# US 10,441,236 B2 · Integration between 3D maps and fluoroscopic images

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- Number: US 10,441,236 B2
- Document ID: US10441236B2
- Status: Granted
- Kind: B2
- Application number: 14/045,246
- Filed: 2013-10-03
- Published: 2014-04-24
- Granted: 2019-10-15
- Earliest claimed: 2012-10-19
- Assignees: Biosense Webster (Israel) Ltd.
- Applicants: Biosense Webster (Israel) Ltd.
- Inventors: Meir Bar-Tal; Tamir Demri; Tal Haim Bar-on; Eliahu Zino; Ran Glazer; Gil Zigelman; Dror Berman
- Web page: https://patentgrep.com/patent/US10441236B2

## CPC

- A61B 6/5247: {combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound}
- A61B 5/0035: {adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography}
- A61B 5/0522: Magnetic induction tomography
- A61B 5/062: {using magnetic field}
- A61B 5/7425: {Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image}
- A61B 6/02: Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B 6/4417: {related to combined acquisition of different diagnostic modalities}
- A61B 6/4441: {the rigid structure being a C-arm or U-arm}
- A61B 6/463: {characterised by displaying multiple images or images and diagnostic data on one display}
- A61B 6/485: {involving fluorescence X-ray imaging}
- A61B 6/54: {Control of apparatus or devices for radiation diagnosis}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61M 25/0108: {using radio-opaque or ultrasound markers}
- A61M 25/0127: {Magnetic means; Magnetic markers}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/3954: {magnetic, e.g. NMR or MRI}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- 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

A coordinate system registration module, including radiopaque elements arranged in a fixed predetermined pattern and configured, in response to the radiopaque elements generating a fluoroscopic image, to define a position of the module in a fluoroscopic coordinate system of reference. The module further includes one or more connections configured to fixedly connect the module to a magnetic field transmission pad at a predetermined location and orientation with respect to the pad, so as to characterize the position of the registration module in a magnetic coordinate system of reference defined by the magnetic field transmission pad.

## Claims

### Claim 1

An apparatus for generating a transformation between a magnetic coordinate system and a fluoroscopic coordinating system, said apparatus including:
a magnetic tracking coordinate system;
a magnetic system controller;
a fluoroscope;
a fluoroscope coordinate system;
a fluoroscope controller;
a patient table;
a location pad attached to the patient table;
coils attached to the location pad for transmitting magnetic fields under control of the magnetic system controller;
a coordinate system calibration jig; and
a plurality of spheres on the coordinate system calibration jig for providing a fluoroscopic image of the spheres whereby the fluoroscopic controller analyzes the fluoroscopic image to determine a location and an orientation of the coordinate system calibration jig in the fluoroscopic coordinate system;
a number of magnetic sensors attached to the coordinate system calibration jig whereby signals from the magnetic sensors generated in response to the transmitted magnetic fields from the location pad coils are analyzed by the magnetic system controller to determine a location and an orientation of the coordinate system calibration jig in the magnetic coordinate system;
a registration module comprising radiopaque elements arranged in a fixed predetermined pattern in fixed connection to the location pad and configured in response to the radiopaque elements being imaged by the fluoroscope to enable the fluoroscopic controller to generate a position of the registration module in the fluoroscopic coordinate system; and
a system processor which receives the results of the location and orientation of the coordinate system calibration jig in the fluoroscopic coordinate system and in the magnetic coordinate system as well as the registration module in the fluoroscopic coordinate system to generate a transformation between the fluoroscopic coordinate system and the magnetic coordinate system.

### Claim 2 (depends on 1)

An apparatus according to claim 1 wherein the plurality of spheres on the coordinate system calibration jig are metal.

### Claim 3 (depends on 1)

An apparatus according to claim 1 including one or more connections configured to connect the registration module to the location pad at a predetermined location and orientation with respect to the location pad, so as to characterize the position of the registration module in the magnetic coordinate system.

### Claim 4 (depends on 1)

An apparatus according to claim 1 wherein the registration module comprises a pair of parallel plates defining a line of symmetry and wherein the radiopaque elements comprise a plurality of radiopaque markers distributed symmetrically above the line.

### Claim 5 (depends on 1)

An apparatus according to claim 1 wherein the registration module comprises a pair of parallel plates defining a line of symmetry, and wherein the radiopaque markers are distributed symmetrically about the line.

### Claim 6 (depends on 1)

An apparatus according to claim 1 wherein the predetermined shape is selected from a group containing a disk and a rectangle.

### Claim 7 (depends on 1)

The apparatus according to claim 1 wherein the spheres are spaced evenly within a period of a helical pattern.

### Claim 8 (depends on 7)

The apparatus according to claim 7 wherein each period of the helical pattern comprises a different number of radio opaque elements.

### Claim 9 (depends on 7)

The apparatus according to claim 7 wherein at least some of the periods of the helical pattern have different lengths as compared to other periods of the helical pattern, and wherein the periods of the helical patterns are spaced unevenly.

### Claim 10 (depends on 1)

The apparatus according to claim 1 further comprising a catheter having one or more coils, the coils being adapted to generate signals in response to magnetic fields generated by coils of the magnetic tracking system.

### Claim 11 (depends on 1)

The apparatus according to claim 1 wherein the coordinate system calibration jig includes retro-reflectors having openings for receiving removable balls.

### Claim 12 (depends on 11)

The apparatus according to claim 11 wherein the retro reflectors comprise a plurality of cavities in the exterior surface of the coordinate system calibration jig, and a plurality of removable balls each positioned in one of said plurality of cavities.

### Claim 13 (depends on 1)

The apparatus according to claim 1 wherein the coordinate system calibration jig further comprises a catheter holder shaped to temporarily hold a catheter.

### Claim 14 (depends on 1)

The apparatus according to claim 1 wherein the plurality of spheres are arranged in one or more straight lines along an exterior surface of the coordinate system calibration jig and wherein at least some of the spheres are not identical to other spheres which are arranged in the helical pattern.

### Claim 15 (depends on 1)

The apparatus according to claim 1 wherein the plurality of spheres are arranged in each of two or more straight lines along an exterior surface of the coordinate system calibration jig, the straight lines being parallel to the center axis of the jig body; and wherein at least some of the spheres are not identical to the spheres which are arranged in the helical pattern.