title: Cryo-Balloon Catheter Localization Based on a Support-Vector-Machine Approach.
abstract: Cryo-balloon catheters have attracted an increasing amount of interest in the medical community as they can reduce patient risk during left atrial pulmonary vein ablation procedures. As cryo-balloon catheters are not equipped with electrodes, they cannot be localized automatically by electro-anatomical mapping systems. As a consequence, X-ray fluoroscopy has remained an important means for guidance during the procedure. Most recently, image guidance methods for fluoroscopy-based procedures have been proposed, but they provide only limited support for cryo-balloon catheters and require significant user interaction. To improve this situation, we propose a novel method for automatic cryo-balloon catheter detection in fluoroscopic images by detecting the cryo-balloon catheter's built-in X-ray marker. Our approach is based on a blob detection algorithm to find possible X-ray marker candidates. Several of these candidates are then excluded using prior knowledge. For the remaining candidates, several catheter specific features are introduced. They are processed using a machine learning approach to arrive at the final X-ray marker position. Our method was evaluated on 75 biplane fluoroscopy images from 40 patients, from two sites, acquired with a biplane angiography system. The method yielded a success rate of 99.0% in plane A and 90.6% in plane B, respectively. The detection achieved an accuracy of 1.00 mm±0.82 mm in plane A and 1.13 mm±0.24 mm in plane B. The localization in 3-D was associated with an average error of 0.36 mm±0.86 mm.
authors.forename: Tanja
authors.initials: T
authors.lastname: Kurzendorfer
authors.forename: Philip W
authors.initials: PW
authors.lastname: Mewes
authors.forename: Andreas
authors.initials: A
authors.lastname: Maier
authors.forename: Norbert
authors.initials: N
authors.lastname: Strobel
authors.forename: Alexander
authors.initials: A
authors.lastname: Brost
mesh_terms: D002404:Catheterization; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D011667:Pulmonary Veins; D060388:Support Vector Machine