Guidance system for localization and cannulation of the coronary sinus

• US 10,004,467 B2
• Filed: 04/25/2014
• Issued: 06/26/2018
• Est. Priority Date: 04/25/2014
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Lahm, Ryan P., Drake, Ronald Alan, Schilling, Eric A., Schousek, Brian W., Shepler, Mark W., Stener, Lester O.
• Primary Examiner(s): FERNANDEZ, KATHERINE L
• Application Number:
  US14/261,990
• Publication Number:
  US 20150305695A1
• Time in Patent Office: 1,523 Days
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/462 characterised by constructional features of the display
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/5211 involving processing of medical diagnostic data
• CPC Class Codes: A61B 6/5294 involving using additional data, e.g. patient information, image labeling, acquisition parameters
• CPC Class Codes: G06T 2207/10121 Fluoroscopy
• CPC Class Codes: G06T 2207/30048 Heart; Cardiac
• CPC Class Codes: G06T 2207/30101 Blood vessel; Artery; Vein; Vascular
• CPC Class Codes: G06T 7/0014 using an image reference approach
• CPC Class Codes: G06T 7/74 involving reference images or patches
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A high contrast instrument, such as a radiopaque portion, can be captured and/or viewed in an image that is acquired with an imaging system, such as with a fluoroscopic imaging system. A statistical model can be used to assist in identifying a possible or probable location of a target. A user may move the instrument coil to the statistically probable location of the target to, for example, perform a procedure or carry out a task.

Claims

1. A method for moving an instrument to a selected location, comprising:

determining an orientation of an imageable member based on an analysis of a region of interest in an image including the imageable member associated with the instrument;

recalling a probable location of an ostium based upon a predetermined triangulated location of the ostium from selected landmarks in the image;

displaying on a display device a target icon at the recalled probable location of the ostium;

displaying on the display device the imageable member relative to the displayed target icon with the determined orientation of the imageable member;

moving the instrument relative to the ostium based on the determined orientation of the imageable member and the displayed target icon;

receiving image data of the imageable member, wherein the image data may be used to generate the image for display; and

executing instructions with a processor to perform the analysis of the region of interest in the image;

wherein executing instructions with a processor to perform the analysis of the region of interest in the image includes;

determining a center longitudinal line along a distal portion of the imageable member;

determining a first line extending substantially parallel to and on a first side of the center longitudinal line;

determining a second line extending substantially parallel to and on a second side of the center longitudinal line;

determining a first period length of high contrast portions intersecting the first line along its length; and

determining a second period length of high contrast portions intersecting the second line along its length;

wherein the orientation of the imageable member is determined by evaluating at least one of the first period length or the second period length relative to a recalled manufacturer period length, an assumed period length, a maximum period length, or a calculation of an arc cosine within the region of interest.

2. A method for moving an instrument to a selected location, comprising:

analyzing a region of interest in an image to determine an orientation of an imageable member, wherein the image is a single image including the imageable member associated with the instrument, wherein the imageable member is a helical member wrapped around a longitudinal axis of the elongated member;

recalling a probable location of a target in the single image based upon a predetermined triangulated location of the target from selected landmarks in the single image;

displaying on a display device a target icon at the recalled probable location of the target on the single image;

displaying on the display device the helical member relative to the displayed target icon with the determined orientation of the imageable member; and

determining the region of interest in the single image based upon movement of the helical member between a prior image and the single image;

wherein analyzing the region of interest in the single image to determine the orientation of the imageable member includes;

determining a center longitudinal line along a distal portion of the helical member;

determining a first line extending substantially parallel to and on a first side of the center longitudinal line;

determining a second line extending substantially parallel to and on a second side of the center longitudinal line;

determining a first period of high contrast portions intersecting the first line along its length;

determining a second period of high contrast portions intersecting the second line along its length; and

evaluating the first period and the second period to determine the orientation of the imageable member;

wherein the instrument is configured to be moved within a volume relative to the target with the helical member wrapped around the instrument.

3. The method of claim 2, wherein analyzing the region of interest in the single image includes:

determining a period length of a coil portion of the helical member to determine an angle of the helical member, wherein the angle of the helical member is between a first portion and a second portion of the helical member;

analyzing a shape of the helical member in the single image to determine a direction of the helical member relative to the plane of the single image; and

combine the determined angle and the determined direction to determine the orientation of the helical member as a combination of the determined angle and the determined direction.

4. The method of claim 2, wherein displaying on the display device the helical member includes displaying on the display device the imageable member as at least as one of a “

n”

shape or a “

u”

shape.

5. The method of claim 4, wherein analyzing the region of interest in the single image to determine the orientation of the imageable member further includes includes determining whether the imageable member is imaged as a “

n”

shape or a “

u”

shape.

6. The method of claim 2, further comprising:

determining a movement of the instrument relative to an ostium based on the determined orientation of the imageable member and the displayed target icon.

7. The method of claim 2, further comprising:

configuring the instrument to be moved in a determined movement relative to an ostium based on the determined orientation of the imageable member and the displayed target icon.

8. The method of claim 2, further comprising:

receiving the selected landmarks as at least a first landmark location and a second landmark location.

9. The method of claim 8, wherein receiving the selected landmarks includes receiving a manual input from a user.

10. The method of claim 2, further comprising:

determining the region of interest in the image by identifying a moving object in a plurality of images including the single image.

11. The method of claim 10, further comprising:

selecting at least a portion of the identified moving object as the region of interest.

12. The method of claim 2, further comprising:

displaying an imageable member icon representative of a first determined orientation of the imageable member at a first time relative to a displayed current determined orientation of the imageable member at a second time that is after the first time.

13. The method of claim 2, further comprising:

receiving image data of the imageable member; and

wherein the received image data may be used to generate the image.

14. The method of claim 2, wherein determining the region of interest in the single image based upon movement of the helical member between the prior image and the single image comprises analyzing radiopaque properties of the helical member in the region of interest.

15. The method of claim 14, further comprising:

recalling from a memory system the radiopaque properties.

16. A method for moving an instrument to a selected location, comprising:

determining an orientation of an imageable member based on an analysis of a region of interest in an image including the imageable member associated with the instrument, wherein the image is a single image;

recalling a probable location of an ostium based upon a predetermined triangulated location of the ostium from selected landmarks in the image;

displaying on a display device a target icon at the recalled probable location of the ostium;

displaying on the display device the imageable member relative to the displayed target icon with the determined orientation of the imageable member at least as one of a “

n”

shape or a “

u”

shape for viewing by a user; and

wherein the instrument is configured to be moved relative to the ostium;

wherein the imageable member is a helix coil;

wherein determining the orientation of the helix coil is based on the analysis of the region of interest in the image including the helix coil including;

determining a period length of helix coil to determine an angle of the helix coil, wherein the angle of the helix coil is between a first portion and a second portion of the helix coil;

analyzing a shape of the helix coil in the image to determine a direction of the helix coil relative to a plane of the image; and

combining the determined angle and the determined direction to determine the orientation of the helix coil as a combination of the determined angle and the determined direction.

17. A method for moving an instrument to a selected location, comprising:

determining an orientation of an imageable member based on an analysis of a region of interest in an image including the imageable member associated with the instrument, wherein the image is a single image;

recalling a probable location of an ostium based upon a predetermined triangulated location of the ostium from selected landmarks in the image, displaying on a display device a target icon at the recalled probable location of the ostium;

displaying on the display device the imageable member relative to the displayed target icon with the determined orientation of the imageable member at least as one of a “

n”

shape or a “

u”

shape for viewing by a user; and

providing the imageable member as a helix coil;

wherein the instrument is configured to be moved by the user relative to the ostium;

wherein determining the orientation of the imageable member includes;

determining a center longitudinal line along a distal portion of the helix coil;

determining at least one of a first line extending substantially parallel to and on a first side of the center longitudinal line or a second line extending substantially parallel to and on a second side of the center longitudinal line;

determining at least one of a first period length of high contrast portions of the helix coil intersecting the first line along its length or determining a second period length of high contrast portions of the helix coil intersecting the second line along its length; and

calculating an angle of the helix coil based on the determined first period length or the second period length for determining the orientation of the imageable marker.

18. A method for moving an instrument to a selected location, comprising:

determining an orientation of an imageable member based on an analysis of a region of interest in an image including the imageable member associated with the instrument, wherein the image is a single image;

recalling a probable location of an ostium based upon a predetermined triangulated location of the ostium from selected landmarks in the image;

displaying on a display device a target icon at the recalled probable location of the ostium;

displaying on the display device the imageable member relative to the displayed target icon with the determined orientation of the imageable member at least as one of a “

n”

shape or a “

u”

shape for viewing by a user; and

wherein the instrument is configured to be moved by the user relative to the ostium;

wherein determining the orientation of the imageable member based on the analysis of the region of interest in the image includes determining whether the imageable member is imaged as a “

n”

shape or a “

u”

shape.

19. The method of claim 18, further comprising providing the imageable member as a helical member.