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Biplane fluoroscopic imaging is an important tool for minimally invasive procedures for the treatment of cerebrovascular diseases. However, finding a good working angle for the C-arms of the angiography system as well as navigating based on the 2D projection images can be a difficult task. The purpose of this work is to propose a novel 4D reconstruction algorithm for interventional devices from biplane fluoroscopy images and to propose new techniques for a better visualization of the results. The proposed reconstruction methods binarizes the fluoroscopic images using a dedicated noise reduction algorithm for curvilinear structures and a global thresholding approach. A topology preserving thinning algorithm is then applied and a path search algorithm minimizing the curvature of the device is used to extract the 2D device centerlines. Finally, the 3D device path is reconstructed using epipolar geometry. The point correspondences are determined by a monotonic mapping function that minimizes the reconstruction error. The three dimensional reconstruction of the device path allows the rendering of virtual fluoroscopy images from arbitrary angles as well as 3D visualizations like virtual endoscopic views or glass pipe renderings, where the vessel wall is rendered with a semi-transparent material. This work also proposes a combination of different visualization techniques in order to increase the usability and spatial orientation for the user. A combination of synchronized endoscopic and glass pipe views is proposed, where the virtual endoscopic camera position is determined based on the device tip location as well as the previous camera position using a Kalman filter in order to create a smooth path. Additionally, vessel centerlines are displayed and the path to the target is highlighted. Finally, the virtual endoscopic camera position is also visualized in the glass pipe view to further improve the spatial orientation. The proposed techniques could considerably improve the workflow of minimally invasive procedures for the treatment of cerebrovascular diseases.
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