Cardiac ablation involves the risk of serious complications when thermal injury to the esophagus occurs. This paper proposes to reduce the risk of such injuries by a proactive visualization technique, improving physician awareness of the esophagus location in the absence of or in addition to a reactive monitoring device such as a thermal probe. This is achieved by combining a graphical representation of the esophagus with live fluoroscopy. Toward this goal, we present an automated method to reconstruct and visualize a 3-D esophagus model from fluoroscopy image sequences acquired using different C-arm viewing directions. In order to visualize the esophagus under fluoroscopy, it is first biomarked by swallowing a contrast agent such as barium. Images obtained in this procedure are then used to automatically extract the 2-D esophagus silhouette and reconstruct a 3-D surface of the esophagus internal wall. Once the 3-D representation has been computed, it can be visualized using fluoroscopy overlay techniques. Compared to 3-D esophagus imaging using CT or C-arm CT, our proposed fluoroscopy method requires low radiation dose and enables a simpler workflow on geometry-calibrated standard C-arm systems.
['Liron Yatziv', 'Julian Ibarz', 'Norbert Strobel', 'Saurabh Datta', 'Guillermo Sapiro']
Esophagus Silhouette Extraction and Reconstruction From Fluoroscopic Views for Cardiac Ablation Procedure Guidance