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）是一种行之有效的诊断和治疗脑血管病的工具， 外周血管疾病，提供无背景的复杂血管解剖结构的2D和3D图像 解剖学上的混乱尽管如此，仍有几类胸部和腹部的介入手术， 是具有挑战性的，并且通常不执行，即使感兴趣的血管可能被解剖结构遮挡， 背景在这些身体区域中，背景组织的运动可能难以完全控制，导致 DSA图像中的减影伪影可以很容易地与血管信号本身一样大。的总目标 本项目旨在通过开发无掩模双能DSA消除这些限制。临床 所涉及的应用是肺栓塞的介入治疗，其涉及复杂的3D 肺动脉解剖结构和具有挑战性的导管器械引导任务。在美国，肺栓塞 每年有多达10万人死亡，并且是住院治疗的一个日益增长的原因。基于导管 使用X射线图像引导的治疗在大多数中心被用于肺栓塞患者，然而， 当前的成像技术仍然牢固地植根于2D非减影方法。双能DSA（德萨） 基于快速KV切换的图像处理系统能够从高能量和低能量投影生成减影图像 其在时间上非常接近地获得，并且完全消除了传统的掩模阶段。我们假设 与传统的减时DSA相比，德萨对背景组织的运动不敏感， 此外，德萨将消除非减影血管造影中存在的背景杂波。具体 目标是i）实现快速kV开关C臂原型并开发双能量技术，ii）评估 2D德萨在体模中性能，和iii）评估体模中和动物模型中的3D德萨， 肺栓塞成功完成将建立一个新的介入成像技术的程序 其传统上遭受DSA减影伪影。除了肺部应用，我们预计这些 技术将扩展到腹部、头部和外周手术的干预。