Fusion of three-dimensional X-ray angiography and three-dimensional echocardiography

Objective Cardiovascular intervention guidance requires knowledge of heart function relative to its blood supply or venous drainage. Functional and vascular anatomic data are usually generated on different imaging systems, so fusion of the data is necessary to simultaneously visualize the results for intervention planning and guidance. The objective of this work is to establish the feasibility of fusing volumetric ultrasound (U/S) data with three-dimensional (3D) X-ray imaging data for visualization of cardiac morphology, function and coronary venous drainage. Methods Temporally resolved U/S volume data was registered with the 3D reconstruction of vascular structures derived from X-ray modeling and reconstruction. U/S image registration was obtained by optical tracking fiducial markers with simultaneous X-ray imaging. The proposed technique was applied to phantom data for accuracy assessment of the registration process and to biventricular pacemaker implantation as clinical example. Results Fusion of U/S data with 3D X-ray reconstruction data produced an RMS registration error below 2 mm. Conclusion Preliminary clinical feasibility of U/S-derived data synchronously with X-ray derived 3D coronary venography was established. This technique can be applied for fusion of functional U/S data with 3D anatomic X-ray data of the coronary veins during a biventricular pacemaker implantation procedures.