Intracavitary ultrasound imaging with automatic and assisted labeling and bookmarking

Abstract

An intraluminal ultrasound imaging system is disclosed, comprising: a processor circuit in communication with an intraluminal ultrasound imaging catheter and configured to: receive a plurality of intraluminal ultrasound images from the imaging catheter during movement of the imaging catheter in a body cavity of a patient, the body cavity comprising a plurality of segments. The processor circuit is further configured to: generate a marker to be applied to an intraluminal ultrasound image in the plurality of intraluminal ultrasound images, wherein the marker is generated based on movement of the intraluminal ultrasound imaging catheter and wherein the marker represents a segment in the plurality of segments; and output the marker and the plurality of intraluminal ultrasound images shown continuously to a display.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority to and the benefit of U.S. Provisional Patent Application No. 62 / 751,268, filed on October 26, 2018, the entire contents of which are hereby incorporated by reference. Technical Field

[0003] The subject matter described herein relates to systems for medical imaging. Specifically, the disclosed system provides a system for bookmarking and labeling peripheral intravascular ultrasound or IVUS images during a pullback procedure. The system has particular, but not exclusive, utility for the diagnosis and treatment of vascular disease. Background Art

[0004] Peripheral vascular procedures, such as angioplasty and stenting in peripheral veins (inferior vena cava - IVC, iliac veins, femoral veins), IVC-filter retrieval, atherectomy and thrombectomy for EVAR and FEVAR (and similar abdominal features) are procedures in which IVUS is used. Different diseases or medical procedures produce physical features with different sizes, structures, densities, water content, and accessibility to imaging sensors. For example, deep vein thrombosis (DVT) produces blood cell clots, while post-thrombotic syndrome (PTS) produces webbing or other residual structural effects in the blood vessels that have a similar composition to the vessel wall itself and may therefore be difficult to distinguish from the vessel wall. A stent is a dense (e.g., metal) object that can be placed in a blood vessel or lumen to hold the vessel or lumen open to a specific diameter. Compression occurs when anatomical structures outside the blood vessel or lumen impinge on the blood vessel or lumen, causing it to constrict.

[0005] In some cases, intraluminal medical imaging is performed using an IVUS device that includes one or more ultrasonic transducers. The IVUS device can be delivered into a blood vessel and guided to the area to be imaged. The transducer transmits ultrasonic energy and receives ultrasonic echoes reflected from the blood vessel. The ultrasonic echoes are processed to create an image of the blood vessel of interest. The image of the blood vessel of interest may include one or more lesions or blockages in the blood vessel. Stents can be placed in the blood vessel to treat these blockages, and intraluminal imaging can be performed to view the placement of the stent in the blood vessel. Other types of treatments include thrombectomy, ablation, angioplasty, medications, etc.

[0006] In a typical IVUS workflow, marking and annotation are often repetitive and time-consuming. In addition, when placing bookmarks, the time between the physician or other user calling the bookmark and the actual placement of the bookmark can cause the bookmark to be placed on a frame that the physician or other user did not intend. In these cases, the physician or other user often has to go back and find the appropriate frame of interest for further investigation, measurement or analysis. Current methods of bookmarking / labeling often include selecting from a pick list or involving manual interactive editing of the user. Typically, the saved bookmarks only include general text, which must be customized or detailed by the clinician later.

[0007] The information included in this background section of the specification, including any references cited herein and any description or discussion thereof, is included for technical reference purposes only and should not be construed as subject matter that would limit the scope of the present disclosure. Summary of the invention

[0008] A system is disclosed for advantageously labeling, tagging, and annotating intraluminal images from an intraluminal medical imaging sequence (e.g., an IVUS pullback sequence) using tags automatically (e.g., predictively) provided by the system or selected by a user from a short list automatically provided by the system, thereby allowing rapid, accurate, real-time bookmarking of the location and severity of disease or compression of the lumen along with reference images, post-treatment images, and other images. The system is hereinafter referred to as an automatic and assisted bookmarking system.

[0009] Automatically generated or assisted suggested labels / bookmarks for IVUS make placement of labels / bookmarks simpler and faster than currently possible. By allowing the user to select a procedure type such as coronary / peripheral venous or arterial, the system can provide a list of relevant bookmarks for the user to choose from. The user can drag and drop the labels / bookmarks in the appropriate place and can also edit labels and bookmarks as needed. Labels and bookmarks can be automatic, semi-automatic or user driven. Bookmarks can also provide an optional range of adjacent frames for selection.

[0010] The automatic and assisted bookmarking system disclosed herein has particular, but not exclusive, utility to intraluminal ultrasound imaging procedures. One general aspect includes an intraluminal ultrasound imaging system, comprising: a processor circuit configured to communicate with an intraluminal ultrasound imaging catheter, wherein the processor circuit is configured to: receive a plurality of intraluminal ultrasound images acquired by the intraluminal ultrasound imaging catheter during movement of the intraluminal ultrasound imaging catheter within a body cavity of a patient, the body cavity comprising a plurality of segments; generate a marker to be applied to an intraluminal ultrasound image in the plurality of intraluminal ultrasound images, wherein the marker is generated based on movement of the intraluminal ultrasound imaging catheter, and wherein the marker predicts and / or represents a segment in the plurality of segments; and output a screen display including the marker and the plurality of intraluminal ultrasound images to a display in communication with the processor circuit. Other embodiments of this aspect include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each of which is configured to perform the actions of the method.

[0011] Implementations may include one or more of the following features. The system further includes a user interface, wherein the processor circuit is configured to receive user input via the user interface to apply the mark to an intraluminal ultrasound image in the plurality of intraluminal ultrasound images. The system, wherein, in response to receiving user input to apply the mark, the processor circuit is configured to apply one or more other intraluminal ultrasound images adjacent to the intraluminal ultrasound image using the mark. The system, wherein the display includes a touch screen, and wherein the user interface includes a drag-and-drop interface on the touch screen, and wherein the user input includes a drag-and-drop input. The system, wherein the user interface includes a voice recognition interface, and the user input includes voice confirmation. The system, wherein the processor circuit is further configured to output a stylized image of the body cavity including the plurality of segments, wherein the mark identifies the location where the segment begins in the stylized image. The system, wherein the processor circuit is configured to: generate a plurality of markers to be applied to the plurality of ultrasound images; and continuously output the plurality of markers, wherein each of the plurality of markers corresponds to a different segment of the plurality of segments. The system, wherein the processor circuit is configured to determine an order of continuous output for the plurality of markers based on movement of the intraluminal ultrasound imaging catheter. The system, wherein the processor circuit is configured to determine the order based on at least one of an entry point into the body cavity or a direction of movement of the intraluminal ultrasound imaging catheter. The system also includes the intraluminal ultrasound imaging catheter, wherein the intraluminal ultrasound imaging catheter includes an intravascular ultrasound (IVUS) imaging catheter, and wherein the body cavity includes a peripheral blood vessel. Implementations of the described technology may include hardware, methods or processes, or computer software on a computer-accessible medium.

[0012] One general aspect includes an intraluminal ultrasound imaging system, comprising: a processor circuit configured to communicate with an intraluminal ultrasound imaging catheter, wherein the processor circuit is configured to: receive an intraluminal ultrasound image obtained by the intraluminal ultrasound imaging catheter during movement of the intraluminal ultrasound imaging catheter within a body cavity of a patient; generate a plurality of text labels; output a screen display including a first portion and a second portion, the first portion including the intraluminal ultrasound image, the second portion including the plurality of text labels, wherein the first portion is proximate to the second portion; receive a drag-and-drop user input to move a text label of the plurality of text labels from the second portion to the first portion; and associate the text label with the intraluminal ultrasound image. Other embodiments of this aspect include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each of which is configured to perform the actions of the method.

[0013] One general aspect includes a method of intraluminal ultrasound imaging, comprising: receiving, at a processor circuit in communication with an intraluminal ultrasound imaging catheter, a plurality of intraluminal ultrasound images acquired by the intraluminal ultrasound imaging catheter during movement of the intraluminal ultrasound imaging catheter within a body cavity of a patient, the body cavity comprising a plurality of segments; generating a marker to be applied to an intraluminal ultrasound image in the plurality of intraluminal ultrasound images, wherein the marker is generated based on movement of the intraluminal ultrasound imaging catheter, and wherein the marker predicts and / or represents a segment in the plurality of segments; and outputting a screen display including the marker and the plurality of intraluminal ultrasound images shown in succession to a display in communication with the processor circuit. Other embodiments of this aspect include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each of which is configured to perform the actions of the method.

[0014] Implementations may include one or more of the following features. The method further includes receiving user input via a user interface operating on the processor circuit to apply the tag to an intraluminal ultrasound image in the plurality of intraluminal ultrasound images. The method further includes applying the tag in response to receiving the user input, applying the tag to one or more other intraluminal ultrasound images adjacent to the intraluminal ultrasound image. The method, wherein the display includes a touch screen, and wherein the user interface includes a drag-and-drop interface on the touch screen, and wherein the user input includes a drag-and-drop input. The method, wherein the user interface includes a voice recognition interface, and the user input includes voice confirmation. The method further includes outputting a stylized image of the body cavity including the plurality of segments, wherein the tag identifies the location where the segment begins in the stylized image. The method further includes generating a plurality of tags to apply to a plurality of ultrasound images; and continuously outputting a screen display including the plurality of tags to the display in communication with the processor circuit, wherein each of the plurality of tags corresponds to a different segment of the plurality of segments. The method further includes determining an order of sequential output of the plurality of markers based on movement of the intraluminal ultrasound imaging catheter. The method further includes determining the order based on at least one of an entry point into the body cavity or a direction of movement of the intraluminal ultrasound imaging catheter. Implementations of the described technology may include hardware, methods or processes, or computer software on a computer-accessible medium.

[0015] This Summary is provided to introduce some concepts in a simplified form that are further described in the Detailed Description below. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to limit the scope of the claimed subject matter. A more extensive presentation of the features, details, utilities, and advantages of the automatic and assisted bookmarking system is provided in the following written description of various embodiments of the disclosure and shown in the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] Illustrative embodiments of the present disclosure will be described with reference to the accompanying drawings, in which:

[0017] Figure 1 is a schematic illustration of an intraluminal imaging system according to aspects of the present disclosure.

[0018] Figure 2 Blood vessels (eg, arteries and veins) in the human body are illustrated.

[0019] Figure 3 The image shows a vessel with associated compression.

[0020] Figure 4Illustration shows a blood vessel with compression and its internal stent expanded to restore blood flow.

[0021] Figure 5 An exemplary intraluminal imaging display screen is illustrated in accordance with at least one embodiment of the present disclosure.

[0022] Figure 6 A graphical roadmap screen display of an exemplary automatic and assisted bookmarking system during a pullback procedure in a left leg vein of a patient in accordance with at least one embodiment of the present disclosure is shown.

[0023] Figure 7 A graphical roadmap screen display of an exemplary automatic and assisted bookmarking system during a pullback procedure in a left leg vein of a patient in accordance with at least one embodiment of the present disclosure is shown.

[0024] Figure 8 is a flow chart of an intraluminal image bookmarking method according to the prior art.

[0025] Fig. 9 is a flow chart of a method for bookmarking an intraluminal image according to at least one embodiment of the present disclosure.

[0026] Fig.10 is a schematic diagram of a processor circuit according to an embodiment of the present disclosure.

[0027] Fig.11 is a screenshot of an IVUS access point selection screen in accordance with at least one embodiment of the present disclosure. DETAILED DESCRIPTION

[0028] The present disclosure generally relates to medical imaging, including imaging associated with a patient's body cavity using an intraluminal imaging device. For example, the present disclosure describes a system, device and method for labeling and bookmarking intraluminal images during an intraluminal imaging process such as IVUS pullback. Drag-and-drop tags and bookmarks are provided to users to achieve a simpler and faster way to place tags and bookmarks. Appropriate tags and bookmarks appear based on user selections, including process types (coronary / peripheral, venous / arterial, etc.), entry points, entry directions or pullback directions, and disease types. Tags and bookmarks contain information such as anatomical references or disease states / types. Using confirmation input from the user, the system can place the tags and bookmarks at the appropriate place and time. The system also enables customization or editing of tags and bookmarks. Tags and bookmarks can be saved to IVUS images, ILDs, graphical representations of anatomical structures, before / after images, roadmap images, and reports. On the anatomical map, the automatic labels will appear in a sequential order to allow the user to correctly label anatomical segments and segments or sub-segments within segments (e.g., lesions / plaque accumulations, compression areas, healthy tissue used as reference, etc.) According to aspects of the present disclosure, the creation of labels or bookmarks can be automatic, semi-automatic, or user-driven.

[0029] The automatic and / or assisted bookmarking system provides easy and quick placement of labels and bookmarks for both pre- and post-treatment images using, for example, drag-and-drop functionality, not only for the IVUS image itself but also for other graphical representations of ILDs, graphic roadmaps, or anatomical structures. In an example, the processor circuit is receiving an electrical signal that identifies the drag-and-drop input. Depending on the application, a list of commonly used labels for anatomical locations / disease states is created for coronary / peripheral and venous / arterial processes and accessed by the user via the drag-and-drop functionality. In addition, the user of the system can manually edit labels and / or bookmarks as needed, if necessary. The system is referred to as the automatic and assisted bookmarking system hereinafter.

[0030] The devices, systems, and methods described herein can include those disclosed in U.S. Provisional Application No. 62 / 750,983 filed on October 26, 2018 (Agent Docket No. 2018PF01112-44755.2000PV01), U.S. Provisional Application No. 62 / 751,268 filed on October 26, 2018 (Agent Docket No. 2018PF01160-44755.1997PV01), U.S. Provisional Application No. 62 / 751,289 filed on October 26, 2018 (Agent Docket No. 2018PF01159-44755.1998PV01), and U.S. Provisional Application No. 62 / 751,290 filed on October 26, 2018 (Agent Docket No. 2018PF01161-44755.1997PV01). One or more features described in U.S. Provisional Application US62 / 750996 filed on October 26, 2018 (Agent File Number 2018PF01145-44755.1999PV01), U.S. Provisional Application US62 / 751167 filed on October 26, 2018 (Agent File Number 2018PF01115-44755.2000PV01), and U.S. Provisional Application US62 / 751185 filed on October 26, 2018 (Agent File Number 2018PF01116-44755.2001PV01), each of which is incorporated herein by reference in its entirety as if fully set forth herein.

[0031] The devices, systems, and methods described herein can also include U.S. Provisional Application No. 62 / 642847 filed on March 14, 2018 (Agent Docket No. 2017PF02103) (and non-provisional application serial number US16 / 351175 filed therefrom on March 12, 2019), U.S. Provisional Application No. 62 / 712009 filed on July 30, 2018 (Agent Docket No. 2017PF02296), and U.S. Provisional Application No. 62 / 712009 filed on July 30, 2018 (Agent Docket No. 2017PF02297). One or more features described in U.S. Provisional Application US62 / 711927 (Agent File Number 2017PF02101) filed on March 15, 2018 (Agent File Number 2017PF02365) (and a non-provisional application filed therefrom on March 15, 2019, U.S. Serial Number US16 / 354970), each of which is incorporated herein by reference in its entirety as if fully set forth herein.

[0032] The present disclosure substantially assists clinicians to understand a large amount of intraluminal imaging data, as well as reports and treatment plans, and reduced case time and improved ease of use. The present disclosure achieves the above goals by providing fast, seamless processing along the length of the inspection for identification, marking and annotation of the location of interest in the blood vessel or lumen in real time during the imaging process (e.g., IVUS pullback process). The automatic and auxiliary bookmarking system disclosed in this article implemented on the medical imaging console (e.g., IVUS imaging console) communicating with the medical imaging sensor (e.g., intraluminal ultrasound sensor) saves time and improves the accuracy of the captured image bookmarking and labeling. The improved imaging workflow converts the time-consuming imaging, image selection, data input, viewing and revision process into a streamlined process involving fewer steps and simpler steps. For example, when this happens, it is usually not necessary for secondary or non-sterile users to type in the routine of bookmarking and labeling data in real time and the associated time lag. By automating the bookmarking and labeling steps that are usually performed manually by clinicians or other users, this unconventional solution improves the function of the medical imaging console and sensor.

[0033] The automatic and assisted bookmarking system can be implemented as a set of logical branches and mathematical operations whose output is visible on a display and is operated by a control process executed on a processor that accepts user input (e.g., from a user interface such as a keyboard, mouse, or touch screen interface) and communicates with one or more medical imaging sensors (e.g., an intraluminal ultrasound sensor). In this regard, the control process performs certain specific operations in response to different inputs or selections made by the user at the beginning of an imaging procedure, and may also respond to inputs made by the user during the procedure. Certain structures, functions, and operations of processors, displays, sensors, and user input systems are known in the art, and other structures, functions, and operations are listed herein to specifically implement novel features or aspects of the present disclosure.

[0034] Various types of intraluminal imaging systems are used to diagnose and treat disease. For example, intravascular ultrasound (IVUS) imaging is used as a diagnostic tool for visualizing blood vessels within a patient's body. This can assist in evaluating diseased or compressed blood vessels (such as arteries or veins) within the body to determine the need for treatment, optimize treatment, and / or evaluate the effectiveness of treatment (e.g., by imaging the blood vessels before and after treatment).

[0035] In some cases, intraluminal imaging is performed using an IVUS device that includes one or more ultrasonic transducers. The IVUS device can be delivered into a blood vessel and guided to the area to be imaged. The transducer transmits ultrasonic energy and receives ultrasonic echoes reflected from the blood vessel. The ultrasonic echoes are processed to create an image of the vessel of interest. The image of the vessel of interest can include one or more lesions or blockages in the vessel. Stents can be placed in the blood vessel to operate on these blockages, and intraluminal imaging can be performed to view the placement of the stent in the blood vessel. Other types of treatments include thrombectomy, ablation, angioplasty, medications, etc.

[0036] In some embodiments, the automatic and assisted bookmarking system includes a screen display that provides the clinician with a suggested "next bookmark" representing an upcoming region of interest, along with associated label information, enabling the clinician or another user to simply confirm when a desired intraluminal imaging frame from within the region of interest appears on the display.

[0037] When recording IVUS pullback, the IVUS system continuously stacks the cross section of each recorded tomographic frame on the screen. The resulting image stack is referred to as online digital or image longitudinal display (ILD) view. Bookmarks can be automatically associated with the intraluminal image itself and ILD and / or roadmap or graphic roadmap image and the report generated accordingly.

[0038] IVUS pullback measurements require recording, bookmarking, labeling, annotation and reporting by the clinician.The automatic and assisted bookmarking system reduces the workload of the clinician and allows certain aspects of bookmarking, labeling, annotation and reporting to be performed automatically during the IVUS procedure itself.

[0039] These descriptions are provided for exemplary purposes only, and should not be considered to limit the scope of the automatic and assisted bookmarking system. Certain features may be added, removed, or modified without departing from the spirit of the claimed subject matter.

[0040] In order to promote the understanding of the principles of the present disclosure, reference will now be made to the embodiments illustrated in the accompanying drawings, and specific language will be used to describe them. However, it should be understood that it is not intended to limit the scope of the present disclosure. As would be normally contemplated by a person skilled in the art to which the present disclosure pertains, any changes and further modifications to the described devices, systems and methods, as well as any further application of the principles of the present disclosure, are fully contemplated and included in the present disclosure. In particular, it is fully contemplated that the features, components and / or steps described with respect to one embodiment may be combined with the features, components and / or steps described with respect to other embodiments of the present disclosure. However, for the sake of brevity, many iterations of these combinations will not be described separately.

[0041] Figure 1 is a schematic illustration of an intraluminal imaging system incorporating automatic and assisted bookmarking systems in accordance with aspects of the present disclosure. In some embodiments, the intraluminal imaging system 100 can be an intravascular ultrasound (IVUS) imaging system. The intraluminal imaging system 100 can include an intraluminal device 102, a patient interface module (PIM) 104, a console or processing system 106, a monitor 108, and an external imaging system 132, which can include angiography, ultrasound, X-ray tomography (CT), magnetic resonance imaging (MRI), or other imaging techniques, devices, and methods. The intraluminal device 102 is sized and shaped and / or otherwise structurally arranged to be positioned within a body cavity of a patient. For example, in various embodiments, the intraluminal device 102 can be a catheter, a guidewire, a guide catheter, a pressure wire, and / or a flow wire. In some environments, the system 100 can include additional components and / or can be used without Figure 1 For example, the system 100 may omit the external imaging system 132 .

[0042] The intraluminal imaging system 100 (or intravascular imaging system) can be any type of imaging system suitable for use in a lumen or vasculature of a patient. In some embodiments, the intraluminal imaging system 100 is an intraluminal ultrasound (IVUS) imaging system. In other embodiments, the intraluminal imaging system 100 may include a system configured for forward-looking intraluminal ultrasound (FL-IVUS) imaging, intraluminal photoacoustic (IVPA) imaging, intracardiac echocardiography (ICE), transesophageal echocardiography (TEE), and / or other suitable imaging modalities.

[0043] It should be understood that the system 100 and / or the device 102 can be configured to obtain any suitable intraluminal imaging data. In some embodiments, the device 102 can include imaging components of any suitable imaging modality, such as optical imaging, optical coherence tomography (OCT), etc. In some embodiments, the device 102 can include any suitable non-imaging components, including pressure sensors, flow sensors, temperature sensors, optical fibers, reflectors, mirrors, prisms, ablation elements, radio frequency (RF) electrodes, conductors, or combinations thereof. Generally, the device 102 can include imaging elements to obtain intraluminal imaging data associated with the lumen 120. The device 102 can be sized and shaped (and / or configured) for insertion into a vessel or lumen 120 of a patient.

[0044] System 100 can be deployed in a catheterization laboratory with a control room. Processing system 106 can be located in the control room. Optionally, processing system 106 can be located elsewhere, such as in the catheterization laboratory itself. The catheterization laboratory can include a sterile area, and its associated control room may be sterile or not sterile, depending on the process and / or health care organization to be performed. The catheterization laboratory and the control room can be used to perform many medical imaging processes, such as angiography, fluoroscopy, CT, IVUS, virtual histology (VH), prospective IVUS (FL-IVUS), intraluminal photoacoustic (IVPA) imaging, fractional blood flow reserve (FFR) determination, coronary blood flow reserve (CFR) determination, optical coherence tomography (OCT), computed tomography, intracardiac echocardiography (ICE), prospective ICE (FLICE), intraluminal contrast, transesophageal ultrasound, fluoroscopy and other medical imaging modalities, or a combination thereof. In some embodiments, equipment 102 can be controlled from a remote location such as a control room so that the operator is not required to be very close to the patient.

[0045] The intraluminal device 102, PIM 104, monitor 108, and external imaging system 132 can be directly or indirectly communicatively coupled to the processing system 106. These elements can be communicatively coupled to the medical processing system 106 via a wired connection (such as a standard copper link or an optical fiber link) and / or via a wireless connection using the IEEE 802.11 Wi-Fi standard, ultra-wideband (UWB) standard, wireless FireWire, wireless USB, or other high-speed wireless network standards. The processing system 106 can be communicatively coupled to one or more data networks, for example, a TCP / IP-based local area network (LAN). In other embodiments, different protocols, such as synchronous optical network (SONET) can be utilized. In some cases, the processing system 106 can be communicatively coupled to a wide area network (WAN). The processing system 106 can utilize network connectivity to access various resources. For example, the processing system 106 can communicate with a medical digital imaging and communication (DICOM) system, a picture archiving and communication system (PACS), and / or a hospital information system (HIS) via a network connection.

[0046] At a high level, the ultrasound imaging intraluminal device 102 transmits ultrasound energy from a transducer array 124 included in a scanner assembly 110 mounted near the distal end of the intraluminal device 102. The ultrasound energy is reflected by tissue structures in the medium surrounding the scanner assembly 110 (such as the lumen 120), and the ultrasound echo signal is received by the transducer array 124. The scanner assembly 110 generates (one or more) electrical signals representing the ultrasound echo. The scanner assembly 110 can include one or more single ultrasound transducers and / or any suitable configuration of transducer array 124, such as a planar array, a curved array, a circumferential array, an annular array, etc. For example, in some cases, the scanner assembly 110 can be a one-dimensional array or a two-dimensional array. In some cases, the scanner assembly 110 can be a rotating ultrasound device. The active area of ​​the scanner assembly 110 can include one or more transducer materials and / or one or more segments of ultrasound elements (e.g., one or more rows, one or more columns, and / or one or more directions), which can be uniformly or independently controlled and activated. The active area of ​​the scanner assembly 110 can be patterned or configured into a variety of basic or complex geometric shapes. The scanner assembly 110 can be arranged in a side-view orientation (e.g., ultrasonic energy emitted perpendicular to and / or orthogonal to the longitudinal axis of the intraluminal device 102) and / or a forward-view orientation (e.g., ultrasonic energy occurring parallel to and / or along the longitudinal axis). In some cases, the scanner assembly 110 is structurally arranged to emit and / or receive ultrasonic energy at an oblique angle relative to the longitudinal axis in a proximal or distal direction. In some embodiments, the ultrasonic energy emission can be electronically controlled by selectively triggering one or more transducer elements of the scanner assembly 110.

[0047] The ultrasonic transducers of the scanner assembly 110 can be piezoelectric micromachined ultrasonic transducers (PMUTs), capacitive micromachined ultrasonic transducers (CMUTs), single crystals, lead zirconate titanate (PZT), PZT composites, other suitable transducer types, and / or combinations thereof. In embodiments, the ultrasonic transducer array 124 can include any suitable number of individual transducer elements or acoustic elements between 1 acoustic element and 1000 acoustic elements, including values ​​such as 2 acoustic elements, 4 acoustic elements, 36 acoustic elements, 64 acoustic elements, 128 acoustic elements, 500 acoustic elements, 812 acoustic elements, and / or other greater and lesser values.

[0048] The PIM 104 transmits the received echo signals to a processing system 106, where an ultrasound image (including flow information) is reconstructed and displayed on a monitor 108. The console or processing system 106 can include a processor and a memory. The processing system 106 is operable to facilitate the features of the intraluminal imaging system 100 described herein. For example, the processor can execute computer-readable instructions stored on a non-transitory tangible computer-readable medium.

[0049] The PIM 104 facilitates signal communication between the processing system 106 and the scanner assembly 110 included in the intraluminal device 102. The communication may include providing commands to the integrated circuit controller chip(s) within the intraluminal device 102, selecting the specific element(s) on the transducer array 124 to be used for transmission and reception, providing a transmission trigger signal to the integrated circuit controller chip(s) to activate the transmitter circuit to generate an electrical pulse to excite the selected transducer array element(s), and / or accepting an amplified echo signal received from the selected transducer array element(s) via an amplifier included on the integrated circuit controller chip(s). In some embodiments, the PIM 104 performs preliminary processing of the echo data before relaying the data to the processing system 106. In an example of such an embodiment, the PIM 104 performs amplification, filtering, and / or aggregation on the data. In an embodiment, the PIM 104 also provides high and low voltage DC power to support the operation of the intraluminal device 102, which includes circuits within the scanner assembly 110.

[0050] The processing system 106 receives echo data from the scanner assembly 110 through the PIM 104 and processes the data to reconstruct an image of tissue structures in the medium surrounding the scanner assembly 110. In general, the device 102 can be utilized within any suitable anatomical structure and / or body cavity of a patient. The processing system 106 outputs image data so that an image of a vessel or lumen 120, such as a cross-sectional IVUS image of the lumen 120, is displayed on the monitor 108. The lumen 120 can represent natural and artificial structures filled with fluid or surrounded by fluid. The lumen 120 can be within the body of a patient. The lumen 120 can be a blood vessel, such as an artery or vein of the patient's vasculature, including the cardiac vasculature, peripheral vasculature, neural vasculature, renal vasculature, and / or any other suitable lumen within the body. For example, the device 102 may be used to examine any number of anatomical locations and tissue types, including, but not limited to: organs, including the liver, heart, kidneys, gallbladder, pancreas, lungs; ducts; intestinal tract; nervous system structures, including the brain, thecal sac, spinal cord, and peripheral nerves; urinary tract; and valves within the blood, heart chambers or other parts of the heart, and / or other systems of the body. In addition to natural structures, the device 102 may be used to examine artificial structures, such as, but not limited to: heart valves, stents, shunts, filters, and other devices.

[0051] The controller or processing system 106 may include a processing circuit having one or more processors communicating with a memory and / or other suitable tangible computer-readable storage media. The controller or processing system 106 may be configured to perform one or more aspects of the present disclosure. In some embodiments, the processing system 106 and the monitor 108 are separate components. In other embodiments, the processing system 106 and the monitor 108 are integrated in a single component. For example, the system 100 can include a touch screen device, which includes a housing with a touch screen display and a processor. The system 100 can include any suitable input device, such as a touch-sensitive pad or a touch screen display, a keyboard / mouse, a joystick, a button, etc., for the user to select the options shown on the monitor 108. The processing system 106, the monitor 108, the input device and / or a combination thereof can be referred to as the controller of the system 100. The controller can communicate with other components of the device 102, the PIM 104, the processing system 106, the monitor 108, the input device and / or the system 100.

[0052] In some embodiments, the intraluminal device 102 includes some features similar to conventional solid-state IVUS catheters, such as those available from Volcano Corporation. catheters and those disclosed in U.S. Pat. No. 7,846,101, which is incorporated herein by reference in its entirety. For example, the intraluminal device 102 can include a scanner assembly 110 near the distal end of the intraluminal device 102 and a transmission harness 112 extending along the longitudinal body of the intraluminal device 102. The cable or transmission harness 112 can include a plurality of conductors, including one, two, three, four, five, six, seven or more conductors.

[0053] The transmission harness 112 terminates at a PIM connector 114 at the proximal end of the intraluminal device 102. The PIM connector 114 electrically couples the transmission harness 112 to the PIM 104 and physically couples the intraluminal device 102 to the PIM 104. In an embodiment, the intraluminal device 102 also includes a guidewire outlet 116. Thus, in some cases, the intraluminal device 102 is a rapid exchange catheter. The guidewire outlet 116 allows a guidewire 118 to be inserted toward the distal end in order to guide the intraluminal device 102 through the lumen 120.

[0054] Monitor 108 may be a display device, such as a computer monitor or other type of screen. Monitor 108 may be used to display selectable prompts, instructions, and visualizations of imaging data to the user. In some embodiments, monitor 108 may be used to provide a process-specific workflow to the user to complete an intraluminal imaging process. The workflow may include performing a pre-stent planning to determine the state of the lumen and the potential for stenting, as well as a post-stent inspection to determine the state of a stent that has been placed in the lumen. The workflow may be presented to the user as a Figure 5-11 Any display or visualization shown in .

[0055] The external imaging system 132 can be configured to obtain X-ray, radiographic, angiographic / venographic (e.g., with contrast agent), and / or fluoroscopic (e.g., without contrast agent) images of the patient's body (including the blood vessel 120). The external imaging system 132 can also be configured to obtain computed tomography images of the patient's body (including the blood vessel 120). The external imaging system 132 can include an external ultrasound probe configured to obtain ultrasound images of the patient's body (including the blood vessel 120) when located outside the body. In some embodiments, the system 100 includes other imaging modality systems (e.g., MRI) to obtain images of the patient's body (including the blood vessel 120). The processing system 106 can utilize the images of the patient's body in conjunction with the intraluminal images obtained by the intraluminal device 102.

[0056] Figure 2 Blood vessels (eg, arteries and veins) in a human body are illustrated. For example, veins of a human body are labeled. Aspects of the present disclosure can relate to peripheral vasculature, for example, veins in a torso or leg.

[0057] Blockage may occur in an artery or vein.Blockage can generally represent any obstruction or other structural arrangement, for example, causing restriction of fluid flow through a lumen (e.g., an artery or vein) in a manner that is harmful to the health of the patient.For example, blockage narrows the lumen, thereby reducing the cross-sectional area of ​​the lumen and / or the available space for fluid to flow through the lumen.In the case where the anatomical structure is a blood vessel, blockage may be due to compression (e.g., from an external blood vessel), plaque accumulation (including but not limited to plaque components, such as fiber, fiber-lipid (fibrous fat)), necrotic core, calcification (dense calcium), blood and / or thrombus (e.g., acute, subacute, chronic, etc.) and the result of narrowing.In some instances, blockage can be referred to as thrombus, stenosis and / or lesion.Usually, the composition of blockage will depend on the type of anatomical structure being assessed.Healthier parts in the anatomical structure can have uniform or symmetrical profiles (e.g., cylindrical profiles with circular cross-sectional profiles).Blockage may not have uniform or symmetrical profiles.Therefore, the diseased or compressed parts of the anatomical structure with blockage will have asymmetric and / or other irregular profiles. The anatomical structure can have one obstruction or multiple obstructions.

[0058] The formation of obstruction (e.g., thrombus, deep vein thrombosis or DVT, chronic total occlusion or CTO, etc.) is a way of reducing the cross-sectional area of ​​veins in the peripheral vascular system (e.g., trunk, abdomen, groin, leg). Other anatomical structures that contact the vein can also reduce its cross-sectional area, thereby limiting blood flow therethrough. For example, an artery or ligament in the trunk, abdomen, groin or leg can press on the vein, which changes the shape of the vein and reduces its cross-sectional area. This reduction in cross-sectional area due to contact with other anatomical structures can be referred to as compression, because contact with an artery or ligament causes the vein wall to be compressed.

[0059] Figure 3 A blood vessel 300 is illustrated incorporating a compression 330. Compression 330 occurs external to the vessel wall 310 and may restrict the flow of blood 320. Compression may be caused by other anatomical structures external to the vessel 300 including, but not limited to, tendons, ligaments, or adjacent lumens.

[0060] Figure 4A blood vessel 300 is illustrated with compression 330 incorporated and its internal stent 440 expanded to restore blood flow. Stent 440 displaces and blocks compression 330, pushing vessel wall 310 outward, thereby reducing flow restriction to blood 320. Other treatment options for relieving blockage may include, but are not limited to: thrombectomy, ablation, angioplasty, and medication. However, in most cases, it is highly desirable to obtain accurate and timely intravascular images of the affected area, as well as to accurately and in detail know the location, direction, length, and volume of the affected area before, during, or after treatment.

[0061] Figure 5 An exemplary intraluminal imaging display screen 500 according to at least one embodiment of the present disclosure is illustrated. In this example, the screen display 500 includes a current tomographic IVUS image 510 from a series of continuous tomographic images, an image longitudinal display (ILD) 520 containing stacked longitudinal cross-sections of a series of continuous tomographic images, and a graphical roadmap 530. Bookmarks 540a, 540b, 540c, 540d, 540e, and 540f are also visible, which are associated with both the graphical roadmap 530 and the ILD 520. Bookmark 540d is also associated with the current IVUS image 510, and label 550 contains information about the location and properties of the IVUS image 510. In this example, the IVUS image is identified as a reference image of the left external iliac vein. In addition, the bookmark information can be saved in an automatically generated report. If a bookmark is changed at any of these locations, the automatic and auxiliary bookmarking system will update the bookmarks in all these locations, thereby saving time and simplifying the bookmark editing workflow.

[0062] Figure 6A graphical roadmap screen display 530 of an exemplary automatic and assisted bookmarking system during a pullback procedure in a left leg vein of a patient in accordance with at least one embodiment of the present disclosure is shown. In this example, the graphical roadmap screen display includes multiple vein segments: the inferior vena cava (IVC) 610, the left common iliac vein (CIV) 620, the left external iliac vein (EIV) 630, the left common femoral vein (CFV) 640, and the left femoral vein (F) 650. The corresponding segment on the right 660 is also displayed for reference, but is grayed out to indicate that it is not part of the current procedure and will not be traversed by the intraluminal imaging probe during the procedure. Other vessel segments or luminal segments may be identified in other areas of the body. In some embodiments, identification of vessel segments is automatically performed by the automatic and assisted bookmarking system (e.g., using image recognition, velocity tracking, and position estimation), and bookmarks are automatically applied. In other embodiments, bookmarks are predictively suggested to clinicians or other users. Predicting the next bookmark that the user will need advantageously avoids requiring the user to browse a list of bookmarks to find the correct bookmark or to type in a manual bookmark. In other embodiments, identification of the vessel segments is performed by a clinician or other user with the assistance of an automatic and assisted bookmarking system. Bookmarks or labels can be applied, for example, to where the segment begins or ends or where another segment begins or ends.

[0063] exist Figure 6In the example shown in , the automatic and assisted bookmarking system provides instructions 670 and bookmarks 680 to clinicians or other users, and the instructions 670 and bookmarks 680 are based on the system's understanding of the process being executed, the current position and movement direction of the intraluminal imaging probe 102 in the lumen 300, the proximity of anatomical landmarks (e.g., the branch of the lumen or the branch of the adjacent lumen), and other information required to perform the function. When the clinician or other user has advanced the intraluminal imaging probe 102 into the portion of the lumen 300 indicated by the instruction 670, the clinician or other user then activates or confirms the bookmark, for example, by double-clicking the bookmark or by dragging it to the current intraluminal image 510 in the intraluminal imaging display screen 500, or by issuing a voice command to confirm the bookmark for the current intraluminal image 510. When the operation is completed, the bookmark 680 is not only automatically associated with the current intraluminal image 510, but also associated with the corresponding position on the ILD 520 and the graphic roadmap 530. Additionally, the automatic and assisted bookmarking system automatically populates a tag 550 that is automatically associated with the bookmark 680 and the current intraluminal image and may include, for example, bookmark information, image location, and image type (e.g., reference, pre-treatment target, post-treatment target, etc.). In some embodiments, these steps are automatically performed by the automatic and assisted bookmarking system based on image recognition to track known bifurcations of vessels or lumens as anatomical landmarks without requiring any type of user input. Bookmarks may also be suggested or automatically placed based on automatic image recognition of tissue such as thrombus, webbing, and compression (venous) or stenosis (arterial).

[0064] Examples of boundary detection, image processing, image analysis, and / or pattern recognition include: U.S. Patent No. 6,200,268, issued on March 13, 2001, inventors D. Geoffrey Vince, Barry D. Kuban, and Anuja Nair, entitled “VASCULAR PLAQUE CHARACTERIZATION”; U.S. Patent No. 6,381,350, issued on April 30, 2002, inventors D. Klingensmith, D. Geoffrey Vince, and Raj Shekhar, entitled “INTRAVASCULAR ULTRASONIC ANALYSIS USING ACTIVE CONTOUR METHOD AND SYSTEM”; U.S. Patent No. 6,381,350, issued on July 11, 2006, inventors Anuja Nair, D. Geoffrey Vince, Jon D. Klingensmith, and Barry D. Kuban, entitled “SYSTEM AND METHOD OF CHARACTERIZING VASCULAR TISSUE”; US Patent No. 7,074,188, issued on February 13, 2007, with inventors D. Geoffrey Vince, Anuja Nair and Jon D. Klingensimith, entitled “NON-INVASIVE TISSUE CHARACTERIZATION SYSTEM AND METHOD”; US Patent No. 7,175,579, issued on February 13, 2007, with inventors Jon D. Klingensmith, Anuja Nair, Barry D. Kuban and D. Geoffrey Vince, entitled “SYSTEM AND METHOD FOR VASCULAR BORDER DETECTION”; US Patent No. 7,215,802, issued on May 8, 2007, with inventors Jon D. Klingensmith, Anuja Nair, Barry D. Kuban and D. Geoffrey Vince, entitled “SYSTEM AND METHOD FOR IDENTIFYING AVASCULAR BORDER DETECTION”; US Patent No. 7,215,802, issued on April 15, 2008, with inventors D. Klingensmith, D. Geoffrey Vince and Raj Shekhar, entitled “SYSTEM AND METHOD FOR IDENTIFYING AVASCULAR BORDER”; and U.S. Patent No. 7,359,554, issued on December 9, 2008, with inventors D. Klingensmith, Anuja Nair, Barry D. Kuban and D.Geoffrey Vince's U.S. Pat. No. 7,463,759, entitled "SYSTEM AND METHOD FOR VASCULAR BORDER DETECTION," the teachings of which are incorporated herein by reference in their entirety.

[0065] Figure 7 A graphical roadmap screen display 530 of an exemplary automatic and assisted bookmarking system during a pullback procedure in a left leg vein of a patient in accordance with at least one embodiment of the present disclosure is shown. Figure 6 As in the example of FIG. 6 , the graphical roadmap screen display includes multiple vein segments 610, 620, 630, 640, and 650. The corresponding segment on the right 660 is also shown for reference, but is gray. In this example, the screen display also includes a tomographic image 510. In this example, instead of providing a single instruction 670 and suggesting a single bookmark 680, the automatic and assisted bookmarking system provides a menu 670 including multiple different suggested tags (e.g., bookmarks) 680, which are based on the system's understanding of the ongoing process and the direction of probe movement, as well as an approximate but imperfect understanding of the position of the intraluminal imaging probe 102 within the lumen 300. In this example, the system also provides an "other" option 780 that allows a clinician or other user to manually enter tag information (e.g., bookmark and label information). For example, this may be useful during a non-standard process or during a process in which the positioning information of the intraluminal probe 102 is considered inaccurate. Input from the user allows the system to select a desired bookmark from the suggested bookmarks 680 and 780. In an example, the bookmark can be dragged and dropped onto the tomographic image 510 or the roadmap image 530 and automatically applied to both at a location corresponding to the currently displayed tomographic image.

[0066] In an example, a bookmark is a position mark on a pullback (e.g., on an ILD, roadmap, or cross-sectional tomography image) that facilitates easy navigation. A label is a text annotation that can be associated with a frame or pullback or even an area in a bookmark. A bookmark can look like a small logo, or a mark in a longitudinal view or roadmap. A label can include text that is associated or not associated with a bookmark.

[0067] Figure 8 800 is a flow chart of an intraluminal image bookmarking method according to the prior art. In step 810, the primary user (e.g., a clinician) pushes or pulls the intraluminal imaging probe 102 through a region of interest within the lumen 300. The region of interest may be, for example, a target region where diseased or compressed tissue is to be examined, or a reference region where the dimensions of the lumen 300 may be recorded for comparison.

[0068] The primary user requests a bookmark to mark the current intraluminal imaging frame in step 820. However, typically, the primary user does not stop moving the intraluminal imaging probe 102, but continues to push or pull it at a nearly constant speed.

[0069] Step 830 represents the inevitable time delay between the primary user requesting a bookmark and the secondary user (eg, surgical assistant or non-sterile staff) actually entering the bookmark information. This time delay is represented by variable T1.

[0070] In step 840, the secondary user enters the bookmark information. This may involve entering the current or suspected location of the intraluminal imaging probe 102, as well as information about the image type (e.g., target or reference). This data entry also takes time, represented by the variable T2. Meanwhile, in a typical intraluminal imaging procedure, the intraluminal imaging probe 102 continues to move at a relatively constant speed.

[0071] Once the imaging procedure (e.g., IVUS pullback procedure) has been completed, the primary user examines the intraluminal imaging data in the examination mode of the intraluminal imaging system 100 and locates the bookmark 540 placed by the secondary user in step 850. Due to the time delays T1 and T2, the bookmark is often placed on a frame later than the expected frame. In some cases, if the secondary user has anticipated and attempted to compensate for the time delays T1 and T2, the bookmark may be placed on a frame earlier than the expected frame.

[0072] In step 860 , the primary user scrolls through the intraluminal images 510 and / or the ILD 520 to find the image 510 in which the bookmark 540 is to be placed.

[0073] In step 870, the primary user repositions the bookmark 540 to the desired image 510, or deletes and re-enters the bookmark 540. The primary user then performs measurements, annotations, and other analyses on the bookmarked image 510.

[0074] This process is time consuming and error prone, which creates a need in the art for improved tools and processes.

[0075] Fig. 9 is a flow chart of an intraluminal image bookmarking method 900 according to at least one embodiment of the present disclosure. In step 910, a primary user (e.g., a clinician) pushes or pulls the intraluminal imaging probe 102 through a region of interest within the lumen 300. The region of interest may be, for example, a target region or a reference region.

[0076] In step 920, the automatic and assisted bookmarking method 900 suggests bookmarks 680 and / or associated tag information 550 to the primary user. Based on the system's knowledge of the type of procedure being performed, the entry point, the direction of movement of the intraluminal imaging probe, and the position of the intraluminal imaging probe, the system is able to anticipate which bookmarks will be needed and in what order. In an example, a user can, for example, specify jugular entry or femoral entry, as well as the direction of movement (e.g., pull back or forward longitudinal movement). For example, a typical procedure may involve a pull back from the abdomen to the leg or from the leg to the abdomen. The system knows the order and reverse order of the vessel segments occurring (EIV, CIV, etc.) and presents them in the correct order based on the entry point and direction of movement.

[0077] In step 930, the user (primary user or secondary user) confirms the bookmark and / or associated tag information. For example, the confirmation can be performed by dragging and dropping the bookmark 680 onto the current intraluminal image 510, or by double-clicking the bookmark 680, or by issuing a voice confirmation to the voice recognition interface of the automatic and assisted bookmarking system (e.g., the processor circuit is receiving an electrical signal representing the voice confirmation). Thus, the bookmark 680 is placed directly on the desired frame during the pullback process and does not need to be re-operated during the inspection phase.

[0078] In step 940, the primary user continues to move the intraluminal imaging probe 102 through the lumen at a constant speed. In some cases, the system may return to step 920 and suggest additional bookmarks during the process. In other cases, the process is complete after step 940.

[0079] Another aspect of the automatic and assisted bookmarking system is to present multiple adjacent frames to the user around the bookmarked frame. Figure 8 In the illustrated workflow, the primary user often does not place the bookmark on the correct frame due to the time delay associated with T1 and possibly T2. Some embodiments of the present disclosure assist the user by recording a set of frames or a short video clip around the bookmark, which allows the user to be more confident that the frame of interest is actually captured by the bookmark. The user is then able to select the actual frame during the case review without having to access the primary pullback itself to report or research the current case. In addition, if a bookmark is edited in any of these frames, the change is applied to all frames (and can also be applied to the ILD or roadmap image), thereby simplifying the bookmark editing workflow.

[0080] Fig.101 is a schematic diagram of a processor circuit 1050 according to an embodiment of the present disclosure. The processor circuit 1050 can be implemented in the ultrasound imaging system 100 or other devices or workstations (e.g., third-party workstations, network routers, etc.), or implemented on a cloud processor or other remote processing unit to implement the method as necessary. As shown, the processor circuit 1050 may include a processor 1060, a memory 1064, and a communication module 1068. These elements can communicate with each other directly or indirectly, for example, via one or more buses.

[0081] The processor 1060 may include any combination of a central processing unit (CPU), a digital signal processor (DSP), an ASIC, a controller, or a general purpose computing device, a reduced instruction set computing (RISC) device, an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), or other related logic devices (including mechanical and quantum computers). The processor 1060 may also include another hardware device, a firmware device, or any combination thereof configured to perform the operations described herein. The processor 1060 may also be implemented as a combination of computing devices, for example, a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors combined with a DSP core, or any other such configuration.

[0082] The memory 1064 may include a cache memory (e.g., a cache memory of the processor 1060), a random access memory (RAM), a magnetoresistive RAM (MRAM), a read-only memory (ROM), a programmable read-only memory (PROM), an erasable programmable read-only memory (EPROM), an electrically erasable programmable read-only memory (EEPROM), a flash memory, a solid-state memory device, a hard disk drive, other forms of volatile and non-volatile memory, or a combination of different types of memory. In an embodiment, the memory 1064 includes a non-transitory computer-readable medium. The memory 1064 may store instructions 1066. The instructions 1066 may include instructions that, when executed by the processor 1060, cause the processor 1060 to perform the operations described herein. The instructions 1066 may also be referred to as code. The terms "instructions" and "code" should be interpreted broadly to include any type of computer-readable statements. For example, the terms "instructions" and "code" may refer to one or more programs, routines, subroutines, functions, processes, etc. "Instructions" and "code" may include a single computer-readable statement or many computer-readable statements.

[0083] The communication module 1068 can include any electronic circuit and / or logic circuit to facilitate direct or indirect data communication between the processor circuit 1050 and other processors or devices. In this regard, the communication module 1068 can be an input / output (I / O) device. In some examples, the communication module 1068 facilitates direct or indirect communication between the processor circuit 1050 and / or various elements of the ultrasound imaging system 100. The communication module 1068 can communicate within the processor circuit 1050 through a variety of methods or protocols. Serial communication protocols may include, but are not limited to: US SPI, I 2 C, RS-232, RS-485, CAN, Ethernet, ARINC 429, MODBUS, MIL-STD-1553, or any other suitable method or protocol. Parallel protocols include, but are not limited to, ISA, ATA, SCSI, PCI, IEEE-488, IEEE-1284, and other suitable protocols. Where appropriate, serial and parallel communications may be bridged via UART, USART, or other suitable subsystems.

[0084] External communications (including but not limited to: software updates, firmware updates, preset sharing between the processor and the central server, or readings from the ultrasound device) can be implemented using any appropriate wireless or wired communication technology (e.g., cable interface), such as USB, micro USB, Lightning or FireWire interface, Bluetooth, Wi-Fi, ZigBee, Li-Fi, or cellular data connection, such as 2G / GSM, 3G / UMTS, 4G / LTE / WiMax or 5G. For example, a Bluetooth low energy (BLE) radio can be used to establish a connection with a cloud service, to transfer data and to receive software patches. The controller can be configured to communicate with a remote server or a local device (such as a laptop, tablet computer, or handheld device), or can include a display capable of showing state variables and other information. Information can also be transmitted on a physical medium (e.g., a USB flash drive or memory stick).

[0085] Fig.111 is a screenshot of an IVUS access point selection screen 1100 in accordance with at least one embodiment of the present disclosure. Automatic and assisted bookmarking systems are typically able to automatically identify different regions of a patient's circulatory system by matching IVUS images against prior data sets or knowledge sets that statistically represent the endoluminal anatomy of different human subpopulations using machine learning algorithms or other training-based AI algorithms. However, the accuracy of vessel identification is improved when the IVUS pullback venography system begins with accurate and specific information about the starting point and direction of travel of the ultrasound transducer 124 of the imaging catheter 102. In this example, the screen display 1100 therefore includes an access point selector 1110 that allows the clinician or other user to select between femoral access and jugular access. The screen display 1100 also includes a target limb selector 1120 that allows the clinician or other user to select between the patient's right leg and left leg as the location for the IVUS pullback. These examples are illustrative only; other access points and target limbs, target regions (e.g., abdomen), or target anatomical structures (e.g., heart) are possible and may be used instead or in addition, depending on the type of procedure, type of disease, and location of the anatomical features of interest.

[0086] Also visible are an exit button 1130 and a start button 1140. Other controls may also be provided including, but not limited to, a help button, a procedure type selector, a disease type selector, and an anatomy type selector.

[0087] There can be many variations on the above examples and embodiments. For example, the automatic and assisted bookmarking system can be used in anatomical systems within the body other than those described, or can be used to image other disease types, object types, or process types other than those described. The technology described herein can be applied to various types of intraluminal imaging sensors, whether currently existing or later developed. The system can be used with IVUS for coronary and peripheral arterial or venous imaging, such as Philips' IGT-D device and IVUS console software. Alternatively or in addition, the system can be used with X-ray, angiography, and venography applications that require or enable tags and bookmarks. The system can be used with any imaging modality that employs tags or bookmarks, but allows those findings to be edited.

[0088] Therefore, the logical operations constituting the embodiments of the technology described herein are variously referred to as operations, steps, objects, elements, components or modules. In addition, it should be understood that these can occur or be performed in any order, unless otherwise explicitly required, or a specific order is inherently required by the claim language. All directional references (e.g., up, down, inside, outside, up, down, left, right, side, front, back, top, bottom, above, below, vertical, horizontal, clockwise, counterclockwise, near end and far end) are only used for identification purposes, to assist readers in understanding the claimed subject matter, and do not generate restrictions, particularly in the position, orientation or use of automatic and auxiliary bookmarking systems. Unless otherwise noted, connection references (e.g., attachment, coupling, connection and engagement) should be broadly interpreted, and may include intermediate members between element sets and relative movement between elements. In this way, connection references do not necessarily imply that two elements are directly connected and are in a fixed relationship with each other. The term "or" should be interpreted as meaning "and / or", rather than "exclusive or". Unless otherwise stated in the claims, the stated values ​​should be interpreted as illustrative only and should not be regarded as limiting.

[0089] The foregoing specification, examples, and data provide a complete description of the structure and use of an exemplary embodiment of the automatic and assisted bookmarking system as defined in the claims. Although various embodiments of the claimed subject matter have been described above with a certain degree of particularity or with reference to one or more individual embodiments, a person skilled in the art may make numerous changes to the disclosed embodiments without departing from the spirit or scope of the claimed subject matter. Other embodiments are also contemplated. It is intended that all matter contained in the above description and shown in the accompanying drawings shall be construed as illustrative only of particular embodiments and not as limitations. Changes in detail or structure may be made without departing from the basic elements of the subject matter as defined in the appended claims.

Claims

1. An intraluminal ultrasound imaging system, comprising: A processor circuit configured to communicate with an intraluminal ultrasound imaging catheter, wherein the processor circuit is configured to: receiving a plurality of intraluminal ultrasound images acquired by the intraluminal ultrasound imaging catheter during movement of the intraluminal ultrasound imaging catheter in a body cavity of a patient, the body cavity comprising a plurality of segments; generating a marker to be applied to an intraluminal ultrasound image of the plurality of intraluminal ultrasound images, wherein the marker is generated based on the movement of the intraluminal ultrasound imaging catheter, and wherein the marker represents a segment of the plurality of segments; and outputting a screen display including the indicia and the plurality of intraluminal ultrasound images to a display in communication with the processor circuit; The processor circuit is configured to provide instructions and indicia based on the procedure being executed, the current position and movement direction of the intraluminal ultrasound imaging catheter in the lumen.

2. The system according to claim 1, further comprising a user interface, wherein: The processor circuit is configured to receive a user input via the user interface to apply the marker to the intraluminal ultrasound image of the plurality of intraluminal ultrasound images.

3. The system according to claim 2, wherein: In response to receiving user input to apply the marker, the processor circuit is configured to apply the marker to one or more other intraluminal ultrasound images adjacent to the intraluminal ultrasound image.

4. The system according to claim 2, wherein: The display comprises a touch screen, and wherein the user interface comprises a drag and drop interface on the touch screen, and wherein the user input comprises a drag and drop input.

5. The system according to claim 2, wherein: The user interface comprises a speech recognition interface, and the user input comprises a voice confirmation.

6. The system according to claim 1, wherein: The processor circuit is further configured to output a stylized image of the body lumen including the plurality of segments, wherein the markers identify locations in the stylized image where the segments begin.

7. The system according to claim 1, wherein: The processor circuit is configured to: generating a plurality of markers to be applied to the plurality of ultrasound images; and The plurality of markers are outputted continuously, wherein each marker of the plurality of markers corresponds to a different segment of the plurality of segments.

8. The system according to claim 7, wherein: The processor circuit is configured to determine an order for successively outputting the plurality of marks based on the movement of the intraluminal ultrasound imaging catheter.

9. The system according to claim 8, wherein: The processor circuit is configured to determine the order based on at least one of an entry point into the body cavity or the movement direction of the intraluminal ultrasound imaging catheter.

10. The system of claim 1, further comprising the intraluminal ultrasound imaging catheter, wherein: The intraluminal ultrasound imaging catheter comprises an intravascular ultrasound (IVUS) imaging catheter, and wherein the body lumen comprises a peripheral blood vessel.

11. An intraluminal ultrasound imaging system, comprising: A processor circuit configured to communicate with an intraluminal ultrasound imaging catheter, wherein the processor circuit is configured to: receiving an intraluminal ultrasound image acquired by the intraluminal ultrasound imaging catheter during movement of the intraluminal ultrasound imaging catheter in a body cavity of a patient; Generate multiple text labels; outputting a screen display including a first portion and a second portion, wherein the first portion includes the intraluminal ultrasound image, and the second portion includes the plurality of text labels, wherein the first portion is proximate to the second portion; receiving a drag-and-drop user input to move a text tag of the plurality of text tags from the second portion to the first portion; and associating the text label with the intraluminal ultrasound image, The processor circuit is configured to provide instructions and the plurality of text labels, wherein the instructions and the plurality of text labels are based on the procedure being executed, the current position and movement direction of the intraluminal ultrasound imaging catheter in the lumen.

12. A computer program product comprising code, which, when executed, is used to perform an intraluminal ultrasound imaging method, comprising: receiving, at a processor circuit in communication with the intraluminal ultrasound imaging catheter, a plurality of intraluminal ultrasound images acquired by the intraluminal ultrasound imaging catheter during movement of the intraluminal ultrasound imaging catheter within a body cavity of a patient, the body cavity comprising a plurality of segments; generating a marker to be applied to an intraluminal ultrasound image of the plurality of intraluminal ultrasound images, wherein the marker is generated based on the movement of the intraluminal ultrasound imaging catheter, and wherein the marker represents a segment of the plurality of segments; and outputting a screen display including the indicia and the plurality of intraluminal ultrasound images shown successively to a display in communication with the processor circuit; The intraluminal ultrasound imaging method further comprises: providing instructions and marks, wherein the instructions and marks are based on the process being executed, the current position and moving direction of the intraluminal ultrasound imaging catheter in the lumen.

13. The computer program product of claim 12, wherein: The intraluminal ultrasound imaging method further includes receiving a user input via a user interface operating on the processor circuit to apply the marker to the intraluminal ultrasound image of the plurality of intraluminal ultrasound images.

14. The computer program product of claim 13, wherein: The intraluminal ultrasound imaging method further includes: in response to receiving user input to apply the mark, applying the mark to one or more other intraluminal ultrasound images adjacent to the intraluminal ultrasound image.

15. The computer program product of claim 13, wherein: The display comprises a touch screen, and wherein the user interface comprises a drag and drop interface on the touch screen, and wherein the user input comprises a drag and drop input.

16. The computer program product of claim 13, wherein: The user interface comprises a speech recognition interface, and the user input comprises a voice confirmation.

17. The computer program product of claim 12, wherein: The intraluminal ultrasound imaging method further includes outputting a stylized image of the body cavity including the plurality of segments, wherein the markers identify locations in the stylized image where the segments begin.

18. The computer program product of claim 12, wherein: The intraluminal ultrasound imaging method further comprises: Generate multiple tags to be applied; and A screen display including the plurality of indicia is continuously output to the display in communication with the processor circuit, wherein each indicia of the plurality of indicia corresponds to a different segment of the plurality of segments.

19. The computer program product of claim 18, wherein: The intraluminal ultrasound imaging method further includes determining an order of continuously outputting the plurality of marks based on the movement of the intraluminal ultrasound imaging catheter.

20. The computer program product of claim 19, wherein: The intraluminal ultrasound imaging method further includes determining the order based on at least one of an entry point of the body cavity or a moving direction of the intraluminal ultrasound imaging catheter.

Images