Three-dimensional catheter navigation of airways using continuous-sweep limited angle fluoroscopy on a C-arm

Wagner, Martin; Periyasamy, Sarvesh; Schäfer, Sebastian; Laeseke, Paul F.; Speidel, Michael A.

doi:10.1117/1.jmi.8.5.055001

Cited by 3 publications

(4 citation statements)

References 31 publications

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“…In addition to the phantom studies, data from animal studies (

n=2

, 55 kg) were retrospectively analyzed using data from Wagner et al 20 . who investigated the use of a model‐based iterative approach for CLA reconstruction.…”

Section: Methodsmentioning

confidence: 99%

“…Continuous‐sweep limited angle (CLA) fluoroscopy is a recently proposed imaging technique where conventional single plane x‐ray fluoroscopy images are acquired using a C‐arm system as the gantry rotates back‐and‐forth within a small angular range to enable frame‐by‐frame 3D reconstruction of curvilinear devices 20 . Previous work used model‐based iterative approaches to determine the device shape in three dimensions 20 ; however, the iterative cost function optimization scheme is difficult to parallelize and time consuming, making it less suitable for real‐time applications. Additionally, while the algorithm considers the constraining vessels, it does not prevent outliers where the reconstructed device path jumps between different branches of the vessel tree.…”

Section: Introductionmentioning

confidence: 99%

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Topology observing 3D device reconstruction from continuous‐sweep limited angle fluoroscopy

Wagner,

Kutlu,

Davis

et al. 2024

Medical Physics

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BackgroundMinimally invasive procedures usually require navigating a microcatheter and guidewire through endoluminal structures such as blood vessels and airways to sites of the disease. For numerous clinical applications, two‐dimensional (2D) fluoroscopy is the primary modality used for real‐time image guidance during navigation. However, 2D imaging can pose challenges for navigation in complex structures. Real‐time 3D visualization of devices within the anatomic context could provide considerable benefits for these procedures. Continuous‐sweep limited angle (CLA) fluoroscopy has recently been proposed to provide a compromise between conventional rotational 3D acquisitions and real‐time fluoroscopy.PurposeThe purpose of this work was to develop and evaluate a noniterative 3D device reconstruction approach for CLA fluoroscopy acquisitions, which takes into account endoluminal topology to avoid impossible paths between disconnected branches.MethodsThe algorithm relies on a static 3D roadmap (RM) of vessels or airways, which may be generated from conventional cone beam CT (CBCT) acquisitions prior to navigation. The RM is converted to a graph representation describing its topology. During catheter navigation, the device is segmented from the live 2D projection images using a deep learning approach from which the centerlines are extracted. Rays from the focal spot to detector pixels representing 2D device points are identified and intersections with the RM are computed. Based on the RM graph, a subset of line segments is selected as candidates to exclude device paths through disconnected branches of the RM. Depth localization for each point along the device is then performed by finding the point closest to the previous 3D reconstruction along the candidate segments. This process is repeated as the projection angle changes for each CLA image frame. The approach was evaluated in a phantom study in which a catheter and guidewire were navigated along five pathways within a complex vessel phantom. The result was compared to static cCBCT acquisitions of the device in the final position.ResultsThe average root mean squared 3D distance between CLA reconstruction and reference centerline was 1.87 ± 0.30 mm. The Euclidean distance at the device tip was 2.92 ± 2.35 mm. The correct pathway was identified during reconstruction in 100% of frames (). The percentage of 3D device points reconstructed inside the 3D roadmap was with an average distance of 0.62 ± 0.30 mm between the device points outside the roadmap and the nearest point within the roadmap.ConclusionsThis study demonstrates the feasibility of reconstructing curvilinear devices such as catheters and guidewires during endoluminal procedures including intravascular and transbronchial interventions using a noniterative reconstruction approach for CLA fluoroscopy. This approach could improve device navigation in cases where the structure of vessels or airways is complex and includes overlapping branches.

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“…In addition to the phantom studies, data from animal studies (

n=2

, 55 kg) were retrospectively analyzed using data from Wagner et al 20 . who investigated the use of a model‐based iterative approach for CLA reconstruction.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Topology observing 3D device reconstruction from continuous‐sweep limited angle fluoroscopy

Wagner,

Kutlu,

Davis

et al. 2024

Medical Physics

Self Cite

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show abstract

“…The model-based device reconstruction approach was implemented as described in Wagner et al 12,13 , where the device was represented by a 3D cubic spline described by 8 control points. To estimate the control point locations for each time frame, the catheter centerline was segmented from the 2D images using a previously trained U-net 14 followed by topology preserving thinning 15 .…”

Section: Model-based Device Reconstruction (Mdr)mentioning

confidence: 99%

Comparison of model-based iterative vs non-iterative 3D device reconstruction for continuous-sweep limited-angle fluoroscopy

Wagner,

Kutlu,

Davis

et al. 2024

Medical Imaging 2024: Physics of Medical Imaging

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Continuous-sweep limited angle (CLA) fluoroscopy is a recently proposed method for live 3D catheter reconstruction using a single-plane C-arm that continuously rotates back-and-forth within a narrow angle during fluoroscopic image acquisition. This study compares the accuracy and computation time of two real-time 3D catheter reconstruction algorithms. The first approach, iterative model-based device reconstruction (MDR), optimizes the 3D location of 8 control points representing the catheter as a cubic spline. Optimization was performed by minimizing a cost function that describes the data consistency between reconstructed shape and 2D catheter segmentations in the current and previous fluoroscopic images. Alternatively, the second approach is a topology observing reconstruction (TOR) algorithm, which reduces the solution space by performing a graph-based analysis of the 3D vessel tree followed by an analytical minimization of a simplified cost function. Both approaches were evaluated in an experimental study where a microcatheter was navigated through a 3D printed vessel phantom. Accuracy was determined by comparing the reconstructed final catheter pose to a reference 3D cone beam CT scan. The root mean squared distance (RMSD) between reference and CLA reconstruction was considerably smaller for the TOR approach (1.88 ± 0.34mm) than for MDR (6.78 ± 4.4mm). Computation time was also shorter for TOR (0.34ms) compared to MDR (518.6ms) making it suitable for real-time reconstruction with clinically relevant frame rates. The clinical translation of CLA could improve procedure efficiency by providing an intuitive 3D visualization of the device within a vessel. Further work is needed to evaluate the approach in vivo in the presence of respiratory motion.

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“…This continuous-sweep limited angle (CLA) strategy allows depth estimation and thus 3D reconstruction of the catheter shape and location. 12,13 Similar to the above mentioned biplane approaches, single-plane CLA reconstruction accuracy is highly dependent on a robust and accurate 2D device segmentation. Furthermore, in contrast to previous methods such as 4D fluoroscopy that use the subtraction of a static mask image to remove anatomical background and simplify device segmentation, 1 CLA requires device segmentation from native (unsubtracted) images, where the anatomical background changes in every frame and projection angle.…”

Section: Introductionmentioning

confidence: 99%

A study on the influence of radiation dose on device tracking accuracy during continuous-sweep limited angle fluoroscopy

Wagner,

Laeseke,

Raval

et al. 2024

Medical Imaging 2024: Physics of Medical Imaging

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Continuous-sweep limited angle (CLA) fluoroscopy is a proposed technique for real-time 3D device guidance during catheter-based procedures, where the x-ray C-arm continuously rotates back-and-forth within a limited angle during fluoroscopic image acquisition. The 3D device reconstruction relies on accurate and robust tracking of the device centerline in the 2D projection images. The purpose of this study was to investigate the influence of radiation dose per frame on deep learning-based device segmentation and tracking accuracy. A convolutional neural network was trained based on simulated and manually annotated images from retrospectively analyzed animal studies. After binarization, images were postprocessed using topology preserving thinning and a graph-based path search was used to extract the device centerline. To evaluate the accuracy of the approach, a porcine study was conducted, where a microcatheter and guidewire were navigated through the hepatic arteries. Image sequences with three different detector dose levels were acquired (80nGy/frame, 170nGy/frame, and 380nGy/frame at the detector). The deep learning-based device tracking results were compared to manually annotated reference device centerlines. The average root mean squared distance (RMSD) between reference and automatic segmentation was 0.45±0.07mm and 0.50±0.07mm for the two higher dose levels and 2.75±7.71mm for the lowest level. A significant difference was only detected for the lowest dose level (p<0.00001). However, when only the first 1.5cm from the tip of the device was evaluated, no significant differences were found for all dose levels with average RMSDs between 0.56 and 0.62mm. This suggests that accurate device-tip tracking is possible even at the lowest dose level.

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Three-dimensional catheter navigation of airways using continuous-sweep limited angle fluoroscopy on a C-arm

Cited by 3 publications

References 31 publications

Topology observing 3D device reconstruction from continuous‐sweep limited angle fluoroscopy

Topology observing 3D device reconstruction from continuous‐sweep limited angle fluoroscopy

Comparison of model-based iterative vs non-iterative 3D device reconstruction for continuous-sweep limited-angle fluoroscopy

A study on the influence of radiation dose on device tracking accuracy during continuous-sweep limited angle fluoroscopy

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