Intraoperative stent segmentation in X-ray fluoroscopy for endovascular aortic repair

International Journal of Computer Assisted Radiology and Surgery
Katharina BreiningerAndreas Maier

Abstract

Fusion of preoperative data with intraoperative X-ray images has proven the potential to reduce radiation exposure and contrast agent, especially for complex endovascular aortic repair (EVAR). Due to patient movement and introduced devices that deform the vasculature, the fusion can become inaccurate. This is usually detected by comparing the preoperative information with the contrasted vessel. To avoid repeated use of iodine, comparison with an implanted stent can be used to adjust the fusion. However, detecting the stent automatically without the use of contrast is challenging as only thin stent wires are visible. We propose a fast, learning-based method to segment aortic stents in single uncontrasted X-ray images. To this end, we employ a fully convolutional network with residual units. Additionally, we investigate whether incorporation of prior knowledge improves the segmentation. We use 36 X-ray images acquired during EVAR for training and evaluate the segmentation on 27 additional images. We achieve a Dice coefficient of 0.933 (AUC 0.996) when using X-ray alone, and 0.918 (AUC 0.993) and 0.888 (AUC 0.99) when adding the preoperative model, and information about the expected wire width, respectively. The proposed method is...Continue Reading

References

May 3, 2011·Medical Image Analysis·Vincent BismuthLaurent Najman
Jul 2, 2011·Medical Image Analysis·Almar KleinCornelis H Slump
Oct 19, 2011·Medical Image Computing and Computer-assisted Intervention : MICCAI·Stefanie DemirciNassir Navab
Jan 5, 2013·Medical Image Computing and Computer-assisted Intervention : MICCAI·Terrence ChenDorin Comaniciu
Jul 22, 2014·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A HertaultS Haulon
Mar 1, 2015·Journal of Vascular and Interventional Radiology : JVIR·Claude KauffmannGilles Soulez
May 16, 2015·International Journal of Computer Assisted Radiology and Surgery·Daniele VolpiStefanie Demirci
Oct 7, 2015·IEEE Transactions on Medical Imaging·Matthias HoffmannJoachim Hornegger
Jul 28, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Christof J SchulzPhilipp Geisbüsch
Aug 31, 2016·Journal of Vascular Surgery·Giuseppe PanuccioMartin Austermann

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Citations

Aug 24, 2019·International Journal of Computer Assisted Radiology and Surgery·Katharina BreiningerAndreas Maier
Apr 26, 2020·International Journal of Computer Assisted Radiology and Surgery·Robert B GruppRussell H Taylor

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