A method for identifying a rotational orientation of a lead includes obtaining a radiological image of the lead having a lead body, a distal tip, electrodes, and an asymmetric marker, where the lead defines a lead axis along the portion of the lead extending from the distal tip and including the electrodes and the asymmetric marker； determining, using the set of lead slices and the set of marker slices, a direction vector extending from an estimated lead axis and passing through a determined center of weighted mass of the lead； and providing an indication of a direction of the direction vector on a display.
