| Summary: | 博士 === 國立陽明大學 === 生物醫學影像暨放射科學系 === 107 === The pathological mechanism of atrial fibrillation (AF) or the success rate of radiofrequency ablation (RFA) has a strong correlation with the myocardial morphology of the left atrium (LA). However, the clinical technique used to interpret LA myocardial morphology is not only time-consuming but also ineffective in providing clinically needed information. Therefore, this study will use a computed tomography (CT) image to develop a mapping application that is easy for LA myocardial morphology interpretation. It is expected to improve the interpretation efficiency and clinical applicability of LA myocardial morphology. This study developed a mapping application for left atrial myocardial morphology: (1) LA wall-mapping application for wall thickness visualization. The accuracy of the application was validated using digital phantoms, physical phantoms, and clinical CT images. (2) Invention patent application for system and method of mapping medical image of single heart chamber. The novelty and inventive step are to convert stereoscopic myocardial morphology into a common plane by image space transformation method, and give space coordinates, record, and position for clinical analysis and discussion. No preliminary case has been found through preliminary search of patents. (3) Assessment mapping application for analysis of variability and reproducibility of global and regional left atrial myocardial morphology. In order to confirm that the mapping application has the ability to meet the clinical analysis of LA myocardial morphology. This study aims to establish a set of standard operating procedures for the LA myocardial morphology of mapping application. Further assessing the coefficient of variation (CV%) of this work and the reproducibility of data of global and reginal LA myocardial morphology. The results showed that there was no significant difference between the analytical data and the standard data in the analysis of the prosthetic or clinical computed tomography images. (p>0.05). In addition, the degree of variation in the LA myocardial morphology data generated by the mapping application (CV%=10%) was lower than that proposed in the other literature (CV%>20%). Furthermore, the reproducibility of global or localized left atrial myocardial morphology is higher than 0.81 (95% CI=0.71~0.99) when the operator follows standard operating procedures. The mapping application developed in this study has good accuracy, data reproducibility and small variability, and is easy for LA myocardial morphology interpretation. This software has been awarded a patent in Taiwan and is currently in the process of patent applications in the US and China. As a conclusion, this mapping application tool can potentially provide new clinical insights into the LA myocardial morphology and improve clinical understanding in the relationship between LA morphology and AF disease pathology, increasing the successes rate in RFA surgery.
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