Motion compensation for image-guided coronary intervention

经皮冠状动脉介入治疗(PCI)是心脏病学中的一种常规程序，目的是使用导丝、球囊和支架对冠状动脉血管进行再血管化。到目前为止，冠状动脉介入治疗的成功主要依赖于心脏病专家的经验，他们能够在精神上补偿冠状动脉的运动，并在移动的管腔内安全地导航，只需一张X光片。术前3D图像与二维线上X线片的图像配准有助于导航指导。然而，这将只提供冠状动脉的静态路线图，而没有在手术过程中观察到的心脏和呼吸运动的综合影响。该研究项目的主要目的是提出一种在线心脏和呼吸运动补偿的方法，在冠状动脉成像引导的过程中提供来自多层螺旋CT(MSCT)的动态3D路线图。这项研究计划的科学贡献是多方面的：1)创新的2D/3D配准技术，在运动占主导地位的困难情况下，这是医学成像中一个非常具有挑战性的研究领域，因为我们依赖2D投影来恢复3D姿势；2)基于模式识别的稳健和个性化的运动补偿方案；3)医学成像中新颖的可变形2D/3D配准，允许在经皮手术过程中从单一视角匹配患者的解剖结构。心脏病和中风每年给加拿大经济造成超过222亿美元的医生服务、医院费用、工资损失和生产率下降。因此，具有运动补偿的导航导航系统为心脏病专家提供额外的视觉提示是非常有意义的。这项研究计划研究如何利用新的物体识别和图像配准算法来改进PCI导航。先进的医学图像数据可视化工具是保证经皮冠状动脉介入治疗安全导航的关键，也是提高患者治疗水平、缩短手术时间的有效手段。这项研究的影响将是实施更安全的经皮冠状动脉介入治疗，从而降低医疗成本。

Percutaneous Coronary Intervention (PCI) is a routine procedure in cardiology aimed at providing revascularization of coronary vessel using a guide wire, a balloon and a stent. As of today, the success of PCI relies mostly on the experience of the cardiologist to mentally compensate for coronary motion and navigate safely inside the moving lumen, with a single radiographic view. Image registration of preoperative 3D image with 2D online X-ray imaging would be helpful for navigation guidance. However, this would provide only a static roadmap of the coronary vessels without the combined effect of cardiac and breathing motion observed during the procedure. The main goal of this research program is to propose a methodology for online cardiac and breathing motion compensation, to provide a dynamic 3D roadmap from Multi Slice Computed Tomography (MSCT) during image guided procedures of coronary vessels. The scientific contributions of this research program are numerous: 1) innovative 2D/3D registration techniques in the difficult case where motion is predominant, a very challenging field of study in medical imaging, since we rely on a 2D projection to recover a 3D pose; 2) robust and personalized motion compensation scheme, based on pattern recognition; 3) novel deformable 2D/3D registration in medical imaging, which allows matching patient anatomy from a single view available during percutaneous procedure. Heart disease and stroke costs the Canadian economy more than $22.2 billion every year in physician services, hospital costs, lost wages and decreased productivity. Hence, a navigation guidance system with motion compensation is of great interest to provide additional visual cues for cardiologists. This research program investigates the improvement of PCI navigation with novel object recognition and image registration algorithms. Advanced visualization tools of medical image data are paramount to ensure safe navigation during PCI and can be effective to improve patient's treatment and to reduce operating time. The impact of this research would to perform safer PCI and hence reduce medical costs.