Catheter navigation support for mechanical thrombectomy guidance: 3D/2D multimodal catheter-based registration with no contrast dye fluoroscopy - Assistance aux Gestes et Applications THErapeutiques Accéder directement au contenu
Article Dans Une Revue International Journal of Computer Assisted Radiology and Surgery Année : 2023

Catheter navigation support for mechanical thrombectomy guidance: 3D/2D multimodal catheter-based registration with no contrast dye fluoroscopy

Résumé

Purpose: The fusion of pre-operative imaging and intra-operative fluoroscopy may support physicians during mechanical thrombectomy for catheter navigation from the aortic arch to carotids. Nevertheless, the aortic arch volume is too important for intra-operative contrast dye injection leading to a lack of common anatomical structure of interest that results in a challenging 3D/2D registration. The objective of this work is to propose a registration method between pre-operative 3D image and no contrast dye intra-operative fluoroscopy. Methods: The registration method exploits successive 2D fluoroscopic images of the catheter navigating in the aortic arch. The similarity measure is defined as the normalized cross-correlation between a binary combination of catheter images and a pseudo-DRR resulting from the 2D binary projection of the pre-operative 3D image (MRA or CTA). The 3D/2D transformation is decomposed in out-plane and in-plane transformations to reduce computational complexity. The 3D/2D transformation is then obtained by maximizing the similarity measure through multiresolution exhaustive search. Results: We evaluated the registration performance through dice score and mean landmark error. We evaluated the influence of parameters setting, aortic arch type and 2D navigation sequence duration. Results on a physical phantom and data from a patient who underwent a mechanical thrombectomy showed good registration accuracy with a dice score higher than 92% and a mean landmark error lower than the quarter of a carotid diameter (8-10 mm). Conclusion: A new registration method compatible with no contrast dye fluoroscopy has been proposed to guide the crossing from aortic arch to a carotid in mechanical thrombectomy. First evaluation showed the feasibility and accuracy of the method as well as its compatibility with clinical routine practice.
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Dates et versions

hal-04329254 , version 1 (29-01-2024)

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Aurelien de Turenne, François Eugène, Raphaël Blanc, Jérome Szewczyk, Pascal Haigron. Catheter navigation support for mechanical thrombectomy guidance: 3D/2D multimodal catheter-based registration with no contrast dye fluoroscopy. International Journal of Computer Assisted Radiology and Surgery, 2023, International Journal of Computer Assisted Radiology and Surgery, ⟨10.1007/s11548-023-03034-6⟩. ⟨hal-04329254⟩
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