Marker detection evaluation by phantom and cadaver experiments for C-arm pose estimation pattern

C-arm fluoroscopy is used for guidance during several clinical exams, e.g. in bronchoscopy to locate the bronchoscope inside the airways. Unfortunately, these images provide only 2D information. However, if the C-arm pose is known, it can be used to overlay the intrainterventional fluoroscopy images with 3D visualizations of airways, acquired from preinterventional CT images. Thus, the physician's view is enhanced and localization of the instrument at the correct position inside the bronchial tree is facilitated. We present a novel method for C-arm pose estimation introducing a marker-based pattern, which is placed on the patient table. The steel markers form a pattern, allowing to deduce the C-arm pose by use of the projective invariant cross-ratio. Simulations show that the C-arm pose estimation is reliable and accurate for translations inside an imaging area of 30 cm x 50 cm and rotations up to 30°. Mean error values are 0:33 mm in 3D space and 0:48 px in the 2D imag ing plane. First tests on C-arm images resulted in similarly compelling accuracy values and high reliability in an imaging area of 30 cm x 42:5 cm. Even in the presence of interfering structures, tested both with anatomy phantoms and a turkey cadaver, high success rates over 90% and fully satisfying execution times below 4 sec for 1024 px x 1024 px images could be achieved.