The CT2TEE Simulator

SELECT A SET:			TYPICAL VIEWS: (from Tab.1 and Tab.2)
		P R O B E D E P T H	ROTATION DEFLECTION	P L A N E A N G U L.	S C A N D E P T H

ANIMATION: (only for DYNAMIC sets) (FireFox turns off GIF animation, please use Internet Explorer if possible)
Interpolation (checked off - a little bit faster)
EduLayer (only for animation checked off, for testing set (4), only 1GB RAM on server ;|)
Projection size: (smaller - faster)
direct connection - faster

CONTROLS

A. ROTATION
the default rotation is 00, meaning that the ultrasound beam spreads in the direction from the oesophagus to the sternum. Moving the slider right you turn the probe clockwise and moving it left turns the TEE probe counterclockwise.

B. DEFLECTION
Moving the slider right bents the tip of the TEE probe in the direction of ultrasound beam spread and moving it left causes a bend in the opposite direction

C. PLANE ANGULATION
the default angulation is 00, meaning that (by rotation=00 and deflection=00) when looking from the sternum on the TEE probe the ultrasound beam plane is perpendicular to the TEE probe long axis. Increasing the angulation makes the ultrasound beam plane move counterclockwise in this view.

D. PROBE DEPTH
reflects the depth of the insertion of the TEE probe into the oesophagus. Moving the slider up moves the virtual TEE Probe toward the stomach and moving it down pulls the TEE probe.

E. SCAN DEPTH
reflects the range of the ultrasound beam.

Standard views

The table below presents the settings (for the "normal cardio set") allowing to visualize similar views as proposed by the American Society of Echocardiography [1].
http://www.asefiles.org/multiplanetee.pdf

The table below presents additional, interesting views:

Suggestions for changes or additional views are welcome.

Help

Server is working properly, but some browser SECURITY SETTINGS can make images unavailable. You should see an image like that shown below. If you don't see any image or the simulator view doesn't change after moving the sliders please check if the JavaScript is enabled or if special security settings are disabled.

If it doesn't work feel free to contact the administrator: pioro(at)agh.edu.pl.

Example

About

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.

We therefore developed an online TEE simulator, that in our opinion can help to learn TEE.

There are currently data sets:

normal cardio — patient without any major abnormalities,
coronary anomaly — patient with an anomalous origin of the coronary artery,
unroofed CS — patient with totally unroofed coronary sinus and persistent left superior caval vein.

The CT2TEE simulator uses data from Computed Tomography (CT), causing several limitations of this simulator. Further development, including e.g. implementation of motion and adding further data sets is planned [2].

In the download version of the simulator the view changes smoothly while moving the sliders. If you like the online version and would like to download the standalone version - contact the authors.

Authors:

Aleksander Kempny, MD
Adult Congenital and Valvular Heart Disease Center
University of Muenster,
Muenster, Germany

Aleksander.Kempny(at)rbht.nhs.uk

Adam Piorkowski, PhD
Department of Geoinformatics and Applied Computer Science,
AGH University of Science and Technology,
Cracow, Poland

pioro(at)agh.edu.pl (Administrator)

Andrzej Gackowski, DSc,
Jagiellonian University, Medical College, Dept. of Coronary Disease, John Paul II Hospital, Kraków, Poland

Pawel Piatek, PhD, Tomasz Dziwinski, MSc,
AGH University of Science and Technology, Cracow, Poland

Kamil Szostek
Department of Geoinformatics and Applied Computer Science, AGH University of Science and Technology, Cracow, Poland

We thank dr Robert Pawel Banys for his help in CT sets retrieving.

Deployment:
Kamil Kipiel, CTT John Paul II Hospital, Kraków, Poland

References:

[1] J.S. Shanewise, et al., ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography, J Am Soc Echocardiogr, 12 (1999) 884-900.

[2] A. Kempny, A. Piórkowski, CT2TEE - a novel, internet-based simulator of transoesophageal echocardiography in congenital heart disease, Kardiol Pol 2010; 68: 374-379. PDF

[3] A. Piórkowski, A. Kempny. The transesophageal echocardiography simulator based on computed tomography images. IEEE Transactions on Biomedical Engineering, vol 60(2): pp 292-9, 2013. pdf

If you would like to cite us, please use [2-3].