Innovative Integration of 4D Cardiovascular Reconstruction and Hologram: Framework Development of a New Visualization Tool for Coronary Artery Bypass Grafting Planning.
Shuo Wang, Tong Ren, Nan Cheng, Li Zhang, Rong Wang
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引用次数: 0
Abstract
Background: Planning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions.
Objective: This study aimed to address these requirements by reconstructing a dynamic cardiovascular model, displaying it as a naked-eye hologram, and evaluating the clinical utility of this innovative visualization tool for preoperative CABG planning.
Methods: We used preoperative 4D cardiac computed tomography angiography (4D-CCTA) data from 14 patients scheduled for CABG to develop a semiautomated workflow. This workflow enabled time-resolved segmentation of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries, complete with calcium scoring. Methods for segmenting cardiac structures, quantifying coronary calcification, visualizing coronary depth within EAT, and assessing pericardial adhesions via motion analysis were incorporated. These dynamic reconstructions captured spatial relationships, coronary stenosis, calcification, and depth in EAT, as well as pericardial adhesions. Dynamic cardiovascular holograms were then generated and displayed using the Looking Glass platform (Looking Glass Factory Inc). Thirteen cardiac surgeons assessed the utility of the holographic visualization tool on a Likert scale. In addition, a surgeon visually scored pericardial adhesions using the holograms of all 21 patients (including 7 undergoing secondary cardiac surgeries) and compared these scores with actual intraoperative findings.
Results: Cardiac surgeons highly rated the visualization tool for its utility in preoperative planning, with a mean Likert score of 4.57/5.0 (SD 0.5). The hologram-based scoring of pericardial adhesions showed a strong correlation with intraoperative findings (correlation coefficient r=0.786; P<.001).
Conclusions: This study delineates the structural framework of a visualization tool specifically designed for preoperative CABG planning. It produces high-quality, clinically relevant, dynamic holograms from patient-specific volumetric data, with clinical feedback confirming its practicality and effectiveness for preoperative surgical planning.
期刊介绍:
JMIR Medical Informatics (JMI, ISSN 2291-9694) is a top-rated, tier A journal which focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. It has a focus on applied, translational research, with a broad readership including clinicians, CIOs, engineers, industry and health informatics professionals.
Published by JMIR Publications, publisher of the Journal of Medical Internet Research (JMIR), the leading eHealth/mHealth journal (Impact Factor 2016: 5.175), JMIR Med Inform has a slightly different scope (emphasizing more on applications for clinicians and health professionals rather than consumers/citizens, which is the focus of JMIR), publishes even faster, and also allows papers which are more technical or more formative than what would be published in the Journal of Medical Internet Research.