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Pre to Intraoperative Data Fusion Framework for Multimodal Characterization of Myocardial Scar Tissue

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Pre to Intraoperative Data Fusion Framework for Multimodal Characterization of Myocardial Scar Tissue
Merging multimodal information about myocardial scar tissue can help electrophysiologists to find the most appropriate target during catheter ablation of ventricular arrhythmias. A framework is presented to analyze and combine information from delayed enhancement magnetic resonance imaging (DE-MRI) and electro-anatomical mapping data. Using this information, electrical, mechanical, and image-based characterization of the myocardium are performed. The presented framework allows the left ventricle to be segmented by DE-MRI and the scar to be characterized prior to the intervention based on image information. It allows the electro-anatomical maps obtained during the intervention from a navigation system to be merged together with the anatomy and scar information extracted from DE-MRI. It also allows for the estimation of endocardial motion and deformation to assess cardiac mechanics. Therefore, electrical, mechanical, and image-based characterization of the myocardium can be performed. The feasibility of this approach was demonstrated on three patients with ventricular tachycardia associated to ischemic cardiomyopathy by integrating images from DE-MRI and electro-anatomical maps data in a common framework for intraoperative myocardial tissue characterization. The proposed framework has the potential to guide and monitor delivery of radio frequency ablation of ventricular tachycardia. It is also helpful for research purposes, facilitating the study of the relationship between electrical and mechanical properties of the tissue, as well as with tissue viability from DE-MRI.
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Authors

See complete bios of the authors in the full version of this article.
A PorrasA Porras
Mr. Porras is currently pursuing a Ph.D. degree with Universitat Pompeu Fabra, Barcelona. His main research interest is biomedical data/images integration for motion and deformation estimation of the heart.

G PiellaG Piella
Dr. Piella is with the Department of Technology, Universitat Pompeu Fabra, Barcelona. Her work has focused on multiresolution analyses, adaptive wavelets, geometrical image processing, and image fusion and registration.

A BerruezoA Berruezo
Dr. Berruezo is with the Arrhytmia Section, Thorax Institute of Hospital Clínic de Barcelona, Universitat de Barcelona. He is involved in several research projects related with atrial brillation, cardiac resynchronization therapy, and ventricular arrhythmias, with ventricular tachycardia ablation as his main area of interest.

J Fernandez-ArmentaJ Fernandez-Armenta
Dr. Fernandez-Armenta received his Ph.D. degree from the Universitat de Barcelona, Barcelona, Spain, in 2014. He has been awarded with the European Accreditation in Interventional Cardiac Electrophysiology and Cardiac Pacing. His main research fields are ventricular arrhythmias and sudden cardiac death.

A FrangiA Frangi
Mr. Frangi is currently a Professor of Biomedical Image Computing with the University of Shefeld, Shefeld, U.K. His main research interests are in medical image computing, medical imaging, and image-based computational physiology.

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