The rise in number of fluoroscopy-guided procedures has prompted strategies for radiation management in order to minimize exposure to ionizing radiation in patients and healthcare personnel. The FluoroShield system utilizes an artificial intelligence (AI) approach towards radiation exposure reduction. The system automatically tracks the region of interest (ROI) in real-time, controls a rapid lead shutter for collimating the X-ray beam to the ROI, and blends the imaged ROI with the entire field of view that is updated at a lower frame rate to present, at all times, a full image to the operator. In this work, we discuss the AI-based component of the system that is used for tracking the ROI in endoscopic procedures. Known as the auto-ROI processor (ARP), the methodology comprises a merged architecture of convolutional neural networks for object detection that allows for both fine and contextual features to be captured. The detection probabilities are incorporated within a particle filtering framework for spatial and temporal updating of the ROI in a Bayesian approach. The ARP's performance is evaluated on fluoroscopic sequences, taking into consideration the estimated radiation reduction rates. The reduction in radiation exposure based on simulations is comparable to the reported values in a clinical study.
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