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WO2015071343A1 - Détection d'angle de rotation d'un dispositif d'intervention - Google Patents

Détection d'angle de rotation d'un dispositif d'intervention Download PDF

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Publication number
WO2015071343A1
WO2015071343A1 PCT/EP2014/074441 EP2014074441W WO2015071343A1 WO 2015071343 A1 WO2015071343 A1 WO 2015071343A1 EP 2014074441 W EP2014074441 W EP 2014074441W WO 2015071343 A1 WO2015071343 A1 WO 2015071343A1
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WIPO (PCT)
Prior art keywords
sensor
optical fiber
optical
interventional
osf
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PCT/EP2014/074441
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English (en)
Inventor
Melike BOZKAYA
Ahmet Ekin
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Koninklijke Philips NV
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Koninklijke Philips NV
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Publication of WO2015071343A1 publication Critical patent/WO2015071343A1/fr
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; Determining position of diagnostic devices within or on the body of the patient
    • A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0062—Arrangements for scanning
    • A61B5/0066—Optical coherence imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
    • A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters

Definitions

  • the present invention relates to the field of medical devices, more specifically interventional devices with image capabilities, such as intravascular catheters with an image sensor.
  • CAD Coronary Artery Disease
  • IVUS Intra Vascular Ultra Sound
  • OCT Optical Coherence Tomography
  • NIRS Near-InfraRed Spectroscopy
  • FFR Fractional Flow Reserve
  • intravascular imaging technologies provide high resolution assessment of the plaque and vessel walls, the generated images do not allow determination of the location and the orientation of a specific intravascular image frame in 3D space.
  • different co-registration techniques have been proposed. These techniques link the intravascular data with the global vessel geometry in different ways, such as recording X-ray fluoroscopy images during the pullback of the intravascular image sensor. By this, the location of the intravascular sensor at the time of the acquisition can be shown on the vessel geometry on X-ray.
  • X-ray for solving the localization problem introduces additional radiation.
  • X-ray does not provide a measure of orientation of the image sensor for each frame.
  • the orientation of the image sensor that is used to provide image data from the vessel wall at a given longitudinal position is not known. This may be important for a physician to be able to provide a correct anatomical interpretation of an image, e.g. by comparing the image with another image captured at another longitudinal position in the vessel.
  • the orientation is important both in case of images of a limited angular portion of the vascular cross section, or in case the image sensor is capable of providing a 360° cross sectional image.
  • Intravascular image frames captured at different longitudinal positions of a blood vessel may also be used to provide a longitudinal view of a vessel wall, e.g. by providing a combined longitudinal image by stacking the individual image frames each obtained at one longitudinal position. Also in this case, information about orientation of the individual image frames is important to be able to correctly rotationally align the images, since in curved vessels, the image sensor will in general be oriented differently at different longitudinal positions. None or incorrect orientation information may provide a resulting constructed longitudinal view with a poor image information of the vessel wall, thus offering a limited value for a physician to diagnose a patient based thereon.
  • the invention provides an interventional device comprising: - an elongated device arranged for interventional application,
  • a sensor positioned on a distal portion of the elongated device, wherein the sensor is arranged to sense characteristics of material present perpendicular to a longitudinal axis of the elongated device, and
  • an optical fiber with optical shape sensing properties along at least a part of its longitudinal extension wherein the optical fiber is attached to at least a part of the elongated device and a portion of the optical fiber is positioned with a non-zero angle relative to a longitudinal axis of the elongated device, at or near a longitudinal position of the elongated device where the sensor is positioned, so as to allow optical tracking of rotational angle orientation of the sensor.
  • optical shape sensing e.g. built into an IVUS catheter or the like
  • OSS optical shape sensing
  • an orientation rotational angle
  • a measure of rotation angle of the sensor e.g. referred to a reference position.
  • a more meaningful interpretation of an image is possible, and a more meaningful comparison between two images captured at different positions is possible, since it is possible to rotationally align the images even though they may be captured with different orientations of the sensor.
  • the individual images captured at respective longitudinal positions can be combined into a combined image by aligning the plurality of images with respect to said data indicative of orientation of the sensor.
  • a combined image which takes into account the different rotational orientation of the sensor during the pull back procedure, and therefore rotational mis-alignment between subsequent images in the combined image can be eliminated or at least reduced.
  • a longitudinal view i.e. an image of the interior of a blood vessel wall, with an improved quality without distortion caused by rotational misalignment, thereby providing a physician with an image with an improved diagnostic value.
  • the device is advantageous for use in various types of devices with different types of sensors, e.g. in IVUS catheters.
  • the location (position) of the sensor e.g. referring to a reference position, can also be determined, thus eliminating the need for X-ray for determination the location of the sensor during capturing of each image.
  • the invention is based on the insight, that in addition to a 3D shape, it is possible to provide optical information from an OSS fiber to allow determination of an orientation (i.e. twist or rotational angle) of the elongated device at the longitudional position where the sensor is positioned. This can be done in several ways by selecting a suitable position of the OSS fiber in or on the elongated device relative to the sensor position, and by selection of a proper calculation algorithms, as will be further explained below.
  • OSS is known to be able to reconstruct a 3D shape of an elongated object by integration of an optical fiber with optical shape sensing elements in such a device.
  • optical interrogating the optical fiber e.g. with optical shape sensing elements by means of Fiber Bragg Gratings or Rayleigh based elements.
  • This can be done in real time which may be useful for visualization of the reconstructed 3D shape e.g. within medical applications as navigational guidance for elongated interventional medical devices.
  • the optical fiber can be utilized in addition for navigational guidance during insertion of the elongated interventional, e.g. into a blood vessel to be examined.
  • the OSS properties of the optical fiber can be obtained in various ways, as known by the skilled persons.
  • the optical interrogation may use Rayleigh scattering, or make use of Fiber Bragg Gratings written into the fiber.
  • the method for optical interrogation of the optical shape sensing properties may be performed in several ways, such as also known by the skilled person.
  • the optical fiber only has optical shape sensing properties in a part of its length.
  • the optical fiber only has shape sensing properties along a distal part of its longitudinal extension.
  • a low cost optical fiber can be used, which only has optical shape sensing properties in a limited part of its length, where it is necessary in a given application.
  • only a distal portion of the optical fiber length may be important to be shape sensed, e.g. to identify an orientation of a tip position of the longitudinal device, or at least to precisely identify a distal position of the optical fiber which may be used for estimating the tip position of the longitudinal device.
  • an optical fiber with optical shape sensing properties' is understood to cover an OSS fiber consisting of a single optical fiber with OSS properties, as well as it covers variants in the form of a multi-core cable comprising several optical fiber cores each with OSS properties, e.g. multi-core variants comprising two, three, or more single optical fiber cores.
  • the senor is capable of providing information regarding characteristics of material, e.g. a vessel wall, to the side of the elongated device. It is to be understood that the sensor may further be capable of providing more information than this.
  • the sensor may cover only a limited angular window, or the sensor (or a plurality of individual sensors) may be arranged to cover a full cross sectional image, i.e. a 360° image.
  • a portion of the optical fiber may be positioned with a non-zero angle relative to a longitudinal axis of the elongated device, at a longitudinal position near or at the longitudinal position where the sensor is positioned. This will allow an optical feature which by means of optical interrogation can be used to identify a deviation from the longitudinal axis of the elongated device which is caused by a rotation (twist).
  • a portion of the optical fiber may be positioned perpendicular to a longitudinal axis of the elongated device, at a longitudinal position near or at the longitudinal position where the sensor is positioned.
  • the tip portion of the optical fiber may be positioned perpendicular to a longitudinal axis of the elongated device, at a longitudinal position near or at the longitudinal position where the sensor is positioned.
  • the tip portion may especially be "hook" shaped and placed at the tip or even slightly in front of a tip of the elongated device, just ahead of where the sensor is positioned.
  • a portion of the optical fiber is positioned parallel to a longitudinal axis of the longitudinal device.
  • its tip portion may end at a longitudinal position near or at the longitudinal position where the sensor is positioned.
  • the twist angle at the tip portion, and thus the orientation of the sensor, can thus be determined by optical interrogation.
  • the orientation may be determined as a rotational angle relative to an orientation determined for a reference position defining also a reference orientation in 3D space.
  • a portion of the optical fiber may be attached to a portion of the elongated device, so as to allow tracking of a three-dimensional shape of said portion of the elongated device.
  • the optical fiber may be arranged to optically shape sense a predetermined distal portion of a catheter, e.g. by the optical fiber being arranged along the center of the elongated device, or at least following the longitudinal axis of the elongated device. This allows navigational guidance in 3D space during insertion of the interventional device, and further it allows longitudinal tracking when capturing intravascular images.
  • the sensor can be many different types of sensors arranged for providing different types of images of material present to a side of the elongated device where the sensor is positioned.
  • the sensor may comprise at least one of: an ultrasound sensor (UV), an optical coherence tomography (OCT) sensor, a near-infrared spectroscopy (NIRS) sensor, and a fractional flow reserve (FFR) sensor.
  • the sensor may be arranged to capture at least a two-dimensional image covering at least an angular window perpendicular to the longitudinal axis of the elongated device. E.g. the sensor may be able to cover an entire cross-sectional view, i.e. a 360° angular window.
  • the orientational alignment of a stack of images is important to be able to provide a combined image of a longitudinal portion of e.g. a blood vessel wall without severe distortion due to different (unknown) orientations of the individual images captured at different longitudinal positions inside the blood vessel, e.g. during a pull back procedure.
  • the optical fiber may comprise at least one optical fiber core arranged so as to allow determination of a twist for the optical fiber.
  • the optical fiber may comprise a plurality of single optical fiber cores arranged so as to allow determination of a twist for the optical fiber.
  • the optical fiber may comprise a cable incorporating three optical fiber cores spatially arranged within the cable to allow computation of twist, i.e. rotational angle of the cable between nodes at different longitudinal positions of the cable.
  • the optical fiber may be attached to the elongated device in various ways, e.g. the optical fiber may be attached to an outside part of the elongated device, however it may be preferred that the optical fiber is arranged within the elongated device, e.g. except for the tip portion of the optical fiber.
  • the elongated device may be formed by a structural element, such as made of a material known in the art of interventional devices.
  • the interventional device is an intravascular catheter, e.g. arranged for intravascular imaging, e.g. an IVUS catheter.
  • the interventional device may be an intravascular catheter arranged for imaging of human blood vessels.
  • the invention provides an interventional imaging system comprising:
  • a sensor positioned on a distal portion of the elongated device, wherein the sensor is arranged to sense characteristics of material present perpendicular to a longitudinal axis of the elongated device, and
  • optical fiber with optical shape sensing properties along at least a part of its longitudinal extension, wherein the optical fiber is attached to at least a part of the elongated device and a portion of the optical fiber is positioned with a non-zero angle relative to a longitudinal axis of the elongated device, at or near a longitudinal position of the elongated device where the sensor is positioned, so as to allow optical tracking of rotational angle orientation of the sensor, and
  • optical console system arranged for:
  • Such system allows viewing of e.g. cross sectional images obtained with the sensor inside a human blood vessel.
  • the known orientation of the sensor it is possible to visualize the image to the user with a correct orientation, thereby providing a more meaningful information to the user. This may be even more pronounced if two images captured at different longitudinal positions in the vessel should be compared, since here the orientation information allows correct rotational alignment of the two images, thus allowing a more meaningful comparison of the two images.
  • Preferred embodiments of the system enables determining a reference orientation.
  • a reference orientation can be chosen by registering a coordinate system of the OSS fiber and the interventional device technology prior to using the interventional device, i.e. prior to the data acquisition using the sensor.
  • a reference orientation can be chosen by a user input, and/or by selecting the first obtained image frame as having a reference orientation, and the subsequently obtained image frames are the referred to this reference orientation.
  • a reference orientation is selected for the image, e.g. selected by the user.
  • Such single image may be aligned and overlaid on an image obtained with another modality, e.g. an X-ray image. This may provide additional information to a physician.
  • system further comprises:
  • an imaging system arranged for:
  • the system is used to generate a so-called L-view based on a plurality of images from the sensor, and the orientational information for all images used in this L-view allows a correct orientational alignment of the images.
  • the user can additionally select a new L-view referring to a different orientational angle, and this is provided by rotating/shifting all the stacked images forming the L-view. This may provide additional anatomical information to a physician, since in case of intravascular image data, this will allow the physician to rotate the cross-sectional view of the blood vessel wall.
  • Such system embodiment allows generation of a longitudinal view of a vessel wall without disturbing effects caused by different orientations of the sensor when capturing the individual image frames.
  • the orientation information for each individual image allows correct rotational alignment of the images to produce a longitudinal view with improved image quality.
  • the optical console system may be arranged to determine a measure of three-dimensional location of the sensor in response to said optical interrogation of the optical fiber, and wherein the imaging system may be arranged for generating said combined image in accordance with said measure of three-dimensional location of the sensor for each of the plurality of images.
  • both orientation and position are provided by means of OSS technique, thus eliminating the need for X-ray images.
  • the invention provides a method for interventional imaging, the method comprising:
  • an elongated device arranged for interventional application with a sensor positioned on a distal portion of the elongated device, wherein the sensor is arranged to sense characteristics of material present perpendicular to a longitudinal axis of the elongated device, and wherein an optical fiber with optical shape sensing properties along at least a part of its longitudinal extension is attached to at least a part of the elongated device and a portion of the optical fiber is positioned with a non-zero angle relative to a longitudinal axis of the elongated device, at or near a longitudinal position of the elongated device where the sensor is positioned,
  • the method further comprises
  • the invention provides a computer executable program code adapted to control an optical console system forming part of an interventional imaging system comprising a sensor positioned on a distal portion of an interventional longitudinal device, wherein the program code is adapted to:
  • Such computer executable program code is thus capable of performing the steps of the method according to the third aspect which can be implemented in software, e.g. as an add-on or modification of the existing OSS software.
  • the program code may be further arranged to generate a combined image being combined from a plurality of captured images aligned in accordance with correspondingly calculated orientations of the sensor.
  • the computer executable program code may especially be present on a non- transitory computer readable storage medium, or it may be loaded into memory of a processor system arranged to execute the program code.
  • first, second, third, and fourth aspects may be combined and coupled in any way possible within the scope of the invention.
  • Fig. 1A illustrates a tip of an interventional device embodiment where an OSS fiber is provided near a longitudinal position of the elongated device where the sensor is positioned
  • Fig. IB illustrates a tip of an interventional device embodiment where an OSS fiber is provided with a hook-shaped tip portion to identify a rotational angle at the position of a catheter where the image sensor resides,
  • Fig. 2 illustrates a cross sectional sketch of a three-core OSS fiber which can be used for determination of twist
  • Fig. 3 illustrates an intravascular catheter positioned in a curved blood vessel
  • FIG. 4A illustrates an X-ray image of a blood vessel, and corresponding grayscale IVUS data sets are shown: cross-sectional IVUS image is given in FIG. 4C, while longitudinal view (L-view), which is constructed by stacking up the cross-sectional images in single axis, is given in FIG. 4B,
  • Fig. 5 illustrates a block diagram of an imaging system embodiment with a catheter with optical shape sensing properties according to the invention
  • Fig. 6 illustrates a diagram of steps of an imaging method embodiment. DESCRIPTION OF EMBODIMENTS
  • Figs. 1A and IB illustrate sketches of a distal portion of interventional device embodiments in the form of a catheter C with different configurations of optical shape sensing fiber OSF to provide orientational information of the image sensor I_S.
  • Both of Figs. 1 A and IB illustrate an interventional device in the form of a catheter C, e.g. an IVUS catheter.
  • An image sensor I_S in the form of an ultrasonic sensor is arranged on a distal portion of the flexible elongated structural element SE forming the core of the catheter C.
  • the image sensor I_S has a reference direction perpendicular to the longitudinal axis of the elongated device SE, since it is arranged to provide ultrasonic images of a cross section of a blood vessel.
  • the flexible catheter C When inserted into a curved blood vessel, the flexible catheter C bends to follow the curve of the blood vessel, and further the catheter C will twist, thus changing the orientation or rotational angle of the image sensor I_S relative to proximal end of the catheter C (not shown).
  • the orientation of the image sensor I_S is unknown, e.g. if the location of the tip of the catheter C is tracked by means of an X-ray image.
  • an OSS fiber OSF is arranged along the longitudinal extension of the structural element SE with its fiber tip FT positioned near the longitudinal position of the structural element SE where the image sensor I_S is located. At least the optical fiber OSF should be attached to the structural element SE to follow its bending and twisting in the area wherein the image sensor I_S is positioned.
  • a single core OSS fiber OSF may be used in this embodiment, however it is also possible to use a multi-core OSS fiber, e.g. a 3-core OSS fiber.
  • a multi-core OSS fiber e.g. a 3-core OSS fiber.
  • An advantage of this embodiment is that it is easy to provide an interventional device C with a small overall cross sectional area, thus allowing the catheter C to be used also in rather narrow human blood vessels.
  • the tip portion FT of the OSS fiber OSF before is bent to provide a tip portion FT which is perpendicular to the longitudinal axis of the elongated structural element SE of the catheter C.
  • OSS technique it is possible to use OSS technique to track both the location and the orientation of the point of the catheter C where the image sensor I_S is positioned, since the hook shaped tip portion FT provides a distinct feature to allow both tracking of location and orientation of the tip of the optical fiber OSF.
  • a measure of orientation of the image sensor I_S is obtained.
  • At least the optical fiber OSF should be attached to the structural element SE of the catheter C to follow its bending and twisting in the area wherein the image sensor I_S is positioned.
  • a single core OSS fiber OSF may be used in this embodiment, however it is also possible to use a multi- core OSS fiber.
  • Fig. IB is based on detection of a known shape or curvature of the fiber tip FT of the OSS fiber OSF. It is to be understood that it may be curved in other distinct and predetermined ways than the shown perpendicularly bent shaped tip portion FT.
  • An alternative way of forming the identifiable feature FT of the optical fiber OSF can be a semi circular shape that surrounds the sensor I_S and has the sensor I_S in its center. More alternatively, the optical fiber OSF can be placed at the distal end of the elongated structural element SE of the catheter C in order not to affect the signals of the imaging sensor I_S, e.g. in the form of an ultrasonic transducer.
  • the crucial point is to provide an identifiable shape of the optical fiber OSF that can be identified by optical interrogation, and thus allow determination of location as well as orientation (rotational angle) of the elongated structural element SE, and thus the interventional device C, at the longitudinal position where the sensor I_S is positioned.
  • the tip part FT of the optical fiber OSF serves to provide the optically identifiable feature, it may be other parts of the optical fiber OSF that provide this identifiable feature that serves to provide information regarding position and orientation of the sensor I_S.
  • FIG. IB the tip part FT of the optical fiber OSF serves to provide the optically identifiable feature, it may be other parts of the optical fiber OSF that provide this identifiable feature that serves to provide information regarding position and orientation of the sensor I_S.
  • the tip part FT of the optical fiber OSF points in the direction perpendicular to the longitudinal axis of the elongated structural element SE of the catheter C, where the image sensor I_S is positioned.
  • the tip part FT may point in other directions different from where the sensor I_S is positioned, since the crucial point regarding proper angular alignment of images from the sensor I_S is to provide a known angular position of each image frame in relation to a known reference.
  • the total thickness of the interventional device C puts a limit to the maximum size allowed for the optically identifiable feature FT of the optical fiber OSF, e.g. an IVUS device arranged for narrow blood vessels.
  • the optically identifiable feature FT of the optical fiber OSF e.g. an IVUS device arranged for narrow blood vessels.
  • Large features are easier to optically identify, but it has been found in tests that it is possible to identify features FT having a curvature below 10 mm, such as features FT having a size of 5-10 mm, such as features FT having a size of 1-5 mm, and even features FT below 1 mm.
  • the principle behind the embodiment of FIG. 1 can be applied in thin interventional devices C suitable for use in blood vessels, even for use in a variety of human blood vessels.
  • the smaller the feature FT the more sensitive the optical identification is to noise, and thus proper filtering techniques are preferably applied in the signal processing of the optical interrogation of the optical fiber OSF.
  • the rotational angle may be possible to detect only with a limited precision, however still with an angular precision of such as 10°- 20°, or even poorer, a valuable orientational information may be obtained that allows improved quality in the following alignment and combination of image frames obtained with the sensor I_S, e.g. obtained in a pull back procedure.
  • Applying filtering steps which will be explained more below, it is possible to detect bending, twist, curvature values that allow computation of rotation angle for each node along the catheter C. Because of noise and other constraints, these parameters may be noisy and may not be accurate.
  • the optical feature FT i.e. the shape and/or curvature of the optical fiber OSF to detect
  • reliable measurements can be obtained that enable the use of the fixed shape information of the FT to compute the rotation angle more accurately, and thus knowledge of orientation of the sensor I_S is provided.
  • the signal processing may comprise a filtering step that utilizes rotation information from previous time instant(s). As smooth changes can be expected in the values of these parameters, temporal filtering can be used to get better estimates of the rotation angles.
  • the optical fiber OSF of FIG. 1 A may be a single core or a multi-core optical fiber OSF.
  • Fig. 2 shows a cross-section of an optical fiber in the form of a multi-core OSS cable comprising 3 optical fiber cores CRl, CR2, CR3 along an x-axis, and arranged mutually displaced in the yz -plane.
  • the optical fiber cores CRl, CR2, CR3 are shown an arbitrary bending direction 0 b .
  • OSS technology uses strain measurements at individual nodes along each optical fiber core CRl, CR2, CR3 to compute shape. This allows to compensate for the effects of temperature-induced changes and to resolve multiple angles in 3D.
  • interpolation methods such as splines
  • splines To calculate the values of these parameters between the nodes, interpolation methods, such as splines, are used. Having all these parameters, it is possible to compute the rotation angle around the x-, y-, and z-axes, see e.g. the above- mentioned papers. Because the position of the sensor, e.g. ultrasonic transducer, it is known which nodes correspond to the sensor location. In order to remove noise in measurements, data can be filtered, and estimate the rotation angle by using combination of filtered measurements. It can be considered to use median filtering or averaging of the bending, twist, and curvature values. In a possible further filtering step, it is possible to use the rotation information from the previous time instant(s). As smooth changes in the values of these parameters is expected, temporal filtering can be used to get even better estimates of the rotation angles.
  • a plurality of OSS sensors e.g. in the form of two or three, or even more separate OSS fibers, may be used to improve rotational tracking accuracy.
  • This principle can be used both for the embodiments in Figs. 1A and IB, and the embodiment in Fig. 2.
  • a plurality of OSS fibers may be placed adjacent to each other in or on the catheter C, and each having respective curvature or bend features FT to allow improved accuracy in the determination of orientation angle.
  • the OSS results can be used in the signal processing to improve rotational tracking accuracy by utilizing the spatial redundancy obtained by using several separate OSS fibers.
  • the signal processing for rotation angle can use the combination of estimates from the plurality of separate OSS fibers or sensors, and different methods. E.g. angle estimations can be averaged to find the final rotation angle estimate.
  • image- based refinement of rotation angle can be considered for improvement of the orientational precision that can be obtained from the OSS system.
  • a first estimated rotation angle may be obtained from the OSS system, e.g. an OSS system as one of or a combination of the embodiments described above.
  • image data from the sensor I_S e.g. from an IVUS device, is used to find the best rotation angle within the estimate coming from the OSS system.
  • image features are used as matching metrics to evaluate the quality of the match.
  • Fig. 3 illustrates to the left a catheter C arranged insides a curved blood vessel VS, and to the right cross sectional views are seen at two longitudinal positions xl and x2.
  • Intravascular technologies that provide information about the internal structure of the vessels are evolved as a complementary method to the standard coronary angiography. Angiography images depict the lumen whereas intravascular imaging techniques, e.g. IVUS, allows analyzing vessel VS wall and plaque.
  • IVUS provides localized information and lacks the global information. For the global information, co-registration techniques are in use.
  • IVUS does not provide a geometrically correct 3D representation of the vessel VS as the catheter C also moves with a rotational angle during the pullback. This is illustrated in FIG. 3, since at position xl, the catheter C is positioned close to one angular part of the vessel VS wall, whereas at position x2, the catheter C is positioned close to another angular part of the vessel VS wall.
  • Different effects cause rotational movement of the catheter C such as bending of the catheter C due to vessel VS curvature, heart motion, etc.
  • the orientation of the sensor during capturing of image frames is different, resulting in generated images that are not centered and aligned as will be shown.
  • Figs. 4A, 4B, and 4C illustrate an example of co-registered X-ray image of a human blood vessel VS and IVUS data sets.
  • the IVUS catheter has been used in a pull-back procedure to examine the vessel VS wall, and markers xl and x2 indicated two different longitudinal positions.
  • a cross-sectional IVUS image within this segment is shown in FIG. 4C.
  • Fig. 4B illustrates the longitudinal view (L-view) of this defined segment with the corresponding markers xl and x2.
  • the L-view gives an oversimplification of the defined vessel segment since it is constructed by stacking up the cross- sectional IVUS images on a single axis. Due to the simplified view of the vessel structure, curvature info of the vessel is missing. Moreover, this view lacks axial twisting of the catheter during the pullback and therefore, orientation of the cross-sectional images is unknown, and this may provide difficulties in medically interpreting the combined image.
  • the interventional device and the method according to the present invention manual pull-back is possible as well, and still the OSS technique can provide orientational information of the image sensor at each captured image frame, thus allowing a calibration or alignment of the image frames, so as to provide a clearer combined image of a curved vessel VS wall. This allows better possibilities for physicians in providing a meaningful medical interpretation of such images.
  • FIG. 5 shows an interventional imaging system embodiment.
  • An elongated interventional device C_OSF comprising an elongated device arranged for interventional application, e.g. an IVUS catheter, having a sensor I_S positioned on a distal portion of the elongated device.
  • the sensor I_S may be an ultrasonic transducer arranged to sense characteristics of a blood vessel wall present to the side of the catheter C_OSF.
  • An optical fiber with OSS properties is integrated to follow the catheter C_OSF. This optical fiber is attached to at least a part of the catheter C_OSF at or near a longitudinal position of the catheter C_OSF where the sensor I_S is positioned, so as to allow optical tracking of an orientation of the sensor I_S, i.e. a rotational angle relative to a longitudinal axis of the catheter C_OSF.
  • the OSS fiber is connected to an optical console system OSS_C arranged for optically interrogating the OSS properties of the optical fiber, and for determining an orientation 0_D of the sensor I_S in response to said optical interrogation.
  • the system further comprises a unit CS_I arranged to collect a plurality of cross sectional images from the sensor I_S at respective points in time, and a processor P which receives these images, and stores for each image, data 0_D indicative of orientation of the sensor I_S, received from the optical console OSS_C. Finally, the processor generates a combined image S_CS_I in response to said plurality of images by aligning the plurality of images with respect to said data 0_D indicative of orientation of the sensor I_S.
  • the system may further use single images and still utilize the orientation data 0_D to provide a visualization of one single cross-sectional image which is correct with respect to a reference orientation.
  • the optical console system OSS_C may further be arranged to determine a measure of three-dimensional location, or longitudinal position in a blood vessel, of the sensor I_S by means of optical interrogation of the optical fiber, and wherein the processor is then arranged for generating said combined image in accordance with said measure of three- dimensional location of the sensor I_S for each of the plurality of images.
  • Fig. 6 illustrates steps of a method embodiment in the form of a specific interventional imaging method, namely an intravascular imaging method, e.g. based on data from an catheter C.
  • First step is to provide (P_IV_OSF) an elongated device arranged for interventional application, e.g. an IVUS catheter, with a sensor (e.g.
  • ultrasonic transducer positioned on a distal portion of the elongated device, wherein the sensor is arranged to sense characteristics of material present perpendicular to a longitudinal axis of the elongated device, and wherein an optical fiber with optical shape sensing properties along at least a part of its longitudinal extension is attached to at least a part of the elongated device at or near a longitudinal position of the elongated device where the sensor is positioned.
  • Next step is to capture C_I an image with the sensor, and to optically interrogate I_OSF the optical fiber, and calculate a measure of orientation C_0_L of the sensor in response to the optical interrogation of the optical fiber.
  • the sub steps C_I, I_OSF, C_0_L are then repeated N times, e.g. during a pull-back procedure, to obtain a set of data with a plurality of images (obtained at respective longitudinal position in a blood vessel), and a corresponding plurality of measures of orientation of the sensor.
  • the plurality of images are combined CM_I, e.g. stacked, into a combined image by aligning the plurality of images with respect to said measures of orientation of the sensor.
  • CM_I e.g. stacked
  • optical interrogation of the optical fiber is further used to provide precise and corresponding 3D position information of the sensor for each image frame.
  • a post-processing uses the stored orientation and position information to align e.g. IVUS image frames with respect to the previous frame and/or a reference orientation, which can be a specified angle or which can be the angle at a certain anatomical location.
  • a reference orientation which can be a specified angle or which can be the angle at a certain anatomical location.
  • Accurate alignment of IVUS frames with respect to each other provides an accurate local orientation, and this data can be used to stack the IVUS frames on a single-axis to construct a so-called L-view.
  • the same orientation information of each IVUS image can also be used in relation to the X-ray image in order to display the cross-sectional images in the accurate x-y alignment on the X-ray image.
  • the invention is suitable for IVUS longitudinal construction, i.e. stacking of a plurality of images, for X-ray IVUS Co-registration (x-y axis alignment information), i.e. orientation alignment for visualization of single cross sectional images, and for 3D reconstruction of coronary arteries from fusion of IVUS/OCT and X-ray angiography images.
  • x-y axis alignment information i.e. orientation alignment for visualization of single cross sectional images
  • 3D reconstruction of coronary arteries from fusion of IVUS/OCT and X-ray angiography images.
  • the interventional device, the imaging system, and the method according to the invention has a number of applications within medical or within non-medical applications.
  • the invention provides an interventional device, e.g. an intravascular catheter such as IVUS or OCT, by using an optical shape sensor (OSS)-based mechanism at the time of the intravascular image acquisition.
  • An OSS fiber with a predetermined shape is merged with the intravascular catheter and the predetermined shape of OSS fiber has OSS identifiable features positioned to allow optical determination of orientation (rotational angle relative to a longitudinal axis of the catheter) at the longitudinal position of the catheter where the imaging sensor resides.
  • the predetermined shape of the OSS-device indicates an angle of rotation of a predetermined reference orientation of the catheter relative to an OSS sensor during navigation/pullback of the intravascular catheter through a vessel.
  • a multi-core OSS cable can be used, which allows calculation of twist angle between two nodes of the OSS cable, and thus a measure of rotational angle.
  • rotational angle (orientation) information can be gathered for each intravascular image.
  • Such orientation information can be used to visualize one single image with correct angular alignment.
  • calibrating individual images of a pull-back sequence with respect to the gathered rotational angle and position information it is possible to orient the cross-sectional intravascular data on an X-ray image with improved accuracy that may have better diagnostic value.

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Abstract

L'invention concerne un dispositif d'intervention, par exemple un cathéter intravasculaire tel que IVUS ou OCT, utilisant un mécanisme basé sur un capteur de forme optique (OSS) au moment de l'acquisition d'image intravasculaire. Une fibre OSS ayant une forme prédéterminée est fusionnée au cathéter intravasculaire, et la forme prédéterminée de la fibre OSS présente des caractéristiques identifiables OSS pour permettre une détermination optique d'orientation (angle de rotation par rapport à un axe longitudinal du cathéter) dans la position longitudinale du cathéter dans lequel se trouve le capteur d'imagerie. La forme prédéterminée du dispositif OSS indique un angle de rotation d'une orientation de référence prédéterminée du cathéter par rapport à un capteur OSS pendant une navigation/marche arrière du cathéter intravasculaire à travers un vaisseau. Autrement, ou en plus, un câble OSS multicœur peut être utilisé et permettre le calcul d'un angle de torsion entre deux nœuds du câble OSS, et ainsi une mesure d'un angle de rotation. Avec un tel système, il est possible d'obtenir des informations d'angle de rotation (orientation) collectées pour chaque image intravasculaire. De telles informations d'orientation peuvent être utilisées pour visualiser une image unique ayant un alignement angulaire correct. En outre, en calibrant des images individuelles d'une séquence de marche arrière par rapport aux informations d'angle de rotation et de position collectées, il est possible d'orienter les données intravasculaires transversales sur une image à rayons X avec une précision améliorée qui peut avoir une meilleure valeur de diagnostic.
PCT/EP2014/074441 2013-11-13 2014-11-13 Détection d'angle de rotation d'un dispositif d'intervention Ceased WO2015071343A1 (fr)

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WO2017051279A1 (fr) * 2015-09-24 2017-03-30 Koninklijke Philips N.V. Système et procédé pour trouver des vues améliorées lors d'un remplacement de valve par transcathéter, d'utilisation une détection de forme optique et d'un guidage par image ultrasonore combinés
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US11589943B2 (en) 2017-12-20 2023-02-28 Koninklijke Philips N.V. Torsional deployment detection of a vascular therapy
CN109730693A (zh) * 2018-12-13 2019-05-10 北京理工大学 一种新型管状结构三视场光学手持探头
US12109783B2 (en) 2019-07-02 2024-10-08 Sekisui Chemical Co., Ltd. Intermediate film for laminated glass, and laminated glass

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