In image-guided cardiac interventions, X-ray imaging and intravascular ultrasound (IVUS) imaging are two often used modalities. Interventional X-ray images, including angiography and fluoroscopy, are used to assess the lumen of the coronary arteries and to monitor devices in real time. IVUS provides rich intravascular information, such as vessel wall composition, plaque, and stent expansions, but lacks spatial orientations. Since the two imaging modalities are complementary to each other, it is highly desirable to co-register the two modalities to provide a comprehensive picture of the coronaries for interventional cardiologists. In this paper, we present a solution for co-registering 2-D angiography and IVUS through image-based device tracking. The presented framework includes learning-based vessel detection and device detections, model-based tracking, and geodesic distance-based registration. The system first interactively detects the coronary branch under investigation in a reference angiography image. During the pullback of the IVUS transducers, the system acquires both ECG-triggered fluoroscopy and IVUS images, and automatically tracks the position of the medical devices in fluoroscopy. The localization of tracked IVUS transducers and guiding catheter tips is used to associate an IVUS imaging plane to a corresponding location on the vessel branch under investigation. The presented image-based solution can be conveniently integrated into existing cardiology workflow. The system is validated with a set of clinical cases, and achieves good accuracy and robustness.

Segmentation of ultrasound images is often a very challenging task due to speckle noise that contaminates the image. It is well known that speckle noise exhibits an asymmetric distribution as well as significant spatial correlation. Since these attributes can be difficult to model, many previous ultrasound segmentation methods oversimplify the problem by assuming that the noise is white and/or Gaussian, resulting in generic approaches that are actually more suitable to MR and X-ray segmentation than ultrasound. Unlike these methods, in this paper we present an ultrasound-specific segmentation approach that first decorrelates the image, and then performs segmentation on the whitened result using statistical region-based active contours. In particular, we design a gradient ascent flow that evolves the active contours to maximize a log likelihood functional based on the Fisher-Tippett distribution. We present experimental results that demonstrate the effectiveness of our method.