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

Breininger K, Albarqouni S, Kurzendorfer T, Pfister M, Kowarschik M, Maier A (2018)

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Publication Type: Journal article

Publication year: 2018

Journal

Publisher: Springer Verlag

Book Volume: 13

Pages Range: 1221-1231

Journal Issue: 8

DOI: 10.1007/s11548-018-1779-6

Abstract

Purpose: 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. Method: 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. Results: 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. Conclusion: The proposed method is fully automatic, fast and segments aortic stent grafts in fluoroscopic images with high accuracy. The quality and performance of the segmentation will allow for an intraoperative comparison with the preoperative information to assess the accuracy of the fusion.

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How to cite

APA:

Breininger, K., Albarqouni, S., Kurzendorfer, T., Pfister, M., Kowarschik, M., & Maier, A. (2018). Intraoperative stent segmentation in X-ray fluoroscopy for endovascular aortic repair. International Journal of Computer Assisted Radiology and Surgery, 13(8), 1221-1231. https://dx.doi.org/10.1007/s11548-018-1779-6

MLA:

Breininger, Katharina, et al. "Intraoperative stent segmentation in X-ray fluoroscopy for endovascular aortic repair." International Journal of Computer Assisted Radiology and Surgery 13.8 (2018): 1221-1231.

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