# US 10,441,235 B2 · Vascular selection from images

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- Number: US 10,441,235 B2
- Document ID: US10441235B2
- Status: Granted
- Kind: B2
- Application number: 15/959,024
- Filed: 2018-04-20
- Published: 2018-08-23
- Granted: 2019-10-15
- Earliest claimed: 2016-05-16
- Assignees: CathWorks Ltd.
- Applicants: CathWorks Ltd.
- Inventors: Guy Lavi; Ofek Shilon; Sarit Semo; Omri Harish; Asaf Shimshovitz
- Web page: https://patentgrep.com/patent/US10441235B2

## CPC

- A61B 6/504: {for diagnosis of blood vessels, e.g. by angiography}
- A61B 6/5217: {extracting a diagnostic or physiological parameter from medical diagnostic data}
- G06T 7/0012: {Biomedical image inspection}
- G06T 7/11: Region-based segmentation
- G06T 7/12: Edge-based segmentation
- G06T 7/149: involving deformable models, e.g. active contour models
- G16H 50/30: for calculating health indices; for individual health risk assessment
- A61B 6/481: {involving the use of contrast agents}
- G06T 2207/20076: Probabilistic image processing
- G06T 2207/20096: Interactive definition of curve of interest
- G06T 2207/30101: Blood vessel; Artery; Vein; Vascular
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Methods and systems for manually assisted definition of vascular features are described. In some embodiments, vascular centerlines identified by image analysis are divided into segments. Optionally, one or more candidate paths extending to the vascular root position along chains of segments are generated for each of a plurality of vascular endpoint. Selection of paths which correspond to anatomical paths of blood flow is optionally based on manual review. Optionally, paths are manually defined, for example, based on selection of a plurality of waypoints. Optionally, paths are edited by use of an active contour method that allows relative rough indication of corrections to be transformed into path changes that conform closely to the geometry of nearby vasculature.

## Claims

### Claim 1

A method of segmenting a vascular image into vascular paths for defining paths of blood flow, the method comprising:
receiving, in a processor, the vascular image;
defining, via the processor, first and second targeted vascular path end regions within the vascular image;
segmenting, via the processor, the vascular image to identify the positions of vascular portions in the vascular image;
automatically generating, via the processor, a plurality of vascular path options from the identified vascular portions, each vascular path option defining a potential vascular path that extends between the first and second targeted vascular path end regions;
displaying, via the processor, the plurality of vascular path options registered to the vascular image for selection by a user, each of the displayed vascular path options including the first and second targeted vascular path end regions;
receiving, in the processor, a path option selected by the user for defining a path of blood flow; and
adjusting, removing, or adding vascular path options for other targeted vascular path end regions that are within the vascular image based on the path option selected by the user.

### Claim 2 (depends on 1)

The method of claim 1, wherein the plurality of paths are automatically generated based on a first set of criteria, and the path option selected by the user is selected based on a second set of criteria.

### Claim 3 (depends on 1)

The method of claim 1, further comprising predetermining an order of selection for the vascular path options, wherein the predetermining comprises ranking the vascular path options in an order, based on assessment of a likelihood that each vascular path option corresponds to an actual path of blood flow in blood vessels imaged in the vascular image.

### Claim 4 (depends on 3)

The method of claim 3, wherein the predetermining includes applying a cost function that assigns numerical costs to one or more features related to the vascular path options.

### Claim 5 (depends on 4)

The method of claim 4, wherein the cost function assigns numerical costs based on features of a plurality of vascular segment centerlines from which the vascular path option is concatenated.

### Claim 6 (depends on 5)

The method of claim 5, wherein the features of the plurality of vascular segment centerlines include one or more from the group consisting of centerline orientation, centerline offset, and a count of centerlines extending from a nodal region.

### Claim 7 (depends on 3)

The method of claim 3, wherein the cost function assigns numerical costs based on features of the vascular image over which the vascular path option extends.

### Claim 8 (depends on 7)

The method of claim 7, wherein the features of the vascular image include one or more of the group consisting of: continuity of vascular segment image intensity, continuity of vascular segment image width, and the position of a relative change in vascular intensity with respect to a nodal region from which three or more vascular segments extend.

### Claim 9 (depends on 3)

The method of claim 3, wherein the predetermining includes applying a cost function that assigns numerical costs based on an estimated relative position of a vascular segment image in depth, relative to an axis extending perpendicular to a plane of the vascular image.

### Claim 10 (depends on 3)

The method of claim 3, wherein the displaying includes presenting the plurality of vascular path options in a sequential order determined by the order of selection.

### Claim 11 (depends on 3)

The method of claim 3, wherein the displaying includes presenting the plurality of vascular path options simultaneously, and the order of selection corresponds to an order in which the vascular path options are displayed as active for selection.

### Claim 12 (depends on 1)

The method of claim 1, wherein each vascular path option defines a vascular path which extends through an image region between the first and second targeted vascular path end regions, ending at a vascular region of the image which is nearest to one of the first and second targeted vascular path end positions.

### Claim 13

A user interface for semi-automatic segmentation of a vascular path, the user interface comprising:
at least one interface module operable to present an automatically generated default vascular path extending between two target end points; and
at least one interface module operable to present at least one additional automatically generated vascular path extending between the two target end points,
wherein the at least one additional generated vascular path is presented simultaneously with the default vascular path.

### Claim 14 (depends on 13)

The user interface of claim 13, further comprising at least one interface module configured to enable definition of at least one way point, and operable to present an automatically generated vascular path extending between the two target end points via the at least one way point.

### Claim 15 (depends on 14)

The user interface of claim 14, further comprising at least one interface module operable to modify a previously defined vascular path by dragging a portion of the vascular path to a new location.

### Claim 16 (depends on 1)

The method of claim 1, further comprising:
receiving, in the processor, an indication that none of the plurality of vascular path options are acceptable; and
enabling, via the processor, a new path to be defined or drawn manually by the user with respect to the vascular image.

### Claim 17 (depends on 16)

The method of claim 16, wherein enabling the new path to be defined or drawn includes receiving, in the processor, an indication of the new path based on the user sequentially selecting at least some of the positions of vascular portions.

### Claim 18 (depends on 1)

The method of claim 1, wherein at least some of the positions of vascular portions include individual segments connected to a node comprising at least one of crossing vessels, a bifurcation, a double bifurcation, a trifurcation, or a free end.

### Claim 19 (depends on 1)

The method of claim 1, further comprising storing, via the processor, the plurality of vascular path options to a path list; and
after selection of the path option, causing, via the processor, the other of the plurality of vascular path options for the first and second targeted vascular path end regions to be discarded or designated as being false path options.

### Claim 20 (depends on 1)

The method of claim 1, wherein the first targeted vascular path end region or the second targeted vascular path end region includes a root position, and the other of the first targeted vascular path end region or the second targeted vascular path end region includes a terminal position.