Abstract
Purpose
Ventricular septal defects (VSDs) are common congenital heart malformations. Echocardiography used during VSD hybrid cardiac procedures requires extensive training for image acquisition and interpretation. Cardiac surgery simulators with heart phantoms have shown usefulness for such training, but they are limited in visualization and characterization of complex VSD. This study explores a new method to build patient-specific heart phantoms with VSD, with proper tissue echogenicity for ultrasound imaging.
Methods
Heart phantoms were designed from preoperative imaging of three patients with complex VSDs. Each whole heart phantom, including atrial and ventricular septums, was obtained by manual segmentation and by surface reconstruction, then by molding and by casting in different materials. Heart phantoms in silicone and polyvinyl alcohol cryogel (PVA-C) were considered, and they were reconstructed in 3-D using 2-D freehand ultrasound imaging.
Results
An electromagnetic measurement system was used to measure the mean VSD diameters from the heart phantoms. Errors were evaluated below 1.0 mm for mean VSD diameters between 6.2 and 7.5 mm.
Conclusion
Patient-specific heart phantoms promise for representing complex heart malformations such as VSDs. PVA-C showed better tissue echogenicity than silicone for VSDs visualization and characterization.
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Availability of data and material
The clinical datasets cannot be publicly released. The material used in this study is commercially available.
References
Dakkak W, Oliver TI (2020) Ventricular septal defect. StatPearls (Internet). https://www.ncbi.nlm.nih.gov/books/NBK470330/. Accessed 6 March 2021
Amin Z, Berry JM, Foker JE, Rocchini AP, Bass JL (1998) Intraoperative closure of muscular ventricular septal defect in a canine model and application of the technique in a baby. J Thorac Cardiovasc Surg 115(6):1374–1376. https://doi.org/10.1016/S0022-5223(98)70222-3
Harrison CM, Gosai JN (2017) Simulation-based training for cardiology procedures: are we any further forward in evidencing real-world benefits? Trends Cardiovasc Med 27(3):163–170. https://doi.org/10.1016/j.tcm.2016.08.009
Bhatla P, Tretter JT, Ludomirsky A, Argilla M, Latson LA, Chakravarti S, Barker PC, Yoo SJ, McElhinney DB, Wake N, Mosca RS (2017) Utility and scope of rapid prototyping in patients with complex muscular ventricular septal defects or double-outlet right ventricle: does it alter management decisions? Pediat Cardiol 38(1):103–114. https://doi.org/10.1007/s00246-016-1489-1
Morais P, Tavares JMR, Queirós S, Veloso F, D’hooge J, Vilaça JL (2017) Development of a patient-specific atrial phantom model for planning and training of inter-atrial interventions. Med Phys 44(11):5638–5649. https://doi.org/10.1002/mp.12559
Laing J, Moore JT, Vassallo R, Bainbridge D, Drangova M, Peters TM (2018) Patient-specific cardiac phantom for clinical training and preprocedure surgical planning. J Med Imaging 5(2):021222. https://doi.org/10.1117/1.JMI.5.2.021222
Alves N, Kim A, Tan J, Hwang G, Javed T, Neagu B, Courtney BK (2020) Cardiac tissue-mimicking ballistic gel phantom for ultrasound imaging in clinical and research applications. Ultrasound Med Biol 46(8):2057–2069. https://doi.org/10.1016/j.ultrasmedbio.2020.03.011
Wan W, Campbell G, Zhang Z, Hui A, Boughner D (2002) Optimizing the tensile properties of polyvinyl alcohol hydrogel for the construction of a bioprosthetic heart valve stent. J Biomed Mater Res 63(6):854–861. https://doi.org/10.1002/jbm.10333
Surry K, Austin H, Fenster A, Peters T (2004) Poly (vinyl alcohol) cryogel phantoms for use in ultrasound and MR imaging. Phys Med Biol 49(24):5529. https://doi.org/10.1088/0031-9155/49/24/009
Lesniak-Plewinska B, Cygan S, Kaluzynski K, D’hooge J, Zmigrodzki J, Kowalik E, Kordybach M, Kowalski M (2010) A dual-chamber, thick-walled cardiac phantom for use in cardiac motion and deformation imaging by ultrasound. Ultrasound Med Biol 36(7):1145–1156. https://doi.org/10.1016/j.ultrasmedbio.2010.04.008
Lasso A, Heffter T, Rankin A, Pinter C, Ungi T, Fichtinger G (2014) PLUS: open-source toolkit for ultrasound-guided intervention systems. IEEE Trans Biomed Eng 61(10):2527–2537. https://doi.org/10.1109/TBME.2014.2322864
Decourt C, Duong L (2020) Semi-supervised generative adversarial networks for the segmentation of the left ventricle in pediatric MRI. Comput Biol Med 123:103884. https://doi.org/10.1016/j.compbiomed.2020.103884
Gomes-Fonseca J, Morais P, Queirós S, Veloso F, Pinho AC, Fonseca JC, Correia-Pinto J, Vilaça JL (2018) Personalized dynamic phantom of the right and left ventricles based on patient-specific anatomy for echocardiography studies-preliminary results. In: IEEE 6th international conference on serious games and applications for health (SeGAH). https://doi.org/10.1109/SeGAH.2018.8401362
Funding
This work was funded by Fonds de recherche du Québec–Nature et technologies (FRQNT), File: 276451.
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Tibamoso-Pedraza, G., Navarro, I., Dion, P. et al. Design of heart phantoms for ultrasound imaging of ventricular septal defects. Int J CARS 17, 177–184 (2022). https://doi.org/10.1007/s11548-021-02406-0
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DOI: https://doi.org/10.1007/s11548-021-02406-0