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Left atrial appendage segmentation from 3D CCTA images for occluder placement procedure

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Abstract
Background: Percutaneous left atrial appendage (LAA) closure (placement of an occluder to close the appendage) is a novel procedure for stroke prevention in patients suffering from atrial fibrillation. The closure procedure planning requires accurate LAA measurements which can be obtained from computed tomography (CT) images. Method: We propose a novel semi-automatic LAA segmentation method from 3D coronary CT angiography (CCTA) images. The method segments the LAA, proposes the location for the occluder placement (a delineation plane between the left atrium and LAA) and calculates measurements needed for closure procedure planning. The method requires only two inputs from the user: a threshold value and a single seed point inside the LAA. Proposed location of the delineation plane can be intuitively corrected if necessary. Measurements are calculated from the segmented LAA according to the final delineation plane. Results: Performance of the proposed method is validated on 17 CCTA images, manually segmented by two medical doctors. We achieve the average dice coefficient overlap of 92.52% and 91.63% against the ground truth segmentations. The average dice coefficient overlap between the two ground truth segmentations is 92.66%. Our proposed LAA orifice localization is evaluated against the desired location of the LAA orifice determined by the expert. The average distance between our proposed location and the desired location is 2.51 mm. Conclusion: Segmentation results show high correspondence to the ground truth segmentations. The occluder placement method shows high accuracy which indicates potential in clinical procedure planning.
Keywords
Left atrial appendage, Image segmentation, Image analysis, Left atrial appendage occlusion, Left atrial appendage closure, CARDIAC CT, TRANSESOPHAGEAL ECHOCARDIOGRAPHY, STROKE PREVENTION, FIBRILLATION, ANGIOGRAPHY, CLOSURE, DEVICE

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Chicago
Leventić, Hrvoje, Danilo Babin, Lazar Velicki, Daniel Devos, Irena Galić, Vladimir Zlokolica, Krešimir Romić, and Aleksandra Pizurica. 2019. “Left Atrial Appendage Segmentation from 3D CCTA Images for Occluder Placement Procedure.” Computers in Biology and Medicine 104: 163–174.
APA
Leventić, H., Babin, D., Velicki, L., Devos, D., Galić, I., Zlokolica, V., Romić, K., et al. (2019). Left atrial appendage segmentation from 3D CCTA images for occluder placement procedure. COMPUTERS IN BIOLOGY AND MEDICINE, 104, 163–174.
Vancouver
1.
Leventić H, Babin D, Velicki L, Devos D, Galić I, Zlokolica V, et al. Left atrial appendage segmentation from 3D CCTA images for occluder placement procedure. COMPUTERS IN BIOLOGY AND MEDICINE. 2019;104:163–74.
MLA
Leventić, Hrvoje et al. “Left Atrial Appendage Segmentation from 3D CCTA Images for Occluder Placement Procedure.” COMPUTERS IN BIOLOGY AND MEDICINE 104 (2019): 163–174. Print.
@article{8582512,
  abstract     = {Background: Percutaneous left atrial appendage (LAA) closure (placement of an occluder to close the appendage) is a novel procedure for stroke prevention in patients suffering from atrial fibrillation. The closure procedure planning requires accurate LAA measurements which can be obtained from computed tomography (CT) images. 
Method: We propose a novel semi-automatic LAA segmentation method from 3D coronary CT angiography (CCTA) images. The method segments the LAA, proposes the location for the occluder placement (a delineation plane between the left atrium and LAA) and calculates measurements needed for closure procedure planning. The method requires only two inputs from the user: a threshold value and a single seed point inside the LAA. Proposed location of the delineation plane can be intuitively corrected if necessary. Measurements are calculated from the segmented LAA according to the final delineation plane. 
Results: Performance of the proposed method is validated on 17 CCTA images, manually segmented by two medical doctors. We achieve the average dice coefficient overlap of 92.52\% and 91.63\% against the ground truth segmentations. The average dice coefficient overlap between the two ground truth segmentations is 92.66\%. Our proposed LAA orifice localization is evaluated against the desired location of the LAA orifice determined by the expert. The average distance between our proposed location and the desired location is 2.51 mm. 
Conclusion: Segmentation results show high correspondence to the ground truth segmentations. The occluder placement method shows high accuracy which indicates potential in clinical procedure planning.},
  author       = {Leventi\'{c}, Hrvoje and Babin, Danilo and Velicki, Lazar and Devos, Daniel and Gali\'{c}, Irena and Zlokolica, Vladimir and Romi\'{c}, Kre\v{s}imir and Pizurica, Aleksandra},
  issn         = {0010-4825},
  journal      = {COMPUTERS IN BIOLOGY AND MEDICINE},
  language     = {eng},
  pages        = {163--174},
  title        = {Left atrial appendage segmentation from 3D CCTA images for occluder placement procedure},
  url          = {http://dx.doi.org/10.1016/j.compbiomed.2018.11.006},
  volume       = {104},
  year         = {2019},
}

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