Real time localization and shape extraction of guide wire in fluoroscopic images plays a significant role in the image guided navigation during cerebral and cardiovascular interventions. Given the complexity of the non-rigid and sparse characteristics of guide wire structures, and the low SNR(Signal Noise Ratio) of fluoroscopic images, traditional handcrafted guide wire tracking methods such as Frangi filter, Hessian Matrix, or open active contour usually produce insufficient accuracy with high computational cost, and may require extra human intervention for proper initialization or correction. The application of deep learning techniques to guide wire tracking is reported to produce significant improvement in guide wire localization accuracy, but the heavy calculation cost is still a concern. In this paper we propose a two phase deep learning scheme for accurate and real time guide wire shape extraction in fluoroscopic sequences. In the first phase we train a guide wire localization network to pick image regions containing guide wire structures. From the picked image regions, we train a guide wire shape extraction network in the second phase to mark the guide wire pixels. We report that our proposed method can accurately distinguish about 99% of the guide wire structure pixels, and the falsely detected pixels in the background are close to 0, the average offset from the ground truth is less than 1 pixel. For extreme cases where traditional handcrafted method may fail, our proposed method can still extract guide wire completely and accurately. The processing time for a 512 × 512 pixels image is 78 ms. Compared with the traditional filtering based method from our previous work, we show that our proposed method can achieve more accurate and stable performance. Compared with other deep learning methods, our proposed method significantly improve calculation efficiency to meet the real time requirement of clinical applications.
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