Method for visually supporting an invasive examination or therapy of the heart with the aid of an invasive instrument

• US 20070083108A1
• Filed: 09/21/2006
• Published: 04/12/2007
• Est. Priority Date: 09/21/2005
• Status: Active Grant

• Current Assignee: Siemens Healthineers AG (Siemens AG)
• Original Assignee: Siemens AG
• Inventors: Rahn, Norbert, Boese, Jan
• Granted Patent: US 8,583,214 B2
• Time in Patent Office: Days
• US Class Current: 600/426
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/543 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

To visually support a catheter ablation in the heart, three-dimensional image data have been used prior to the intervention. During ablation, the position of the catheter is pinpointed by an orientation system. The orientation system acquires electroanatomical 3D mapping data. the two-dimensional image data is assigned to the 3D mapping data in the correct position and dimensions which is a time-consuming step. The invention makes provision for the orientation system being in a fixed location relative to the X-ray system so that a positionally and dimensionally correct alignment of the X-ray image data set with the 3D mapping data is no longer required. An image or surface based 3D-3D alignment of the three-dimensional data acquired prior to the intervention with the three-dimensional X-ray image data is considerably less time-consuming than alignment thereof with the 3D mapping data and is more reliable because more structures is recognized in the three-dimensional X-ray image data.

Claims

1-9. -9. (canceled)

10. A method for displaying an invasive instrument during an invasive examination of a heart of a patient, comprising:

providing an X-ray system;

arranging an orientation system for the invasive instrument in a fixed location relative to the X-ray system, the orientation system;

transmitting a radio waves from a transmitter affixed to the X-ray system,

receiving the radio wave from a receiver affixed to the invasive instrument,

determining a position of the invasive instrument relative to the transmitter without a registration relative to the X-ray system;

generating a three-dimensional X-ray image data set of the heart with the X-ray image;

determining a coordinate of the invasive instrument relative to a coordinate of the X-ray system via the orientation system; and

displaying the three-dimensional X-ray image data set with the invasive instrument being visible in the X-ray image data set on a screen.

11. The method as claimed in claim 10, wherein the invasive instrument is displayed as a symbolic image of the invasive instrument.

12. The method as claimed in claim 10, wherein the three-dimensional X-ray image data set is viewed through the invasive instrument.

13. The method as claimed in claim 10, wherein the steps of determining and displaying are repeated during the examination.

14. The method as claimed in claim 10, wherein the generating step is repeated during the examination.

15. The method as claimed in claim 10, wherein the three-dimensional X-ray image data set is generated using ECG gating.

16. The method as claimed in claim 15, wherein the three-dimensional X-ray image data set is aligned with a particular phase in a cardiac cycle and is displayed on the screen.

17. The method as claimed in claim 16, wherein a further three-dimensional X-ray image data set is generated with the X-ray system and aligned with a different phase in the cardiac cycle and displayed on the screen.

18. The method as claimed in claim 17, wherein the three-dimensional X-ray image data set and the further three-dimensional X-ray image data set are spatially or temporally combined to a unified image data and the unified image data is displayed on the screen.

19. The method as claimed in claim 10, wherein a three-dimensional pre-operative image data set is acquired prior to the examination by an image system that is different from the X-ray system.

20. The method as claimed in claim 19, wherein the pre-operative image data set is aligned with the X-ray image data set in a correct position and dimension based on a position of the invasive instrument in a coordinate of the pre-operative image data set.

21. The method as claimed in claim 20, wherein the pre-operative image data set is displayed on the screen with the invasive instrument represented by a symbolic image.

22. The method as claimed in claim 21, wherein the pre-operative image data set is viewed on the screen through the invasive instrument.

23. The method as claimed in claim 19, wherein the pre-operative image data set is acquired by a system selected from the group consisting of:

a computer tomography system, a magnetic resonance imaging system, an ultrasound system, a positron emission tomography system, and a single positron emission computer tomography system.

24. The method as claimed in claim 19, wherein the pre-operative image data set is acquired using ECG gating and the X-ray image data set and the pre-operative image data set are aligned with an identical phase in a cardiac cycle.

25. The method as claimed in claim 10, wherein the invasive instrument comprises a measurement device which determines a cardiac signal and the cardiac signal is combined into an electro-anatomical map which is aligned with the orientation system and the map is displayed on the screen.

26. A method for displaying an invasive instrument during an invasive therapy of a heart of a patient, comprising:

providing an ultrasound image generation system comprising an ultrasound transducer and a radio receiver located on the ultrasound transducer to determine a position of the ultrasound transducer;

arranging an orientation system, the orientation system;

transmitting a signal from a radio transmitter of the ultrasound generation system,

receiving the signal from another receiver affixed to the invasive instrument;

inserting the ultrasound transducer into the patient;

generating a three-dimensional ultrasound image data set of the patient;

inserting the invasive instrument into the patient;

determining a coordinate of the invasive instrument relative to a coordinate of the ultrasound image generation system by the orientation system without a registration; and

displaying the three-dimensional ultrasound image data set with the invasive instrument being visible in the three-dimensional ultrasound image data set on a screen.

27. The method as claimed in claim 26, wherein the orientation system comprises a further radio transmitter located in a fixed position relative to the radio transmitter of the ultrasound generation system.

28. The method as claimed in claim 26, wherein the invasive instrument comprises a measuring device for an electrophysiological detection of a cardiac signal and the cardiac signal is combined into an electroanatomical map with a coordinate permanently aligned with the orientation system and the map is superimposed and displayed.

29. A device for displaying an invasive instrument during an invasive therapy of a patient, comprising:

an image generating system which generates a three-dimensional image data set of the patient;

an orientation system for the invasive instrument in a fixed location relative to the image generating system, the orientation system comprising;

a transmitter affixed to the image generating system which transmits a wave signal,

a receiver affixed to the invasive instrument which receives the radio wave,

a processing unit which determines a coordinate of the invasive instrument relative to a coordinate of the image generation system without a registration; and

a display unit which displays the three-dimensional image data set with the invasive instrument being visible in the three-dimensional image data set.