Optimized viewing angles for cardiac electrophysiology ablation procedures

Electrophysiology Catheter Detection and Reconstruction From Two Views in Fluoroscopic Images

Electrophysiology (EP) studies and catheter ablation have become important treatment options for several types of cardiac arrhythmias. We present a novel image-based approach for automatic detection and 3-D reconstruction of EP catheters where the physician marks the catheter to be reconstructed by a single click in each image. The result can be used to provide 3-D information for enhanced navigation throughout EP procedures. Our approach involves two X-ray projections acquired from different angles, and it is based on two steps: First, we detect the catheter in each view after manual initialization using a graph-search method. Then, the detection results are used to reconstruct a full 3-D model of the catheter based on automatically determined point pairs for triangulation. An evaluation on 176 different clinical fluoroscopic images yielded a detection rate of 83.4%. For measuring the error, we used the coupling distance which is a more accurate quality measure than the average point-wise distance to a reference. For successful outcomes, the 2-D detection error was 1.7 mm ±1.2 mm. Using successfully detected catheters for reconstruction, we obtained a reconstruction error of 1.8 mm ±1.1 mm on phantom data. On clinical data, our method yielded a reconstruction error of 2.2 mm ±2.2 mm.