Innovative Integration of 4D Cardiovascular Reconstruction and Hologram: Framework Development of a New Visualization Tool for Coronary Artery Bypass Grafting Planning
Planning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions. This study aimed to address these requirem...
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| Vydané v: | JMIR medical informatics Ročník 13; s. e72237 |
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JMIR Publications
30.09.2025
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| ISSN: | 2291-9694, 2291-9694 |
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| Abstract | Planning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions.
This study aimed to address these requirements by reconstructing a dynamic cardiovascular model, displaying it as a naked-eye hologram, and evaluating the clinical utility of this innovative visualization tool for preoperative CABG planning.
We used preoperative 4D cardiac computed tomography angiography (4D-CCTA) data from 14 patients scheduled for CABG to develop a semiautomated workflow. This workflow enabled time-resolved segmentation of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries, complete with calcium scoring. Methods for segmenting cardiac structures, quantifying coronary calcification, visualizing coronary depth within EAT, and assessing pericardial adhesions via motion analysis were incorporated. These dynamic reconstructions captured spatial relationships, coronary stenosis, calcification, and depth in EAT, as well as pericardial adhesions. Dynamic cardiovascular holograms were then generated and displayed using the Looking Glass platform (Looking Glass Factory Inc). Thirteen cardiac surgeons assessed the utility of the holographic visualization tool on a Likert scale. In addition, a surgeon visually scored pericardial adhesions using the holograms of all 21 patients (including 7 undergoing secondary cardiac surgeries) and compared these scores with actual intraoperative findings.
Cardiac surgeons highly rated the visualization tool for its utility in preoperative planning, with a mean Likert score of 4.57/5.0 (SD 0.5). The hologram-based scoring of pericardial adhesions showed a strong correlation with intraoperative findings (correlation coefficient r=0.786; P<.001).
This study delineates the structural framework of a visualization tool specifically designed for preoperative CABG planning. It produces high-quality, clinically relevant, dynamic holograms from patient-specific volumetric data, with clinical feedback confirming its practicality and effectiveness for preoperative surgical planning. |
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| AbstractList | Planning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions.
This study aimed to address these requirements by reconstructing a dynamic cardiovascular model, displaying it as a naked-eye hologram, and evaluating the clinical utility of this innovative visualization tool for preoperative CABG planning.
We used preoperative 4D cardiac computed tomography angiography (4D-CCTA) data from 14 patients scheduled for CABG to develop a semiautomated workflow. This workflow enabled time-resolved segmentation of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries, complete with calcium scoring. Methods for segmenting cardiac structures, quantifying coronary calcification, visualizing coronary depth within EAT, and assessing pericardial adhesions via motion analysis were incorporated. These dynamic reconstructions captured spatial relationships, coronary stenosis, calcification, and depth in EAT, as well as pericardial adhesions. Dynamic cardiovascular holograms were then generated and displayed using the Looking Glass platform (Looking Glass Factory Inc). Thirteen cardiac surgeons assessed the utility of the holographic visualization tool on a Likert scale. In addition, a surgeon visually scored pericardial adhesions using the holograms of all 21 patients (including 7 undergoing secondary cardiac surgeries) and compared these scores with actual intraoperative findings.
Cardiac surgeons highly rated the visualization tool for its utility in preoperative planning, with a mean Likert score of 4.57/5.0 (SD 0.5). The hologram-based scoring of pericardial adhesions showed a strong correlation with intraoperative findings (correlation coefficient r=0.786; P<.001).
This study delineates the structural framework of a visualization tool specifically designed for preoperative CABG planning. It produces high-quality, clinically relevant, dynamic holograms from patient-specific volumetric data, with clinical feedback confirming its practicality and effectiveness for preoperative surgical planning. Background:Planning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions.Objective:This study aimed to address these requirements by reconstructing a dynamic cardiovascular model, displaying it as a naked-eye hologram, and evaluating the clinical utility of this innovative visualization tool for preoperative CABG planning.Methods:We used preoperative 4D cardiac computed tomography angiography (4D-CCTA) data from 14 patients scheduled for CABG to develop a semiautomated workflow. This workflow enabled time-resolved segmentation of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries, complete with calcium scoring. Methods for segmenting cardiac structures, quantifying coronary calcification, visualizing coronary depth within EAT, and assessing pericardial adhesions via motion analysis were incorporated. These dynamic reconstructions captured spatial relationships, coronary stenosis, calcification, and depth in EAT, as well as pericardial adhesions. Dynamic cardiovascular holograms were then generated and displayed using the Looking Glass platform (Looking Glass Factory Inc). Thirteen cardiac surgeons assessed the utility of the holographic visualization tool on a Likert scale. In addition, a surgeon visually scored pericardial adhesions using the holograms of all 21 patients (including 7 undergoing secondary cardiac surgeries) and compared these scores with actual intraoperative findings.Results:Cardiac surgeons highly rated the visualization tool for its utility in preoperative planning, with a mean Likert score of 4.57/5.0 (SD 0.5). The hologram-based scoring of pericardial adhesions showed a strong correlation with intraoperative findings (correlation coefficient r=0.786; P<.001).Conclusions:This study delineates the structural framework of a visualization tool specifically designed for preoperative CABG planning. It produces high-quality, clinically relevant, dynamic holograms from patient-specific volumetric data, with clinical feedback confirming its practicality and effectiveness for preoperative surgical planning. Planning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions.BackgroundPlanning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions.This study aimed to address these requirements by reconstructing a dynamic cardiovascular model, displaying it as a naked-eye hologram, and evaluating the clinical utility of this innovative visualization tool for preoperative CABG planning.ObjectiveThis study aimed to address these requirements by reconstructing a dynamic cardiovascular model, displaying it as a naked-eye hologram, and evaluating the clinical utility of this innovative visualization tool for preoperative CABG planning.We used preoperative 4D cardiac computed tomography angiography (4D-CCTA) data from 14 patients scheduled for CABG to develop a semiautomated workflow. This workflow enabled time-resolved segmentation of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries, complete with calcium scoring. Methods for segmenting cardiac structures, quantifying coronary calcification, visualizing coronary depth within EAT, and assessing pericardial adhesions via motion analysis were incorporated. These dynamic reconstructions captured spatial relationships, coronary stenosis, calcification, and depth in EAT, as well as pericardial adhesions. Dynamic cardiovascular holograms were then generated and displayed using the Looking Glass platform (Looking Glass Factory Inc). Thirteen cardiac surgeons assessed the utility of the holographic visualization tool on a Likert scale. In addition, a surgeon visually scored pericardial adhesions using the holograms of all 21 patients (including 7 undergoing secondary cardiac surgeries) and compared these scores with actual intraoperative findings.MethodsWe used preoperative 4D cardiac computed tomography angiography (4D-CCTA) data from 14 patients scheduled for CABG to develop a semiautomated workflow. This workflow enabled time-resolved segmentation of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries, complete with calcium scoring. Methods for segmenting cardiac structures, quantifying coronary calcification, visualizing coronary depth within EAT, and assessing pericardial adhesions via motion analysis were incorporated. These dynamic reconstructions captured spatial relationships, coronary stenosis, calcification, and depth in EAT, as well as pericardial adhesions. Dynamic cardiovascular holograms were then generated and displayed using the Looking Glass platform (Looking Glass Factory Inc). Thirteen cardiac surgeons assessed the utility of the holographic visualization tool on a Likert scale. In addition, a surgeon visually scored pericardial adhesions using the holograms of all 21 patients (including 7 undergoing secondary cardiac surgeries) and compared these scores with actual intraoperative findings.Cardiac surgeons highly rated the visualization tool for its utility in preoperative planning, with a mean Likert score of 4.57/5.0 (SD 0.5). The hologram-based scoring of pericardial adhesions showed a strong correlation with intraoperative findings (correlation coefficient r=0.786; P<.001).ResultsCardiac surgeons highly rated the visualization tool for its utility in preoperative planning, with a mean Likert score of 4.57/5.0 (SD 0.5). The hologram-based scoring of pericardial adhesions showed a strong correlation with intraoperative findings (correlation coefficient r=0.786; P<.001).This study delineates the structural framework of a visualization tool specifically designed for preoperative CABG planning. It produces high-quality, clinically relevant, dynamic holograms from patient-specific volumetric data, with clinical feedback confirming its practicality and effectiveness for preoperative surgical planning.ConclusionsThis study delineates the structural framework of a visualization tool specifically designed for preoperative CABG planning. It produces high-quality, clinically relevant, dynamic holograms from patient-specific volumetric data, with clinical feedback confirming its practicality and effectiveness for preoperative surgical planning. Abstract BackgroundPlanning for coronary artery bypass grafting (CABG) necessitates advanced spatial visualization skills and consideration of multiple factors, including the depth of coronary arteries within the subepicardium, calcification levels, and pericardial adhesions. ObjectiveThis study aimed to address these requirements by reconstructing a dynamic cardiovascular model, displaying it as a naked-eye hologram, and evaluating the clinical utility of this innovative visualization tool for preoperative CABG planning. MethodsWe used preoperative 4D cardiac computed tomography angiography (4D-CCTA) data from 14 patients scheduled for CABG to develop a semiautomated workflow. This workflow enabled time-resolved segmentation of the heart chambers, epicardial adipose tissue (EAT), and coronary arteries, complete with calcium scoring. Methods for segmenting cardiac structures, quantifying coronary calcification, visualizing coronary depth within EAT, and assessing pericardial adhesions via motion analysis were incorporated. These dynamic reconstructions captured spatial relationships, coronary stenosis, calcification, and depth in EAT, as well as pericardial adhesions. Dynamic cardiovascular holograms were then generated and displayed using the Looking Glass platform (Looking Glass Factory Inc). Thirteen cardiac surgeons assessed the utility of the holographic visualization tool on a Likert scale. In addition, a surgeon visually scored pericardial adhesions using the holograms of all 21 patients (including 7 undergoing secondary cardiac surgeries) and compared these scores with actual intraoperative findings. ResultsCardiac surgeons highly rated the visualization tool for its utility in preoperative planning, with a mean Likert score of 4.57/5.0 (SD 0.5). The hologram-based scoring of pericardial adhesions showed a strong correlation with intraoperative findings (correlation coefficient rP ConclusionsThis study delineates the structural framework of a visualization tool specifically designed for preoperative CABG planning. It produces high-quality, clinically relevant, dynamic holograms from patient-specific volumetric data, with clinical feedback confirming its practicality and effectiveness for preoperative surgical planning. |
| Author | Wang, Shuo Wang, Rong Ren, Tong Cheng, Nan Zhang, Li |
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| Cites_doi | 10.2196/24081 10.1109/TMI.2022.3219284 10.1161/CIR.0000000000001039 10.1109/TMI.2023.3294128 10.1093/eurheartj/ehaa518 10.1007/s10439-016-1762-8 10.1016/j.image.2018.09.014 10.1016/j.neuroimage.2010.09.025 10.1038/s41569-018-0104-y 10.1093/ehjci/jew087 10.4244/EIJV12SXA15 10.1016/j.jcmg.2017.10.019 10.1016/j.mri.2012.05.001 10.1161/CIRCULATIONAHA.117.031182 10.2196/59839 10.1016/j.atherosclerosis.2021.02.008 10.1016/j.echo.2023.03.010 10.1038/s41569-022-00679-9 10.1093/ehjdh/ztad071 10.1093/eurheartj/ehaa159 10.1016/j.jcmg.2021.08.017 10.2196/36931 10.1016/0735-1097(90)90282-t 10.1016/S0140-6736(24)00685-8 10.2967/jnumed.115.154229 10.1007/s10278-022-00659-y |
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| Copyright | Shuo Wang, Tong Ren, Nan Cheng, Li Zhang, Rong Wang. Originally published in JMIR Medical Informatics (https://medinform.jmir.org). 2025. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| SubjectTerms | Aged Calcification Cardiovascular disease Clinical medicine Collaboration Computed Tomography Angiography - methods Coronary Artery Bypass - methods Coronary vessels Coronary Vessels - diagnostic imaging Endocarditis Female Heart surgery Holography - methods Humans Magnetic resonance imaging Male Medical imaging Middle Aged Patients Performance evaluation Surgical outcomes Tomography Vein & artery diseases Visualization |
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| Title | Innovative Integration of 4D Cardiovascular Reconstruction and Hologram: Framework Development of a New Visualization Tool for Coronary Artery Bypass Grafting Planning |
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