Structure-to-Shape Aortic 3-D Deformation Reconstruction for Endovascular Interventions

Fluoroscopy-guided endovascular interventions by using X-ray images are challenging. The catheter needs to be manipulated precisely inside the aorta, while only 2-D views from the X-ray fluoroscopy are currently used to help the surgeons. Because the catheter is operated in a 3-D space, a visualization of the deforming 3-D aorta will be useful as guidance for catheter manipulation. Existing 3-D reconstruction methods fall short in only focusing on the deformation reconstruction of the aortic 3-D centerline, or using additional prior knowledge of 3-D catheter position for estimating the aortic 3-D deformation. In this article, we propose a novel framework that reconstructs the aortic 3-D deformation by fusing a preoperative 3-D model and two intraoperative X-ray images. Different from existing methods, the proposed framework reconstructs aortic deformation using a coarse-to-fine pipeline by first reconstructing the aortic 3-D centerline and then reconstructing the 3-D shape. To obtain the accurate features for the fluoroscopic-based 3-D reconstruction, we extract semantic features from the X-ray images, and compute the distance field to efficiently calculate the 3-D–2-D nonrigid correspondence. Nonlinear least squares optimization is used to solve the deformation of both centerline and shape. The proposed framework is validated using phantom and patient datasets, whose results demonstrate improved efficiency and accuracy compared with the existing methods. This framework provides a valuable clinical tool for endovascular interventions.