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Lasso A, Herz C, Nam H, Cianciulli A, Pieper S, Drouin S, Pinter C, St-Onge S, Vigil C, Ching S, Sunderland K, Fichtinger G, Kikinis R, Jolley MA. SlicerHeart: An open-source computing platform for cardiac image analysis and modeling. Front Cardiovasc Med 2022; 9:886549. [PMID: 36148054 PMCID: PMC9485637 DOI: 10.3389/fcvm.2022.886549] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022] Open
Abstract
Cardiovascular disease is a significant cause of morbidity and mortality in the developed world. 3D imaging of the heart's structure is critical to the understanding and treatment of cardiovascular disease. However, open-source tools for image analysis of cardiac images, particularly 3D echocardiographic (3DE) data, are limited. We describe the rationale, development, implementation, and application of SlicerHeart, a cardiac-focused toolkit for image analysis built upon 3D Slicer, an open-source image computing platform. We designed and implemented multiple Python scripted modules within 3D Slicer to import, register, and view 3DE data, including new code to volume render and crop 3DE. In addition, we developed dedicated workflows for the modeling and quantitative analysis of multi-modality image-derived heart models, including heart valves. Finally, we created and integrated new functionality to facilitate the planning of cardiac interventions and surgery. We demonstrate application of SlicerHeart to a diverse range of cardiovascular modeling and simulation including volume rendering of 3DE images, mitral valve modeling, transcatheter device modeling, and planning of complex surgical intervention such as cardiac baffle creation. SlicerHeart is an evolving open-source image processing platform based on 3D Slicer initiated to support the investigation and treatment of congenital heart disease. The technology in SlicerHeart provides a robust foundation for 3D image-based investigation in cardiovascular medicine.
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Affiliation(s)
- Andras Lasso
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, ON, Canada
| | - Christian Herz
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Hannah Nam
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Alana Cianciulli
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | | | - Simon Drouin
- Software and Information Technology Engineering, École de Technologie Supérieure, Montreal, QC, Canada
| | | | - Samuelle St-Onge
- Software and Information Technology Engineering, École de Technologie Supérieure, Montreal, QC, Canada
| | - Chad Vigil
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Stephen Ching
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Kyle Sunderland
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, ON, Canada
| | - Gabor Fichtinger
- Laboratory for Percutaneous Surgery, School of Computing, Queen's University, Kingston, ON, Canada
| | - Ron Kikinis
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Matthew A. Jolley
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States,Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States,*Correspondence: Matthew A. Jolley
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de Oliveira DC, Espino DM, Deorsola L, Mynard JP, Rajagopal V, Buchan K, Dawson D, Shepherd DET. A toolbox for generating scalable mitral valve morphometric models. Comput Biol Med 2021; 135:104628. [PMID: 34246162 DOI: 10.1016/j.compbiomed.2021.104628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022]
Abstract
The mitral valve is a complex anatomical structure, whose shape is key to several traits of its function and disease, being crucial for the success of surgical repair and implantation of medical devices. The aim of this study was to develop a parametric, scalable, and clinically useful model of the mitral valve, enabling the biomechanical evaluation of mitral repair techniques through finite element simulations. MATLAB was used to parameterize the valve: the annular boundary was sampled from a porcine mitral valve mesh model and landmark points and relevant boundaries were selected for the parameterization of leaflets using polynomial fitting. Several geometric parameters describing the annulus, leaflet shape and papillary muscle position were implemented and used to scale the model according to patient dimensions. The developed model, available as a toolbox, allows for the generation of a population of models using patient-specific dimensions obtained from medical imaging or averaged dimensions evaluated from empirical equations based on the Golden Proportion. The average model developed using this framework accurately represents mitral valve shapes, associated with relative errors reaching less than 10% for annular and leaflet length dimensions, and less than 24% in comparison with clinical data. Moreover, model generation takes less than 5 min of computing time, and the toolbox can account for individual morphological variations and be employed to evaluate mitral valve biomechanics; following further development and validation, it will aid clinicians when choosing the best patient-specific clinical intervention and improve the design process of new medical devices.
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Affiliation(s)
- Diana C de Oliveira
- Department of Mechanical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Daniel M Espino
- Department of Mechanical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Luca Deorsola
- Paedriatic Cardiac Surgery, Ospedale Infantile Regina Margherita Sant Anna, Turin, 10126, Italy
| | - Jonathan P Mynard
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, VIC, 3010, Australia; Heart Research, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, 3052, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, 3010, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, VIC, 3052, Australia
| | - Vijay Rajagopal
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Keith Buchan
- Department of Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, AB24 2ZN, Scotland, UK
| | - Dana Dawson
- School of Medicine, University of Aberdeen, Aberdeen, AB25 2ZD, Scotland, UK; Cardiology Department, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN, Scotland, UK
| | - Duncan E T Shepherd
- Department of Mechanical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Herz C, Cianciulli A, Ching S, Vigil C, Lasso A, Nam HH, Drouin S, Biko DM, Gillespie M, Fichtinger G, Jolley MA. Open-Source Tool Kit for Interactive Planning of Transcatheter Mitral Valve Replacement Using Multimodality Imaging. J Am Soc Echocardiogr 2021; 34:917-920. [PMID: 33819621 DOI: 10.1016/j.echo.2021.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/26/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Christian Herz
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Alana Cianciulli
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stephen Ching
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Chad Vigil
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Andras Lasso
- Laboratory for Percutaneous Surgery, Queen's University, Kingston, Ontario
| | - Hannah H Nam
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Simon Drouin
- École de Technologie Supérieure, Montreal, Quebec, Canada
| | - David M Biko
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Matthew Gillespie
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Gabor Fichtinger
- Laboratory for Percutaneous Surgery, Queen's University, Kingston, Ontario
| | - Matthew A Jolley
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Narang A, Hitschrich N, Mor-Avi V, Schreckenberg M, Schummers G, Tiemann K, Hitschrich D, Sodian R, Addetia K, Lang RM, Mumm B. Virtual Reality Analysis of Three-Dimensional Echocardiographic and Cardiac Computed Tomographic Data Sets. J Am Soc Echocardiogr 2020; 33:1306-1315. [DOI: 10.1016/j.echo.2020.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/20/2020] [Accepted: 06/22/2020] [Indexed: 12/13/2022]
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Haller C, Honjo O. Commentary: The antifragility of the Melody valve. JTCVS Tech 2020; 4:251-252. [PMID: 34318032 PMCID: PMC8308233 DOI: 10.1016/j.xjtc.2020.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Christoph Haller
- Department of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Osami Honjo
- Department of Cardiovascular Surgery, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Janson CM, Nam HH, Herz C, Lasso A, Cianciulli A, Jolley MA. Successful integration of a three-dimensional transthoracic echocardiography-derived model with an electroanatomic mapping system to guide catheter ablation of WPW. J Cardiovasc Electrophysiol 2020; 31:2770-2773. [PMID: 32780501 DOI: 10.1111/jce.14712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Abstract
Three-dimensional transthoracic echocardiography (3DE)-derived heart models have not previously been utilized to guide catheter ablation. In this case report, we describe the creation of a 3DE model from transthoracic echocardiography, import of the model into CARTO3, and successful use of the model as a guide during mapping and ablation of a right lateral accessory pathway. We believe this technique represents a valuable alternative to the integration of computed tomography or magnetic resonance imaging-derived anatomic data, and that it has the potential to improve the definition of the atrioventricular valve annuli during catheter ablation of accessory pathways.
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Affiliation(s)
- Christopher M Janson
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hannah H Nam
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Christian Herz
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Andras Lasso
- Laboratory for Percutaneous Surgery, Queen's University, Kingston, Ontario, USA
| | - Alana Cianciulli
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Matthew A Jolley
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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