低能投影中生成减影图像 它们在时间上都非常接近，并且完全消除了传统的掩模相位。我们假设 与传统的时间减影DSA相比，DESA对背景组织的运动不敏感， 此外，DESA将消除非减影血管造影术中存在的背景杂波。具体的 目标是i)实施快速千伏开关C形臂原型并开发双能源技术，ii)评估 2D DESA在体模中的表现，以及iii)在体模和动物模型中评估3D DESA 肺栓塞。成功的完成将为手术建立一种新的介入成像技术 传统上受到DSA减影伪影的影响。除了肺部应用，我们预计这些 这项技术将可扩展到腹部、头部和外周手术的干预。