# Real-time guidewire tracking and segmentation in intraoperative x-ray

arXiv: https://arxiv.org/abs/2404.08805 · HTML: https://mlsanity.com/paper/2404.08805/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 5 of its 15 references that are in the map.
- First posted on arXiv 12 Apr 2024.

## Builds on (most cited first, 5 of 5)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Road Extraction by Deep Residual U-Net](https://mlsanity.com/paper/1711.10684/) (2017)
- [Recurrent Residual Convolutional Neural Network based on U-Net (R2U-Net) for Medical Image Segmentation](https://mlsanity.com/paper/1802.06955/) (2018)
- [CS2-Net: Deep Learning Segmentation of Curvilinear Structures in Medical Imaging](https://mlsanity.com/paper/2010.07486/) (2020)
- [Fully Automatic and Real-Time Catheter Segmentation in X-Ray Fluoroscopy](https://mlsanity.com/paper/1707.05137/) (2017)

## Built on by (most cited first, 3 of 3)

- [Advancing Embodied Intelligence in Robotic-Assisted Endovascular Procedures: A Systematic Review of AI Solutions](https://mlsanity.com/paper/2504.15327/) (2025)
- [Generalizing Segmentation Foundation Model Under Sim-to-real Domain-shift for Guidewire Segmentation in X-ray Fluoroscopy](https://mlsanity.com/paper/2410.07460/) (2024)
- [SplineFormer: An Explainable Transformer-Based Approach for Autonomous Endovascular Navigation](https://mlsanity.com/paper/2501.04515/) (2025)

## Abstract (arXiv)

During endovascular interventions, physicians have to perform accurate and immediate operations based on the available real-time information, such as the shape and position of guidewires observed on the fluoroscopic images, haptic information and the patients' physiological signals. For this purpose, real-time and accurate guidewire segmentation and tracking can enhance the visualization of guidewires and provide visual feedback for physicians during the intervention as well as for robot-assisted interventions. Nevertheless, this task often comes with the challenge of elongated deformable structures that present themselves with low contrast in the noisy fluoroscopic image sequences. To address these issues, a two-stage deep learning framework for real-time guidewire segmentation and tracking is proposed. In the first stage, a Yolov5s detector is trained, using the original X-ray images as well as synthetic ones, which is employed to output the bounding boxes of possible target guidewires. More importantly, a refinement module based on spatiotemporal constraints is incorporated to robustly localize the guidewire and remove false detections. In the second stage, a novel and efficient network is proposed to segment the guidewire in each detected bounding box. The network contains two major modules, namely a hessian-based enhancement embedding module and a dual self-attention module. Quantitative and qualitative evaluations on clinical intra-operative images demonstrate that the proposed approach significantly outperforms our baselines as well as the current state of the art and, in comparison, shows higher robustness to low quality images.