Vision-based position and orientation determination for endovascular tools

A computer-implemented system comprising at least one processor and at least one electronic storage medium, the electronic storage medium storing instructions configured to cause the at least one processor to:

• receive, from a medical imaging device, a two-dimensional medical image, wherein the two-dimensional medical images comprises a fluoroscopic image and includes a view of at least a distal portion of a medical instrument, the distal portion of the medical instrument including one or more fiducials positioned thereon, the one or more fiducials being radio-opaque and visible in the two-dimensional medical image, wherein the one or more fiducials are configured to provide a unique two-dimensional appearance, when viewed in the two-dimensional medical image, at all roll angles of the medical instrument relative to a longitudinal axis of the medical instrument and incline angles less than 90 degrees relative to an image plane of the two-dimensional medical image;
• detect, within the two-dimensional medical image, the unique two-dimensional appearance of the one or more fiducials;
• based on the unique two-dimensional appearance of the one or more fiducials, determine:
• a roll angle of the distal portion of the medical instrument about the longitudinal axis of medical instrument, and
• an incline of the distal portion of the medical instrument relative to the plane of the two-dimensional medical image, wherein the incline includes a sign of the incline;
• and
• based on the roll angle and the incline, generate one or more motor commands configured to cause a robotic system coupled to the medical instrument to move the medical instrument;
• and
• cause the robotic system to move the medical instrument based on the one or more motor commands.