Over the past decade, significant advancements have been made in the research and industrialization of robotic systems for endovascular procedures, yet their clinical application remains relatively limited. Physicians commonly report that these robots lack certain intelligent assistive capabilities during procedures. There has been increasing interest and attempts to apply learning-centered algorithms to the training and enhancement of surgical robot skills. This paper proposes an autonomous navigation algorithm for interventional guidewires that is initially trained solely in a virtual simulation environment and subsequently deployed to a real-world robot. Experimental results demonstrate the feasibility of this approach for real-world applications. The proposed approach can help physicians reduce the learning curve for guidewire manipulation and elevate the robot to a higher level of autonomous operation, thereby breaking through the current bottleneck in the level of intelligence for clinical applications of interventional robots. It also holds promise for bringing intelligent transformation to future interventional procedures. Note to Practitioners—This work is motivated by the emerging need to increase the level of autonomy in robotic-assisted endovascular procedures, which has the potential to improve procedural efficiency, standardize procedures, and broaden the adoption of robotic systems in clinical practice. The proposed simulation-based reinforcement learning provides a safe and efficient method for training robotic systems, enabling them to master complex tasks in simulation environments prior to real-world application. The successful deployment of models trained in simulation onto physical robotic platforms demonstrates the feasibility of this method for real-world applications. The proposed simulation-based reinforcement learning method offers a promising and viable pathway for enhancing skill acquisition in endovascular interventional robots.

We introduce PLIKS (Pseudo-Linear Inverse Kinematic Solver) for reconstruction of a 3D mesh of the human body from a single 2D image. Current techniques directly regress the shape, pose, and translation of a parametric model from an input image through a non-linear mapping with minimal flexibility to any external influences. We approach the task as a model-in-the-loop optimization problem. PLIKS is built on a linearized formulation of the parametric SMPL model. Using PLIKS, we can analytically reconstruct the human model via 2D pixel-aligned vertices. This enables us with the flexibility to use accurate camera calibration information when available. PLIKS offers an easy way to introduce additional constraints such as shape and translation. We present quantitative evaluations which confirm that PLIKS achieves more accurate reconstruction with greater than 10% improvement compared to other state-of-the-art methods with respect to the standard 3D human pose and shape benchmarks while also obtaining a reconstruction error improvement of 12.9 mm on the newer AGORA dataset.

In tomographic imaging, anatomical structures are reconstructed by applying a pseudo-inverse forward model to acquired signals. Geometric information within this process is usually depending on the system setting only, i.e., the scanner position or readout direction. Patient motion therefore corrupts the geometry alignment in the reconstruction process resulting in motion artifacts. We propose an appearance learning approach recognizing the structures of rigid motion independently from the scanned object. To this end, we train a siamese triplet network to predict the reprojection error (RPE) for the complete acquisition as well as an approximate distribution of the RPE along the single views from the reconstructed volume in a multi-task learning approach. The RPE measures the motion-induced geometric deviations independent of the object based on virtual marker positions, which are available during training. We train our network using 27 patients and deploy a 21-4-2 split for training, validation and testing. In average, we achieve a residual mean RPE of 0.013mm with an inter-patient standard deviation of 0.022mm. This is twice the accuracy compared to previously published results. In a motion estimation benchmark the proposed approach achieves superior results in comparison with two state-of-the-art measures in nine out of twelve experiments. The clinical applicability of the proposed method is demonstrated on a motion-affected clinical dataset.

Blood flow velocity estimation techniques from 2D fluoroscopy and more recently rotational angiography images represent a topic of wide interest in various clinical research areas. In particular, they can be an important step towards patient-specific flow simulations. Additionally, it can be of diagnostic interest to evaluate volumetric blood flow in stenotic vessel segments; e.g. in a patient's brain. In this work, we present a robust optimization-based approach to estimate mean blood flow velocities from rotational digital subtraction angiography (DSA) images. Our method was extensively evaluated on 70 simulated datasets and 6 clinical datasets with MR phase contrast ground truth data. Our evaluation explores the limitations of image-based velocity estimation; i.e., measurements over short or small vessel segments. Overall, we were able to estimate the mean velocity with average errors as little as 4% for simulation studies, if the vessel segment is sufficiently long, and achieved results within the confines of the MR phase contrast ground truth data for our clinical data, with an average relative error to the centerline measurement of 9.5%±10.5%. The achieved accuracy enables patient-specific hemodynamic simulations and may also be of immediate diagnostic interest.

Flow diversion is an emerging endovascular treatment option for cerebral aneurysms. Quantitative assessment of hemodynamic changes induced by flow diversion can aid clinical decision making in the treatment of cerebral aneurysms. In this article, besides summarizing past key research efforts, we propose a novel metric for the angiographic assessment of flow diverter deployments in the treatment of cerebral aneurysms. By analyzing the frequency spectra of signals derived from digital subtraction angiography (DSA) series, the metric aims to quantify the prevalence of frequency components that correspond to the patient-specific heart rate. Indicating the decoupling of aneurysms from healthy blood circulation, our proposed metric could advance clinical guidelines for treatment success prediction. The very promising results of a retrospective feasibility study on 26 DSA series warrant future efforts to study the validity of the proposed metric within a clinical setting.

Tissue perfusion measurement using C-arm angiography systems capable of CT-like imaging (C-arm CT) is a novel technique with potentially high benefit for catheter guided treatment of stroke in the interventional suite. However, perfusion C-arm CT (PCCT) is challenging: the slow C-arm rotation speed only allows measuring samples of contrast time attenuation curves (TACs) every 5-6 s if reconstruction algorithms for static data are used. Furthermore, the peak values of the TACs in brain tissue typically lie in a range of 5-30 HU, thus perfusion imaging is very sensitive to noise. We present a dynamic, iterative reconstruction (DIR) approach to reconstruct TACs described by a weighted sum of basis functions. To reduce noise, a regularization technique based on joint bilateral filtering (JBF) is introduced. We evaluated the algorithm with a digital dynamic brain phantom and with data from six canine stroke models. With our dynamic approach, we achieve an average Pearson correlation (PC) of the PCCT canine blood flow maps to co-registered perfusion CT maps of 0.73. This PC is just as high as the PC achieved in a recent PCCT study, which required repeated injections and acquisitions.

The design and implementation of the reconstruction system in medical X-ray imaging is a challenging issue due to its immense computational demands. In order to ensure an efficient clinical workflow it is inevitable to meet high performance requirements. Hence, the usage of hardware acceleration is mandatory. The software architecture of the reconstruction system is required to be modular in a sense that different accelerator hardware platforms are supported and it must be possible to implement different parts of the algorithm using different acceleration architectures and techniques.

Abstract Sophisticated parallel languages are difficult to develop; most parallel distributed memory scientific applications are developed using a serial language, expressing parallelism through third party libraries (e.g. MPI). As a result, frameworks and libraries are often used to encapsulate significant complexities. We define a novel approach to optimize the use of libraries within applications. The resulting tool, named ROSE, leverages the additional semantics provided by library‐defined abstractions enabling library specific optimization of application codes. It is a common perception that performance is inversely proportional to the level of abstraction. Our work shows that this is not the case if the additional semantics can be leveraged. We show how ROSE can be used to leverage the semantics within the compile‐time optimization. Copyright © 2004 John Wiley & Sons, Ltd.

Conventional implementations of iterative numerical algorithms, especially multigrid methods, merely reach a disappointing small percentage of the theoretically available CPU performance when applied to representative large problems.One of the most important reasons for this phenomenon is that the current DRAM technology cannot provide the data fast enough to keep the CPU busy.Although the fundamentals of cache optimizations are quite simple, current compilers cannot optimize even elementary iterative schemes.In this paper, we analyze the memory and cache behavior of iterative methods with extensive profiling and describe program transformation techniques to improve the cache performance of two-and three-dimensional multigrid algorithms.This project is partially funded by DFG Ru 422/7-1,2.1 All benchmarks in the article were compiled with native FORTRAN77 compilers and aggressive optimizations enabled.On the Intel platform we used egcs (V2.91.60).The platforms include an Intel PentiumII Xeon PC (450 MHz, 450 MFLOPS), a SUN Ultra 60 (296 MHz, 592 MFLOPS), a HP SPP2200 Convex Exemplar Node (200 MHz, 800 MFLOPS), a Compaq PWS 500au (500 MHz, 1 GFLOPS), and a Compaq XP1000 (500 MHz, 1 GFLOPS).1