MRI-GUIDED INTERVENTIONAL SYSTEMS THAT CAN TRACK AND GENERATE DYNAMIC VISUALIZATIONS OF FLEXIBLE INTRABODY DEVICES IN NEAR REAL TIME

• US 20100312096A1
• Filed: 06/08/2010
• Published: 12/09/2010
• Est. Priority Date: 06/08/2009
• Status: Active Grant

• Current Assignee: Clearpoint Neuro, Inc.
• Original Assignee: MRI Interventions, Inc. (Clearpoint Neuro, Inc.)
• Inventors: Guttman, Michael, Vij, Kamal, Jenkins, Kimble L., Piferi, Peter
• Granted Patent: US 9,439,735 B2
• Time in Patent Office: Days
• US Class Current: 600/411
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 lymph vessels, ducts or nodes

Abstract

MRI guided cardiac interventional systems are configured to generate dynamic (interactive) visualizations of patient anatomy and medical devices during an MRI-guided procedure and may also include at least one user selectable 3-D volumetric (tissue characterization) map of target anatomy, e.g., a defined portion of the heart.

Claims

1. An MRI-guided cardiac interventional system, comprising:

a circuit configured to;

(a) generate near real time (RT) MRI images of at least a portion of a heart of a patient using relevant anatomical scan planes associated with a 3-D MRI image space having a coordinate system;

(b) identify coordinates in the MRI image space coordinate system associated with a location of at least a distal portion of at least one flexible intrabody catheter in the 3-D MRI image space using tracking coil data from at least one tracking coil on a distal end portion of the catheter; and

(c) render interactive near RT visualizations of at least a distal end portion of the at least one flexible catheter in the 3-D image space with a three-dimensional physical representation, wherein the at least one flexible catheter is not required to be in any of the relevant anatomical scan planes used to obtain MR data for the near RT MRI images.

2. The system of claim 1, wherein the circuit is further configured to provide a window on a display of a catheter tip-tissue interface associated with the at least one flexible catheter, the window providing near real-time high resolution MRI images separate from the visualizations, and wherein the visualizations are provided in an adjacent separate window on the display.

3. The system of claim 1, wherein the circuit is further configured to provide a patient planning map with at least one target treatment site identified thereon registered to the 3-D MRI image space.

4. The system of claim 3, wherein the circuit is in communication with a display with a User Interface that allows a user to select whether to show the at least one target treatment site in the visualizations so that:

(i) the at least one treatment site is shown with the near RT MRI images without a model or with the model faded relative to the at least one treatment site and near RT MRI images;

or (ii) the at least one treatment site is shown with the planning map or other registered patient model and with the near RT MRI images.

5. The system of claim 1, wherein the at least one flexible catheters comprises a flexible catheter with a tip end with at least two spaced apart tracking coils residing a distance rearward of the tip on the distal end portion of the catheter, and wherein the circuit is configured to calculate a position of the tip of the catheter in the 3-D imaging space using the tracking coil signal data from the tracking coils and generate the physical representation of at least the distal end portion of the catheter in the visualizations based on at least one of the following:

(i) known or predictable shape variation of the distal end portion of the at least one flexible catheter; and

(ii) a spatial relationship of the tracking coils with respect to each other and/or a tip of the at least one catheter.

6. The system of claim 1, wherein the at least one flexible catheter comprises a plurality of axially spaced apart tracking coils on the distal end portion, each tracking coil connected to a different channel of an MRI Scanner, wherein the circuit is in communication with and/or integral with the MRI Scanner, and wherein the MRI Scanner substantially continuously interleaves obtaining tracking coil data with image data to generate the interactive visualizations with the physical representations of at least the distal end portion of the at least one catheter.

7. The system of claim 1, wherein the circuit is configured to render the visualizations to show the distal end portion of the at least one catheter in the 3-D imaging space by calculating a location of each of the tracking coils in the 3-D imaging space and determining a shape and orientation of the distal end portion of the catheter based on the tracking coil data and pre-defined configuration data of the distal end portion of the catheter.

8. The system of claim 1, wherein the circuit is in communication with at least one display with a User Interface, and wherein the User Interface is configured to allow a user to selectively fade and/or turn on and off tissue characterization or electroanatomical data in at least one visualization either or both:

(a) on a three dimensional pre-acquired model of a patient'"'"'s heart in the visualizations, the model shown in and/or registered to the 3-D imaging space; and

/or (b) in the near RT MR images without the pre-acquired model.

9. The system of claim 1, wherein the circuit is in communication with at least one display with a User Interface, and wherein the User Interface is configured to allow a user to (i) selectively fade and/or turn on and off tissue characterization data or electroanatomical data in the visualizations and (ii) to show the tissue and/or electroanatomical data only with the near RT MRI images in the visualizations or with a model and the near RT MRI images in the visualizations.

10. The system of claim 1, wherein the physical representation is substantially a replica representation of an actual physical configuration of at least a distal end portion of the at least one catheter.

11. The system of claim 1, wherein the circuit is configured to present a 3-D volumetric model of at least a portion of the patient'"'"'s heart in the rendered visualizations with the model registered to the 3-D imaging space along with the physical representation of at least the distal end portion of the at least one catheter in the 3-D imaging space.

12. The system of claim 11, wherein the circuit is in communication with a display and a User Interface, the User Interface configured to allow a user to alter a displayed visualization to include only a near RT image of the anatomy, to include the near RT image of the anatomy and the registered model of the heart, or to include only the registered model of the heart.

13. The system of claim 1, wherein the circuit is configured to render the visualizations to show a tip location of the at least one catheter with a first three-dimensional shape and to show each tracking coil on the distal end portion with a second different three dimensional shape or shapes and a color, with each tracking coil having a respective different color from the other tracking coils, and to render the visualizations and to include a line or spline connecting the tip and the coil shapes.

14. The system of claim 1, wherein the circuit is configured to generate the visualizations with at least two visual reference planes that are oblique or orthogonal to each other.

15. The system of claim 14, the circuit is in communication with a display having a User Interface, and wherein the two planes are transparent and/or translucent with different color perimeters and can move relative to the model and/or locked to the model, and wherein the User Interface is configured to allow a user to rotate the model and move the reference planes to change the view of anatomy shown in the visualization.

16. The system of claim 1, wherein the circuit is in communication with a display and a User Interface, the User Interface configured to allow a user to fade the rendered at least one catheter in the visualizations to show a near real-time MR image of the at least one catheter.

17. The system of claim 1, wherein the circuit is configured to show a volumetric patient anatomical model of at least a portion of the heart and at least two orthogonal or oblique intersecting reference planes in the image space in the visualizations, the reference planes intersecting and extending across the patient model and the near RT MRI images of local tissue, wherein the reference planes align with the anatomical scan planes.

18. The system of claim 11, wherein the circuit is configured to show the model in the visualizations in one of a plurality of different selectable ways including at least two of:

a cutaway, wireframe, translucent, color-coded or opaque configuration, according to user input using a User Interface.

19. The system of claim 1, wherein the circuit is configured to allow a user to manipulate the visualizations using a User Interface in communication with a display including to:

rotate, crop or zoom the model in a respective visualization, and wherein the circuit automatically selects anatomically relevant scan planes to obtain MR image data in response thereto.

20. The system of claim 1, wherein one of the at least one flexible catheter is a therapeutic catheter including at least one of an injection or ablation catheter with a catheter tip portion, the circuit in communication with at least one display, wherein the at least one display comprises a close-up viewing window to show lesion forming or injection delivery, wherein the circuit automatically electronically directs a MRI Scanner to obtain image slices using scan planes that are based on a known position of the catheter tip portion, and wherein at least some of the images in the close-up viewing window are generated using high-resolution MR image data.

21. The system of claim 1, further comprising a display with a User Interface UI), and wherein the UI is configured to allow a user to select a dimensional offset of between about 0-5 mm for an image scan plane that is projected forward a distance relative to the distal end portion and/or tip of the flexible catheter identified using the tracking coil signal data, wherein the circuit calculates a catheter-tissue interface location of at least one of the at least one flexible catheters in the MRI three dimensional image space and uses the calculated interface location and the selected offset to automatically define at least one scan plane used to obtain the near real time MR image data.

22. The system of claim 1, wherein the at least one flexible catheter comprises an injection or ablation catheter, and wherein the circuit calculates a scan plane location for an en face view at a catheter-tissue interface location of the catheter in the three dimensional image space that is projected catheter to be substantially parallel to tissue proximate the catheter-tissue interface, and wherein the calculated scan plane location is used to obtain the near real time MR image data during and/or proximate in time to an injection or ablation using the at least one catheter.

23. The system of claim 1, wherein the circuit is configured to direct a Scanner to snap-to a projected tissue-device interface to use at least one scan plane to obtain near real time image data of the tissue-device interface based on a known spatial relationship between at least two tracking coils on a distal end of the flexible catheter.

24. The system of claim 1, wherein the circuit is in communication with a display with a User Interface, and wherein the User Interface is configured to allow a user to select different pre-acquired and/or in situ generated maps including at least two of the following for presentation of the selected map or data associated therewith on the at least one display, registered to or spatially aligned with the 3-D MRI image space:

a thermal tissue characterization map;

an edema tissue characterization map;

a first delayed enhancement tissue characterization map;

a second delayed enhancement tissue characterization map taken after the first delayed enhancement tissue characterization map;

a hypoxic tissue characterization map;

a vasculature tissue characteristic map;

a fibrous tissue characteristic map;

an ischemic tissue characterization map;

a fluid distribution map;

a light exposure map; and

an electroanatomical map.

25. An MRI guided system, comprising:

at least one flexible intrabody therapeutic or diagnostic medical device configured to be introduced into a patient via a tortuous and/or natural lumen path, the at least one medical device having at least one tracking coil that is connected to a channel of the MRI scanner;

a circuit adapted to communicate with and/or reside in an MRI Scanner, the circuit configured to;

(a) obtain MR image data and generate a series of near real time (RT) MRI images of target anatomy of a patient during a surgical procedure using relevant anatomical scan planes associated with a 3-D MRI image space of the MRI Scanner, the 3-D MRI image space having a coordinate system;

(b) identify a location of at least a distal end portion of the flexible intrabody medical device in the coordinate system of the 3-D MRI image space using tracking coil signal data from the at least one tracking coil; and

(c) render near RT interactive visualizations of the at least one flexible medical device in the 3-D image space with near RT image data of target patient anatomical structure and a registered pre-acquired first volumetric model of the target anatomical structure of the patient, wherein the circuit illustrates the at least one flexible medical device with a physical representation in the visualizations; and

a display with a User Interface in communication with the circuit configured to display the visualizations during an MRI guided interventional procedure, wherein the User Interface is configured to allow a user to (a) rotate the visualizations and (b) alter a displayed visualization to include only a near RT image of the target anatomy, to include the near RT image of the anatomy and the registered model of the anatomical structure, or to include only the registered model of the anatomical structure,

wherein the MRI Scanner is configured to interleave signal acquisition of image data with signal acquisition of tracking coil signals from the at least one tracking coil, and wherein the circuit is configured to electronically track the at least one flexible medical device in the 3-D image space using the tracking coil signals independent of scan planes used to obtain the MR image data so that the at least one flexible device is not required to be in any of the relevant anatomical scan planes used to obtain MR image data for the near RT MRI images.

26. The system of claim 25, wherein the circuit is configured to calculate a device-tissue interface location proximate a tip location of the device in the three dimensional image space, and wherein the calculated tissue interface location is used to direct the Scanner to automatically define at least one scan plane used to obtain the MR image data during and/or proximate in time to delivery of a therapeutic treatment and/or a diagnostic procedure.

27. The system of claim 25, wherein the circuit is further configured to include a visualization with at least one tissue characteristic map either in lieu of the first volumetric model, overlaid on the first volumetric model, or integrated into the first volumetric model to form a composite model.

28. The system of claim 27, wherein the system is a cardiac system, and wherein the tissue characterization map data is color-coded to show either lesions associated with ablation sites created during a cardiac procedure or injection sites and associated fluid distribution from the injections during a cardiac procedure.

29. The system of claim 27, wherein the system is a cardiac system, and wherein the tissue characterization map or data therefrom is configured to show lesion formation proximate a pulmonary vein so that a clinician can evaluate whether an ablation therapy carried out using the at least one flexible catheter has electrically isolated a pulmonary vein.

30. The system of claim 27, wherein the system is a cardiac system, and wherein the tissue characterization map or data therefrom is configured to show fluid distribution in cardiac tissue so that a clinician can evaluate whether injections of a therapeutic using the at least one flexible catheter has generated a desired fluid distribution in cardiac tissue.

31. The system of claim 25, wherein the circuit is configured to display an electroanatomical (EA) map as the first volumetric model, the EA map imported from a different imaging modality and/or generated from MRI data in the 3-D MRI image space using a mapping catheter with tracking coils.

32. The system of claim 25, wherein the User Interface is configured to allow a user to selectively fade and/or turn at least one tissue characterization map or data therefrom on and off so that the map or data is shown or not shown in the visualizations on the display.

33. The system of claim 32, wherein the at least one tissue characterization map includes at least two of the following:

a thermal tissue characterization map;

an edema tissue characterization map;

a first delayed enhancement tissue characterization map;

a second delayed enhancement tissue characterization map taken after the first delayed enhancement tissue characterization map;

a hypoxic tissue characterization map;

a vasculature map;

a fibrous tissue map;

an ischemic tissue characterization map;

a fluid distribution map; and

a light exposure map.

34. The system of claim 25, wherein the circuit is configured to allow a user via the User Interface to selectively fade and/or turn on and off tissue characterization data and/or electroanatomical data in the visualizations.

35. The system of claim 34, wherein the circuit is configured to allow a user via the User Interface to selectively fade and/or turn on and off data in the visualizations so that the display shows the tissue characterization or electroanatomical data:

(a) on the registered model in the visualizations;

or (b) in the near RT MR images alone without the first pre-acquired model or any other model.

36. The system of claim 25, wherein the circuit is configured to accept user input via the User Interface to selectively fade and/or turn on and off visual indications of target treatment sites in the visualizations.

37. The system of claim 25, wherein the circuit is configured to accept user input via the UI to selectively show on the display the target treatment sites in the visualizations as either:

(a) target treatment sites on the registered first pre-acquired model with the near RT MRI images;

or (b) in the near RT MR images without the registered first pre-acquired model.

38. The system of claim 25, wherein the at least one tracking coil comprises a plurality of spaced apart tracking coils, and wherein the circuit is configured to direct a Scanner to snap-to a projected tissue-device interface to use at least one scan plane to obtain near real time image data of the tissue-device interface.

39. The system of claim 28, wherein the at least one tracking coil comprises at least three spaced apart tracking coils, with at least two of the tracking coils being closely spaced together in fixed relationship on a substantially rigid distal end portion of the flexible device, and wherein the circuit is configured to direct the Scanner to snap-to a projected tissue-device interface that is a distance of between about 0-4 mm beyond a calculated location of the tip to use at least one scan plane to obtain near real time image data of the tissue-device interface based on tracking coil signal data from only the two distal tracking coils and a known spatial relationship between the two tracking coils.

40. The system of claim 38, wherein the at least one flexible device includes at least one loop catheter with a distal loop end having a plurality of spaced apart tracking coils, and wherein the circuit is configured to direct the Scanner to snap-to a projected tissue-device interface calculated as a plane in 3-D image space proximate a projected plane defined by at least three points associated with three different tracking coils on the loop to obtain near real time image data of the tissue-device interface.

41. The system of claim 38, wherein the at least one tracking coil comprises at least three spaced apart tracking coils on a shaft of a bendable or deflectable catheter, and wherein the circuit is configured to direct the Scanner to snap-to a projected tissue-device interface that is tangent and substantially in-line with at least two of the tracking coils to obtain near real time image data of the tissue-device interface.

42. The system of claim 38, wherein the at least one tracking coil is a plurality of spaced apart tuned tracking coils, each connected to a tuning circuit with a diode at a proximal end of the device using respective coaxial cables, and wherein the coaxial cables each have an electrical length in the Scanner measured from the tracking coil to the diode that is about ¼

lambda or a higher odd harmonic thereof (¾

lambda, 5/4 lambda and the like), and wherein the circuit is configured to identify the location of the tracking coils with a precision of at least about 1 mm.

43. The system of claim 38, wherein the at least one tracking coil is a plurality of spaced apart tuned tracking coils that are connected to a diode at a proximal end of the device using respective coaxial cables, wherein the coaxial cables each have an electrical length in the Scanner measured from the tracking coil to the diode that is about ¼

lambda or a higher odd harmonic thereof (¾

lambda, 5/4 lambda and the like), and wherein the circuit is configured to obtain tracking coil signals from two adjacent tracking coils in a fixed spatial relationship with each other with respective tracking signals that define a substantially constant and correct physical offset distance.

44. An MRI guided cardiac intervention system, comprising:

an MR Scanner having a plurality of channels;

a plurality of flexible intrabody catheters, each having a plurality of tracking coils, each tracking coil of each catheter connected to a different MR Scanner channel; and

at least one display in communication with the MR Scanner,

wherein the MR Scanner is configured to;

(a) generate near real time (RT) MRI images of at least a portion of a heart of a patient using relevant anatomical scan planes associated with a 3-D MRI image space having a coordinate system;

(b) identify a location of at least a distal portion of the flexible intrabody catheters in the 3-D MRI image space using tracking coil signal data in the MRI image space coordinate system; and

(c) render dynamic near RT visualizations with physical representations of the flexible catheters in the 3-D image space with respect to a volumetric pre-acquired model of the patient'"'"'s heart registered to the imaging space with the near RT MRI images, wherein the flexible catheters are not required to be in any of the relevant anatomical scan planes used to obtain MR image data for the near RT MRI images.

45. A system according to claim 44, wherein the circuit is configured to show at least one of a plurality of user-selectable tissue characteristic maps or data associated therewith on or integrated into the model or show the selected tissue characteristic map in lieu of the model on the display, wherein the display is in communication with a User Interface that is configured to allow a user to selectively fade and/or turn one or more of the tissue characterization maps or data therefrom on and off, and wherein the tissue characteristic maps include a plurality of the following:

a thermal tissue characterization map;

an edema tissue characterization map;

a first delayed enhancement tissue characterization map;

a second delayed enhancement tissue characterization map taken after the first delayed enhancement tissue characterization map;

a hypoxic tissue characterization map;

a vasculature map;

a fibrous map;

an ischemic tissue characterization map;

a fluid distribution map; and

a light exposure map.

46. The system of claim 44, wherein the display is in communication with a User Interface that is configured to allow a user to electronically mark and/or select a target treatment site on the model and/or in a near RT MRI image and the circuit is configured to define relevant anatomical scan planes associated with a selected or marked site.

47. The system of claim 44, wherein the circuit is configured to allow a user via a User Interface in communication with the display to show an electroanatomical (EA) map as the volumetric model, the EA map imported from a different imaging modality and/or generated from MRI data.

48. The system of claim 44, wherein the circuit is configured to provide a patient planning map that is shown in the visualizations on the display aligned with or instead of the first volumetric map with at least one target treatment site identified thereon registered to the 3-D MRI image space.

49. The system of claim 44, wherein the display is in communication with a User Interface that allows a user to select whether to show a visual indication of at least one pre-identified target treatment site in the visualizations so that:

(i) the at least one treatment site is shown only with the near RT MRI images;

(ii) the at least one treatment site is shown in the near RT MRI images with the rendered at least one catheter and without a model;

or (iii) the at least one treatment site is shown with the planning map or other registered patient model and the near RT MRI images.

50. The system of claim 44, wherein the display is in communication with a User Interface, and wherein the User Interface is configured to allow a user to selectively fade and/or turn on and off tissue characterization and/or electroanatomical data in at least one visualization and to show such data either:

(a) on a three dimensional pre-acquired model of a patient'"'"'s heart in the visualizations, the model shown in and/or registered to the 3-D imaging space;

or (b) in the near RT MR images without the pre-acquired model.

51. The system of claim 44, wherein the display and circuit are in communication with a User Interface, the User Interface configured to allow a user to fade and/or turn on and off the rendered at least one catheter in the visualizations to show a near real-time MR image of the at least one catheter.

52. A method for carrying out an MRI-guided procedure, comprising:

introducing a flexible intrabody medical device into a natural lumen or cavity of a patient during an MRI-guided procedure;

electronically obtaining tracking signals from tracking coils connected to channels of an MR Scanner and attached to the flexible intrabody device during the MRI-guided procedure, wherein the intrabody device has a distal end portion that can take on a non-linear shape as it moves into position in the patient'"'"'s body;

electronically identifying X, Y, Z coordinate locations in 3-D MRI image space of each of the tracking coils using the tracking signals;

obtaining near RT MR image data of target anatomy of the patient during the MRI-guided procedure;

obtaining a pre-acquired 3-D volumetric model of the target anatomy of the patient and registering the model to the 3-D image space; and

generating visualizations of the medical device showing;

(i) the model of the patient'"'"'s anatomy;

(ii) a physical representation of at least a distal end portion of the medical device using the identified locations of the tracking coils; and

(iii) the near RT MR image data.

53. The method of claim 52, further comprising showing the tracking coils in the physical representation of the distal end portion of the medical device in the rendered visualizations in a three-dimensional shape or shapes and in different colors using the identified location of the tracking coils and defined form factor and/or dimensional data regarding actual coil configuration and placement on the device.

54. The method of claim 52, further comprising:

electronically calculating a device-tissue interface location proximate a tip or distal end location of the device in the three dimensional image space using the identified locations of the tracking coils; and

automatically defining at least one scan plane used to obtain the MR image data for the near RT images during and/or proximate in time to delivery of a therapeutic treatment and/or a diagnostic procedure using the device tip interface location.

55. The method of claim 52, further comprising electronically rotating the visualizations based on user input and electronically selectively altering a view of the displayed visualization based on user input so that the visualization includes the physical representation of the at least one flexible device with (a) only a near RT image of the target anatomy, (b) both the near RT image of the target anatomy and the registered model of the anatomical structure, or (c) only the registered model of the anatomical structure.

56. The method of claim 52, wherein the model of the target anatomy comprises at least one tissue characteristic map generated using MR image segmentation carried out prior to the MRI-guided procedure.

57. The method of claim 52, wherein the model of the target anatomy comprises an electroanatomical map.

58. The method of claim 52, further comprising allowing a user to selectively display one or more maps or data therefrom instead of or aligned with and/or registered to the volumetric model, wherein the map selections include at least two of the following:

a thermal tissue characterization map;

an edema tissue characterization map;

a delayed enhancement tissue characterization map taken at a first point in time;

a delayed enhancement tissue characterization map taken at a second point in time after at least some ablation lesions are created in heart tissue;

a vasculature tissue map;

a fibrous tissue map;

a hypoxic tissue characterization map;

an ischemic tissue characterization map;

a fluid distribution map;

a light exposure map; and

an electroanatomical map.

59. A computer program product for facilitating an MRI-guided interventional therapy in a patient, the computer program product comprising:

a computer readable non-transitory storage medium having computer readable program code embodied in the medium, the computer-readable program code comprising;

computer readable program code that directs an MRI Scanner to obtain in an interleaved manner (a) tracking signal data from tracking coils associated with an intrabody flexible device and (b) MR image data, both in the same 3-D image space with a coordinate system;

computer readable program code that generates near, real time (RT) MRI image data of at least a portion of target anatomy of a patient using relevant anatomical scan planes;

computer readable program code that identifies spatial coordinates associated with a location of at least a distal end portion of at least one flexible intrabody medical device in the 3-D MRI image space using the tracking signal data; and

computer readable program code that renders dynamic near RT visualizations of the intrabody flexible medical device in the 3-D image space with near RT MRI images, wherein the device is not required to be in any of the relevant anatomical scan planes used to obtain the near real time MR image data, and wherein the distal end portion of the device can vary in shape during the MRI-guided procedure.

60. The computer program product of claim 59, further comprising:

computer readable program code that calculates a device-tissue interface location proximate a tip location of the device in the three dimensional MRI image space, the calculation configured to mathematically project axially forward a defined distance beyond the tip to define the device-tissue interface; and

computer readable program code that uses the calculated tissue interface location to automatically define at least one scan plane used by the MRI Scanner to obtain the MR image data during and/or proximate in time to delivery of a therapeutic treatment and/or a diagnostic procedure.

61. The computer program product of claim 60, wherein the computer readable program code that renders the dynamic visualizations further comprises computer readable program code that provides a registered pre-acquired volumetric model of a patient'"'"'s target anatomical structure in the visualizations.

62. The computer program product of claim 61, further comprising computer readable program code configured to allow a user to (a) rotate the visualizations and (b) alter a displayed visualization to include only near RT image data of the target anatomy, to include the near RT image data of the anatomy and the registered model of the anatomical structure, or to include only the registered model of the anatomical structure.

63. The computer program product of claim 61, further comprising computer readable program code that allows a user to electronically mark or select target lesion sites on the model.

64. The computer program product of claim 61, further comprising computer readable program code that allows a user to electronically selectively display one or more tissue maps aligned with and/or registered to the volumetric model or displayed in lieu of the model, wherein the map selections include at least two of the following:

a thermal tissue characterization map;

an edema tissue characterization map;

a delayed enhancement tissue characterization map taken at a first point in time;

a delayed enhancement tissue characterization map taken at a second point in time after at least some ablation lesions are created in heart tissue;

a vasculature tissue map;

a fibrous tissue map;

a hypoxic tissue characterization map;

an ischemic tissue characterization map;

a fluid distribution map;

a light exposure map; and

an electroanatomical map.

65. An MRI guided cardiac interventional system, comprising:

a display;

a processor in communication with the display and adapted to communicate with a MRI scanner;

electronic memory coupled to the processor; and

computer program code residing in the memory that is executable by the processor for;

(a) generating near (RT) MRI images of at least a portion of a heart of a patient using relevant anatomical scan planes associated with a 3-D MRI image space having a coordinate system;

(b) identifying coordinates in the same 3-D MRI image space associated with a location of at least a distal portion of at least one flexible intrabody catheter using tracking coil signal data from at least one tracking coil held by the at least one catheter;

(c) rendering dynamic near RT visualizations of the at least one flexible catheter in the 3-D image space, wherein the at least one flexible catheter is not required to be in any of the relevant anatomical scan planes used to obtain MR data for the near RT MRI images, and wherein the distal end portion of the flexible catheter can change in shape;

(d) displaying a graphical user interface (GUI) containing at least one of the visualizations within the display; and

(e) allowing a user to alter the visualizations using the GUI to selectively show different volumetric patient-specific tissue maps.

66. The system of claim 65, wherein the computer program code that is executable by the processor is further adapted to automatically define at least one scan plane used by the MRI scanner for a target catheter-tissue interface site before and/or during the ablating step based on the location of the of the distal end portion of the catheter.

67. The system of claim 65, wherein the computer program code that is executable by the processor is further adapted to accept user input via the GUI to selectively fade and/or turn on and off tissue characterization or electroanatomical data in the visualizations.

68. The system of claim 67, wherein the computer program code that is executable by the processor to selectively fade and/or turn on and off data is carried out to show the tissue characterization or elecroanatomical data:

(a) on a three dimensional pre-acquired model of a patient'"'"'s heart in the visualizations, the model shown in and/or registered to the 3-D imaging space; and

/or (b) in the near RT MR images without the pre-acquired model.

69. The system of claim 65, wherein the computer program code that is executable by the processor is further adapted to accept user input via the GUI to selectively fade and/or turn on and off visual indications of target treatment sites in the visualizations.

70. The system of claim 65, wherein the computer program code that is executable by the processor to selectively show the target treatment sites is carried out to show the sites:

(a) on a three dimensional pre-acquired model of a patient'"'"'s heart in the visualizations, the model shown in and/or registered to the 3-D imaging space;

or (b) in the near RT MR images without the pre-acquired model.

71. An MRI guided interventional system, comprising:

a circuit in communication with a display with a User Interface, the circuit configured to;

(a) provide a patient planning map and allow a user to identify at least one target treatment site on the patient planning map using the User Interface;

then (b) register the planning map in 3-D MRI image space prior to or during an MRI guided procedure and (c) define locations of the at least one treatment site in 3-D MRI image space based on the registered planning map.

72. The system of claim 71, wherein the circuit is configured to accept user input via the User Interface to selectively fade and/or turn on and off a visual indication of the at least one target treatment site in position in 3-D MRI imaging space in rendered visualizations during an MRI guided procedure.

73. The system of claim 71, wherein the circuit is configured to accept user input via the User Interface to selectively show on the display the at least one target treatment site in visualizations during an MRI guided procedure either:

(a) on the registered planning map or a different patient model with near RT MRI images;

or (b) in near RT MR images without the registered planning map or a different patient model.

74. The system of claim 71, wherein the circuit is configured to allow a user to select whether to show tissue characterization data on the display in interactive visualizations during the MRI guided procedure in different viewing formats including:

(a) on a registered map with near RT image data;

or (b) in near RT images without a map in visualizations during an MRI guided procedure.