Intraluminal image visualization with adaptive scaling and related systems, methods, and devices

Abstract

Systems, methods, and devices for automatically adjusting a scale or magnification of an intraluminal image on a display of an intraluminal imaging system based on a measured or calculated tube size are provided. For example, a system can include a processor configured to receive a first intraluminal image of a body lumen from an intraluminal imaging catheter or guidewire and calculate a size of an anatomical feature of the body lumen based on the first intraluminal image. The processor calculates a scaling factor for the first intraluminal image based on the size of the body lumen, scales the first intraluminal image by the scaling factor, and outputs the scaled first intraluminal image to a display in communication with the processor circuit.

Description

Technical Field

[0001] The subject matter described herein relates to a system for medical imaging. Specifically, this disclosure describes aspects relating to acquiring and displaying intraluminal medical images obtained from an intraluminal imaging catheter or guidewire. The disclosed systems, methods, and apparatus have specific, but not exclusive, applications in the diagnosis and treatment of vascular diseases. Background Technology

[0002] Various types of intraluminal imaging systems are used for the diagnosis and treatment of diseases. For example, intravascular ultrasound (IVUS) imaging is used as a diagnostic tool to visualize tubes within a patient's body. IVUS imaging is performed through an IVUS catheter or guidewire that includes one or more ultrasound transducers. The IVUS catheter is inserted into the tube and guided to the area to be imaged. The transducers emit ultrasound energy and receive the ultrasound echoes reflected from the tube. The ultrasound echoes are processed to form an image of the tube of interest. IVUS images can help assess diseased tubes (such as arteries or veins in the human body), determine treatment needs, optimize treatment, and / or evaluate the effectiveness of treatment.

[0003] Different diseases or medical procedures produce physical features with varying sizes, structures, densities, water content, and imaging sensor accessibility. For example, deep vein thrombosis (DVT) produces blood cell clots, while post-thrombotic syndrome (PTS) creates a network or other residual structural effect in the vessel, whose composition is similar to the vessel wall itself and may therefore be difficult to distinguish from the vessel wall. Arteries (such as coronary or peripheral arteries) can exhibit plaque buildup or lesions that constrict the cross-sectional area of ​​the arterial lumen, restrict blood flow through the artery, and increase the risk of complete occlusion. A stent is a dense (e.g., metallic) object that can be placed within a tube or lumen to keep the tube or lumen open to a specific diameter. IVUS imaging can be used to visualize these features and structures, for example, to assess the severity of intravascular occlusion and / or ensure proper stent placement within the vessel.

[0004] When an intraluminal imaging system (e.g., an IVUS imaging system) displays images of the lumen on a monitor, the proportion of the displayed image is typically fixed and based on the depth of field of view of the ultrasound transducer, regardless of the location and / or size of the lumen being imaged. Therefore, tubes with larger diameters or areas occupy a larger area of ​​the monitor, while lumens with smaller diameters occupy a smaller area, regardless of the anatomical details being imaged. Consequently, the natural taper of the tube (whether coronal or peripheral) can result in lumen images captured at different locations occupying different portions of the monitor.

[0005] The information contained in the Background section of this specification, including any references cited herein and any descriptions or discussions thereof, is included for technical reference purposes only and should not be considered as subject to limiting the scope of this disclosure. Summary of the Invention

[0006] Disclosed are systems, methods, and apparatuses for automatically adjusting the scale or magnification of intraluminal images on a display of an intraluminal imaging system based on measured or calculated tube dimensions. This system may be referred to hereinafter as an adaptive tube visualization system. The adaptive tube visualization system may include an intraluminal imaging apparatus in communication with a processor. The processor is configured to measure or calculate the dimensions of features of the lumen, such as the outer wall of the vessel. Based on the measured lumen dimensions, the processor automatically adjusts the scale or magnification of the image output to the display. It should be understood that the systems and methods disclosed herein may have specific, but not unique, applications for intravascular ultrasound (IVUS) imaging operations.

[0007] In one embodiment, an endoluminal imaging system includes: an endoluminal imaging catheter or guidewire configured to be positioned within a patient's body lumen; and processor circuitry in communication with the endoluminal imaging catheter or guidewire. The processor circuitry is configured to: receive a first endoluminal image of the body lumen from the endoluminal imaging catheter or guidewire; calculate dimensions of anatomical features of the body lumen based on the first endoluminal image; calculate a scaling factor for the first endoluminal image based on the dimensions of the body lumen; scale the first endoluminal image using the scaling factor; and output the scaled first endoluminal image to a display in communication with the processor circuitry.

[0008] In some embodiments, the anatomical feature includes the vessel wall. In some embodiments, the dimension is a diameter. In some embodiments, the dimension is a cross-sectional area. In some embodiments, the processor circuitry is configured to automatically scale the first intraluminal image. In some embodiments, the processor circuitry is configured to scale the first intraluminal image based on input from a user interface communicating with the processor circuitry. In some embodiments, the processor circuitry is configured to scale the first intraluminal image by changing the field of view of the intraluminal imaging catheter or guidewire. In some embodiments, the processor circuitry is configured to scale the first intraluminal image by changing the magnification of the first intraluminal image on the display.

[0009] In some embodiments, the processor circuitry is configured to scale the image within the first lumen in real time using a scaling factor.

[0010] In some embodiments, the first intraluminal image is obtained at a first location within a body lumen. In some embodiments, the processor circuitry is further configured to: receive a second intraluminal image obtained at a different second location within a body lumen, wherein the size of the anatomical feature at the second location is different compared to its size at the first location; and scale the second intraluminal image such that the anatomical feature is represented at approximately the same size in both the second intraluminal image and the scaled second intraluminal image.

[0011] According to another embodiment of this disclosure, a method for scaling an intraluminal image includes: receiving a first intraluminal image of the patient's body lumen obtained by the intraluminal imaging catheter at a processor circuit in communication with the intraluminal imaging catheter or guidewire, while an intraluminal imaging catheter is positioned within a patient's body lumen; calculating, via the processor circuit, dimensions of anatomical features of the body lumen based on the first intraluminal image; calculating a scaling factor based on the dimensions of the body lumen; scaling the first intraluminal image by the scaling factor; and outputting the scaled first intraluminal image to a display in communication with the processor circuit.

[0012] In some embodiments, anatomical features include the tube wall or lumen. In some embodiments, the size is a diameter or cross-sectional area. In some embodiments, scaling of the first intraluminal image is automatic. In some embodiments, scaling of the first intraluminal image occurs based on input from a user interface. In some embodiments, scaling of the first intraluminal image is achieved by changing the field of view of the intraluminal imaging catheter. In some embodiments, scaling of the first intraluminal image is achieved by changing the magnification of the first intraluminal image on the display. In some embodiments, scaling of the first intraluminal image is performed in real time. In some embodiments, scaling of the first intraluminal image is performed such that anatomical features are represented at a size similar to that of a second intraluminal image, the size of which differs from that of the anatomical features in the first intraluminal image.

[0013] This summary portion is provided to present selected concepts in a simplified form, which will be further described in the detailed description portion. The summary portion is not intended to identify key or essential features of the claimed subject matter, nor is it intended to limit the scope of the claimed subject matter. A broader description of the features, details, functionality, and advantages of the adaptive tube visualization system, as defined in the claims, will be provided in the following written description of various embodiments of this disclosure, and illustrated in the accompanying drawings. Attached Figure Description

[0014] Illustrative embodiments of this disclosure will be described with reference to the accompanying drawings, in which:

[0015] Figure 1This is a schematic diagram of an intraluminal imaging system based on various aspects of this disclosure.

[0016] Figure 2 The illustration shows a blood vessel containing a thrombus and opened by a stent, according to several aspects of this disclosure.

[0017] Figure 3 This is a screenshot of a tomographic image of a lumen generated by an intraluminal imaging system according to at least one embodiment of the present disclosure.

[0018] Figure 4 This is a schematic cross-sectional view of an intraluminal imaging probe that is pulled back through a tube including a natural taper, according to various aspects of this disclosure.

[0019] Figure 5a It is a schematic cross-sectional view of the distal portion of the tube according to various aspects of this disclosure.

[0020] Figure 5b It is a schematic cross-sectional view of the proximal portion of the tube according to various aspects of this disclosure.

[0021] Figure 6 This is a screenshot of an exemplary intraluminal imaging system according to at least one embodiment of the present disclosure.

[0022] Figure 7 This is a screenshot of an exemplary intraluminal imaging system according to at least one embodiment of the present disclosure.

[0023] Figure 8 This is a flowchart of an exemplary adaptive tube visualization system according to various aspects of this disclosure.

[0024] Figure 9 This is a schematic diagram of a processor circuit according to various aspects of this disclosure. Detailed Implementation

[0025] This disclosure generally relates to medical imaging, including imaging in relation to a patient's body lumens using an intraluminal imaging device. For example, this disclosure describes systems, apparatus, and methods for determining the diameter or area of ​​a tube region currently imaged by an intraluminal imaging probe and scaling the current intravascular image on a display based on the determined diameter or area, such that tubes of different sizes occupy approximately the same portion of the display. This feature helps clinicians or other users view and interpret the anatomical details of tubes of various sizes or diameters, whether they are large (such as the carotid artery or aorta), medium-sized (such as the external iliac vein or femoral artery), or small (such as peripheral veins or arteries). This can be particularly useful during pull-back procedures or other procedures in which the intraluminal imaging probe passes through tubes with gradually increasing or decreasing diameters or areas. Such systems (hereinafter referred to as adaptive tube visualization systems) improve workflows associated with assessing and diagnosing blood vessels in vivo. However, while some embodiments provided herein may specifically refer to blood vessels, it should be understood that the systems, methods, and apparatus described herein can be used to visualize, assess, and / or diagnose other body lumens, including the esophagus, intestine, or any other suitable body lumen.

[0026] In some cases using conventional equipment, pullback sequences are recorded at maximum field of view (FOV) and displayed in real time at either the maximum FOV or the display FOV selected by the user at the start of the operation. During review mode (e.g., after pullback), the display FOV of the image may be changed, but even then, the decision of which display FOV to use and the selection of that display FOV are performed manually by the clinician or other user. The purpose of this disclosure is to provide systems, methods, and apparatus that can be used to automatically select and / or dynamically change the display FOV in real time during pullback, thereby effectively magnifying or reducing the image based on the size of the tube being imaged at the longitudinal position of the intraluminal imaging probe.

[0027] Embodiments of this disclosure substantially assist clinicians in viewing, interpreting, measuring, assessing, and / or diagnosing the health of blood vessels or other bodily lumens (e.g., esophagus, intestines, veins, arteries, etc.) by magnifying the features of smaller tubes and / or diminishing the features of larger tubes, such that different tubes or different locations of tubes occupy substantially the same portion of the display, thereby improving visibility on the display. Implemented on a medical imaging console (e.g., an intraluminal imaging console) in communication with a medical imaging sensor (e.g., an intraluminal ultrasound sensor), the adaptive tube visualization system disclosed herein provides time savings and improved diagnostic confidence. This improved imaging workflow transforms raw imaging data into an image that is automatically scaled on the display for readability and interpretability. This can occur without input from clinicians or other users to allow for changes in the field of view during surgery.

[0028] An adaptive tube visualization system can be implemented as a set of logical branches and mathematical operations, the output of which can be viewed on a display and operated by a control process executed on a processor that accepts user input from a keyboard, mouse, or touchscreen interface and communicates with one or more medical imaging sensors (e.g., intraluminal ultrasound sensors). In this respect, the control process performs certain specific operations in response to different inputs or selections made by the user at the start of the imaging operation, and can also react to inputs made by the user during the operation. Certain structures, functions, and operations of the processor, display, sensors, and user input system are known in the art, while other structures, functions, and operations are described herein to characterize novel features or aspects of this disclosure.

[0029] Various types of intraluminal imaging systems are used for the diagnosis and treatment of diseases. For example, intravascular ultrasound (IVUS) imaging is used as a diagnostic tool to visualize tubes within a patient's body. This can help assess diseased tubes (such as arteries or veins) in the body to determine the need for treatment, optimize treatment, and / or evaluate the effectiveness of treatment (e.g., by imaging the tubes before and after treatment).

[0030] In some cases, intraluminal imaging is performed using an IVUS device comprising one or more ultrasound transducers. The IVUS device can be positioned within the tube and guided to the area to be imaged. The transducer emits ultrasound energy and receives ultrasound echoes reflected from the tube. The ultrasound echoes are processed to form an image of the tube of interest. The image of the tube of interest may include one or more lesions or obstructions within the tube. Stents can be placed within the lumen to dispose of these obstructions, and intraluminal imaging can be performed to view the placement of the stent within the tube. Other types of treatment include thrombectomy, ablation, angioplasty, and medication.

[0031] Performing imaging pullback on tubes whose size changes from distal to proximal can be challenging. The problem might be that at the distal end of the pullback, the tube is very small and suited to a small field of view, but at the proximal end, it is very large and suited to a large field of view, or vice versa. As the tube narrows and the image of the tube becomes smaller, there is less detail on the monitor, making it increasingly challenging to interpret the tube's anatomical details. One solution to this problem is to allow the user to select a single field of view and accept that one or two ends cannot be visualized well, or alternatively, to modify the field of view during review (if the system allows). Neither of these solutions allows for optimal visualization during pullback and both require manual user intervention.

[0032] The adaptive tube visualization system disclosed herein adapts to the reduction in image size by adaptively changing the field of view during retraction, thereby drawing blood vessels at a scale suitable for or optimized for a display and / or graphical interface. In some embodiments, this benefit of scaling the image to a relatively constant size can be achieved without user intervention, regardless of the diameter or area of ​​the tube or body lumen being imaged. In some embodiments, the adaptive tube visualization function is turned on and off via user input through a user interface. The adaptive tube visualization system can reduce the reliance of vascular surgeons on reviewing magnified images by combining imaging and display functions in a novel way, thus meeting unmet user needs. The combined functions include automatic tube size detection and tube size-based field of view changes or image magnification.

[0033] For example, on an IVUS imaging system, a feature that enables adaptive field of view during IVUS recording mode (pullback) can be added. When the user enables this feature (e.g., by selecting input on a user interface device), an image processing algorithm is applied to determine the size of the tube to be displayed. In some aspects, this image processing algorithm can be applied in real time. Based on the determined tube size (e.g., the diameter of the outer wall), the system automatically changes the field of view. For example, the system can automatically and dynamically scale the image so that the outer wall of the tube appears to be the same size, or approximately the same size, even if the actual size of the blood vessel varies in the image. In some aspects, a tube boundary detection algorithm can be used for tube size estimation. In some embodiments, the boundary detection algorithm is configured to run in real time. In some embodiments, since the algorithm does not need to rely on detailed boundary shapes or contours (only an estimate of size), the boundary detection algorithm can be modified, simplified, and / or optimized to allow it to run in real time on an IVUS imaging system. This concept can be implemented, for example, as a software update to existing hardware.

[0034] In other embodiments, the size of the tube can be determined through image processing of external images of the tube (e.g., angiography), which may or may not be co-registered with IVUS images using existing co-registration techniques. This concept can also be implemented in OCT or other intravascular imaging modalities. Therefore, in some aspects, embodiments of this disclosure provide novel and efficient methods for FOV and image scaling. This may be relevant to both coronary and peripheral cases, but may be particularly relevant and beneficial in peripheral vessels.

[0035] For the purpose of promoting an understanding of the principles of this disclosure, reference will now be made to the embodiments shown in the accompanying drawings, and the embodiments described above will be used in specific language. However, it should be understood that there are no limitations on the scope of this disclosure. Any changes and further modifications to the described apparatus, systems, and methods, as well as any further application of the principles of this disclosure, are fully contemplated and included within the scope of this disclosure, as would typically occur to those skilled in the art related to this disclosure. Specifically, it is fully contemplated that features, components, and / or steps described with respect to one embodiment may be combined with features, components, and / or steps described with respect to other embodiments of this disclosure. However, for the sake of brevity, various repetitions of these combinations will not be described separately.

[0036] Figure 1 This is a schematic diagram of an intraluminal imaging system including an adaptive tube visualization system according to various aspects of this disclosure. In some embodiments, the intraluminal imaging system 100 may be an intravascular ultrasound (IVUS) imaging system. The intraluminal imaging system 100 may 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 may include angiography, ultrasound, X-ray, computed tomography (CT), magnetic resonance imaging (MRI), or other imaging techniques, devices, and methods. The intraluminal device 102 is sized and shaped and / or structurally otherwise arranged to be positioned within a patient's body lumen, such as a blood vessel. For example, in various embodiments, the intraluminal device 102 may be a catheter, guidewire, guide tube, pressure line, and / or flow line. In some cases, the system 100 may include additional components and / or may be available without... Figure 1 The system is implemented with one or more of the components shown. For example, the external imaging system 132 may be omitted from system 100.

[0037] The intraluminal imaging system 100 (or intravascular imaging system) can be any type of imaging system suitable for use within a patient's body lumen or blood vessels. 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, for example, a system configured for forward-looking intravascular ultrasound (FL-IVUS) imaging, intravascular photoacoustic (IVPA) imaging, intracardiac echocardiography (ICE), transesophageal echocardiography (TEE), optical coherence tomography (OCT), and / or other suitable imaging modalities.

[0038] It should be understood that system 100 and / or device 102 can be configured to acquire any suitable intraluminal imaging data. In some embodiments, device 102 may 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, device 102 may include imaging elements to acquire intraluminal imaging data associated with tube 120. Device 102 may be sized and shaped (and / or configured) for insertion into tube 120 in a patient.

[0039] System 100 may be deployed in a catheterization laboratory with a control room. Processing system 106 may be located in the control room. Alternatively, processing system 106 may be located elsewhere, such as within the catheterization laboratory itself. The catheterization laboratory may include a sterile area, while its associated control room may be sterile or may not be sterile, depending on the procedure to be performed and / or the medical facility. The catheterization laboratory and control room may be used to perform any number of medical imaging procedures, such as angiography, fluoroscopy, CT, IVUS, virtual histology (VH), forward-looking IVUS (FL-IVUS), intraluminal photoacoustic (IVPA) imaging, fractional flow reserve (FFR) determination, coronary flow reserve (CFR) determination, optical coherence tomography (OCT), computed tomography, intracardiac echocardiography (ICE), forward-looking ICE (FLICE), intraluminal palpation, transesophageal echocardiography, fluoroscopy, and other medical imaging modalities, or combinations thereof. In some embodiments, device 102 may be controlled from a remote location (such as a control room), eliminating the need for operator access to the patient.

[0040] The intraluminal device 102, PIM 104, monitor 108, and external imaging system 132 can be directly or indirectly communicatively connected to the processing system 106. These components can be communicatively connected to the medical processing system 106 via wired connections (such as standard copper wire links or fiber optic links) and / or wireless connections using the IEEE 802.11 Wi-Fi standard, Ultra-Wideband (UWB) standard, FireWire, wireless USB, or another high-speed wireless network standard. The processing system 106 can be communicatively connected to one or more data networks, such as 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 connected 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 (PACS) system, and / or a hospital information system via network connectivity.

[0041] At a high level, the intraluminal ultrasound imaging device 102 emits ultrasonic energy from a transducer array 124 included in a scanner assembly 110 mounted near the distal end of the intraluminal device 102. The ultrasonic energy is reflected by tissue structures (e.g., tube 120) in the medium surrounding the scanner assembly 110, and the ultrasonic echo signals are received by the transducer array 124. The scanner assembly 110 generates electrical signals representing the ultrasonic echoes. The scanner assembly 110 may include one or more individual ultrasonic transducers and / or a transducer array 124 in any suitable configuration, such as a planar array, a curved array, a circular array, a ring array, etc. For example, the scanner assembly 110 may be a one-dimensional or two-dimensional array in some cases. In some cases, the scanner assembly 110 may be a rotating ultrasound device. The effective area of ​​the scanner assembly 110 may include one or more transducer materials and / or one or more segments of ultrasonic elements (e.g., one or more rows, one or more columns, and / or one or more orientations), which may be uniformly or independently controlled and activated. The effective area of ​​the scanner assembly 110 can be patterned or structured in various basic or complex geometries. The scanner assembly 110 can be configured in a lateral orientation (e.g., the emitted ultrasonic energy is perpendicular to and / or orthogonal to the longitudinal axis of the intraluminal device 102) and / or a forward orientation (e.g., the emitted ultrasonic energy is 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 angle relative to the longitudinal axis in a proximal or distal direction. In some embodiments, the emission of ultrasonic energy can be electronically redirected by selectively triggering one or more transducer elements of the scanner assembly 110.

[0042] The ultrasonic transducer of the scanner assembly 110 may be a piezoelectric micromechanical ultrasonic transducer (PMUT), a capacitive micromechanical ultrasonic transducer (CMUT), a single crystal, lead zirconate titanate (PZT), PZT composite material, other suitable transducer types, and / or combinations thereof. In one embodiment, the ultrasonic transducer array 124 may include any suitable number of individual transducer elements or acoustic elements between 1 and 100,000 acoustic elements, including, for example, 2 acoustic elements, 4 acoustic elements, 36 acoustic elements, 64 acoustic elements, 128 acoustic elements, 500 acoustic elements, 812 acoustic elements, 1,000 acoustic elements, 10,000 acoustic elements, 65,000 acoustic elements, and / or other larger and smaller values.

[0043] The PIM 104 transmits the received echo signal to the processing system 106, where the ultrasound image (including flow information) is reconstructed and displayed on the monitor 108. The console or processing system 106 may include a processor and memory. The processing system 106 is operable to facilitate the features of the intraluminal imaging system 100 described herein. For example, the processor may execute computer-readable instructions stored on a non-transitory tangible computer-readable medium.

[0044] PIM 104 facilitates signal communication between processing system 106 and scanner assembly 110 included in in-lumen device 102. This communication may include providing commands to an integrated circuit controller chip within in-lumen device 102 to select specific elements on transducer array 124 for transmission and reception, providing a transmission trigger signal to the integrated circuit controller chip to activate transmitter circuitry to generate electrical pulses for exciting selected transducer array elements, and / or receiving amplified echo signals received from selected transducer array elements via an amplifier included on the integrated circuit controller chip. In some embodiments, PIM 104 performs preliminary processing of the echo data before transferring the data to processing system 106. In examples of such embodiments, PIM 104 performs data amplification, filtering, and / or aggregation. In one embodiment, PIM 104 also provides high-voltage and low-voltage DC power to support the operation of in-lumen device 102, including circuitry located within scanner assembly 110.

[0045] Processing system 106 receives echo data from scanner assembly 110 via PIM 104 and processes the data to reconstruct an image of tissue structures located in the medium surrounding scanner assembly 110. Typically, device 102 can be used within any suitable anatomical structure and / or body lumen of a patient. Processing system 106 outputs image data such that an image of tube 120 (e.g., a cross-sectional IVUS image of tube 120) is displayed on monitor 108. Tube 120 may represent a structure filled or surrounded by fluid, including both natural and artificial structures. Tube 120 may be inside a patient's body. Tube 120 may be an artery or vein of the patient's vascular system, including the cardiac vascular system, peripheral vascular system, neurovascular system, renal vascular system, and / or any other suitable lumen within the body. For example, device 102 can 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, and lungs; ducts; intestines; nervous system structures, including the brain, dura mater, spinal cord, and peripheral nerves; the urinary tract; and valves within the blood vessels, chambers, or other parts of the heart, and / or other systems of the body. In addition to natural structures, device 102 can also be used to examine artificial structures, such as, but not limited to, heart valves, stents, shunts, filters, and other devices.

[0046] The controller or processing system 106 may include processing circuitry having one or more processors that communicate with 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 this 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 into a single component. For example, system 100 may include a touchscreen device comprising a housing having a touchscreen display and a processor. System 100 may include any suitable input device, such as a touchpad or touchscreen display, keyboard / mouse, joystick, buttons, etc., for a user to select options displayed on monitor 108. The processing system 106, monitor 108, input device, and / or combinations thereof may be referred to as the controller of system 100. The controller may communicate with device 102, PIM 104, processing system 106, monitor 108, input device, and / or other components of system 100.

[0047] In some embodiments, the intraluminal device 102 includes features similar to those of conventional solid-state IVUS catheters, such as those available from Philips. The catheters and those disclosed in U.S. Patent No. 7,846,101, which is incorporated herein by reference in its entirety. For example, the intraluminal device 102 may 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 may include a plurality of conductors, including one, two, three, four, five, six, seven or more conductors.

[0048] The transmission harness 112 terminates in the PIM connector 114 at the proximal end of the intraluminal device 102. The PIM connector 114 electrically connects the transmission harness 112 to the PIM 104 and physically connects the intraluminal device 102 to the PIM 104. In one embodiment, the intraluminal device 102 also includes a guidewire exit port 116. Therefore, in some cases, the IVUS device is a rapid exchange catheter. The guidewire exit port 116 allows the guidewire 118 to be inserted distally to guide the intraluminal device 102 through the tube 120.

[0049] 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 a visual representation of imaging data to a user. In some embodiments, display 108 may be used to provide a user with a workflow for specific operations to complete an intraluminal imaging procedure. This workflow may include performing pre-stent planning to determine the status of the vessel and the likelihood of stent placement, and post-stent examination to determine the status of the stent already positioned in the vessel. This workflow may be presented to the user on a display screen, such as in Figures 5 to 6. Figure 8 Examples of displays or visualizations shown are provided.

[0050] External imaging system 132 may be configured to acquire X-ray, radiographic, vascular (e.g., with contrast agent), and / or fluoroscopic (e.g., without contrast agent) images of the patient's body (including tube 120). External imaging system 132 may also be configured to acquire computed tomographic images of the patient's body (including tube 120). External imaging system 132 may include an external ultrasound probe configured to acquire ultrasound images of the patient's body (including tube 120) when positioned externally to the body. In some embodiments, system 100 includes other imaging modalities (e.g., MRI) to acquire images of the patient's body (including tube 120). Processing system 106 may utilize images of the patient's body in combination with intraluminal images acquired via intraluminal device 102.

[0051] Figure 2 A blood vessel 300 containing a thrombus 330 and dilated or expanded by a stent 340 is shown. The thrombus is present between the vessel walls 310 and may restrict blood flow 320. There are many types of thrombi, including subacute thrombi, acute thrombi, and chronic thrombi.

[0052] The stent 340 compresses and displaces the thrombus 330, patency of the vessel 300 and preventing the thrombus 330 from traveling through the vessel 300. The stent 340 also pushes the vessel wall 310 outward, thereby reducing the restriction on blood flow 320. Other treatment options for relieving occlusion may include, but are not limited to, thrombectomy, ablation, angioplasty, and medication. However, in most cases, accurate and timely intravascular imaging of the affected area, as well as an accurate and detailed understanding of the location of the affected area, may be highly desirable before, during, or after treatment. For example, inaccurate or imprecise location or orientation information in IVUS images may lead to the risk of healthy tissue being ablated or stents being placed instead of diseased tissue during treatment.

[0053] Plaque buildup (e.g., arterial stenosis, plaque buildup, thrombosis, deep vein thrombosis, chronic total occlusion, or chronic total occlusion, or CTO) is one way in which the cross-sectional area of ​​veins in peripheral blood vessels (e.g., trunk, abdomen, groin, legs) can be reduced. Other anatomical structures in contact with veins can also reduce their cross-sectional area, thus restricting blood flow from there. For example, arteries or ligaments in the trunk, abdomen, groin, or legs may press against veins, altering the shape of the vein and reducing its cross-sectional area. This reduction in cross-sectional area due to contact with other anatomical structures can be termed compression, as the vein wall is compressed due to contact with the artery or ligament.

[0054] During, for example, a pullback operation, the intraluminal probe 102 begins in a narrower section of the tube and ends in a wider section, with the tube diameter increasing during the pullback. This typically results in the tube gradually increasing in size on the display or monitor 108 during the pullback, causing the tube to occupy a significant portion of the display 108. This disclosure provides systems, methods, and apparatuses that allow for automated, adaptive tube visualization, which can be initiated by user input received via a user interface to adjust the size of the displayed image based on the measured / calculated diameter or cross-sectional area of ​​the tube, adjusting the FOV or magnification setting. Thus, according to embodiments of this disclosure, tubes can be displayed with a substantially consistent image size, such that the tube occupies a similar portion or amount of the display (e.g., within ±1% to ±20%, including values ​​such as ±5% and ±10%), regardless of variations in the actual measured or calculated diameter or cross-sectional area of ​​the tube. This helps clinicians visualize tube details equally easily, regardless of the tube's size.

[0055] Figure 3This is a screenshot 400 obtained by an intraluminal imaging system comprising a tomographic image 410 of tube 120 according to at least one embodiment of the present disclosure. Screenshot 400 also includes a graphical route map 430 and an image longitudinal display (ILD) 420. The image longitudinal display 420 consists of longitudinal cross-sections of multiple tomographic IVUS images 410 captured at different locations along tube 120 (each representing a lateral or radial cross-sectional view of tube 120). In this example, the left side 432 of the graphical route map 433 (e.g., representing the patient's right leg) is displayed in a very faint color (e.g., dark gray against a black background) to indicate that the right side of the body was not examined during the current operation. The inferior vena cava 434, common iliac vein 436, and common femoral vein 438 are shown in a more prominent color (e.g., a lighter gray) to indicate that they are along the path of the current traction operation, while the external iliac vein 439 is highlighted in a color (e.g., blue) for emphasis (e.g., because this is the segment currently being observed by the endovascular imaging probe). Other coloring or highlighting schemes may be used instead of or supplemented. Furthermore, it should be understood that the graphical route map 430 may represent any body lumen or vessel, including coronary arteries and / or peripheral arteries. For example, in some embodiments, branches of the route map 430 may represent branches of the coronary arteries.

[0056] Also visible is the detected boundary 440 of the lumen of tube 120. It should be noted that at the magnification or field of view settings used to capture this tomographic image 610, the tube boundary 440 occupies a relatively small portion of the tomographic image 610. A larger magnification setting or a smaller FOV setting will increase the size of the tube in the tomographic image 610, making it easier for clinicians or other users to see details of the tube's anatomical structure.

[0057] Figure 4This is a schematic longitudinal cross-sectional view of an intraluminal imaging probe 102 according to various aspects of this disclosure, pulled back through a tube 300 including a natural taper. The tube includes a tube wall 310 having an outer surface 320. The outer surface 320 of the tube wall 310 defines the outermost boundary of the tube 300, and therefore the tube diameter is measured from the outer surface 320 on one side to the outer surface 320 on the other. This tube diameter, measured from the outer surface 320 of the tube wall 310, may be more useful than the lumen diameter because the lumen diameter varies more greatly near the lesion tissue within the tube 300. However, it should be understood that any diameter or tube measurement may be used, including the lumen diameter, the diameter measured from the intima, media, adventitia, endothelium, or any other suitable portion of the tube. The natural taper of the tube 300 is such that the lumen enclosed by the tube wall 310 in the distal portion 510 is narrower than the lumen in its wider proximal portion 520. Therefore, the tube has a narrower diameter D1 at the distal portion 510 and a wider diameter D2 at the proximal portion 520. If pullback is performed at a constant FOV or magnification setting, and within the tube 300 from a more distal position to a more proximal position, this could cause the tomographic ultrasound image of the tube 300 to appear increasingly larger on the monitor as the pullback moves proximally. However, as described below, this disclosure describes embodiments that allow the FOV or magnification to change automatically in response to the tube diameter, such that smaller tubes or tube regions are viewed with a smaller FOV or a larger magnification, while larger tubes or tube regions are viewed with a larger FOV or a smaller magnification. Therefore, as the pullback proceeds, the tomographic ultrasound image can appear to be a relatively constant size on the monitor.

[0058] Figure 5a Based on various aspects of this disclosure, such as Figure 4 An illustrated cross-sectional view of an auto-scaled image of the distal portion 510 of the tube 300 shown. (Reference) Figure 5a The tube 300 is shown having a thickness 312 and an apparent diameter Da, which can be a function of the actual diameter D1 of the tube at the distal portion and a given FOV or magnification setting (e.g., it can correlate a number of screen pixels with a number of millimeters of tissue). Also visible are the tube wall 310, the lumen 122, and the intra-lumen imaging probe 102. For example, Figure 5a The view shown may represent a tomographic image captured early in the pullback operation, such as... Figure 4 As shown, the pullback operation is performed within the tube 300 from the distal portion 510 to the proximal portion 520.

[0059] Figure 5b Based on various aspects of this disclosure, such as Figure 4The diagram shows a cross-sectional view of the proximal portion 520 of the tube 300. In this example, although the proximal portion 520 of the tube 300 is wider than the distal portion 510 of the tube (e.g., its diameter D2 is larger than the tube diameter D1 of the distal portion 510), Figure 5b The view is displayed with a high magnification or a small FOV (which is calculated based on the measured diameter D of the tube at this point along the pullback), thus making the tube appear at least as... Figure 5a The images in the image have approximately the same apparent diameter Da (e.g., within the range of ±1% to ±20%, including values ​​such as ±5%, ±10%, or any other suitable range). Therefore, Figure 5b The view occupies the same amount or approximately the same amount of the display or graphical user interface. Furthermore, due to the decrease in magnification (or increase in FOV), the thickness 312 of the tube wall 310 and the intraluminal imaging probe 102... Figure 5b In the view, they are all better than in Figure 5a It appears proportionally smaller.

[0060] Figure 6 This is a screenshot of a screen display 700 or graphical interface of an exemplary intraluminal imaging system 100 according to at least one embodiment of the present disclosure. Visible are tomographic images 610 (e.g., B-mode ultrasound images) of the tube 300 captured by the intraluminal imaging probe 102 for a given FOV setting, which is typically determined at the start of the imaging operation. In this example, image 610 is not automatically scaled, so the tube 300 does not occupy the available display area on screen display 700, but instead exhibits a smaller apparent diameter Da1 proportional to the diameter of the tube 300.

[0061] Figure 7 This is a screenshot of a screen display 800 of an exemplary intraluminal imaging system 100 according to at least one embodiment of the present disclosure, wherein a tomographic image 610 is automatically scaled to occupy the available portion of the display 800. Figure 7 What is visible is a tomographic image 610 of the tube 300 captured by the intraluminal imaging probe 102. In this example, the FOV, depth of field, or magnification settings are changed in real time during pull-back (as opposed to later, during playback), so that the tomographic image 610 has been automatically scaled or magnified, giving the tube an apparent diameter Da2 greater than Da1. Therefore, in Figure 7In this example, the automatically scaled image 610 occupies a large portion of the available display area of ​​the screen display 800, making it easier for clinicians or other users to interpret the details of the tube 300. In one example, the degree of magnification or scaling is based on a scaling factor proportional to the ratio of the measured or calculated diameter of the tube 300 to a reference diameter. The tube diameter is used instead of the lumen diameter because diseased tubes may have thick walls (e.g., due to plaque) and small lumens, and it is necessary to capture the details of the walls regardless of how the lumen size varies in the diseased area. For example, if the reference diameter is 16 mm, then a tube 300 with a diameter of 16 mm is displayed at standard magnification to fill a certain area of ​​the screen display 800, while a tube with a diameter of 32 mm is displayed at -50% or 0.5 times the standard magnification (i.e., half size), and a tube with a diameter of 8 mm is displayed at +100% or 2 times the standard magnification (i.e., double size), so that the apparent diameter Da2 of the tube in the tomographic image 610 remains relatively constant on the display screen 800 visible on the monitor 108, regardless of the actual size of the tube 300 imaged by the intraluminal imaging probe 102 or the actual size of the lumen of the tube 300. In some embodiments, the cross-sectional area may be used instead of the diameter or in addition to the diameter for scaling.

[0062] In one example, the diameter or area of ​​the tube is determined using image recognition to identify and locate the outer boundary of the tube wall. The diameter can be determined in pixels. In some embodiments, the diameter or area of ​​the tube can be converted to distance units based on, for example, a conversion between pixels and millimeters or square millimeters (which is a linear function of the FOV setting of the endoluminal imaging system 100, e.g., in millimeters). Because the calculation of the tube diameter or area is purely for scaling purposes, rather than for clinical decisions such as changing the size of a stent, the calculation can be approximate (e.g., an allowable error of ±20% or even ±33%), and thus can benefit from fast, simple identification and calculation algorithms running in real time, as well as slower, more accurate identification and calculation algorithms that can run in near real time, or in the background after pullback to determine an auto-scaling value for each image in review mode.

[0063] Examples of different boundary detection, image processing, image analysis, and / or pattern recognition algorithms include U.S. Patent No. 6,200,268, issued March 13, 2001, entitled "VASCULARPLAQUE CHARACTERIZATION," inventored by D. Geoffrey Vince, Barry D. Kuban, and Anuja Nair; U.S. Patent No. 6,381,350, issued April 30, 2002, entitled "INTRAVASCARULTRASONIC ANALYSIS USING ACTIVE CONTOUR METHOD AND SYSTEM," inventored by Jon D. Klingensmith, D. Geoffrey Vince, and Raj Shekhar; and U.S. Patent No. 6,381,350, issued July 11, 2006, entitled "SYSTEM AND METHOD OF CHARACTERIZING," inventored by Anuja Nair, D. Geoffrey Vince, Jon D. Klingensmith, and Barry D. Kuban. U.S. Patent No. 7,074,188, entitled "VASCULAR TISSUE", filed February 13, 2007, entitled "NON-INVASIVE TISSUE CHARACTERIZATION SYSTEM AND METHOD", inventord by D. Geoffrey Vince, Aenuja Nair, and Jon D. Klingensmith; U.S. Patent No. 7,175,597Z, published May 8, 2007, entitled "SYSTEM AND METHOD FOR VASCULAR BORDER DETECTION", inventord by Jon D. Klingensmith, Anuja Nair, Barry D. Kuban, and D. Geoffrey Vince; and U.S. Patent No. 7,215,802, published April 15, 2008, entitled "SYSTEM AND METHOD FOR IDENTIFYING A The U.S. Patent No. 7,359,554 to “VASCULAR BORDER” was issued on December 9, 2008, by Jon D. Klingensmith, Anuja Nair, Barry D. Kuban, and D.The teachings of Geoffrey Vince's U.S. Patent No. 7,463,759, entitled "SYSTEM AND METHOD FORVASCULAR BORDER DETECTION," are incorporated herein by reference in their entirety. Other algorithms, whether or not related to these, may be used in place of or supplementing these algorithms. For example, to calculate an approximate pipe diameter, it is not necessary to identify the entire boundary. Instead, it may be sufficient, for example, to determine a fixed number of different cross-sections at a fixed orientation and to average the results.

[0064] According to the implementation, the adaptive tube visualization system may employ other values ​​for the scaling algorithm, and may use other magnification algorithms instead of the aforementioned algorithm, or other magnification algorithms besides those described above. For example, scaling may be based on the tube cross-sectional area and a reference cross-sectional area, or it may be non-linear. Scaling can be adjusted by keeping the magnification constant and changing the FOV of the captured image, or by keeping the FOV constant and adjusting the magnification level of the captured image. Optionally, the FOV and / or the degree of scaling may be displayed in an information box 810 as part of the screen display 800. In one example, scaling the image does not require any change to the transmission mode of the ultrasonic transducer array 124—only the analysis and display of the received echoes need to be changed.

[0065] Figure 8 A flowchart of an exemplary adaptive tube visualization system 900 according to several aspects of this disclosure is shown. These steps can be performed by an intraluminal imaging system, such as... Figure 1 The intraluminal imaging system 100 shown. For example, these steps can be used as coded instructions in, for example... Figure 1 The processing system 106 executes on the processor and responds to input from clinicians or other users, for example in Figure 1 It is displayed on monitor 108.

[0066] In step 910, the intraluminal imaging system captures radial cross-sectional images of the intraluminal cavity, which may also be referred to as tomographic intraluminal images. Such images can be captured discretely or continuously during an operation (e.g., a pullback operation) and stored in the memory of the processing system.

[0067] In step 920, the adaptive tube visualization system 900 measures or calculates the tube diameter or area. This can be performed, for example, using depth or extent information from an intraluminal imaging probe in conjunction with image recognition, to identify at least a portion of the vessel wall and distinguish the vessel wall from surrounding tissue and the blood flowing within the tube.

[0068] In step 930, the adaptive tube visualization system scales the tomographic intraluminal image (e.g., by changing the display FOV setting of the intraluminal imaging system) or magnifies it (e.g., by changing the image magnification on the display) based on the sensed or calculated diameter or cross-sectional area of ​​the tube determined in step 920. In some embodiments, scaling may be performed such that successive images of the tube at different longitudinal positions are scaled, magnified, or converted to the same size, or approximately the same size, even if the size of the tube is different at different longitudinal positions.

[0069] In step 940, the system displays a scaled image on the monitor of the intraluminal imaging system. Then, the process returns to step 910.

[0070] In some embodiments, one or more of the steps described above may be omitted or performed in a different order, and additional steps may be added. For example, in some embodiments, the system operates in a fully autonomous mode, requiring no input from the user. In other embodiments, adaptive scaling based on tube size occurs only when a specific control is activated (e.g., when input is typed on a user input device). In still other embodiments, the adaptive scaling feature is a toggle key that can be turned on and off by the user via a user interface. In some embodiments, the steps of method 900 are performed in real time. In other embodiments, the steps of method 900 are performed at a later time, after a series of intraluminal images have been obtained. For example, the steps of method 900 may be performed during a post-retraction review of images obtained during a retraction sequence. In some embodiments, the system is configured to generate a longitudinal cross-sectional image, such as an ILD, based on multiple radial cross-sectional intraluminal images (e.g., tomographic images) (which have been scaled according to the methods and schemes described above).

[0071] Applications of the adaptive vascular visualization system include IVUS education, the use of the IVUS system to treat peripheral vascular (PV) diseases, and linking with other IVUS navigation and visualization systems (Philips' Vessel Navigator).

[0072] Figure 9 This is a schematic diagram of processor circuitry 1250 according to various aspects of this disclosure. Processor circuitry 1250 may be implemented in ultrasound imaging system 100, or in other devices or workstations (e.g., third-party workstations, network routers, etc.) required to implement one or more methods disclosed herein (including method 900). As shown, processor circuitry 1250 may include processor 1260, memory 1264, and communication module 1268. These components may communicate directly with each other or indirectly, for example, via one or more buses.

[0073] Processor 1260 may include any combination of a central processing unit (CPU), digital signal processor (DSP), ASIC, controller, or general-purpose computing device, simplified instruction set computing (RISC) device, application-specific integrated circuit (ASIC), field-programmable gate array (FPGA), or other related logic device, including mechanical and quantum computers. Processor 1260 may also include another hardware device, firmware device, or any combination thereof configured to perform the operations described herein. Processor 1260 may also be implemented as a combination of computing devices, such as a combination of a DSP and a microprocessor, multiple microprocessors, one or more microprocessors cooperating with a DSP core, or any other such configuration.

[0074] Memory 1264 may include cache memory (e.g., cache memory of processor 1260), random access memory (RAM), magnetoresistive RAM (MRAM), read-only memory (ROM), programmable read-only memory (PROM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), flash memory, solid-state storage devices, hard disk drives, other forms of volatile and non-volatile memory, or combinations of different types of memory. In one embodiment, memory 1264 includes a non-transitory computer-readable medium. Memory 1264 may store instructions 1266. Instructions 1266 may include instructions that, when executed by processor 1260, cause processor 1260 to perform the operations described herein (including one or more steps of method 900). Instructions 1266 may also be referred to as code. The terms “instruction” and “code” should be interpreted broadly to include any type of computer-readable statement. For example, the terms “instruction” and “code” may refer to one or more programs, routines, subroutines, functions, procedures, etc. "Instructions" and "codes" may include a single computer-readable statement or many computer-readable statements.

[0075] The communication module 1268 may include any electronic circuitry and / or logic circuitry to facilitate direct or indirect data communication between the processor circuitry 1250 and other processors or devices. In this regard, the communication module 1268 may be an input / output (I / O) device. In some cases, the communication module 1268 facilitates direct or indirect communication between the processor circuitry 1250 and / or various components of the ultrasound imaging system 100. The communication module 1268 can communicate within the processor circuitry 1250 via a variety of methods or protocols. Serial communication protocols may include, but are not limited to, US SPI, I... 2C. Serial and parallel communication may be carried out using methods or protocols such as 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 communication may be bridged via UART, USART, or other suitable subsystems.

[0076] External communication (including but not limited to software updates, firmware updates, preset sharing between the processor and central server, or readings from the ultrasound device) can be accomplished using any suitable wireless or wired communication technology, such as cable interfaces (e.g., USB, micro USB, Lightning, or FireWire), Bluetooth, Wi-Fi, ZigBee, Li-Fi, or cellular data connections (e.g., 2G / GSM, 3G / UMTS, 4G / LTE / WiMax, or 5G). For example, Bluetooth Low Energy (BLE) radios can be used to establish connections to cloud services for data transfer and for receiving software patches. The controller can be configured to communicate with remote servers or local devices (e.g., laptops, tablets, or handheld devices) and may include a display capable of showing status variables and other information. Information can also be transmitted over physical media, such as USB flash drives or memory sticks.

[0077] Numerous variations are possible within the examples and embodiments described above. For instance, the adaptive tube visualization system can be used within anatomical systems of the body other than those described, or for imaging other types of diseases, objects, or procedures. The techniques described herein can be applied to different types of intraluminal imaging sensors (such as OCT), whether currently existing or developed in the future. In some embodiments, the diameter or area of ​​the tube is determined based on co-registered angiographic images. For example, U.S. Patent Nos. 7,930,014 and 8,298,147 describe various aspects of co-registration, the entire contents of which are incorporated herein by reference.

[0078] Therefore, the logical operations constituting embodiments of the technology described herein are referred to differently as operations, steps, objects, elements, components, or modules. Furthermore, it should be understood that these operations may occur in any order unless explicitly required otherwise, or the language of the requirement inherently necessitates a specific order.

[0079] All directional references, such as up, down, inside, outside, upward, downward, left, right, side, front, back, top, bottom, above, below, vertical, horizontal, clockwise, counterclockwise, near, and far, are used only for identification purposes to aid the reader in understanding the claimed subject matter and do not impose limitations, particularly regarding the location, orientation, or use of the adaptive tube visualization system. The terms "connection," such as attachment, link, joint, and engagement, should be interpreted broadly and may include intermediate members located between sets of elements and relative movement between elements, unless otherwise stated. Therefore, the term "connection" does not necessarily mean that two elements are directly connected and mutually fixed. The term "or" should be interpreted as "and / or," not "exclusively or." Unless otherwise stated in the claims, numerical values ​​should be interpreted as illustrative only and should not be considered restrictive.

[0080] The foregoing specification, examples, and data provide a complete description of the structure and use of exemplary embodiments of the adaptive tube visualization system as defined in the claims. Although various embodiments of the claimed subject matter have been described above with reference to certain features or individual examples, those skilled in the art can make many changes to the disclosed embodiments without departing from the spirit or scope of the claimed subject matter. Other embodiments are also contemplated. All matters contained in the foregoing description and shown in the drawings should be interpreted as merely illustrative of particular embodiments and not as limiting. Changes to details or structure may be made without departing from the essential elements of the subject matter as defined in the following claims.

Claims

1. An intraluminal imaging system, comprising: An intraluminal imaging device, configured to be positioned within the lumen of a patient's body; and Processor circuitry that communicates with the intraluminal imaging device, wherein the processor circuitry is configured to: Receives a first intraluminal image of the body cavity obtained at a first location within the body cavity from the intraluminal imaging device; Receive second intraluminal images obtained at different second locations within the body lumen, wherein the anatomical features of the body lumen are different in size at the second location compared to their size at the first location; Calculate the first dimension of the anatomical feature based on the first intraluminal image; The scaling factor of the first intraluminal image is calculated based on the first size of the anatomical features; The image inside the first lumen is scaled using the scaling factor; The second dimension of the anatomical feature is calculated based on the second intraluminal image; Based on the second size, the second intraluminal image is scaled so that the anatomical features are represented at the same size in both the scaled second intraluminal image and the first intraluminal image; as well as The scaled images of the first and second lumens are output to a display that communicates with the processor circuitry.

2. The system according to claim 1, wherein, The anatomical features include the tube wall.

3. The system according to claim 1, wherein, The dimension mentioned is the diameter.

4. The system according to claim 1, wherein, The dimension referred to is the cross-sectional area.

5. The system according to claim 1, wherein, The processor circuitry is configured to automatically scale the image within the first lumen.

6. The system according to claim 1, wherein, The processor circuitry is configured to scale the first intraluminal image based on input from a user interface that communicates with the processor circuitry.

7. The system according to claim 1, wherein, The processor circuitry is configured to scale the first intraluminal image by changing the field of view of the intraluminal imaging device.

8. The system according to claim 1, wherein, The processor circuitry is configured to scale the first intracavitary image by changing the magnification of the first intracavitary image on the display.

9. The system according to claim 1, wherein, The processor circuit is configured to scale the image inside the first lumen in real time using the scaling factor.

10. A method for scaling an intraluminal image during review, the intraluminal image being stored in the memory of a processing system, the method comprising: Receive a first intraluminal image of the body lumen at a first location within the patient's body lumen; Receive second intraluminal images obtained at different second locations within the body lumen, wherein the anatomical features of the body lumen are different in size at the second location compared to their size at the first location; Calculate the first dimension of the anatomical feature based on the first intraluminal image; The scaling factor is calculated based on the first dimension according to the anatomical features; The image inside the first lumen is scaled using the scaling factor; The second dimension of the anatomical feature is calculated based on the second intraluminal image; Based on the second size, the second intraluminal image is scaled so that the anatomical features are represented at the same size in both the scaled second intraluminal image and the first intraluminal image; as well as The scaled images of the first and second lumens are output to the display.

11. The method according to claim 10, wherein, The anatomical features include the tube wall or lumen.

12. The method according to claim 10, wherein, The dimension refers to the diameter or cross-sectional area.

13. The method according to claim 10, wherein, The scaling of the image within the first lumen is automatic.

14. The method of claim 10, wherein, The scaling of the first intraluminal image occurs based on input from the user interface.

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