Automated Registration of 3D Neurovascular Territory Atlas to 2D DSA for Targeted Quantitative Angiography Analysis

Subarachnoid hemorrhage (SAH), typically due to intracranial aneurysms, demands precise imaging for effective treatment. Digital Subtraction Angiography (DSA), despite being the gold standard, broadly visualizes cerebral blood flow, potentially masking key details in areas. This study introduces an approach integrating a 3D vascular atlas with 2D DSA images to allow targeted quantitative analysis in these crucial regions, thus enhancing diagnostic accuracy during interventions. Initially, DSA data was examined to ascertain the injection site. Following this, the appropriate viewing angle was determined to align accurately with the 3D vascular atlas. Utilizing this atlas, regions corresponding to the areas indicated as perfused were selected. Concurrently, a mask representing the perfused areas was created from the DSA sequence. This mask facilitated the initial coarse alignment of the projected 3D atlas to the DSA perfused territory deformable registration techniques, ensuring a precise overlay with the DSAs perfused territories. The performance of each overlay was measured using the Structural Similarity Index Measure (SSIM). The coregistration process revealed that deformable registrations was essential to achieve precise overlays of the 3D atlas projections with the 2D DSA perfused areas. This approach enabled the extraction of targeted quantitative angiography parameters, essential for detailed vascular assessment in subarachnoid hemorrhage cases. The integration of 3D atlas registration with 2D DSA projections facilitates a more precise and targeted diagnostic process for SAH during critical interventions. This image processing strategy enhances the visualization of affected arterial territories, potentially improving the accuracy of diagnostics and supporting better informed clinical decisions at the time of intervention