Fully Automated 4D Echocardiographic Mitral Valve Analysis for Surgical Repair

用于手术修复的全自动 4D 超声心动图二尖瓣分析

• 批准号: 8882544
• 负责人: Alison Marie Pouch
• 金额: $ 5.42万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-15 至 2016-07-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8882544
• 关键词: Address; Adult; Affect; Algorithms; American; Atlases; Cardiac; Clinical; Data; Data Set; Databases; Geometry; Goals; Gold; Health; Image; Image Analysis; Imagery; Interobserver Variability; Intraobserver Variability; Label; Left; Longitudinal Studies; Manuals; Methods; Mitral Valve; Mitral Valve Insufficiency; Modeling; Morphology; Motion; Operating Rooms; Operative Surgical Procedures; Outcome; Patients; Performance; Physiological; Population; Recurrence; Reproducibility; Series; Severities; Shapes; Stress; Surgeon; Techniques; Testing; Three-Dimensional Echocardiography; Three-Dimensional Image; Time; Training; Two-Dimensional Echocardiography; Validation; Visual; base; design; imaging modality; improved; in vivo; in vivo Model; morphometry; mortality; novel; quantitative imaging; repaired; spatiotemporal; tool

DESCRIPTION (provided by applicant): Mitral regurgitation (MR) affects 2.4% of adult Americans [1] and increases mortality even when mild, with a strongly-graded relationship between severity and reduced survival.[2,3] Mitral valve repair with undersized ring annuloplasty has become the preferred surgical treatment for both functional and degenerative MR. However, several recent long-term studies have documented unexpectedly high recurrence rates of significant MR after surgery.[5-9] Improving the clinical outcome of valve repair requires a thorough pre-operative analysis of patient-specific in vivo valve morphology, to predict which patients will benefit from valve repair over replacement and to identify repair strategies that target patient-specific distortions in valve geometry. Real-time 3D echocardiography (rt-3DE) is the most practical tool for inspection of in vivo valve morphology and function in the operating room. However, the current methods for examining rt-3DE image data are both inefficient and limited in the amount of information conveyed to the surgical team. Therefore, the goal of this proposal is to develop and validate a fully automated 4D spatiotemporal segmentation method that automatically generates dynamic geometric models of the mitral valve from rt-3DE image data. It is hypothesized that these models can accurately and robustly capture the dynamic morphology of the in vivo mitral valve. To investigate this hypothesis, a database of expert-labeled rt-3DE atlases of the mitral valve will be constructed in Specific Aim 1. These atlases encode information about dynamic valve morphology in a population of normal and diseased subjects and serve as training data for 4D automatic segmentation. In Specific Aim 2, a fully automatic 4D segmentation of the mitral leaflets will be implemented using the reference atlases constructed in Specific Aim 1. The proposed algorithm integrates complementary probabilistic segmentation and shape modeling techniques to automatically generate 4D patient-specific shape models of the mitral valve from rt-3DE images. In Specific Aim 3, the 4D segmentation algorithm will be validated using manual image analysis as a gold standard. The accuracy and reproducibility of the method will be assessed, and the algorithm will be optimized for performance efficiency. Upon successful completion of this project, surgeons will have an efficient tool for pre-operative valve assessment that will provide unprecedented visual and quantitative data for guidance of mitral valve repair surgery.

描述（由申请人提供）：二尖瓣反流（MR）影响了2.4％的成年美国人[1]，即使在轻度时也会增加死亡率，并且严重程度与生存率降低之间的关系较强。[2,3]二尖瓣修复效率不足，具有未尺寸的环形成形术，已成为功能性的首选手术治疗，是功能性和变性的首选。然而，最近的一些长期研究记录了手术后明显MR的出乎意料的高复发率。[5-9]改善瓣膜修复的临床结果需要对体内特定于体内患者特异性患者的术前进行彻底的术前分析，以预测哪些患者将受益于瓣膜修复中的瓣膜修复，以替代替换术，并确定valve caltecixific tallortions in Valve Geometions in valve deafletions in valve natery nater-celement in valve dealortions。实时3D超声心动图（RT-3DE）是检查手术室中体内瓣膜形态和功能的最实际工具。但是，目前检查RT-3DE图像数据的方法既效率低下又有限，而传达给手术团队的信息量则有限。因此，该提案的目的是开发和验证完全自动化的4D时空分割方法，该方法自动从RT-3DE图像数据中自动生成二尖瓣的动态几何模型。假设这些模型可以准确，可靠地捕获体内二尖瓣的动态形态。为了研究这一假设，将在特定的目标1中构建二尖瓣的专家标记的RT-3DE图书馆的数据库。这些地图器编码有关正常和患病受试者人群中动态瓣膜形态的信息，并用作4D自动分割的训练数据。在特定的目标2中，将使用特定目标1构建的参考图谱进行二尖瓣的全自动4D分割。所提出的算法集成了互补的概率分割和形状建模技术，以自动生成4D患者特异性形状模型的RT-3DE图像的二尖瓣形状模型。在特定的目标3中，将使用手动图像分析作为黄金标准来验证4D分割算法。将评估该方法的准确性和可重复性，并将算法优化以提高性能效率。成功完成该项目后，外科医生将拥有一个有效的术前评估工具，该工具将提供前所未有的视觉和定量数据，以指导二尖瓣维修手术。

项目成果

Validation of semiautomated and locally resolved aortic wall thickness measurements from computed tomography.

• DOI: 10.1016/j.jvs.2013.11.065
• 发表时间: 2015-04
• 期刊: JOURNAL OF VASCULAR SURGERY
• 影响因子: 4.3
• 作者: Shang, Eric K.;Lai, Eric;Pouch, Alison M.;Hinmon, Robin;Gorman, Robert C.;Gorman, Joseph H., III;Sehgal, Chandra M.;Ferrari, Giovanni;Bavaria, Joseph E.;Jackson, Benjamin M.
• 通讯作者: Jackson, Benjamin M.