# US 10,959,780 B2 · Method and system for helping to guide an endovascular tool in vascular structures

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- Number: US 10,959,780 B2
- Document ID: US10959780B2
- Status: Granted
- Kind: B2
- Application number: 15/737,544
- Filed: 2016-06-24
- Published: 2018-06-14
- Granted: 2021-03-30
- Earliest claimed: 2015-06-26
- Assignees: Therenva
- Applicants: Therenva
- Inventors: Aurelien Dumenil; Cemil Goksu; Florent Lalys; Antoine Lucas
- Web page: https://patentgrep.com/patent/US10959780B2

## CPC

- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 6/12: Arrangements for detecting or locating foreign bodies
- A61B 6/463: {characterised by displaying multiple images or images and diagnostic data on one display}
- A61B 6/466: {adapted to display 3D data}
- A61B 6/481: {involving the use of contrast agents}
- A61B 6/487: {involving fluoroscopy}
- A61B 6/488: {involving pre-scan acquisition}
- A61B 6/504: {for diagnosis of blood vessels, e.g. by angiography}
- A61B 6/5235: {combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT}
- G06T 7/33: using feature-based methods
- G06T 17/10: Constructive solid geometry [CSG] using solid primitives, e.g. cylinders, cubes
- G06T 19/20: Editing of three-dimensional [3D] images, e.g. changing shapes or colours, aligning objects or positioning parts
- A61B 6/032: {Transmission computed tomography [CT]}
- A61B 2034/101: {Computer-aided simulation of surgical operations}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2090/065: {for measuring contact or contact pressure}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- A61B 2090/374: {NMR or MRI}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/3764: {with a rotating C-arm having a cone beam emitting source}
- G06T 3/00: Geometric image transformations in the plane of the image
- G06T 3/10: Selection of transformation methods according to the characteristics of the input images
- G06T 3/14: Transformations for image registration, e.g. adjusting or mapping for alignment of images
- G06T 17/00: Three-dimensional [3D] modelling for computer graphics
- G06T 2200/08: involving all processing steps from image acquisition to 3D model generation
- G06T 2207/10081: Computed x-ray tomography [CT]
- G06T 2207/10116: X-ray image
- G06T 2207/10121: Fluoroscopy
- G06T 2207/30101: Blood vessel; Artery; Vein; Vascular
- G06T 2219/2021: Shape modification
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL

## Abstract

A method and a system are provided for helping to guide an endovascular tool in vascular structures. The method includes an initial planning phase in which a first three-dimensional anatomical model specific to the patient is determined from an acquired three-dimensional image, and an intervention phase in which a final transformation, which is a combination of a rigid transformation and of an elastic transformation, is applied to the first three-dimensional anatomical model specific to the patient in order to obtain a second three-dimensional model specific to the patient. The rigid transformation is estimated between the preoperative three-dimensional image and one or more perioperative two-dimensional images of perioperative two-dimensional images, and the elastic transformation is calculated as a function of a simulation of vascular deformations that are induced by introducing the tool into the target vascular structure.

## Claims

### Claim 1

A method for helping to guide an endovascular tool in vascular structures, wherein the method comprises acts of:
during an initial planning phase,
obtaining and memorising a preoperative three-dimensional image comprising a target vascular structure of a patient,
determining a first three-dimensional anatomical model specific to the patient from the three-dimensional image acquired, with this first three-dimensional anatomical model being located in the same spatial reference as the three-dimensional image, and
during an intervention phase,
acquiring one or several perioperative two-dimensional images comprising the target vascular structure of the patient, opacified or not,
estimating a rigid transformation between the preoperative three-dimensional image and the perioperative two-dimensional images,
estimating an elastic transformation between said three-dimensional image and the two-dimensional images according to the rigid transformation and of a simulation of vascular deformations induced by introducing the tool into the target vascular structure,
applying a final transformation, a combination of the rigid transformation and of the elastic transformation, to the first three-dimensional anatomical model specific to the patient in order to obtain a second three-dimensional model specific to the patient, and
displaying said second three-dimensional model specific to the patient as superposition on the two-dimensional images acquired.

### Claim 2 (depends on 1)

The method according to claim 1, wherein the act of estimating an elastic transformation comprises modelling of the vascular structures of the patient from the preoperative three-dimensional image acquired.

### Claim 3 (depends on 1)

The method according to claim 1, wherein the act of estimating an elastic transformation comprises constructing biomechanical interaction model between the vascular structures and the endovascular tool.

### Claim 4 (depends on 3)

The method according to claim 3, comprising simulation of the interaction between the endovascular tool and the target vascular structure carried out by a finite element analysis method.

### Claim 5 (depends on 1)

The method according to claim 1, wherein the estimating of the elastic transformation comprises an additional act of correlation that uses said perioperative two-dimensional images.

### Claim 6 (depends on 5)

The method according to claim 5, wherein the act of correction comprises a projection of simulated positions of the endovascular tool on at least one perioperative two-dimensional image taken after the actual introduction of the endovascular tool, and a quantification of the difference between said simulated positions and actual positions of the endovascular tool.

### Claim 7 (depends on 6)

The method according to claim 6, further comprising an act of recalibration between said simulated positions and said actual positions.

### Claim 8 (depends on 1)

The method according to claim 1, wherein the first three-dimensional anatomical model specific to the patient is represented by a structure among a volume, a mesh of points, a set of contours and a set of anatomical markers.

### Claim 9 (depends on 1)

The method according to claim 1, wherein the estimating of a rigid transformation is carried out by automatic, semi-automatic or manual recalibration, between the preoperative three-dimensional image and at least one perioperative two-dimensional image.

### Claim 10

A system for helping to guide an endovascular tool in vascular structures, comprising:
an imaging device to acquire two-dimensional images of portions of a body of a patient;
a programmable device; and
a viewing unit,
wherein the programmable device is configured to:
during an initial planning phase,
obtaining and memorising a preoperative three-dimensional image comprising a target vascular structure of a patient,
determining a first three-dimensional anatomical model specific to the patient from the three-dimensional image acquired, with this first three-dimensional anatomical model being located in the same spatial reference as the three-dimensional image,
during an intervention phase,
acquire one or several perioperative two-dimensional images comprising the target vascular structure of the patient, opacified or not,
estimate a rigid transformation between the preoperative three-dimensional image and the perioperative two-dimensional images,
estimate an elastic transformation between said three-dimensional image and the two-dimensional images according to the rigid transformation and a simulation of vascular deformations induced by introducing the tool into the target vascular structure,
apply a combination of the rigid transformation and of the elastic transformation to the first three-dimensional anatomical model specific to the patient in order to obtain a second three-dimensional model specific to the patient, and
display on the viewing unit said second three-dimensional model specific to the patient in superposition on the two-dimensional images acquired.

### Claim 11

A non-transitory computer-readable medium comprising a computer program stored thereon comprising instructions for implementing acts of a method for helping to guide an endovascular tool in vascular structures during execution of the program by a processor of a programmable device, wherein the method comprises:
during an initial planning phase,
obtaining and memorising a preoperative three-dimensional image comprising a target vascular structure of a patient,
determining a first three-dimensional anatomical model specific to the patient from the three-dimensional image acquired, with this first three-dimensional anatomical model being located in the same spatial reference as the three-dimensional image, and
during an intervention phase,
acquiring one or several perioperative two-dimensional images comprising the target vascular structure of the patient, opacified or not,
estimating a rigid transformation between the preoperative three-dimensional image and the perioperative two-dimensional images,
estimating an elastic transformation between said three-dimensional image and the two-dimensional images according to the rigid transformation and of a simulation of vascular deformations induced by introducing the tool into the target vascular structure,
applying a final transformation, a combination of the rigid transformation and of the elastic transformation, to the first three-dimensional anatomical model specific to the patient in order to obtain a second three-dimensional model specific to the patient, and
displaying said second three-dimensional model specific to the patient as superposition on the two-dimensional images acquired.