# US 11,026,747 B2 · Endoscopic view of invasive procedures in narrow passages

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- Number: US 11,026,747 B2
- Document ID: US11026747B2
- Status: Granted
- Kind: B2
- Application number: 15/907,739
- Filed: 2018-02-28
- Published: 2018-10-25
- Granted: 2021-06-08
- Earliest claimed: 2017-04-25
- Assignees: Biosense Webster (Israel) Ltd.
- Applicants: Biosense Webster (Israel) Ltd.
- Inventors: Andres Claudio Altmann; Vadim Gliner
- Web page: https://patentgrep.com/patent/US11026747B2

## CPC

- A61B 5/062: {using magnetic field}
- A61B 5/064: {using markers (A61B5/062 takes precedence)}
- A61B 5/6803: {Head-worn items, e.g. helmets, masks, headphones or goggles}
- A61B 5/6814: {Head}
- A61B 6/032: {Transmission computed tomography [CT]}
- A61B 17/24: for use in the oral cavity, larynx, bronchial passages or nose (for medical inspection of cavities or tubes in the body A61B1/00); Tongue scrapers
- 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
- A61B 1/00009: {of image signals during a use of endoscope}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2034/2072: {Reference field transducer attached to an instrument or patient}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- A61B 2562/0223: Magnetic field sensors
- A61M 25/09: Guide wires
- 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 method for visualization includes registering, within a common frame of reference, a position sensing system and a three-dimensional (3D) computerized tomography (CT) image of at least a part of a body of a patient. A location and orientation of at least one virtual camera are specified within the common frame of reference. Coordinates of a medical tool moving within a passage in the body are tracked using the position sensing system. A virtual endoscopic image, based on the 3D CT image, of the passage in the body is rendered and displayed from the specified location and orientation, including an animated representation of the medical tool positioned in the virtual endoscopic image in accordance with the tracked coordinates.

## Claims

### Claim 1

A method for visualization, comprising:
registering, within a common frame of reference, a position sensing system and a three-dimensional (3D) computerized tomography (CT) image of at least a part of a body of a patient;
specifying, via user input, a performance characteristic, location, and orientation of at least one virtual camera within the common frame of references, wherein specifying the performance characteristic comprises instructing a processor to enable the at least one virtual camera to begin to render and display a virtual endoscopic image only when the medical tool approaches the specified location;
tracking coordinates of a medical tool moving within a passage in the body using the position sensing system; and
rendering and displaying the virtual endoscopic image, based on the 3D CT image, of the passage in the body from the specified location and orientation including an animated representation of the medical tool positioned in the virtual endoscopic image in accordance with the tracked coordinates.

### Claim 2 (depends on 1)

The method according to claim 1, wherein the part of the body comprises a head of the patient, and wherein the passage comprises a nasal passage.

### Claim 3 (depends on 2)

The method according to claim 2, wherein the medical tool comprises a guidewire, which is inserted into the nasal passage.

### Claim 4 (depends on 1)

The method according to claim 1, wherein the position sensing system comprises an electromagnetic tracking system, which comprises one or more magnetic field generators positioned around the part of the body and a magnetic field sensor at a distal end of the medical tool.

### Claim 5 (depends on 4)

The method according to claim 4, wherein the one or more magnetic field generators mounted on a frame that is fixed to the part of the body, and wherein registering the position sensing system and the 3D CT image comprises the processor:
formulating a first calibration of the electromagnetic tracking system relative to the frame;
formulating a second calibration of the frame within the CT image; and
combining the first and second calibrations to register the distal end of the tool in the common frame of reference.

### Claim 6 (depends on 1)

The method according to claim 1, wherein specifying the location and orientation of the at least one virtual camera comprises receiving an input from an operator indicating the location and orientation relative to the CT image.

### Claim 7 (depends on 1)

The method according to claim 1, wherein specifying the location and orientation of the at least one virtual camera comprises positioning multiple virtual cameras at different, respective locations along a route of the medical tool through the passage.

### Claim 8 (depends on 7)

The method according to claim 7, wherein rendering and displaying the virtual endoscopic image comprises simultaneously rendering and displaying multiple virtual endoscopic images from different viewpoints corresponding to the different respective locations of the virtual cameras.

### Claim 9 (depends on 1)

The method according to claim 1, wherein rendering and displaying the virtual endoscopic image comprises changing a viewing characteristic of the virtual endoscopic image responsively to a movement of the medical tool within the passage as indicated by the tracked coordinates.

### Claim 10 (depends on 9)

The method according to claim 9, wherein changing the viewing characteristic comprises changing at least one of the location and the orientation of the at least one virtual camera so as to keep the medical tool in a field of view of the at least one virtual camera as the medical tool moves through the passage.

### Claim 11 (depends on 1)

The method according to claim 1, wherein specifying the location and orientation of the at least one virtual camera comprises positioning the at least one virtual camera in a chamber having an opening that is to be accessed by the medical tool via the passage in the body, and wherein rendering and displaying the virtual endoscopic image comprises visualizing the medical tool in the passage through the opening.

### Claim 12

Medical apparatus, comprising:
a medical tool, which is configured to move within a passage in a body of a patient;
a position sensing system, which is configured to track coordinates of the medical tool within the body;
a display screen; and
a processor, which is configured to:
register the position sensing system and a three-dimensional (3D) computerized tomography (CT) image of at least a part of the body within a common frame of reference,
receive input specifying a performance characteristic, a location, and orientation of at least one virtual camera within the common frame of reference, wherein the input specifying the performance characteristic comprises an instruction to enable the at least one virtual camera to begin to render and display a virtual endoscopic image only when the medical tool approaches the specified location, and
render and display on the display screen the virtual endoscopic image, based on the 3D CT image, of the passage in the body from the specified location and orientation including an animated representation of the medical tool positioned in the virtual endoscopic image in accordance with the tracked coordinates.

### Claim 13 (depends on 12)

The apparatus according to claim 12, wherein the part of the body comprises a head of the patient, and wherein the passage comprises a nasal passage.

### Claim 14 (depends on 13)

The apparatus according to claim 13, wherein the medical tool comprises a guidewire, which is inserted into the nasal passage.

### Claim 15 (depends on 12)

The apparatus according to claim 12, wherein the position sensing system comprises an electromagnetic tracking system, which comprises one or more magnetic field generators positioned around the part of the body and a magnetic field sensor at a distal end of the medical tool.

### Claim 16 (depends on 15)

The apparatus according to claim 15, and comprising a frame, which is fixed to the part of the body and on which the one or more magnetic field generators are mounted, wherein the processor is configured to register the position sensing system and the 3D CT image by formulating a first calibration of the electromagnetic tracking system relative to the frame, formulating a second calibration of the frame within the CT image, and combining the first and second calibrations to register the distal end of the tool in the common frame of reference.

### Claim 17 (depends on 12)

The apparatus according to claim 12, wherein the processor is configured to identify the location and orientation of the last least one virtual camera by performing steps comprising receiving an input from an operator of the apparatus indicating the location and orientation of the at least one virtual camera relative to the CT image.

### Claim 18 (depends on 12)

The apparatus according to claim 12, wherein the processor is configured to position multiple virtual cameras at different, respective locations along a route of the medical tool through the passage.

### Claim 19 (depends on 18)

The apparatus according to claim 18, wherein the processor is configured to simultaneously render and display on the display screen multiple virtual endoscopic images from different viewpoints corresponding to the different respective locations of the virtual cameras.

### Claim 20 (depends on 12)

The apparatus according to claim 12, wherein the processor is configured to change a viewing characteristic of the virtual endoscopic image responsively to a movement of the medical tool within the passage as indicated by the tracked coordinates.

### Claim 21 (depends on 20)

The apparatus according to claim 20, wherein changing the viewing characteristic comprises changing at least one of the location and the orientation of the at least one virtual camera so as to keep the medical tool in a field of view of the at least one virtual camera as the medical tool moves through the passage.

### Claim 22 (depends on 12)

The apparatus according to claim 12, wherein the processor is configured to position a virtual camera in a chamber having an opening that is to be accessed by the medical tool via the passage in the body, and to render and display the virtual endoscopic image so as to visualize the medical tool in the passage through the opening.