Although robot-assisted cardiovascular catheterization is commonly performed for intervention of cardiovascular diseases, more studies are needed to support the procedure with automated tool segmentation. This can aid surgeons on tool tracking and visualization during intervention. Learning-based segmentation has recently offered state-of-the-art segmentation performances however, generating ground-truth signals for fully-supervised methods is labor-intensive and time consuming for the interventionists. In this study, a weakly-supervised learning method with multi-lateral pseudo labeling is proposed for tool segmentation in cardiac angiograms. The method includes a modified U-Net model with one encoder and multiple lateral-branched decoders that produce pseudo labels as supervision signals under different perturbation. The pseudo labels are self-generated through a mixed loss function and shared consistency in the decoders. We trained the model end-to-end with weakly-annotated data obtained during robotic cardiac catheterization. Experiments with the proposed model shows weakly annotated data has closer performance to when fully annotated data is used. Compared to three existing weakly-supervised methods, our approach yielded higher segmentation performance across three different cardiac angiogram data. With ablation study, we showed consistent performance under different parameters. Thus, we offer a less expensive method for real-time tool segmentation and tracking during robot-assisted cardiac catheterization.
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