Image guidance for neurovascular intervention: proposed setup for a 3D-roadmap system

Navigation in neurovascular interventions is currently hindered by the fact that the vessel infrastructure and the instruments are only shown simultaneously in a single real-time image during the use of a roadmap. An image guidance system based on a single C-arm is proposed, which will enable a 3D-roadmap showing a blended image of a 3D-rotational angiography and a real-time fluoroscopy image. The images are combined using machine-based registration, employing sensors mounted on the patient table and the C-arm. The setup of the system and its implications for the interventional procedures are described. The feasibility of the system is discussed with respect to the desired accuracy of matching and speed. The 3D-roadmap is expected to enhance 3D-insight for the interventionist and will facilitate instrument navigation. Implementation of the system will lead to a reduction both of the X-ray dosage and of the use of contrast agent.