Respiratory liver motion tracking during transcatheter procedures using guidewire detection

Transcatheter chemoembolization of liver tumors is performed under X-ray fluoroscopic image guidance. This is a difficult procedure because the vessels of the liver are constantly moving due to respiration and they are not visible in the X-ray image unless a contrast medium is injected. In order to help the interventional radiologist during the treatment, we propose to superimpose on to the fluoroscopic image a pre-acquired contrast-enhanced 2D or 3D image while accounting for liver motion. Our approach proposes to track the guidewire from frame to frame. Our proposed method can be split into two steps. First the guidewire is automatically detected; then the motion between two frames is estimated using a robust ICP (iterative closest point) algorithm. We have tested our method on simulated X-ray fluoroscopic images of a moving guidewire and applied it on 4 clinical sequences. Simulation demonstrated that the mean precision of our method is inferior to 1 mm. On clinical data, preliminary results demonstrated that this method allows for respiratory motion compensation of liver vessels with a mean accuracy inferior to 3 mm.