The instant disclosure relates to imaging, including medical imaging. In particular, the instant disclosure relates to apparatuses, systems, and methods for creating three-dimensional volumetric images.
Ultrasound transducers are utilized in a variety of medical applications. In many applications, the transducer is mounted in a catheter that can be navigated through a patient's vasculature and/or body organs to a site of interest.
In many such catheters, in order to obtain a three-dimensional volumetric image of the tissue being imaged, the transducer is rotated around a longitudinal axis of the catheter in order to obtain a plurality of two-dimensional image slices for assembly into a three-dimensional volumetric image. The transducer, for example a phased two dimensional image array, can be rotated via a motor or a manual actuator (e.g., a finger slider), either of which necessitates a relatively complex, relatively large diameter, and expensive catheter structure. For example, a motorized continuously-rotating transducer typically requires a rotating drivewire, a rotating energized (“hot”) lead, and a rotating ground lead, as well as electrical slip rings or rotary transformers in or near the catheter handle.
Disclosed herein is an apparatus for imaging tissue that includes: an acoustic imaging element (e.g., a phased array two-dimensional imaging transducer) having an active face that emits energy along a beam path and towards a tissue to be imaged; and an acoustically transmissive oscillating energy deflector positioned within the beam path. The acoustically transmissive oscillating energy deflector can be an acoustically transparent prism or lens. A drive assembly can be coupled to and operable to oscillate the acoustically transmissive energy deflector. For example, the drive assembly can include a motor and/or piezomotor, a cyclically inflatable element, and/or can be a cyclically fluid-driven assembly. Oscillating the deflector allows the capture of multiple closely-spaced and/or overlapping two-dimensional image slices that can be assembled to create a three-dimensional volumetric image.
In certain embodiments, the acoustically transmissive energy deflector oscillates at a frequency of between 15 Hz and 30 Hz, allowing for the capture of between 30 and 60 volumes per second (e.g., one volume in each direction of the oscillation). It can also oscillate through a range of 70 degrees.
It is contemplated that the acoustic imaging element and the acoustically transmissive energy deflector can be disposed within an enclosure, such as the catheter shaft or an inflatable balloon or membrane.
Also disclosed herein is an apparatus for imaging tissue including: an acoustic imaging element (e.g., a phased array two-dimensional imaging transducer) having an active face that emits energy along a beam path and towards a tissue to be imaged; and an oscillating reflective acoustic mirror deflector positioned within the beam path. The reflective acoustic mirror can be secured to the apparatus via at least one elastic element biased such that, when the elastic element is in a relaxed position, the acoustic mirror forms an angle of zero degrees with the active face of the acoustic imaging element (e.g., it lays flat against the apparatus/imaging element). A drive assembly, including one or more of a cyclically inflatable element, a motor, and a piezomotor, can be coupled to and operable to oscillate the acoustic mirror.
In another embodiment, an apparatus for volumetrically imaging tissue includes: a shaft; an imaging element disposed within the shaft, the imaging element including an active face that emits energy along a beam path and towards a tissue to be imaged; an energy deflector (e.g., a prism, lens, or acoustic mirror) positioned within the beam path; and a drive assembly coupled to the energy deflector operable to oscillate the energy deflector. The apparatus can also include a sensor for measuring a rotational or deflected position of the energy deflector as it oscillates. For example, the drive assembly can include a stepper motor.
The apparatus can also include a processor to assemble a three-dimensional volumetric image of the tissue to be imaged from a plurality of two-dimensional image slices of the tissue, wherein each image slice of the plurality of two-dimensional image slices is associated with a corresponding rotational or deflected position of the energy deflector. It is contemplated that the processor can also include additional functions, such as graphical user interface (“GUI”) presentation, system control, deflection control, and the like.
The imaging element will emit energy along the beam path to form two-dimensional image slices at a frame rate, and the energy deflector will oscillate at an oscillation frequency. It is contemplated that the frame rate and the oscillation frequency will be integer multiples of each other, and can be identical (e.g., the integer can be 1).
in still another embodiment, an apparatus for imaging tissue includes: an imaging element having an active face that emits energy along a beam path and towards a tissue to be imaged; an asymmetric transmissive lens positioned within the beam path; and an enclosure within which the imaging element and the energy deflector are disposed.
It should be understood from the foregoing summary and the detailed description that follows that, to form a three-dimensional volumetric image, the imaging element (e.g., a phased array two-dimensional imaging transducer) can have its electronically-scanned two-dimensional image plane mechanically deflected in a deflection direction, which is out of or at an angle to the imaging element's own two-dimensional image plane. This allows a set of closely spaced and/or overlapping two-dimensional image slices to be acquired, which, when assembled, create the three-dimensional volumetric image.
It should also be understood from the foregoing summary and the detailed description that follows that the two-dimensional image slices may not be perfectly parallel to each other in space, for example if the deflection mechanism swings the energy deflector about a hinge or pivot axis. Thus, as used herein, the term “deflection” (and its derivatives, such as “deflect” or “deflector”) includes not just pure rotation, but also a combination of rotation and translation. The various processors described herein can also compensate for any non-parallel offset in two-dimensional image slices.
The foregoing and other aspects, features, details, utilities, and advantages of the present invention will be apparent from reading the following description and claims, and from reviewing the accompanying drawings.
The present disclosure provides three dimensional imaging apparatuses, systems, and methods. For purposes of illustration, certain exemplary embodiments will be described herein in the context of an intracardiac echocardiography (“ICE”) device, such as the ViewFlex™ Xtra ICE Catheter of St. Jude Medical, Inc. It is contemplated, however, that the apparatuses, systems, and methods described herein can be used in other contexts, including, without limitation, intravascular ultrasound (“IVUS”) devices and optical coherence tomography (“OCT”) devices.
As shown in the close up and partially cut-away view of
In the case of ICE catheter 10, imaging element 20 is an acoustic element, and more particularly an ultrasound element. For example, imaging element 20 can be a multi-element (e.g., 64 element) phased or linear ultrasound two-dimensional transducer array or any other suitable ultrasound transducer (including a single-element transducer) or arrangement of multiple ultrasound transducers (each of which can, for example, be either single- or multi-element). It should be understood, however, that any suitable imaging element can be employed, including both acoustic and/or electromagnetic (e.g., optical, near-infrared) elements. In general, the ordinarily skilled artisan will appreciate how to select and configure a suitable imaging element 20 for a given application of the teachings herein.
Distal section 18 also includes an energy deflector 24 positioned in the beam path of imaging element 20. Energy deflector 24 acts to deflect, steer, shape, focus, defocus, or otherwise alter the energy emitted by imaging element 20 as it passes therethrough (in the case of an acoustic prism or acoustic lens) or reflects therefrom (in the case of an acoustic mirror). The ordinarily skilled artisan will understand from the foregoing disclosure that imaging element 20 emits energy towards the tissue being imaged through (e.g., in the case of a lens or prism) or off of (e.g., in the case of an acoustic mirror) energy deflector 24, which redirects the energy as it propagates.
Those of ordinary skill in the art will appreciate that imaging element 20 will not only emit energy through (or off of) deflection element 24, but will also receive incoming acoustic energy through (or off of) deflection element 24. Thus, it is desirable to design distal section 18 (e.g., imaging element 20, deflection element 24, and the like) to reduce multiple internal reflections and reverberations in or off of deflection element 24. It is also desirable to ensure that any gaps (e.g., the varying-size gap between imaging element 20 and deflection element 24 as deflection element 24 oscillates) are filled with an acoustically-transmissive liquid or other flowable material that minimizes acoustic reflections due to acoustic impedance mismatches. For example, as discussed below, one such flowable material is saline. In other embodiments, however, a permanent gel can be used to fill the gaps as they vary.
It should be understood, however, that
The ordinarily skilled artisan will also understand that shaft 14 can be filled with a medium (e.g., saline, as described above) in order to facilitate the transmission of ultrasonic energy emitted by imaging element 20 as it propagates towards, off of, and/or through energy deflector 24. Advantageously, saline acts as an acoustic coupling material to reduce loss/reflection of acoustic energy at the transducer interface.
It will be understood from the description herein that, for each rotational position of energy deflector 24 relative to the longitudinal axis of shaft 14 (see the arrows in
Rather than rotating the entirety of catheter 10 to capture various rotational orientations as is the case in some prior art devices, and rather than rotating imaging element 20 within catheter 10, which introduces additional complexity to the construction of catheter 10, as is the case in other extant devices, energy deflector 24 can be rotated by itself to capture a plurality of two-dimensional image slices that collectively define a three-dimensional volumetric image. More particularly, energy deflector 24 can be oscillated about the longitudinal axis of shaft 14 (e.g., on a hinge or pivot that runs parallel to the longitudinal axis of shaft 14); as energy deflector 24 oscillates, the energy passing therethrough (or reflected therefrom, in the case of an acoustic mirror, as described below) will impinge upon a different slice or portion of the tissue to be imaged.
The pivot or hinge about which energy deflector 24 rotates or oscillates may be positioned running through energy deflector 24, on a side of energy deflector 24, or elsewhere. For example, in some embodiments, a drive shaft (or drive wire) 28 can be attached to energy deflector 24 at one end and to a motor 30 (shown schematically in
In some embodiments, motor 30 can be a piezomotor (e.g., a rotary piezomotor), which may be situated in handle 12 and connected by drive shaft 28 to energy deflector 24. In other embodiments, the piezomotor can he disposed within distal section 18, which advantageously simplifies construction by reducing or eliminating the need for drive shaft 28.
Motor 30 can also be a stepper motor, a reversible stepper motor, or a servo motor.
In still other embodiments, energy deflector 24 can be rotated by an inflatable balloon or membrane, wherein inflation of the balloon or membrane forces deflection element 24 to move via contact therewith and/or mechanical coupling thereto. Such a balloon or membrane may be oscillated in inflation-extent for rotational scanning as by a fluid or gas piston residing in handle 12. The piston can be driven, for example by a linear piezoactuator, and can be fluidically connected to the driving or oscillating balloon or membrane via a pressurized fluid lumen in shaft 14. An advantage of the foregoing embodiment is that it minimizes or avoids the torque of drive shaft 28, which can cause unintended wholesale rotation of the entire distal section 18, as opposed to just the deflection element 24 as desired.
In further embodiments, drive shaft 28 may include a rotatable drive wire inside a rotationally-static tube (e.g., a rotatable nitinol drive wire in a rotationally-static nitinol tube). By attaching the body of motor 30 to the containment tube and the drive shaft of motor 30 to the drive wire, it is possible to minimize unwanted torque being delivered to distal section 18. The drive wire may have a lubricious coating (e.g., polytetrafluouroethylene (PTFE), such as TEFLON®) to minimize stick/slip events between the drive wire and the tube within which it is constrained.
As yet another alternative, energy deflector 24 can be driven as disclosed in U.S. application Ser. No. 12/347,116, which is hereby incorporated by reference as though fully set forth herein. The fluid (e.g., saline) driving the impeller as disclosed in the foregoing patent application can also advantageously act as described above to facilitate the transmission of ultrasonic energy emitted by imaging element 20. The fluid could also cyclically drive a bellows- or balloon-type mechanism (e.g., as the fluid fills the balloon or bellows, a (described below) gets progressively larger; as fluid is drained therefrom, a gets progressively smaller), rather than turning an impeller.
According to additional aspects of the disclosure, energy deflector 24 is driven by a temperature-driven shape memory actuator.
According to certain aspects, energy deflector 24 oscillates through a range of about 70 degrees (e.g., ±α, as shown in
The ordinarily skilled artisan will appreciate from the present disclosure that the upper limit on the oscillation frequency of energy deflector 24 will be dictated by the speed of sound in the medium to be imaged and by excessive fluid drag/cavitation associated with any saline or liquid surrounding energy deflector 24 as it moves. In certain embodiments, however, the oscillation frequency of energy deflector 24 will be between about 15 Hz and about 30 Hz.
Indeed, it is desirable to oscillate energy deflector 24 at the frequency at which imaging element 20 emits energy (commonly referred to as the “frame rate”), or at a rate that is an integer multiple of the frame rate, to improve the efficiency with which the three-dimensional volumetric image is assembled. For example, in one embodiment, a single 3D volume is gathered by 180 degrees of the full 360 degrees of phase of the full oscillation cycle (that is, each full cycle over the angular deflection limits can provide 2 sequential volumes).
As described above, each rotational position of energy deflector 24 is associated with a corresponding two-dimensional image slice of the tissue to be imaged. Thus, for example, a two-dimensional image slice can be taken at each degree step as energy deflector 24 oscillates from, e.g., −35 degrees to 35 degrees (i.e., a 180 degree of phase or half cycle of a full sine wave oscillation) relative to the position designated as “neutral” for a total of 71 two-dimensional image slices. These 71 two-dimensional image slices can be assembled into a single three-dimensional volumetric image of the tissue to be imaged. Depending on the oscillation rate of energy deflector 24, multiple volumetric images can be created each second, which facilitates the smooth depiction of cardiac motion.
In the embodiment depicted in
As described above, in certain aspects of the disclosure, motor 30 is a stepper or servo motor, such that the various rotational positions of energy deflector 24 are known (e.g., by a motor-integrated encoder). Alternatively, a rotary encoder (which can be mechanical, optical, magnetic, capacitive, or of any other suitable technology) can be used at distal section 18 to output the rotational position of energy deflector 24.
Another suitable rotational sensor 62 is an electromagnetic coil. As described above, two such coils can be used, with a first mounted on energy deflector 24 and a second mounted on distal section 18 itself. This enables one to detect the rotational position of energy deflector 24, for example by driving the first coil and detecting the first coil using the second coil (e.g., the coil on distal section 18 itself) via mutual induction coupling. Likewise, to determine the orientation and position of distal section 18, an external magnetic field can be applied and the response of the second coil can be measured (as is generally known in connection with magnetic field-based localization systems, including those referenced herein).
In turn, ultrasonic imaging module 52, under control of (and/or executing on) processor 58, assembles a plurality of such image slices, according to their associated rotational positions, into a volumetric image. To aid in understanding the assembly of a plurality of image slices into a volumetric image by processor 36,
Navigation/localization module 54 is operable to detect the position, and, in some aspects, rotational orientation, of a medical device, such as catheter 10 and/or ablator 64, within a localization field. When navigation/localization module 54 also localizes catheter 10, the localization of catheter 10 can be used to identify the location of the tissue depicted in the three-dimensional volumetric image assembled as discussed above.
In some embodiments, navigation/localization module 54 is the EnSite™ Velocity™ cardiac mapping and visualization system of St. Jude Medical, Inc., which operates on the principle that, when electrical currents are passed through a resistive medium, the voltage sensed by a tracking electrode can be used to determine the position of a medical device within the body. Other similar systems that rely upon electrical fields to localize a medical device within a patient's body can also be used. Other systems, however, may be used in connection with the present teachings, including for example, the CARTO navigation and location system of Biosense Webster, Inc., the AURORA® system of Northern Digital Inc., or Sterotaxis' NIOBE® Magnetic Navigation System, all of which utilize magnetic fields rather than electrical fields. The localization and mapping systems described in the following patents (all of which are hereby incorporated by reference in their entireties) can also be used: U.S. Pat. Nos. 6,990,370; 6,978,168; 6,947,785; 6,939,309; 6,728,562; 6,640,119; 5,983,126; and 5,697,377. Insofar as various navigation; localization systems (including those mentioned above) are well known, however, a detailed explanation thereof is not necessary to the instant disclosure.
Ablator 64 is also in communication with ablation module 56. Ablator 64 can include a radiofrequency ablation catheter and a radiofrequency generator to drive the catheter, but other manners of ablation (e.g., ultrasound ablation, cryogenic ablation, laser ablation) are contemplated. A detailed description of ablation module 56, however, is not necessary to the understanding of the teachings herein. Instead, it will suffice to mention that the imaging teachings herein can be applied to good advantage to observe and monitor the progress of a lesion being created by ablator 64.
In another aspect of the disclosure, energy deflector 24 does not oscillate to capture the plurality of image slices 34 that are assembled into the desired three-dimensional volumetric image. Instead, as shown in
As such, asymmetric transmissive lens 24e facilitates the capture of image slices at various rotational orientations, without mechanical oscillation, such as by sequentially activating one or more elements within imaging element 20 and “walking” the activated elements along the length of imaging element 20 (e.g., activating a moving window of 8 elements of a total of 64 elements within imaging element 20).
In certain embodiments, asymmetric lens 24e can capture image slices over a range of up to about 30 degrees (e.g., ±about 15 degrees from the “neutral” position normal to the surface of imaging element 20, shown in
The image slices can be gathered by sequentially activating different elements subsets of elements) within imaging element 20. Each activation can he termed an “aperture,” and, by “walking” the aperture along imaging element 20, the plurality of two-dimensional image slices can be captured. Advantageously, this avoids any mechanical oscillation of or within distal section 18.
It should also be understood, by analogy to
An alternative aspect of the instant teachings is illustrated in
As shown in
In vivo, acoustic mirror 24f can be deployed and caused to oscillate using any of the mechanisms described above (e.g., a motor, a piezomotor, a fluid driven impeller, a piezo-driven fluidic piston, a bellows, or balloon, etc.). Once deployed, and as acoustic mirror 24f oscillates, it will define an angle w with the face of imaging element 20. In certain aspects, acoustic mirror 24f oscillates through a total range of about 20 degrees. For example, if one assumes a “neutral” acoustic mirror 24f position of ψ=45 degrees (that is, the position of acoustic mirror 24f corresponding to the central two-dimensional image slice), then the total oscillatory range can be defined as 35≦ψ≦55.
Advantageously, the volumetric range imaged by a reflective oscillating acoustic mirror 24f is twice the oscillatory range. Thus, if acoustic mirror 24f oscillates through a range of about 20 degrees total, it will be able to image a three-dimensional volume spanning about 40 degrees total (e.g., a total of 41 two-dimensional image slices). This yields a two-times advantage over extant mechanical wobblers, which typically move the entire transducer within the imaging device tip.
It is contemplated that acoustic mirror 24f can be a permanent part of catheter 10. For example, as shown in
It should also be understood, by analogy to
In still another embodiment, illustrated in
The devices disclosed herein can gather three-dimensional volumes during oscillation of energy deflector 24. It is also contemplated that the systems disclosed herein can control the oscillation of energy deflector 24 to “lock on” to a particular region of tissue, or even particular two-dimensional image slice(s). This ability to “lock on” to a target can save time (e.g., a practitioner need not manually re-aim the ICE catheter periodically) and/or resources (e.g., it may reduce or eliminate the need for a practitioner dedicated to aiming the ICE catheter).
Although several embodiments of this invention have been described above with a certain degree of particularity, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the spirit or scope of this invention.
For example, imaging element 20 can include one or more capacitive micromechanical ultrasound transducers (“CMUT”).
As another example, the hinge or pivot about which energy deflector 24 deflects may not only rotate energy deflector 24, but also allow for translation of energy deflector 24.
As yet another example, imaging element can alternatively be coupled to a higher-power energy source, which can allow the use of imaging element for ablation as well (e.g., high intensity focused ultrasound (“HIFU”) ablation).
All directional references (e.g., upper, lower, upward, downward, left, right, leftward, rightward, top, bottom, above, below, vertical, horizontal, clockwise, and counterclockwise) are only used for identification purposes to aid the reader's understanding of the present invention, and do not create limitations, particularly as to the position, orientation, or use of the invention. Joinder references (e.g., attached, coupled, connected, and the like) are to be construed broadly and may include intermediate members between a connection of elements and relative movement between elements. As such, joinder references do not necessarily infer that two elements are directly connected and in fixed relation to each other.
It is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. Changes in detail or structure may be made without departing from the spirit of the invention as defined in the appended claims.
This application claims the benefit of U.S. provisional application No. 62/100,756, filed 7 Jan. 2015, which is hereby incorporated by reference as though fully set forth herein.
Filing Document | Filing Date | Country | Kind |
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PCT/US2015/064960 | 12/10/2015 | WO | 00 |
Number | Date | Country | |
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62100756 | Jan 2015 | US |