Three‐dimensional computed tomography in the cardiac catheterization laboratory

Objectives: To establish the feasibility of fusion of a 3‐dimensional computed tomography (3D CT) dataset to the routine fluoroscopic image in the cardiac catheterization laboratory. Background: Routine fluoroscopic imaging in the cardiac catheterization laboratory often does not provide adequate anatomic detail for structural cardiac interventions. The modern C‐arm is capable of acquiring CT‐like 3D images (Syngo DynaCT), and the overlay of CT‐acquired details on the fluoroscopic image may be useful. The feasibility of this new technology has not yet been reported. Methods: Three patients (presenting with three different clinical indications) were selected, all of whom had previously undergone contrast‐enhanced chest CT. Anatomic details of interest were marked on the preprocedural CT, and the CT was registered to a DynaCT acquired in the catheterization laboratory. The CT:CT registration was then fused to the “real‐time” fluoroscopic image. Results: Fusion of the CT to the fluoroscopic image was successful in these three patients and provided a substantial degree of anatomic guidance for catheter and device manipulation. Conclusions: We have demonstrated the ability to delineate cardiovascular structures of interest on the “real‐time” fluoroscopic image using CT fusion. Future studies should address whether this technology can reduce overall contrast administration and radiation dose. © 2011 Wiley‐Liss, Inc.