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Stent detection for presentation by overlay in injected x-ray cardiac images

Coronary stenting is now a widely - used technique for the treatment of stenosis of coronary arteries. One of the main difficulties for the interventionists is the difficulty of locating the dilated stent in the image and controlling its accurate positioning with respect to the lesion. Indeed, the stent is less contrasted than injected vessels and can hardly be located in the injected frames. We propose to help them by identifying the stent in the non-injected frames and then showing it by overlay in the injected frames. Physicians can then more easily appreciate the relative positioning of the stent and the pathology. For the detection task, the performance of our algorithm varies around 80% with a standard deviation about 10%. This result has been obtained with more than 20 series. Each of them includes about 20 non-injected frames acquired on a LC+ system. At least one stent is present in these series. Our database includes stents whose radio opacity varies in a large range. With our non optimized implementation, time computation for a 512*512 image is about 20 seconds. This work is a first step in the use of image processing techniques for the segmentation of the prothesis that are routinely used by interventionists. By locating them in the image, the x-ray imaging system will be able to provide a better display of them.