Evaluation of the Accuracy and Intraprocedural Use of a Holographic Display for 3-Dimensional Transesophageal Echocardiography

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

CJC Open Pub Date : 2025-06-01 DOI:10.1016/j.cjco.2025.03.014

Elchanan Bruckheimer MBBS , Alexander Lowenthal MD , Nili Schamroth Pravda MD , Hana Vaknin-Assa MD , Mordehay Vaturi MD , Gabriel Amir MD , Leor Perl MD , Pablo Codner MD , Yaron Shapira MD , Tamir Dagan MD , Ran Kornowski MD, FACC , Einat Birk MD

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引用次数: 0

Abstract

Background

Real-time 3-dimensional transesophageal echocardiography (3DTEE) data acquired during interventional procedures are displayed on 2-dimensional screens, limiting intuitive depth perception and spatial comprehension. The study objectives were to evaluate the feasibility of intraprocedural use of a holography display during structural cardiology procedures employing 3DTEE, and to assess the accuracy of offline linear measurements in 3DTEE datasets.

Methods

A prospective single-center study was conducted using the HOLOSCOPE-i to guide catheter-based procedures using intraprocedural 3DTEE. Qualitative measures of recognition of anatomic structures, 3D spatial comprehension, and interaction with intracardiac anatomic structures and catheter position were evaluated using a Likert scale. Additionally, a retrospective analysis of offline 3DTEE datasets of mitral valve measurements were performed using the HOLOSCOPE-i vs QLAB. Intra- and interobserver variability was assessed, assuming an intraclass correlation coefficient > 0.75 indicates adequate reliability.

Results

A total of 13 patients were enrolled. In all cases, anatomic structures were identified in real time, and spatial comprehension was enhanced (Likert scale). No nausea or headache was reported by the operators. Retrospective analysis of 41 mitral valve 3DTEE datasets was performed. Annular diameter measurements (anteroposterior [AP] and anterolateral-posteromedial [AL-PM]) demonstrated a Pearson correlation of 0.89 (HOLOSCOPE-i) and 0.91 (QLAB). Intraobserver ICC for AP, AL-PM was 0.97, 0.94 (HOLOSCOPE-i) and 0.95, 0.97 (QLAB); interobserver ICC for AP and AL-PM was 0.77 and 0.88 (HOLOSCOPE-i) and 0.96 and 0.98 (QLAB).

Conclusions

Holographic display of intraprocedural real-time 3DTEE data is feasible and augments the experience of the operator. Linear measurements in the 3D holographic display are accurate, with good correlation to those using 2-dimensional multiplanar reconstruction 3DTEE software.

Clinical Trial Registration

MOH_2021-09-13_010255.

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三维经食管超声心动图全息显示的准确性及术中应用评价

介入过程中获得的实时三维经食管超声心动图（3DTEE）数据显示在二维屏幕上，限制了直观的深度感知和空间理解。本研究的目的是评估在采用3DTEE的结构心脏病学手术中术中使用全息显示的可行性，并评估3DTEE数据集离线线性测量的准确性。方法采用HOLOSCOPE-i进行前瞻性单中心研究，指导术中3DTEE导管手术。采用李克特量表评估解剖结构识别、三维空间理解以及与心内解剖结构和导管位置的相互作用的定性措施。此外，使用HOLOSCOPE-i和QLAB对二尖瓣测量的离线3DTEE数据集进行回顾性分析。假设类内相关系数为>；0.75表示信度足够。结果共纳入13例患者。在所有病例中，解剖结构被实时识别，空间理解能力增强（李克特量表）。操作人员未报告恶心或头痛。回顾性分析41例二尖瓣3DTEE数据。环形直径测量（正位[AP]和前侧-后内侧[AL-PM]）显示Pearson相关性为0.89 （HOLOSCOPE-i）和0.91 （QLAB）。AP、AL-PM的观察者内ICC分别为0.97、0.94 （HOLOSCOPE-i）和0.95、0.97 (QLAB)；AP和AL-PM的观察者间ICC分别为0.77和0.88 （HOLOSCOPE-i）和0.96和0.98 （QLAB）。结论术中实时3DTEE数据的全息显示是可行的，增加了操作者的经验。三维全息显示器的线性测量精度高，与二维多平面重建3DTEE软件的线性测量结果具有良好的相关性。临床试验注册号：moh_2021 -09-13_010255。

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