Real-time X-ray-based 4D image guidance of minimally invasive interventions.

Objective: A new technology is introduced that enables real-time 4D (three spatial dimensions plus time) X-ray guidance for vascular catheter interventions with acceptable levels of ionising radiation.Methods: The enabling technology is a combination of low-dose tomographic data acquisition with nov...

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Publicado en:European Radiology Vol. 23; no. 6; pp. 1669 - 1678
Autores principales: Kuntz, Jan, Gupta, Rajiv, Schönberg, Stefan O, Semmler, Wolfhard, Kachelrieß, Marc, Bartling, Sönke
Formato: research Journal Article
Publicado: Springer Nature Jun2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2013
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      pub: Springer Nature
      place: New York, New York
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        atl: Real-time X-ray-based 4D image guidance of minimally invasive interventions.
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        au:
          Kuntz, Jan
          Gupta, Rajiv
          Schönberg, Stefan O
          Semmler, Wolfhard
          Kachelrieß, Marc
          Bartling, Sönke
        affil: Department of Medical Physics in Radiology, German Cancer Research Center-DKFZ, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany, j.kuntz@dkfz.de.
      sug:
        subj:
          Tomography, X-Ray Computed Methods
          Algorithms
          Angiography Methods
          Animals
          Catheters
          Fluoroscopy Methods
          Human
          Radiation Dosage
          Radiation, Ionizing
          Radiographic Image Interpretation, Computer-Assisted
          Specialties, Medical Methods
          Radiometry Methods
          Reproducibility of Results
          Swine
          Treatment Outcomes
          X-Rays
      ab: Objective: A new technology is introduced that enables real-time 4D (three spatial dimensions plus time) X-ray guidance for vascular catheter interventions with acceptable levels of ionising radiation.Methods: The enabling technology is a combination of low-dose tomographic data acquisition with novel compressed sensing reconstruction and use of prior image information. It was implemented in a prototype set-up consisting of a gantry-based flat detector system. In pigs (n = 5) angiographic interventions were simulated. Radiation dosage on a per time base was compared with the "gold standard" of X-ray projection imaging.Results: Contrary to current image guidance methods that lack permanent 4D updates, the spatial position of interventional instruments could be resolved in continuous, spatial 4D guidance; the movement of the guide wire as well as the expansion of stents could be precisely tracked in 3D angiographic road maps. Dose rate was 23.8 μGy/s, similar to biplane standard angiographic fluoroscopy, which has a dose rate of 20.6 μGy/s.Conclusion: Real-time 4D X-ray image-guidance with acceptable levels of radiation has great potential to significantly influence the field of minimally invasive medicine by allowing faster and safer interventions and by enabling novel, much more complex procedures for vascular and oncological minimally invasive therapy.Key Points: • Real-time 4D (three spatial dimensions plus time) angiographic intervention guidance is realistic. • Low-dose tomographic data acquisition with special compressed sensing-based algorithms is enabled. • Compared with 4D CT fluoroscopy, this method reduces radiation to acceptable levels. • Once implemented, vascular interventions may become safer and faster. • More complex intervention approaches may be developed.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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