# US 12,223,118 B2 · Imaging system and method for use in surgical and interventional medical procedures > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,223,118 B2 - Document ID: US12223118B2 - Status: Granted - Kind: B2 - Application number: 18/587,114 - Filed: 2024-02-26 - Published: 2024-08-15 - Granted: 2025-02-11 - Earliest claimed: 2010-10-06 - Assignees: Globus Medical, Inc. - Applicants: NuVasive, Inc. - Inventors: Robert E. Isaacs; Samuel Morris Johnston; David Alexander Skwerer; Randall Graham Campbell - Web page: https://patentgrep.com/patent/US12223118B2 ## CPC - A61B 6/06: Diaphragms - A61B 6/12: Arrangements for detecting or locating foreign bodies - A61B 6/4405: {the apparatus being movable or portable, e.g. handheld or mounted on a trolley} - A61B 6/4441: {the rigid structure being a C-arm or U-arm} - A61B 6/486: {involving generating temporal series of image data} - A61B 6/5241: {combining overlapping images of the same imaging modality, e.g. by stitching} - A61B 6/547: {involving tracking of position of the device or parts of the device} - G06F 3/017: {Gesture based interaction, e.g. based on a set of recognized hand gestures (interaction based on gestures traced on a digitiser G06F3/04883)} - G06T 3/20: Linear translation of whole images or parts thereof, e.g. panning - G06T 3/4053: based on super-resolution, i.e. the output image resolution being higher than the sensor resolution - G06T 7/0016: {involving temporal comparison} - G06T 7/33: using feature-based methods - G06T 11/60: Creating or editing images; Combining images with text - G06T 15/08: Volume rendering - H04N 7/18: Closed-circuit television [CCTV] systems, i.e. systems in which the video signal is not broadcast - G06T 2207/10124: Digitally reconstructed radiograph [DRR] - G06T 2207/20212: Image combination - G06T 2207/20221: Image fusion; Image merging - G06T 2207/30004: Biomedical image processing - G06T 2210/41: Medical - H04N 7/183: {for receiving images from a single remote source} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G06F: ELECTRIC DIGITAL DATA PROCESSING (computer systems based on specific computational models G06N) - G06T: IMAGE DATA PROCESSING OR GENERATION, IN GENERAL - H04N: PICTORIAL COMMUNICATION, e.g. TELEVISION ## Abstract A system and method for displaying images of internal anatomy includes an image processing device configured to provide high resolution images of the surgical field from low resolution scans during the procedure. The image processing device digitally manipulates a previously-obtained high resolution baseline image to produce many representative images based on permutations of movement of the baseline image. During the procedure a representative image is selected having an acceptable degree of correlation to the new low resolution image. The selected representative image and the new image are merged to provide a higher resolution image of the surgical field. The image processing device is also configured to provide interactive movement of the displayed image based on movement of the imaging device, and to permit placement of annotations on the displayed image to facilitate communication between the radiology technician and the surgeon. ## Claims ### Claim 1 A system for generating a display of an image of a patient's internal anatomy, the image being at least one of an X-ray scan and computer tomography (CT) scan, in a surgical field during a medical procedure, the system comprising: a memory configured to store a first image of the surgical field; a display; and a processor, in electronic communication with the memory and display, configured to: produce an image set that includes permutations of a first image, the first image being based on a three-dimensional representation of the surgical field including the patient's internal anatomy and being with respect to a baseline orientation, acquire a new image of the surgical field, select a representative image from the image set based on a correlation between the representative image and the new image, merge the selected representative image with the new image, and display the merged image on the display, wherein the new image includes at least one region where the internal anatomy is blocked or obscured by one or more tools, instruments, implants or other objects used during the medical procedure, wherein the processor is further configured to determine the correlation based on comparing the representative image and the new image, wherein the comparing the representative image and the new image includes only comparing portions of the images outside the at least one region, and wherein the processor is further configured to: determine the at least one region based on identifying pixels having a value outside a pre-determined threshold. ### Claim 2 (depends on 1) The system of claim 1, wherein the new image corresponds to a lower dose of radiation than a dose of radiation corresponding to the first image. ### Claim 3 (depends on 1) The system of claim 1, wherein the permutations of the first image correspond to a predefined grid of image movements. ### Claim 4 (depends on 1) The system of claim 1, wherein the processor is further configured to: determine the correlation, wherein determining the correlation includes comparing overlapping pixels between the representative image and the new image. ### Claim 5 (depends on 1) The system of claim 1, wherein the processor is further configured to: heuristically selecting the representative images from the image set. ### Claim 6 (depends on 1) The system of claim 1, wherein the image set includes a plurality of parallel images each parallel image corresponding to another image and having certain anatomic features are reduced or enhanced relative to the another image; wherein merging the selected representative image with the new image includes merging the parallel image with the new image. ### Claim 7 (depends on 1) The system of claim 1, wherein the processor is further configured to: receive the three-dimensional representation from a computed tomography device. ### Claim 8 (depends on 1) The system of claim 1, wherein: applying a first dose of radiation to the patient obtains the three-dimensional representation; and applying a second dose of radiation to the patient obtains the new image; wherein the first dose of radiation is greater than the second dose of radiation. ### Claim 9 (depends on 1) The system of claim 1, wherein producing the image set includes using a graphics processing unit to perform at least part of the producing. ### Claim 10 (depends on 1) The system of claim 1, wherein the processor is further configured to: receive the three-dimensional representation of the surgical field from an intraoperative imaging device; and receive the new image from the intraoperative imaging device. ### Claim 11 (depends on 10) The system of claim 10, wherein the processor is further configured to: track movement of the intraoperative imaging device, the patient, or table relative to each other from the first orientation to a second orientation. ### Claim 12 (depends on 1) The system of claim 1, wherein the processor is further configured to: identify, within the new image, a location of a glyph caused by a radiodense object coupled to an imaging device used to obtain the new image; and use the location of the glyph as part of the merging. ### Claim 13 (depends on 1) The system of claim 1, wherein the merged image is enhanced to reduce visibility of a surgical tool within the merged image relative to visibility of the surgical tool within the new image. ### Claim 14 (depends on 1) The system of claim 1, wherein the first image is a digitally reconstructed radiograph. ### Claim 15 (depends on 1) The system of claim 1, wherein the three-dimensional representation is a computed tomography scan. ### Claim 16 (depends on 1) The system of claim 1, wherein the processor is further configured to: determine a virtual outline of a surgical instrument; and overlay a representation of the surgical instrument onto the merged image.