Left-ventricle to coronary venous tree 3D fusion for cardiac resynchronization therapy applications

Response to cardiac resynchronization therapy (CRT) may be improved if coronary venous anatomy is fused with information on regional left ventricular (LV) function to guide LV lead placement. We propose a method to register a 3D model of the LV and its corresponding coronary venous tree (reconstructed from biplane X-ray fluoroscopy) for CRT applications. A template coronary venous tree (CVT) centerline, learned from a training set, was utilized to find point-to-point correspondence between the LV surface and the coronary vessels. The method was validated retrospectively on a set of 15 CRT candidates. Two validation experiments were conducted; on a randomly relocated patient specific LV and on a randomly relocated average LV. The absolute distance error between the ground truth and the registered LV was 3.4±1.0 mm for the case of patient specific LV and 4.2±1.0 mm for the case of average LV model. The probability of targeting the correct coronary branch, when using the registered LV compared to the ground truth, was 95.3±2.5 % for the case of patient specific LV and 94.5±3.5 % for the case of average LV model. The results suggest that the method can be used to provide an automatic registration of a 3D LV model to X-ray imaging with potential applications in image fusion to aid image-guided CRT implantation.