Erick Oberstar, Presenter: Research Grant, Siemens AG

Brian Davis, Abstract Co-Author: Research Grant, Siemens AG

Martin Wagner, Abstract Co-Author: Nothing to Disclose

Kevin Royalty MS, MBA, Abstract Co-Author: Employee, Siemens AG

Markus Kowarschik PhD, Abstract Co-Author: Employee, Siemens AG

Sebastian Schafer, Abstract Co-Author: Consultant, Siemens AG

Charles Milton Strother MD, Abstract Co-Author: Research Consultant, Siemens AG Research support, Siemens AG License agreement, Siemens AG

Charles Anthony Mistretta PhD, Abstract Co-Author: Grant, General Electric Company Founder, Mistretta Medical Intellectual Property Licensing Activities Research, Siemens AG

Endoscopic views of devices inside the vasculature could be beneficial for navigation placement in complicated vascular anatomy. By leveraging 3D or 4D DSA, in with UW Madison’s 4D Omni-Plane Fluorosopy (4DOPF) technique for creating any desired virtual fluoroscopic views from biplane fluoroscopy, endoscopic views of vascular structures can be generated to provide additional information about the presence of complex anatomy or obstructions that would inhibit a device entering a vascular orifice or make device navigation challenging. Although 4DOPF is typically used to show the motion of a device relative to a vascular roadmap, it could be helpful to view the placement of interventional devices as they enter vascular structures from an endoscopic view.

A 3D or 4D DSA volume is acquired in addition to orthogonal biplane fluorocopic views. A 3D vessel lumen volume is created by subtracting a DSA volume from a dilated version of the volume to remove contrast signal inside the vessel. A device volume is generated by 4DOPF (backprojection of segmented orthogonal biplane fluoro views) and is combined with the vessel lumen volume. Endoscopic views of the vascular lumen are generated from the combined data set at each time frame.

The images shown were done retrospectively with parallel ray processing without correction for geometrical inconsistencies. Figure 1 shows an example of a cerebral aneurysm, and time series images of two different views of the neck of the aneurysm. Several camera views were established showing optimal device and neck visibility as indicated by the red and yellow arrows on the aneurysm in Fig 1a. Vessels obstructing the view of the aneurysm have been removed. The images surrounded by red and yellow backgrounds show four time instances of a device moving into the aneurysm from superior and inferior views Fig 1b-c.

By leveraging 3D/4D-DSA & 4DOPF, endoscopic views of an interventional device and vascular lumen can be generated to provide physicians additional information about the presence of complex anatomy or obstructions that would inhibit a device entering a vascular orifice.

The clinical goal of our work is to develop and optimize techniques which will enhance the ability to use road mapping techniques in image guided abdominal and peripheral interventions.

Oberstar, E, Davis, B, Wagner, M, Royalty, K, Kowarschik, M, Schafer, S, Strother, C, Mistretta, C, Feasibility of 4D Endoscopic Rendering of Interventional Devices.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13020534.html