Validation of a New Method for 2D Fusion Imaging Registration in a System Prepared Only for 3D
(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
- Edsfeldt, Andreas LU ; Sonesson, Björn LU ; Rosén, Helena ; Petri, Marcelo H. LU ; Hongku, Kiattisak ; Resch, Timothy LU and Dias, Nuno V. LU
- organization
- publishing date
- 2020-06-01
- 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
-
- scopus:85082649431
- pmid:32193989
- 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
- 2024-08-21 20:31:44
@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<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}}, keywords = {{computed tomography angiography; cone beam computed tomography; endovascular aneurysm repair; fusion imaging; procedure guidance; radiation exposure; registration protocol}}, 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}}, }