Novel 3D instrument navigation in intracranial vascular surgery with multi-source image fusion and self-calibration

Abstract

In cerebrovascular interventional surgery, spatial position prediction navigation (SPPN) provides 3D spatial information of the vascular lumen, reducing the spatial dimension loss from digital subtraction angiography (DSA) and improving surgical precision. However, it is limited in its adaptability to complex vascular environments and prone to error accumulation. To address these issues, we propose spatial position prediction-based multimodal navigation (SPPMN), integrating minimal intraoperative X-ray images to enhance SPPN accuracy. In the first phase, a feature-weighted dynamic time warping (FDTW)-based branch matching algorithm is introduced for 3D topological positioning under non-registered conditions, with a dynamic location repositioning module for real-time corrections. In the second phase, an occlusion correction module, based on the elastic potential energy of the instrument tip, dynamically adjusts the tip’s angle to achieve low-projection occlusion control. Experimental validation using a high-precision electromagnetic tracking system (EMTS) on a 3D vascular model shows that the proposed method achieves an average 3D positioning accuracy of 9.36 mm in intracranial vascular regions, with a 78% reduction in radiation exposure, significantly enhancing both precision and safety in interventional surgeries.

Keywords

Cerebrovascular interventional surgery / Surgical robot / 3D prediction guide / Autonomous instrumentation control

CRediT authorship contribution statement

Linsen Zhang: Writing - review & editing, Writing - original draft, Visualization, Validation, Methodology, Investigation, Data curation. Shiqi Liu: Writing - review & editing. Xiaoliang Xie: Writing - review & editing. Xiaohu Zhou: Writing - review & editing. Zengguang Hou: Supervision. Xinkai Qu: Investigation. Wenzheng Han: Investigation. Meng Song: Investigation. Xiyao Ma: Writing - review & editing. Haining Zhao: Writing - review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgments

This work was supported in part by the National Key Research and Development Program of China (2024YFF1206902); in part by the National Natural Science Foundation of China (62303463); in part by the Beijing Natural Science Foundation, China (L232137, L246047); in part by the National High Level Hospital Clinical Research Funding (2022-PUMCH-B-125).

Appendix A.

The following are the abbreviations used in the text. Right Subclavian Artery (RSCA), Right Common Carotid Artery (RCCA), Right Vertebral Artery (RVA), Left Vertebral Artery (LVA), Left Common Carotid Artery (LCCA), Left Subclavian Artery (LSCA).

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