IEEE Trans Med Imaging. 2016 Aug;35(8):1892-902. doi: 10.1109/TMI.2016.2537052. Epub 2016 Mar 9.
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.
冷冻球囊导管在医学领域越来越受到关注，因为它们可以降低左心房肺静脉消融手术过程中的患者风险。由于冷冻球囊导管没有配备电极，因此无法被电解剖映射系统自动定位。因此，X 射线透视仍然是手术过程中的重要指导手段。最近，已经提出了基于透视的程序的图像引导方法，但它们仅为冷冻球囊导管提供有限的支持，并且需要大量的用户交互。为了改善这种情况，我们提出了一种通过检测冷冻球囊导管内置的 X 射线标记来自动检测透视图像中冷冻球囊导管的新方法。我们的方法基于斑点检测算法来找到可能的 X 射线标记候选者。然后使用先验知识排除其中的几个候选者。对于剩余的候选者，引入了几个导管特定的特征。然后使用机器学习方法对它们进行处理，以得出最终的 X 射线标记位置。我们的方法在来自两个地点的 40 名患者的 75 张双平面透视图像上进行了评估，这些图像是使用双平面血管造影系统获取的。该方法在 A 平面上的成功率为 99.0%，在 B 平面上的成功率为 90.6%。在 A 平面上的检测精度为 1.00 毫米±0.82 毫米，在 B 平面上的检测精度为 1.13 毫米±0.24 毫米。3-D 中的定位与平均误差为 0.36 毫米±0.86 毫米相关。
