Generative AI Pipeline for Interactive Prompt-driven 2D-to-3D Vascular Reconstruction for Fontan Geometries from Contrast-Enhanced X-Ray Fluoroscopy Imaging

• URL: http://arxiv.org/abs/2509.13372v1
• Date: Tue, 16 Sep 2025 04:47:25 GMT
• Title: Generative AI Pipeline for Interactive Prompt-driven 2D-to-3D Vascular Reconstruction for Fontan Geometries from Contrast-Enhanced X-Ray Fluoroscopy Imaging
• Authors: Prahlad G Menon,
• Abstract summary: Current assessment of Fontan palliation relies on fluoroscopic angiography.<n>A multi-step AI pipeline was developed for systematic, iterative processing of fluoroscopic angiograms.<n>The pipeline successfully generated geometrically optimized 2D projections from single-view angiograms.
• Score: 0.0
• License: http://creativecommons.org/licenses/by-nc-sa/4.0/
• Abstract: Fontan palliation for univentricular congenital heart disease progresses to hemodynamic failure with complex flow patterns poorly characterized by conventional 2D imaging. Current assessment relies on fluoroscopic angiography, providing limited 3D geometric information essential for computational fluid dynamics (CFD) analysis and surgical planning. A multi-step AI pipeline was developed utilizing Google's Gemini 2.5 Flash (2.5B parameters) for systematic, iterative processing of fluoroscopic angiograms through transformer-based neural architecture. The pipeline encompasses medical image preprocessing, vascular segmentation, contrast enhancement, artifact removal, and virtual hemodynamic flow visualization within 2D projections. Final views were processed through Tencent's Hunyuan3D-2mini (384M parameters) for stereolithography file generation. The pipeline successfully generated geometrically optimized 2D projections from single-view angiograms after 16 processing steps using a custom web interface. Initial iterations contained hallucinated vascular features requiring iterative refinement to achieve anatomically faithful representations. Final projections demonstrated accurate preservation of complex Fontan geometry with enhanced contrast suitable for 3D conversion. AI-generated virtual flow visualization identified stagnation zones in central connections and flow patterns in branch arteries. Complete processing required under 15 minutes with second-level API response times. This approach demonstrates clinical feasibility of generating CFD-suitable geometries from routine angiographic data, enabling 3D generation and rapid virtual flow visualization for cursory insights prior to full CFD simulation. While requiring refinement cycles for accuracy, this establishes foundation for democratizing advanced geometric and hemodynamic analysis using readily available imaging data.

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