Please use this identifier to cite or link to this item: https://hdl.handle.net/1822/62499

TitleSemi-automatic estimation of device size for left atrial appendage occlusion in 3D TEE images
Author(s)Morais, Pedro
Vilaça, João L.
Queirós, Sandro Filipe Monteiro
De Meester, Pieter
Budts, Werner
Tavares, João Manuel R. S.
D'Hooge, Jan
KeywordsLeft atrial appendage occlusion
Semi-automatic occluding device sizing
3D image segmentation
Iterative closest point
3D transesophageal echocardiography
left atrial appendage (LAA) occlusion
Issue dateMay-2019
PublisherIEEE
JournalIEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control
Abstract(s)Left atrial appendage (LAA) occlusion is used to reduce the risk of thromboembolism in patients with nonvalvular atrial fibrillation by obstructing the LAA through a percutaneously delivered device. Nonetheless, correct device sizing is complex, requiring the manual estimation of different measurements in preprocedural/periprocedural images, which is tedious and time-consuming and with high interobserver and intraobserver variability. In this paper, a semiautomatic solution to estimate the required relevant clinical measurements is described. This solution starts with the 3-D segmentation of the LAA in 3-D transesophageal echocardiographic images, using a constant blind-ended model initialized through a manually defined spline. Then, the segmented LAA surface is aligned with a set of templates, i.e., 3-D surfaces plus relevant measurement planes (manually defined by one observer), transferring the latter to the unknown situation. Specifically, the alignment is performed in three consecutive steps, namely: 1) rigid alignment using the LAA clipping plane position; 2) orientation compensation using the circumflex artery location; and 3) anatomical refinement through a weighted iterative closest point algorithm. The novel solution was evaluated in a clinical database with 20 volumetric TEE images. Two experiments were set up to assess: 1) the sensitivity of the model's parameters and 2) the accuracy of the proposed solution for the estimation of the clinical measurements. Measurement levels manually identified by two observers were used as ground truth. The proposed solution obtained results comparable to the interobserver variability, presenting narrower limits of agreement for all measurements. Moreover, this solution proved to be fast, taking nearly 40 s (manual analysis took 3 min) to estimate the relevant measurements while being robust to the variation of the model's parameters. Overall, the proposed solution showed its potential for fast and robust estimation of the clinical measurements for occluding device selection, proving its added value for clinical practice.
TypeArticle
URIhttps://hdl.handle.net/1822/62499
DOI10.1109/TUFFC.2019.2903886
ISSN0885-3010
e-ISSN1525-8955
Peer-Reviewedyes
AccessRestricted access (Author)
Appears in Collections:ICVS - Artigos em revistas internacionais / Papers in international journals

Files in This Item:
File Description SizeFormat 
Morais2019.pdf
  Restricted access
1,06 MBAdobe PDFView/Open

Partilhe no FacebookPartilhe no TwitterPartilhe no DeliciousPartilhe no LinkedInPartilhe no DiggAdicionar ao Google BookmarksPartilhe no MySpacePartilhe no Orkut
Exporte no formato BibTex mendeley Exporte no formato Endnote Adicione ao seu ORCID