Registration of atrium models to c-arm x-ray images based on devices inside the coronary sinus and the esophagus

Abstract

For augmented fluoroscopy in the context of minimally invasive EP procedures, a patient-specific model of the atrium segmented from a 3D volume can be overlaid on fluoroscopic images. This requires a registration between the 3D model coordinate system and the coordinate system of the C-arm X-ray device. We propose an indirect registration that makes use of surrounding anatomical structures that can be segmented both in the 3D volume obtained by CT or MRI and also in fluoroscopic images. More precisely, the coronary sinus and the esophagus segmented from the 3D volume is registered to reconstructed 3D devices which are located in the respective structures during the intervention. An evaluation on 6 images of 6 different patients yielded a mean registration error of 3.2 mm. Results became significantly worse if only one of the anatomical structures was used.