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In vitro photoacoustic visualization of myocardial ablation lesions.

Abstract

BACKGROUND

Radiofrequency (RF) ablation to treat atrial arrhythmia is limited by the inability to reliably assess lesion durability and transmurality.

OBJECTIVE

The purpose of this study was to determine the feasibility of photoacoustic characterization of myocardial ablation lesions in vitro. In this study, we investigated the feasibility of combined ultrasound (US) and spectroscopic photoacoustic imaging to visualize RF ablation lesions in three dimensions (3D) based on unique differences in the optical absorption spectra between normal and ablated myocardial tissue.

METHODS

Tissue samples were excised from the ventricles of fresh porcine hearts. Lesions were generated using an RF catheter ablation system using 20 to 30 W of power applied for 40 to 60 seconds. Ablated samples were imaged in the near-infrared regime (740-780 nm) using a combined PA/US imaging system. Measured PA spectra were correlated to the absorption spectra of deoxyhemoglobin and ablated tissue to produce a tissue characterization map (TCM) identifying 3D lesion location and extent. Tissue samples were stained and photographed for gross pathology. TCM and gross pathology images were coregistered to assess TCM accuracy.

RESULTS

TCM reliably characterized ablated and non-ablated tissue up to depths of 3 mm. TCM also assessed lesion position and extent with submillimeter accuracy in multiple dimensions. Segmented TCMs achieved >69% agreement with gross pathology.

CONCLUSION

The study results suggest that spectroscopic photoacoustic imaging has the potential to accurately assess RF ablation lesion size and position with submillimeter precision and may be well suited to guide transcatheter RF atrial ablation in clinical practice.

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  • Authors+Show Affiliations

    ,

    Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas; Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.

    ,

    Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas; Department of Cardiology, University of Foggia, Foggia, Italy; Albert Einstein College of Medicine, Montefiore Hospital, New York, New York.

    ,

    Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.

    ,

    Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas; Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.

    Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas; Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: RRBouchard@mdanderson.org.

    Source

    Heart rhythm 11:1 2014 Jan pg 150-7

    MeSH

    Animals
    Atrial Fibrillation
    Catheter Ablation
    Disease Models, Animal
    Female
    Heart Atria
    Myocardium
    Photoacoustic Techniques
    Reproducibility of Results
    Swine
    Tomography, Optical Coherence

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    24080065

    Citation

    TY - JOUR T1 - In vitro photoacoustic visualization of myocardial ablation lesions. AU - Dana,Nicholas, AU - Di Biase,Luigi, AU - Natale,Andrea, AU - Emelianov,Stanislav, AU - Bouchard,Richard, Y1 - 2013/09/27/ PY - 2013/08/25/received PY - 2013/10/2/entrez PY - 2013/10/2/pubmed PY - 2016/4/26/medline KW - 3D KW - AF KW - ARFI KW - Ablation KW - Atrial fibrillation KW - CBR KW - FOV KW - Hb KW - Imaging KW - MRI KW - NTB KW - OCT KW - PA KW - PBS KW - Photoacoustic KW - RF KW - ROI KW - RT KW - Radiofrequency KW - TCM KW - Tissue characterization KW - US KW - acoustic radiation force impulse KW - atrial fibrillation KW - contrast-to-background ratio KW - deoxyhemoglobin KW - field of view KW - magnetic resonance imaging KW - nitrotetrazolium blue KW - optical coherence tomography KW - phosphate-buffered saline KW - photoacoustic KW - radiofrequency KW - real time KW - region of interest KW - sPA KW - spectroscopic photoacoustic KW - tPA KW - thermographic photoacoustic KW - three-dimensional KW - tissue characterization map KW - ultrasound SP - 150 EP - 7 JF - Heart rhythm JO - Heart Rhythm VL - 11 IS - 1 N2 - BACKGROUND: Radiofrequency (RF) ablation to treat atrial arrhythmia is limited by the inability to reliably assess lesion durability and transmurality. OBJECTIVE: The purpose of this study was to determine the feasibility of photoacoustic characterization of myocardial ablation lesions in vitro. In this study, we investigated the feasibility of combined ultrasound (US) and spectroscopic photoacoustic imaging to visualize RF ablation lesions in three dimensions (3D) based on unique differences in the optical absorption spectra between normal and ablated myocardial tissue. METHODS: Tissue samples were excised from the ventricles of fresh porcine hearts. Lesions were generated using an RF catheter ablation system using 20 to 30 W of power applied for 40 to 60 seconds. Ablated samples were imaged in the near-infrared regime (740-780 nm) using a combined PA/US imaging system. Measured PA spectra were correlated to the absorption spectra of deoxyhemoglobin and ablated tissue to produce a tissue characterization map (TCM) identifying 3D lesion location and extent. Tissue samples were stained and photographed for gross pathology. TCM and gross pathology images were coregistered to assess TCM accuracy. RESULTS: TCM reliably characterized ablated and non-ablated tissue up to depths of 3 mm. TCM also assessed lesion position and extent with submillimeter accuracy in multiple dimensions. Segmented TCMs achieved >69% agreement with gross pathology. CONCLUSION: The study results suggest that spectroscopic photoacoustic imaging has the potential to accurately assess RF ablation lesion size and position with submillimeter precision and may be well suited to guide transcatheter RF atrial ablation in clinical practice. SN - 1556-3871 UR - https://www.unboundmedicine.com/medline/citation/24080065/In_vitro_photoacoustic_visualization_of_myocardial_ablation_lesions_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S1547-5271(13)01082-5 ER -