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Catheter navigation support for liver radioembolization guidance: feasibility of structure-driven intensity-based registration

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

The fusion of pre/intraoperative images may improve catheter manipulation during radioembolization (RE) interventions by adding relevant information. The objective of this work is to propose and evaluate the performance of a RE guidance strategy relying on structure-driven intensity-based registration between preoperative CTA and intraoperative X-ray images.

Methods

The navigation strategy is decomposed into three image fusion steps, supporting the catheter navigation from the femoral artery till reaching the injection site (IS). During the pretreatment assessment intervention, the aorta and the origins of its side branches are projected on the intraoperative 2D fluoroscopy following a 3D/2D bone-based registration process, to assist the celiac trunk access. Subsequently, a similar approach consisting in projecting the hepatic vasculature on intraoperative DSA through 3D/2D vessel-based registration is performed to assist the IS location. Lastly, the selected IS is reproduced during the treatment intervention by employing 2D/2D image-based registration between pretreatment and treatment fluoroscopic images.

Results

The three fusion steps were independently evaluated on subsets of 20, 19 and 5 patient cases, respectively. Best results were obtained with gradient difference as similarity measure and with a delimited preoperative vascular structure for vessel-based registration. The approach resulted in qualitatively appropriate anatomical correspondences when projecting the preoperative structures on intraoperative images. With the best configuration, the registration steps showed accuracy and feasibility in aligning data, with global mean landmarks errors of 1.59 mm, 2.32 mm and 2.17 mm, respectively, a computation time that never exceeded 5 s, 25 s and 11 s, respectively, and a user interaction limited to manual initialization of the 3D/2D registration.

Conclusion

An image fusion-based approach has been specifically proposed for RE procedures guidance. The catheter manipulation strategy based on the fusion of pre- and intraoperative images has the potential to support different steps of the RE clinical workflow and to guide the overall procedure.

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Code availability

The code implemented for this study is not publicly available.

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Acknowledgements

This work was partially supported by the French National Association for Research and Technology (ANRT, Grant No. 2017/1639), and by the French National Research Agency (ANR) in the framework of the Investissement d’Avenir Program through Labex CAMI (ANR-11- LABX-0004).

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Authors and Affiliations

  1. Therenva, 35000, Rennes, France

    Houda Hammami, Florent Lalys & Antoine Petit

  2. CLCC Eugène Marquis, Inserm, LTSI – UMR 1099, Univ Rennes, 35000, Rennes, France

    Houda Hammami, Yan Rolland & Pascal Haigron

Authors
  1. Houda Hammami
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  2. Florent Lalys
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  3. Yan Rolland
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  4. Antoine Petit
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Contributions

H.H and P.H conceived the presented idea. H.H collected the data, carried out the experiments and performed the analysis. F.L and P.H verified the analytical method. P.H supervised the findings of the work. H.H wrote the manuscript with support from P.H, F.L, Y.R and A.P. All authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Houda Hammami.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This was an observational study for which anonymous retrospective data were used. It was performed in accordance with the ethical standards.

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Informed consent was obtained from all individual patients included in the study.

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Informed consent was obtained from all patients for whom data are included in this article.

Availability of data and materials

The data that support the findings of this study are available from the corresponding author, H.H, upon reasonable request.

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Hammami, H., Lalys, F., Rolland, Y. et al. Catheter navigation support for liver radioembolization guidance: feasibility of structure-driven intensity-based registration. Int J CARS 15, 1881–1894 (2020). https://doi.org/10.1007/s11548-020-02250-8

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  • DOI: https://doi.org/10.1007/s11548-020-02250-8

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