title: Automatic detection of selective arterial devices for advanced visualization during abdominal aortic aneurysm endovascular repair.
abstract: Here we address the automatic segmentation of endovascular devices used in the endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) that deform vascular tissues. Using this approach, the vascular structure is automatically reshaped solving the issue of misregistration observed on 2D/3D image fusion for EVAR guidance. The endovascular devices we considered are the graduated pigtail catheter (PC) used for contrast injection and the stent-graft delivery device (DD). The segmentation of the DD was enhanced using an asymmetric Frangi filter. The segmented geometries were then analysed using their specific features to remove artefacts. The radiopaque markers of the PC were enhanced using a fusion of Hessian and newly introduced gradient norm shift filters. Extensive experiments were performed using a database of images taken during 28 AAA-EVAR interventions. This dataset was divided into two parts: the first half was used to optimize parameters and the second to compile performances using optimal values obtained. The radiopaque markers of the PC were detected with a sensitivity of 88.3% and a positive predictive value (PPV) of 96%. The PC can therefore be positioned with a majority of its markers localized while the artefacts were all located inside the vessel lumen. The major parts of the DD, the dilatator tip and the pusher surfaces, were detected accurately with a sensitivity of 85.9% and a PPV of 88.7%. The less visible part of the DD, the stent enclosed within the sheath, was segmented with a sensitivity of 63.4% because the radiopacity of this region is low and uneven. The centreline of the DD in this stent region was alternatively traced within a 0.74 mm mean error. The automatic segmentation of endovascular devices during EVAR is feasible and accurate; it could be useful to perform elastic registration of the vascular lumen during endovascular repair.
authors.affiliation: Laboratoire clinique du traitement de l'image (LCTI), Canada; Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Lessard
authors.affiliation: Laboratoire clinique du traitement de l'image (LCTI), Canada; Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Canada.
authors.forename: Claude
authors.initials: C
authors.lastname: Kauffmann
authors.affiliation: Siemens AG, Healthcare Sector, Forchheim, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Pfister
authors.affiliation: Laboratoire de biorhéologie et d'ultrasonographie médicale (LBUM), Canada; Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: Cloutier
authors.affiliation: Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Canada.
authors.forename: Éric
authors.initials: É
authors.lastname: Thérasse
authors.affiliation: Laboratoire de recherche en imagerie et orthopédie (LIO), Canada; Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Canada.
authors.forename: Jacques A
authors.initials: JA
authors.lastname: de Guise
authors.affiliation: Laboratoire clinique du traitement de l'image (LCTI), Canada; Centre de recherche du centre hospitalier de l'Université de Montréal (CRCHUM), Canada; Department of Radiology, Centre hospitalier de l'Université de Montréal (CHUM), Canada. Electronic address: gilles.soulez.chum@ssss.gouv.qc.ca.
authors.forename: Gilles
authors.initials: G
authors.lastname: Soulez
mesh_terms: D000465:Algorithms; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D016477:Artifacts; D001807:Blood Vessel Prosthesis; D057785:Catheters; D003287:Contrast Media; D066264:Datasets as Topic; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008955:Models, Cardiovascular; D010363:Pattern Recognition, Automated / Q000379:methods*; D012680:Sensitivity and Specificity; D015607:Stents; D025321:Surgery, Computer-Assisted / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Automatic segmentation; Endovascular devices; Gradient norm shift; Interventional radiology; Radiopaque marker