Finite-Element Based Image Registration for Endovascular Aortic Aneurysm Repair

Abstract

In this paper we introduce a new method for the registration between preoperative and intraoperative computerized tomography (CT) images used in endovascular interventions for aortic aneurysm repair. The method relies on a 3D finite-element model (FEM) of the aortic centerline reconstructed from preoperative CT scans. Intraoperative 2D fluoroscopic images are used to deform the 3D FEM and align it onto the current aortic geometry. The method was evaluated on clinical datasets for which a reference CT scan was available to evaluate the registration errors made by our method and to compare them with other registration methods based on rigid transformations. Errors were estimated based on the predicted locations of landmarks positioned at different branch ostia. It appeared that our method always reduced the registration errors of at least 20% compared to gold standard 3D rigid registration and permitted to reach a global precision of 3.8 mm and a renal precision of 2.6 mm, which is a significant improvement compatible with surgical specifications. Finally, the major asset of our method is that it only requires one fluoroscopic intraoperative 2D image to perform the 3D non-rigid registration. This would reduce patient irradiation and cut the costs compared to traditional methods.

Evaluation and Verification of Fast Computational Simulations of Stent-Graft Deployment in Endovascular Aneurysmal Repair

“…Centerlines were extracted using the Voronoi diagram method implemented in the VMTK library ( 34 ). We proposed previously a non-rigid registration method based on intraoperative images of the aorta and a FEM of the aortic centerline ( 14 ). The updated geometry was converted into a triangular surface mesh easily implementable in an FEM.…”

“…Regarding the first goal, different approaches are currently available: pre-computing deformation during pre-operative planning (7,8), using two fluoroscopic images (9)(10)(11), using a single fluoroscopic image coupled to length regularization (12), or using graph-matching (13). We recently proposed a finite element model of the aorta with geometric constraints extracted from intraoperative images (14). Regarding the second goal, many studies have modeled stents (15)(16)(17)(18)(19) or stent graft (20)(21)(22) deployment in patient-specific geometries using the finite-element method.…”

Patient‐specific computational modeling of endovascular aneurysm repair: State of the art and future directions

“…A number of publications proposed biomechanical models and methods to predict the deformations caused by guidewire insertion during EVAR procedure 40,53,105,106,130,144–148 . Among them, Gindre et al 105 were the first to present an evaluation of modeling results against quantitative patient‐specific intraoperative data.…”

HNSF Log‐Demons: Diffeomorphic demons registration using hierarchical neighbourhood spectral features

“…In recent years, a large number of non-rigid registration models for medical images has been reported, such as the free form deformation (FFD) models based on B-spline [9][10][11], finite elements model (FEM) [12][13][14][15], viscous fluid model [16,17], and Demons [4,5,[18][19][20][21][22] etc. Since FFD based on B-spline employs the cubic B-spline to model the elastic deformation and each B-spline curve is only related to four adjacent control points, it can provide a high degree of flexibility for estimating the local motions of human tissues and organs.…”