Feasibility and accuracy of real-time 3D-holographic graft length measurements

Tsung-Ying Tsai; Shigetaka Kageyama; XingQiang He; Giulio Pompilio; Daniele Andreini; Gianluca Pontone; Mark La Meir; Johan De Mey; Kaoru Tanaka; Torsten Doenst; John Puskas; Ulf Teichgräber; Ulrich Schneider; Himanshu Gupta; Jonathon Leipsic; Scot Garg; Pruthvi C Revaiah; Maciej Stanuch; Andrzej Skalski; Yoshinobu Onuma; Patrick W Serruys

doi:10.1093/ehjdh/ztad071

Feasibility and accuracy of real-time 3D-holographic graft length measurements

Eur Heart J Digit Health. 2023 Nov 14;5(1):101-104. doi: 10.1093/ehjdh/ztad071. eCollection 2024 Jan.

Authors

Tsung-Ying Tsai^{1

2}, Shigetaka Kageyama², XingQiang He², Giulio Pompilio^{3

4}, Daniele Andreini^{4

5

6}, Gianluca Pontone^{4

7}, Mark La Meir⁸, Johan De Mey⁹, Kaoru Tanaka¹⁰, Torsten Doenst¹¹, John Puskas¹², Ulf Teichgräber¹³, Ulrich Schneider¹¹, Himanshu Gupta¹⁴, Jonathon Leipsic¹⁵, Scot Garg¹⁶, Pruthvi C Revaiah², Maciej Stanuch^{17

18}, Andrzej Skalski^{17

18}, Yoshinobu Onuma², Patrick W Serruys²

Affiliations

¹ Cardiovascular center, Taichung Veterans General Hospital, Taichung, Taiwan.
² Corrib Research Centre for Advanced Imaging and Core Laboratory, University of Galway, University Road, H91 TK33, Galway, Ireland.
³ Department of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCS, Milan, Italy.
⁴ Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milano, Italy.
⁵ Division of Cardiology and Cardiac Imaging, IRCCS Galeazzi Sant'Ambrogio, Milan, Italy.
⁶ Department of Biomedical and Clinical Sciences, University of Milan, Milano, Italy.
⁷ Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy.
⁸ Department of Cardiac Surgery, Universitair Ziekenhuis Brussel, VUB, Brussels, Belgium.
⁹ Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Belgium.
¹⁰ Department of Radiology, University Hospital Brussels, Brussels, Belgium.
¹¹ Department of Cardiothoracic Surgery, University Hospital Jena, Jena, Germany.
¹² Department of Cardiovascular Surgery, Mount Sinai Morningside, NewYork, USA.
¹³ Department of Radiology, University Hospital Jena, Jena, Germany.
¹⁴ Department of Cardiology and Radiology, The Valley Hospital, Ridgewood, NJ, USA.
¹⁵ Centre for Cardiovascular Innovation, St.Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
¹⁶ Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom.
¹⁷ MedApp S.A., Kraków, Poland.
¹⁸ Department of Measurements and Electronics, AGH University of Krakow, Kraków, Poland.

Abstract

Aims: Mixed reality (MR) holograms can display high-definition images while preserving the user's situational awareness. New MR software can measure 3D objects with gestures and voice commands; however, these measurements have not been validated. We aimed to assess the feasibility and accuracy of using 3D holograms for measuring the length of coronary artery bypass grafts.

Methods and results: An independent core lab analyzed follow-up computer tomography coronary angiograms performed 30 days after coronary artery bypass grafting in 30 consecutive cases enrolled in the FASTTRACK CABG trial. Two analysts, blinded to clinical information, performed holographic reconstruction and measurements using the CarnaLife Holo software (Medapp, Krakow, Poland). Inter-observer agreement was assessed in the first 20 cases. Another analyst performed the validation measurements using the CardIQ W8 CT system (GE Healthcare, Milwaukee, Wisconsin). Seventy grafts (30 left internal mammary artery grafts, 31 saphenous vein grafts, and 9 right internal mammary artery grafts) were measured. Holographic measurements were feasible in 97.1% of grafts and took 3 minutes 36 s ± 50.74 s per case. There was an excellent inter-observer agreement [interclass correlation coefficient (ICC) 0.99 (0.97-0.99)]. There was no significant difference between the total graft length on hologram and CT [187.5 mm (157.7-211.4) vs. 183.1 mm (156.8-206.1), P = 0.50], respectively. Hologram and CT measurements are highly correlated (r = 0.97, P < 0.001) with an excellent agreement [ICC 0.98 (0.97-0.99)].

Conclusion: Real-time holographic measurements are feasible, quick, and accurate even for tortuous bypass grafts. This new methodology can empower clinicians to visualize and measure 3D images by themselves and may provide insights for procedural strategy.

Keywords: Augmented reality; Computed tomography; Coronary artery bypass graft; Hologram; Mixed reality.