Feb 3, 2017 Post By: Children's Health

3D heart imaging: A new dimension to cardiac care
Innovative approaches to cardiac imaging is changing the way we diagnose and treat pediatric heart patients

When your child has a heart condition, you want to understand everything about that condition, their treatment options and the procedures they undergo. What if you could see your child’s heart in order to visualize exactly what’s happening? Now, you can. The award-winning Heart Center at Children’s Health℠ is employing advanced imaging techniques to better evaluate and diagnose pediatric heart patients. One of these techniques involves 3D mapping that can be used to create real 3D models or interactive virtual models of the heart.

Better planning for more accurate procedures

One way that 3D visualization is being used is to help plan for surgeries and other procedures. “In straightforward procedures, 3D planning is not necessary because we’re very familiar with what we’re going to see,” explains Dr. Tarique Hussain, pediatric cardiologist at Children’s Health. “It’s when we have a difficult procedure, and the surgical decision making is difficult, this kind of 3D planning really helps.”

Already, cardiac interventionalists at Children’s Health are using 3D imaging in clinical practice every day. For patients needing a stent in the pulmonary artery, for example, the 3D image can be overlaid on the 2D catheter image to plan the procedure more effectively. This helps because the interventionalist can view the anatomy more clearly and in real time. “We can be sure that the position is perfect for the intervention we want to do,” says Dr. Hussain. “And then when we actually do the procedure we can use the landmarks of the 3D image to make sure they’re in the right place.” In addition, using this technology reduces the amount of radiation a patient needs in the planning process and increases the accuracy of the procedure overall.

Non-invasive imaging with interactive results

Because every child’s heart and condition are different, 3D mapping enables highly customized evaluation of the heart and a diagnosis unique to that patient. The best part is, 3D imaging is no different from other types of imaging, so your child is comfortable during the process.

“There are two steps: the first is to get some very good pictures of the heart, which we can do using either CT, MRI or echocardiography,” says Dr. Hussain. “After that we can use dedicated software to depict those images in a 3D format.” The format can either be a 3D TV image for planning purposes or an actual model printed in 3D. 

The key to an accurate 3D model is to ensure that the images are high quality. This requires that the patient remains still and has a low heart rate. Young infants may be given a bottle of milk to help them fall asleep before the imaging is done, while older children may watch a movie to help them relax.

After the 3D imaging is complete, your doctor can use the model to plan the procedure and show families, in 360 degrees, what will be taking place during surgery. After the procedure, the models can be used for further training with other surgeons.

A bright, 3D future

Another use of 3D imaging is as a training tool for future cardiothoracic surgeons. This April, Children’s Health will host a nationwide training event in collaboration with colleagues and surgeons in Toronto on 3D modeling and 3D TV technology for use in planning procedures.

But it’s not all about planning the procedures. Advances in the field of cardiothoracic surgery and trans-catheter interventions mean that we can help more children with complex heart defects. Already, the technology is being used to complete procedures that were previously not thought possible. Specifically, Dr. Hussain and Dr. Tom Zellers have worked with Dr. Shaq Qureshi from London, UK on a catheterization procedure for a heart defect called sinus venosus defect. “Traditionally, nobody has thought this could be treated by a minimally invasive procedure,” explains Dr. Hussain.

However, after reviewing a case report, the doctors realized 3D imaging could be used to print the defect and a stent could be placed using a minimally invasive technique. “For a lot of these cases, we would be able to deal with the defect without doing surgery,” says Dr. Hussain. “It’s a novel procedure and the 3D printing gave us the confidence that the procedure would work.” So far Dr. Qureshi has performed three of these procedures in London, while Dr. Zellers has performed one here at Children’s Health and is in the planning stages for a second.

Looking even further ahead, Dr. Hussain sees more widespread use of what’s already been happening with 3D imaging. “In the future 3D visualization will become more important and people will be using 3D TV, and even 3D holographics to plan procedures and review the imaging in multidisciplinary meetings,” says Dr. Hussain. It will change the way doctors discuss the cases—moving from 2D imaging to 3D TV and eventually to 3D holograms of the heart.

A bit further away, but also a possibility, is a customized procedure based on this type of technology, including biological 3D printing to make valves, for example, specific to patients.