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

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

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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Fig. 1

Image adapted from: Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014.” WikiJournal of Medicine 1 (2): 10. https://doi.org/10.15347/wjm/2014.010. ISSN 2002-4436

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Funding

This work is part of the BMBF VIP+ project DSS Mitral (partially funded by the German Federal Ministry of Education and Research under Grant 03VP00852).

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Authors and Affiliations

  1. Fraunhofer MEVIS, Bremen, Germany

    Lennart Tautz, Lars Walczak, Joachim Georgii & Anja Hennemuth

  2. Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Lennart Tautz, Lars Walczak, Amer Jazaerli, Katharina Vellguth & Anja Hennemuth

  3. Department of Cardiovascular Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Simon Sündermann & Volkmar Falk

  4. Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany

    Isaac Wamala, Simon Sündermann & Volkmar Falk

  5. DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany

    Simon Sündermann & Volkmar Falk

  6. Department of Health Science and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland

    Volkmar Falk

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  1. Lennart Tautz
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  2. Lars Walczak
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  3. Joachim Georgii
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  9. Anja Hennemuth
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Correspondence to Lennart Tautz.

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Tautz, L., Walczak, L., Georgii, J. et al. Combining position-based dynamics and gradient vector flow for 4D mitral valve segmentation in TEE sequences. Int J CARS 15, 119–128 (2020). https://doi.org/10.1007/s11548-019-02071-4

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  • DOI: https://doi.org/10.1007/s11548-019-02071-4

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