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International Journal of Computer Assisted Radiology and Surgery

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01-01-2020 | Transesophageal Echocardiography | Original Article

Combining position-based dynamics and gradient vector flow for 4D mitral valve segmentation in TEE sequences

Authors: Lennart Tautz, Lars Walczak, Joachim Georgii, Amer Jazaerli, Katharina Vellguth, Isaac Wamala, Simon Sündermann, Volkmar Falk, Anja Hennemuth

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 1/2020

Abstract

Purpose

For planning and guidance of minimally invasive mitral valve repair procedures, 3D+t transesophageal echocardiography (TEE) sequences are acquired before and after the intervention. The valve is then visually and quantitatively assessed in selected phases. To enable a quantitative assessment of valve geometry and pathological properties in all heart phases, as well as the changes achieved through surgery, we aim to provide a new 4D segmentation method.

Methods

We propose a tracking-based approach combining gradient vector flow (GVF) and position-based dynamics (PBD). An open-state surface model of the valve is propagated through time to the closed state, attracted by the GVF field of the leaflet area. The PBD method ensures topological consistency during deformation. For evaluation, one expert in cardiac surgery annotated the closed-state leaflets in 10 TEE sequences of patients with normal and abnormal mitral valves, and defined the corresponding open-state models.

Results

The average point-to-surface distance between the manual annotations and the final tracked model was \(1.00\,\hbox {mm} \pm 1.08\,\hbox {mm}\). Qualitatively, four cases were satisfactory, five passable and one unsatisfactory. Each sequence could be segmented in 2–6 min.

Conclusion

Our approach enables to segment the mitral valve in 4D TEE image data with normal and pathological valve closing behavior. With this method, in addition to the quantification of the remaining orifice area, shape and dimensions of the coaptation zone can be analyzed and considered for planning and surgical result assessment.

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Title: Combining position-based dynamics and gradient vector flow for 4D mitral valve segmentation in TEE sequences
Authors: Lennart Tautz
Lars Walczak
Joachim Georgii
Amer Jazaerli
Katharina Vellguth
Isaac Wamala
Simon Sündermann
Volkmar Falk
Anja Hennemuth
Publication date: 01-01-2020
Publisher: Springer International Publishing
Keyword: Transesophageal Echocardiography
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 1/2020
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-019-02071-4

At a glance: The STEP trials

Springer Medicine

Combining position-based dynamics and gradient vector flow for 4D mitral valve segmentation in TEE sequences

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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