Dazeo Nicolas, Orlando José Ignacio, García Camila, Muñoz Romina, Obrado Laura, Fernandez Hector, Blasco Jordi, Román Luis San, Macho Juan M, Ding Andreas, Utz Raphael, Larrabide Ignacio
Yatiris Research Group, PLADEMA Institute, CONICET-UNICEN, Campus Universitario, Tandil, Argentina.
Mentice S. L., Barcelona, Spain.
Cardiovasc Eng Technol. 2024 Dec;15(6):691-703. doi: 10.1007/s13239-024-00745-y. Epub 2024 Aug 19.
To introduce a computational tool for peri-interventional intracranial aneurysm treatment guidance that maps preoperative planning information from simulation onto real-time X-Ray imaging.
Preoperatively, multiple flow diverter (FD) devices are simulated based on the 3D mesh of the vessel to treat, to choose the optimal size and location. In the peri-operative stage, this 3D information is aligned and mapped to the continuous 2D-X-Ray scan feed from the operating room. The current flow diverter position in the 3D model is estimated by automatically detecting the distal FD marker locations and mapping them to the treated vessel. This allows to visually assess the possible outcome of releasing the device at the current position, and compare it with the one chosen pre-operatively.
The full pipeline was validated using retrospectively collected biplane images from four different patients (5 3D-DSA datasets in total). The distal FD marker detector obtained an average F1-score of 0.67 ( ) in 412 2D-X-Ray scans. After aligning 3D-DSA + 2D-X-Ray datasets, the average difference between simulated and deployed positions was 0.832 mm ( mm). Finally, we qualitatively show that the proposed approach is able to display the current location of the FD compared to their pre-operatively planned position.
The proposed method allows to support the FD deployment procedure by merging and presenting preoperative simulation information to the interventionists, aiding them to make more accurate and less risky decisions.
介绍一种用于介入治疗颅内动脉瘤的计算工具，该工具可将术前规划信息从模拟映射到实时X射线成像上。
术前，基于待治疗血管的三维网格对多个血流导向装置进行模拟，以选择最佳尺寸和位置。在围手术期，将此三维信息进行对齐并映射到手术室连续的二维X射线扫描图像上。通过自动检测血流导向装置远端标记的位置并将其映射到被治疗血管上，来估计三维模型中血流导向装置的当前位置。这使得能够直观地评估在当前位置释放装置可能产生的结果，并将其与术前选择的结果进行比较。
使用从四名不同患者回顾性收集的双平面图像（总共5个三维数字减影血管造影数据集）对整个流程进行了验证。在412次二维X射线扫描中，远端血流导向装置标记检测器的平均F1分数为0.67（ ）。在对齐三维数字减影血管造影 + 二维X射线数据集后，模拟位置与实际部署位置之间的平均差异为0.832毫米（ 毫米）。最后，我们定性地表明，与术前规划位置相比，所提出的方法能够显示出血流导向装置的当前位置。
所提出的方法通过将术前模拟信息合并并呈现给介入医生，支持血流导向装置的部署过程，帮助他们做出更准确、风险更小的决策。
