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Related Experiment Video

Updated: Jan 9, 2026

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
06:59

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Optimized aortic root segmentation during transcatheter aortic valve implantation.

Nikita V Laptev1, Olga M Gerget2, Julia K Belova3

  • 1Siberian State Medical University, Tomsk, Russia.

Frontiers in Cardiovascular Medicine
|December 1, 2025
PubMed
Summary

Convolutional neural networks (CNNs) improve transcatheter aortic valve implantation (TAVI) accuracy by automatically segmenting the aortic root on angiographic images, aiding precise valve placement.

Keywords:
TAVIangiographic imagesaortic rootautomatic segmentationconvolutional neural networks

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Area of Science:

  • Medical Imaging
  • Artificial Intelligence in Healthcare
  • Cardiovascular Surgery

Background:

  • Transcatheter aortic valve implantation (TAVI) is crucial for severe aortic stenosis.
  • Accurate valve positioning is vital for TAVI success, especially with minimal contrast use in chronic kidney disease patients.
  • Fluoroscopic imaging poses challenges due to low contrast, noise, and artifacts, hindering precise anatomical visualization.

Purpose of the Study:

  • To compare various convolutional neural network (CNN) architectures for automatic aortic root segmentation on angiographic images.
  • To identify the optimal CNN model for enhancing TAVI valve positioning accuracy.
  • To explore the potential of CNN-based segmentation in reducing contrast agent use and surgical risks.

Main Methods:

  • Comparative analysis of CNN architectures including FPN, U-Net++, DeepLabV3+, LinkNet, MA-Net, and PSPNet.
  • Models were trained and tested with optimized hyperparameters on angiographic datasets.
  • Performance was evaluated using Dice coefficients and average symmetric surface distance.

Main Results:

  • DeepLabV3+ and U-Net++ demonstrated stable convergence during training (median Dice ~0.88).
  • MA-Net and PSPNet achieved superior patient-level performance, with Dice coefficients of 0.942 and 0.936, respectively.
  • MA-Net and PSPNet also yielded a low average symmetric surface distance of 4.1 mm.

Conclusions:

  • CNN-based automatic aortic root segmentation significantly improves valve positioning accuracy in TAVI.
  • MA-Net and PSPNet show strong potential for clinical application in cardiac surgery decision-support systems.
  • These methods can reduce contrast agent dependency, minimize surgical risks, and enhance TAVI outcomes.