Coregistration of intravascular ultrasound with angiographic images

Abstract

The present disclosure provides for co-registration of an external image of a vessel with an IVUS image captured within the vessel, and provides a graphical user interface that allows for modifications to the co-registration. In particular, the present disclosure provides for co-registration even when the IVUS image is captured before the external image or before co-registration with the external image is initiated.

Description

[Technical Field]

[0001] The present disclosure relates generally to intravascular ultrasound (IVUS) imaging systems. In particular, but not exclusively, the present disclosure relates to co-registration of angiographic images with IVUS images and graphical user interfaces therefor. [Background technology]

[0002] Patient-insertable ultrasound devices have proven diagnostic capabilities for a variety of diseases and disorders. For example, intravascular ultrasound (IVUS) imaging systems are used as an imaging modality to diagnose blocked blood vessels and provide information to assist physicians in selecting and placing stents, selecting sites for atherectomy procedures, etc.

[0003] An IVUS imaging system includes a control module (having a pulse generator, image acquisition and processing components, and a monitor), a catheter, and a transducer disposed within the catheter. The catheter containing the transducer is positioned within a lumen or cavity within or adjacent to an area to be imaged, such as a blood vessel wall or patient tissue adjacent to a blood vessel wall. The pulse generator within the control module generates electrical pulses, which are delivered to the transducer and converted into acoustic pulses that are transmitted through the patient tissue. The patient tissue (or other structure) reflects the acoustic pulses, which are absorbed by the transducer and converted into electrical pulses. The converted electrical pulses are delivered to the image acquisition and processing components and converted into an image that can be displayed on a monitor.

[0004] However, it can be difficult for a physician to correlate an IVUS image with other external images of the vessel being treated. For example, it can be difficult to correlate the overall structure of a vessel shown in an angiogram image with the structure of the same vessel shown in an IVUS image. Therefore, there is a need for a system and method for co-registering an external image with an IVUS image. Summary of the Invention

[0005] This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to necessarily identify key features or essential features of the claimed subject matter, nor is it intended as an aid in determining the scope of the claimed subject matter.

[0006] Generally, the present disclosure provides a workflow, a system, a graphical user interface, and a process for co-registering IVUS images with external images, such as angiographic images.

[0007] In some embodiments, the present disclosure is embodied as a method, e.g., a method for an intravascular ultrasound (IVUS) imaging system, comprising: receiving, when an intravascular ultrasound (IVUS) guide catheter is being inserted into or has been inserted into a blood vessel and the blood vessel is displayed on an external image, an indication of an end position corresponding to a position of an IVUS guide catheter distal tip; and registering each of a plurality of frames of a series of IVUS images captured from within the blood vessel via an IVUS pullback operation to a position on the external image based in part on the position of the IVUS guide catheter distal tip and a start position to generate a pullback path and a side branch of the IVUS pullback operation, wherein the start position is a position at which the IVUS pullback operation is initiated. The method includes generating a pullback path and a side branch of an IVUS pullback operation corresponding to a start position; generating a graphical user interface (GUI) including a display of an external image, a start position, an end position, the pullback path, and the side branch; receiving at least one modification to the pullback path and / or the side branch via the input device and the GUI; regenerating the GUI, the regenerated GUI including a display of the external image, the start position, the end position, the pullback path, and / or the modified side branch; and receiving confirmation via the input device and the regenerated GUI that the modified pullback path and / or the modified side branch have been confirmed.

[0008] Alternatively or additionally to any of the above method embodiments, at least one modification is a modification to a pullback path, and the method may include receiving the modification to the side branch via the input device and the regenerated GUI; and regenerating the GUI a second time, the second regenerated GUI including an external image, a start position, an end position, the modified pullback path, and an indication of the modified side branch.

[0009] Alternatively or additionally to any of the above method embodiments, the pullback path is aligned with the longitudinal axis of the vessel. Alternatively or additionally to any of the above method embodiments, the pullback path includes a plurality of nodes, and the at least one correction to the pullback path includes a correction to the positions of one or more of the plurality of nodes.

[0010] Alternatively or additionally to any of the above method embodiments, the modification to the side branch changes the position of the side branch along the longitudinal axis. Alternatively or additionally to any of the above method embodiments, the side branch may be a first side branch of a plurality of side branches, and the method may include changing the position of a second side branch of the plurality of side branches in response to the modification.

[0011] Alternatively or additionally to any of the above method embodiments, the initially regenerated GUI further includes numerical or textual designations for the plurality of side branches. Alternatively or additionally, any of the above method embodiments may include retrieving an angiographic image comprising a plurality of frames from a memory device; generating an external image selection GUI comprising an indication of one of the plurality of frames of the angiographic image and at least one navigation button for scrolling through the plurality of frames; and receiving, via the input device and the external image selection GUI, an indication to select one of the plurality of frames of the angiographic image as the external image.

[0012] Alternatively or additionally, any of the above method embodiments may include receiving an indication of a starting position from an input device. Alternatively or additionally, any of the above method embodiments may include acquiring a series of IVUS images from a memory device.

[0013] Alternatively or additionally, any of the above method embodiments may include receiving, from an input device, an indication of a starting position on an external image of the blood vessel; capturing the external image via external image acquisition circuitry; and capturing a series of IVUS images via IVUS image acquisition circuitry.

[0014] Alternatively or additionally to any of the above method embodiments, the external image is an X-ray image. Alternatively or additionally to any of the above-described method embodiments, the regenerated GUI further includes a display of a longitudinal view of the series of IVUS images, and the initially regenerated GUI further includes a slider that scrolls along the longitudinal axis of the series of IVUS images and a slider marker positioned on the pullback path, the slider marker being linked to the slider such that movement of the slider causes corresponding movement of the slider marker on the pullback path.

[0015] In some implementations, the present disclosure is embodied as an apparatus comprising a processor coupled to a memory, the memory comprising instructions executable by the processor, the processor configured to couple to an intravascular ultrasound (IVUS) imaging system and configured to execute the instructions, which, when executed, cause the processor to perform a method of any combination of the above examples.

[0016] In some implementations, the present disclosure is embodied as at least one machine-readable storage device including a plurality of instructions that, in response to being executed by a processor of an intravascular ultrasound (IVUS) imaging system, cause the processor to perform a method of any combination of the above examples.

[0017] In some embodiments, the present disclosure is embodied as an apparatus for an intravascular ultrasound (IVUS) imaging system, the apparatus comprising: a display; an interface configured to couple to an IVUS catheter; a processor coupled to the interface and the display; and a memory comprising instructions, which, when executed by the processor, cause the IVUS imaging system to: receive an indication of an end position corresponding to a position of an intravascular ultrasound (IVUS) guide catheter distal tip when the IVUS guide catheter is being inserted into or has been inserted into a blood vessel and the blood vessel is displayed on an external image; and, based in part on the position of the IVUS guide catheter distal tip and the start position, position each of a plurality of frames of a series of IVUS images captured from within the blood vessel via an IVUS pullback operation on the position on the external image. The method includes aligning and generating a pullback path and a side branch for an IVUS pullback operation, wherein a starting position corresponds to a starting position of the IVUS pullback operation; generating a graphical user interface (GUI) including a display of an external image, a starting position, an ending position, the pullback path, and the side branch; receiving at least one modification to the pullback path and / or the side branch via the input device and the GUI; regenerating the GUI, wherein the regenerated GUI includes a display of the external image, the starting position, the ending position, the pullback path, and / or the modified side branch; regenerating the GUI; and receiving confirmation via the input device and the regenerated GUI that the modified pullback path and / or the modified side branch has been confirmed.

[0018] Alternatively or additionally to any of the above device embodiments, at least one of the modifications is a modification to the pullback path, and the memory device may further include instructions that, when executed by the processor, cause the IVUS imaging system to receive the modification to the side branch via the input device and the regenerated GUI, and to regenerate the GUI a second time, the second regenerated GUI including an indication of the external image, the start position, the end position, the modified pullback path, and the modified side branch.

[0019] Alternatively, or additionally, to any of the above device embodiments, the pullback path is aligned with the longitudinal axis of the blood vessel. Alternatively or additionally to any of the above apparatus embodiments, the pullback path includes a plurality of nodes, and the at least one correction to the pullback path includes a correction to one or more positions of the plurality of nodes.

[0020] Alternatively, or additionally, to any of the above device embodiments, modifications to the side branch change the position of the side branch along the longitudinal axis. Alternatively or additionally to any of the above apparatus embodiments, the side branch is a first side branch of a plurality of side branches, and the memory device may further include instructions that, when executed by the processor, cause the IVUS imaging system to change the position of a second side branch of the plurality of side branches in response to the modification.

[0021] Alternatively or additionally to any of the above apparatus embodiments, the initially regenerated GUI further includes numerical or textual designations for the multiple side branches. Alternatively or additionally, in any of the above apparatus embodiments, the memory device, when executed by the processor, causes the IVUS imaging system to generate an external image selection GUI including an indication of one of the multiple frames of the angiographic image and at least one navigation button for scrolling through the multiple frames, and to receive, via the input device and the external image selection GUI, an indication to select one of the multiple frames of the angiographic image as the external image.

[0022] Alternatively or additionally to any of the above apparatus embodiments, the memory device further includes instructions that, when executed by the processor, cause the IVUS imaging system to receive an indication of a starting position from an input device.

[0023] Alternatively or additionally to any of the above apparatus embodiments, the memory device further includes instructions that, when executed by the processor, cause the IVUS imaging system to receive an indication of a starting position on an external image of the blood vessel from the input device, capture the external image via the external image acquisition circuitry, and capture a series of IVUS images via the IVUS image acquisition circuitry.

[0024] In some implementations, the present disclosure is embodied as at least one machine-readable storage device having a plurality of instructions, the plurality of instructions, in response to being executed by a processor of an intravascular ultrasound (IVUS) imaging system, including: receiving an indication of an end position corresponding to a position of an intravascular ultrasound (IVUS) guide catheter distal tip when the intravascular ultrasound (IVUS) guide catheter is being inserted into or has been inserted into a blood vessel and the blood vessel is displayed on an external image; registering each of a plurality of frames of a series of IVUS images captured from within the blood vessel via an IVUS pullback operation to a position on the external image based in part on the position and the start position of the IVUS guide catheter distal tip; generating a pullback path and a side branch for the IVUS pullback operation, wherein a start position corresponds to a position of the start of the IVUS pullback operation; generating a graphical user interface (GUI) including a display of an external image, a start position, an end position, the pullback path, and the side branch; receiving at least one modification to the pullback path and / or the side branch via the input device and the GUI; regenerating the GUI, wherein the regenerated GUI includes a display of the external image, the start position, the end position, the pullback path, and / or the modified side branch; regenerating the GUI; and receiving confirmation via the input device and the regenerated GUI that the modified pullback path and / or the modified side branch has been confirmed.

[0025] Alternatively or additionally to any of the at least one machine-readable storage device embodiments described above, the instructions, in response to being executed by the processor, may further cause the processor to receive modifications to the side branch via the input device and the regenerated GUI, and to regenerate the GUI a second time, the second regenerated GUI including an indication of the external image, the start position, the end position, the modified pullback path, and the modified side branch.

[0026] Alternatively or additionally to any of the at least one machine-readable storage device embodiments described above, the instructions, in response to being executed by the processor, may cause the processor to receive an indication of a starting position on an external image of the blood vessel from an input device, capture the external image via external image acquisition circuitry, and capture a series of IVUS images via IVUS image acquisition circuitry.

[0027] Alternatively or additionally to any of the at least one machine-readable storage device embodiments above, the external image is an X-ray image. Alternatively or additionally to any of the at least one machine-readable storage device embodiments described above, the regenerated GUI further includes a display of a longitudinal view of the series of IVUS images, and the initially regenerated GUI further includes a slider that scrolls along the longitudinal axis of the series of IVUS images and a slider marker positioned on the pullback path, the slider marker being linked to the slider such that movement of the slider causes corresponding movement of the slider marker on the pullback path. [Brief explanation of the drawings]

[0028] [Figure 1] FIG. 1 illustrates an IVUS imaging system. [Figure 2] FIG. 1 shows an angiographic image of a blood vessel. [Figure 3A] FIG. 1 shows a longitudinal view of an IVUS image. [Figure 3B] FIG. 1 shows a cross-sectional view of a frame of an IVUS image. [Figure 4] FIG. 1 illustrates a combined IVUS / external imaging system. [Figure 5] FIG. 1 illustrates an IVUS coregistration visualization system. [Figure 6] FIG. 1 illustrates the logic flow of an IVUS coregistration visualization system. [Figure 7A]FIG. 1 illustrates a first graphical interface for an IVUS coregistration visualization system. [Figure 7B] FIG. 7B illustrates a second view of the graphical interface of FIG. 7A. [Figure 7C] FIG. 7B illustrates a third view of the graphical interface of FIG. 7A. [Figure 7D] FIG. 7B illustrates a fourth view of the graphical interface of FIG. 7A. [Figure 7E] FIG. 7B shows a fifth view of the graphical interface of FIG. 7A. [Figure 7F] FIG. 7B illustrates a sixth view of the graphical interface of FIG. 7A. [Figure 7G] FIG. 10 illustrates a second graphical interface for the IVUS coregistration visualization system. [Figure 8] FIG. 1 illustrates a first method for coregistration. [Figure 9] FIG. 1 illustrates a second method for coregistration. [Figure 10] FIG. 10 illustrates a third method for coregistration. [Figure 11A] FIG. 10 illustrates a second graphical interface for the IVUS coregistration visualization system. [Figure 11B] FIG. 11B illustrates a second view of the graphical interface of FIG. 11A. [Figure 11C] FIG. 11B illustrates a third view of the graphical interface of FIG. 11A. [Figure 11D] FIG. 11B illustrates a fourth view of the graphical interface of FIG. 11A. [Figure 11E] FIG. 11B illustrates a fifth view of the graphical interface of FIG. 11A. [Figure 11F] FIG. 11B illustrates a sixth view of the graphical interface of FIG. 11A. [Figure 11G]FIG. 11B illustrates a seventh view of the graphical interface of FIG. 11A. [Figure 11H] FIG. 11B illustrates an eighth view of the graphical interface of FIG. 11A. [Figure 11I] FIG. 11B illustrates a ninth view of the graphical interface of FIG. 11A. [Figure 11J] FIG. 11B illustrates a tenth view of the graphical interface of FIG. 11A. [Figure 11K] FIG. 11B illustrates an eleventh view of the graphical interface of FIG. 11A. [Figure 12A] FIG. 10 illustrates a third graphical interface for the IVUS coregistration visualization system. [Figure 12B] FIG. 12B illustrates a second view of the graphical interface of FIG. 12A. [Figure 12C] FIG. 12B illustrates a third view of the graphical interface of FIG. 12A. [Figure 12D] FIG. 12B illustrates a fourth view of the graphical interface of FIG. 12A. [Figure 12E] FIG. 12B shows a fifth view of the graphical interface of FIG. 12A. [Figure 12F] FIG. 12B illustrates a sixth view of the graphical interface of FIG. 12A. [Figure 12G] FIG. 12B shows a seventh view of the graphical interface of FIG. 12A. [Figure 12H] FIG. 12B illustrates an eighth view of the graphical interface of FIG. 12A. [Figure 13] FIG. 1 illustrates a computer-readable storage medium. [Figure 14] FIG. 1 is a schematic diagram of the machine. DETAILED DESCRIPTION OF THE INVENTION

[0029] To easily identify the description of any element or operation, the most significant digit(s) of a reference number refers to the number of the drawing in which that element first appears. The foregoing has outlined broadly the features and technical advantages of the present disclosure in order that the following detailed description of the disclosure may be better understood. It will be appreciated by those skilled in the art that the disclosed embodiments may be readily utilized as a basis for modifying or designing other structures for carrying out the same purposes of the present disclosure. The novel features of the present disclosure, both as to its organization and operation, together with further objects and advantages, will be better understood from the following description when considered in connection with the accompanying drawings. It is to be expressly understood, however, that each of the drawings is provided for the purpose of illustration and description, and is not intended as a definition of the limits of the present disclosure.

[0030] As previously mentioned, the present disclosure relates to IVUS images captured within a patient's lumen (e.g., blood vessel), as well as external images of the vessel, such as angiographic images, and to co-registering the IVUS images with the angiographic images. Stated another way, the present disclosure provides for mapping or correlating frames within an IVUS image to positions on an angiographic image. Accordingly, an exemplary IVUS imaging system, a patient's blood vessel, a series of IVUS images, and a combined IVUS / external imaging system are described.

[0031] Suitable IVUS imaging systems include, but are not limited to, one or more transducers disposed at the distal end of a catheter configured and arranged for percutaneous insertion into a patient. Examples of IVUS imaging systems having catheters are described, for example, in U.S. Patent Nos. 7,246,959, 7,306,561, and 6,945,938, as well as U.S. Patent Application Publication Nos. 2006 / 0100522, 2006 / 0106320, 2006 / 0173350, 2006 / 0253028, 2007 / 0016054, and 2007 / 0038111, all of which are incorporated herein by reference.

[0032] 1 schematically illustrates one embodiment of an IVUS imaging system 100. The IVUS imaging system 100 includes a catheter 102 that can be coupled to a control system 104. The control system 104 can include, for example, a processor 106, a pulse generator 108, and a drive unit 110. In at least some embodiments, the pulse generator 108 generates electrical pulses that can be input to one or more transducers (not shown) disposed within the catheter 102.

[0033] In some embodiments, mechanical energy from the drive unit 110 can be used to drive an imaging core (not shown) disposed within the catheter 102. In at least some embodiments, electrical signals transmitted from one or more transducers can be input to the processor 106 for processing. In at least some embodiments, the processed electrical signals from the one or more transducers can be used to form a series of images, which are described in more detail below. For example, a scan converter can be used to map scan line samples (e.g., radial scan line samples, etc.) onto a two-dimensional Cartesian grid, which can be used as the basis for a series of IVUS images that can be displayed to a user.

[0034] In at least some embodiments, the processor 106 may also be used to control one or more functions of other components of the control system 104. For example, the processor 106 may be used to control at least one of the frequency or duration of electrical pulses transmitted from the pulse generator 108 and the speed of rotation of the imaging core by the drive unit 110. Additionally, if the IVUS imaging system 100 is configured for automatic pullback, the drive unit 110 may control the speed and / or length of the pullback.

[0035] 2 shows an image 200 of a patient's blood vessel 202. As will be explained, an IVUS imaging system (e.g., IVUS imaging system 100, etc.) is used to capture a series of images or "recordings" of a blood vessel (e.g., blood vessel 202). For example, an IVUS catheter (e.g., catheter 102) is inserted into blood vessel 202, and records or a series of IVUS images are captured as catheter 102 is withdrawn from distal end 204 to proximal end 206. Catheter 102 can be withdrawn manually or automatically (e.g., under the control of drive unit 110, etc.).

[0036] 3A and 3B show two-dimensional (2D) representations of IVUS images of a blood vessel 202. For example, FIG. 3A shows an IVUS image 300a showing a longitudinal view of an IVUS recording of the blood vessel 202 between the proximal end 206 and the distal end 204.

[0037] 3B shows an image frame 300b showing an on-axial (or short-axis) view of the blood vessel 202 at point 302. Stated differently, the image frame 300b is a single frame or image from a series of IVUS images that may be captured between the distal end 204 and the proximal end 206, as described herein. As discussed above, the present disclosure provides systems and techniques for processing raw IVUS images to identify regions of interest, such as start and end points, that include multiple frames of interest in between in a series of IVUS images.

[0038] For example, IVUS image 300a shows an entire series of IVUS images taken of blood vessel 202 between distal end 204 and proximal end 206. However, not all of these images may be of interest to a physician. This disclosure provides for identifying "key frames," such as proximal and distal key frames, as well as minimum key frames.

[0039] 4 illustrates a combined IVUS external imaging system 400 that includes both an IVUS imaging system 402 (e.g., such as IVUS imaging system 100) and an extravascular imaging system 404 (e.g., an angiography imaging system). The combined IVUS external imaging system 400 further includes a computing device 406, which includes circuitry, a controller, and / or a processor, as well as memory and software, configured to execute a method for vascular image registration of acquired extravascular imaging data and acquired intravascular imaging data. In general, the IVUS imaging system 402 can be configured to generate IVUS intravascular imaging data (e.g., IVUS image 300a and image frame 300b), and the extravascular imaging system 404 can be configured to generate extravascular imaging data (e.g., image 200).

[0040] The extravascular imaging system 404 may include an angiography table 408 that may be positioned to provide sufficient space for positioning a C-arm 410 of the angiography / fluoroscopy unit in an operating position relative to a patient 412 in contact with the drive unit 110. Raw radiographic image data acquired by the C-arm 410 may be transmitted to an extravascular data input port 414 via a transmission cable 416. The input port 414 may be a separate component or may be integrated into or part of the computing device 406. The input port 414 may include a processor that converts the raw radiographic image data received by the input port 414 into extravascular image data (e.g., angiography / fluoroscopy image data), for example, in the form of live video, DICOM, or a series of individual images. The extravascular image data may be initially stored in a memory within the input port 414 or may be stored in a memory of the computing device 406. If the input port 414 is a separate component from the computing device 406, the extravascular image data may be transferred to the computing device 406 via a transmission cable 418 and input to an input port (not shown) of the computing device 406. In some alternatives, communication between devices or processors may be performed via wireless communication rather than by cable as shown.

[0041] The intravascular imaging data may be, for example, IVUS data or OCT data acquired by an IVUS imaging system 402. The IVUS imaging system 402 may include an intravascular imaging device such as an imaging catheter 420. The imaging catheter 420 is configured to be inserted into the body of the patient 412 such that a distal end of the imaging catheter 420, including a diagnostic assembly or diagnostic probe 422 (e.g., an IVUS probe), is near a desired imaging location of a blood vessel. Radiopaque material or markers 424 placed on or near the probe 422 may provide an indication of the current position of the probe 422 in a radiological image.

[0042] The imaging catheter 420 is coupled to a proximal connector 426 to couple the imaging catheter 420 to an image acquisition device 428. The image acquisition device 428 may be connected to the computing device 406 via a transmission cable 430 or a wireless connection. The intravascular image data may be initially stored in memory within the image acquisition device 428 or may be stored in memory of the computing device 406. If the image acquisition device 428 is a separate component from the computing device 406, the intravascular image data may be transferred to the computing device 406 via the transmission cable 430, for example.

[0043] The computing device 406 may also include one or more additional output ports for transferring data to other devices. For example, the computer may include an output port for transferring data to a data archive or memory device 432. The computing device 406 may also include a user interface (described in more detail below) that includes a combination of circuitry, processing components, and instructions executable by the processing components and / or circuitry to enable dynamic coregistration of intravascular and extravascular images.

[0044] The user interface may be rendered and displayed on a display 434 coupled to computing device 406 via a display cable 436. Although display 434 is shown as separate from computing device 406, in some examples, display 434 may be part of computing device 406. Alternatively, display 434 may be remote from computing device 406 and wirelessly connected. As another example, display 434 may be part of another computing device different from computing device 406, such as a tablet computer, which may be coupled to computing device 406 via a wired or wireless connection.

[0045] FIG. 5 illustrates a coregistration system 500 in accordance with some embodiments of the present disclosure. Generally, the coregistration system 500 is a system for coregistrating IVUS images with external images (e.g., angiographic images). The coregistration system 500 can be implemented with commercially available IVUS guidance or navigation systems, such as the AVVIGO® guidance system available from Boston Scientific®, and external imaging systems, such as the extravascular imaging system 404 described in connection with FIG. 4 above. The present disclosure provides an advantage over previous or conventional IVUS imaging systems in that it can coregistrate external images, regardless of whether the external images are captured together with the IVUS images or separately from the IVUS images. For example, the present disclosure can be implemented in an IVUS navigation system used in percutaneous coronary intervention (PCI) where an external image is captured and co-registration begins simultaneously with the capture of the IVUS image (e.g., at pullback), or the IVUS and external images may be captured at different times. That is, the present disclosure can be used to apply co-registration at any time. This is a significant advantage over current systems because it allows a physician to co-register images at any time, even after the images have been captured.

[0046] The coregistration system 500 includes a computing device 502. The computing device 502 can be any of a variety of computing devices. In some embodiments, the computing device 502 can be incorporated into and / or implemented by the computing device 406. In some embodiments, the computing device 502 can be a workstation or server communicatively connected to the IVUS imaging system 100 and an external imaging system (e.g., the extravascular imaging system 404, etc.). In still other embodiments, the computing device 502 can be provided by a cloud-based computing device, such as by a computing as a service system accessible via a network (e.g., the Internet, an intranet, a wide area network, etc.). The computing device 502 can include a processor 504, a memory 506, input and / or output (I / O) devices 508, a network interface 510, and an IVUS / vascular imaging system acquisition circuitry 512.

[0047] Processor 504 may include circuitry or processor logic, such as, for example, any of a variety of commercially available processors. In some examples, processor 504 may include multiple processors, multithreaded processors, multi-core processors (whether multiple cores coexist on the same or separate die), and / or other types of multi-processor architectures in which multiple physically separate processors are linked in some way. Additionally, in some examples, processor 504 may include a graphics processing portion and may include dedicated memory, multithreaded processing, and / or other parallel processing capabilities. In some examples, processor 504 may be an application-specific integrated circuit (ASIC) or a field-programmable integrated circuit (FPGA).

[0048] Memory 506 may include logic, a portion of which may include an array of integrated circuits forming non-volatile memory or a combination of non-volatile and volatile memory for persistently storing data. It should be understood that memory 506 may be based on any of a variety of technologies. In particular, the array of integrated circuits included in memory 120 may be arranged to form one or more types of memory, such as, for example, dynamic random access memory (DRAM), NAND memory, NOR memory, etc.

[0049] The I / O devices 508 may be any of a variety of devices for receiving input and / or providing output. For example, the I / O devices 508 may include a keyboard, a mouse, a joystick, foot pedals, a display, a touch-enabled display, a haptic feedback device, an LED, etc.

[0050] Network interface 510 may include logic and / or functionality to support a communications interface. For example, network interface 510 may include one or more interfaces that operate according to various communications protocols or standards for communicating directly or over a network communications link. Direct communications may occur through the use of communications protocols or standards set forth in one or more industry standards (including derivatives and variations). For example, the network interface 510 may enable communication over a bus such as, for example, a Peripheral Component Interconnect express (PCIe), a Non-Volatile Memory express (NVMe), a Universal Serial Bus (USB), a System Management Bus (SMBus), a SAS (e.g., a serial attached Small Computer System Interface (SCSI) interface, a serial AT attachment (SATA) interface, etc. Additionally, the network interface 510 may include logic and / or functionality that enables communication over various wired or wireless network standards (e.g., the 802.11 communication standard). For example, the network interface 510 may be configured to support a wired communication protocol or standard, such as Ethernet. As another example, the network interface 510 may be configured to support a wireless communication protocol or standard, such as, for example, Wi-Fi, Bluetooth, ZigBee, LTE, 5G, etc.

[0051] The IVUS / vascular imaging system acquisition circuitry 512 may include circuitry including custom-fabricated or specially programmed circuitry configured to receive or transmit signals including a display of an IVUS run, a series of IVUS images, or one or more frames of IVUS images from the IVUS imaging system 100, as well as to receive or transmit signals from or to an external imaging system (e.g., an angiographic imaging system, an extravascular imaging system 404, etc.).

[0052] The memory 506 may include instructions 514. During operation, the processor 504 may execute the instructions 514 to configure or cause the computing device 502 to coregistrate images as described herein. For example, the processor 504 may execute the instructions 514 to receive external images 518 from the IVUS imaging system 402 and to receive external images 518 from the extravascular imaging system 404. Additionally, the processor 504 may execute the instructions 514 to generate graphical components 520 associated with the described coregistration procedures, as well as to generate (or render) a GUI 530 from the graphical components 520 and display the GUI 530 on the display 434, as will be described in more detail below. Generally, however, coregistration involves receiving an indication of an IVUS run start location 522 and an IVUS run end location 524, generating a co-registered pullback path 526 and co-registered side branches 528, and optionally receiving modifications or updates to the co-registered pullback path 526 and co-registered side branches 528. Note that the pullback path 526 is sometimes referred to as a centerline.

[0053] FIG. 6 illustrates a logic flow 600 that can be implemented to coregistrate an IVUS image (e.g., external image 518) with an external image (e.g., one of external images 518). Logic flow 600 can be implemented by coregistration system 500 and will be described with reference to coregistration system 500 for clarity of explanation. However, it should be noted that logic flow 600 can also be implemented by an IVUS coregistration system different from coregistration system 500. Additionally, several examples of graphical user interfaces (GUIs) and interactions with GUIs are referenced in describing logic flow 600. Examples of such GUIs are provided in FIGS. 7A-7G. These exemplary GUIs are used to explain logic flow 600. However, logic flow 600 can be implemented using GUIs different from those described herein.

[0054] Logic flow 600 may begin at decision block 602. At decision block 602, "Has an IVUS image already been captured?", a determination is made as to whether an IVUS image has already been captured. For example, processor 504 may execute instructions 514 to determine whether an external image 518 has already been captured. Logic flow 600 may proceed from decision block 602 to block 604 or may transition to block 610. Logic flow 600 may proceed from decision block 602 to block 604 based on a determination at decision block 602 that an IVUS image has already been captured, while logic flow 600 may transition from decision block 602 to block 610 based on a determination at decision block 602 that an IVUS image has not been captured.

[0055] In block 604, "Acquire or Capture External Image," an external image may be selected or captured. For example, if several external images have already been captured, one of the external images may be selected. Alternatively, a single external image may be captured. For example, multiple external images (e.g., angiogram images) of the blood vessel from which the IVUS image was captured are often already available. Thus, one frame of the angiogram image may be captured. Processor 504 may execute instructions 514 to generate a GUI for presenting multiple external images 518 and for receiving instructions for selecting a frame of external image 518.

[0056] 7A illustrates a GUI 700a that may be generated as GUI 530. GUI 700a displays an angiographic image from which a frame of the angiographic image can be selected. In some embodiments, processor 504 may execute instructions 514 to generate GUI 700a and display GUI 700a on display 434. GUI 700a includes a graphical element or component 520 that includes a display of external images 518 (e.g., an angiographic image), a navigation bar 702 for navigating through external images 518, and selection buttons 704 for selecting a frame of external images 518. Processor 504 may execute instructions 514 to receive instructions via I / O device 508 for navigating external images 518 and for selecting one of external images 518. In some embodiments, external images 518 have not been previously captured or stored. In such an example, processor 504 may execute instructions 514 to receive live external images (e.g., from extravascular imaging system 404, etc.) and select, capture, or acquire the live image.

[0057] Proceeding to block 606, "Receive an indication of the position of the distal tip of the IVUS catheter on the external image," an indication of the position of the distal tip of the IVUS catheter on the external image is received. In other words, a position or marking for the start of IVUS pullback on the external image is received. Processor 504 may execute instructions 514 to receive an indication of the position of the distal tip of the IVUS catheter on a selected frame of external image 518 and save the indication as an IVUS run start position 522.

[0058] Proceeding to block 608, "Acquire IVUS Image," an IVUS image is acquired. The processor 504 may execute instructions 514 to acquire an external image 518 (e.g., from memory 506, from an external storage device, or otherwise). The logic flow 600 proceeds from block 608 to block 616. However, as previously discussed, the logic flow 600 may transition from decision block 602 to block 610, for example, if an IVUS image has not already been captured before coregistration begins. At block 610, "Receive Indication of Distal Tip of IVUS Catheter on External Image," the location of the distal tip of the IVUS catheter on the external image is received. The processor 504 may execute instructions 514 to receive an indication of the location of the distal tip of the IVUS catheter on the external image and save the indication as an IVUS run start position 522. In some embodiments, the indication of the IVUS run start position 522 is received from a user (e.g., via the I / O device 508). In other embodiments, the IVUS run start position 522 is detected automatically.

[0059] Proceeding to block 612 “Capture External Image,” an external image is captured. The processor 504 may execute instructions 514 to capture the external image (e.g., via the IVUS / vascular imaging system acquisition circuitry 512 and the extravascular imaging system 404, etc.). Further, the processor 504 may execute instructions 514 to store the captured external image in memory 506 as an external image 518. Proceeding to block 614 “Capture IVUS Image,” an IVUS image is captured. The processor 504 may execute instructions 514 to capture the external image 518 (e.g., via the IVUS / vascular imaging system acquisition circuitry 512 and the IVUS imaging system 402, etc.). For example, the processor 504 may execute instructions 514 to send instructions to the IVUS imaging system 402 to initiate an automatic pullback IVUS image capture process. Further, the processor 504 may execute instructions 514 to store the captured IVUS image in memory 506 as an external image 518.

[0060] At block 616, "Receive an indication of the position of the distal tip of the IVUS guide catheter on the external image," an indication of the position of the distal tip of the IVUS guide catheter on the external image is received. In other words, the position or mark of the end of the IVUS pullback on the external image is received. The processor 504 may execute the instructions 514 to receive an indication of the position of the distal tip of the IVUS guide catheter on a selected (or captured) frame of the external image 518 and save the indication as an IVUS run end position 524. In some embodiments, the indication of the IVUS run end position 524 is received from a user (e.g., via the I / O device 508). In other embodiments, the IVUS run end position 524 is detected automatically.

[0061] 7B illustrates a GUI 700b that may be generated as GUI 530. GUI 700b displays a frame of an angiographic image (e.g., a frame of external image 518) on which the locations of the distal tip of the IVUS catheter and the distal tip of the IVUS guide catheter may be marked. In some embodiments, processor 504 may execute instructions 514 to generate GUI 700b and display GUI 700b on display 434. GUI 700b includes a graphical element or component 520 that includes a frame of external image 518, selection button 704, and an IVUS execution start location 522 and an IVUS execution end location 524. Processor 504 may execute instructions 514 to receive the display via I / O device 508 and generate graphical component 520 to display a graphical representation of the display for the frame of external image 518 on GUI 700b. For example, the processor 504 may execute the instructions 514 to display an IVUS execution start position 522 corresponding to an indication of the position of the distal tip of the IVUS catheter or the position of the start of IVUS pullback, and an IVUS execution end position 524 corresponding to an indication of the position of the IVUS guide catheter or the position of the end of IVUS pullback.

[0062] Proceeding to block 618, "Co-register IVUS image with external image," the IVUS image is co-registered with the external image. The frames of the external image 518 are mapped or aligned to positions along the blood vessel 202 shown in the frames of the external image 518. The processor 504 may execute the instructions 514 to co-register the images. In some examples, the processor 504 may co-register the images using a machine learning model trained to co-register the IVUS image to the external image. The processor 504 may execute the instructions 514 to identify a centerline of the blood vessel 202 corresponding to a pullback path of the IVUS catheter through the blood vessel on the external image 518 and to register side branches along the longitudinal length of the blood vessel 202, and store the results as a co-registered pullback path 526 and a co-registered side branch 528.

[0063] Proceeding to block 620, "Display Editable Coregistration Results," the coregistration results may be displayed in an editable or manipulable format. The processor 504 may execute the instructions 514 to generate a graphical component 520 that includes a representation of the coregistration results (e.g., a representation of the coregistration pullback path 526 and a representation of the coregistration side branch 528). The processor 504 may execute the instructions 514 to generate a GUI 530 from the graphical component 520 and display the GUI 530 on the display 434, where the results can be manipulated by a user.

[0064] Proceeding to decision block 622, “Have Corrections to Coregistration Results Received?”, a determination is made whether corrections to the coregistration results have been received. The processor 504 may execute instructions 514 to determine whether corrections to the coregistration pullback path 526 and / or the coregistration side branch 528 have been received. In some examples, the corrections are received via the graphical component GUI 530 (e.g., via a touch screen, via a mouse, etc.). The logic flow 600 may proceed from decision block 622 to block 624 or may transition from decision block 622 to block 626. For example, the logic flow 600 may proceed from decision block 622 to block 624 based on a determination at decision block 622 that correction(s) have been received, whereas the logic flow 600 may transition from decision block 622 to block 626 based on a determination at decision block 622 that correction(s) have not been received. In some examples, processor 504 may execute instructions 514 to receive an indication that selection button 704 has been activated and no modifications have been received.

[0065] At block 624 "Adjust pullback path and / or side branches based on the modifications," the pullback path and / or side branches may be adjusted based on the modifications as outlined below.

[0066] 7C illustrates a GUI 700c that may be generated as GUI 530. GUI 700c displays a frame of an angiographic image (e.g., a frame of external image 518 selected or captured as outlined above) with the results of coregistration displayed. Processor 504 may execute instructions 514 to generate GUI 700c and display GUI 700c on display 434. GUI 700c includes a frame of external image 518, a selection button 704, and a graphical element or component 520 that includes an IVUS run start location 522, an IVUS run end location 524, a coregistrated pullback path 526, and a coregistrated side branch 528.

[0067] As described above, at least some of the graphical components 520 of GUI 700c are manipulable. That is, a user can move the graphical components to change the position represented by the graphical components. For example, in GUI 700c, coregided pullback path 526 is adjustable. Processor 504 can execute instructions 514 to receive instructions for manipulation of the coregided results and update the coregided results based on the received manipulation. For example, processor 504 can execute instructions 514 to receive, via I / O device 508, an adjustment or manipulation to adjustment node 706 of coregided pullback path 526 and store the manipulation as coregided pullback path 526 in memory 506. Furthermore, processor 504 can execute instructions 514 to update GUI 530 (e.g., GUI 700c) in real time to display the adjusted coregided results (e.g., coregided pullback path 526).

[0068] 7D shows a GUI 700d illustrating manipulation of the co-registered side branch 528. The processor 504 can execute the instructions 514 to generate the GUI 700d and display the GUI 700d on the display 434. The GUI 700d includes a graphical element or component 520 that includes a frame of the external image 518, a selection button 704, an IVUS run start location 522, an IVUS run end location 524, a co-registered pullback path 526, the co-registered side branch 528 depicted on the external image 518, the IVUS image 516, a slider 708 for movement along the longitudinal length of the IVUS image 516, and a slider marker 710 that indicates the position of the slider 708 relative to a position along the longitudinal length of the vessel 202 within the frame of the external image 518.

[0069] Similar to GUI 700c, at least some of the graphical components 520 of GUI 700d are manipulable. That is, a user can move the graphical components to change the position represented by the graphical components. For example, in GUI 700d, coregided side branch 528 is adjustable. Processor 504 can execute instructions 514 to receive instructions for manipulations to the coregided results and update the coregided results based on the received manipulations. For example, processor 504 can execute instructions 514 to receive adjustments or manipulations to coregided side branch 528 via I / O device 508 and store the manipulations as coregided side branch 528 in memory 506. Furthermore, processor 504 can execute instructions 514 to update GUI 530 in real time to display the adjusted coregided results (e.g., coregided pullback path 526). Additionally, the slider 708 can be operated to move the slider marker 710 along the length of the blood vessel 202 shown in the frame of the external image 518, while the slider 708 moves along the length of the IVUS image 516 to visually match the co-registered side branches 528 between the IVUS image 516 and the external image 518.

[0070] FIG. 7E illustrates a GUI 700e similar to GUI 700d, where “real-time” adjustments to the co-registered side branches 528 are reflected in GUI 700e. For example, the processor 504 can execute instructions 514 to receive, via the I / O device 508, instructions to move one of the co-registered side branches 528 (e.g., branch number 4). In some examples, only a selected one of the co-registered side branches 528 is adjusted. In other examples, when the selected side branch is moved, the other co-registered side branches 528 may also be moved. For example, all upstream (or proximal to the moved side branch) can be adjusted similarly, all downstream (or distal to the moved side branch) can be adjusted similarly, or all side branches can be adjusted. In the case illustrated in FIGS. 7D and 7E, the co-registered side branch 528 with side branch number 4 is adjusted, and the co-registered side branches 528 with side branch numbers 5, 6, 7, and 8 are also adjusted.

[0071] At block 626, "Confirm Coregistration," the coregistration may be confirmed. The processor 504 may execute instructions 514 to generate a graphical component 520 from the IVUS run start location 522, the IVUS run end location 524, the coregistrated pullback path 526, and the coregistrated side branch 528, and to generate a GUI 530 from the graphical component 520 to display a graphical representation of the coregistration. FIG. 7F shows a GUI 700f displaying the graphical component 520 including the IVUS run start location 522, the IVUS run end location 524, the coregistrated pullback path 526, and the coregistrated side branch 528 displayed on a frame of the external image 518. The processor 504 may execute instructions 514 to receive, via the I / O device 508, an indication that the displayed coregistration (e.g., the IVUS run start location 522, the IVUS run end location 524, the coregistrated pullback path 526, and the external image 518) is complete. For example, processor 504 may receive an indication that select button 704 has been activated (e.g., clicked) to confirm the displayed coregistration. Additionally, although not described above, a back or "previous" button may be present in a GUI (e.g., GUI 700f) for returning to a previous step of adjusting the coregistration, etc.

[0072] Block 626 may further include generating a GUI for displaying the results of the coregistration. FIG. 7G shows GUI 700g. GUI 700g may be generated as GUI 530. Processor 504 may execute instructions 514 to generate GUI 530 including graphical component 520 as shown in GUI 700g. GUI 700g includes a graphical representation of IVUS image 516 and a vessel profile 716 of the vessel boundary and lumen boundary of blood vessel 202 represented in IVUS image 516. GUI 700g further includes a slider 708 that moves longitudinally along IVUS image 516 and a corresponding slider marker 710 that represents the position of slider 708 on external image 518. Additionally, GUI 700g includes a cross-sectional view 714 of the vessel (or frame of IVUS image 516) and the vessel boundary and lumen boundary at the position of slider 708.

[0073] As previously mentioned, the present disclosure provides a workflow for a physician that can perform coregistration either before or after image acquisition. FIG. 8 illustrates a method 800 for coregistrating IVUS images and external images. Method 800 is described with reference to the tools, systems, and GUIs described above. Method 800 can begin with either method 1000 or method 900. In particular, the workflow differs depending on whether IVUS images have already been captured. For example, if IVUS images have already been captured, method 800 can begin with method 900, whereas if coregistration is performed or initiated before IVUS images are captured, method 800 can begin with method 1000.

[0074] 9 illustrates a method 900. Method 900 may begin at decision block 902, "Use a previously acquired extravascular image?", where a physician may decide whether to use a previously acquired extravascular image. Method 900 may transition from decision block 902 to block 904 based on a decision to use a previously acquired extravascular image, while method 900 may transition from decision block 902 to block 906 based on a decision not to use a previously acquired extravascular image (because no extravascular image exists or because the physician desires to capture another extravascular image).

[0075] In block 904 "Select an existing extravascular image," an existing extravascular image may be selected. For example, a physician may select a frame of the external image 518, such as via the GUI 700a. In block 906 "Position an extravascular imaging device," the extravascular imaging system 404 is positioned over the patient 412 to capture the external image 518, and in block 908, the external image 518 is captured.

[0076] Method 900 can proceed from both block 904 and block 908 to block 910. In block 910, "Identify Estimated Location of Catheter Distal Tip in Extravascular Image," a physician can identify an estimated location for the start of IVUS pullback (e.g., the distal-most location of IVUS catheter 102 within blood vessel 202). For example, the physician can identify IVUS run start location 522 via GUI 700b.

[0077] 10 illustrates a method 1000. The method 1000 may begin at block 1002, "Deliver IVUS Catheter," where a physician may deliver or position an IVUS imaging catheter 420 of the IVUS imaging system 402 into a patient 412. Proceeding to block 1004, "Identify Catheter Distal Tip in Extravascular Image," the distal tip of the IVUS imaging catheter 420 may be identified in the extravascular image (e.g., via the extravascular imaging system 404, etc.). Proceeding to block 1006, "Acquire Extravascular Image," an extravascular image may be acquired (e.g., via the extravascular imaging system 404 and the computing device 406, etc.). Proceeding to block 1008, "Initiate Coregistration," coregistration may be initiated (e.g., via the computing device 406). Proceeding to block 1010, "Initiate IVUS Pullback," an IVUS pullback image or IVUS image acquisition may be initiated (e.g., via the IVUS imaging system 402 and the computing device 406).

[0078] Proceeding to block 1012, "Identify catheter tip in extravascular image," the physician may identify the location of the start of the IVUS pullback (e.g., the distal-most position of the IVUS catheter 102 within the blood vessel 202). For example, the physician may identify the IVUS run start location 522 via GUI 700b.

[0079] 8, method 800 may proceed to block 802 from both method 900 and method 1000. In block 802, "Identify Guide Catheter Distal Tip," the guide catheter distal tip may be identified. For example, a physician may identify IVUS run end location 524 via GUI 700b.

[0080] Proceeding to block 804, "Display Coregistration Results," the coregistration results are displayed (e.g., via the GUI 530). Proceeding to decision block 806, "Does the Pullback Path Match?", a determination is made as to whether the pullback paths match. For example, a physician may determine whether the coregistrated pullback path 526 matches the vessel 202 represented within the frame of the external image 518. The method 800 may proceed from decision block 806 to block 808 based on a determination that the pullback paths do not match, while the method 800 may transition from decision block 806 to decision block 810 based on a determination that the pullback paths match. In block 808, "Adjust Pullback Path," the pullback path may be adjusted. For example, a physician may adjust the coregistrated pullback path 526 via the GUI 700c.

[0081] From block 808, the method 800 proceeds to decision block 810. At decision block 810, "Do the side branches match?", a determination is made as to whether the side branches match. For example, a physician may determine whether the co-registered side branches 528 match the vessels 202 depicted in the frame of the external image 518. Based on a determination that the side branches do not match, the method 800 may proceed from decision block 810 to block 812, while based on a determination that the side branches do match, the method 800 may transition from decision block 810 to block 814. At block 812, "Adjust Side Branch(s)," one or more side branches may be adjusted. For example, a physician may adjust the co-registered side branches 528 via GUI 700d and / or GUI 700e.

[0082] The coregistration may be confirmed at block 814, "Confirm Coregistration." For example, the physician may confirm the coregistration via GUI 700f and then view the results view GUI 700g.

[0083] 11A illustrates a GUI 1100a. The GUI 1100a may be generated as a GUI 530. The processor 504 may execute instructions 514 to generate the GUI 530, which includes a graphical component 520. The GUI 1100a includes an external image view 1102, a cross-sectional view 1106, a vascular profile view 1104, and various menus and selection buttons. For example, the GUI 1100a includes a coregistration view button 1108 for selecting a coregistration view as shown in this figure. The external image view 1102 includes an external image acquisition button 1110 for selecting and / or acquiring an external image (e.g., external image 518) as described above. In some examples, the processor 504 may execute instructions 514 to capture and / or select a single frame from a live angiography feed; in other examples, the processor 504 may execute instructions 514 to capture an angiography image (e.g., as described above) and select a frame from the angiography image. In a further example, the processor 504 may execute instructions 514 to recapture (or repeatedly capture) frames of a live external image (eg, angiographic image, etc.).

[0084] The vascular profile view 1104 includes a graphical representation of the vessel and lumen boundaries, as well as a longitudinal view 1112 of the vessel based on frames of the IVUS image 516. Additionally, the vascular profile view 1104 includes a graphical depiction of the vessel and lumen boundaries (e.g., vessel boundary / lumen boundary 1114) represented in the IVUS image 516, as well as a slider 1116 for panning or traversing frames of the IVUS image 516.

[0085] The cross-sectional view 1106 includes a cross-sectional view of the vessel (eg, a frame of the IVUS image 516 ) as well as a cross-sectional view of the boundary (eg, the vessel boundary / lumen boundary 1114 ) at the position of the slider 1116 .

[0086] 11B shows a GUI 1100b that can be generated as GUI 530. GUI 1100b can be displayed when a user selects a coregistration view button 1108 and an acquire external image button 1110 to coregistrate one of the external images 518 with a frame of IVUS image 516, as described herein. GUI 1100b includes a graphical element or component 520 that includes a displayed external image 518 (e.g., an angiogram image), an acquire new image button 1118 for acquiring a new one of the external images 518, and a continue button 1120 for continuing coregistration. Processor 504 can execute instructions 514 and receive instructions via I / O device 508 to select one of the external images 518 and begin coregistration using the selected image.

[0087] 11C shows a GUI 1100c that may be generated as GUI 530. GUI 1100c displays a frame of an angiographic image (e.g., a frame of external image 518 selected or captured as outlined above via GUI 1100b). Processor 504 may execute instructions 514 to generate GUI 1100c and display GUI 1100c on display 434. GUI 1100c includes a graphical element or component 520 that includes the frame of external image 518 and may be interacted with (e.g., via I / O device 508, etc.) to select an IVUS execution start location 522.

[0088] 11D shows GUI 1100d, which may be generated as GUI 530. GUI 1100d displays a frame of an angiographic image (e.g., a frame of external image 518 selected or captured as outlined above via GUI 1100b). Processor 504 may execute instructions 514 to generate GUI 1100d and display GUI 1100d on display 434. GUI 1100d includes a graphical element or component 520 that includes the frame of external image 518 and may be interacted with (e.g., via I / O device 508, etc.) to select an IVUS execution start location 522. For example, processor 504 may execute instructions 514 to add IVUS execution start location 522 at a location on external image 518 based on a touch, mouse, or other input or gesture received via display 434 or I / O device 508.

[0089] 11E shows a GUI 1100e that may be generated as GUI 530. GUI 1100e displays a frame of an angiographic image (e.g., a frame of external image 518 selected or captured as outlined above via GUI 1100b). Processor 504 may execute instructions 514 to generate GUI 1100e and display GUI 1100e on display 434. GUI 1100e includes a graphical element or component 520 that includes the frame of external image 518 and may be interacted with (e.g., via I / O device 508, etc.) to select an IVUS run end location 524.

[0090] 11F illustrates a GUI 1100f that may be generated as GUI 530. GUI 1100f displays a frame of an angiographic image (e.g., a frame of external image 518 selected or captured as outlined above via GUI 1100b). Processor 504 may execute instructions 514 to generate GUI 1100f and display GUI 1100f on display 434. GUI 1100f includes a graphical element or component 520 that includes a frame of external image 518 and may be interacted with (e.g., via I / O device 508, etc.) to select an IVUS execution start location 522. For example, processor 504 may execute instructions 514 to add an IVUS execution end location 524 at a location on external image 518 based on a touch, mouse, or other input or gesture received via display 434 or I / O device 508.

[0091] 11G illustrates a GUI 1100g that can be generated as GUI 530. GUI 1100g displays a frame of an angiographic image (e.g., a frame of the external image 518 selected or captured as outlined above) with the coregistration results displayed. Processor 504 can execute instructions 514 to generate GUI 1100g and display GUI 1100g on display 434. GUI 1100g includes a graphical element or component 520 that includes a frame of the external image 518, an adjust pullback path button 1122, an adjust side branch button 1124, and a confirm coregistration button 1126. Additionally, GUI 1100g includes a display of an IVUS run start location 522, an IVUS run end location 524, a coregistrated pullback path 526, and a coregistrated side branch 528.

[0092] As previously mentioned, the present disclosure provides for a user to be able to manipulate or adjust the coregistration results. The processor 504 can execute instructions 514 to receive an instruction to enter a pullback path adjustment interface (e.g., via activation of the pullback path adjustment button 1122), an instruction to enter a side branch adjustment interface (e.g., via activation of the side branch adjustment button 1124), or an instruction to confirm the coregistration results (e.g., via activation of the confirm coregistration button 1126).

[0093] 11H illustrates GUI 1100h, which may be generated as GUI 530. Processor 504 may execute instructions 514 to generate GUI 1100h and to display GUI 1100h on display 434 in response to activation of pullback path adjustment button 1122. GUI 1100h includes a graphical component 520 illustrating a frame of an angiographic image (e.g., a frame of external image 518 selected or captured as outlined above) with coregiven pullback path 526 and adjustment node 706. Processor 504 may execute instructions 514 to receive adjustments to coregiven pullback path 526 via manipulation of adjustment node 706 via various input devices (e.g., touchscreen display, I / O device 508, etc.). Additionally, processor 504 may execute instructions 514 to update GUI 530 (e.g., GUI 1100h, etc.) in real time to display the adjusted coregiven pullback path 526.

[0094] 11I illustrates a GUI 1100i, which may be generated as GUI 530. The processor 504 may execute the instructions 514 to generate the GUI 1100i and display the GUI 1100i on the display 434 in response to activation of a side branch adjustment button 1124. The GUI 1100h includes a graphical component 520 illustrating a frame of an angiographic image (e.g., a frame of the external image 518 selected or captured as outlined above) having a coregiven pullback path 526, a coregiven side branch 528, and a side branch adjustment node 1128. Additionally, the GUI 1100h includes a back button 1130 for returning to the previous GUI (e.g., GUI 1100h), and a confirm coregiven button 1126.

[0095] Additionally, the GUI 1100i includes a graphical component 520 showing a longitudinal representation of the IVUS image 516 and a mini vessel profile view 1132 including key frames 1134 and co-registered side branches 528. In some embodiments, the co-registered side branches may be depicted as lines, numbers, letters, or other indications to distinguish between different side branches.

[0096] The processor 504 can execute the instructions 514 to receive adjustments to the co-registered side branch 528 via operation of the side branch adjustment node 1128 via various input devices (e.g., touchscreen display, I / O device 508, etc.). Additionally, the processor 504 can execute the instructions 514 to update the GUI 530 (e.g., GUI 1100i, etc.) in real time to display the adjusted co-registration results (e.g., the co-registered side branch 528).

[0097] In some embodiments, some of the co-registered side branches 528 may be adjusted by selecting two (or more) side branches and moving one of the selected side branches. In some embodiments, the processor 504 may execute the instructions 514 to emphasize (e.g., highlight, bold, etc.) some of the co-registered side branches 528 selected for adjustment via the side branch adjustment node 1128 in the mini vessel profile view 1132. In some embodiments, the selected side branches may be adjusted via interaction with a graphical element of the side branch adjustment node 1128 shown on the external image 518 or via interaction with a graphical element of the co-registered side branches 528 shown in the mini vessel profile view 1132.

[0098] 11J and 11K show GUIs 1100j and 1100k, respectively. GUIs 1100j and 1100k include graphical components 520 illustrating similar elements as GUI 1100i, and further illustrate adjustments to side branch adjustment nodes 1128. For example, these figures show side branch adjustment nodes 1128 corresponding to co-registered side branches 528 "A" and "C" being adjusted. Processor 504 can execute instructions 514 to generate GUI 1100j and / or GUI 1100k in response to receiving adjustments or manipulations to co-registered side branches 528 (e.g., via a touchscreen, via I / O device 508, etc.).

[0099] It should be noted that GUIs 1100a-1100k may be generated as part of logic flow 600. However, further description of logic flow 600 is omitted for the sake of brevity.

[0100] 12A-12H illustrate GUIs 1200a-1200h, respectively, each of which may be generated as GUI 530. Processor 504 may execute instructions 514 to generate GUIs 530 including graphical components 520 as shown in these GUIs. Generally, these GUIs include a graphical representation like GUI 1100a, but the confirmed coregistration results are shown in external image view 1102. These GUIs show a graphical representation of a key frame 1134 positioned on external image 518 and a slider marker 1202 coupled to slider 1116. Thus, processor 504 may execute instructions 514 to receive instructions (e.g., via I / O device 508, etc.) to move slider 1116. Additionally, in some embodiments, a bookmark (or multiple bookmarks) for frames of IVUS images 516 may be displayed in external image view 1102 and vascular profile view 1104. For example, FIG. 12B illustrates a GUI 1200b showing a graphical representation of a bookmark 1204 displayed in the external image view 1102 and the vessel profile view 1104.

[0101] In response to receiving the instruction, the processor 504 can execute the instructions 514 to generate the GUIs in these figures. When the slider 1116 is moved in the vessel profile view 1104, the slider marker 1202 is moved in the external image view 1102, and the frame of the IVUS image 516 shown in the cross-sectional view 1106 is adjusted accordingly. An advantage of co-registration is that the frame of the IVUS image 516 is aligned with the external image 518, so that when the slider 1116 is adjusted and the slider marker 1202 indicates the position of the slider 1116 on the external image 518, the frame of the IVUS image 516 that matches the position of the vessel 202 in the external image 518 is displayed in the cross-sectional view 1106.

[0102] 12C shows GUI 1200c illustrating slider 1116 moved proximally along blood vessel 202, the position of slider marker 1202 in external image view 1102, and the frame of IVUS image 516 represented in cross-sectional view 1106 adjusted accordingly. Processor 504 can execute instructions 514 to generate GUI 1200c as GUI 530 in response to received input.

[0103] 12D shows GUI 1200d showing slider 1116 moved further proximally along vessel 202, the position of slider marker 1202 in external image view 1102, and the frame of IVUS image 516 represented in cross-sectional view 1106 adjusted accordingly. Processor 504 can execute instructions 514 to generate GUI 1200d as GUI 530 in response to received input.

[0104] 12E shows GUI 1200e showing slider 1116 moved further proximally along vessel 202, the position of slider marker 1202 in external image view 1102, and the frame of IVUS image 516 represented in cross-sectional view 1106 adjusted accordingly. Processor 504 can execute instructions 514 to generate GUI 1200e as GUI 530 in response to received input.

[0105] 12F shows GUI 1200f showing slider 1116 moved further proximally along vessel 202, the position of slider marker 1202 in external image view 1102, and the frame of IVUS image 516 represented in cross-sectional view 1106 adjusted accordingly. Processor 504 can execute instructions 514 to generate GUI 1200f as GUI 530 in response to received input.

[0106] 12G shows GUI 1200g showing slider 1116 moved further proximally along vessel 202, the position of slider marker 1202 in external image view 1102, and the frame of IVUS image 516 represented in cross-sectional view 1106 adjusted accordingly. Processor 504 can execute instructions 514 to generate GUI 1200g as GUI 530 in response to received input.

[0107] 12H shows GUI 1200h showing slider 1116 moved further proximally along vessel 202, the position of slider marker 1202 in external image view 1102, and the frame of IVUS image 516 represented in cross-sectional view 1106 adjusted accordingly. Processor 504 can execute instructions 514 to generate GUI 1200h as GUI 530 in response to received input.

[0108] 13 illustrates a computer-readable storage medium 1300. The computer-readable storage medium 1300 may comprise any non-transitory computer-readable or machine-readable storage medium, such as an optical storage medium, a magnetic storage medium, or a semiconductor storage medium. In various embodiments, the computer-readable storage medium 1300 may constitute an article of manufacture. In some embodiments, the computer-readable storage medium 1300 may store computer-executable instructions 1302 that can be executed by a circuit (e.g., processor 106, processor 504, IVUS / vascular imaging system acquisition circuitry 512, etc.). For example, the computer-executable instructions 1302 may include instructions for performing the operations described with respect to instructions 514, logic flow 600, graphical component 520, and / or GUI 530. Examples of computer-readable storage medium 1300 or machine-readable storage media may include any tangible medium capable of storing electronic data, including volatile or non-volatile memory, removable or non-removable memory, erasable or non-erasable memory, writable or rewritable memory, etc. Examples of computer-executable instructions 1302 may include any suitable type of code, such as source code, compiled code, interpreted code, executable code, static code, dynamic code, object-oriented code, visual code, etc.

[0109] 14 illustrates a schematic diagram of a machine 1400 in the form of a computer system upon which a set of instructions may be executed to cause the machine to perform any one or more of the methodologies described herein. More specifically, FIG. 14 illustrates a schematic diagram of a machine 1400 in the exemplary form of a computer system upon which instructions 1408 (e.g., software, program, application, applet, app, or other executable code) may be executed to cause the machine 1400 to perform any one or more of the methodologies described herein. For example, the instructions 1408 may cause the machine 1400 to perform logic flow 600 of FIG. 6 , or the like. More generally, the instructions 1408 may cause the machine 1400 to automatically determine key frames pre-, peri-, or post-PCI using IVUS. It should be noted that the present disclosure provides specific implementations for co-registration of an IVUS image 516 with an external image 518, even after acquisition, which is a significant improvement over the prior art.

[0110] The instructions 1408 transform a general, unprogrammed machine 1400 into a specific machine 1400 programmed to perform the functions described and illustrated in a specific manner. Alternatively, the machine 1400 may operate as a standalone device or may be coupled (e.g., networked) to other machines. In a networked arrangement, the machine 1400 may operate in the capacity of a server or client machine in a server-client network environment, or as a peer machine in a peer-to-peer (or distributed) network environment. The machine 1400 may include, but is not limited to, a server computer, a client computer, a personal computer (PC), a tablet computer, a laptop computer, a netbook, a set-top box (STB), a PDA, an entertainment media system, a mobile phone, a smartphone, a mobile device, a wearable device (e.g., a smart watch), a smart home device (e.g., a smart appliance), other smart devices, a web appliance, a network router, a network switch, a network bridge, or any machine capable of sequentially or otherwise executing instructions 1408 that specify operations to be performed by the machine 1400. Additionally, although only a single machine 1400 is illustrated, the term "machine" is also intended to include a collection of multiple machines 1400 that individually or jointly execute instructions 1408 to perform any one or more of the methodologies described herein.

[0111] Machine 1400 may include processor 1402, memory 1404, and I / O components 1442, which may be configured to communicate with each other via a bus 1444 or the like. In one embodiment, processor 1402 (e.g., a central processing unit (CPU), a reduced instruction set computing (RISC) processor, a complex instruction set computing (CISC) processor, a graphics processing unit (GPU), a digital signal processor (DSP), an ASIC, a radio frequency integrated circuit (RFIC), another processor, or any suitable combination thereof) may include, for example, processor 1406 and processor 1410, which may execute instructions 1408. The term "processor" is intended to include multi-core processors, which may include two or more independent processors (sometimes referred to as "cores") capable of simultaneously executing instructions. While FIG. 14 shows multiple processors 1402, machine 1400 may include a single processor with a single core, a single processor with multiple cores (e.g., a multi-core processor), multiple processors with a single core, multiple processors with multiple cores, or any combination thereof.

[0112] The memory 1404 may include a main memory 1412, a static memory 1414, and a storage unit 1416, all of which are accessible to the processor 1402, such as via a bus 1444. The main memory 1404, the static memory 1414, and the storage unit 1416 store instructions 1408 that embody any one or more of the methods or functions described herein. Also, the instructions 1408 may reside, completely or partially, within the main memory 1412, within the static memory 1414, within a machine-readable medium 1418 in the storage unit 1416, within at least one of the processors 1402 (e.g., within a processor's cache memory), or any suitable combination thereof, during their execution by the machine 1400.

[0113] I / O components 1442 may include a wide variety of components for receiving input, providing output, generating output, transmitting information, exchanging information, capturing measurements, etc. The particular I / O components 1442 included in a particular machine will depend on the type of machine. For example, a portable device such as a mobile phone will likely include a touch input device or other such input mechanism, while a headless server machine will likely not include such a touch input device. It will be understood that I / O components 1442 may include many other components not shown in FIG. 14 . I / O components 1442 are grouped according to function merely to simplify the following description, and this grouping is in no way limiting. In various exemplary embodiments, I / O components 1442 may include output components 1428 and input components 1430. Output components 1428 may include visual components (e.g., a display such as a plasma display panel (PDP), light-emitting diode (LED) display, liquid crystal display (LCD), projector, or cathode ray tube (CRT)), auditory components (e.g., speakers), tactile components (e.g., vibration motors, resistive mechanisms), other signal generators, etc. Input components 1430 may include alphanumeric input components (e.g., a keyboard, a touchscreen configured to receive alphanumeric input, a photo-optical keyboard, or other alphanumeric input component), point-based input components (e.g., a mouse, touchpad, trackball, joystick, motion sensor, or another pointing device), tactile input components (e.g., physical buttons, a touchscreen that provides the position and / or force of a touch or touch gesture, or other tactile input component), audio input components (e.g., a microphone), etc.

[0114] In further exemplary embodiments, I / O component 1442 may include a biometric component 1432, a motion component 1434, an environmental component 1436, or a position component 1438, among a wide variety of other components. For example, biometric component 1432 may include components for detecting facial expressions (e.g., hand expressions, facial expressions, vocal expressions, gestures, or eye tracking), measuring biosignals (e.g., blood pressure, heart rate, body temperature, sweat, or brain waves), identifying people (e.g., voice identification, retinal identification, face identification, fingerprint identification, or brainwave-based identification), etc. Motion component 1434 may include an acceleration sensor component (e.g., an accelerometer), a gravity sensor component, a rotation sensor component (e.g., a gyroscope), etc. The environmental components 1436 may include, for example, an illumination sensor component (e.g., a light meter), a temperature sensor component (e.g., one or more thermometers that detect ambient temperature), a humidity sensor component, a pressure sensor component (e.g., a barometer), an acoustic sensor component (e.g., one or more microphones that detect background noise), a proximity sensor component (e.g., an infrared sensor that detects nearby objects), a gas sensor (e.g., a gas detection sensor that detects concentrations of harmful gases or measures pollutants in the air for safety purposes), or other components that may provide an indication, measurement, or signal corresponding to the surrounding physical environment. The position component 1438 may include a location sensor component (e.g., a GPS receiver component), an altitude sensor component (e.g., an altimeter or barometer that detects air pressure from which altitude can be derived), an orientation sensor component (e.g., a magnetometer), etc.

[0115] Communication may be achieved using a wide variety of technologies. I / O component 1442 may include a communication component 1440 operable to couple machine 1400 to network 1420 or device 1422 via coupling 1424 and coupling 1426, respectively. For example, communication component 1440 may include a network interface component or another suitable device for interfacing with network 1420. In further embodiments, communication component 1440 may include a wired communication component, a wireless communication component, a cellular communication component, a near-field communication (NFC) component, a Bluetooth® component (e.g., Bluetooth® Low Energy), a Wi-Fi® component, and other communication components that provide communication via other modalities. Device 1422 may be another machine or any of a wide variety of peripheral devices (e.g., a peripheral device connected via USB).

[0116] Further, the communication component 1440 may detect an identifier or may include a component operable to detect an identifier. For example, the communication component 1440 may include a radio frequency identification (RFID) tag reader component, an NFC smart tag detection component, an optical reader component (e.g., an optical sensor for detecting one-dimensional barcodes such as Universal Product Code (UPC) barcodes, multidimensional barcodes such as Quick Response (QR) code, Aztec code, Data Matrix, Dataglyph, MaxiCode, PDF417, Ultra Code, UCC RSS-2D barcodes, and other optical codes), or an acoustic detection component (e.g., a microphone for identifying tagged audio signals). Additionally, various information may be derived via the communication component 1440, such as location via Internet Protocol (IP) geolocation, location via Wi-Fi signal triangulation, location by detection of NFC beacon signals that may indicate a particular location, etc.

[0117] Various memories (i.e., memory 1404, main memory 1412, static memory 1414, and / or memory of processor 1402) and / or storage unit 1416 may store one or more sets of instructions and data structures (e.g., software) that embody or are utilized by any one or more of the methods or functions described herein. These instructions (e.g., instructions 1408), when executed by processor 1402, cause various operations to be performed to implement the disclosed exemplary embodiments.

[0118] As used herein, the terms “machine storage medium,” “device storage medium,” and “computer storage medium” mean the same thing and may be used interchangeably in this disclosure. These terms refer to single or multiple storage devices and / or media (e.g., centralized or distributed databases, and / or associated caches and servers) that store executable instructions and / or data. Accordingly, these terms shall be interpreted to include, but are not limited to, solid-state memory, including memory internal or external to a processor, and optical and magnetic media. Specific examples of machine storage medium, computer storage medium, and / or device storage medium include, for example, non-volatile memory, including semiconductor memory devices such as erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), FPGAs, and flash memory devices; magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and CD-ROM and DVD-ROM disks. The terms "machine storage media," "computer storage media," and "device storage media" specifically exclude carrier waves, modulated data signals, and other such media, at least some of which are covered under the term "signal media" discussed below.

[0119] In various embodiments, one or more portions of network 1420 may be an ad-hoc network, an intranet, an extranet, a VPN, a LAN, a WLAN, a WAN, a WWAN, a MAN, the Internet, a portion of the Internet, a portion of the PSTN, a plain old telephone service (POTS) network, a cellular telephone network, a wireless network, a Wi-Fi network, another type of network, or a combination of two or more such networks. For example, network 1420 or portions of network 1420 may include a wireless or cellular network, and coupling 1424 may be a Code Division Multiple Access (CDMA) connection, a Global System for Mobile (GSM) connection, or another type of cellular or wireless connection. In this example, coupling 1424 may implement any of various types of data transfer technologies, such as Single Carrier Radio Transmission Technology (1xRTT), Evolution-Data Optimized (EVDO) technology, General Packet Radio Service (GPRS), Enhanced Data rates for GSM Evolution (EDGE) technology, third Generation Partnership Project (3GPP) including 3G, fourth generation wireless (4G) networks, Universal Mobile Telecommunications System (UMTS), High Speed ​​Packet Access (HSPA), Worldwide Interoperability for Microwave Access (WiMAX), Long Term Evolution (LTE) standards, others defined by various standards bodies, other long-range protocols, or other data transfer technologies.

[0120] The instructions 1408 may be transmitted or received over the network 1420 using a transmission medium via a network interface device (e.g., a network interface component included in the communications component 1440) and utilizing any one of several well-known transfer protocols (e.g., Hypertext Transfer Protocol (HTTP)). Similarly, the instructions 1408 may be transmitted or received using a transmission medium via a coupling 1426 (e.g., a peer-to-peer coupling) to the device 1422. The terms “transmission medium” and “signal medium” mean the same thing and may be used interchangeably in this disclosure. The terms “transmission medium” and “signal medium” shall be interpreted to include any intangible medium capable of storing, encoding, or carrying the instructions 1408 for execution by the machine 1400, including digital or analog communications signals or other intangible media for enabling the communication of such software. Accordingly, the terms “transmission medium” and “signal medium” shall be interpreted to include any form of modulated data signal, carrier wave, etc. The term “modulated data signal” means a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal.

[0121] Terms used in this specification should be governed by their ordinary meaning in the relevant art or the meaning indicated by usage in context, except that if an explicit definition is provided, that meaning shall prevail.

[0122] References herein to "one embodiment" or "an embodiment" do not necessarily refer to the same embodiment, but may. Throughout this specification and claims, words such as "comprise," "comprising," and the like, should be construed in an inclusive sense, i.e., "including, but not limited to," as opposed to an exclusive or exhaustive sense, unless the context clearly dictates otherwise. Words using the singular or plural also include the plural or singular, respectively, unless expressly limited to one or more. Furthermore, the words "herein," "above," "below," and words of similar import, when used in this application, refer to this application as a whole, not to any part of it. When a claim uses the word "or" in connection with a list of two or more items, the word encompasses all interpretations of the word: any of the items in the list, all of the items in the list, and any combination of the items in the list, unless expressly limited to one or the other. Any term not expressly defined herein has its conventional meaning as commonly understood by one of ordinary skill in the art.

[0123] Using authentic anatomical models allows for more accurate surgical planning than is possible through statistical modeling. Terms used in this specification should be governed by their ordinary meaning in the relevant art or the meaning indicated by usage in context, except that where an explicit definition is provided, that meaning shall prevail.

[0124] References herein to "one embodiment" or "an embodiment" do not necessarily refer to the same embodiment, but may. Throughout this specification and claims, words such as "comprise," "comprising," and the like, should be construed in an inclusive sense, i.e., "including, but not limited to," as opposed to an exclusive or exhaustive sense, unless the context clearly dictates otherwise. Words using the singular or plural also include the plural or singular, respectively, unless expressly limited to one or more. Furthermore, the words "herein," "above," "below," and words of similar import, when used in this application, refer to this application as a whole, not to any part of it. When a claim uses the word "or" in connection with a list of two or more items, the word encompasses all interpretations of the word: any of the items in the list, all of the items in the list, and any combination of the items in the list, unless expressly limited to one or the other. Any term not expressly defined herein has its conventional meaning as commonly understood by one of ordinary skill in the art.

Claims

1. 1. A method comprising: receiving an indication of an end position on an external image when the IVUS guide catheter is being inserted or has been inserted into the blood vessel and the blood vessel is represented on the external image; and generating a pullback path and a side branch of the IVUS pullback operation by registering each of a plurality of frames of a series of IVUS images captured from within a blood vessel via an IVUS pullback operation to a position on the external image based in part on a position and a starting position of the IVUS guide catheter, wherein the starting position corresponds to a position of a start of the IVUS pullback operation; generating a graphical user interface (hereinafter referred to as GUI) including a representation of the external image, the start location, the end location, the pullback path, and the side branch; receiving at least one modification to the pullback path and / or the side branch via an input device and the GUI; Regenerating the GUI, wherein the regenerated GUI comprises: the external image, the start position, the end position, and the pullback path and modified side branch; a modified pullback path and said side branch, or regenerating the GUI, the GUI including a representation of the modified pullback path and the modified side branch; and receiving, via the input device and the regenerated GUI, confirmation that the modified pullback path and / or the modified side branch have been confirmed.

2. The at least one correction is a correction to the pullback path, and the method includes: receiving modifications to the side branch via the input device and the regenerated GUI; and regenerating the GUI a second time, the second regenerated GUI including a display of the external image, the start position, the end position, the modified pullback path, and the modified side branch.

3. The method of claim 2 , wherein the pullback path is aligned with a longitudinal axis of a blood vessel.

4. The method of claim 3 , wherein the pullback path includes a plurality of nodes, and the at least one modification to the pullback path includes a modification to the position of one or more of the plurality of nodes.

5. The method of claim 4 , wherein the modification to the side branch changes the position of the side branch along the longitudinal axis.

6. 6. The method of claim 5, wherein the side branch is a first side branch of a plurality of side branches, and the method includes repositioning a second side branch of the plurality of side branches in response to the modification.

7. The method of claim 6 , wherein the regenerated GUI further comprises a numerical or textual designation for the plurality of side branches.

8. capturing an angiographic image displayed on a display device; and designating the angiographic image as the external image.

9. The method of claim 8 , including receiving an indication of the starting position from the input device.

10. The method of claim 9 , further comprising retrieving the series of IVUS images from a memory device.

11. 11. A method according to any preceding claim, comprising receiving an indication of the starting position on the external image from the input device.

12. The method according to any one of claims 1 to 11, wherein the external image is an X-ray image.

13. 13. The method of claim 1, wherein the regenerated GUI further includes a display of a longitudinal view of the series of IVUS images, and wherein the initially regenerated GUI further includes a slider that scrolls along a longitudinal axis of the series of IVUS images and a slider marker positioned on the pullback path, the slider marker being linked to the slider such that movement of the slider causes corresponding movement of the slider marker on the pullback path.

14. 14. An apparatus comprising: a processor coupled to a memory, the memory including instructions executable by the processor, the processor configured to be coupled to an intravascular ultrasound (IVUS) imaging system and configured to execute the instructions, which, when executed, cause the processor to perform the method of any one of claims 1 to 13.

15. 14. At least one machine-readable storage device comprising a plurality of instructions that, in response to being executed by a processor of an intravascular ultrasound (IVUS) imaging system, cause the processor to perform the method of any one of claims 1 to 13.

Images