Image-Guided Intervention and Therapy: The First Time Right
B. H. W. Hendriks, D. Mioni, W. Crooijmans and H. van Houten
Philips Research, High Tech Campus 34, Eindhoven, The Netherlands
In 2006, Dr Elias Zerhouni, director of the U.S. National Institutes of Health, outlined the vision that “medicine in the future has to be predictive, personalized, and very precise to the individual, and it has to be pre-emptive.”1 He stressed the importance of imaging in understanding complex biological systems, a topic we reviewed in FTM-2006.2 He also articulated a second and perhaps even bolder vision: “Twenty-five years from now, I hope that we won't perform any more open surgery. There would be no need to essentially take the risk of full exposure of the human body to go to a targeted region that needs to be affected.”1 How this might be achieved is the topic we address in this chapter.
In cardiology, one of the main causes of mortality today, major progress has already been made through minimally invasive interventions, such as placing a stent. Heart rhythm disorders can also be treated using catheters, by first mapping the disturbed pattern of electrical activity around the heart chambers, followed by selectively altering the current paths through local tissue ablation. Valve replacement is also rapidly gaining ground. These procedures require careful navigation and steering of the various catheters, which can be optimized using 3D X-ray and ultrasound imaging methods, ...