Heart specialist revolutionises 3D imaging with "slice" technique

MPRscreenimage

A leading cardiologist based at Southampton’s teaching hospitals is the first in the world to develop a unique technique to “slice” 3D images of the heart into intricate sections using computer software.

The advanced method, known as multiplane review (MPR) 3D echocardiography, allows the user to identify heart defects much more accurately than on traditional 2D or standard 3D scans and is revolutionising the accuracy and speed of diagnosis.

Consultant congenital cardiologist Dr Joseph Vettukattil pioneered its development at Southampton General Hospital to identify heart abnormalities that are present from birth.

It is believed the technology, which lets the user see the three dimensions of the heart move simultaneously for the first time, could eventually replace the need for magnetic resonance imaging (MRI) for most aspects of cardiac imaging.

“The most important aspect is the operator's ability to slice the dynamic cardiac structures in infinite sections through all the three dimensions, which was not possible before we developed MPR 3D echocardiography,” said Dr Vettukattil.

“You can chop the heart into small pieces and see what is wrong and exactly where it is wrong on the screen. By using MPR, because you are slicing and seeing it in three different planes, you can get a clear understanding of a patient – especially in a child whose heart is congenitally malformed.”

Traditionally, diagnosis of heart defects has been made using 2D scans with the addition of invasive cardiac catheterisation.

“The 2D images show pictures of the heart in two planes, so it just takes one slice of the heart and, because it has not been easy to know without doubt what the problem is, surgeons have often had to perform exploratory operations as well,” he said.

“Now, though, we are able to visualise even more than a surgeon can during an operation, minimising the need for additional and invasive assessments.” 

He made the discovery after an upgrade from conventional 2D imaging on echo machines in the children’s heart unit at Southampton General, however, the new basic 3D method of examination only enabled users to view a full cube shape and not definitively dissect the defective part of a patient’s heart on screen.

This led Dr Vettukattil to set up two PCs with 3D software programs to read results from the echo scans in a small side room, where he went on to develop MPR after many hours of study.

He has since travelled to hospitals around the world and continues to hold international workshops to train people in MPR 3D, as well as receiving scans from colleagues abroad that he is asked to analyse and report back on.

“People across the world are constantly asking me to teach them how to use MPR,” he said. “I have been to hospitals in Germany, Sweden, Denmark and I am soon to visit India and Malaysia, while there is also interest from heart specialists in America.”

This technique allows fellow cardiologists and cardiac surgeons around the world to capture 3D data of patients and upload to a dedicated website or email them for detailed assessment.

Dr Vettukattil now hopes to develop Southampton University Hospitals NHS Trust as the world leader in advanced 3D echocardiography through the establishment of an imaging and training centre.

He added: “The success of our work has led to 3D echocardiography moving from a research tool to a clinical tool, with bi-weekly clinics and ward echograms performed in Southampton. We are also seeing increased numbers of patients referred for 3D assessment and are determined to push forward our vision.”

Posted on Wednesday 21 July 2010