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A Unified Framework for Multi-Guidewire Endpoint Localization in Fluoroscopy Images

Objective: In this paper, Keypoint Localization Region-based CNN (KL R-CNN) is proposed, which can simultaneously accomplish the guidewire detection and endpoint localization in a unified model. Methods: KL R-CNN modifies Mask R-CNN by replacing the mask branch with a novel keypoint localization branch. Besides, some settings of Mask R-CNN are also modified to generate the keypoint localization results at a higher detail level. At the same time, based on the existing metrics of Average Precision (AP) and Percentage of Correct Keypoints (PCK), a new metric named APPCK is proposed to evaluate the overall performance on the multi-guidewire endpoint localization task. Compared with existing metrics, APPCK is easy to use and its results are more intuitive. Results: Compared with existing methods, KL R-CNN has better performance when the threshold is loose, reaching a mean APPCK of 90.65% when the threshold is 9 pixels. Conclusion: KL R-CNN achieves the state-of-the-art performance on the multi-guidewire endpoint localization task and has application potentials. Significance: KL R-CNN can achieve the localization of guidewire endpoints in fluoroscopy images, which is a prerequisite for computer-assisted percutaneous coronary intervention. KL R-CNN can also be extended to other multi-instrument localization tasks.