Patent Issued for Imaging Method for the Representation of the Results of Intravascular Imaging and CFD Results and Medical System for Execution of the Method
The patent's inventor is Klingenbeck, Klaus (Aufse.beta., DE).
This patent was filed on
From the background information supplied by the inventors, news correspondents obtained the following quote: "In the visualization of the vascular vessel tree, the blood flow, the plaque formation, the plaque structure and further CFD parameters the following standard methods are used:
"The 3-D image modalities serve to enable reconstruction of the vascular vessel tree. To this end a contrast medium is injected, in order to strengthen the blood vessels to be observed. The segmentation of the vessels from a 3-D data set represents the vascular lumen, which is used as the input for CFD methods.
"The intravascular imaging, for example IVUS (
"The simulation of the blood flow by means of the CFD method (Computational Fluid Dynamics) delivers a three-dimensional distribution of the flow parameters, such as for example WSS (Wall Shear Stress), along the surface of the vessel lumen.
"3-D image modalities
"3-D DSA rotation angiography is a standard method used for the assessment of vascular anatomy before and during interventions. In digital subtraction angiography (DSA), after the creation of mask images, images without contrast medium, and filling images, images with contrast medium, these are subtracted from each other, so that only the temporal changes arising as a result of the contrast medium are obtained, which represent the vessels.
"In neuroradiology especially, three-dimensional digital subtraction angiography (3-D DSA) is a routine tool for the planning and execution of minimally invasive procedures. Modem neurological operating theaters integrate this 3-D capability too with a rotating C-arm, in order to enable pre- and intra-procedural 3-D imaging of the cerebral blood vessels.
"By means of the articulated-arm robot 1 known, for example, from U.S. Pat. No. 7,500,784 B2, which preferably has six axes of rotation and thus six degrees of freedom, the C-arm 2 can be spatially adjusted at will, for example by being rotated about a center of rotation between the x-ray emitter 3 and the x-ray detector 4. The inventive x-ray system 1 to 4 is in particular rotatable about centers of rotation and axes of rotation in the C-arm plane of the x-ray image detector 4, preferably about the center point of the x-ray image detector 4 and about the axes of rotation bisecting the center point of the x-ray image detector 4.
"The known articulated-arm robot 1 has a base frame, which for example is fixedly mounted on a base. Thereupon is fixed a carousel which can be rotated about a first axis of rotation. Arranged pivotably about a second axis of rotation on the carousel is a robot pinion, to which is attached a robot arm, which can be pivoted about a third axis of rotation. On the end of the robot aim is arranged a robot hand, which is rotatable about a fourth axis of rotation. The robot hand has a fixing element for the C-arm 2, which can be pivoted about a fifth axis of rotation and rotated about a sixth axis of rotation running perpendicular thereto.
"The realization of the x-ray diagnostic device is not reliant on the industrial robot. Conventional C-arm devices can also be employed here.
"The x-ray image detector 4 can be a rectangular or square, flat semiconductor detector, which is preferably created from amorphous silicon (a-Si). Integrating and possibly counting CMOS detectors can, however also be employed.
"A patient 6 to be examined as the object under examination is located in the beam path of the x-ray emitter 3 on a patient couch 5, for scanning a heart, for example. Connected to the x-ray diagnostic apparatus is a system control unit 7 with an image system 8, which receives and processes the image signals from the x-ray image detector 4 (operating elements are, for example, not shown). The x-ray images can then be examined on a monitor 9.
"Other systems, for example for neuroradiology, use two C-arms. These are so-called biplane systems, as described in greater detail with reference to FIG. 2.
"These essentially have two so-called planes, wherein the first plane 10 can comprise the x-ray diagnostic device shown in FIG. 1 with C-arm 2, x-ray emitter 3 and x-ray image detector 4. Via a ceiling bracket 11 a ceiling-hung C-arm 2' with an x-ray emitter 3' and an x-ray image detector 4' of a second plane 12 can be provided. A monitor traffic light 13 with a first display 14 for the first plane 10 and a second display 15 for the second plane 12 can likewise be arranged on the ceiling. A high-voltage generator 16 is provided alongside the system control unit 7.
"Intravascular Imaging (IVB)
"In order to render the plaque more readily visible, a separate IVUS (
"For intravascular imaging (IVB), a generally known OCT-catheter (Optical Coherence Tomography) can however also be introduced into the vessel.
"In DE 10 2008 014 792 B3 a method for the simulation of a blood flow in a vessel section is described, wherein an image acquisition of a vessel area encompassing the vessel section is obtained, a 3-D vessel section model is determined from the image acquisition, a number of blood flow parameters are read in, taking account of the, or of each blood flow parameter, the blood flow in the vessel section model is simulated and a number of hemodynamic parameters are output. It is here provided for that the image acquisition with an implant introduced into the vessel section is obtained in such a way that image data of the implant is included, and that the 3-D vessel section model is determined taking account of the image data of the implant employed. Further, a corresponding device for the simulation of a blood flow in a vessel section is specified.
"In today's medical world, the dynamic behavior of the blood flow in an aneurysm is frequently regarded as an important factor for the pathogenesis of the aneurysm, that is for its occurrence and development.
"As is known from the article 'Image-Based Computational Simulation of Flow Dynamics in a Giant Intracranial Aneurysm' by
"In order to draw conclusions about hemodynamic parameters of this kind, for example, the blood flow in a vessel section, which for example includes the aneurysm, is for example simulated.
"To this end, in the aforementioned article 'Image-Based Computational Simulation of Flow Dynamic in a Giant Intracranial Aneurysm' a 3-D vessel section model is determined from a 3-D image acquisition, which was obtained by means of a rotation angiography. The blood flow in the 3-D vessel section model is simulated by means of the CFD method. The simulation is here performed assuming rigid vessel walls and a constant blood viscosity. CFD is a method of numeric flow simulation. The model equations used in the numeric flow mechanics are mostly based on a Nervier-Stokes equation, on a Euler or potential equation."
Supplementing the background information on this patent, VerticalNews reporters also obtained the inventor's summary information for this patent: "The object of the invention is to represent the results of intravascular imaging and CFD results of plaques of a vascular vessel tree of a patient, such as for example the plaque formation, the plaque structure and CFD parameters like the wall shear stress, and thus to improve the workflow in a simple manner.
"The object is achieved by a method and by a device according to the features specified in the independent claims. Advantageous embodiments are specified in the dependent claims.
"According to the invention the object is achieved for a method by the following steps: acquisition of a 3-D image data set of the area under examination with x-ray beams for the generation of 3-D x-ray images, generation of a 3-D reconstruction image of the area under examination from the 3-D x-ray images, generation of IVB images by means of intravascular imaging (IVB), identification of larger calcified plaques in the 3-D x-ray images and IVB images for the determining of orientation points or landmarks, correlation and/or registration of the spatial position of the plaques on the basis of the orientation points or landmarks and merging and reproduction of the IVB image data and 3-D image data.
"It is thereby possible in a simple manner to obtain a readily comprehensible representation of results of intravascular imaging and CFD results of plaques of a vascular vessel tree of a patient, such as for example the plaque formation, the plaque structure and CFD parameters such as wall shear stress.
"According to the invention a minimizing of the distance of the voxels in the 3-D space can be performed for correlation and/or registration.
"It has proved to be advantageous if the function for minimization of the distance of the voxels in the 3-D space takes the following form:
".times..times. ##EQU00001## where r.sub.i.sup.IVB or r.sub.j.sup.X respectively determine the coordinates of the i.sup.th or j.sup.th voxels respectively in the IVB or 3-D x-ray data set.
"In an advantageous manner the identification of larger calcified plaques in the 3-D x-ray images and NB images can take place by means of identification of the voxels which contain calcium.
"According to the invention the reproduction of the NB image data and 3-D image data can take place by means of color-coded 3-D rendering of CFD results derived from the IVB image data.
"It has proved to be advantageous if the reproduction of the IVB image data and 3-D image data takes place based on corresponding cross-sectional information from the intravascular imaging (NB) and/or 3-D x-rays in a multiplanar format.
"According to the invention the reproduction can take place in selected positions along the vessel, which for example displays abnormal WSS behavior.
"According to the invention the NB images by means of intravascular imaging can take place with intravascular ultrasound (NUS) or optical coherence tomography (OCT).
"According to the invention the object is achieved for a device by means of a 3-D x-ray machine for the generation of a 3-D image data set, an IVB-device for the generation of at least one NB image, image storage means for buffering of the 3-D image data set and of the NB image, a 3-D image processing stage for the generation of a 3-D reconstruction image from the 3-D image data set and identification of blood vessels in the 3-D reconstruction image, an NB image processing stage for the identification of blood vessels in the NB image, a correlation or registration device for the correlation or registration of the 3-D reconstruction image and of the NB image with the aid of the data from the identification, a fusion device for precise vessel superimposition and a 3-D reproduction device for reproduction of the merged images.
"In an advantageous manner the device for generation of an NB image can be an IVUS catheter and the device for generation of an IVB image an OCT catheter."
For the URL and additional information on this patent, see: Klingenbeck, Klaus. Imaging Method for the Representation of the Results of Intravascular Imaging and CFD Results and Medical System for Execution of the Method. U.S. Patent Number 8630468, filed
Keywords for this news article include: Robotics, Machine Learning, Emerging Technologies,
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