630Comparative study of registration accuracy between 64 multislice spiral CT and contrast enhanced MRI in left atrium imaging for integrated cartography system


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Abstract

Objective: To evaluated the registration accuracy and the efficacy of integrated cartography (CARTO) system with 64 multislice spiral CT scan and contrast enhanced MRI for the assessment of left atrium (LA) geometry and to investigate the registration accuracy error between CT and MRI.Methods: Forty consecutive patients with drug-refractory Atrial fibrillatin (AF) underwent catheter ablation under the guidance of a three-dimensional(3D) CARTO System (Biosence Webster,Inc.,Diamond Bar,CA,USA). Gadolinium-enhanced MRI (1.5-T,n=20) and contrast-enhanced high-resolution CT(64-slice,n=20) imaging was performed within 1 day prior to the ablation procedures. The DICOM data acquired by CT/MRA were input into CARTO system and the LA images were extracted for CARTO image registration. So the limpid LA geometry guided clinical AF ablation.Then analyzed the registrated values of general samples, CT group, MRA group and to compare the mean deviation of registrated values between CT and MRA group.Results: The segmented 3D MRI and CT LA reconstruction was accurately registerted to the real-time mapping space with a combination of landmark registration and surface registration. The registered 3D CT/MR LA reconstruction was successfully used to guide deployment of RF applications encircling the pulmonary veins (PVs). The distance between the surface of the registered LA reconstruction and multiple electroanatomic map points with an error of 2.3± 0.5 mm in general group, 2.2 ± 0.4 mm in CTA group, and 2.4 ± 0.6 mm in MRA group respectively.The mean deviation of the registration were 2.2 ± 0.4 mm in CTA group and 2.4 ± 0.5 mm in MRA group respectively There was no significant difference in the LA registration error between the two groups.Conclusion: Both three-dimensional CTA and MRA images integrated into an CARTO system can be successfully performed in patients undergoing catheter ablation for AF and there was no difference in registration accuracy between the two groups. With a greater appreciation of the LA anatomy this technology enables tailored RF ablation. With the advantage of no radiation and low incidence rate of contrast adverse effect, MR images of LA could be the optimizing medical imaging technology.

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