Real-Time Stent Enhancement via Motion-Compensated Fluoroscopy
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Solution Overview
Problem
Current methods for visualizing stents during percutaneous coronary intervention (PCI) using X-ray fluoroscopy are limited by low stent visibility due to minimal radiation exposure, leading to increased risks of incomplete stent expansion, and existing image processing techniques provide only offline solutions that are not suitable for real-time clinical use.
Innovation Solution
A real-time stent enhancement system that generates a motion-compensated enhanced stent image from a sequence of fluoroscopic frames, using a weighting field to compound new frames with the enhanced image, allowing for live visualization of the stent during procedures without artifacts that could affect diagnosis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If radiation dose is increased to improve stent visibility, then stent visibility is improved, but negative clinical effects occur
Solution Approach 1:
The system performs preliminary action by accumulating and processing multiple low-dose fluoroscopic frames before the actual intervention procedure. Motion-compensated stent enhancement is pre-calculated and stored, ready for real-time application. This allows the system to prepare enhanced stent images in advance without requiring high radiation doses during the actual procedure, thus improving visibility while avoiding negative clinical effects from excessive radiation exposure.
Solution Approach 2:
The system creates a copied and enhanced version of the stent structure by processing multiple fluoroscopic frames to generate a motion-compensated enhanced stent image. This copied enhanced image is then superimposed on the live fluoroscopic scene, allowing physicians to see the stent clearly without exposing patients to high radiation doses. The copying approach separates the enhancement process from the actual imaging, enabling artifact-free visualization.
2Illumination intensity
If image processing techniques are used to improve stent visibility, then stent visibility is improved, but the solution is offline and not suitable for real-time clinical use
Solution Approach 1:
The system performs motion-compensated stent enhancement processing in advance, before the actual intervention procedure begins. The enhanced stent images are pre-calculated and stored, ready for immediate application during the procedure. This preliminary processing eliminates the need for real-time computation during the intervention, ensuring that when the enhanced images are displayed, they are immediately available without delay, thus achieving both high visibility and real-time performance.
Solution Approach 2:
The system dynamically adapts the enhancement process by using motion compensation techniques that track and correct for patient and equipment movement. The pre-processed enhanced images are dynamically superimposed on the live fluoroscopic scene, maintaining accurate alignment despite motion. This dynamic approach ensures that the enhancement remains effective and artifact-free throughout the procedure, preserving both image quality and real-time capability.
3Measurement precision
If IVUS is used to assess stent expansion, then assessment accuracy is improved, but the procedure becomes invasive and expensive
Solution Approach 1:
The system creates a visual copy of the stent structure by processing multiple fluoroscopic frames to generate a motion-compensated enhanced stent image. This copied enhanced image provides clear visualization of the stent expansion and deployment, serving as an alternative to IVUS. The enhancement technique extracts and emphasizes stent features from standard fluoroscopic images, achieving accurate assessment without requiring invasive ultrasound catheters or additional expensive equipment.
Solution Approach 2:
The system replaces the mechanical IVUS system with a computational image processing approach. Instead of physically inserting an ultrasound transducer into the coronary artery, the system uses software-based motion-compensated enhancement of existing fluoroscopic images to achieve similar diagnostic goals. This substitution eliminates the need for invasive procedures and expensive specialized equipment, providing a cost-effective and non-invasive alternative for stent expansion assessment.
Data Source
AI summary
A method and system for real time stent enhancement on a live 2D fluoroscopic scene is disclosed. A motion compensated stent enhancement image is generated from a first set of frames in a fluoroscopic image sequence. A weighting field is generated based on the motion compensated stent enhancement image. For each new frame in the fluoroscopic image sequence that is received, the stent is enhanced in the new frame by compounding the new frame with the motion compensated stent enhancement image using the weighting field.