Difference between revisions of "DBP3:Utah:RegCases"

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{| class="wikitable"
 
{| class="wikitable"
 
|-
 
|-
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! LGE-MRI Image
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! Pre-ablation LGE-MRI Image
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! Post-ablation LGE-MRI Image
 
! Segmentation of LGE-MRI Image
 
! Segmentation of LGE-MRI Image
−
! MRA Image
 
 
|-
 
|-
 
| [[File:carma_ex_pre.png|thumb|center]]
 
| [[File:carma_ex_pre.png|thumb|center]]
 +
| [[File:carma_ex_post.png|thumb|center]]
 
| [[File:carma_ex_pre_seg.png|thumb|center]]
 
| [[File:carma_ex_pre_seg.png|thumb|center]]
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|-
 +
|}
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 +
{| class="wikitable"
 +
|-
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! MRA Image
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! Immediately Post-ablation (IPA) LGE-MRI Image
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|-
 
| [[File:carma_ex_mra.png|thumb|center]]
 
| [[File:carma_ex_mra.png|thumb|center]]
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| [[File:Carma_no_reflow.png|thumb|center]]
 
|-
 
|-
 
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== Registration Case Types ==
 
== Registration Case Types ==
  
−
=== Longitudinal LGEs (typically, pre-ablation LGE to post-ablation LGE) ===
+
=== Pre-ablation LGE to 3 months (or more) post-ablation LGE ===
  
−
* Frequently, clinicians ask about the ability to directly compare the pre-ablation and post-ablation LGE scans
+
* Examine the location of ablation-induced scar formation relative to fibrosis
−
* Accurate registration of longitudinal LGE scans allows for assessment of disease progression, structural remodeling of the cardiac tissue, and ablation-induced lesion formation
+
* Utah score staging of patients [http://www.healthsciences.utah.edu/carma/images/Publications/Akoum2011.pdf]
 +
 
 +
=== Pre-ablation LGE to Immediately post-ablation(IPA) LGE ===
 +
 
 +
* Can compare acute ablation-induced changes to the pre-ablation tissue
 +
 
 +
=== Immediately post-ablation to 3 months (or more) post-ablation LGE ===
 +
 
 +
* Dark regions on IPA LGE scans result in stable scar formation at 3 or more months post-ablation -> [http://www.sci.utah.edu/~prastawa/papers/JACC2011_McGann_PredictAfibScar.pdf]
 +
* Look for gaps in the ablation lesion sets - Ravi's project
 +
 
 +
=== Post-ablation LGE to Post-ablation LGE ===
 +
 
 +
* Comparing the outcome of repeated ablation procedures to the  
 +
 
 +
=== Pre-ablation LGE to Pre-ablation LGE ===
 +
 
 +
* Comparison across patients prior to ablation
 +
 
 +
=== LGE to Dark-blood MRI ===
 +
 
 +
* Dark blood images can be used to detect early lesion formation
 +
* Can compare with lesion formation seen later on LGE images
  
 
=== LGE to MRA ===
 
=== LGE to MRA ===
  
−
* MRA scans present a hyper-enhanced LA blood pool, which is ripe for thresholding
+
* The boundaries of the LA in the MRA mirror the endocardial surface in the LGE scans
−
* Registration of the MRA to the LGE could allow for initial guesses to an automated segmentation routine or rough endocardial segmentations
+
* There is the possibility for thresholding the MRA and then registering the segmented region to the LGE
 +
 
 +
=== LGE to Electroanatomic map (Carto) ===
 +
 
 +
* Compare the low voltage regions of Carto maps to the LGE scans
  
−
=== Pre-ablation MRA to Post-ablation MRA ===
+
=== LGE to CT ===
  
−
* The ability to quickly threshold the MRA makes them attractive for rough endocardial segmentations, such as are used for shape analysis
+
* Align LGE and CT for those patients that have both
−
* Alignment of MRAs could facilitate alignment of the label masks used for shape analysis
+
* Maybe helpful for shape analysis studies
  
 
=== Pre-ablation LGE/Endo to Post-ablation LGE/Endo ===
 
=== Pre-ablation LGE/Endo to Post-ablation LGE/Endo ===

Revision as of 04:46, 3 April 2012

Home < DBP3:Utah:RegCases

Back to Utah AFib DBP


Background

  • The CARMA Center uses late gadolinium enhanced MRI (LGE-MRI) images to evaluate new patients, predict procedural success, and evaluate therapeutic outcomes. The MRI images for each patient are further accompanied by MR angiographic images (MRA) and manual segmentations of relevant structures. These images are acquired longitudinally over the course of a patient's evaluation, treatment, and follow-up (i.e. months or years). Registration is often necessary to compare images from different time points in a patient's treatment, across patient cohorts at the same stage of disease progression or treatment, or different image types.
Pre-ablation LGE-MRI Image Post-ablation LGE-MRI Image Segmentation of LGE-MRI Image
Carma ex pre.png
Carma ex post.png
Carma ex pre seg.png
MRA Image Immediately Post-ablation (IPA) LGE-MRI Image
Carma ex mra.png
Carma no reflow.png

Registration Case Types

Pre-ablation LGE to 3 months (or more) post-ablation LGE

  • Examine the location of ablation-induced scar formation relative to fibrosis
  • Utah score staging of patients [1]

Pre-ablation LGE to Immediately post-ablation(IPA) LGE

  • Can compare acute ablation-induced changes to the pre-ablation tissue

Immediately post-ablation to 3 months (or more) post-ablation LGE

  • Dark regions on IPA LGE scans result in stable scar formation at 3 or more months post-ablation -> [2]
  • Look for gaps in the ablation lesion sets - Ravi's project

Post-ablation LGE to Post-ablation LGE

  • Comparing the outcome of repeated ablation procedures to the

Pre-ablation LGE to Pre-ablation LGE

  • Comparison across patients prior to ablation

LGE to Dark-blood MRI

  • Dark blood images can be used to detect early lesion formation
  • Can compare with lesion formation seen later on LGE images

LGE to MRA

  • The boundaries of the LA in the MRA mirror the endocardial surface in the LGE scans
  • There is the possibility for thresholding the MRA and then registering the segmented region to the LGE

LGE to Electroanatomic map (Carto)

  • Compare the low voltage regions of Carto maps to the LGE scans

LGE to CT

  • Align LGE and CT for those patients that have both
  • Maybe helpful for shape analysis studies

Pre-ablation LGE/Endo to Post-ablation LGE/Endo

  • Combined the LGE images and manual segmentations can be used to improve the quality of registration
  • Yi Gao previously developed a Slicer module to register pre- and post-ablation images driven by the LGE images/segmentations -> AFib Registration


Implementation

  • We need to define a suitable set of registration parameters for each of the above cases
  • We will develop a Slicer extension module with the pre-defined registration parameters for each of the above scenarios
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