# US 10,244,963 B2 · Ascertaining a position and orientation for visualizing a tool

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- Number: US 10,244,963 B2
- Document ID: US10244963B2
- Status: Granted
- Kind: B2
- Application number: 14/978,811
- Filed: 2015-12-22
- Published: 2017-06-22
- Granted: 2019-04-02
- Earliest claimed: 2015-12-22
- Assignees: Biosense Webster (Israel) Ltd.
- Applicants: Biosense Webster (Israel) Ltd.
- Inventors: Vadim Gliner
- Web page: https://patentgrep.com/patent/US10244963B2

## CPC

- A61B 5/066: {Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging}
- A61B 5/055: involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
- A61B 5/064: {using markers (A61B5/062 takes precedence)}
- A61B 5/6852: {Catheters}
- A61B 5/7425: {Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image}
- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61M 25/0127: {Magnetic means; Magnetic markers}
- A61B 2018/00351: {Heart}
- A61B 2018/00577: {Ablation}
- A61B 2560/0223: of calibration, e.g. protocols for calibrating sensors
- A61B 2576/00: Medical imaging apparatus involving image processing or analysis (A61B1/00009, A61B6/52 and A61B8/52 take precedence)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

While a catheter that includes (i) a catheter body, and (ii) a catheter shaft, which includes a sensor and which is disposed inside a lumen of the catheter body, is inside a body of a subject, a position and an orientation of a distal end of the catheter body with respect to the sensor are ascertained, based on (a) a calibration image, acquired by an imaging system, that shows an indication of the distal end of the catheter body, and (b) a signal from the sensor, but not based on any indication of the sensor shown in the calibration image. Using the ascertained position and orientation of the distal end of the catheter body with respect to the sensor, a visual output is generated. Other embodiments are also described.

## Claims

### Claim 1

A method, comprising:
providing an electrical interface;
providing a processor; and
while a catheter that includes (i) a catheter body, and (ii) a catheter shaft, which includes a sensor and which is disposed inside a lumen of the catheter body, is inside a body of a subject, ascertaining a position and an orientation of a distal end of the catheter body with respect to the sensor, based on (a) a calibration image, acquired by an imaging system, that shows an indication of the distal end of the catheter body, and (b) a signal from the sensor, but not based on any indication of the sensor shown in the calibration image; and
using the position and orientation of the distal end of the catheter body with respect to the sensor, generating a visual output,
wherein generating the visual output comprises displaying a map of a portion of the body of the subject,
wherein the map includes an electroanatomical map of at least a portion of a heart of the subject,
wherein the calibration image is an MRI image,
wherein the indication of the distal end of the catheter body includes a void in the MRI image that corresponds to the distal end of the catheter body,
wherein ascertaining the position and orientation of the distal end of the catheter body with respect to the sensor comprises:
ascertaining a position and an orientation of the distal end of the catheter body with respect to a coordinate system of the imaging system, by identifying the indication of the distal end of the catheter body in the calibration image,
based on the signal from the sensor, ascertaining a position and an orientation of the sensor with respect to the coordinate system of the sensor, and
based on (i) the position and orientation of the distal end of the catheter body with respect to the coordinate system of the imaging system, (ii) the position and orientation of the sensor with respect to the coordinate system of the sensor, and (iii) a prior registration between the coordinate system of the sensor and the coordinate system of the imaging system, ascertaining the position and orientation of the distal end of the catheter body with respect to the sensor,
further comprising performing the following steps,
receiving and analyzing a plurality of ECG signals, and wherein the processor ascertains the position and orientation of the sensor at the time that the ECG signals were recorded, based on the sensor signal,
using DE_S, wherein DE_S denotes position and orientation of the distal end of the catheter body with respect to the sensor obtained during calibration, to ascertain DE_CS, wherein DE_CS denotes position and orientation of the distal end of the catheter body with respect to the coordinate system of the sensor, from S_CS, wherein S_CS denotes position and orientation of the sensor with respect to the coordinate system of the sensor,
updating the electroanatomical map, wherein the processor derives a plurality of local activation times from the ECG signals, and updates the electroanatomical map to reflect the local activation times, wherein, in performing the updating, the processor uses DE_CS to derive positions of the electrodes on tissue inside the body of the subject, wherein in updating the map, the processor places a visual representation of the distal end of the catheter body on the electroanatomical map, at the position and orientation indicated by DE_CS, and
displaying the electroanatomical map in registration with the calibration image using CS_CIS, wherein CS_CIS denotes registration between the coordinate system of the imaging system.

### Claim 2 (depends on 1)

The method according to claim 1, wherein generating the visual output comprises superimposing a visual representation of the distal end of the catheter body on an image of a portion of the body of the subject.

### Claim 3 (depends on 2)

The method according to claim 2, wherein the distal end of the catheter body includes one or more electrodes, and wherein the visual representation of the distal end of the catheter body includes a visual representation of the one or more electrodes.

### Claim 4 (depends on 2)

The method according to claim 2, wherein superimposing the visual representation of the distal end of the catheter body on the image of the portion of the body of the subject comprises superimposing the visual representation of the distal end of the catheter body on the image of the portion of the body of the subject during an ablation of the portion of the body of the subject.

### Claim 5 (depends on 1)

The method according to claim 1, wherein the sensor is an electromagnetic sensor.

### Claim 6

Apparatus, comprising:
an electrical interface; and
a processor, configured to: while a catheter that includes (i) a catheter body, and (ii) a catheter shaft, which includes a sensor and which is disposed inside a lumen of the catheter body, is inside a body of a subject, ascertain a position and an orientation of a distal end of the catheter body with respect to the sensor, based on (a) a calibration image, acquired by an imaging system, that shows an indication of the distal end of the catheter body, and (b) a signal from the sensor, but not based on any indication of the sensor shown in the calibration image; and
using the position and orientation of the distal end of the catheter body with respect to the sensor, drive a display to generate a visual output,
wherein the processor is configured to drive the display to generate the visual output by driving the display to display a map of a portion of the body of the subject,
wherein the map includes an electroanatomical map of at least a portion of a heart of the subject,
wherein the calibration image is an MRI image,
wherein the indication of the distal end of the catheter body includes a void in the MRI image that corresponds to the distal end of the catheter body,
wherein the processor is configured to ascertain the position and orientation of the distal end of the catheter body with respect to the sensor by:
ascertaining a position and an orientation of the distal end of the catheter body with respect to a coordinate system of the imaging system, by identifying the indication of the distal end of the catheter body in the calibration image,
based on the signal from the sensor, ascertaining a position and an orientation of the sensor with respect to the coordinate system of the sensor, and
based on (i) the position and orientation of the distal end of the catheter body with respect to the coordinate system of the imaging system, (ii) the position and orientation of the sensor with respect to the coordinate system of the sensor, and (iii) a prior registration between the coordinate system of the sensor and the coordinate system of the imaging system, ascertaining the position and orientation of the distal end of the catheter body with respect to the sensor,
wherein the processor is further adapted to perform the following steps,
receiving and analyzing a plurality of ECG signals, and wherein the processor ascertains the position and orientation of the sensor at the time that the ECG signals were recorded, based on the sensor signal,
using DE_S, wherein DE_S denotes position and orientation of the distal end of the catheter body with respect to the sensor obtained during calibration, to ascertain DE_CS, wherein DE_CS denotes position and orientation of the distal end of the catheter body with respect to the coordinate system of the sensor, from S_CS, wherein S_CS denotes position and orientation of the sensor with respect to the coordinate system of the sensor,
updating the electroanatomical map, wherein the processor derives a plurality of local activation times from the ECG signals, and updates the electroanatomical map to reflect the local activation times, wherein, in performing the updating, the processor uses DE_CS to derive positions of the electrodes on tissue inside the body of the subject, wherein in updating the map, the processor places a visual representation of the distal end of the catheter body on the electroanatomical map, at the position and orientation indicated by DE_CS, and
displaying the electroanatomical map in registration with the calibration image using CS_CIS, wherein CS_CIS denotes registration between the coordinate system of the imaging system.

### Claim 7 (depends on 6)

The apparatus according to claim 6, wherein the processor is configured to drive the display to generate the visual output by driving the display to superimpose a visual representation of the distal end of the catheter body on an image of a portion of the body of the subject.

### Claim 8 (depends on 7)

The apparatus according to claim 7, wherein the distal end of the catheter body includes one or more electrodes, and wherein the visual representation of the distal end of the catheter body includes a visual representation of the one or more electrodes.

### Claim 9 (depends on 6)

The apparatus according to claim 6, wherein the sensor is an electromagnetic sensor.