A medical instrument system includes an elongate flexible instrument body with an optical fiber substantially encapsulated in a wall of the instrument body, the optical fiber including one or more fiber gratings. A detector is operatively coupled to the optical fiber and configured to detect respective light signals reflected by the one or more fiber gratings. A controller is operatively coupled to the detector, and configured to determine a twist of at least a portion of the instrument body based on detected reflected light signals. The instrument may be a guide catheter and may be robotically or manually controlled.