Guidewire Distal End Localization Using Duct Geometry Similarity
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
During ERCP procedures, it is challenging for physicians to accurately determine whether the tip of a guidewire is located in the common bile duct or the pancreatic duct, leading to a risk of complications such as pancreatitis.
Innovation Solution
A method that uses a data set describing the geometry of a main duct and its branches, detects the course of a medical instrument within these ducts, and calculates similarity measures to determine the location of the instrument's distal end, thereby avoiding the need for contrast agent administration.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If contrast agent is injected to visualize bile duct anatomy, then the physician can see the anatomy around the guidewire, but the risk of complications such as pancreatitis increases
Solution Approach 1:
The system performs preliminary action by pre-calculating and storing the expected courses of the common bile duct and pancreatic duct based on anatomical data, then comparing the guidewire position against these pre-established pathways to determine location without requiring contrast agent injection
Solution Approach 2:
The system introduces an intermediary computational model that mediates between the guidewire position detection and the anatomical structure identification. Instead of directly visualizing anatomy through contrast agents, the system uses a mediating algorithm that compares measured guidewire courses against pre-stored anatomical pathways to infer location
2Measurement precision
If the physician advances the guidewire further to determine duct location, then the distal end location becomes clearer, but the risk of unintended cannulation increases
Solution Approach 1:
The system provides continuous feedback to the physician during the cannulation process by calculating and displaying the current distal end location of the guidewire in real-time. This feedback loop allows the physician to stop advancement when the guidewire reaches the common bile duct-pancreatic duct junction, preventing unintended cannulation while maintaining accurate location knowledge
Solution Approach 2:
The system performs preliminary identification of the common bile duct-pancreatic duct junction location using imaging data before the physician advances the guidewire further. This pre-identification allows the physician to stop advancement at the correct location, avoiding the need to push the guidewire deeper into the pancreatic duct
3Measurement precision
If X-ray imaging is used for ERCP procedures, then the guidewire is visible, but the bile duct anatomy remains invisible making location determination difficult
Solution Approach 1:
The system creates a computational copy or model of the bile duct anatomy based on pre-stored anatomical data and imaging information. This virtual copy allows the system to visualize and analyze the anatomical structures without requiring actual contrast agent injection, enabling the physician to see the anatomy through the computational model rather than through direct radiological visualization
Data Source
AI summary
Systems and methods for more reliability located the distal end of a medical instrument. A data set is provided that describes a course of a main duct, of a first branch from the main duct, and of a second branch from the main duct. A course of the medical instrument in the main duct and in one of the first or second branches is moreover detected. The course of the main duct and of the two branches is brought into register with the course of the medical instrument. A first similarity measure relating to the end portion and the first branch and a second similarity measure of the end portion and the second branch are then calculated. An item of location information about the distal end of the medical instrument is determined from the similarity measures.