Feasibility Study of Respiratory Motion Modeling Based Correction for MRI-Guided Intracardiac Interventional Procedures

Goal: The purpose of this study is to improve the accuracy of interventional catheter guidance during intracardiac procedures. Specifically, the use of preprocedural magnetic resonance roadmap images for interventional guidance has limited anatomical accuracy due to intraprocedural respiratory motion of the heart. Therefore, we propose to build a novel respiratory motion model to compensate for this motion-induced error during magnetic resonance imaging (MRI)-guided procedures. Methods: We acquire 2-D real-time free-breathing images to characterize the respiratory motion, and build a smooth motion model via registration of 3-D prior roadmap images to the real-time images within a novel principal axes frame of reference. The model is subsequently used to correct the interventional catheter positions with respect to the anatomy of the heart. Results: We demonstrate that the proposed modeling framework can lead to smoother motion models, and potentially lead to more accurate motion estimates. Specifically, MRI-guided intracardiac ablations were performed in six preclinical animal experiments. Then, from retrospective analysis, the proposed motion modeling technique showed the potential to achieve a 27% improvement in ablation targeting accuracy. Conclusion: The feasibility of a respiratory motion model-based correction framework has been successfully demonstrated. Significance: The improvement in ablation accuracy may lead to significant improvements in success rate and patient outcomes for MRI-guided intracardiac procedures.