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Image-based view-angle independent cardiorespiratory motion gating and coronary sinus catheter tracking for x-ray-guided cardiac electrophysiology procedures

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)8087-8108
Number of pages22
JournalPhysics in Medicine and Biology
Issue number20
Published1 Oct 2015

King's Authors


Determination of the cardiorespiratory phase of the heart has numerous
applications during cardiac imaging. In this article we propose a novel
view-angle independent near-real time cardiorespiratory motion gating and
coronary sinus (CS) catheter tracking technique for x-ray fluoroscopy images
that are used to guide cardiac electrophysiology procedures. The method is
based on learning CS catheter motion using principal component analysis and
then applying the derived motion model to unseen images taken at arbitrary
projections, using the epipolar constraint. This method is also able to track
the CS catheter throughout the x-ray images in any arbitrary subsequent
view. We also demonstrate the clinical application of our model on rotational
angiography sequences. We validated our technique in normal and very low
dose phantom and clinical datasets. For the normal dose clinical images we
established average systole, end-expiration and end-inspiration gating success
rates of 100%, 85.7%, and 92.3%, respectively. For very low dose applications,
the technique was able to track the CS catheter with median errors not exceeding
1mm for all tracked electrodes. Average gating success rates of 80.3%, 71.4%, and 69.2% were established for the application of the technique on clinical
datasets, even with a dose reduction of more than 10 times. In rotational
sequences at normal dose, CS tracking median errors were within 1.2mm for
all electrodes, and the gating success rate was 100%, for view angles from RAO
90° to LAO 90°. This view-angle independent technique can extract clinically
useful cardiorespiratory motion information using x-ray doses significantly
lower than those currently used in clinical practice.

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