Patent Grant
10621790
The present disclosure generally relates to cardiac mapping systems and methods. More specifically, the present disclosure relates to editing anatomical shells that are based on cardiac structures.
Diagnosing and treating cardiac disorders often involve the introduction of a catheter into a cardiac chamber through the surrounding vasculature. The catheter has a plurality of sensors, located on the catheter's distal end. Information received from the plurality of sensors, including the position of the plurality of sensors and electrical signals associated with each position, can be used to generate and display an approximate anatomical shell of the cardiac chamber. In some instances, the anatomical shell can include representations of features of the electrical signals associated with each position. The anatomical shell can be used by a physician or other medical professional for treating cardiac disorders.
One consideration of anatomical shell construction is how close the shape of the anatomical shell is to the actual shape of the cardiac tissue. While anatomical shell construction using a catheter having a plurality of sensors may provide a fair approximation of the cardiac tissue, there often may be various issues associated with it. One issue is “under-contact,” in which some points of the constructed anatomical shell are a significant distance from the actual tissue. Another issue is “over-contact,” in which the catheter operator has exerted too much force during a portion of the reconstruction phase and pushes the cardiac tissue outwards resulting in shapes that constitute an exaggerate representation of the cardiac chamber. Even another issue is “webbing,” in which small, sharp features of the cardiac chamber do not appear on the anatomical shell. This problem may be exacerbated by the catheter's rigidity.
Embodiments of the subject matter disclosed herein include cardiac mapping systems that facilitate editing a constructed anatomical shell. In embodiments, a user-editing toolbox may include tools for selecting and removing specific sub-volumes, surface regions, and/or the like. In embodiments, a processing device may be configured to implement one or more algorithms to automatically edit the anatomical shell. In this manner, embodiments of the disclosure may facilitate enhancing the accuracy of cardiac mapping technologies. Exemplary embodiments include the following.
In an Example 1, a processor-implemented method for voltage-guided anatomical shell editing, the processor-based method comprising: outputting, to a display device, an anatomical shell of a cardiac structure, wherein the anatomical shell is based on a plurality of signals sensed by a mapping probe and wherein each of the plurality of signals includes a respective sensed voltage; receiving, from the user input device, a user input specifying a first target depth for editing; receiving, from a user input device, a selection of a first region of the anatomical shell; generating a first modified anatomical shell by: removing a first portion of the anatomical shell, the first portion of the anatomical shell comprising the selected first region of the surface and extending inward to a first editing depth based on the first target depth, the first editing depth comprising at least one finite depth, and generating a first new surface region on the first modified anatomical shell, corresponding to the selected region, wherein the first new surface is disposed at the first editing depth and includes at least one representation of a sensed voltage at the first editing depth; outputting, to the display device, the first modified anatomical shell.
In an Example 2, the method according to Example 1, further comprising: receiving, from the user input device, a command to undo the generation of the first modified anatomical shell; regenerating the anatomical shell; and outputting the regenerated anatomical shell to the display device.
In an Example 3, the method according to any of Examples 1 and 2, further comprising: receiving, from the user input device, a user input specifying a second target depth for editing; receiving, from a user input device, a selection of a second region of the anatomical shell, the second region comprising at least a portion of the first region; generating a second modified anatomical shell by: removing a second portion of the anatomical shell, the second portion of the anatomical shell comprising the selected second region of the surface and extending inward to a second editing depth based on the second target depth, the second editing depth comprising at least one finite depth, and generating a second new surface region on the second modified anatomical shell, corresponding to the selected second region, wherein the second new surface is disposed at the second editing depth and includes at least one representation of a sensed voltage at the second editing depth; and outputting, to the display device, the second modified anatomical shell.
In an Example 4, the method according to Example 3, wherein the second target depth is at least 1 millimeter and at most 5 millimeters.
In an Example 5, the method according to any of Examples 3-4, wherein the at least one representation of a sensed voltage at the first editing depth indicates a voltage magnitude corresponding to a blood pool.
In an Example 6, the method according to any of Examples 3-5, wherein the at least one representation of a sensed voltage at the second editing depth indicates a voltage magnitude corresponding to cardiac tissue.
In an Example 7, a processor-based method for anatomical shell editing comprises generating a first anatomical shell, wherein the first anatomical shell comprises a first surface that intersects a first plurality of mesh points, the first plurality of mesh points corresponding to a plurality of signals, wherein each of the plurality of signals includes at least one respective sensed electrical signal; selecting a test point, wherein the first surface does not intersect the test point, the test point having a position within a test neighborhood of a position of a first mesh point; performing a test associated with the test point, comprising: determining a first value of a metric corresponding to the first mesh point; determining a second value of the metric corresponding to the test point; computing a gradient feature of the metric based on the first and second values; determining whether the gradient feature satisfies a condition; and generating a second anatomical shell, wherein the second anatomical shell comprises a second surface that intersects a second plurality of mesh points, wherein: if the gradient feature satisfies the condition, the second plurality of mesh points includes the test point; and if the gradient feature does not satisfy the condition, the second plurality of mesh points does not include the test point.
In an Example 8, the method according to Example 7, wherein, if the gradient feature does not satisfy the condition, the method further comprises: selecting an additional test point, the additional test point having a position within the test neighborhood of the position of the first mesh points; and performing the test associated with the additional test point.
In an Example 9, the method according to any of Examples 7 and 8, wherein the position of the test point is located opposite the direction of a normal to the first surface at the first mesh point.
In an Example 10, the method according to any of Examples 7-9, wherein the test neighborhood comprises a sphere with a radius of 2 millimeters.
In an Example 11, the method according to any of Examples 7-10, wherein the metric comprises at least one of an out-of-cardiac-band impedance measurement, a unipolar electrode activation voltage measurement, a contact force measurement of the mapping probe, and a position-based cardiac motion measurement.
In an Example 12, the method according to any of Examples 7-11, wherein performing the test further comprises: determining a sensed voltage value corresponding to the test point; and determining whether the sensed voltage value exceeds a voltage threshold.
In an Example 13, the method according to Example 12, wherein: if the gradient feature satisfies the condition and the sensed voltage value exceeds the voltage threshold, the second plurality of mesh points includes the test point; and if the gradient feature does not satisfy the condition or the sensed voltage value does not exceed the voltage threshold, the second plurality of mesh points does not include the test point.
In an Example 14, the method according to any of Examples 7-13, wherein determining whether the gradient feature satisfies a condition comprises determining whether an absolute value of the gradient feature exceeds a gradient threshold.
In an Example 15, a system comprises: a mapping probe configured to sense a plurality of signals associated with a cardiac structure; a processing device configured to: generate a first anatomical shell, wherein the first anatomical shell comprises a first surface that intersects a first plurality of mesh points, the first plurality of mesh points corresponding to a plurality of signals, wherein each of the plurality of signals includes at least one respective sensed electrical signal; select a test point, wherein the first surface does not intersect the test point, the test point having a position within a test neighborhood of a position of a first mesh point; determine a first value of a metric corresponding to the first mesh point; determine a second value of the metric corresponding to the test point; compute a gradient feature of the metric based on the first and second values; determine whether the gradient feature satisfies a condition; and generate a second anatomical shell, wherein the second anatomical shell comprises a second surface that intersects a second plurality of mesh points; wherein if the gradient feature satisfies the condition, the second plurality of mesh points includes the test point, and if the gradient feature does not satisfy the condition, the second plurality of mesh points does not include the test point; and a display device configured to display the second anatomical shell.
In an Example 16, a processor-implemented method for voltage-guided anatomical shell editing comprises: outputting, to a display device, an anatomical shell of a cardiac structure, wherein the anatomical shell is based on a plurality of signals sensed by a mapping probe and wherein each of the plurality of signals includes a respective sensed voltage; receiving, from the user input device, a user input specifying a first target depth for editing; receiving, from a user input device, a selection of a first region of the anatomical shell; generating a first modified anatomical shell by: removing a first portion of the anatomical shell, the first portion of the anatomical shell comprising the selected first region of the surface and extending inward to a first editing depth based on the first target depth, the first editing depth comprising at least one finite depth, and generating a first new surface region on the second modified anatomical shell, corresponding to the selected region, wherein the first new surface is disposed at the first editing depth and includes at least one representation of a sensed voltage at the first editing depth; outputting, to the display device, the modified anatomical shell; receiving, from the user input device, a command to undo the generation of the modified anatomical shell; regenerating the anatomical shell; outputting the regenerated anatomical shell to the display device; receiving, from the user input device, a user input specifying a second target depth for editing; receiving, from a user input device, a selection of a second region of the anatomical shell, the second region comprising at least a portion of the first region; generating a second modified anatomical shell by: removing a second portion of the anatomical shell, the second portion of the anatomical shell comprising the selected second region of the surface and extending inward to a second editing depth based on the second target depth, the second editing depth comprising at least one finite depth, and generating a second new surface region on the second modified anatomical shell, corresponding to the selected second region, wherein the second new surface is disposed at the second editing depth and includes at least one representation of a sensed voltage at the second editing depth; and outputting, to the display device, the second modified anatomical shell.
In an Example 17, the method of Example 16, wherein the at least one representation of a sensed voltage at the first editing depth indicates a voltage magnitude corresponding to a blood pool.
In an Example 18, the method of Example 16, wherein the at least one representation of a sensed voltage at the second editing depth indicates a voltage magnitude corresponding to cardiac tissue.
In an Example 19, the method of Example 16, wherein the first target depth is at least 1 millimeter and at most 5 millimeters.
In an Example 20, the method of Example 19, wherein the second target depth is less than the first target depth.
In an Example 21, a system, comprising: a mapping probe configured to sense a plurality of signals associated with a cardiac structure; a processing device configured to: generate a first anatomical shell, wherein the first anatomical shell comprises a first surface that intersects a first plurality of mesh points, the first plurality of mesh points corresponding to a plurality of signals, wherein each of the plurality of signals includes at least one respective sensed electrical signal; select a test point, wherein the first surface does not intersect the test point, the test point having a position within a test neighborhood of a position of a first mesh point; determine a first value of a metric corresponding to the first mesh point; determine a second value of the metric corresponding to the test point; compute a gradient feature of the metric based on the first and second values; determine whether the gradient feature satisfies a condition; and generate a second anatomical shell, wherein the second anatomical shell comprises a second surface that intersects a second plurality of mesh points; wherein if the gradient feature satisfies the condition, the second plurality of mesh points includes the test point, and if the gradient feature does not satisfy the condition, the second plurality of mesh points does not include the test point; and a display device configured to display the second anatomical shell.
In an Example 22, the system of Example 21, wherein the metric comprises at least one of an out-of-cardiac-band impedance measurement, a unipolar electrode activation voltage measurement, a contact force measurement of the mapping probe, and a position-based cardiac motion measurement.
In an Example 23, a processor-based method for anatomical shell editing, the method comprising: generating a first anatomical shell, wherein the first anatomical shell comprises a first surface that intersects a first plurality of mesh points, the first plurality of points corresponding to a plurality of signals, wherein each of the plurality of signals includes at least one respective sensed electrical signal; selecting a test point, wherein the first surface does not intersect the test point, the test point having a position within a test neighborhood of a position of a first mesh point; performing a test associated with the test point, comprising: determining a first value of a metric corresponding to the first mesh point; determining a second value of the metric corresponding to the test point; computing a gradient feature of the metric based on the first and second values; determining whether the gradient feature satisfies a condition; and generating a second anatomical shell, wherein the second anatomical shell comprises a second surface that intersects a second plurality of mesh points, wherein: if the gradient feature satisfies the condition, the second plurality of mesh points includes the test point; and if the gradient feature does not satisfy the condition, the second plurality of mesh points does not include the test point.
In an Example 24, the method of Example 23, wherein, if the gradient feature does not satisfy the condition, the method further comprising: selecting an additional test point, the additional test point having a position within the test neighborhood of the position of the first mesh points; and performing the test associated with the additional test point.
In an Example 25, the method of Example 23, wherein the position of the test point is located opposite the direction of a normal to the first surface at the first mesh point.
In an Example 26, the method of Example 23, wherein the test neighborhood is a sphere with a radius of 2 millimeters.
In an Example 27, the method of Example 23, wherein the metric comprises at least one of an out-of-cardiac-band impedance measurement, a unipolar electrode activation voltage measurement, a contact force measurement of the mapping probe, and a position-based cardiac motion measurement.
In an Example 28, the method of Example 23, wherein performing the test further comprises: determining a sensed voltage value corresponding to the test point; and determining whether the sensed voltage value exceeds a voltage threshold.
In an Example 29, The method according to Example 28, wherein: if the gradient feature satisfies the condition and the sensed voltage value exceeds the voltage threshold, the second plurality of mesh points includes the test point; and if the gradient feature does not satisfy the condition or the sensed voltage value does not exceed the voltage threshold, the second plurality of mesh points does not include the test point.
In an Example 30, the method of Example 23, wherein determining whether the gradient feature satisfies a condition comprises determining whether an absolute value of the gradient feature exceeds a gradient threshold.
In an Example 31, a computer program product comprising a non-transitory computer readable storage medium containing program code, the computer program code when executed by a processor causes the processor to: generate a first anatomical shell, wherein the first anatomical shell comprises a first surface that intersects a first plurality of mesh points, the first plurality of points corresponding to a plurality of signals, wherein each of the plurality of signals includes at least one respective sensed electrical signal; select a test point, wherein the first surface does not intersect the test point, the test point having a position within a test neighborhood of a position of a first mesh point; perform a test associated with the test point, comprising: determining a first value of a metric corresponding to the first mesh point; determining a second value of the metric corresponding to the test point; computing a gradient feature of the metric based on the first and second values; determining whether the gradient feature satisfies a condition; and generate a second anatomical shell, wherein the second anatomical shell comprises a second surface that intersects a second plurality of mesh points, wherein: if the gradient feature satisfies the condition, the second plurality of mesh points includes the test point; and if the gradient feature does not satisfy the condition, the second plurality of mesh points does not include the test point.
In an Example 32, the computer program product of Example 31, wherein, if the gradient feature does not satisfy the condition, the computer program code when executed by a processor causes the processor to: select an additional test point, the additional test point having a position within the test neighborhood of the position of the first mesh points; and perform the test associated with the additional test point.
In an Example 33, the computer program product of Example 31, wherein the position of the test point is located opposite the direction of a normal to the first surface at the first mesh point.
In an Example 34, the computer program product of Example 31, wherein the metric comprises at least one of an out-of-cardiac-band impedance measurement, a unipolar electrode activation voltage measurement, a contact force measurement of the mapping probe, and a position-based cardiac motion measurement.
In an Example 35, the computer program product of Example 31, wherein performing the test further comprises: determining a sensed voltage value corresponding to the test point; and determining whether the sensed voltage value exceeds a voltage threshold, wherein if the gradient feature satisfies the condition and the sensed voltage value exceeds the voltage threshold, the second plurality of mesh points includes the test point; and if the gradient feature does not satisfy the condition or the sensed voltage value does not exceed the voltage threshold, the second plurality of mesh points does not include the test point.
While multiple embodiments are disclosed, still other embodiments of the present disclosure will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the disclosure. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
While the disclosed subject matter is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to limit the disclosure to the particular embodiments described. On the contrary, the disclosure is intended to cover all modifications, equivalents, and alternatives falling within the scope of the disclosure as defined by the appended claims.
Although the term “block” may be used herein to connote different elements illustratively employed, the term should not be interpreted as implying any requirement of, or particular order among or between, various steps disclosed herein unless and except when explicitly referring to the order of individual steps.
The system 100 includes a mapping probe 14. The mapping probe 14 includes a flexible catheter body 18. When mapping cardiac structures 102, a physician or medical professional inserts the distal end of the catheter body 18 into a cardiac chamber (e.g., the left ventricle of the heart) of a patient. While the left ventricle of the heart is shown, alternatively, the distal end of the catheter body 18 can be deployed in other parts of the heart and/or surrounding vasculature, such as, e.g., the left atrium, the right atrium, or the right ventricle, the coronary sinus and its tributaries and the pulmonary artery. The distal end of the catheter body 18 has a multiple electrode structure 20. In the illustrated embodiments, the electrode structure 20 takes the form of a basket defining an open interior space 22. While the electrode structure 20 takes the form of a basket in the illustrated embodiments, this is only an example and other electrode structures can be utilized. For example, the electrode structure may include one or more electrodes (e.g., ablation electrodes, microelectrodes, ring electrodes, etc.) disposed on an ablation catheter, a diagnostic catheter, and/or the like.
As shown in
Each signal may be associated with a set of respective position coordinates that correspond to the location at which the signal was sensed. The respective electrical signals can include, but are not limited to, voltage magnitudes, activation signals and changes in activation signals over a period of time. Each of the respective position coordinates may include three-dimensional Cartesian coordinates, polar coordinates, and/or the like. In embodiments, other coordinate systems can be used. In embodiments, an arbitrary origin is used and the respective position coordinates refer to positions in space relative to the arbitrary origin. Since, in embodiments, the signals may be sensed on the endocardium surface as well as in the chamber enclosed by the endocardium surface, the respective position coordinates may be on the endocardium surface of the patient's heart and/or below the endocardium surface.
The electrodes 24 are electrically coupled to a processing device 32. That is, each electrode 24 on the basket structure 20 may be communicatively coupled to the processing device 32, via a wired and/or wireless connection. In embodiments where there is a wired connection, the wires (not shown) from each electrode may extend through the catheter body 18 of the mapping probe 14 and electrically couple each electrode 24 to the processing device 32. In embodiments where there is a wireless connection, a transmitter (not shown) may be included in the mapping probe 14 which may transmit sensed signals from each electrode 24 on the basket structure 20 to a receiver (not shown) that is coupled to the processing device 32.
Once the sensed points are received by the processing device 32 from the electrodes 24, the processing device 32 processes the sensed signals. The processing device 32 processes the sensed points according to anatomical shell editing instructions 36, which are stored on memory 34. The processing device 32 may be, include, or be included in, an electrical processor, a software processor, a general purpose microprocessor and/or a special purpose microprocessor, and may include a sole processor or one of multiple processors or cores. The processed signals are displayed on a display device 40. The display device 40 can include, but is not limited to, one of the following display devices: a cathode ray tube (CRT) display, a light emitting diode (LED) display, or a liquid crystal display (LCD) display.
The memory 34 can be in the form of volatile and/or nonvolatile memory and may be removable, nonremovable, or a combination thereof. Media examples include Random Access Memory (RAM); Read Only Memory (ROM); Electronically Erasable Programmable Read Only Memory (EEPROM); flash memory; optical or holographic media; magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices; data transmissions; and/or any other medium that can be used to store information and can be accessed by a processing device 32 such as, for example, quantum state memory, and/or the like. Mapping instructions 36 may be programmed on the memory 34 using any number of different programming environments, including various languages, development kits, frameworks, and/or the like. Some or all of the functionality contemplated herein may also, or alternatively, be implemented in hardware and/or firmware.
The processing device 32, the memory 34 and the display device 40 can be coupled together, directly and/or indirectly, by a bus 42. Any number of additional components, different components, and/or combinations of components may also be coupled to the processing device 32, memory 34 and display device 40, via the bus 42. The bus represents what may be one or more busses (such as, for example, an address bus, data bus, or combination thereof).
The illustrative mapping system 100 shown in
The basket structure 20 comprises a base member 41 and an end cap 42 between which flexible splines 44 generally extend in a circumferentially spaced relationship. As discussed above, the basket structure 20 takes the form of a basket defining an open interior space 22. In embodiments, the splines 44 are made of a resilient inert material, such as Nitinol metal or silicone rubber, and are connected between the base member 41 and the end cap 42 in a resilient, pre-tensed condition, to bend and conform to the tissue surface they contact. In the illustrated embodiments, eight splines 44 form the three-dimensional structure 20. Additional or fewer splines 44 could be used in other embodiments, and the three-dimensional structure 20 may be configured according to any number of different shapes such as, for example, generally spherical shapes, generally elliptical shapes, generally tear-drop shapes, and/or the like. As illustrated, each spline 44 carries eight mapping electrodes 24. Additional or fewer mapping electrodes 24 could be disposed on each spline 44 in other embodiments of the three-dimensional structure 20. In the illustrated embodiments, the three-dimensional structure 20 is relatively small (e.g., 40 mm or less in diameter). In embodiments, the three-dimensional structure 20 is larger (e.g., 40 mm in diameter or greater).
In embodiments, a slidable sheath 50 is movable along the major axis of the catheter body 30. Moving the sheath 50 forward (i.e., toward the distal end) causes the sheath 50 to move over the three-dimensional structure 20, thereby collapsing the structure 20 into a compact, low profile condition suitable for introduction into an interior space, such as, for example, into the heart. In contrast, moving the sheath 50 rearward (i.e., toward the proximal end) exposes the three-dimensional structure 20, allowing the structure 20 to elastically expand and assume the pre-tensed position illustrated in
In embodiments where the mapping probe 14 uses a wired connection, a signal wire (not shown) may be electrically coupled to each mapping electrode 24. The wires may extend through the body 30 of the mapping catheter 20 into a handle 54, in which they may be coupled to an external connector 56, which may be, for example, a multiple pin connector. The connector 56 electrically couples the mapping electrodes 24 to the processing system 32. Further details on mapping systems and methods for processing signal generated by mapping catheters are discussed, for example, in U.S. Pat. No. 6,070,094, entitled “Systems and Methods for Guiding Movable Electrode Elements within Multiple-Electrode Structure;” U.S. Pat. No. 6,233,491, entitled “Cardiac Mapping and Ablation Systems;” and U.S. Pat. No. 6,735,465, entitled “Systems and Processes for Refining a Registered Map of a Body Cavity,” the disclosures of which are incorporated herein by reference.
It is noted that other electrode structures could be deployed on the distal end of a mapping catheter. It is further noted that the multiple mapping electrodes 24 may be disposed on more than one structure, rather than, for example, the single mapping probe 14 illustrated in
Although the mapping electrodes 24 have been described as being carried by dedicated mapping probes, such as the mapping probe 14, the mapping electrodes may be carried on non-mapping dedicated probes or multifunction probes. For example, an ablation catheter can be configured to include one or more mapping electrodes 24 disposed on the distal end of the catheter body and coupled to the signal processing system 32.
Each of the plurality of voltages sensed by the mapping probe has a corresponding set of three-dimensional position coordinates. The three-dimensional position coordinates for a sensed voltage is referred to as the point at which the voltage was sensed. In embodiments, the points may be represented in Cartesian coordinates. However, other coordinate systems can be used. In embodiments, an arbitrary origin is used and the points are defined with respect to the arbitrary origin. In some embodiments, the points have non-uniform spacing, while in other embodiments, the points have uniform spacing. In embodiments, a point corresponding to a sensed voltage may be located on the endocardium surface of the heart and/or below to the endocardium surface of the heart.
In embodiments, the anatomical shell may be generated based, at least in part, on the electrical signals. The shell may be generated, at least in part, using any number of other signals, techniques, and/or the like. For example, embodiments may utilize impedance mapping techniques to generate the shell. In embodiments, a surface may be fitted on one or more of the points associated with the electrical signals to generate a shell representing the endocardium surface. In embodiments, one or more features of the electrical signals at the corresponding points can be included in the map of the endocardium surface. For example, embodiments may include displaying annotations on the shell that represent features extracted from the electrical signals such as, for example, voltages, activation amplitudes, signal sharpness and/or the like. As another example, a surface may be fitted on one or more of the points associated with the electrical signals to generate a shell representing an epicardium surface or other excitable cardiac tissue.
An image of an illustrative first anatomical shell 400A outputted to a display device is shown in
Embodiments of method 300 also include receiving, from a user input device, a selection of a region of the first anatomical shell (block 304). The user input device used to make the selection may include a mouse, a touchscreen and/or the like, that is used to manipulate a selection tool that is provided on a user interface provided by the display device. The selection tool may include, for example, a brush, a cursor for enclosing the selected region by drawing a freeform shape around the region, an expandable polygon selection tool, and/or the like, and may be, in embodiments, selected from a number of optional selection tools. In embodiments, the selection tool may have an adjustable size, behavior and/or other characteristics thereof. In this manner, for example, a user may select a desired selection tool and a size thereof. Selecting a region of the surface of the anatomical shell may include, for example, circling the region of the surface of the anatomical shell using a mouse or touchscreen device to manipulate a cursor, brushing over the region of the surface using an input device to manipulate a brush, and/or the like.
Referring to
In some embodiments, method 300 may also include receiving, from an input device, a modification to the selection of the region of the surface of the anatomical shell. In response to receiving the modification, the modified selection may be made of a region of the surface of the anatomical shell. Being able to modify the selection may be useful to a user that selected too big or too small of a region, for facilitating incremental selection, to facilitate more accurate selection, and/or the like. In embodiments, a modification to the selection may include a modification to the target depth of the selection, a modification to the size of the region of the surface selected, and/or the like. For example, in embodiments, the modification may include a selection of an additional region of the surface of the anatomical shell. Similar to selecting a portion above, a mouse, touchscreen or the like can be used to modify the selection. In embodiments, modifying the selected portion may include deselecting the selected region and then reselecting a region. In embodiments, modifying the selection may include modifying the selection by altering the boundaries of the selection. In embodiments this may be done, for example, by clicking on a portion of the border of the selected region and dragging the selected portion of the border to a new location.
Embodiments of method 300 also include receiving, from a user input device, a target depth for the selected region (block 306). Using the received target depth, the selected region 410A may be removed to an editing depth that is based on the target depth and that follows the contour of the anatomical shell 400A. In embodiments, the removed portion includes the selected region (or modified selected region) of the surface and extending inward to an editing depth. The editing depth may include at least one finite depth and may vary, corresponding to the contour of the surface of the anatomical shell. That is, for example, the editing depth may be the distance, along an axis normal to the surface of the anatomical shell, between a point on the surface of the anatomical shell and a point inward from the surface (i.e., below the surface) of the anatomical shell. In that manner, the editing depth may change with the contour of the surface.
According to embodiments, the editing depth may be adjustable and/or selectable. That is, for example, a user may input and/or select a target depth, via the user interface, such that the editing depth, corresponding to each point in the selected region, may be at least approximately equal to the target depth (e.g., equal to the target depth, within at least 0.1 millimeters of the target depth, within at least 0.5 millimeters of the target depth, within 1 millimeter of the target depth, and/or the like. In embodiments, the target depth may be less than one millimeter, at least one millimeter and no more than 10 millimeters, at least one millimeter and no more than 5 millimeters, and/or the like.
In embodiments, method 300 can include receiving, from a user input device, a command to rotate the displayed anatomical shell 400A after the region 410A is selected, before the region 410A is selected, and/or at any time while the anatomical shell 400A is displayed. The method 300 can include generating a rotated view of the first anatomical shell based on the command. In embodiments, the anatomical shell 400A may be rotated in any direction. Additionally, any number of other methods of adjusting a displayed image may be employed such as, for example, zoom, pan, invert, and/or the like. Additionally, any number of different colors, textures, and/or the like may be implemented, adjusted, and/or selected for representing various displayed features such as, for example, anatomical features, voltage magnitudes, signal sharpness, activation amplitudes, activation propagations, and/or the like.
In embodiments, method 300 can include receiving, from a user input device, a command to generate the modified anatomical shape (block 308). Therefore, instead of automatically generating the modified shape once the region 410A is selected, the processor-based method waits until a user inputs a command to generate the modified anatomical shape. This can be useful to determine whether the selected region 410A is what the user intended to select. Embodiments of the disclosure also include automatically generating the modified anatomical shape, based on the selected region.
Embodiments of method 300 also include generating a modified (second) anatomical shell that includes the at least one voltage sensed by the mapping probe at approximately the finite depth for the selected portion (block 310). That is, in embodiments, the modified anatomical shell has the same shape and voltages as the first anatomical shell 400A, except that the selected portion 410A displays the voltage(s) sensed by the mapping probe at approximately the finite depth. In embodiments, the modified anatomical shell may be altered in shape to indicate the presence or absence of a feature, structure, and/or the like. In embodiments, the selected region may be removed to the editing depth, in the modified anatomical shell, with a new surface region being generated at the editing depth, upon which is displayed the respective voltage values. After the modified anatomical shape is generated, embodiments of method 300 include outputting the modified anatomical shell to the display device (block 312). The display device may have some or all of the same characteristics as the display device 40 in
An image of an exemplary modified anatomical shell 400B outputted to a display device is shown in
After a user chooses to undo the generation of the modified anatomical shell 400B, a user may then modify the selected region 410A, either by increasing or decreasing the boundary of the selected region 410A or changing the depth of the selected region 410A. In the example illustrated in
While embodiments of a user-directed method of voltage-guided anatomical shell editing are described above, embodiments of the disclosure include automated anatomical shell editing. In embodiments, for example, a processing device (e.g., the processing device 32 depicted in
In embodiments, the chosen metric (or metrics) such as those listed above may tend to exhibit behaviors for which proximity to tissue will coincide with meaningful outliers, allowing for intelligent annotation and aggregation. The metric may also be some combination of those quantities. In embodiments, the metric may be a R3→R function, such that for every point where the metric was measured, a 3D position is recorded as well as a scalar value.
In embodiments, a metric may be selected so that the likelihood, proximity, and/or degree of contact between an electrode (and/or mapping probe) and the cardiac structure at a particular point (e.g., a test point) can be determined. For example, by determining the likelihood, proximity, and/or degree of contact between an electrode (and/or mapping probe) and a cardiac structure, one may determine whether or not the generated anatomical shell is a distorted version of the actual shape of the cardiac structure. For example, an observation about the profile exhibited by embodiments of the metric is embodied in
As illustrated in
where d is the distance of a location of a measured signal from a cardiac structure, e is a first threshold, and δ is a second threshold. Similarly,
That is, embodiments of the system may utilize the information that is in the gradient. For example, in the blood pool (e.g., in the case of under-contact), the values of the metric may be considered to be roughly uniform around some low mean, and conversely, for over-contact, the values may be considered to be roughly uniform around some high mean. The endocardium surface may be considered to be in the vicinity of the vertical axis (or, e.g., within ϵ of the vertical axis). This 1-dimensional model may be expanded to 3D, for example, by means of spatial quantization, if linearization by density is assumed. That is, for example, one may reduce the generalized 3D case, described by the similarly generalized 3D gradient, to a set of linear gradients taken between a set of selected points.
For example, a metric 502 may be chosen so that when there is a preferred amount (or likelihood) of contact between a mapping electrode and the cardiac structure, the gradient of the metric 502 is greater, and exceeds a threshold, than the gradient of the metric 502 when the mapping electrode is either not in contact with the cardiac structure or is distending the cardiac structure (e.g., in a situation of over-contact). In embodiments, a sensed electrical signal may exhibit the properties of metric 502 in
Referring to
Referring to
According to embodiments, to determine whether the sensed point 606A is an appropriate surface point, a test, based on a gradient of one or more metrics, as discussed above, may be performed with respect to a test point 610A. In particular, a test point 610A may be selected that has a position within a test neighborhood of the position of the sensed point 606A. Since the sensed point 606A is one of the outermost points sensed by the mapping probe, the test point will be located below the cardiac structure surface 604A with respect to the sensed point 606A. Since the sensed point 606A is on the surface of the cardiac structure 804A, any point that is located below the surface 604A may be located in the blood pool 608A of the cardiac structure 604A. Blood generally exhibits a distinctly lower voltage than what is sensed on the surface (e.g., the endocardium) of the cardiac structure 604A. Since the voltage measured in blood generally is distinctly lower than the voltage measured on the surface of the cardiac structure 604A, there may be a steep gradient between the two values of the sensed voltage (i.e., the values of the metric at the sensed point 606A and the test point 610A). If the gradient exceeds a threshold, it may be determined that the sensed point 606A is located within a threshold distance of the surface of the cardiac structure 604A.
Referring to
In embodiments, a determination may be made as to whether the electrode 602B is touching the surface of the cardiac structure 604B. That is, since the electrode 602B is touching the surface of the cardiac structure 604B, a voltage will be sensed at the sensed point 606B that is distinctly higher than if the sensed point 606B were sensing a voltage in the blood pool 608B. Accordingly, it can be determined that the electrode 602B is touching the surface of the cardiac structure 604B. Additionally, or alternatively, a force-sensing metric, an impedance metric, and/or the like, may be utilized to determine whether the electrode 602B is contacting the surface of the cardiac structure 604B. In embodiments, after making this determination, the test may be performed.
In particular, a test point 610B may be selected that is located within a test neighborhood of sensed point 606B. Since the sensed point 606B is one of an outermost point sensed by the mapping probe, the selected point will be located below the surface of the cardiac structure 604B with respect to the sensed point 606B. Since the sensed point 606B is distending the surface of the cardiac structure 604B, a test point 610B and a corresponding voltage may, for example, have been sensed that is just touching the surface of the cardiac structure 604B (similar to the configuration shown in
Referring to
In some embodiments, before performing the test, a determination as to whether the electrode 602C is touching the surface of the cardiac structure 604C may be performed. That is, since the electrode 602C is located in a blood pool 608C and not touching the surface of the cardiac structure 604C, a voltage may be sensed at the sensed point 606C that is distinctly smaller than if the sensed point 606C were touching the surface of the cardiac structure 604C. Additionally, or alternatively, a force-sensing metric, an impedance metric, and/or the like, may be utilized to determine whether the electrode 602C is contacting the surface of the cardiac structure 604C. Accordingly, it may be determined that the electrode 602C is not touching the surface of the cardiac structure 604C. In embodiments, when a determination is made that the electrode 606C is not touching the cardiac structure 604C, the test may not be performed. Instead, a physician or other medical professional may choose to map the cardiac structure 604C near sensed point 606C more thoroughly. In embodiments, if the test is performed, it may be determined that the sensed point 606C is not on the surface of the cardiac structure 604C since the voltage at a test point 610B, in the blood pool, will be similar to the voltage at the sensed point 606C and, therefore, the gradient of the metric will be low and not exceed a threshold.
In embodiments, the processing device 32 may be configured to automatically improve the accuracy of its algorithms by using one or more artificial intelligence (i.e., machine-learning) techniques, classifiers, and/or the like. In embodiments, for example, the processing device may use one or more supervised and/or unsupervised techniques such as, for example, support vector machines (SVMs), k-nearest neighbor techniques, artificial neural networks, and/or the like. In embodiments, classifiers may be trained and/or adapted using feedback information from a user, other metrics, and/or the like.
As shown in
The method 700 also includes selecting a test point, where the first surface does not intersect the test point (block 704). As stated above, the method 700 may be used to determine whether a surface of a generated anatomical shell should intersect a first mesh point of the first set of mesh points or whether the surface should, instead, intersect another point, e.g., a test point. As such, in embodiments, the selection of a test point may be based on the first mesh point. That is, in embodiments, the test point may be selected based on whether the position of the test point is located within a test neighborhood of a position of the first mesh point. The test neighborhood, in embodiments, may be a sphere with its center located at the position of the first mesh point and may have some predetermined, selectable, and/or adjustable radius (e.g., 2 millimeters).
The position of the test point may be located below the endocardium surface of the first generated anatomical shell. In embodiments, a test point may be selected that has a position located in the opposite direction of the normal to the surface of the mesh at the first mesh point. In embodiments, the test point may have a position that is located closest to the position of the first mesh point of all the points sensed by the mapping probe that are located in the opposite direction of the normal. In this manner, for example, if the generated first anatomical shell intersects the outermost points sensed by the mapping probe and it is determined that the surface of the anatomical shell should intersect a test point instead of the first mesh point, the surface of the anatomical shell will be adjusted inward to intersect the test point.
To determine if a generated anatomical shell should intersect the test point instead of the first mesh point, the method 700 includes performing a test associated with the test point (block 706). In embodiments, the test may include multiple steps, such as, for example, embodiments of the steps discussed below with regard to
After the test associated with the test point is performed, the method 700 includes determining whether the test was passed (block 708). If the test was passed, the method 700 includes generating a second anatomical shell that includes a second surface that intersects a second set of mesh points, where the second set of mesh points includes the test point (block 710). In embodiments, the test point may be substituted in place of the first mesh point. Additionally, in embodiments, the system may perform an interpolation and/or other smoothing technique to smooth the surface around the location of the test point. In embodiments, the method 700 may be performed with respect to other mesh points included in the first set of mesh points. If, on the other hand, the test was not passed, the method 700 includes generating a second anatomical shell having a second surface that intersects a second set of mesh points, where the second set of mesh points does not include the test point (block 712). In embodiments, the first mesh point may be included in the second set of mesh points. For example, the second set of mesh points, in this case, may be identical to the first set of mesh points.
As stated above,
As shown in
For example, in embodiments, the test may include selecting a step size, s, which may be, for example, some distance (e.g., 0.1 mm, 0.2 mm, 1 mm, etc.). Then, for each mesh vertex position x, with normal n, embodiments of the method 800 may include evaluating the metric, f, for x and x-sn. In embodiments, the anatomical shell may be generated by interpolating signal features collected in a grid to the mesh surface, in which case, the evaluation may be grid-based, and may be performed as described in more detail below, with respect to grid-based tests. In embodiments, the evaluation may be mesh-based, such as, for example, a distance-weighted average of the neighborhood within some radius, r, (e.g., 2 mm). The method 800 may include computing the gradient feature:
Where, if G<-Gm (where −Gm is some negative threshold), the method 800 may include repositioning the vertex at x-sn, and repeating the process at that vertex. Otherwise, a new vertex may be chosen, and the test applied with respect to that new vertex.
As indicated above, some mapping systems may utilize a grid-based data aggregation scheme. In such systems, for each collected electrode/spatial record, embodiments may include establishing a pre-determined radius of influence, such that the metric is assigned to a set of surrounding voxels. If a voxel is influenced by more than one electrode acquisition, embodiments may include averaging the measurements. This may be based on a philosophy that tissue shape and position don't necessarily change over time, and, consequently, that it may be assumed that all measurements should be considered, not just the latest or first one.
In embodiments, for each voxel, vi, with assigned valid metrics for itself and its neighbors, the test may include computing the cross-voxel gradient:
where vc is the facing voxel and d is the distance. The test may further include finding
GM=max{G(vi)}
which is the voxel's processed metric value. Where data density is sufficient, this measurement may provide a good indication of the voxel's position on the gradient curve, and consequently, any generated mesh triangle. In embodiments, the system may also, or alternatively, consider the direction of maximum gradient, which may be expressed, for example, as a vector formed between the two adjacent voxels.
Based on the above metric value assignment, any number of refinement steps can be taken. In embodiments, the refinement steps may be based on a threshold, which may be variable or fixed, predetermined, adjustable, selectable, and/or the like. For example, in embodiments, voxels with low values may be simply turned off. In embodiments, an entire other surface can be generated using our existing mesh generation algorithm (with the iso level being applied as a normalized threshold to a normalized grid), shown along with the standard reconstruction, with the user choosing which areas of the reconstruction to snap to the new surface
In embodiments, a direct visualization of some form of the metric as it's acquired can be used to indicate instantaneous proximity to cardiac tissue (for example, an averaging of currently sensed out-of-cardiac-band impedance values). In some instances, however, such embodiments may have some flaws because, for example, any given set of instantaneous measurements may be distorted by noise and/or other ambient signals near the probe for some metrics (application of ablation energy, for example, is the cause for many such effects). As such, in embodiments, the refined anatomical shell may utilize an aggregation of one or more of the above metrics over time and space, allowing for handling of such outliers, resulting in an accurate approximation of the cardiac tissue's shape and position. Utilizing the aggregation of one or more of the above metrics over time and space, in conjunction with the acquired positions of the probe, which are generally considered stable and reliable, an alternative indication of proximity to cardiac tissue can be generated by computing the proximity to the refined anatomical shell. Embodiments may use this alternative indication of proximity to cardiac tissue to overcome the above challenges (i.e., distortion caused by noise and/or other ambient signals near the probe) by itself or in conjunction with other methods by deciding to make a switch when noise and/or ambient signals are detected (for example, by detecting that ablation energy is being applied, or by sensing heightened levels of noise on the acquired mapping probe signal).
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present disclosure. For example, while the embodiments described above refer to particular features, the scope of this disclosure also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present disclosure is intended to embrace all such alternatives, modifications, and variations as fall within the scope of the claims, together with all equivalents thereof.
This application claims priority to Provisional Application No. 62/233,347, filed Sep. 26, 2015, which is herein incorporated by reference in its entirety.
| Number | Name | Date | Kind |
|---|---|---|---|
| 4649924 | Taccardi | Mar 1987 | A |
| 4674518 | Salo | Jun 1987 | A |
| 4840182 | Carlson | Jun 1989 | A |
| 4920490 | Isaacson | Apr 1990 | A |
| 5156151 | Imran | Oct 1992 | A |
| 5284142 | Goble et al. | Feb 1994 | A |
| 5297549 | Beatty et al. | Mar 1994 | A |
| 5300068 | Rosar et al. | Apr 1994 | A |
| 5341807 | Nardella | Aug 1994 | A |
| 5381333 | Isaacson et al. | Jan 1995 | A |
| 5469858 | Osborne | Nov 1995 | A |
| 5480422 | Ben-Haim | Jan 1996 | A |
| 5483968 | Adam et al. | Jan 1996 | A |
| 5500011 | Desai | Mar 1996 | A |
| 5553611 | Budd et al. | Sep 1996 | A |
| 5568809 | Ben-Haim | Oct 1996 | A |
| 5577502 | Darrow et al. | Nov 1996 | A |
| 5588429 | Isaacson et al. | Dec 1996 | A |
| 5623583 | Nishino | Apr 1997 | A |
| 5634469 | Bruder et al. | Jun 1997 | A |
| 5647870 | Kordis et al. | Jul 1997 | A |
| 5662108 | Budd et al. | Sep 1997 | A |
| 5687737 | Branham et al. | Nov 1997 | A |
| 5697377 | Wittkampf | Dec 1997 | A |
| 5704365 | Albrecht et al. | Jan 1998 | A |
| 5722402 | Swanson et al. | Mar 1998 | A |
| 5810740 | Paisner | Sep 1998 | A |
| 5840025 | Ben-Haim | Nov 1998 | A |
| 5840031 | Crowley | Nov 1998 | A |
| 5846198 | Killmann | Dec 1998 | A |
| 5848972 | Triedman et al. | Dec 1998 | A |
| 5876336 | Swanson et al. | Mar 1999 | A |
| 5921982 | Lesh et al. | Jul 1999 | A |
| 5954665 | Ben-Haim | Sep 1999 | A |
| 5971933 | Gopakumaran et al. | Oct 1999 | A |
| 5983126 | Wittkampf | Nov 1999 | A |
| 6014581 | Whayne et al. | Jan 2000 | A |
| 6050267 | Nardella et al. | Apr 2000 | A |
| 6070094 | Swanson et al. | May 2000 | A |
| 6095150 | Panescu et al. | Aug 2000 | A |
| 6167296 | Shahidi | Dec 2000 | A |
| 6216027 | Willis et al. | Apr 2001 | B1 |
| 6226542 | Reisfeld | May 2001 | B1 |
| 6233491 | Kordis et al. | May 2001 | B1 |
| 6236886 | Cherepenin et al. | May 2001 | B1 |
| 6240307 | Beatty et al. | May 2001 | B1 |
| 6246898 | Vesely et al. | Jun 2001 | B1 |
| 6254536 | DeVito | Jul 2001 | B1 |
| 6278894 | Salo et al. | Aug 2001 | B1 |
| 6298257 | Hall et al. | Oct 2001 | B1 |
| 6301496 | Reisfeld | Oct 2001 | B1 |
| 6308093 | Armoundas et al. | Oct 2001 | B1 |
| 6314310 | Ben-Haim et al. | Nov 2001 | B1 |
| 6317619 | Boernert et al. | Nov 2001 | B1 |
| 6318375 | Plicchi et al. | Nov 2001 | B1 |
| 6360123 | Kimchi et al. | Mar 2002 | B1 |
| 6368285 | Osadchy et al. | Apr 2002 | B1 |
| 6400981 | Govari | Jun 2002 | B1 |
| 6490474 | Willis et al. | Dec 2002 | B1 |
| 6516807 | Panescu et al. | Feb 2003 | B1 |
| 6547082 | Babini | Apr 2003 | B1 |
| 6556695 | Packer et al. | Apr 2003 | B1 |
| 6574492 | Ben-Haim et al. | Jun 2003 | B1 |
| 6574498 | Gilboa | Jun 2003 | B1 |
| 6593884 | Gilboa et al. | Jul 2003 | B1 |
| 6600948 | Ben-Haim et al. | Jul 2003 | B2 |
| 6603996 | Beatty et al. | Aug 2003 | B1 |
| 6631290 | Guck et al. | Oct 2003 | B1 |
| 6640119 | Budd et al. | Oct 2003 | B1 |
| 6650927 | Keidar | Nov 2003 | B1 |
| 6690963 | Ben-Haim et al. | Feb 2004 | B2 |
| 6701176 | Halperin et al. | Mar 2004 | B1 |
| 6728562 | Budd et al. | Apr 2004 | B1 |
| 6735465 | Panescu | May 2004 | B2 |
| 6773402 | Govari et al. | Aug 2004 | B2 |
| 6807439 | Edwards et al. | Oct 2004 | B2 |
| 6839588 | Rudy | Jan 2005 | B1 |
| 6847839 | Ciaccio et al. | Jan 2005 | B2 |
| 6872428 | Yang et al. | Mar 2005 | B2 |
| 6892090 | Verard et al. | May 2005 | B2 |
| 6892091 | Ben-Haim et al. | May 2005 | B1 |
| 6893588 | Lawson et al. | May 2005 | B2 |
| 6939309 | Beatty et al. | Sep 2005 | B1 |
| 6941166 | MacAdam et al. | Sep 2005 | B2 |
| 6957101 | Porath et al. | Oct 2005 | B2 |
| 6978168 | Beatty et al. | Dec 2005 | B2 |
| 6984207 | Sullivan et al. | Jan 2006 | B1 |
| 6990370 | Beatty et al. | Jan 2006 | B1 |
| 7016719 | Rudy et al. | Mar 2006 | B2 |
| 7043292 | Tarjan et al. | May 2006 | B2 |
| 7136694 | Hadley et al. | Nov 2006 | B2 |
| 7263397 | Hauck et al. | Aug 2007 | B2 |
| 7505810 | Harlev et al. | Mar 2009 | B2 |
| 7515954 | Harlev et al. | Apr 2009 | B2 |
| 7628757 | Koh | Dec 2009 | B1 |
| 7629981 | West | Dec 2009 | B1 |
| 7729752 | Harlev et al. | Jun 2010 | B2 |
| 7890155 | Burns et al. | Feb 2011 | B2 |
| 8103338 | Harlev et al. | Jan 2012 | B2 |
| 8137343 | Harlev et al. | Mar 2012 | B2 |
| 8208991 | Markowitz et al. | Jun 2012 | B2 |
| 8463368 | Harlev et al. | Jun 2013 | B2 |
| 8498699 | Wells et al. | Jul 2013 | B2 |
| 8571647 | Harlev et al. | Oct 2013 | B2 |
| 8744566 | Harlev et al. | Jun 2014 | B2 |
| 8768440 | Brodnick et al. | Jul 2014 | B1 |
| 9113809 | Harlev et al. | Aug 2015 | B2 |
| 9510769 | Harlev et al. | Dec 2016 | B2 |
| 9636032 | Thakur et al. | May 2017 | B2 |
| 9898825 | Rivet-Sabourin | Feb 2018 | B2 |
| 9918649 | Thakur et al. | Mar 2018 | B2 |
| 20020065459 | MacAdam et al. | May 2002 | A1 |
| 20020151807 | Goldin | Oct 2002 | A1 |
| 20030018251 | Solomon | Jan 2003 | A1 |
| 20030065271 | Khoury | Apr 2003 | A1 |
| 20030076277 | Muramatsu et al. | Apr 2003 | A1 |
| 20030078509 | Panescu | Apr 2003 | A1 |
| 20030093067 | Panescu | May 2003 | A1 |
| 20030216630 | Jersey-Willuhn et al. | Nov 2003 | A1 |
| 20040059237 | Narayan et al. | Mar 2004 | A1 |
| 20040077942 | Hall et al. | Apr 2004 | A1 |
| 20040097806 | Hunter et al. | May 2004 | A1 |
| 20040158165 | Yonce et al. | Aug 2004 | A1 |
| 20040243015 | Smith et al. | Dec 2004 | A1 |
| 20040254437 | Hauck et al. | Dec 2004 | A1 |
| 20050037489 | Gepstein et al. | Feb 2005 | A1 |
| 20050038337 | Edwards | Feb 2005 | A1 |
| 20050054918 | Sra | Mar 2005 | A1 |
| 20050107834 | Freeman et al. | May 2005 | A1 |
| 20050154282 | Li et al. | Jul 2005 | A1 |
| 20050288599 | MacAdam et al. | Dec 2005 | A1 |
| 20060085049 | Cory | Apr 2006 | A1 |
| 20060106375 | Werneth et al. | May 2006 | A1 |
| 20060116575 | Willis | Jun 2006 | A1 |
| 20060122526 | Berenfeld et al. | Jun 2006 | A1 |
| 20060173251 | Govari et al. | Aug 2006 | A1 |
| 20060178587 | Khoury | Aug 2006 | A1 |
| 20060241401 | Govari et al. | Oct 2006 | A1 |
| 20070016007 | Govari et al. | Jan 2007 | A1 |
| 20070038078 | Osadchy | Feb 2007 | A1 |
| 20070049821 | Willis | Mar 2007 | A1 |
| 20070112276 | Simms | May 2007 | A1 |
| 20070197929 | Porath et al. | Aug 2007 | A1 |
| 20070232949 | Saksena | Oct 2007 | A1 |
| 20070255588 | Hamilton | Nov 2007 | A1 |
| 20070265539 | Hastings et al. | Nov 2007 | A1 |
| 20070270688 | Gelbart et al. | Nov 2007 | A1 |
| 20070270703 | He et al. | Nov 2007 | A1 |
| 20070287902 | Fuimaono et al. | Dec 2007 | A1 |
| 20070299351 | Harlev et al. | Dec 2007 | A1 |
| 20070299352 | Harlev et al. | Dec 2007 | A1 |
| 20070299353 | Harlev et al. | Dec 2007 | A1 |
| 20080137934 | Sakaguchi et al. | Jun 2008 | A1 |
| 20080188765 | Stolarski et al. | Aug 2008 | A1 |
| 20080190438 | Harlev et al. | Aug 2008 | A1 |
| 20080221566 | Krishnan | Sep 2008 | A1 |
| 20080222109 | Sakurai | Sep 2008 | A1 |
| 20080234588 | Feldman et al. | Sep 2008 | A1 |
| 20080249424 | Harlev et al. | Oct 2008 | A1 |
| 20080269813 | Greenhut et al. | Oct 2008 | A1 |
| 20080273227 | Dattilo et al. | Nov 2008 | A1 |
| 20090103793 | Borland et al. | Apr 2009 | A1 |
| 20090171274 | Harlev et al. | Jul 2009 | A1 |
| 20090177072 | Harlev et al. | Jul 2009 | A1 |
| 20090253976 | Harlev et al. | Oct 2009 | A1 |
| 20090262979 | Markowitz | Oct 2009 | A1 |
| 20090264741 | Markowitz | Oct 2009 | A1 |
| 20090264777 | Markowitz | Oct 2009 | A1 |
| 20100023082 | Dong et al. | Jan 2010 | A1 |
| 20100094274 | Narayan et al. | Apr 2010 | A1 |
| 20100268059 | Ryu | Oct 2010 | A1 |
| 20100286551 | Harlev et al. | Nov 2010 | A1 |
| 20110098771 | Thakur et al. | Apr 2011 | A1 |
| 20110169828 | Pedersen | Jul 2011 | A1 |
| 20110206256 | Ramanathan et al. | Aug 2011 | A1 |
| 20110251505 | Narayan et al. | Oct 2011 | A1 |
| 20110288605 | Kaib et al. | Nov 2011 | A1 |
| 20120029504 | Afonso et al. | Feb 2012 | A1 |
| 20120184858 | Harlev et al. | Jul 2012 | A1 |
| 20120184863 | Harlev et al. | Jul 2012 | A1 |
| 20120184865 | Harlev et al. | Jul 2012 | A1 |
| 20120191087 | Pachon Mateos et al. | Jul 2012 | A1 |
| 20120226110 | Markowitz | Sep 2012 | A1 |
| 20120290976 | Lahm et al. | Nov 2012 | A1 |
| 20130035576 | O'Grady et al. | Feb 2013 | A1 |
| 20130079645 | Amirana et al. | Mar 2013 | A1 |
| 20130274582 | Afonso | Oct 2013 | A1 |
| 20130310702 | Reinders et al. | Nov 2013 | A1 |
| 20140052118 | Laske et al. | Feb 2014 | A1 |
| 20140073194 | Lim et al. | Mar 2014 | A1 |
| 20140200874 | Zeng et al. | Jul 2014 | A1 |
| 20140235986 | Harlev et al. | Aug 2014 | A1 |
| 20140278324 | Bates et al. | Sep 2014 | A1 |
| 20140330150 | Thakur et al. | Nov 2014 | A1 |
| 20140343388 | Thakur et al. | Nov 2014 | A1 |
| 20150133764 | Sakuragi | May 2015 | A1 |
| 20150254419 | Laughner et al. | Sep 2015 | A1 |
| 20150254893 | Laughner et al. | Sep 2015 | A1 |
| 20150373068 | Allen et al. | Dec 2015 | A1 |
| 20160012646 | Huang | Jan 2016 | A1 |
| 20160051204 | Harlev et al. | Feb 2016 | A1 |
| 20160066814 | Markowitz | Mar 2016 | A1 |
| 20160100770 | Afonso | Apr 2016 | A1 |
| 20170024907 | Bermano | Jan 2017 | A1 |
| 20170164928 | Oh et al. | Jun 2017 | A1 |
| 20170189118 | Chopra | Jul 2017 | A1 |
| 20170278301 | Peterson et al. | Sep 2017 | A1 |
| 20170311833 | Afonso | Nov 2017 | A1 |
| 20180153426 | Thakur et al. | Jun 2018 | A1 |
| Number | Date | Country |
|---|---|---|
| 1253761 | May 2000 | CN |
| 101933803 | Jan 2011 | CN |
| 102821694 | Dec 2012 | CN |
| 102917638 | Feb 2013 | CN |
| 2204120 | Jul 2010 | EP |
| 2427106 | Mar 2012 | EP |
| 2485194 | Aug 2012 | EP |
| 2010057943 | Mar 2010 | JP |
| 1999005971 | Feb 1999 | WO |
| WO2006037172 | Apr 2006 | WO |
| 2006066324 | Jun 2006 | WO |
| 2007035306 | Mar 2007 | WO |
| 2007108776 | Sep 2007 | WO |
| 2007146864 | Dec 2007 | WO |
| 2008138009 | Nov 2008 | WO |
| 2010054320 | May 2010 | WO |
| 2010129095 | Nov 2010 | WO |
| WO2012037471 | Mar 2012 | WO |
| 2012092016 | Jul 2012 | WO |
| 2013006713 | Jan 2013 | WO |
| 2014185977 | Nov 2014 | WO |
| 2015130824 | Sep 2015 | WO |
| 2015134248 | Sep 2015 | WO |
| Entry |
|---|
| International Search Report and Written Opinion issued in PCT/US2016/053613, dated Jan. 4, 2017, 11 pages. |
| International Search Report and Written Opinion issued in PCT/US2015/017289, dated May 6, 2015, 10 pages. |
| International Search Report and Written Opinion issued in PCT/US2015/017482, dated Jun. 5, 2015, 9 pages. |
| Jain et al., “Cell Therapy Attenuates Deleterious Ventricular Remodeling and Improves Cardiac Performance after Myocardial infarction”, Circulation, 103:1920-1927, 2001. |
| Jalife, “Rotors and Spiral Waves in Atrial Fibrillation”, Journal of Cardiovascular Electrophysiology, 14:776-780, 2003. |
| Jane et al., “Alignment Methods for Averaging of High-Resolution Cardiac Signals: A Comparative Study of Performance”, IEEE Transactions on Biomedical Engineering, 38(6):571-579, 1991. |
| Japanese Office Action in JP Application No. 2009-515586, dated Jun. 26, 2012, 4 pages. |
| Jia et al., “Electrophysiologic Endocardial Mapping from a Noncontact Nonexpandable Catheter: A Validation Study of a Geometry-Based Concept”. Journal of Cardiovascular Electrophysiology, 11:1238-1251, 2000. |
| Kikuchi et al., “Targeted Modification of Atrial Electrophysiology by Homogeneous Transmural Atrial Gene Transfer”, Circulation, 111:264-270, 2005. |
| Kistler et al., “Validation of Three-Dimensional Cardiac Image Integration: Use of Integrated CT Image into Electroanatomic Mapping System to Performa Catheter Ablation of Atrial Fibrillation”, Journal of Cardiovascular Electrophysiology, 17:341-348, 2006. |
| Kuklik et al., “The reconstruction, from a set of points, and analysis of the interior surface of the heart chamber”, Physiol. Meas. 25:617-627, 2004. |
| Kun, Stevan et al., “Conductance Volumetric Model of an Eccentrically Positioned Catheter Wthin a Three-Compartment Ellipsoidal Ventricle”, IEEE Transactions on Biomedical Engineering, vol. 40, No. 6, Jun. 1993, pp. 589-592. |
| L. Piegl, W. Tiller: The NURBS Book, 2nd Edition, Monographs in Visual Communication, Springer (1997). |
| Laciar et al., Improved Alignment Method for Noisy High-Resolution ECG and Holter Records Using a Multiscale Cross-Correlation, IEEE Transactions on Biomedical Engineering, 50(3), pp. 344-353, 2003. |
| Liu et al., “Endocardial Potential Mapping from a Noncontact Nonexpandable Catheter: A Feasibility Study”, Annals of Biomedical Engineering, 26:994-1009, 1998. |
| Lorensen et al. “Marching Cubes: A High Resolution 3D Surface Construction Algorithm”, Computer Graphics, 21(4):163-169, Jul. 1987. |
| Makela et al., “A Review of Cardiac Image Registration Methods”, IEEE Transactions on Medical Imaging, 21(9):1011-1021, Sep. 2002. |
| Malladi, R. et al., “A Geometric Approach to Segmentation and Analysis of 3D Medical Images”, Mathematical Methods in Biomedical Image Analysis, Proceedings of the Workshop on, Jun. 21-22, 1996, pp. 244-252. |
| Mangan, Alan et al., “Partitioning 3D Surface Meshes Using Watershed Segmentation”, IEEE Transactions on Visualization and Computer Graphics, vol. 05, No. 4, pp. 308-321, (Oct.-Dec. 1999). |
| Meininger et al., “Initial Experience with a Novel Focused Ultrasound Ablation System for Ring Ablation Outside the Pulmonary Vein”, Journal of Interventional Cardiac Electrophysiology, 8:141-148, 2003. |
| Merrill, Daniel R. et al., “Electrical stimulation of excitable tissue: design of efficacious and safe protocols”, Journal of Neuroscience Methods, vol. 141, pp. 171-198 (2005). |
| Miller, “Editor's Forum—Application of Registration for Ablation: A Marriage of Technologies”, Journal of Interventional Cardiac Electrophysiology, 11:87-89, 2004. |
| Nademanee et al., “A New Approach for Catheter Ablation of Atrial Fibrillation: Mapping of the Electrophysiologic Substrate”, Journal of the American College of Cardiology, 43(11):2044-2053, 2004. |
| Non-final Office Action issued in U.S. Appl. No. 11/451,898, dated Sep. 25, 2008, 13 pages. |
| Non-final Office Action issued in U.S. Appl. No. 11/451,908, dated Sep. 4, 2008, 12 pages. |
| Noseworthy et al., “The Impact of Respiration on Left Atrial and Pulmonary Venous Anatomy: Implications for Image-Guided Intervention”, Heart Rhythm, 2(11), pp. 1173-1178, Nov. 2005. |
| Pappone et al., “Robotic Magnetic Navigation for Atrial Fibrillation Ablation”, Journal of the American College of Cardiology, 47(7):1390-1400, 2006. |
| Paragios, “A Level Set Approach for Shape-Driven Segmentation and Tracking of the Left Ventricle”, IEEE Transactions on Medical Imaging, 22(6):773-776, Jun. 2003. |
| Persson et al., “A Simple Mesh Generator in MATLAB”, SIAM Review, 46(2):329-345, 2004. |
| Persson, “Mesh Generation for implicit Geometries”, Massachusetts Institute of Technology—Thesis, Feb. 2005. |
| Pham, Dzung et al., “Current Methods in Medical image Segmentation”, Annu. Rev. Biomed. Eng., 02: pp. 315-337, (2000). |
| Rao et al., “Novel Noncontact Catheter System for Endocardial Electrical and Anatomical Imaging”, Annals of Biomedical Engineering, 32(4):573-584, 2004. |
| Reddy et al., “Integration of Cardiac Magnetic Resonance Imaging With Three-Dimensional Electroanatornic Mapping to Guide Left Ventricular Catheter Manipulation—Feasibility in a Porcine Model of Healed Myocardial Infarction”, Journal of the American College of Cardiology, 44(11):2202-2213, 2004. |
| Reddy et al., “Use of a Diode Laser Balloon Ablation Catheter to Generate Circumferential Pulmonary Venous Lesions in an Open-Thoracotomy Caprine Model”, PACE, 27:52-57, 2004. |
| Sanders et al., “Spectral Analysis Identifies Sites of High-Frequency Activity Maintaining Atrial Fibrillation in Humans”, Circulation, 112:789-797, 2005. |
| Sethian, “Level Set Methods arid Fast Marching Methods: Evolving Interfaces in Computational Geometry, Fluid Mechanics, Computer Vision, and Materials Science”, Department of Mathematics-University of California, Berkeley, Cambridge University Press, 1999. |
| Simon et al., “Electroanatomic Mapping of the Right Atrium With a Right Atrial Basket Catheter and Three-Dimensional Intracardiac Echocardiography”, PACE, 27:318-326, 2004. |
| Smits et al., “Catheter-Based Intramyocarial Injection of Autologous Skeletal Myoblasts as a Primary Treatment of Ischemic Heart Failure”, Journal of the American College of Cardiology, 42(12):2063-2069, 2003. |
| Solomon et al., “Real-Time Cardiac Catheter Navigation on Three-Dimensional CT Images”, Journal of Interventional Cardiac Electrophysiology, 8:27-36, 2003. |
| Sra et al., “Registration of Three-Dimensional Left Atrial Computed Tomographic Images With Projection Images Obtained Using Fluoroscopy”, Circulation, 112:3763-3768, 2005. |
| Sra, Jasbir et al, “Registration of 3D Computed Tomographic Images With Interventional Systems: Implications for Catheter Ablation of Atrial Fibrillation”, J Interv Card Electrophysiol, 16:141-148, 2006. |
| Stevenson, “Radiofrequency Catheter Ablation of Ventricular Tachycardia After Myocardial Infarction”, Circulation, 98:308-314, 1998. |
| Supplemental European Search Report issued in EP App[lication 10772414.8, dated May 7, 2013, 6 pages. |
| Supplemental European Search Report issued in EP Application No. 09824015, dated Jun. 1, 2012, 7 pages. |
| Supplementary European Search Report issued in EP Applicaion No. 09727423, dated May 15, 2012, 5 pages. |
| Supplementary European Search Report issued in EP Application No. 07798369.0 dated Jul. 30, 2010, 6 pages. |
| Supplementary Europeant Search Report issued in EP Application No. 08728501, dated Feb. 25, 2011, 4 pages. |
| Taccardi et al., “A New Intracavitary Probe for Detecting the Site of the Origin of Ectopic Ventricular Beats During One Cardiac Cycle”, Circulation, 75(1):272-281, 1987. |
| Thai et al., “Novel Applications in Catheter Ablation”, Journal of Interventional Cardiac Electrophysiology, 13:17-21, 2005. |
| Thiagalingam et al., “Noncontact Mapping of the Left Ventricle: Insights from Validation Wth Transmural Contact Mapping”, PACE, 27:570-578, 2004. |
| Voth, “The Inverse Problem of Electrocardiography: Industrial Solutions and Simulations”, BEM and NFSI Conference Proceedings, Minneapolis, MN, May 12-15, 2005, pp. 191-194. |
| Wittkampf et al., “LocaLisa: New Technique for Real-Time 3-Dimensional Localization of Regular Intracardiac Electrodes”, Circulation, 99:1312-1317, 1999. |
| Yezzi, Anthony et al., “A Geometric Snake Model for Segmentation of Medical Imagery”, IEEE Transactions on Medical Imag, vol. 16, No. 2, Apr. 1997. |
| Adams et al., “Seeded Region Growing”, IEEE Transactions on Pattern Analysis and Machine Intelligence, 16(6):641-647, 1994. |
| Arthur et al., “Clinical Use of Intracardiac Impedance: Current Applications and Future Perspectives”, PACE, vol. 24, No. 4, Part 1, Apr. 2001, pp. 500-506. |
| Baan, Jan et al., “Continuous Measurement of Left Ventricular Volume in Animals and Humans by Conductance Catheter”, Diagnostic Methods-Conductance Catheter, Circulation, vol. 70, No. 5, 1984, pp. 812-823. |
| Badics et al., “Real-Time Reconstruction of Endocardial Potential Maps in Non-Contact Cardiac Mapping”, International Journal for computation and Mathematics in Electrical and Electronic Engineering (COMPEL), vol. 28, No. 4, 2009. |
| Ben-Haim et al., “Nonfluoroscopic, in Vivo Navigation and Mapping Technology”, Nature Medicine, 2(12):1393-1395, Dec. 1996. |
| Besl et al., “A Method for Registration of 3-D Shapes”, IEEE Transactions on Pattern Analysis and Machine Intelligence, 14(2):239-256, Feb. 1992. |
| Blomstrom-Lundqvist et al., “ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias-Executive Summary”, Journal of the American College of Cardiology, 42(8):1493-1531, 2003. |
| Breithardt et al., “AHA Medical/Scientific Statement—Special Report: Standards for Analysis of Ventricular Late Potentials Using High-Resolution or Signal-Averaged Electrocardiography”, Circulation, 83(4):1481-1488, Apr. 1991. |
| Brooks et al., “Electrical Imaging of the Heart”, IEEE Signal Processing Magazine, pp. 24-42, 1997. |
| Buneo, Christopher A., Analyzing Neural Responses with Vector Fields, Journal of Neuroscience Methods, vol. 197, 2011, pp. 109-117. |
| Caspi et al., “Stem Cell Research: Regenerating the Heart Using Human Embryonic Stem Cells—from Cell to Bedside”, IMAJ 8:208-214, 2006. |
| Cheney et al., “Electrical Impedance Tomography”, SIAM Review 41(1):85-101, 1999. |
| Communication pursuant to Article 94(3) EPC issued in EP Application No. 07 798 369.0, dated Nov. 17, 2011, 5 pages |
| De Groot et al., “Three-Dimensional Catheter Positioning During Radiofrequency Ablation in Patients: First Application of a Real-Time Position Management System”, Journal of Cardiovascular Electrophysiology, 11(11):1183-1192, Nov. 2000. |
| Donahue et al., “Focal Modification of Electrical Conduction in the Heart by Viral Gene Transfer”, Nature Medicine, 6(12):1395-1398, 2000. |
| Dong et al., “Integrated Electroanatomic Mapping With Three-Dimensional Computed Tomographic Images for Real-Time Guided Ablations”, Circulation 113:186-194, 2006. |
| Durrer et al., “Total Excitation of the Isolated Human Heart”, Circulation, vol. XLI, pp. 899-912, 1970. |
| E. J. Haug et al.: Design Sensitivity Analysis of Structural Systems, Mathematics in Science and Engineering, vol. 177 (1986). |
| Ector et al., “Cardiac Three-Dimensional Magnetic Resonance Imaging and Fluoroscopy Merging—A New Approach for Electroanatornic Mapping to Assist Catheter Ablation”, Circulation, (Dec. 13, 2005), pp. 3769-3776. |
| Extended European Search Report issued in EP Application No. 10 772 414, dated May 7, 2013, 6 pages. |
| Fletcher, R. “Chapter 6: Sums of Squares and Nonlinear Equations,” Practical Methods of Optimization, 2nd Edition, J. Willey & Sons, pp. 110-119 (1967). |
| Friedman, “Catheter Cryoablation of Cardiac Arrhythmias”, Current Opinion in Cardiology, 20:48-54, 2005. |
| Friedman, “Novel Mapping Techniques for Cardiac Electrophysiology”, Heart 2002, 87:575-582. |
| Geddes, L.A. et al., “Criteria for the Selection of Materials for Implanted Electrodes”, Annals of Biomedical Engineering, vol. 31, pp. 879-890 (2003). |
| Gepstein et al., “A Novel Method for Nonfluoroscopic Catheter-Based Electroanatomical Mapping of the Heart”, Circulation 95:1611-1622, 1997. |
| Gitosusastro et al., Performance Derivative Calculations and Optimization Process, IEEE Transactions on Magnetics, vol. 25, No. 4 (Jul. 1989) pp. 2834-2839. |
| Hansen: Rank-Deficient and Discrete Ill-Posed Problems: Numerical Aspects of Linear Inversion, SIAM, Philadelphia, USA, pp. 100-103, 1998. |
| He, Ye H. et al., “An Interactive Graphical System for Automated Mapping and Display of Cardiac Rhythms”, Journal of Electrocardiology, vol. 32, No. 3, 1999, 17 pages. |
| He, Ye H., “An interactive graphical system for automated mapping and display of cardiac rhythms”, Journal of Electrocardiology, vol. 32, No. 3, Jul. 1, 1999, pp. 225-241. |
| Holm, Magnus et al. A New Method for Analysis of Atrial Activation During Chronic Atrial Fibrillation in Man. IEEE Transactions on Biomedical Engineering, 43(2): 198-210, Feb. 1996. |
| Huang, Yi-Chih et al., “Development of a Third Generation Intraventricuiar Impedance Imaging (III) System: Evaluation of Hardware Design”, Engineering in Medicine and Biology Society,. Proceedings of the 19th Annual International Conference of the IEEE, Oct. 30-Nov. 2, 1997 vol. 6, pp. 336-338 (1997). |
| International Preliminary Report on Patentability in PCT/US2007/070854, dated Dec. 16, 2008, 9 pages. |
| International Preliminary Report on Patentability in PCT/US2009/061277, dated May 3, 2011 11 pages. |
| International Preliminary Report on Patentability in PCT/US2010/027568 dated Oct. 25, 2011, 4 pages. |
| International Preliminary Report on Patentability issued in PCT/US2008/052385 dated Aug. 11, 2009, 6 pages. |
| International Preliminary Report on Patentability issued in PCT/US2009/036099, dated Oct. 14, 2010, 20 pages. |
| International Preliminary Report on Patentability issued in PCT/US2010/027436, dated Nov. 9, 2011, 4 pages. |
| International Preliminary Report on Patentability issued in PCT/US2014/000114, dated Nov. 26, 2015, 9 pages. |
| International Preliminary Report on Patentability issued in PCT/US2014/036939, dated Nov. 19, 2015, 8 pages. |
| International Preliminary Report on Patentability issued in PCT/US2015/0017289 dated Sep. 15, 2016, 8 pages. |
| International Preliminary Report on Patentability issued in PCT/US2015/017482 dated Sep. 15, 2016, 4 pages. |
| International Search Report and the Written Opinion in PCT/US08/52385 dated Aug. 8, 2008, 11 pages. |
| International Search Report and Written Opinion in PCT/US2010/027568, dated Nov. 4, 2010, 6 pages. |
| International Search Report and Written Opinion in PCT/US2012/020946, dated May 7, 2012, 15 pages. |
| International Search Report and Written Opinion issued in PCT/US2007/070854, dated Sep. 12, 2008, 10 pages. |
| International Search Report and Written Opinion issued in PCT/US2009/036099, dated Apr. 28, 2009, 21 pages. |
| International Search Report and Written Opinion issued in PCT/US2009/061277, dated Apr. 8, 2010, 12 pages. |
| International Search Report and Written Opinion issued in PCT/US2010/027436 dated Oct. 27, 2010, 10 pages. |
| International Search Report and Written Opinion issued in PCT/US2014/000114, dated Sep. 8, 2014, 12 pages. |
| International Search Report and Written Opinion issued in PCT/US2014/036939, dated Jul. 30, 2014, 11 pages. |
| Andras Lasso et al., “SlicerWiki VolumeClip”, Dec. 25, 2014, pp. 1-4, XP55332376, retrieved from teh internet: https://www.slicer.org/wiki/Documentation/4.4/Extensions/VolumeClip, retrieved on Jan. 5, 2017. |
| Anonymous: Solid Commands—Rhino 3-D Modeling (Rhinoceros 5), Sep. 17, 2015, XP055332631, Retrieved from Internet: http://docs.mcneel.com/rhino/5/help/en-us/seealso/sak_solidtools.htm, retrieved on Jan. 5, 2017, see under Cap, 2 pages. |
| International Search Report and Written Opinion issued in PCT/US2016/053633, dated Jan. 17, 2017, 14 pages. |
| International Search Report and Written Opinion issued in PCT/US2016/053630, dated Jan. 17, 2017, 12 pages. |
| International Preliminary Report on Patentability issued in PCT/US2016/053613, dated Apr. 5, 2018, 7 pages. |
| International Preliminary Report on Patentability issued in PCT/US2016/053630, dated Apr. 5, 2018, 7 pages. |
| International Preliminary Report on Patentability issued in PCT/US2016/053633, dated Apr. 5, 2018, 9 pages. |
| Diaz, J., Monclus, E., Navazo, I., and Vazquez, P. Adaptive cross-sections of anatomical models. Pacific Graphics, 31(7):2155-2164, 2012. |
| Wilmot, L., Ritter, L., Agrawala, M., Curless, B., and Salesin, D. Interactive cutaway illustration of complex 3D models. ACM Transactions on Graphics, 26(3):31-1-31-11, Jul. 2007. |
| Number | Date | Country | |
|---|---|---|---|
| 20170092014 A1 | Mar 2017 | US |
| Number | Date | Country | |
|---|---|---|---|
| 62233347 | Sep 2015 | US |
