Interventional heart wall motion analysis with cardiac C-arm CT systems

Area of Science:

• Medical Imaging
• Cardiovascular Physiology
• Biomedical Engineering

Background:

• Current catheter lab imaging (C-arm systems) limits quantitative 3D/4D left ventricular (LV) dynamics analysis.
• Myocardial wall analysis relies on 2D images or pre-procedural 3D/4D imaging, hindering real-time assessment.

Purpose of the Study:

• To develop and validate a framework for direct 4D LV wall motion analysis in the catheter lab.
• To enable real-time detection of ventricular dyssynchrony using C-arm CT data.
• To transfer established quantitative LV dynamics features to C-arm CT imaging.

Main Methods:

• Generation of dynamic 3D LV surface models from 2D C-arm projection images.
• Application of quantitative features: ejection fraction, 3D fractional shortening, and phase to maximal contraction (ϕi, max).
• Evaluation using simulated phantom data and eight clinical patient datasets.

Main Results:

• The framework successfully generates 4D LV models and detects ventricular dyssynchrony.
• Quantitative features were adapted and applied to C-arm CT data.
• Initial clinical results show promising performance in identifying regional myocardial dysfunction.

Conclusions:

• The developed framework enables direct 4D LV dynamics analysis in the catheter lab.
• This tool can serve as an indicator of LV dyssynchrony and differentiate pathological myocardium.
• Further clinical validation in larger studies is warranted.