Related Experiment Video
Updated: Apr 15, 2026
Three-Dimensional Echocardiographic Method for the Visualization and Assessment of Specific Parameters of the Pulmonary Veins
Published on: October 28, 2020
Improved Segmentation of Multiple Cavities of the Heart in Wide-View 3-D Transesophageal Echocardiograms
Alexander Haak1, Ben Ren2, Harriët W Mulder3
1Department of Biomedical Engineering of the Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
Insights
Wide-view 3-D transesophageal echocardiography (TEE) enhances cardiac imaging for electrophysiology interventions. This improved visualization supports procedures by increasing anatomical coverage and segmentation accuracy, especially for the left atrium.
Area of Science:
- Cardiovascular Imaging
- Medical Interventions
- Echocardiography
Background:
- Minimally invasive cardiac electrophysiology interventions are increasingly important.
- Current pre-operative computed tomography angiography (CTA) lacks real-time feedback and involves radiation.
- Standard 3-D transesophageal echocardiography (TEE) has limited coverage, complicating left atrial segmentation.
Purpose of the Study:
- To evaluate wide-view 3-D TEE as an alternative or supplement to CTA for electrophysiology interventions.
- To assess the impact of wide-view TEE on cardiac cavity segmentation accuracy and coverage.
- To improve anatomical visualization during cardiac interventions.
Main Methods:
- Acquired 3-D TEE and CTA images from 20 patients.
- Manually registered TEE images to generate wide-view volumes.
- Segmented five heart cavities using single-view and wide-view TEE, comparing with CTA-derived segmentations.
Main Results:
- Segmentation accuracy (Dice coefficients) improved by 5%, 15%, and 9% for the left atrium, right atrium, and aorta, respectively.
- Anatomical coverage increased by 2%, 29%, 62%, and 49% for the right ventricle, left atrium, right atrium, and aorta, respectively.
- Wide-view TEE demonstrated superior performance compared to single-view TEE.
Conclusions:
- Wide-view 3-D TEE significantly improves anatomical coverage and segmentation accuracy for cardiac interventions.
- This technique offers a valuable, real-time alternative to CTA in electrophysiology.
- Wide-view TEE supports enhanced visualization and planning for cardiac procedures.
Abstract:
Minimally invasive interventions in the heart such as in electrophysiology are becoming more and more important in clinical practice. Currently, preoperative computed tomography angiography (CTA) is used to provide anatomic information during electrophysiology interventions, but this does not provide real-time feedback and burdens the patient with additional radiation and side effects of the contrast agent. Three-dimensional transesophageal echocardiography (TEE) is an excellent modality for visualization of anatomic structures and instruments in real time, but some cavities, especially the left atrium, suffer from the limited coverage of the 3-D TEE volumes. This leads to difficulty in segmenting the left atrium. We propose replacing or complementing pre-operative CTA imaging with wide-view TEE. We tested this proposal on 20 patients for which TEE image volumes covering the left atrium and CTA images were acquired. The TEE images were manually registered, and wide-view volumes were generated. Five heart cavities in single-view and wide-view TEE were segmented and compared with atlas based-segmentations derived from the CTA images. We found that the segmentation accuracy (Dice coefficients) improved relative to segmentation of single-view images by 5, 15 and 9 percentage points for the left atrium, right atrium and aorta, respectively. Average anatomic coverage was improved by 2, 29, 62 and 49 percentage points for the right ventricle, left atrium, right atrium and aorta, respectively. This finding confirms that wide-view 3-D TEE can be useful in supporting electrophysiology interventions.
Related Concept Videos
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...