用非对比X光图生成血管造影,让介入手术不用碘剂也能看清血管。
VeCAS: Vessel-Focused Contrast-Free Angiogram Synthesis for Vascular Interventions

- 分两阶段:先定位血管,再在定位区域合成造影图像。
- 合成图像血管结构保真度高,医生评估真实感强。
- 实测可提升机器人导丝导航效率,减少40%以上操作步骤。
X射线血管造影依赖碘对比剂显影血管结构,但对比剂使用存在不良反应风险,推动无对比替代方案的发展。从非对比X光图像直接生成X射线血管造影提供了一种可能,但现有方法受限于(i)血管位置控制不足,(ii)冗余背景建模效率低。为此,我们提出VeCAS,一种两阶段的血管聚焦无对比血管造影合成框架,将血管结构定位与造影外观合成分离。第一阶段采用判别模型在非对比图像中定位血管结构,并通过跨模态潜在知识蒸馏,将来自血管造影图像中的血管敏感信息迁移至训练过程。第二阶段采用血管聚焦的图像修复模型,在定位的血管区域内合成造影外观,同时保留非血管背景。在自建的下肢血管介入数据集上的实验表明,VeCAS在血管结构保真度和图像质量上优于对比方法。视觉图灵测试与医生评估显示合成图像具有高感知真实感。此外,在血管模拟体上进行的机器人导丝导航实验表明,与非对比引导相比,VeCAS引导使到达目标时间减少41.4%,操作步数减少40.7%。这些结果表明,VeCAS具备作为“元对比剂”用于血管介入治疗的潜力。
原文摘要 · Abstract (English)
X-ray angiography relies on iodinated contrast agents to visualize vascular structures during image-guided interventions. However, contrast administration carries risks of adverse events, motivating the development of contrast-free alternatives. Generating X-ray angiograms directly from non-contrast X-ray images offers a potential solution, but existing approaches remain limited by (i) insufficient control over vascular localization and (ii) inefficient modeling of redundant background content. To address these challenges, we propose VeCAS, a two-stage vessel-focused contrast-free angiogram synthesis framework that separates vascular structure localization from angiographic appearance synthesis. In Stage I, a discriminative model localizes vascular structures in non-contrast X-ray images, while cross-modality latent distillation transfers vessel-sensitive knowledge from X-ray angiograms during training. In Stage II, a vessel-focused inpainting model synthesizes angiographic appearance within the localized vascular regions while preserving the non-vascular background. Experiments on an in-house lower-limb vascular intervention dataset show that VeCAS outperforms the comparison methods in terms of vascular structural fidelity and image quality. Visual Turing tests and physician assessments indicate the perceptual realism of the synthesized angiograms. In addition, robotic guidewire navigation experiments in vascular phantoms show that VeCAS guidance reduces the time to target by 41.4% and the number of operation steps by 40.7% compared with non-contrast guidance. Together, these results suggest the potential of VeCAS to serve as ``meta contrast agent'' for vascular interventions.
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