Localizing a Guidewire in Three Dimensions during Endovascular
Interventions Using Single-view Fluoroscopy and a Stereo
Roadmap: Method and Feasibility Study
Interventional radiology is the medical specialty where instruments such as guide-wires and
catheters are inserted into a patient's vasculature under image guidance. During a procedure,
X-ray source-detector pair delivers live images of the anatomy and instruments based on X-ray
In this context I want to introduce an algorithm which makes it possible to localize a
monoscopically-visualized guidewire within a stereo roadmap or a 3D reconstruction of the
vessel tree. Besides the algorithm itself I will introduce its validation and implementation
within our application.
This application is intended to run in an interventional room, equipped with a Siemens X-ray
system (Fig. 1). Diagnostic imaging capabilities of this system include 2D projections (Fig 2,
left) and 3D reconstruction (Fig. 2, right) of the vasculature. However, during the intervention
when the instruments are being guided by a physician this system is capable to produce only
2D fluoroscopic images (Fig 3). The goal is to display 2D fluoroscopic images within a pre-
computed stereo roadmap or a 3D reconstruction.
Figure 1. Siemens Axiom Artis dBA.
Figure 2. 2D projection and 3D reconstruction.
Having 3D data you might want to use some existing product which is capable to fade between
2D fluoroscopic image and a reconstructed 3D volume, e.g. Syngo iPilot (Fig 4). Another
possibility is to use RoRo (Rotational Roadmapping). This application uses a rotational
acquisition and proposes to do roadmapping directly on the 2D projections. Alternatively it
can fade between 2D fluoro image and a stereo pair. Here we define a stereo pair as two DSA
(Digital Subtraction Angiography) images acquired at slightly different angles (Fig. 5). The key
feature of this approach is that it does not require 3D reconstruction, which sometimes