Abstract #4281

Contrast-Free CMR-based Transcatheter Aortic Valve Implantation Planning: Aortic Annulus and Coronary Ostias detection

Enrique Almar-Munoz¹, Mathias Pamminger¹, Christian Kremser¹, Markus Haltmeier², and Agnes Mayr¹

¹Radiology, Medical University of Innsbruck, Innsbruck, Austria, ²Mathematics, Medical University of Innsbruck, Innsbruck, Austria

Synopsis

Keywords: AI/ML Software, Cardiovascular, TAVI planning

Motivation: Contrast-enhanced CT is the gold-standard for TAVI planning but is not suitable for patients with kidney disease. Contrast-free MRI-guided planning is a reliable alternative, offering similar accuracy and implantation success.

Goal(s): Propose a fully-automated pipeline for TAVI planning using contrast-free MRI. Segmenting the Aortic Annulus and identifying the coronary ostias.

Approach:

AA Segmentation: Segment the aorta, apply an aorta unfolding method to detect the hinge easily and fold it back to obtain the AA virtual plane.
Coronary Ostia: Aorta+coronaries segmentation and identify the intersection points.

Results: MAE AA diameter of 2.279±0.922mm, AA axial direction RMSE of 2.671±1.111mm and ostium MAE of 2.24±1.63mm.

Impact: Our CMR based TAVI planning algorithm advances by automating pre-procedural assessments without iodinated contrast. For the AA segmentation, the double-network architecture and the unwrapping technique effectively address the challenge of segmenting a virtual plane. Blind tests reafirm our results.

How to access this content:

For one year after publication, abstracts and videos are only open to registrants of this annual meeting. Registrants should use their existing login information. Non-registrant access can be purchased via the ISMRM E-Library.

After one year, current ISMRM & ISMRT members get free access to both the abstracts and videos. Non-members and non-registrants must purchase access via the ISMRM E-Library.

After two years, the meeting proceedings (abstracts) are opened to the public and require no login information. Videos remain behind password for access by members, registrants and E-Library customers.

Click here for more information on becoming a member.