Systems and methods for determining a rotational orientation of a lead for use in electrostimulation of a body tissue are disclosed. A system may receive image data of at least a portion of the lead including image data of a marker configured to identify a rotational orientation of the lead. The system may receive at least one template of the lead having a specified rotational orientation. Each template may include a reference data cube and a reference marker direction vector. The system may generate a target data cube of the marker using the image data of the marker, and register the reference data cube to the target data cube to produce a transformation operator. The system may estimate the rotational orientation of the lead using the reference marker direction vector and the determined transformation operator.
