open access

Vol 68, No 3 (2010)
Letters to the Editor
Published online: 2010-04-23
Submitted: 2012-12-28
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CT2TEE - a novel, internet-based simulator of transoesophageal echocardiography in congenital heart disease

Aleksander Kempny, Adam Piórkowski
Kardiol Pol 2010;68(3):374-379.

open access

Vol 68, No 3 (2010)
Letters to the Editor
Published online: 2010-04-23
Submitted: 2012-12-28

Abstract

Background: Echocardiography is one of the most important diagnostic tools in cardiology. The two most widespread modes of echocardiography are transthoracic (TTE) and transoesophageal (TEE) echocardiography, both requiring extensive training. In TEE the manual skills seem to be less important, but it is more challenging for the trainee to imagine the orientation of the cutting planes in space. This becomes more complicated, even for an experienced echocardiographer, in patients with congenital heart disease. There is a growing interest in TEE simulators. All of them are, however, manikin based and their use is limited to only a few medical centres.
Aim: To develop an internet-based TEE simulator offering interactive training in cases with and without congenital heart disease.
Methods: Because of high spatial resolution we use data from ECG-triggered heart computed tomography (CT) to build the 3D heart model. On every CT image the oesophagus has to be marked and the greyscale values converted in order to mimic the tissue greyscales seen in TEE. After such preparations the 3D set created from CT data can be cut in any plane. The trainee can use the slider buttons in the simulator interface to freely steer the virtual TEE probe. While setting the desired TEE plane the application conducts calculations in order to simulate the typical sonographic artefacts.
Results: We were able to construct an application allowing a TEE simulation based on CT data. There are two versions of the simulator. The first one has to be downloaded to a personal computer together with the CT data. The second one is internet based and freely accessible on the project’s web page (www.ct2tee.agh.edu.pl). It doesn’t offer real time simulation, but is sufficient to obtain all possible views in the TEE. There are currently three data sets, two with congenital heart disease, and further development of the database and simulator is planned.
Conclusions: The CT2TEE simulator, described in this paper, is the first fully interactive, internet-based TEE simulator. It can be a training tool both in learning TEE basics and in congenital heart disease.

Abstract

Background: Echocardiography is one of the most important diagnostic tools in cardiology. The two most widespread modes of echocardiography are transthoracic (TTE) and transoesophageal (TEE) echocardiography, both requiring extensive training. In TEE the manual skills seem to be less important, but it is more challenging for the trainee to imagine the orientation of the cutting planes in space. This becomes more complicated, even for an experienced echocardiographer, in patients with congenital heart disease. There is a growing interest in TEE simulators. All of them are, however, manikin based and their use is limited to only a few medical centres.
Aim: To develop an internet-based TEE simulator offering interactive training in cases with and without congenital heart disease.
Methods: Because of high spatial resolution we use data from ECG-triggered heart computed tomography (CT) to build the 3D heart model. On every CT image the oesophagus has to be marked and the greyscale values converted in order to mimic the tissue greyscales seen in TEE. After such preparations the 3D set created from CT data can be cut in any plane. The trainee can use the slider buttons in the simulator interface to freely steer the virtual TEE probe. While setting the desired TEE plane the application conducts calculations in order to simulate the typical sonographic artefacts.
Results: We were able to construct an application allowing a TEE simulation based on CT data. There are two versions of the simulator. The first one has to be downloaded to a personal computer together with the CT data. The second one is internet based and freely accessible on the project’s web page (www.ct2tee.agh.edu.pl). It doesn’t offer real time simulation, but is sufficient to obtain all possible views in the TEE. There are currently three data sets, two with congenital heart disease, and further development of the database and simulator is planned.
Conclusions: The CT2TEE simulator, described in this paper, is the first fully interactive, internet-based TEE simulator. It can be a training tool both in learning TEE basics and in congenital heart disease.
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Keywords

transoesophageal echocardiography; simulator; computed tomography

About this article
Title

CT2TEE - a novel, internet-based simulator of transoesophageal echocardiography in congenital heart disease

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 68, No 3 (2010)

Pages

374-379

Published online

2010-04-23

Bibliographic record

Kardiol Pol 2010;68(3):374-379.

Keywords

transoesophageal echocardiography
simulator
computed tomography

Authors

Aleksander Kempny
Adam Piórkowski

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