MRI-guided interventional systems that can track and generate dynamic visualizations of flexible intrabody devices in near real time

• US 9,439,735 B2
• Filed: 06/08/2010
• Issued: 09/13/2016
• 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, Jenkins, Kimble L., Piferi, Peter, Vij, Kamal
• Primary Examiner(s): Le, Long V
• Assistant Examiner(s): BOR, HELENE CATHERINE
• Application Number:
  US12/796,017
• Publication Number:
  US 20100312096A1
• Time in Patent Office: 2,289 Days
• Field of Search: 607/2, 606/130, 600/414, 600/417
• US Class Current: 1/1
• 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. A circuit for an MRI-guided cardiac interventional system, comprising:

at least one processor 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 3-D MRI image space coordinate system associated with a location of at least a distal end portion of at least one flexible intrabody catheter in the 3-D MRI image space using tracking coil data from a plurality of longitudinally spaced apart tracking coils on the distal end portion of the at least one flexible intrabody catheter; and

(c) render interactive near RT visualizations with MR image data and at least the distal end portion of the at least one flexible intrabody catheter shown with a three-dimensional physical representation; and

at least one display in communication with the at least one processor configured to display the rendered interactive near RT visualizations,

wherein the at least one processor is configured to direct an MRI scanner to generate a tracking sequence and an imaging sequence, the imaging sequence using the anatomical scan planes used to generate the near RT MRI images, wherein the tracking sequence is carried out independent of the imaging sequence, wherein the tracking sequence generates X, Y, Z coordinates of the tracking coils of the distal end portion of the flexible catheter from signals from different MR scanner channels associated with coaxial cables from the tracking coils of the at least one flexible intrabody catheter which, during operation, are connected to the different channels of the MR scanner, wherein the at least one processor is configured to generate the three dimensional physical representation of at least the distal end of the flexible catheter showing orientation and shape using the X, Y and Z coordinates of the tracking coils and pre-defined information of the at least one flexible intrabody catheter including a distance to a tip of the at least one flexible intrabody catheter from one or more of the tracking coils and a spatial relationship of the tracking coils to select relevant anatomical scan planes for the near RT MRI images that can include scan volumes that exclude the catheter, wherein the at least one processor is configured to calculate a location in the 3-D MRI image space coordinate system associated with the tip and/or distal end portion of the at least one flexible intrabody catheter using the tracking coil data to identify at least one of the relevant anatomical scan planes,

wherein the at least one processor is configured to calculate a catheter-tissue interface location proximate the tip of the at least one flexible intrabody catheter in the 3-D MRI image space using the X, Y, Z coordinates of locations of the tracking coils, wherein the calculation is carried out to place the catheter tissue interface location a distance of between about 0-5 mm beyond a calculated location of the tip of the at least one flexible intrabody catheter, and wherein the calculated catheter-tissue interface is either (a) calculated to be tangent and substantially in-line with at least two of the tracking coils or (b) calculated as a plane in the 3-D MRI image space proximate a projected plane defined by at least three points associated with three different ones of the tracking coils.

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

3. The circuit of claim 1, wherein the at least one processor 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 circuit of claim 3 wherein the at least one display comprises 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 the planning map or with the planning map 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 and with the near RT MRI images.

5. The circuit of claim 1, further comprising the at least one flexible intrabody catheter, and wherein the at least one processor is configured to generate the physical representation of at least the distal end portion of the at least one flexible intrabody catheter in the visualizations based on the pre-defined information that includes the following:

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

(ii) the spatial relationship of the tracking coils.

6. The circuit of claim 1, further comprising the at least one flexible intrabody catheter and the MRI Scanner, wherein the at least one processor is in communication with and/or integral with the MRI Scanner, and wherein the MRI Scanner 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 flexible intrabody catheter.

7. The circuit of claim 1, wherein the at least one display comprises 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 either or both:

(a) on a three dimensional pre-acquired model of a patient'"'"'s heart in the visualizations, the pre-acquired 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.

8. The circuit of claim 1 , wherein the at least one display comprises 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 and/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.

9. The circuit of claim 1, wherein the tracking coils comprise at least three closely spaced apart tracking coils on the distal end portion of the at least one flexible catheter, wherein the three-dimensional physical representation is an electronically generated physical representation of a physical configuration in an intrabody shape and orientation of at least a distal end portion of the at least one flexible intrabody catheter.

10. The circuit of claim 1, wherein the at least one processor 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 3-D volumetric model registered to the 3-D MRI image space along with the physical representation of at least the distal end portion of the at least one flexible intrabody catheter in the 3-D MRI image space.

11. The circuit of claim 10 , wherein the at least one display comprises a User Interface, the User Interface configured to allow a user to alter a respective displayed visualization to include only a near RT MRI image of the anatomy, to include the near RT MRI image of the anatomy and the registered 3-D volumetric model of the heart, or to include only the registered 3-D volumetric model of the heart.

12. The circuit of claim 10, wherein the at least one display comprises a User Interface, and wherein the at least one processor is configured to show the 3-D volumetric 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 the User Interface.

13. The circuit of Claim 10, wherein the at least one display comprises a User Interface, and wherein the at least one processor is configured to allow a user to manipulate the visualizations using the User Interface including to:

rotate, crop or zoom the 3-D volumetric model in a respective visualization, and wherein the at least one processor automatically selects anatomically relevant scan planes to obtain MR image data in response thereto.

14. The circuit of claim 1, wherein the at least one processor is configured to render the visualizations with the three dimensional physical representation to show a location of the tip of the at least one flexible intrabody 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 connect the tip and the coil shapes with a line or a spline.

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

16. The circuit of claim 15 , wherein the at least one display comprises a User Interface, and wherein the two planes are transparent and/or translucent with different color perimeters and can move relative to and/or be locked to an anatomical model shown in the visualizations, 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 visualizations.

17. The circuit of claim 1 , wherein the at least one display comprises a User Interface, the User Interface configured to allow a user to fade the three dimensional physical representation of the at least one flexible intrabody catheter in the visualizations on the at least one display from a near real-time MR image of the heart.

18. The circuit of claim 1, wherein the at least one processor 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 3-D MRI image space in the visualizations, the reference planes intersecting and extending across the volumetric patient anatomical model and the near RT MRI images, wherein the reference planes align with the relevant anatomical scan planes.

19. The circuit of claim 1, further comprising at least one flexible intrabody catheter, wherein one of the at least one flexible intrabody catheter is a therapeutic catheter including at least one of an injection or ablation catheter with a catheter tip portion as the distal end portion of the catheter with the tip used by the at least one processor to calculate the catheter-tissue interface, wherein the at least one display comprises a close-up viewing window to show near RT MRI images of ablation lesion forming or injection delivery, and wherein at least some of the images in the close-up viewing window are generated using high-resolution MR image data.

20. The circuit of claim 1, wherein the at least one display comprises a User Interface, and wherein the User Interface is configured to allow a user to select a dimensional offset of between about 0-5 mm for the catheter-tissue interface, and wherein the at least one processor uses the calculated catheter-tissue interface location with the selected offset to automatically define at least one scan plane as at least one of the anatomical relevant scan planes used to obtain the MR data for the near RT MR images.

21. The circuit of claim 1, wherein the at least one processor calculates a scan plane location for an en face view at the catheter-tissue interface that is projected to be substantially parallel to tissue proximate the catheter-tissue interface for at least some of the near RT MRI images.

22. The circuit of claim 1, wherein the at least one processor is configured to direct an MRI Scanner to snap-to a projected tissue-device interface based on the calculated catheter-tissue interface for at least one of the relevant anatomical scan planes to obtain near RT MRI image data of the catheter-tissue interface.

23. The circuit of claim 1, wherein the at least one display comprises a User Interface, 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.

24. The circuit of claim 1, wherein the tracking sequence identifies the X, Y, Z coordinates of the tracking coils simultaneously.

25. The circuit of claim 1, wherein the tracking sequence dephases signal perpendicular to a read-out direction to attenuate unwanted signal from 1) bulk objects and 2) regions sensed by signal sensitive parts of the flexible catheter to thereby leave a sharp peak indicating position of the tracking coils, and wherein once a tracking sequence is complete, a spoiler gradient can be used to diphase any transverse signal remaining before the image sequence is executed.

26. The circuit of claim 1, wherein the tracking sequence comprises a plurality of small flip angle excitation with each repetition designed to indicate the X, Y or Z component of the tracking coil coordinates in succession.

27. An MRI guided system, comprising:

an MRI Scanner;

at least one flexible intrabody medical device configured to be introduced into a patient via a tortuous and/or natural lumen path, the at least one flexible intrabody medical device having tracking coils that are connected to channels of the MRI Scanner;

a circuit comprising at least one processor adapted to communicate with and/or reside in the 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 tracking coils; 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 three-dimensional 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 target anatomy, to include the near RT image of the target anatomy and the registered model of the anatomical structure, or to include only the registered first volumetric model of the target anatomical structure,

wherein the MRI Scanner is configured to interleave signal acquisition of image data with signal acquisition of tracking coil signals from the tracking coils, and wherein the circuit is configured to (i) electronically track the at least one flexible intrabody medical device in the 3-D MRI image space using the tracking coil signals independent of scan planes used to obtain the MR image data and to (ii) calculate a location in the 3-D MRI image space of a medical device-tissue interface associated with a tip and/or distal end portion of the at least one flexible intrabody medical device to identify at least one of the relevant anatomical scan planes,

wherein the circuit is configured to calculate the location of the medical device-tissue interface using X, Y, Z coordinates of locations of the tracking coils and a known spatial relationship of the tracking coils, wherein the calculation is carried out to place the location of the device-tissue interface a distance of between about 0-5 mm beyond a calculated location of the tip of the at least one flexible intrabody medical device, and wherein the calculated medical device-tissue interface is either (a) calculated to be tangent and substantially in-line with at least two of the tracking coils or (b) calculated as a plane in the 3-D MRI image space proximate a projected plane defined by at least three points associated with three different ones of the tracking coils.

28. The system of claim 27, wherein the circuit automatically defines at least one of the relevant anatomical scan planes used to obtain the MR image data based on the calculated medical device tissue interface location during and/or proximate in time to delivery of a therapeutic treatment and/or a diagnostic procedure.

29. The system of claim 28, wherein the tracking coils comprise at least three spaced apart tracking coils, with at least two of the tracking coils being closely spaced together in fixed relationship on a rigid distal end portion of the flexible intrabody medical device proximate a distal tip thereof, and wherein the circuit is configured to direct the MR Scanner to snap-to the calculated medical device-tissue interface to obtain near real time image data for the near RT MRI images.

30. The system of claim 27, wherein the circuit is further configured to include a visualization shown on the display with at least one tissue characterization map.

31. The system of claim 30, wherein the at least one 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.

32. The system of claim 30, wherein the at least one flexible intrabody medical device is an ablation catheter, and wherein the at least one tissue characterization map or data therefrom is configured to show ablation lesion formation proximate a pulmonary vein whereby a clinician can evaluate whether an ablation therapy carried out using the ablation catheter has electrically isolated a pulmonary vein.

33. The system of claim 30, wherein the at least one flexible intrabody medical device is an injection catheter, and wherein the tissue characterization map or data is configured to show fluid distribution in cardiac tissue whereby a clinician can evaluate whether injections of a therapeutic using the injection catheter has generated a desired fluid distribution in cardiac tissue.

34. The system of claim 27, wherein the circuit is configured to provide to the 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.

35. The system of claim 27, 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 at least one tissue characterization map or data therefrom is shown or not shown in the visualizations on the display.

36. The system of claim 35, 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.

37. The system of claim 27, 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.

38. The system of claim 37, 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 data and/or electroanatomical data:

(a) on the registered pre-acquired first volumetric model in the visualizations;

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

39. The system of claim 27, 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.

40. The system of claim 27, wherein the circuit is configured to accept user input via the User Interface to selectively show on the display the target treatment sites in the visualizations as either:

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

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

41. The system of claim 27, wherein the tracking coils comprise at least three spaced apart tracking coils connected to respective channels of the MR Scanner, and wherein the circuit is configured to direct the MR Scanner to snap-to the medical device-tissue interface to use at least one scan plane associated therewith as at least one of the relevant anatomical scan planes to obtain near real time image data of the medical device-tissue interface for the near RT MRI images.

42. The system of claim 41, wherein the at least one flexible intrabody medical device includes at least one loop catheter with a distal loop end having the spaced apart tracking coils connected to respective channels of the MR Scanner, and wherein the circuit is configured to direct the MR Scanner to snap-to the calculated medical device-tissue interface, and wherein the calculated medical device-tissue interface is calculated as the plane in 3-D MRI image space proximate the projected plane defined by the at least three points associated with three different tracking coils on the distal loop end to obtain near real time image data of the medical device-tissue interface for the near RT MRI images.

43. The system of claim 41, wherein the at least one flexible intrabody medical device comprises a bendable or deflectable catheter, wherein the tracking coils comprise at least three spaced apart tracking coils on the bendable or deflectable catheter, and wherein the circuit is configured to direct the MR Scanner to snap-to the calculated medical device-tissue interface that is tangent and substantially in-line with the at least two of the tracking coils to obtain near real time image data of the medical device-tissue interface for the near RT MRI images.

44. The system of claim 41, wherein the tracking coils are spaced apart tuned tracking coils, each connected to a tuning circuit with a diode at a proximal end of the at least one flexible medical device using respective coaxial cables, wherein the coaxial cables each have an electrical length in the MR Scanner measured from the tracking coil to the diode that is about ¼

lambda or a higher odd harmonic thereof, and wherein the circuit is configured to identify a location of the tracking coils in the 3-D MRI image space with a precision of at least about 1 mm.

45. The system of claim 41, wherein the tracking coils are a plurality of spaced apart tuned tracking coils that are connected to a diode at a proximal end of the at least one flexible device using respective coaxial cables, wherein the coaxial cables each have an electrical length in the MR Scanner measured from the tracking coil to the diode that is about ¼

lambda or a higher odd harmonic thereof, 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 correct physical offset distance.

46. 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 flexible intrabody catheter connected to a different MR Scanner channel; and

at least one display in communication with the MR Scanner,

wherein the MR Scanner includes at least one circuit with at least one processor that is configured to;

(a) generate near real time (RT) MRI images of at least a portion of a heart of a patient shown on the at least one display 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;

(c) render dynamic near RT visualizations with physical three-dimensional representations of the flexible intrabody 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 shown on the at least one display, and (d) calculate a location in the 3-D MRI image space of a catheter-tissue interface associated with a tip and/or distal end portion of the at least one flexible intrabody catheter to identify at least one of the relevant anatomical scan planes,

wherein the at least one circuit is configured to calculate the location of the catheter-tissue interface proximate the tip of one or more of the flexible intrabody catheters in the 3-D MRI image space using X, Y, Z coordinates of locations of the tracking coils, wherein the calculation is carried out to place the location of catheter-tissue interface a distance of between about 0-5mm beyond a calculated location of the tip of one or more of the flexible intrabody catheters, and wherein the calculated catheter-tissue interface location is either (a) calculated to be tangent and substantially in-line with at least two of the tracking coils or (b) calculated as a plane in the 3-D MRI image space proximate a projected plane defined by at least three points associated with three different ones of the tracking coils.

47. A system according to claim 46, wherein the at least one circuit is configured to show on the at least one display at least one of a plurality of user-selectable tissue characterization maps or data associated therewith on 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 characterization 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.

48. The system of claim 46, wherein the at least one 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 volumetric pre-acquired model and/or in a near RT MRI image and the at least one circuit is configured to define relevant anatomical scan planes associated with a selected or marked site.

49. The system of claim 46, wherein the at least one circuit is configured to allow a user via a User Interface in communication with the at least one display to show an electroanatomical (EA) map as the volumetric pre-acquired model, the EA map imported from a different imaging modality and/or generated from MRI data.

50. The system of claim 46, wherein the at least one circuit that is configured to allow a user using a User Interface associated with the at least one display to select an alternate visualization to provide a patient planning map that is shown on the at least one display aligned with or instead of the volumetric pre-acquired model with at least one target treatment site identified thereon registered to the 3-D MRI image space.

51. The system of claim 46, wherein the at least one 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 pre-identified target treatment site is shown only with the near RT MRI images;

(ii) the at least one pre-identified target treatment site is shown in the near RT MRI images with the physical representations of the flexible intrabody catheters and without the volumetric pre-acquired model;

or (iii) the at least one pre-identified target treatment site is shown with the volumetric pre-acquired model and the near RT MRI images.

52. The system of claim 46, wherein the at least one 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 the volumetric pre-acquired model;

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

53. The system of claim 46, wherein the at least one display is in communication with a User Interface, the User Interface configured to allow a user to fade and/or turn on and off the physical representations of the flexible intrabody catheters in the visualizations to show a near real-time MR image of at least one of the flexible intrabody catheters.

54. A method for performing 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 medical device during the MRI-guided procedure, wherein the flexible intrabody medical 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;

generating and displaying, using at least one processor, visualizations of the flexible intrabody medical device showing;

(i) the 3-D volumetric model of the patient'"'"'s target anatomy;

(ii) a three dimensional physical representation of at least a distal end portion of the flexible intrabody medical device using the identified locations of the tracking coils, known spatial relationship between the tracking coils and dimensional characteristics of the distal end portion of the flexible intrabody medical device; and

(iii) the near RT MR image data;

electronically calculating a device-tissue interface location proximate a tip of the flexible intrabody medical device in the 3-D image space using the identified coordinate locations of the tracking coils, wherein the calculation is carried out to place the device-tissue interface location a distance of between about 0-5 mm beyond a calculated location of the distal tip of the flexible intrabody device, and wherein the calculated device-tissue interface is either (a) calculated to be tangent and substantially in-line with at least two of the tracking coils or (b) calculated as a plane in the 3-D MRI image space proximate a projected plane defined by at least three points associated with three different ones of the tracking coils; and

automatically defining at least one scan plane used for the obtaining step 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 calculated device-tissue interface location.

55. The method of claim 54, further comprising showing the tracking coils in the three-dimensional physical representation of the distal end portion of the flexible intrabody medical device in the visualizations in a three-dimensional shape or shapes and in different colors using the identified coordinate location of the tracking coils, the dimensional characteristics and a defined form factor regarding actual coil configuration and placement on the flexible intrabody medical device.

56. The method of claim 54, further comprising electronically rotating the visualizations based on user input and electronically selectively altering a displayed visualization based on user input so that the altered visualization includes the physical representation of the flexible intrabody medical 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 3-D volumetric model of the anatomical structure, or (c) only the registered 3-D volumetric model of the anatomical structure.

57. The method of claim 54, wherein the 3-D volumetric model of the target anatomy comprises tissue characteristic map generated using MR image segmentation carried out prior to the MRI-guided procedure.

58. The method of claim 54, wherein the 3-D volumetric model of the target anatomy comprises an electroanatomical map.

59. The method of claim 54, further comprising allowing a user to alter the visualizations to selectively display one or more tissue characterization maps or data therefrom wherein the tissue characterization map selections include at least two of the following, which can be individually shown apart from or on the volumetric model:

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.

60. 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 configured to;

direct 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 MRI image space with a coordinate system;

generate near real time (RT) MRI images of at least a portion of target anatomy of a patient using relevant anatomical scan planes;

identify spatial coordinates associated with a location of at least a distal end portion of the intrabody flexible device in the 3-D MRI image space using the tracking signal data;

render dynamic near RT three-dimensional visualizations of the intrabody flexible device in the 3-D image space with near RT MRI images; and

calculate a location in the 3-D MRI image space of a device tissue interface associated with a tip and/or distal end portion of the intrabody flexible device to identify at least one of the relevant anatomical scan planes wherein the distal end portion of the intrabody flexible device can vary in shape during the MRI-guided procedure, and wherein the computer readable program code that calculates the location is configured to use X, Y, Z coordinates of locations of the tracking coils and known spacing of the tracking coils to place the location of device-tissue interface a distance of between about 0-5 mm beyond a calculated location of the tip of the intrabody flexible device, and wherein the calculated device-tissue interface location is either (a) calculated to be tangent and substantially in-line with at least two of the tracking coils or (b) calculated as a plane in the 3-D MRI image space proximate a projected plane defined by at least three points associated with three different ones of the tracking coils.

61. The computer program product of claim 60, further:

wherein the computer readable program code is further configured to use the calculated device-tissue interface location to automatically define at least one scan plane used by the MRI Scanner as at least one of the relevant anatomical scan planes to obtain the MR image data for the near RT MRI images during and/or proximate in time to delivery of a therapeutic treatment and/or a diagnostic procedure.

62. The computer program product of claim 61, 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.

63. The computer program product of claim 62, wherein the computer readable program code is further configured to allow a user to (a) rotate the visualization and (b) alter a displayed visualization to remove the pre-acquired model but include the near RT images of the target anatomy, to include the near RT images of the target anatomy and the registered pre-acquired volumetric model of the anatomical structure, or to include the registered pre-acquired volumetric model of the anatomical structure without the near RT MRI image of the target anatomy.

64. The computer program product of claim 62, wherein the computer readable program code is further configured to allow a user to electronically mark or select target lesion sites on the pre-acquired volumetric model.

65. The computer program product of claim 62, wherein the computer readable program code further configured to allow a user to electronically selectively display one or more tissue maps aligned with and/or registered to the pre-acquired volumetric model wherein the defined tissue maps 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.

66. A cardiac interventional system, comprising:

a display;

an MRI Scanner;

at least one processor in communication with the display and adapted to communicate with the MRI Scanner for;

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

(c) rendering dynamic near RT visualizations of the at least one flexible intrabody catheter in the 3-D image space;

(d) calculating a location in the 3-D MRI image space of a catheter-tissue interface associated with a tip and/or distal end portion of the at least one flexible intrabody catheter to identify at least one of the relevant anatomical scan planes,

wherein calculating the location of the catheter-tissue interface is carried out using the X, Y, Z coordinates of locations of the tracking coils and known spatial spacing between the tracking coils, wherein the calculation is carried out to place the interface location a distance of between about 0-5 mm beyond a calculated location of the tip of the at least one flexible intrabody catheter, and wherein the calculated interface is either (a) calculated to be tangent and substantially in-line with at least two of the tracking coils or (b) calculated as a plane in the 3-D MRI image space proximate a projected plane defined by at least three points associated with three different ones of the tracking coils;

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

(f) selectively altering the visualizations by a user using the GUI to show different volumetric patient-specific tissue maps.

67. The system of claim 66, 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 associated with the catheter-tissue interface.

68. The system of claim 66, 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.

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

70. The system of claim 66, 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.

71. The system of claim 66, further comprising computer program code that is executable by the processor to selectively show pre-defined target treatment sites either:

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

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

72. The system of claim 66, wherein the computer program code residing in the memory that is executable by the processor is also configured for:

directing the MRI Scanner to interleave a tracking sequence and an imaging sequence, the imaging sequence comprises the anatomical scan planes used to generate the near RT MRI images, wherein the tracking sequence is carried out independent of the imaging sequence, and wherein the tracking sequence generates the X, Y, Z coordinates of the tracking coils of the distal end portion of the flexible catheter from signals from different MR scanner channels that the tracking coils are connected to.

73. The system of claim 72, wherein the tracking sequence identifies the X, Y, Z coordinates of the tracking coils simultaneously.

74. The system of claim 72, wherein the tracking sequence dephases signal perpendicular to a read-out direction to attenuate unwanted signal from 1) bulk objects and 2) regions sensed by signal sensitive parts of the flexible catheter to thereby leave a sharp peak indicating position of the tracking coils, and wherein once a tracking sequence is complete, a spoiler gradient can be used to diphase any transverse signal remaining before the image sequence is executed.

75. The system of claim 72, wherein the tracking sequence comprises a plurality of small flip angle excitation with each repetition designed to indicate the X, Y or Z component of the tracking coil coordinates in succession.