Remapping of digital subtraction angiography on a standard fluoroscopy system using 2D-3D registration

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Fluoroscopy-guided endovascular interventions are being performing for more and more complex cases with longer screening times. However, X-ray is much better at visualizing interventional devices and dense structures compared to vasculature. To visualise vasculature, angiography screening is essential but requires the use of iodinated contrast medium (ICM) which is nephrotoxic. Acute kidney injury is the main life-threatening complication of ICM. Digital subtraction angiography (DSA) is also often a major contributor to overall patient radiation dose (81% reported). Furthermore, a DSA image is only valid for the current interventional view and not the new view once the C-arm is moved. In this paper, we propose the use of 2D-3D image registration between intraoperative images and the preoperative CT volume to facilitate DSA remapping using a standard fluoroscopy system. This allows repeated ICM-free DSA and has the potential to enable a reduction in ICM usage and radiation dose. Experiments were carried out using 9 clinical datasets. In total, 41 DSA images were remapped. For each dataset, the maximum and averaged remapping accuracy error were calculated and presented. Numerical results showed an overall averaged error of 2.50 mm, with 7 patients scoring averaged errors < 3 mm and 2 patients < 6 mm.

Original languageEnglish
Title of host publicationProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISBN (Print)9781628415032
Publication statusPublished - 20 Mar 2015
EventMedical Imaging 2015: Image Processing - Orlando, United States
Duration: 24 Feb 201526 Feb 2015


ConferenceMedical Imaging 2015: Image Processing
Country/TerritoryUnited States


  • 2D-3D image registration
  • Digital subtraction angiography (DSA)
  • endovascular aneurysm repair (EVAR)
  • interventional digital tomosynthesis (DTS)
  • iodinated contrast media (ICM)


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