# US 10,499,814 B2 · Automatic generation and utilization of a vascular roadmap

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- Number: US 10,499,814 B2
- Document ID: US10499814B2
- Status: Granted
- Kind: B2
- Application number: 12/648,913
- Filed: 2009-12-29
- Published: 2010-06-24
- Granted: 2019-12-10
- Earliest claimed: 2007-03-08
- Assignees: Sync-Rx, Ltd.
- Applicants: Alexander Steinberg; Sagiv Philipp; Ran Cohen; David Tolkowsky
- Inventors: Alexander Steinberg; Sagiv Philipp; Ran Cohen; David Tolkowsky
- Web page: https://patentgrep.com/patent/US10499814B2

## CPC

- A61B 6/12: Arrangements for detecting or locating foreign bodies
- A61B 5/0044: {for the heart}
- A61B 6/469: {for selecting a region of interest [ROI]}
- A61B 6/481: {involving the use of contrast agents}
- A61B 6/501: {for diagnosis of the head, e.g. neuroimaging or craniography}
- 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}
- A61B 6/541: {involving acquisition triggered by a physiological signal}
- A61B 17/12036: {partial occlusion}
- A61B 17/1204: {temporary occlusion}
- A61B 17/12136: {Balloons}
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- G06T 7/0012: {Biomedical image inspection}
- G06T 7/0014: {using an image reference approach}
- G06T 7/13: Edge detection
- G06T 7/246: using feature-based methods, e.g. the tracking of corners or segments
- G06T 7/62: of area, perimeter, diameter or volume
- G06T 11/60: Creating or editing images; Combining images with text
- G06V 40/103: {Static body considered as a whole, e.g. static pedestrian or occupant recognition}
- G16H 50/30: for calculating health indices; for individual health risk assessment
- A61B 5/7285: {for synchronizing or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal}
- A61B 5/7289: {Retrospective gating, i.e. associating measured signals or images with a physiological event after the actual measurement or image acquisition, e.g. by simultaneously recording an additional physiological signal during the measurement or image acquisition}
- A61B 6/503: {for diagnosis of the heart}
- 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 8/0883: {for diagnosis of the heart}
- A61B 8/0891: {for diagnosis of blood vessels}
- A61B 8/543: {involving acquisition triggered by a physiological signal}
- A61B 18/02: by cooling, e.g. cryogenic techniques
- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61B 18/24: with a catheter (A61B18/26, A61B18/28 take precedence)
- A61B 34/25: {User interfaces for surgical systems}
- A61B 2017/00252: {for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel}
- A61B 2017/00694: {with means correcting for movement of or for synchronisation with the body}
- A61B 2017/00703: {correcting for movement of heart, e.g. ECG-triggered}
- A61B 2017/1205: {Introduction devices}
- A61B 2017/22044: {with a pointed tip}
- A61B 2017/22094: {for crossing total occlusions, i.e. piercing}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/254: {being adapted depending on the stage of the surgical procedure}
- A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image}
- A61F 2/958: Inflatable balloons for placing stents or stent-grafts
- G06T 2207/10121: Fluoroscopy
- G06T 2207/30048: Heart; Cardiac
- G06T 2207/30101: Blood vessel; Artery; Vein; Vascular
- G06V 2201/034: of medical instruments
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06V: IMAGE OR VIDEO RECOGNITION OR UNDERSTANDING
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)

## Abstract

Apparatus and methods are described for receiving into at least one processor a set of images of blood vessels of a subject. A road map of the subject's blood vessels is generated, by automatically (a) deriving at least one image from the set of images of the blood vessels, based upon visibility of at least a portion of the blood vessels in the set of images, and (b) in the derived image, determining a location of edge lines of at least some of the portion of the blood vessels in the image. An output is generated by the processor, based on the road map. Other embodiments are also described.

## Claims

### Claim 1

A method, comprising:
receiving into at least one processor a first set of one or more two-dimensional extraluminal images of blood vessels of a subject;
generating a two-dimensional extraluminal road map image indicating a longitudinal path of at least one of the subject's blood vessels, by automatically:
deriving at least one two-dimensional image from the first set of images of the blood vessels, based upon visibility of at least a portion of the blood vessels in the set of images;
determining a location of one or more edge lines corresponding to a boundary of the blood vessel in the derived two-dimensional image;
determining a location of a center line corresponding to the longitudinal path of the blood vessel in the derived two-dimensional image, wherein the location of the center line is determined using the location of the one or more edge lines; and
connecting, after determining location of the center line using the location of the one or more edge lines, disconnected portions of the center line by comparing locations of the disconnected portions;
acquiring a second set of one or more extraluminal images of the subject's blood vessels;
registering the extraluminal road map image to the one or more extraluminal images belonging to the second set of images; and
generating an output by the processor, based on the registering of the extraluminal road map image to the one or more extraluminal images belonging to the second set of extraluminal images.

### Claim 2 (depends on 1)

The method according to claim 1, wherein generating the output comprises overlaying the center line corresponding to the longitudinal path of the blood vessel on an image stream that is based upon the second set of images.

### Claim 3 (depends on 1)

The method according to claim 1, wherein generating the output comprises overlaying the center line corresponding to the longitudinal path of the blood vessel on a single image that is derived from the second set of images.

### Claim 4 (depends on 1)

The method according to claim 1, wherein generating the road map image comprises generating a road map image that corresponds to a given phase of a motion cycle of the blood vessels, and wherein generating the output comprises overlaying the line corresponding to the longitudinal path of the blood vessel on an image stream of the blood vessels that is gated to the given phase.

### Claim 5 (depends on 1)

The method according to claim 1, further comprising generating distance indicators along the line corresponding to the longitudinal path of the blood vessel.

### Claim 6 (depends on 1)

The method according to claim 1, wherein generating the road map image further comprises automatically enhancing the at least some of the portion of the blood vessels in the derived image.

### Claim 7 (depends on 1)

The method according to claim 1, wherein deriving the at least one two-dimensional image from the first set of images comprises selecting a single two-dimensional image from the first set of images, based upon visibility of at least the portion of the blood vessels in the first set of images.

### Claim 8 (depends on 1)

The method according to claim 1, wherein deriving the at least one two-dimensional image from the first set of images comprises selecting two or more images from the first set of images, based upon visibility of at least the portion of the blood vessels in the first set of images, and generating a two-dimensional image, based upon the two or more images.

### Claim 9 (depends on 1)

The method according to claim 1, wherein the location of the center line corresponds to a first portion of the blood vessel further, and wherein the method further comprises:
identifying a tool that is visible in the extraluminal road map image and in the one or more extraluminal images belonging to the second set of extraluminal images, wherein the tool is positioned in a second portion of the blood vessel and not the first portion of the blood vessel; and
in response to identifying the tool in the second portion, modifying the location of the line corresponding to the longitudinal path of the first portion of the blood vessel.

### Claim 10 (depends on 1)

The method according to claim 1, further comprising:
initiating an image stream of the blood vessels of the subject;
detecting, in the image stream, an increase in a vesselness descriptor to determine a commencement of an angiographic image sequence; and
identifying, in the angiographic image sequence, the first set of one or more two-dimensional extraluminal images of the blood vessels to be received by the at least one processor.

### Claim 11 (depends on 9)

The method according to claim 9, wherein identifying the tool in the road map image and in the one or more images belonging to the second set of images comprises identifying a radiopaque portion of the tool that is visible in the road map image and in the one or more images belonging to the second set of images.

### Claim 12

A method, comprising:
receiving into at least one processor a first set of one or more two-dimensional extraluminal images of blood vessels of a subject;
generating a two-dimensional extraluminal road map image indicating a longitudinal path of at least one of the subject's blood vessels, by automatically:
deriving at least one two-dimensional image from the first set of images of the blood vessels, based upon visibility of at least a portion of the blood vessels in the set of images;
determining a location of one or more edge lines corresponding to a boundary of the blood vessel in the derived two-dimensional image;
determining a location of a center line corresponding to the longitudinal path of the blood vessel in the derived two-dimensional image, wherein the location of the center line is determined using the location of the one or more edge lines; and
connecting, after determining location of the center line using the location of the one or more edge lines, disconnected portions of the one or more edge lines by comparing locations of the disconnected portions;
acquiring a second set of one or more extraluminal images of the subject's blood vessels;
registering the extraluminal road map image to the one or more extraluminal images belonging to the second set of images; and
generating an output by the processor, based on the registering of the extraluminal road map image to the one or more extraluminal images belonging to the second set of extraluminal images.

### Claim 13 (depends on 12)

The method according to claim 12, wherein generating the output comprises overlaying the center line corresponding to the longitudinal path of the blood vessel on an image stream that is based upon the second set of images.

### Claim 14 (depends on 12)

The method according to claim 12, wherein generating the road map image comprises generating a road map image that corresponds to a given phase of a motion cycle of the blood vessels, and wherein generating the output comprises overlaying the line corresponding to the longitudinal path of the blood vessel on an image stream of the blood vessels that is gated to the given phase.

### Claim 15 (depends on 12)

The method according to claim 12, further comprising generating distance indicators along the line corresponding to the longitudinal path of the blood vessel.

### Claim 16 (depends on 12)

The method according to claim 12, wherein generating the road map image further comprises automatically enhancing the at least some of the portion of the blood vessels in the derived image.

### Claim 17 (depends on 12)

The method according to claim 12, wherein deriving the at least one two-dimensional image from the first set of images comprises selecting two or more images from the first set of images, based upon visibility of at least the portion of the blood vessels in the first set of images, and generating a two-dimensional image, based upon the two or more images.

### Claim 18 (depends on 12)

The method according to claim 12, wherein the location of the center line corresponds to a first portion of the blood vessel further, and wherein the method further comprises:
identifying a tool that is visible in the extraluminal road map image and in the one or more extraluminal images belonging to the second set of extraluminal images, wherein the tool is positioned in a second portion of the blood vessel and not the first portion of the blood vessel; and
in response to identifying the tool in the second portion, modifying the location of the line corresponding to the longitudinal path of the first portion of the blood vessel.

### Claim 19 (depends on 18)

The method according to claim 18, wherein identifying the tool in the road map image and in the one or more images belonging to the second set of images comprises identifying a radiopaque portion of the tool that is visible in the road map image and in the one or more images belonging to the second set of images.

### Claim 20 (depends on 12)

The method according to claim 12, further comprising:
initiating an image stream of the blood vessels of the subject;
detecting, in the image stream, an increase in a vesselness descriptor to determine a commencement of an angiographic image sequence; and
identifying, in the angiographic image sequence, the first set of one or more two-dimensional extraluminal images of the blood vessels to be received by the at least one processor.

### Claim 21 (depends on 12)

The method according to claim 12, wherein generating the output comprises overlaying the center line corresponding to the longitudinal path of the blood vessel on a single image that is derived from the second set of images.

### Claim 22 (depends on 12)

The method according to claim 12, wherein deriving the at least one two-dimensional image from the first set of images comprises selecting a single two-dimensional image from the first set of images, based upon visibility of at least the portion of the blood vessels in the first set of images.