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ISMAR 2014 - Sep 10-12 - Munich, Germany

The Role of Augmented Reality Displays for Guiding Intra-cardiac Interventions


Session TitleSpeakerRoomStartEnd
Keynote ThursdayTerry PetersTBA11 Sep, 2014 09:00 AM11 Sep, 2014 10:30 AM
Keynote Speaker
Terry Peters

Many inter-cardiac interventions are performed either via open-heart surgery, or using minimally invasive approaches, where instrumentation is introduced into the cardiac chambers via the vascular system or heart wall. While many of the latter procedures are often employed under x-ray guidance, for some of these x-ray imaging is not appropriate, and ultrasound is the preferred intra-operative imaging modality. Two such procedures involves the repair of a mitral-valve leaflet, and the replacement of aortic valves. Both employ instruments introduced into the heart via the apex. For the mitral procedure, the standard of care for this procedure employs a 3D Trans-esophageal echo (TEE) probe as guidance, but using primarily its bi-plane mode, with full 3D only being used sporadically. In spite of the clinical success of this procedure, many problems are encountered during the navigation of the instrument to the site of the therapy. To overcome these difficulties, we have developed a guidance platform that tracks the US probe and instrument, and augments the US mages with virtual   elements representing the instrument and target, to optimise the navigation process. Results of using this approach on animal studies have demonstrated increased performance in multiple metrics, including total tool distance from ideal pathway, total navigation time, and total tool path lengths, by factors of 3,4,and 5 respectively, as well as a 40 fold reduction in the number of times an instrument intruded into potentially unsafe zones in the heart. 

The aortic valve procedure primarily uses X-ray fluoroscopy guidance, but this suffers from the problem of high radiations dose, poor target visibility and potential kidney damage as a result of x-ray contrast administration. To overcome these limitations, we have adopted similar technology to that used for the mitral valve problem, to develop an ultrasound-only solution, again augmented with virtual models of instruments and key targets to guide aortic valve replacement procedures. Preliminary results of this approach on cardiac phantoms indicate that the US-only approach may be as accurate as the standard fluoroscopy-guided technique.


Dr. Terry Peters is a Scientist in the Imaging Research Laboratories at the Robarts Research Institute (RRI),  London, ON, Canada, and Professor in the Departments of Medical Imaging and Medical Biophysics and a member of the Graduate Programs in Neurosciences and Biomedical Engineering at Western University Canada. He is also an adjunct Professor at McGill University in Montreal, and Hebei University in Baoding China. Dr. Peters received his graduate training at the University of Canterbury in New Zealand in Electrical Engineering, under the direction of Professor Richard Bates. His PhD work dealt with fundamental issues in Computed Tomography image reconstruction, and resulted in a seminal paper on the topic in 1971, just prior to the beginning of CT’s commercial development and worldwide application. For the past 30 years, his research has built on this foundation, focusing on the application of computational hardware and software advances to medical imaging modalities in surgery and therapy. Starting in 1978 at the Montreal Neurological Institute (MNI), Dr. Peters’ lab pioneered many of the image-guidance techniques and applications for image-guided neurosurgery.   In 1997, Dr. Peters was recruited by the Robarts Research Institute at the University of Western Ontario, London Canada, to establish a focus of image-guided surgery and therapy within the Robarts Imaging Research Laboratories.  His lab has expanded over the past seventeen years years to encompass image-guided procedures of the heart, brain, abdomen and spine.

Dr. Peters has authored over 250 peer-reviewed papers and book chapters, a similar number of abstracts, and has delivered over 200 invited presentations.  He is a Fellow of the Institute of Electrical and Electronics Engineers, the Canadian College of Physicists in Medicine; the American Association of Physicists in Medicine, the Australasian College of Physical Scientists and Engineers in Medicine, the MICCAI Society, and the Institute of Physics and the Canadian Organization of Medical Physicists. He has mentored over 80 trainees at the Masters, Doctoral and Postdoctoral levels. He received the Dean’s Award for Research Excellence at Western University in 2011, and the Hellmuth Prize for Achievement in Research from Western in 2012.