A method for enhancing a three-dimensional (3D) reconstruction of an object comprises obtaining a signal indicative of a static 3D reconstruction of an object disposed in a tracking space, co-registering the 3D reconstruction to the 3D tracking space, collecting enhancement data from a tracked tool disposed in the 3D tracking space, and adding real-time features of the object to the static 3D reconstruction using the enhancement data. A system for enhancing data obtained by a medical system includes an electronic control unit configured to receive a first signal for a static 3D reconstruction of an organ, co-register the static 3D reconstruction to a 3D tracking space for a tracked tool, receive a second signal for enhancement data generated by the tracked tool operating within a region of interest of the organ, and add real-time features of the area of interest to the static 3D reconstruction using the enhancement data.

BACKGROUND

a. Field of the Disclosure

The present disclosure relates generally to medical imaging and positioning systems that generate three-dimensional (3D) reconstructions of internal organs. In particular, the present disclosure relates to adding functional enhancements to 3D reconstructed models.

b. Background Art

Various methods exist for generating three-dimensional (3D) reconstructions of internal organs. For example, Computer Tomography (CT), X-ray, Positron Emission Tomography (PET) or Magnetic Resonance Imaging (MRI) may be used to generate a 3D modality that can be projected over fluoroscopy or some other two-dimensional (2D) image. Superimposing a real-time representation of an interventional medical device, such as a catheter or a guide wire, tracked by a Medical Positioning System (MPS), on the 3D reconstruction during a medical procedure is also known in the art.

The 3D reconstruction serves as a map to aid medical staff performing a medical procedure in navigating the medical device within a volume of interest in a body of a patient subjected to the procedure. In order for the superposition to reflect the true position of the medical device within the volume of interest, it is required to register the coordinate system associated with the MPS with the coordinate system associated with the 3D reconstruction.

Furthermore, it is desirable for medical professionals to view the medical device in real-time within the 3D reconstruction while maneuvering medical devices and performing therapy within the patient. Oftentimes, though, it is undesirable or even impossible to capture an image of the anatomy while maneuvering medical devices within the patient. For example, operating constraints associated with some body organs and blood vessels can prevent the simultaneous capture of images showing medical devices and images of the anatomy, particularly where a contrast agent or special dye is utilized.

To illustrate, medical imaging systems may be used to assist with cardiac resynchronization therapy (CRT) implantation procedures. In such procedures, a lead for a medical device is advanced through a coronary sinus ostium of a patient, where the ostium is the orifice of the coronary sinus, to deliver therapy. One way to obtain a representation of the coronary sinus is to take a venogram of the anatomy with a fluoroscopic imaging system. Contrast agent may be injected within the coronary sinus or other organ or blood vessels to facilitate the acquisition of the venogram with the imaging system. The contrast agent may even be trapped within the coronary sinus by positioning a balloon catheter within the coronary sinus ostium. The contrast agent highlights the anatomical structure of the coronary sinus on the venogram. Yet the balloon catheter must be removed before the medical devices, such as guide wires, catheters, and the LV lead, are advanced through the coronary sinus ostium. Thereafter, the contrast agent may disperse from the coronary sinus. Thus, the beneficial effect of the contrast agent highlighting the anatomical structure can be lost before the medical devices are navigated through the patient to the target location. The medical professional must then navigate the medical devices through the patient while only receiving partially highlighted images of the coronary sinus.

Though prior art 3D reconstructions have been able to combine images, models and information from many different sources, such as using CT or MRI projected over fluoroscopy, including historical information from tracked tools, such as Ensite™ NavX™ or MediGuide™ gMPS™ (guided Medical Positioning System) enabled devices (both of which are commercially available from St. Jude Medical, Inc.), such 3D reconstructions rely on stored image data. Thus, the 3D reconstructions do not reflect current, real-time conditions of tissue, as can be influenced by respiration of the patient and activation of the heart.

BRIEF SUMMARY

In one embodiment, a method for enhancing a three-dimensional (3D) reconstruction of an internal organ of a patient disposed in a tracking space comprises obtaining a signal indicative of a static 3D reconstruction of an object disposed in a tracking space, co-registering the 3D reconstruction to the 3D tracking space, collecting enhancement data from a tracked tool disposed in the 3D tracking space, and adding real-time features of the object to the static 3D reconstruction using the enhancement data.

In another embodiment, a system for enhancing data acquired from a medical system comprises an electronic control unit (ECU) configured to receive a first signal for a static 3D reconstruction of an organ, co-register the static 3D reconstruction to a 3D tracking space for a tracked tool, receive a second signal for enhancement data generated by the tracked tool operating within a region of interest of the organ, and add real-time features of the area of interest to the static 3D reconstruction using the enhancement data.

DETAILED DESCRIPTION

The present disclosure allows for a 3D reconstructed model to be enhanced with supplemental data during real-time manipulation of tools by the operator, regardless of how the 3D reconstructed model was originally created. By this approach, features that originally did not exist in the model (motion, missing or partial branches, etc.) become available for the benefit of the operator.

FIG. 1is a schematic illustration of medical imaging system10for determining the position of catheter12relative to a 3D reconstructed model of an organ of patient14, as well as for generating and displaying tracking-based enhancement information on display unit16. System10includes moving imager18, which includes intensifier20and emitter22, and medical positioning system24, which includes positioning sensor26and field generators28. Electrophysiology map information and cardiac mechanical activation data pertaining to the model generated by medical imaging system10are displayed on computer display16to facilitate treatment and diagnosis of patient14. The present disclosure describes a way for system10to gather physiological information from patient14in order to enhance the 3D reconstructed model in order to facilitate diagnosis and treatment. For example, system10can be configured to collect cardiac motion and respiration motion data with catheter12, and to further merge that data with the 3D model in a visual format. In another embodiment, the 3D reconstructed model is enhanced with anatomical features obtained by catheter12that were lacking in the originally obtained 3D reconstructed model.

Moving imager18is a device that acquires an image of region of interest30while patient14lies on operation table32. Intensifier20and emitter22are mounted on C-arm34, which is positioned using moving mechanism36. In one embodiment, moving imager18comprises a fluoroscopic or X-ray type imaging system that generates a two-dimensional (2D) image of the heart of patient14.

Medical positioning system (MPS)24includes a plurality of magnetic field generators28and catheter12, to which positioning sensor26is mounted near a distal end. MPS24determines the position of the distal portion of catheter12in a magnetic coordinate system generated by field generators28, according to output of positioning sensor26. In one embodiment, MPS24comprises a Mediguide™ gMPS™ magnetically guided medical positioning system, as is commercially offered by St. Jude Medical, Inc., that generates a three-dimensional (3D) model of the heart of patient14. In other embodiments, MPS24may comprise an impedance-based system such as, for example, an EnSite™ Velocity™ system utilizing EnSite™ NavX™ technology commercially available from St. Jude Medical, Inc., or as seen generally, for example, by reference to U.S. Pat. No. 7,263,397, or U.S. Pub. No. 2007/0060833, both of which are hereby incorporated by reference in their entireties as though fully set forth herein. Furthermore, hybrid magnetic and impedance based systems may be used.

C-arm34is oriented so that intensifier20is positioned above patient14and emitter22is positioned underneath operation table32. Emitter22generates, and intensifier20receives, imaging field FI, e.g., a radiation field, that generates a 2D image of area of interest30on display16. Intensifier20and emitter22of moving imager18are connected by C-arm34so as to be disposed at opposites sides of patient14along imaging axis AI, which extends vertically with reference toFIG. 1in the described embodiment. Moving mechanism36rotates C-arm34about rotational axis AR, which extends horizontally with reference toFIG. 1in the described embodiment. Moving mechanism36or an additional moving mechanism may be used to move C-arm34into other orientations. For example, C-arm34can be rotated about an axis (not shown) extending into the plane ofFIG. 1such that imaging axis AIis rotatable in the plane ofFIG. 1. As such, moving imager18is associated with a 3D optical coordinate system having x-axis XI, y-axis YI, and z-axis ZI.

Medical positioning system (MPS)24is positioned to allow catheter12and field generators28to interact with system10through the use of appropriate wiring or wireless technology. Catheter12is inserted into the vasculature of patient14such that positioning sensor26is located at area of interest30. In the described embodiment, field generators28are mounted to intensifier20so as to be capable of generating magnetic field FMin area of interest30coextensive with imaging field FI. In other embodiments, field generators28may be mounted elsewhere, such as under operation table32. MPS24is able to detect the presence of position sensor26within magnetic field FM. In one embodiment, position sensor26may include three mutually orthogonal coils, as described in U.S. Pat. No. 6,233,476 to Strommer et al., which is hereby incorporated by reference in its entirety for all purposes. As such, MPS24is associated with a 3D magnetic coordinate system having x-axis XP, y-axis YP, and z-axis ZP.

The 3D optical coordinate system and the 3D magnetic coordinate system are independent of each other, that is they have different scales, origins and orientations. Movement of C-arm34via moving mechanism36allows imaging field FIand magnetic field FMto move relative to area of interest30within their respective coordinate system. However, field generators28are located on intensifier20so as to register the coordinate systems associated with moving imager18and MPS24. In embodiments where field generators28are not mounted on intensifier20, registration between magnetic field FMand imaging field FIis maintained using other known methods. Thus, images generated within each coordinate system can be merged into single image shown on display unit16. Moving imager18and MPS24may function together as is described in Publication No. US 2008/0183071 to Strommer et al., which is hereby incorporated by reference in its entirety for all purposes.

Display unit16is coupled with intensifier20. Emitter22transmits radiation that passes through patient14. The radiation is detected by intensifier20as a representation of the anatomy of area of interest30. An image representing area of interest30is generated on display unit16, including an image of catheter12. C-arm34can be moved to obtain multiple 2D images of area of interest30, each of which can be shown as a 2D image on display unit16.

Display unit16is coupled to MPS24. Field generators28transmit magnetic fields that are mutually orthogonal, corresponding to axes of the 3D magnetic coordinate system. Position sensor26detects the magnetic fields generated by field generators28. The detected signals are related to the position and orientation of the distal end of catheter12by, for example, the Biot Savart law, known in the art. Thus, the precise position and location of the distal end of catheter12is obtained by MPS24and can be shown in conjunction with the 2D images of area of interest30at display unit16. Furthermore, data from position sensor26can be used to generate a 3D model of area of interest30, as is described in U.S. Pat. No. 7,386,339 to Strommer et al., which is hereby incorporated by reference in its entirety for all purposes.

In one embodiment, system10is integrated with an impedance-based mapping and navigation system, including, for example, an EnSite™ NavX™ system commercially available from St. Jude Medical, Inc., or as seen generally, for example, by reference to U.S. Pat. No. 7,263,397, or Pub. No. US 2007/0060833, both of which are hereby incorporated by reference in their entireties for all purposes. Information from such impedance-based systems can be co-registered and combined with data from MPS24ofFIG. 1. MPS24and the impedance-based system can be structurally integrated, such as is described in Pub. No. US 20012/0265054 to Olson, which is hereby incorporated by reference in its entireties for all purposes.

3D models and data generated by system10can be used to facilitate various medical procedures. For example, it has been found that mechanical activation data, e.g., displacement of heart wall muscle, may be used in conjunction with electrical mapping data to optimize the placement of leads for cardiac resynchronization therapy (CRT) procedures. U.S. Pat. No. 8,195,292 to Rosenberg et al., which is hereby incorporated by reference in its entirety for all purposes, describes exemplary methods for optimizing CRT using electrode motion tracking.

In typical imaging systems, observing, understanding and assessing real-time data from the anatomy can be difficult when the 3D model is static and not reflecting real-time motion of the anatomy. 3D models generated by these typical systems require the operator or physician to mentally reconcile real-time motion with a static 3D model. Thus, diagnosis and treatment of the patient can be encumbered by the skill of the physician.

The present disclosure provides system10with the capability of obtaining and displaying a 3D model along with real-time data points collected during a medical procedure utilizing a catheter or some other tracking device. In particular, the real-time data points can be added to the static 3D model as heart wall motion imaging (e.g., displacement and timing), respiration movement, and extended anatomical features. Real-time features from the data points include real-time position data and real-time physiological data, as described throughout the application. The systems and methods of the present technique allow system10to overcome the disadvantages of the prior art by providing a method and a system for registering a coordinate system associated with a three dimensional (3D) pre-acquired medical image (“a 3D coordinate system”) with a 3D coordinate system associated with an MPS (“MPS coordinate system”) and with a 2D coordinate system associated with a 2D image (“2D coordinate system”), compensating the 3D pre-acquired medical image and the 2D image for respiration and cardiac motion, enhancing the registered images with real-time tracking data to generate supplemental anatomical information, and simultaneously displaying all images, models and data in real-time alone or in combination with each other. It is noted that the MPS coordinate system is a 3D coordinate system.

System10, according to the disclosed technique, pre-acquires a 3D image (FIG. 2A) of a volume of interest, and extracts a 3D image model (FIG. 2B) from the 3D image of at least one tubular organ (e.g., the coronary vessel of the heart) within a volume of interest. System10further obtains an estimated volumetric model (FIG. 3C) of the same tubular organ. System10obtains this estimated volumetric model using a trace (FIG. 3A) of a medical device (i.e., a set of locations representing the trajectory of the medical device), which is inserted into the tubular organ, and at least one 2D image (FIG. 3B) of that same organ. The medical device is fitted with an MPS sensor in order to generate the trace. System10uses these models and the above-mentioned coordinate systems to achieve registered images and models with higher degrees of accuracy (FIG. 4). Such registration procedures are described in U.S. Pat. No. 8,238,625 to Strommer et al., which is hereby incorporated by reference in its entirety for all purposes. The term “registration” refers to finding a transformation associating the coordinates of each point in one coordinate system to the coordinates of the same point in another coordinate system.

Additionally, system10, according to the disclosed technique, compensates the registered coordinate systems for both cardiac and respiratory motion, as is described in Pub. No. US 2013/0172730 to Cohen, which is hereby incorporated by reference in its entirety for all purposes.

Furthermore, with the techniques described herein, system10is able to utilize real-time information obtained with a tracking tool, such as that used to generate the trace ofFIG. 3A, to enhance the registered images (FIG. 5), whether displayed together or individually, such as the 2D image ofFIG. 3Bor the estimated volumetric model ofFIG. 3C.

FIG. 2Ais a schematic illustration of 3D pre-acquired image100associated with 3D coordinate system104in accordance with the disclosed technique. 3D pre-acquired image100may be acquired using any suitable system, e.g., CT, Mill, PET, 3D Ultra Sound, etc. Image100is a 3D image of a volume of interest which includes tubular organ102. 3D pre-acquired image100serves as a 3D reference road-map for navigating a minimally invasive medical device, such as catheter12ofFIG. 1, in the volume of interest. Superimposing a minimally invasive medical device, operative in an MPS coordinate system and fitted with an MPS sensor, on 3D pre-acquired image100, requires registering the 3D coordinate system with the MPS coordinate system.

FIG. 2Bis a schematic illustration of 3D image model106, of tubular organ102, extracted from 3D pre-acquired image100(FIG. 2A). In one embodiment, the tubular organ comprises a coronary sinus having branches108. Extracted image model106is also associated with 3D coordinate system104. To achieve the registration, prior to a medical procedure, system10, according to the disclosed technique, processes (e.g., segments) 3D pre-acquired image100and extracts 3D model106of tubular organ102. Tubular organ102is situated within the imaged volume of interest.

FIG. 3Ais a schematic illustration of trace122of a medical device (e.g. catheter12ofFIG. 1) in accordance with the disclosed technique. Trace122is constructed from a plurality of MPS points, such as MPS point120, representing the locations of the MPS sensor (e.g. sensor26ofFIG. 1), fitted on the medical device. During a medical procedure (e.g., minimally invasive procedure), the medical staff inserts a catheter fitted with an MPS sensor (e.g. catheter12ofFIG. 1), into tubular organ102and moves the catheter along (i.e., pushed forward or pulls back within) tubular organ102to acquire points120. An MPS (e.g. medical positioning system24ofFIG. 1) acquires a plurality of MPS points (i.e., a plurality of locations of the MPS sensor within and along the tubular organ), and determines 3D MPS trace122of the shape of tubular organ102. These MPS points are represented by coordinates in MPS coordinate system118. The terms “trace” and “centerline” both refer herein to a set of locations representing the trajectory of the medical device.

FIG. 3Bis a schematic illustration of 2D image112of the volume of interest. 2D image112includes 2D representation114of tubular organ102, and trajectory116of the medical device inside tubular organ102. 2D image112is associated with 2D coordinate system110. When the medical staff inserts the medical device fitted with an MPS sensor into tubular organ102, system10separately obtains a 2D real-time image of that organ, thereby capturing both representation114and trajectory116together. 2D image112may be obtained using any suitable methods, such as X-ray, 2D Ultra Sound, etc. When system10according to the disclosed technique, uses an X-ray imager to generate a venogram, such as moving imager18ofFIG. 1, to obtain 2D image112, it is desirable to inject the tubular organ with a contrast fluid (e.g. a dye) to increase apparentness of 2D representation114of the tubular organ in image112.

Since MPS coordinate system118is registered with 2D coordinate system110, each of the MPS points, such as MPS point120, has a corresponding point in 2D coordinate system110. Using image processing techniques, such as segmentation or edge detection, system10determines the width of 2D representation114of tubular organ102for each MPS point. System10uses this width, together with trace122of the medical device (i.e., not necessarily the centerline of tubular organ102), to determine an estimated volumetric model of tubular organ102. For example, the width of 2D representation114of tubular organ102, at each MPS point, determines the diameter of a circle encircling that point.

FIG. 3Cis a schematic illustration of estimated volumetric model124of tubular organ102determined from trace122(FIG. 3A) and 2D representation114(FIG. 3B). Estimated volumetric model124is associated with MPS coordinate system118and with 2D coordinate system110. MPS coordinate system118is registered with 2D coordinate system110(e.g., by mechanically coupling MPS transmitters/field generators28to moving imager18, as described above with reference toFIG. 1). Using 3D MPS trace122and at least one 2D image, system10estimates volumetric model124of tubular organ102. In one embodiment, volumetric model124comprises an Angio Survey™ 3D model generated using MediGuide™ Technology. Angio Survey™ features a capability to reconstruct a 3D model of a vascular anatomical structure from two cine-loops where contrast agent is used, recorded at different projections. The reconstructed model can be displayed in 3D and projected on live and pre-recorded fluoroscopy. In one embodiment, a MediGuide™ CPS Courier 0.014 inch (˜0.3556 mm) guide wire is used with the Angio Survey model.

FIG. 4is a schematic illustration of a registration process in accordance with the disclosed technique. System10registers MPS coordinate system118with 3D coordinate system104, for example, by matching extracted 3D model106with estimated volumetric model124. Consequent to this registration, 2D coordinate system110is also registered with coordinate system104. Thus, each point, in each one of coordinate systems110,118and104, has a corresponding point in each of the other coordinate systems. This registration, between coordinate systems110,118and104, enables superimposing MPS points of interest, at their respective locations on a 3D image. For example, 3D pre-acquired image100may now serve, for example, as a roadmap for the medical staff, during medical procedures (e.g., treating structural heart disease, deployment of percutaneous valves, ablation, mapping, drug delivery, ICD/CRT lead placement, deploying a stent and other PCI procedures, surgery, biopsy). On this 3D reference roadmap, system10superimposes 3D trace122of the medical device within tubular organ102. This registration further enables superimposing points of interest included in 3D image100, at their respective location on 2D image112. As a further example, 3D image model106of tubular organ102may be projected onto 2D image112. Thus, the projected 3D image may serve as a virtual dye, instead of injecting a fluoroscopic dye to tubular organ102prior to obtaining 2D image112.

During the medical procedure, the position and orientation of patient14might change. Consequently, the 2D real-time representation of the volume of interest may also change. These changes may affect the registration between 3D coordinate system104and 2D coordinate system110. Therefore, an MPS reference sensor, placed on patient14during the medical procedure, is operative to detect these changes in the patient position and orientation. The information about these changes may be used either for triggering a registration process or as input for such a registration process. All of the registration processes described herein are explained in greater detail in the aforementioned '625 patent to Strommer et al.

Additionally, after registration of the images, movement of each image due to biomechanical effects, such as respiration of the patient and beating of the heart, is compensated for using techniques of the aforementioned Pub. No. US 2013/0172730 to Cohen, which are summarized below. For example, one technique for motion compensation comprises using physical anchors, which may comprise MPS sensors, that serve as common position and orientation markers by which system10associates data from the different coordinate systems. Likewise, virtual anchors may be used to perform motion compensation, as is described in Pub. No. US 2011/0054308 to Cohen et al., which is hereby incorporated by reference in its entirety for all purposes. Additionally, an internal position reference sensor can be used to generate a motion compensation function based on a vector of the internal position reference sensor as the patient moves, as is described in Pub. No. US 2011/0158488 to Cohen et al., which is hereby incorporated by reference in its entirety for all purposes. As another example, one technique for motion compensation comprises continuously monitoring the positions of MPS sensors as they are positioned with a patient's body during first and second time period frequencies, whereby system10can learn the frequencies of specific points of the anatomy so that the location of those points within the various coordinate systems at the moment an image or model is acquired allows system10to determine the cardiac and respiratory phases of the patient's body, as is described in Pub. No. US 2009/0182224 to Shmarak et al., which is hereby incorporated by reference in its entirety for all purposes.

Finally, with respect to the present disclosure, the registered, compensated models and/or images can be enhanced with real-time tracking data, which can be extrapolated to extend the boundary of the previously generated 3D reconstructed model, or generate tissue motion visualization on the previously generated 3D reconstructed model, as is discussed with reference toFIG. 5.

FIG. 5is a schematic illustration of 3D reconstructed model126superimposed over 2D image128along with real-time, tracking-based enhancements of the present technique. 2D image128additionally includes contrast fluid-enhanced portions of anatomy such that coronary sinus130and branches132are distinctly visible. Catheter134is shown inserted into coronary sinus130such that tip136extends from one of branches132. In the described embodiment, the real-time, tracking-based enhancements comprise trace138and trace140.

In one embodiment, 2D image128is generated using X-ray, such as described with reference toFIG. 3B. In one embodiment, 3D reconstructed model126is generated using tracking information generated by tip136of catheter134, which may comprise a MediGuide-enabled tip as described above with reference toFIG. 1. In another embodiment, 3D reconstructed model126may be generated using an estimated volumetric model as discussed with reference toFIG. 3C. In other embodiments, 3D reconstructed model126may be generated using a combination of imaging (angiography, CT, MRI, ultrasound, etc.) and 3D tracking data.

As catheter134is traversed through coronary sinus130, tip136generates real-time position data and real-time physiological data. The position data is influenced by its location within the anatomy. Thus, as tip136moves along each branch132, the position of each branch132is traced as the tissue guides tip136within the various coordinate systems. However, the location of each branch132within the coordinate system does not remain stationary as patient14breaths and the heart of patient14beats. Furthermore, the contrast fluid used to show coronary sinus130dissipates over time, making the visibility of branches132difficult to perceive, or the contrast fluid may not extend all the way to the end of each branch132. As such, it can be difficult to know the actual location of catheter134and tip136relative to coronary sinus130and branches132.

The techniques of the present disclosure enhance 3D reconstructed model126of coronary sinus130by means of collecting 3D tracking data of tip136while it is manipulated within the volume of that organ. As described above, 3D reconstructed model126is co-registered to the 3D tracking space. Specifically, the coordinate system of 3D reconstructed model126is co-registered with the coordinate system of catheter134, e.g., 3D coordinate system104is co-registered with MPS coordinate system118. As such, the tracking data can be associated with any of 3D reconstructed model126, 2D image128, 3D image model106, estimated volumetric model124and 2D image112. The tracking data may include location data, e.g., coordinates in each of the coordinate systems, as well as physiological data (e.g., cardiovascular data and/or electrical data, such as impedance, resistance, conductivity, etc.).

In one embodiment, catheter134collects enhancement data that is used to extend existing portions of 3D reconstructed model126beyond its boundaries as originally reconstructed. For example, 3D reconstructed model126, which may be generated using multiple angiograms, may not fully represent coronary sinus130, such as by not fully extending throughout branches132. In particular, contrast fluid used with 2D image128may have low penetration into some areas of branches132, thus making it difficult to generate 3D reconstructed model126. Thus, once a tracked tool, such as catheter134, is manipulated through one of branches132beyond an edge of 3D reconstructed model126, a skeleton of the extending anatomy can be reconstructed based on trace140from tip136. As such, the shape of 3D reconstructed model126is extended beyond its original borders and the model is further built-out. This enables the operator of system10to better comprehend the orientation of catheter134relative to the anatomy, particularly in areas that are otherwise invisible by fluoroscopy.

Building-out or extension of the model is begun by using system10to track catheter134in three-dimensions within MPS coordinate system118. When catheter134reaches an end of the reconstructed anatomy, e.g. branch132, system10will use the recorded locations of catheter134in order to append portions to the reconstructed model126. Since the contrast fluid has not reached branches132constructed from the recorded locations of catheter134, only a “centerline” of the added branches will be appended to reconstructed model126without lumen contours. The co-registration and motion compensation between the images and models of the various coordinate systems and catheter134will help system10append the added branches in a way that matches both the actual location of catheter134with reconstructed model126and the cardiac and respiratory state of the anatomy, e.g., tubular organ102, with reconstructed model126, as discussed below.

In another embodiment, catheter134collects enhancement data that is used to add a motion component to 3D reconstructed model126. The motion component is based on the actual motion of the anatomy sensed by a tracked tool, such as catheter134, while inside of coronary sinus130. For example, the actual motion data includes local movements of tissue walls within each coordinate system. Thus, even though patient14may remain stationary with respect to each coordinate system, tip136may move as a heart beats or as lungs respirate and contract. The actual motion data collected can be combined with data used to generate static 3D reconstructed model126to add real-time dynamics to 3D reconstructed model126simply by manipulating catheter134within the region of interest. The motion is synchronized with motion of the anatomy, such as coronary sinus130, to create a “4D model” that moves in real-time. Thus, 3D reconstructed model126may be animated with heart beats, muscular contractions, respiration, etc. In the case of animating 3D reconstructed model126with heart beats, the heart beat motions may be gated to a specific time duration of a cardiac cycle, such as the end diastole. The 4D model can be rendered by itself, combined with other images or models, shown on display16(FIG. 1), projected on fluoroscopy, etc. For example, a 4D dynamic model of coronary sinus130is advantageous for use in a CRT implant procedure where it is desirable to see mechanical heart wall motion patterns.

The co-registration and motion compensation between the images and models of the various coordinate systems and catheter134bridges the gap between the real-time motion of catheter134and the stable depiction of the anatomy shown by the imaging of static 3D reconstructed model126. The catheter134typically experiences jerky motion while being moved within the anatomy, while the imaging is depicted as a still picture. Using the techniques described herein, a specific location in reconstructed model126can be correlated to the current position of catheter134. A good example would be the placement or parking of catheter134at a bifurcation in branches132. Because of the co-registration and motion compensation, the position of tip136on reconstructed model126would then be fixed on that bifurcation, regardless of any significant motion that catheter134may continuously experience during operation of the device. Now, if catheter134is not manipulated or moved, the only components of motion would be the cardiac and respiratory motion of the anatomy. The inherent motion compensation functions of the MediGuide™ system will represent that motion as tip136is tracked. Finally, the cardiac and respiratory motion will be applied to the geometry representing that specific bifurcation in 3D reconstructed model126, hence “mobilizing” or “animating” 3D reconstructed model126in a way that is matched to the actual motion of the anatomy, i.e tubular organ102. Multiple points of the anatomy can be tracked this way to enhance reconstructed model126(or parts of it) with motion that represents the actual motion of the anatomy. Any change in the cardiac or respiratory activity of the patient will be reflected automatically in this 4D model. Thus, in aggregate, a system such as the MediGuide™ system keeps track of electrophysiology data, respiration data, patient motions data, etc., and can apply in real-time that data to 3D reconstructed model due to the co-registration and motion compensation capabilities.

The techniques of the present disclosure take advantage of real-time tracking data that is accurately compensated for respiration motion and cardiac motion, and accurately co-registered between different coordinate systems to allow enhancement data collected during active manipulation of the tracked tool to be simultaneously displayed with 3D reconstructed models. The enhancement data shows features not able to be generated in the 3D reconstructed model, which typically comprises a static, historical rendering of the anatomy that may not reflect current conditions of the anatomy. Because of the accuracy of the compensation and registration processes, such as those available with MediGuide™ gMPS™ technology, the enhancement data can be accurately positioned on the 3D reconstructed model in real-time when a physician is most likely to need the information. As such, when a physician is in the middle of a procedure, if the contrast fluid-enhanced X-ray venogram insufficiently shows the area of interest, the procedure can be continued by simply gathering more data with the tracked tool. Furthermore, left ventricular lead placement can be optimized by providing the physician with a visualization of heart wall motion simply by including a tracked tool within the anatomy.

Although a number of embodiments 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 sprit or scope of this disclosure. For example, all 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 disclosure.

Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by referenced herein is incorporated herein only to the extent that the incorporated materials does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference.