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Recalage et fusion d'informations multimodales pour l'optimisation de la thérapie de resynchronisation cardiaque

Abstract : Cardiac Resynchronization Therapy (CRT) is a recognized electrical therapy to correct cardiac asynchronism. However, about one third of implanted patients do not respond properly to the therapy. This thesis is focused on the improvement of the CRT through the optimization of the left ventricular lead placement. The proposed approach here is defined in two parts. Firstly, a pre-operative analysis defines the best left ventricle sites to stimulate thanks to several steps of registration and fusion of multimodales informations. Secondly, a per-operative assistance system is proposed in order to guide clinicians to use these pre-defined implantation sites. The CRT planification is a research theme in the LTSI for many years. In this thesis, novel semi-automatic segmentation methods have been developed for both the coronary veins in CT and diffuse fibrosis characterization in MRI. The previous developments and these novel methods have been gathered and integrated in one software. Then, a 2D/3D registration between angiographic frames, used in clinical routine, and a 3D model produced by the pre-operative analysis is used to assist the implantation. To perform the registration, dedicated methods to extract end-systolic images and segment coronary veins in these images have been developed. Next, the registration is performed between the 3D coronary veins (extracted from the CT volumes) and their 2D equivalent which allows the pre- and per-operative data to be fused.
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Submitted on : Monday, October 23, 2017 - 5:06:08 PM
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  • HAL Id : tel-01621685, version 1

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Sophie Bruge. Recalage et fusion d'informations multimodales pour l'optimisation de la thérapie de resynchronisation cardiaque. Traitement du signal et de l'image [eess.SP]. Université Rennes 1, 2017. Français. ⟨NNT : 2017REN1S018⟩. ⟨tel-01621685⟩

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