Left atrial appendage assessment method
Systems and methods for left atrial appendage closure device specification from two dimensional (2D) Intracardiac Echo imaging (ICE). In an imaging procedure, 2D ICE is used to acquire images of the left atrium of a patient. A model of the left atrium is generated from the images of the left atrium. The model of the left atrium is used to validate subsequent imaging of the left atrial appendage of the patient. Anatomical measurements from the validated subsequent imaging may be used to select or specify a left atrial appendage closure device in order to, for example, treat atrial fibrillation patients.
1 . A method for left atrial appendage assessment, the method comprising:
acquiring a plurality of images of a left atrium of a patient;
generating a model of the left atrium from the plurality of images of the left atrium;
acquiring a plurality of images of a left atrial appendage of the patient;
determining, based on the model, if the plurality of images of the left atrial appendage are sufficient to accurately estimate a specification of an appropriate left atrial appendage closure device by estimating a probability that a diameter of a left atrial appendage ostia has been measured to a predefined accuracy based on a geometric uncertainty in the model and a position of an image frame relative to the model; and
computing and providing, when the probability meets a threshold, an anatomical measurement of the left atrial appendage or providing, when the probability does not meet the threshold, instructions for an operator to acquire additional images of the left atrial appendage, wherein the instructions identify a target catheter position to acquire a subsequent image and are based on one or more simulated alternative views generated from the model.
2 . The method of claim 1 , further comprising:
identifying the appropriate left atrial appendage closure device based on the anatomical measurement of the left atrial appendage.
3 . The method of claim 2 , further comprising:
performing a left atrial appendage closure procedure using the appropriate left atrial appendage closure device.
4 . The method of claim 1 , wherein acquiring comprises acquiring two dimensional images using an ICE ultrasound imaging system.
5 . The method of claim 1 , wherein the model comprises a three dimensional segmentation of the left atrium of the patient.
6 . The method of claim 1 , wherein generating the model comprises:
determining positions of scan planes within a cardiac system of the patient for the plurality of images of the left atrium;
forming an ICE volume from the plurality of images of the left atrium and the positions; and
generating a three-dimensional segmented model from input of the ICE volume to a machine learned network.
7 . The method of claim 6 , wherein determining if the plurality of images of the left atrial appendage are sufficient comprises:
registering one or more of the plurality of images to the three-dimensional segmented model; and
checking that a full diameter of a left atrial appendage ostia is present in at least one image of the plurality of images of the left atrial appendage using a position of the at least one image relative to the model.
8 . The method of claim 1 , wherein providing further comprises:
one or more additional measurements of a size or shape of the left atrial appendage that is used in choosing the appropriate left atrial appendage closure device.
9 . A non-transitory computer implemented storage medium that stores machine-readable instructions executable by at least one processor for left atrial appendage assessment, the machine-readable instructions comprising:
acquiring a plurality of images of a left atrium of a patient;
generating a model of the left atrium from the plurality of images of the left atrium;
acquiring a plurality of images of a left atrial appendage of the patient;
determining, based on the model, if the plurality of images of the left atrial appendage are sufficient to accurately estimate a specification of a left atrial appendage closure device by estimating a probability that a diameter of a left atrial appendage ostia has been measured to a predefined accuracy based on a geometric uncertainty in the model and a position of an image frame relative to the model; and
computing and providing, when the plurality of images of the left atrial appendage are sufficient, an anatomical measurement of the left atrial appendage or providing, and when the plurality of images are not sufficient, instructions for an operator to acquire additional images of the left atrial appendage, wherein the instructions identify a target catheter position to acquire a subsequent image and are based on one or more simulated alternative views generated from the model.
10 . The non-transitory computer implemented storage medium of claim 9 , wherein the instructions for generating the model comprise:
determining positions of scan planes within a cardiac system of the patient for the plurality of images of the left atrium;
forming an ICE volume from the plurality of images of the left atrium and the positions; and
generating a three-dimensional segmented model from input of the ICE volume to a machine learned network.
11 . The non-transitory computer implemented storage medium of claim 9 , wherein the instructions for determining comprise:
registering the plurality of images of the left atrial appendage to the model of the left atrium; and
determining if a full view of a diameter of the left atrial appendage is visualized in the plurality of images of the left atrial appendage.
12 . The non-transitory computer implemented storage medium of claim 9 , wherein acquiring is performed using a 2D ICE imaging system.