Attention on the Wires (AttWire): A Foundation Model for Detecting Devices and Catheters in X-ray Fluoroscopic Images

Objective: Interventional devices, catheters and insertable imaging devices such as transesophageal echo (TOE) probes are routinely used in minimally invasive cardiovascular procedures. Detecting their positions and orientations in X-ray fluoroscopic images is important for many clinical applications. Method: In this paper, a novel attention mechanism was designed to guide a convolution neural network (CNN) model to the areas of wires in X-ray images, as nearly all interventional devices and catheters used in cardiovascular procedures contain wires. The attention mechanism includes multi-scale Gaussian derivative filters and a dot-product-based attention layer. By utilizing the proposed attention mechanism, a lightweight foundation model can be created to detect multiple objects simultaneously with higher precision and real-time speed. Results: The proposed model was trained and tested on a total of 12,438 X-ray images. An accuracy of 0.88 was achieved for detecting an echo probe and 0.87 for detecting an artificial valve at 58 FPS. The accuracy was measured by intersection-over-union (IoU). We also achieved a 99.8% success rate in detecting a 10-electrode catheter and a 97.8% success rate in detecting an ablation catheter. Conclusion: Our detection foundation model can simultaneously detect and identify both interventional devices and flexible catheters in real-time X-ray fluoroscopic images. Significance: The proposed model employs a novel attention mechanism to achieve high-performance object detection, making it suitable for various clinical applications and robotic-assisted surgeries. Codes are available at https://github.com/YingLiangMa/AttWire.