title: Interventional digital tomosynthesis from a standard fluoroscopy system using 2D-3D registration.
abstract: Interventional fluoroscopy provides guidance in a variety of minimally invasive procedures. However, three-dimensional (3D) clinically relevant information is projected onto a two-dimensional (2D) image which can make image interpretation difficult. Moreover, vasculature visualisation requires the use of iodinated contrast media which is nephrotoxic and is the primary cause of renal complications. In this article, we demonstrate how digital tomosynthesis slices can be produced on standard fluoroscopy equipment by registering the preoperative CT volume and the intraoperative fluoroscopy images using 2D-3D image registration. The proposed method automatically reconstructs patient-anatomy-specific slices and removes clutter resulting from bony anatomy. Such slices could provide additional intraoperative information which cannot be provided by the preoperative CT volume alone, such as the deformed aorta position offering improved guidance precision. Image acquisition would fit with interventional clinical work-flow and would not require a high X-ray dose. Experiments are carried out using one phantom and four clinical datasets. Phantom results showed a 3351% contrast-to-noise improvement compared to standard fluoroscopy. Patient results showed our method enabled visualization of clinically relevant features: outline of the aorta, the aortic bifurcation and some aortic calcifications.
authors.affiliation: Biomedical Engineering Dept., King's College London, King's Health Partners, London, UK. Electronic address: mazen.m.alhrishy@kcl.ac.uk.
authors.forename: Mazen
authors.initials: M
authors.lastname: Alhrishy
authors.affiliation: Biomedical Engineering Dept., King's College London, King's Health Partners, London, UK. Electronic address: andreas.varnavas@kcl.ac.uk.
authors.forename: Andreas
authors.initials: A
authors.lastname: Varnavas
authors.affiliation: Vascular Surgery Dept., Guys & St Thomas' NHS Foundation Trust, King's Health Partners, London, UK. Electronic address: tom.carrell@kcl.ac.uk.
authors.forename: Tom
authors.initials: T
authors.lastname: Carrell
authors.affiliation: Biomedical Engineering Dept., King's College London, King's Health Partners, London, UK. Electronic address: andrew.king@kcl.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: King
authors.affiliation: Biomedical Engineering Dept., King's College London, King's Health Partners, London, UK. Electronic address: graeme.penney@kcl.ac.uk.
authors.forename: Graeme
authors.initials: G
authors.lastname: Penney
mesh_terms: D000465:Algorithms; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013382:Subtraction Technique; D025321:Surgery, Computer-Assisted / Q000379:methods*
keywords: 2D-3D image registration; Endovascular aneurysm repair; Interventional digital tomosynthesis