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Validation of a New Method for 2D Fusion Imaging Registration in a System Prepared Only for 3D

Edsfeldt, Andreas LU ; Sonesson, Björn LU ; Rosén, Helena ; Petri, Marcelo H. LU ; Hongku, Kiattisak ; Resch, Timothy LU and Dias, Nuno V. LU (2020) In Journal of Endovascular Therapy 27(3). p.468-472
Abstract

Purpose: To validate a new 2D-3D registration method of fusion imaging during aortic repair in a system prepared only for 3D-3D registration and to compare radiation doses and accuracy. Materials and Methods: The study involved 189 patients, including 94 patients (median age 70 years; 85 men) who underwent abdominal endovascular aneurysm repair (EVAR) with 2D-3D fusion on an Artis zee imaging system and 95 EVAR patients (median age 70 years; 81 men) from a prior study who had 3D-3D registration done using cone beam computed tomography (CBCT). For the 2D-3D registration, an offline CBCT of the empty operating table was imported into the intraoperative dataset and superimposed on the preoperative computed tomography angiogram (CTA). Then... (More)

Purpose: To validate a new 2D-3D registration method of fusion imaging during aortic repair in a system prepared only for 3D-3D registration and to compare radiation doses and accuracy. Materials and Methods: The study involved 189 patients, including 94 patients (median age 70 years; 85 men) who underwent abdominal endovascular aneurysm repair (EVAR) with 2D-3D fusion on an Artis zee imaging system and 95 EVAR patients (median age 70 years; 81 men) from a prior study who had 3D-3D registration done using cone beam computed tomography (CBCT). For the 2D-3D registration, an offline CBCT of the empty operating table was imported into the intraoperative dataset and superimposed on the preoperative computed tomography angiogram (CTA). Then 2 intraoperative single-frame 2D images of the skeleton were aligned with the patient’s skeleton on the preoperative CTA to complete the registration process. A digital subtraction angiogram was done to correct any misalignment of the aortic CTA volume. Values are given as the median [interquartile range (IQR) Q1, Q3]. Results: The 2D-3D registration had an accuracy of 4.0 mm (IQR 3.0, 5.0) after bone matching compared with the final correction with DSA (78% within 5 mm). By applying the 2D-3D protocol the radiation exposure (dose area product) from the registration of the fusion image was significantly reduced compared with the 3D-3D registration [1.12 Gy∙cm2 (IQR 0.41, 2.14) vs 43.4 Gy∙cm2 (IQR 37.1, 49.0), respectively; p<0.001). Conclusion: The new 2D-3D registration protocol based on 2 single-frame images avoids an intraoperative CBCT and can be used for fusion imaging registration in a system originally designed for 3D-3D only. This 2D-3D registration protocol is accurate and leads to a significant reduction in radiation exposure.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
computed tomography angiography, cone beam computed tomography, endovascular aneurysm repair, fusion imaging, procedure guidance, radiation exposure, registration protocol
in
Journal of Endovascular Therapy
volume
27
issue
3
pages
5 pages
publisher
International Society of Endovascular Specialists
external identifiers
  • pmid:32193989
  • scopus:85082649431
ISSN
1526-6028
DOI
10.1177/1526602820912223
language
English
LU publication?
yes
id
d7fde7b8-1a47-4c8a-bfe5-2ad5a663d2d3
date added to LUP
2020-04-24 14:18:30
date last changed
2021-06-16 05:16:57
@article{d7fde7b8-1a47-4c8a-bfe5-2ad5a663d2d3,
  abstract     = {<p>Purpose: To validate a new 2D-3D registration method of fusion imaging during aortic repair in a system prepared only for 3D-3D registration and to compare radiation doses and accuracy. Materials and Methods: The study involved 189 patients, including 94 patients (median age 70 years; 85 men) who underwent abdominal endovascular aneurysm repair (EVAR) with 2D-3D fusion on an Artis zee imaging system and 95 EVAR patients (median age 70 years; 81 men) from a prior study who had 3D-3D registration done using cone beam computed tomography (CBCT). For the 2D-3D registration, an offline CBCT of the empty operating table was imported into the intraoperative dataset and superimposed on the preoperative computed tomography angiogram (CTA). Then 2 intraoperative single-frame 2D images of the skeleton were aligned with the patient’s skeleton on the preoperative CTA to complete the registration process. A digital subtraction angiogram was done to correct any misalignment of the aortic CTA volume. Values are given as the median [interquartile range (IQR) Q1, Q3]. Results: The 2D-3D registration had an accuracy of 4.0 mm (IQR 3.0, 5.0) after bone matching compared with the final correction with DSA (78% within 5 mm). By applying the 2D-3D protocol the radiation exposure (dose area product) from the registration of the fusion image was significantly reduced compared with the 3D-3D registration [1.12 Gy∙cm<sup>2</sup> (IQR 0.41, 2.14) vs 43.4 Gy∙cm<sup>2</sup> (IQR 37.1, 49.0), respectively; p&lt;0.001). Conclusion: The new 2D-3D registration protocol based on 2 single-frame images avoids an intraoperative CBCT and can be used for fusion imaging registration in a system originally designed for 3D-3D only. This 2D-3D registration protocol is accurate and leads to a significant reduction in radiation exposure.</p>},
  author       = {Edsfeldt, Andreas and Sonesson, Björn and Rosén, Helena and Petri, Marcelo H. and Hongku, Kiattisak and Resch, Timothy and Dias, Nuno V.},
  issn         = {1526-6028},
  language     = {eng},
  month        = {06},
  number       = {3},
  pages        = {468--472},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Therapy},
  title        = {Validation of a New Method for 2D Fusion Imaging Registration in a System Prepared Only for 3D},
  url          = {http://dx.doi.org/10.1177/1526602820912223},
  doi          = {10.1177/1526602820912223},
  volume       = {27},
  year         = {2020},
}