Image with adjustable anatomical planes

Abstract

The present invention relates to providing image data of an adjustable anatomical plane. An apparatus for providing image data of an adjustable anatomical plane is provided, the apparatus having a data input, a data processor, a user interface, and an output interface. The data input receives 3D image data of a region of interest of a subject. The data processor establishes an anatomical context for identifying anatomical reference positions in the 3D image data, generates a reference coordinate system based on the identified anatomical reference positions, defines anchor points, and calculates a viewing plane as a selected anatomical imaging plane based on the anchor points and at least one plane-related parameter. The user interface inputs, by a user, at least one plane-related parameter for determining the viewing plane as the selected anatomical imaging plane. The output interface provides a representation of a view in the selected anatomical imaging plane.

Description

[Technical field]

[0001] The present invention relates to an apparatus for providing adjustable anatomical plane image data, a system for intervention planning, a method for providing adjustable anatomical plane image data, and a computer program and computer readable medium for providing adjustable anatomical plane image data. [Background technology]

[0002] As an example, during an intervention on the mitral valve, a physician may use 3D ultrasound to image the structure. To understand the anatomical structure, or to estimate relevant anatomical parameters, or to plan / guide the intervention, a physician needs to evaluate the target structure at a specific location. In one example, pre-defined view planes are created in the 3D volume where the relevant information is visible. Manual definition can be a tedious process. In another example, the view planes are coded in the model, and after segmentation, the pre-coded planes can be retrieved. However, it can be difficult to code all potentially relevant planes in the model. Summary of the Invention [Problem to be solved by the invention]

[0003] Therefore, there may be a need to provide a more user-friendly way of viewing an image in a selected viewing plane. [Means for solving the problem]

[0004] The object of the present invention is solved by the subject matter of the independent claims, further embodiments are incorporated in the dependent claims. It is noted that the below described aspects of the invention also apply to a device for providing adjustable anatomical planar image data, a system for intervention planning and a method for providing adjustable anatomical planar image data.

[0005] According to the present invention, an apparatus for providing image data of an adjustable anatomical viewing plane is provided. The apparatus includes a data input, a data processor, a user interface, and an output interface. The data input is configured to receive 3D image data of a region of interest of a subject. The data processor is configured to establish an anatomical context for identifying an anatomical reference position within the 3D image data. The data processor is also configured to generate a reference coordinate system based on the identified anatomical reference position. The data processor is further configured to define an anchor point. The data processor is further configured to calculate the viewing plane as a selected anatomical imaging plane based on the anchor point and at least one plane-related parameter. The data processor is configured to set the anchor point using the established anatomical knowledge. The user interface is configured to input at least one plane-related parameter for determining the viewing plane as the anatomical imaging plane selected by a user. The output interface is configured to provide a representation of a view within the selected anatomical imaging plane.

[0006] As an effect, users are provided with an easy and hassle-free way to achieve different viewing surfaces that can be customized to their particular needs.

[0007] In another claimed option, an apparatus for providing image data of an adjustable anatomical viewing plane is provided. The apparatus has a data input, a data processor, a user interface, and an output interface. The data input is configured to receive 3D image data of a region of interest of a subject. The data processor is configured to establish an anatomical context for identifying anatomical reference positions within the 3D image data. The data processor is also configured to generate a reference coordinate system based on the identified anatomical reference positions. The data processor is further configured to define anchor points. The data processor is further configured to calculate the viewing plane as a selected anatomical imaging plane based on the anchor points and the at least one plane-related parameter. The user interface is configured to input the at least one plane-related parameter for determining the viewing plane as the anatomical imaging plane selected by a user. The output interface is configured to provide a representation of a view within the selected anatomical imaging plane.

[0008] According to one example, the output interface includes a display configured to display the selected plane. As an additional or alternative option, the user interface includes an adjustment control element configured to adjust a position of the displayed plane. The data processor is configured to provide the adjustment in real time.

[0009] According to one example, the display is configured to display a control image indicating the spatial location of the selected plane within an anatomical context.

[0010] According to one example, the anchor point defines a point that is visible in all possible planes when the user rotates the plane, eg, a point around which the view plane is rotated.

[0011] Alternatively or additionally provided, optionally, the at least one plane-related parameter comprises at least one of an angle, a line of sight direction, one or more image lines, and one or more groups of image points.

[0012] According to one embodiment, the anchor point is predefined, such as the midpoint between the anterior lateral commissure and the posteromedial commissure. The anchor point is provided to establish the point around which the (viewing) plane is rotated. In one example, the user shifts the anchor point from a default position along a perpendicular to the AL-PM direction, which can be defined by the user. After the anchor point is defined, the user defines an angle, for example, either by a specific value or using a slider, which is the angle that determines the actual plane as the viewing plane. The angle may be provided as a deviation from the perpendicular to the AL-PM direction. As an example, the angle is the actual perpendicular direction when it is 0.

[0013] According to one example, to establish the anatomical context, the data processor is configured to segment the 3D image data to provide a segmentation of at least a portion of the 3D image data, and the data processor is also configured to establish the anatomical context for identifying anatomical reference locations within the 3D image data based on the segmentation.

[0014] Optionally, for segmenting the 3D image data, the data input is configured to receive an anatomical model, and the data processor is configured to fit the model to the 3D image data and base the segmentation on the fitted model.

[0015] In an additional or alternative option for establishing the anatomical context, the data processor is configured to provide a machine learning approach having at least one of the following group: machine learning, deep learning, and convolutional neural networks to classify voxels or detect landmarks.

[0016] According to one example, the data processor is configured to define a reference system with a first direction along the mitral valve plane normal, a second direction along the anterior-lateral and posteromedial directions, and a third direction modified accordingly.

[0017] In one example, the data processor is configured to apply a user-selected view for a plurality of interventions. The plurality of interventions may be provided as pre-selected interventions. The interventions may also be referred to as dedicated interventions.

[0018] According to the invention, a system for intervention planning is also provided, which comprises a device for providing image data of an adjustable anatomical viewing plane according to one of the preceding claims, and also comprises an imaging device for providing an image of a region of interest of an object, which imaging device is configured to generate image data of the object and to supply the image data to the device for providing image data of the adjustable anatomical plane.

[0019] According to one example, the imaging device is an ultrasound imaging device configured to provide 3D ultrasound data.

[0020] Optionally, the ultrasound imaging device is configured to acquire 2D ultrasound images according to a selected anatomical imaging plane.

[0021] According to the present invention there is also provided a method for providing image data of an adjustable anatomical viewing plane, the method comprising the steps of: - In a first step, 3D image data of a region of interest of a subject is received. In a second step, an anatomical context for identifying anatomical reference positions within the 3D image data is established. In a third step, a reference coordinate system is generated based on the identified anatomical reference positions. In a fourth step, anchor points of the observation plane are established. The anchor points are set using established anatomical knowledge. In a fifth step, at least one plane-related parameter for determining the observation plane as the selected anatomical imaging plane is input by the user. In a sixth step, a viewing plane as the selected anatomical imaging plane is calculated based on the anchor points and at least one plane-related parameter. In a seventh step, a representation of the selected anatomical imaging plane is provided.

[0022] In another claimed option, a method for providing image data of an adjustable anatomical viewing plane is provided. The method has the following steps: In a first step, 3D image data of a region of interest of a subject is received. In a second step, an anatomical context for identifying anatomical reference positions in the 3D image data is established. In a third step, a reference coordinate system is generated based on the identified anatomical reference positions. In a fourth step, an anchor point of the viewing plane is established. In a fifth step, at least one plane-related parameter for determining the viewing plane as a selected anatomical imaging plane is input by a user. In a sixth step, the viewing plane as a selected anatomical imaging plane is calculated based on the anchor point and the at least one plane-related parameter. In a seventh step, a representation of the selected anatomical imaging plane is provided.

[0023] According to one example, a pre-set / already defined anchor point is provided, i.e. available, such as a midpoint between AL and PM, which can then be adjusted / modified along the normal to the AL-PM direction. The pre-set / already defined anchor point may be provided by the system itself or may be adjusted by user input.

[0024] As an example, the anchor point is set by the system. Optionally, the location is between the commissures or at the center of the mitral valve. Optionally, the system sets the anchor point using anatomical knowledge from the system and knowledge of the intended procedure.

[0025] As another example, further adjustments to the anchor points are possible, such as by the system or by the user.

[0026] After the anchor points are set, the definition of potential viewing planes is left with one degree of freedom, such as the viewing angle. This provides the potential planes as shown in Fig. 6. Furthermore, to select exactly one of the remaining potential planes, possible inputs are provided, e.g. i) a numerical angle value, potentially controlled by a slider, or ii) the point of maximum regurgitation, or iii) another anatomical point derived from the model / segmentation, e.g. an estimate of the location associated with different regions of the mitral valve, e.g. designated A1, A2, A3, P1, P2, P3, or iv) a point clicked by the user on the 3D model.

[0027] According to one embodiment, imaging with adjustable anatomical planes is provided by establishing a frame of reference based on anatomical features. By providing one degree of freedom for the imaging plane, the user can adapt the viewing plane in an intuitive manner to tailor the presentation to the current intervention and the needs of the user.

[0028] These and other aspects of the invention will be apparent from and elucidated with reference to the embodiments described hereinafter.

[0029] Exemplary embodiments of the invention are described below with reference to the following drawings: [Brief description of the drawings]

[0030] [Figure 1] 1 illustrates a schematic diagram of an example of an apparatus for providing image data of an adjustable anatomical viewing plane. [Diagram 2] 2 illustrates an example of a system for intervention planning using an example of an apparatus for providing image data of the adjustable anatomical viewing plane of FIG. 1. [Diagram 3] 1 illustrates an example of method steps for providing image data of an adjustable anatomical viewing plane. [Figure 4] 1 illustrates exemplary steps of a procedure for providing image data of an adjustable anatomical viewing plane. [Diagram 5] 1 shows an example of a provided graphical user interface. [Figure 6] 4 shows further examples of graphical user interfaces that may be provided. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0031] Certain embodiments will now be described in detail with reference to the accompanying drawings. In the following description, like drawing reference numbers are used for like elements in different drawings. Matters defined herein, such as detailed configurations and elements, are provided to aid in a comprehensive understanding of the exemplary embodiments. Also, well-known functions or configurations will not be described in detail since they would obscure the embodiments in unnecessary detail. Furthermore, phrases such as "at least one of," when preceding a list of elements, modify the entire list of elements and do not modify individual elements of the list.

[0032] FIG. 1 shows a schematic diagram of an example of an apparatus 10 for providing image data of an adjustable anatomical viewing plane. The apparatus 10 has a data input 12, a data processor 14, a user interface 16, and an output interface 18. The data input 12 is configured to receive 3D image data of a region of interest of a subject. The data processor 14 is configured to establish an anatomical context for identifying anatomical reference positions in the 3D image data. The data processor 14 is also configured to generate a reference coordinate system based on the identified anatomical reference positions. The data processor 14 is further configured to define anchor points. The data processor 14 is further configured to calculate the viewing plane as a selected anatomical imaging plane based on the anchor points and at least one plane-related parameter. The data processor 14 is configured to set the anchor points using the established anatomical knowledge. The user interface 16 is configured to input at least one plane-related parameter for determining the viewing plane as an anatomical imaging plane selected by a user. The output interface 18 is configured to provide a representation of a view in the selected anatomical imaging plane.

[0033] A first arrow 24 indicates the input of 3D image data of a region of interest of the subject, for example from a database or an imaging device. A second arrow 26 indicates the output of a representation of a view in a selected anatomical plane.

[0034] Frame 28 indicates that data input 12, data processor 14, user interface 16, and output interface 18 may be located within a common housing or structure. In another option, data input 12, data processor 14, user interface 16, and output interface 18 are provided as separate components that are data connected to one another.

[0035] Fig. 2 shows an example of a system 100 for intervention planning. The system 100 comprises an example of the apparatus 10 for providing adjustable anatomical plane image data of Fig. 1. The system 100 also comprises an imaging apparatus 102 for providing an image of a region of interest of an object. The imaging apparatus 102 is configured to generate image data of the object and to provide the image data to the apparatus for providing the adjustable anatomical plane image data.

[0036] Optionally, the imaging device 102 is an ultrasound imaging device configured to provide 3D ultrasound data. A mobile ultrasound transducer 104 is shown for imaging an object 106. Optionally, the ultrasound imaging device is configured to acquire 2D ultrasound images according to a selected anatomical imaging plane.

[0037] 2 also shows a table-like object support 108 having a control panel 110 beside the object support 108. Additionally, an adjustable lighting device 112 is shown suspended from a rail structure mounted to the ceiling. Additionally, a monitoring device 114 is also provided that is suspended from the rail structure mounted to the ceiling.

[0038] The apparatus 10 for providing image data may be provided in the context of an operator console or control arrangement, shown in the right foreground. A display 116 is shown along with a keyboard 118, a mouse 120, a control panel 122, and a graphics tablet 124. The imaging device 102 is in data communication with the apparatus 10 for providing image data in an adjustable anatomical plane, as shown by the connecting line 124.

[0039] The system 100 for intervention planning may also be referred to as a system for intervention guidance.

[0040] In an option not shown, the imaging device is an X-ray imaging device configured to provide 3D X-ray imaging data, such as CT data.

[0041] Optionally, the acquired 2D view is an additional step once the adapted view plane is provided, so to speak in addition to the 2D view in the form of the adapted image plane, but with a better quality acquired 2D view.

[0042] In another option, the acquired 2D view is provided once the adapted view plane is defined, but is not actually provided: the acquired 2D view is so to speak provided as an adapted view plane instead of a 2D view in the form of an adapted image plane, but the acquired 2D view has a better quality, as a direct presentation of the adapted image plane would have.

[0043] In one embodiment, 3D image data, e.g., ultrasound image data, is acquired and based on the geometric information, reformatting is provided within the 3D volume to select and display selected planes without further ultrasound image data acquisition. In one example, an ultrasound imaging system may provide higher ultrasound image quality in 2D than image data in 3D. Providing an option to acquire 2D images along a selected and determined viewing plane allows a user, such as a physician, to provide 2D images with an increased degree of detail at a particular location (where the viewing plane is adapted). In addition to reformatting the 3D volume, by achieving a defined 2D viewing plane, controlling the ultrasound imaging device to acquire a particular 2D view according to a current user selection is provided.

[0044] In one example, it is provided that an apparatus is configured for the following steps. First, a 3D volume is acquired and analyzed to provide a frame of reference; - Second, the user selects the desired 2D viewing plane orientation.

[0045] Then, either a slide through the acquired 3D volume at that position is shown, or a smaller echo volume covering the selected plane with a higher frame rate and / or image quality is reacquired (assuming the ultrasound probe is still in the same position and the reference frame still matches the anatomy). Options for reacquisition are provided: acquiring the exact plane in 2D mode if geometrically possible, i.e. if it intersects with the transducer position, acquiring a 2D plane as close as possible to the selected plane at the position of the mitral annulus, e.g. a plane defined by the intersection of the selected plane with the mitral annulus plane (defining a line) + probe position (defining a plane in combination), and acquiring a smaller 3D volume, e.g. a thin slab that completely includes the selected plane. Since the scanning volume is smaller, e.g. the frame rate can be higher.

[0046] In one example, an apparatus 10 for providing adjustable anatomical planar image data is provided for cardiac intervention, such as a valve repair or replacement procedure.

[0047] The data input 12 is responsible for providing image data to the processor 14. Thus, the image data is received from a data supply or data source and forwarded to the data processing. The image data may be provided directly from an imaging device or from a data storage device. The data input 12 is also referred to as a data image input or an image data input unit or a data receiving module.

[0048] The data processor 14 relates to a device for processing data, i.e. for calculation steps for processing data. The data processor 14 is also called a processing unit or a calculation unit or a processing module.

[0049] The user interface 16 relates to a device for enabling user interaction, such as inputting control commands for data processing. An example of data input is inputting at least one plane-related parameter. Another example of data input is selection or modification of an observation or imaging plane. The user interface 16 is also referred to as a user interaction unit or a user interaction module.

[0050] The at least one plane-related parameter includes at least one of an angle, a line of sight direction, one or more image lines, and one or more groups of image points.

[0051] The output interface 18 is concerned with providing the calculated image plane data, for example for display purposes, and is also referred to as a processed data supply or output unit or output module.

[0052] In the first option, "representation of a view in a selected anatomical imaging plane" refers to the generation of a 2D image from the 3D image data in a 2D viewing plane.

[0053] In a second option, which is additionally or alternatively provided, "representation of a view in a selected anatomical imaging plane" refers to the targeted acquisition of a 2D ultrasound image in a 2D viewing plane.

[0054] Optionally, the user interface 16 and the output interface 18 are provided together as an interactive user interface (not shown in detail).

[0055] The adjustable anatomical plane image data may also be referred to as an adjustable anatomical plane representation.

[0056] As a result, the present invention provides a versatile anatomical plane for intervention planning with a single degree of freedom. As an effect, during the intervention, the physician can focus on the procedure, since he is not forced to deal with multiple measurement systems during the intervention, which is difficult and error-prone. Thus, the user is provided with the option to determine whatever viewing plane is required, which means a more user-friendly way of providing data than, for example, refining pre-coded planes.

[0057] To this end, information is extracted from the model for specific relevant structures, and the remaining refinements to achieve the most appropriate view are selected by the user. This can be done for each problem at hand.

[0058] In one example, anchor points of the observation plane are determined, respectively defined, ie the data processor 14 is further configured to determine or define the anchor points.

[0059] In one example, a common reference frame and user interface for multiple mitral valve interventions is provided. From the segmentation, several anatomical constraints are defined.

[0060] For example, the normal direction of the mitral valve and an anchor point about which the plane is rotated are defined.

[0061] For example, the center of the mitral valve can be defined and then anchor points can be defined relative to the center and normal direction of the mitral valve.

[0062] With a single control, such as a slider, the user can adjust the plane to cover a set of anatomically interesting locations, e.g., a plane that cuts primarily on a direct path from the anterior leaflet to the posterior leaflet. By simply selecting the anchor point and plane-related parameters, such as an optional angle, the method can be applied to interventions that directly target the mitral leaflets, or procedures that target the mitral annulus. In one example, the user interface and associated anatomical boundaries are the same for both procedures. For example, the initial position may be a reference view along the AP direction at the center of the mitral valve, and a specific position of the slider may correspond to a plane that cuts the commissures. Furthermore, in one example, external information is included in the same reference frame, i.e., setting the plane to the location of the tracked device or the location where high regurgitation is detected. Such locations can be encoded in the reference coordinate system, so that the user control can be updated and the physician can navigate further from there.

[0063] In one example, for segmentation, data processor 14 has a segmenter, also referred to as a segmentation unit. In another example, for setting a reference coordinate system, data processor 14 has a geometric post-processing definer, also referred to as a geometric post-processing unit. The geometric post-processing definer or the geometric post-processing unit can be provided as separate processors or integrated into a common processor circuit. In yet another example, for calculation of a view plane, data processor 14 has a view plane updater, also referred to as a view plane update unit.

[0064] In an option also shown in FIG. 1, the output interface 18 includes a display 20 configured to display the selected plane.

[0065] In another option, also shown in FIG. 1, the user interface 16 has an adjustment control element 22, such as a slider or knob, or a virtual representation on a touch-sensitive display interface, configured to adjust the position of the displayed plane through user interaction.

[0066] By way of example, data processor 14 is configured to provide adjustments in real-time, the term "real-time" referring to updates within a period that a user would accept as negligible, for example less than 5 seconds, for example less than 2 seconds or less than 1 second.

[0067] In one example, the user interface 16 has a slider element that controls the angle between the central direction and the displayed plane. The central direction can be further defined as a perpendicular plane to the commissure plane that passes through the mitral valve center.

[0068] In one example, the user interface 16 includes a slider element that controls the angle of the displayed surface.

[0069] If the plane is adjusted by forcing it to cut through a well-defined anatomical point, e.g., an area of ​​high reflux, this plane position corresponds to an angle in a defined coordinate system, and the slider can be adjusted to that angular position. The user can then further manipulate the plane from this position.

[0070] In one example, the variable view plane unit is represented by an interface that can take as input either an angle value or a point selected by the user. This is used to calculate a new view plane, and in the latter case the angle from the given point is also calculated and updated. In one example, an interactive component for modifying the view is provided.

[0071] In one example, the anchor point defines a point that is visible in all possible planes and about which rotation occurs when a user rotates a plane.

[0072] To establish the anatomical context, the data processor 14 may be configured as follows. - segmenting the 3D image data to provide a segmentation of at least a portion of the 3D image data; Establishing an anatomical context for identifying anatomical reference locations within the 3D image data based on the segmentation; Optionally, i) for segmenting the 3D image data, the data input 12 is adapted to receive an anatomical model and the data processor 14 is adapted to adapt the model to the 3D image data and to base the segmentation on the adapted model; and / or ii) To establish the anatomical context, the data processor 14 is configured to provide a machine learning approach having at least one of the following group: machine learning, deep learning, and convolutional neural networks to classify voxels or detect landmarks.

[0073] In a first approach, a model is used for segmentation of image data. In one example, the model has labels to indicate certain anatomical features, such as anatomical landmarks. As a result, segmented image data of the patient is provided, and in addition, geometric landscape landmarks can also be provided.

[0074] In the second approach, machine learning algorithms provide the knowledge to identify anatomical structures in image data.

[0075] In one example, to generate the reference coordinate system, the data processor 14 i) the location of the mitral valve commissures, having at least one of the following groups: an anterior-lateral mitral valve commissure and a posteromedial mitral valve commissure; ii) perpendicular to the mitral valve plane, and iii) a point representing the center of the mitral valve; The at least one of the groups is configured to provide

[0076] In one example, the direction perpendicular to the mitral valve plane is provided as approximately perpendicular to the mitral valve plane. By way of example, the term approximately relates to a maximum deviation of up to + / - 25°, such as up to + / - 10°, or up to + / - 5°. In one example, to determine a direction perpendicular to the mitral valve plane, such as an approximately normal direction, data processor 14 is configured to determine a regression plane that fits through at least a portion of all apexes of the mitral valve annulus, or by taking the cross product between a vector connecting the anterior and posterior ends of the mitral valve commissures and a vector connecting the anterior-lateral and posterior-medial ends.

[0077] In one example, the data processor 14 is configured to define a reference system with a first direction along the mitral valve plane normal, a second direction along the anterior-lateral and posteromedial directions, and a third direction modified accordingly.

[0078] The anterolateral and posteromedial directions refer to the direction from the anterolateral commissure to the posteromedial commissure.

[0079] The data processor 14 may be configured to use information regarding the location of the actual high reflux flow to set the plane position.

[0080] Optionally, display 20 is configured to display a control image that indicates the spatial location of the selected plane within an anatomical context.

[0081] The term spatial location refers to the position and orientation in space with respect to an anatomical structure.

[0082] The data processor 14 is configured to apply user-selected views for multiple interventions.

[0083] In one example, the data processor 14 is configured to apply the user-selected view plane to other imaging modalities as well.

[0084] 3 illustrates an example of steps of a method 200 for providing image data of an adjustable anatomical plane. The method includes the following steps: In a first step 202, receiving 3D image data of a region of interest of a subject is provided. In a second step 204, an establishment of an anatomical context for identifying anatomical reference positions within the 3D image data is provided. In a third step 206, the generation of a reference coordinate system based on the identified anatomical reference positions is provided. In a fourth step 208, establishing anchor points of the observation plane is provided. The anchor points are set using established anatomical knowledge. In a fifth step 210, input of at least one plane-related parameter for determining the observation plane as the anatomical imaging plane selected by the user is provided. In a sixth step 212, there is provided a calculation of a viewing plane as a selected anatomical imaging plane based on the anchor points and at least one plane-related parameter. In a seventh step 214, providing a representation of the selected anatomical imaging plane is provided.

[0085] The generation of the reference coordinate system is also called setting of the reference coordinate system.

[0086] In one example, anchor points of the viewing plane are determined and respectively defined.

[0087] In one example, an anchor point such as the midpoint between the anterior lateral commissure and the posteromedial commissure is provided as a default option, i.e., determined by the system.

[0088] In another example, the anchor point is shifted by the user from the default option along a direction perpendicular to the direction from the anterior lateral commissure to the posteromedial commissure to determine the observation plane as the selected anatomical imaging plane.

[0089] In one example, as at least one plane-related parameter, the user inputs a viewing angle. In one example, the user inputs a line of sight direction, or one or more image lines, or one or more image points. For example, the user inputs or adapts the viewing angle or other plane-related parameter via a slider or by inputting a specific value.

[0090] In another example, the plane-related parameter is an image point. An example of an image point is a point in 3D image data. Another example of an image point is a point determined from an anatomical model, such as the A1 or A2 anatomical point. In one example, an image line is defined by two geometric points in the image space. In another example, the image content is considered for an image line, for example defined by an image gradient.

[0091] The anchor point defines a point that is visible in all possible planes as the user rotates the plane. As also described below, in one example, the anchor point determines which plane is provided for treatment. With the selected anchor point fixed, the user still has one degree of freedom, e.g., angle, clicked point, or high reflux location, to fully define the plane.

[0092] The anchor point may also be referred to as a reference position.

[0093] In one example of the method, the anchor point or reference position for determining the viewing plane can be adjusted by the user.

[0094] In one example, the selection of the anchor point is used to determine which plane is provided for which procedure, for example, a cardioband procedure or a mitral annulus procedure.

[0095] In another example, shifting of the anchor point relative to the mitral valve center is allowed while maintaining the same vertical orientation midway between the projected commissures.

[0096] In one example, the anchor point or reference position is changed by angling or defining another point instead of the mitral valve center, and then a new view is defined.

[0097] As an example, the angle is provided by a user slider that does not change, for example, the anchor point.

[0098] In one example, the image data is ultrasound image data.

[0099] In one example of the method, a step of segmenting the 3D image data is provided that provides a segmentation of at least a portion of the 3D image data to establish an anatomical context. Establishing the anatomical context for identifying anatomical reference locations within the 3D image data is based on the segmentation.

[0100] In one example of the method, an anatomical model is provided for segmenting the 3D image data. Optionally, the model is fitted to the 3D image data. In another option, the segmentation is based on the fitted model.

[0101] In one example, after adaptation of the model to the image, anatomical reference locations are extracted from the model, for example, by looking at which mesh triangles or vertices propagate along a particular set of anatomical labels. For example, this can be the location of the mitral annulus, leaflets, commissures, or center of the mitral valve.

[0102] In one example of the method, a machine learning approach is provided having at least one of the group of deep learning and convolutional neural networks to classify voxels or detect landmarks to establish anatomical context.

[0103] In one embodiment of the method, for generating a reference coordinate system, i) the location of the mitral valve commissures, including at least one of the group of anterior-lateral mitral valve commissure and posteromedial mitral valve commissure; ii) perpendicular to the mitral valve plane; iii) a point representing the center of the mitral valve; At least one of the groups is provided.

[0104] In one example of this method, to determine a direction perpendicular to the mitral valve plane, a regression plane is determined to be fitted through at least a portion of all apexes of the mitral valve annulus, or by taking the cross product between a vector connecting the anterior and posterior ends of the mitral valve commissures and a vector connecting the anterior lateral and posteromedial ends.

[0105] In one example, a point representing the center of the mitral valve is provided as an average of at least a portion of all of the mitral annular apexes.

[0106] In one example of the method, the reference system is defined by a first direction along the mitral valve plane normal, a second direction along the anterior-lateral and posteromedial directions, and a third direction modified accordingly.

[0107] In one example, the third direction is perpendicular to the anterolateral and posteromedial directions in a plane defined by the mitral valve normal, also referred to as the reference direction or 0° plane.

[0108] In one example of this method, information about the location of actual high reflux is used to set the plane position.

[0109] For example, results from a previous evaluation of the flow in another tool may be used to set the plane position.

[0110] In another example, anatomical points from the segmentation are used to set a plane location, for example the center of the scallop of the posterior mitral leaflet, such as "P1."

[0111] As an example, the adaptation of the view surface is provided for products and systems directed to intervention planning, such as ultrasound application for cardiac interventions. The adaptation of the view surface may also be implemented within a cloud-based service or application.

[0112] In one example, information regarding the strength of the regurgitant jet at different plane angles is visible in or near the control slider. For example, the complete slider can have color-coded shading, with the colors representing flow rates (red for high flow rates, blue for low flow rates, etc.). In one example, a base value is derived as the maximum flow velocity in the plane, or as an integral over the complete regurgitant jet visible in the plane.

[0113] Optionally, a step of saving the particular manually selected plane is provided so that the same view can be examined in relation to other objects for consistency without having to repeat the plane selection step. In one example, saving the particular manually selected plane is provided by saving the calculated angle and anchor point.

[0114] In a further option, the step of applying the particular manually selected plane to other imaging modalities is provided.

[0115] 4 illustrates exemplary steps of a procedure for providing image data of an adjustable anatomical plane. A first representation 300 of the anatomical structure is shown at the top left. A second representation 302 of the anatomical structure with a different perspective is shown at the top right. A third representation 304 of the anatomical structure is shown at the bottom left. A fourth representation 306 of the anatomical structure is shown at the bottom right.

[0116] In the top row, the mitral valve center 308 and the normal direction 310 to the mitral valve plane of the left side are shown along with the direction 312 from the anterolateral (AL) mitral valve commissure 314 to the posteromedial (PM) mitral valve commissure 316 .

[0117] In the bottom part the resulting reference system 318 is shown in the left and right part in which a plane can be defined. The reference system 318 is shown with three different axes. One of the axes, indicated with reference number 320, is the reference position used to define the observation plane.

[0118] 5 shows an example of a provided graphical user interface 322 showing a fifth representation 323 of the anatomy. The anterolateral mitral commissure 314 is shown, as is the posteromedial mitral commissure 316. The mitral valve center 308 is also shown. FIG 5 shows the anchor point 321 shifted as a result of user interaction.

[0119] Note that Figure 5 is also shown to depict and explain the position of the plane. In addition, as shown, the user interface is provided with a similar appearance.

[0120] FIG. 6 shows a further example of a graphical user interface 324 showing a sixth representation 325 of an anatomical structure. Again, the anterolateral mitral commissure 314 is shown as well as the posteromedial mitral commissure 316. Also, an anchor point is shown with reference number 319. The anchor point is located between the two commissures. A center line 326 shows a 0° angle line for defining a variable image plane by angle. A first line 328 to the right of the center line 326 shows a +10° angle line as an example, a second line 330 to the left of the center line 326 shows a -10° angle line as an example, and a third line 332 shows a -70° angle line as an example. A double arrow 334 shows an adjustment option for the viewing plane by changing the angle parameter.

[0121] The term "subject" may also be referred to as an individual. A "subject" may also be referred to as a patient, although it should be noted that this term does not indicate whether any illness or disease is actually present in the subject.

[0122] In another exemplary embodiment of the invention, a computer program or a computer program element is provided, characterized in that, on a suitable system, it is configured to carry out the method steps of the method according to one of the previous embodiments.

[0123] Thus, the computer program elements may be stored in a computing unit or distributed across one or more computing units that may be part of an embodiment of the present invention. This computing unit may be configured to execute or direct the execution of the steps of the above-mentioned method. Furthermore, it may be configured to operate the components of the above-mentioned apparatus. The computing unit may be configured to operate automatically and / or to execute a user's order. The computer program may be loaded into a working memory of a data processor. The data processor may thus be configured to execute the method of the present invention.

[0124] Aspects of the invention may be embodied in a computer program product, which may be a collection of computer program instructions stored on a computer-readable storage device that may be executed by a computer. The instructions of the invention may be any interpretable or executable code mechanism, including, but not limited to, a script, an interpretable program, a dynamic link library (DLL), or a Java class. The instructions may be provided as a complete executable program, a partial executable program, a modification (e.g., an update) to an existing program, or an extension (e.g., a plug-in) to an existing program. Additionally, parts of the processing of the invention may be distributed across multiple computers or processors.

[0125] As mentioned above, a processing unit, e.g., a controller, performs the control method. This controller can be implemented in various ways using software and / or hardware to perform the various functions required. A processor is one example of a controller that may employ one or more microprocessors that may be programmed using software (e.g., microcode) to perform the functions required. However, a controller may be implemented with or without a processor, or as a combination of dedicated hardware to perform some functions and a processor (one or more programmed microprocessors and associated circuitry) to perform other functions.

[0126] Examples of controller components that may be used in various embodiments of the present disclosure include, but are not limited to, conventional microprocessors, application specific integrated circuits (ASICs), and field programmable gate arrays (FPGAs).

[0127] This exemplary embodiment of the invention encompasses both computer programs that use the invention from the outset, and computer programs that convert existing programs by means of updates into programs that use the invention.

[0128] Moreover, the computer program element may be capable of providing all the steps required to fulfill the procedures of the exemplary embodiments of the methods described above.

[0129] According to a further exemplary embodiment of the present invention, a computer readable medium, such as a CD-ROM, is presented, having stored thereon a computer program element, which is described by the previous section. The computer program may be stored and / or distributed on a suitable medium, such as an optical storage medium or a solid-state medium, supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunications systems.

[0130] However, the computer program may also be presented over a network such as the World Wide Web and can be downloaded from such a network into the working memory of a data processor. According to a further exemplary embodiment of the invention, a medium for making available for downloading a computer program element is provided, this computer program element being configured to perform a method according to one of the aforementioned embodiments of the invention.

[0131] It should be noted that the embodiments of the present invention are described with reference to different subject matters. In particular, some embodiments are described with reference to method type claims, and other embodiments are described with reference to device type claims. However, those skilled in the art will understand from the above and the following description that, unless otherwise notified, any combination of features belonging to one type of subject matter, as well as any combination between features relating to different subject matters, is considered to be disclosed in this application. However, all features can be combined to provide a synergistic effect that is higher than the simple sum of the features.

[0132] While the invention has been illustrated and described in detail in the drawings and the foregoing description, such illustration and description are to be considered as illustrative or exemplary and not restrictive. The invention is not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention, from a study of the drawings, the disclosure and the dependent claims.

[0133] In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite article "a" or "an" does not exclude a plurality. A single processor or other unit may fulfill the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. Any reference signs in the claims should not be interpreted as limiting the scope.

Claims

1. A data input section; A data processor; A user interface; An output interface; 1. An apparatus for providing image data of an adjustable anatomical plane of a mitral valve having an anterior-lateral mitral valve commissure and a posteromedial mitral valve commissure, comprising: the data input is configured to receive 3D image data of a region of interest of a subject having the mitral valve; the data processor is configured to establish an anatomical context for identifying anatomical reference locations within the 3D image data, generate a reference coordinate system based on the identified anatomical reference locations, define predefined anchor points at positions between the anterior-lateral mitral valve commissure and the posteromedial mitral valve commissure, and calculate a view plane through the anchor points as a selected anatomical imaging plane based on at least one plane-related parameter; the user interface is configured to input the at least one plane-related parameter to determine the viewing plane as the selected anatomical imaging plane by a user; the output interface is configured to provide a representation of a view within the selected anatomical imaging plane. Device.

2. The user interface is configured to input a user entry to adjust the anchor point.

2. The apparatus of claim 1.

3. the output interface having a display configured to display the selected plane; the user interface having an adjustment control element configured to adjust a position of the displayed plane, and the data processor configured to provide the adjustment in real time.

2. The apparatus of claim 1.

4. The apparatus of claim 2 , wherein the display is configured to display a control image indicating the spatial location of the selected plane within the anatomical context.

5. the anchor point defines a point that is visible in all possible planes as the user rotates the plane; and / or the at least one plane-related parameter includes at least one of an angle, a line of sight direction, one or more image lines, and one or more groups of image points; 2. The apparatus of claim 1.

6. To establish the anatomical context, the data processor segmenting the 3D image data to provide a segmentation of at least a portion of the 3D image data; establishing an anatomical context for identifying the anatomical reference locations within the 3D image data based on the segmentation; It is configured as follows: i) for segmenting the 3D image data, the data input is configured to receive an anatomical model and the data processor is configured to fit the model to the 3D image data and to base the segmentation on the fitted model; and / or ii) to establish an anatomical context, the data processor is configured to provide a machine learning approach to classify voxels or detect landmarks, the machine learning approach comprising at least one of the following group: machine learning, deep learning, and convolutional neural networks; 2. The apparatus of claim 1.

7. To generate the reference coordinate system, the data processor i) a location of the mitral valve commissures, the location having at least one of the following groups: an anterior-lateral mitral valve commissure and a posteromedial mitral valve commissure; ii) perpendicular to the mitral valve plane; iii) a point representing the center of the mitral valve; and configured to provide at least one of the following groups:

2. The apparatus of claim 1.

8. 7. The apparatus of claim 6, wherein to determine a direction perpendicular to the mitral valve plane, the data processor is configured to determine a regression plane that is fitted through at least a portion of all apexes of the mitral valve annulus or by taking a cross product between a vector connecting the anterior and posterior ends of the mitral valve commissures and a vector connecting the anterior lateral and posteromedial ends.

9. 2. The apparatus of claim 1, wherein the data processor is configured to define the reference system with a first direction along the mitral valve plane normal, a second direction along the anterolateral and posteromedial directions, and a third direction modified accordingly.

10. The apparatus of claim 1 , wherein the data processor is configured to use information about a position of actual high reflux flow to set a plane position.

11. An apparatus for providing adjustable anatomical plane image data according to any one of claims 1 to 10, an imaging device for providing an image of a region of interest of the subject; 1. A system for intervention planning having the imaging device is configured to generate image data of the object and provide the image data to the device to provide image data of an adjustable anatomical plane; system.

12. the imaging device is an ultrasound imaging device configured to provide 3D ultrasound data; the ultrasound imaging device is configured to acquire 2D ultrasound images according to the selected anatomical imaging plane; The system of claim 11.

13. A method for providing adjustable anatomical plane image data of a mitral valve having an anterior-lateral mitral valve commissure and a posteromedial mitral valve commissure, comprising: receiving 3D image data of a region of interest of a subject having the mitral valve; establishing an anatomical context for identifying anatomical reference locations within the 3D image data; generating a reference coordinate system based on the identified anatomical reference locations; establishing an anchor point of an observation plane, said anchor point being predefined at a location between the anterolateral mitral valve commissure and the posteromedial mitral valve commissure; inputting, by a user, at least one plane-related parameter for determining an observation plane as a selected anatomical imaging plane; calculating a view plane that passes through the anchor points and is the selected anatomical imaging plane based on the at least one plane-related parameter; providing a representation of the selected anatomical imaging plane; The method comprising:

14. A computer program comprising instructions which, when executed by a computer, cause the computer to carry out the method according to claim 13.

15. A computer readable medium storing a computer program according to claim 14.

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