CT-echo fusion imaging: A new approach to congenital heart disease

Abstract

The diagnosis, management, and surgical decision-making in children and adults with congenital heart disease (CHD) are largely based on echocardiography findings. A recent development in cardiac imaging is fusion of different imaging modalities. Our objective was to evaluate the feasibility of computed tomography (CT) and 3D transthoracic echocardiography (TTE) fusion in children and adults with CHD. We prospectively included 13 patients with CHD and 1 patient with a normal heart who underwent both CT and 3D TTE (median age 9.5 years [2.7–15.7], 57% male, median body surface area 0.9 m 2 [0.6–1.7]). CHD was classified as simple ( n = 4, 29%), moderate ( n = 4, 29%), or complex ( n = 6, 42%). We described the steps required to complete the fusion process (alignment, landmarks, and superimposition), navigation, and image evaluation. 3D TTE-CT fusion was successful in all patients. Median total time to complete the fusion process was 735 seconds [628–1163], with no significant difference according to the degree of complexity of the cardiopathy. Landmarks were significantly modified in complex CHD ( Fig. 1 ). We established the feasibility and accuracy of 3D transthoracic echocardiography (TTE)-computed tomography (CT) fusion in a population of children and adults with a variety of CHD. The simultaneous visualization of many intracardiac structures may help to understand the anatomical features of CHD without limitations regarding age, weight, or complexity of the defects.