Method and apparatus for graphical assistance in a medical procedure

Patent metadata

Field	Value
Publication number	US-9603578-B2
Application number	US-201414305212-A
Country	US
Kind code	B2
Filing date	Jun 16, 2014
Priority date	Jun 17, 2013
Publication date	Mar 28, 2017
Grant date	Mar 28, 2017

Abstract

In a method and apparatus for graphical assistance in an interventional procedure to open an occlusion of a hollow organ of a patient a three-dimensional CT image data set of an examination region with the at least one hollow organ having the occlusion is retrieved and visualized segmentation data with segmentation data of the hollow organ at a display unit. At least two x-ray fluoroscopy images are acquired at different angulations the CT image data set is registered with at least two of the x-ray images. A number of fluoroscopy x-ray images are acquired during a time period, with real-time visualization of at least one x-ray fluoroscopy image and data of the CT image data set at the display unit. The steps are implemented individually and in sequence, and control options relating exclusively to the current step can be selected manually via a user interface depending on the step that is currently implemented, and only user inputs that are appropriate for the current step are accepted.

First claim

We claim as our invention:

1. A method for computerized graphical assistance in an interventional medical procedure to open an occlusion of a hollow organ of a patient, comprising:
(1) providing a computerized processor with a three-dimensional computed tomography (CT) image data set of an examination region of a patient comprising at least one hollow organ having an occlusion, determining or retrieving segmentation data of the CT image data set designating the hollow organ, and displaying the three-dimensional CT image data set with the segmentation data of the hollow organ at a display unit, as a displayed image;
(2) operating an x-ray fluoroscopy image acquisition system to acquire at least two fluoroscopy images at different angles with respect to said hollow organ, and, in said processor, bringing the CT image data set into registration with at least two of said x-ray fluoroscopy images;
(3) operating the x-ray fluoroscopy system to continually acquire a plurality of additional x-ray fluoroscopy images during a predetermined time period, and providing a real time visualization, at said display unit, of at least one of said additional fluoroscopy images and said displayed image data set;
(4) storing at least the images displayed in step (3); and
(5) implementing each of steps (1), (2), (3) and (4) individually and in sequence and, at said display unit, presenting control options relating exclusively to each individual step and allowing said control options to be manually selected via a user interface in communication with said processor depending on the individual step being implemented, and, while each step is being individually implemented, accepting user inputs into said processor via said user interface only for the step that is currently being individually implemented.

2. A method as claimed in claim 1 comprising implementing steps (1), (2), (3) and (4) automatically in said processor.

3. A method as claimed in claim 1 comprising:
(1a) between (1) and (2), determining, in said processor, at least one parameter describing an attribute of said occlusion from said three-dimensional CT image data set.

4. A method as claimed in claim 1 comprising in (1a) between (1) and (2), determining at least one of a centerline of said hollow organ or a three-dimensional extent of said hollow organ from said segmentation data, and showing said center line or said three-dimensional extent of said hollow organ in said displayed image in (3).

5. A method as claimed in claim 4 comprising using chronologically most current segmentation data automatically in (1).

6. A method as claimed in claim 4 comprising allowing a presentation of said displayed image to be rotated or otherwise modified in terms of orientation at said display unit.

7. A method as claimed in claim 4 comprising displaying said center line or said three-dimensional extent of said hollow organ highlighted with color or with color coding, at said display unit.

8. A method as claimed in claim 4 comprising, in said processor, generating projection images or MPR images from said CT image data set relative to a selected point at said center line, and displaying said projection images or MPR images.

9. A method as claimed in claim 4 comprising, in said processor, automatically determining a J-CTO score in (1a) as an additional parameter, and displaying said J-CTO score at said display unit.

10. A method as claimed in claim 1 comprising operating said x-ray fluoroscopy imaging acquisition system in (2) with a contrast agent profusion through the hollow organ when acquiring said at least two additional x-ray fluoroscopy images.

11. A method as claimed in claim 1 comprising, in (2), acquiring at least three additional x-ray fluoroscopy images and automatically selecting at least two of said x-ray fluoroscopy images for said registration, or selecting said at least two of said x-ray images for said registration based on a manual input into said processor.

12. A method as claimed in claim 1 comprising, in (2), displaying said x-ray fluoroscopy images with at least one of a center line or a three-dimensional extent of said hollow organ after said registration.

13. A method as claimed in claim 1 comprising, in (3), setting said predetermined time period to correspond to a duration of said interventional medical procedure.

14. A method as claimed in claim 1 comprising displaying the respective images respectively in multiple display windows at said display unit.

15. A method as claimed in claim 1 comprising displaying visualizations of said images at said display unit with color-coding.

16. A method as claimed in claim 1 comprising, in (3), showing said real time visualization with multiple images superimposed or side-by-side.

17. A method as claimed in claim 1 comprising, in (3), displaying said images with a center line of said hollow organ or a three-dimensional lumen of said hollow organ also visualized.

18. A method as claimed in claim 1 comprising allowing said user inputs selected from the group consisting of presentation size, arrangement of images, orientation of images, superimposition of images, number of display windows, and color.

19. A method as claimed in claim 1 comprising, in (4), storing said images according to the DICOM standard.

20. An apparatus for providing computerized graphical assistance in an interventional medical procedure to open an occlusion of a hollow organ of a patient, said apparatus comprising:
a computerized processor having a user interface and a display unit in communication therewith;
an x-ray fluoroscopy image acquisition system;
(1) said computerized processor being configured to receive a three-dimensional computed tomography (CT) image data set of an examination region of a patient comprising at least one hollow organ having an occlusion, determine or retrieve segmentation data of the CT image data set designating the hollow organ, and display the three-dimensional CT image data set with the segmentation data of the hollow organ at the display unit, as a displayed image;
(2) said computerized processor being configured to operate an x-ray fluoroscopy image acquisition system to acquire at least two fluoroscopy images at different angles with respect to said hollow organ, and to bring the CT image data set into registration with at least two of said x-ray fluoroscopy images;
(3) said computerized processor being configured to operate the x-ray fluoroscopy system to continually acquire a plurality of additional x-ray fluoroscopy images during a predetermined time period, and to provide a real time visualization, at said display unit, of at least one of said additional fluoroscopy images and said displayed image data set;
(4) said computerized processor being configured to store at least the images displayed in step (3); and
(5) said computerized processor being configured to implement each of steps (1), (2), (3) and (4) individually and in sequence and, at said display unit, present control options relating exclusively to each individual step and allow said control options to be manually selected via the user interface depending on the individual step being implemented, and, while each step is being individually implemented, accept user inputs into said processor via said user interface only for the step that is currently being individually implemented.

Assignees

• Siemens Ag

Inventors

• Meyer Andreas
• Rahn Norbert
• Rossmeier Markus

Classifications

• A61B2090/364

  Correlation of different images or relation of image positions in respect to the body · CPC title

• A61B6/503

  for diagnosis of the heart · CPC title

• A61B6/487 Primary

  involving fluoroscopy · CPC title

• A61B6/032

  Transmission computed tomography [CT] · CPC title

• A61B2090/376

  using X-rays, e.g. fluoroscopy · CPC title