Title: On-line multi-slice computed tomography interactive overlay with conventional X-ray : a new and advanced imaging fusion concept
Authors: Garcia, Joel A. ×
Bhakta, Shyam
Kay, Joseph
Chan, Kak-Chen
Wink, Onno
Ruijters, Daniel
Carroll, John D. #
Issue Date: Apr-2009
Publisher: Elsevier/North-Holland Biomedical Press
Series Title: International Journal of Cardiology vol:133 issue:3 pages:e101-e105
Abstract: Abstract

Computed tomography (CT) has revolutionized noninvasive cardiovascular evaluations. Complicated percutaneous procedures require precise imaging guidance that conventional X-ray is often unable to provide. By combining X-ray imaging with real-time, interactive, CT-based landmarks, interventional procedures could be facilitated. We describe two cases using the first CT/Live X-ray overlay in which this technology shows its potential.

Case reports
A 31-year-old male with an anatomically complicated atrial septal defect (ASD) was referred for percutaneous closure. Transesophageal echocardiography (TEE) revealed an inferior location of the ASD complicated by it's proximity to a prominent Eustachian ridge. The CT was used to create a patient-specific physical model in preparation for the procedure and an in-lab real-time CT overlay allowing successful closure. A second case of a 41-year-old male with coronary artery disease status-post coronary artery bypass, aortic valve replacement (AVR), and aortic root replacement with an abnormal coronary computed tomography angiogram (CTA). In a prior procedure years ago the saphenous vein graft (SVG) to the left anterior descending artery (LAD) could not be cannulated during invasive angiography, given the patient's complicated and unusual anatomy. Using CT overlay, the superiorly and anteriorly located SVG was cannulated successfully.

CT/Live X-ray overlay provided an adequate anatomical intra-procedural ASD evaluation, defect sizing, and guidance in one case and localization of an anatomically challenging graft ostium in the other case. Adding the CT landmarks as an overlay to traditional X-ray techniques provides a revolutionary and advanced imaging fusion concept that should improve procedural success.

Keywords: Computed tomography; Angiography; Structural heart disease; Image fusion; Overlay
Description: Garcia J.A., Bhakta S., Kay J., Chan K.-C., Wink O., Ruijters D., Carroll J.D., ''On-line multi-slice computed tomography interactive overlay with conventional X-ray : a new and advanced imaging fusion concept'', International journal of cardiology, vol. 133, no. 3, pp. e101-e105, 2009.
ISSN: 0167-5273
Publication status: published
KU Leuven publication type: IT
Appears in Collections:ESAT - PSI, Processing Speech and Images
× corresponding author
# (joint) last author

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