Ultrasonic image guide, related apparatus, system, and method

Abstract

The guidance system is configured to detect a current orientation of the ultrasound transducer and determine a movement to achieve the desired orientation associated with a desired view or imaging plane of the patient's anatomy. The guidance system includes a processor circuit in communication with the ultrasound transducer. The processor circuit is configured to receive input related to the desired orientation of the ultrasound transducer, receive ultrasound imaging data representing the field of view of the ultrasound transducer at the current orientation, determine a movement to align the current orientation of the ultrasound transducer with the desired orientation, and generate a graphical representation of the movement. The graphical representation shows both the current orientation of the ultrasound transducer and the desired orientation of the ultrasound transducer. The graphical representation is output to a display in communication with the processor circuit.

Description

Technical Field

[0001] The present disclosure generally relates to the acquisition and processing of ultrasonic images, and more particularly to systems and methods for guiding an ultrasonic imaging procedure based on the acquired ultrasonic images.

Background Art

[0002] Ultrasonic imaging is frequently used to acquire images of a patient's internal anatomical structures. An ultrasonic system typically includes an ultrasonic transducer probe that includes a transducer array coupled to a probe housing. The transducer array vibrates at an ultrasonic frequency to transmit ultrasonic energy into the patient's anatomical structure and then is operated to receive ultrasonic echoes reflected or backscattered by the patient's anatomical structure to generate an image. Such transducer arrays can include various layers, including some having a piezoelectric material that vibrates in response to an applied voltage to generate a desired pressure wave. These transducers can be used to continuously transmit and receive several ultrasonic pressure waves through various tissues of the body. The various ultrasonic responses can be further processed by an ultrasonic imaging system to display the various structures and tissues of the body.

[0003] An ultrasound examiner may wish to obtain an ultrasound image representing a particular view or imaging plane of an organ in order to evaluate the condition of the organ and / or take measurements of the organ. For example, particular acoustic imaging windows of the heart that an ultrasound examiner may wish to obtain include "apical", "subcostal" (sub-xiphoid), "parasternal", and "suprasternal" windows. Standard imaging planes or views that a sonographer can obtain at each access window include apical four-chamber (A4C), apical two-chamber (A2C), apical three-chamber (A3C), apical five-chamber (A5C), parasternal long axis (PLAX), parasternal short axis (PSSA), subcostal long axis (SCLA), and subcostal four-chamber (SC4C) views. In each view, one or more sub-views may also be obtained, including the parasternal short axis view at the level of the mitral valve, aortic valve, apex, and papillary muscles. Obtaining these views involves positioning an ultrasound probe at a particular region of the patient's body and orienting the probe to obtain an image in the desired view. The movements used by an ultrasound examiner to position and orient the probe may be complex and may involve several degrees of freedom in three-dimensional space. Thus, it can be difficult for a less experienced ultrasound examiner to achieve the desired view. SUMMARY OF THE INVENTION PROBLEMS TO BE SOLVED BY THE INVENTION

[0004] Aspects of the present disclosure provide guidance for ultrasound imaging systems, as well as related devices and methods. MEANS FOR SOLVING THE PROBLEMS

[0005] In an exemplary embodiment, the guidance system is configured to detect the current position and orientation (pose) of the ultrasonic transducer and determine movements to achieve a desired pose related to a desired view or imaging plane of the patient's anatomical structure. In an exemplary embodiment, a processor circuit detects the current pose of the ultrasonic transducer based on ultrasonic imaging data acquired by the ultrasonic transducer and identifies a pose related to a desired view (e.g., an apical view) of the anatomical structure. In some embodiments, the desired pose can be determined using a model-based approach, artificial intelligence, machine learning, a neural network, or the like. Based on the determined movements, the processor circuit generates a graphical user interface, such as a two-dimensional graphical user interface or a three-dimensional graphical user interface, including a first indicator representing the current pose of the ultrasonic transducer and a second indicator representing the desired pose of the ultrasonic transducer, to achieve a desired view of the patient's biological structure. The second indicator is positioned and oriented relative to the first indicator to indicate one or more adjustments related to the movement, such as lateral sliding, sweeping, rotation, rocking, sector scanning, and / or compression. In this regard, embodiments of the present disclosure advantageously provide an intuitive probe-centered interface for guiding an ultrasonic imaging procedure with less mental manipulation or translation for the operator to move the ultrasonic transducer according to the instructions on the screen.

[0006] According to one embodiment of the present disclosure, an apparatus for guiding an ultrasonic imaging procedure includes a processor circuit configured to communicate with an ultrasonic transducer. The processor circuit receives an input associated with a desired orientation of the ultrasonic transducer from a user interface, the ultrasonic transducer is positioned in a current orientation, receives ultrasonic imaging data from the ultrasonic transducer representing a field of view of the ultrasonic transducer in the current orientation, and based on the ultrasonic imaging data and the input, determines a movement for aligning the current orientation of the ultrasonic transducer with the desired orientation and is configured to generate a graphical representation of the movement. The graphical representation includes a first indicator of the current orientation of the ultrasonic transducer and a second indicator of the desired orientation of the ultrasonic transducer positioned and oriented relative to the first indicator to indicate the movement. The processor circuit is further configured to output the graphical representation to a display that communicates with the processor circuit.

[0007] In some embodiments, the processor circuit is configured to detect a change in the current orientation of the ultrasonic transducer and update at least one of a first indicator or a second indicator of the graphical representation based on the detected change in the current orientation. In some embodiments, the processor circuit is configured to update the first indicator in real time based on the detected change in the current orientation. In some embodiments, the processor circuit is configured to use a machine learning algorithm to detect a change in the current orientation of the ultrasonic transducer based on ultrasonic imaging data. In some embodiments, the apparatus further comprises a position sensor configured to acquire position data of the ultrasonic transducer, and the processor circuit is configured to detect a change in the current orientation of the ultrasonic transducer based on the position data. In some embodiments, the first indicator and the second indicator include the same shape. In some embodiments, the movement includes two or more adjustments of the ultrasonic transducer, including a lateral sliding movement, a sweeping movement, a rocking movement, a sector sweeping movement, a rotational movement, a compression movement, or a decompression movement. In some embodiments, the second indicator graphically represents two or more adjustments of the ultrasonic transducer simultaneously.

[0008] In some embodiments, the user interface comprises a touch screen display, and the input is received based on a view selected on the touch screen display. In some embodiments, the second indicator comprises an inclination representing at least one of a rocking motion or a sector motion. In some embodiments, the processor circuit is configured to determine that the current orientation of the ultrasonic transducer is aligned with a desired orientation and, in response to determining that the current orientation is aligned with the desired orientation, save an image frame to the memory of the processor circuit.

[0009] According to another embodiment of the present disclosure, a method for guiding an ultrasonic imaging procedure includes receiving, from a user interface, an input associated with a desired orientation of an ultrasonic transducer; receiving, from the ultrasonic transducer, ultrasonic imaging data representing a field of view of the ultrasonic transducer in a current orientation; determining, based on the ultrasonic imaging data and the input, a movement for aligning the current orientation of the ultrasonic transducer with the desired orientation; and generating a graphical representation of the movement. The graphical representation includes a first indicator of the current orientation of the ultrasonic transducer and a second indicator of the desired orientation of the ultrasonic transducer positioned and oriented relative to the first indicator to indicate the movement. The method further includes outputting the graphical representation to a display.

[0010] In some embodiments, the method further includes detecting a change in the current orientation of the ultrasonic transducer and updating at least one of the first indicator or the second indicator of the graphical representation based on the detected change in the current orientation. In some embodiments, updating at least one of the first indicator or the second indicator includes updating the first indicator in real time based on the detected change in the current orientation. In some embodiments, detecting a change in the current orientation of the ultrasonic transducer includes detecting a change in the current orientation of the ultrasonic transducer based on ultrasonic imaging data using a machine learning architecture. In some embodiments, detecting a change in the current orientation of the ultrasonic transducer includes detecting a change in the current orientation of the ultrasonic transducer based on position data received from a position sensor.

[0011] In some embodiments, the first indicator and the second indicator include the same shape. In some embodiments, the movement includes two or more adjustments of the ultrasonic transducer, including a lateral sliding movement, a sweeping movement, a rocking movement, a fan-out movement, a rotational movement, or a compression movement, and the second indicator graphically represents two or more adjustments of the ultrasonic transducer simultaneously. In some embodiments, the second indicator has an inclination representing at least one of a rocking motion or a fan motion. In some embodiments, the method further includes determining that the current orientation of the ultrasonic transducer is aligned with a desired orientation, and storing an image frame in a memory device in response to determining that the current orientation is aligned with the desired orientation.

[0012] According to another embodiment of the present disclosure, an ultrasonic imaging system includes an ultrasonic probe including an ultrasonic transducer array, a user display configured to display a graphical user interface, a user interface device configured to receive one or more inputs, and a processor circuit in communication with the ultrasonic probe, the user interface device, and the user display. The processor circuit receives an input related to a desired orientation of the ultrasonic transducer from the user interface, the ultrasonic transducer is positioned in a current orientation, receives ultrasonic imaging data representing a field of view of the ultrasonic transducer in the current orientation from the ultrasonic transducer, determines the current orientation of the ultrasonic probe based on the ultrasonic imaging data, calculates a movement for aligning the current orientation of the ultrasonic probe with the desired orientation based on the current orientation and the desired orientation, and is configured to generate a graphical representation of the movement. The graphical representation includes a coordinate system, a first indicator of the current orientation of the ultrasonic probe overlaid on the coordinate system, and a second indicator of the desired orientation of the ultrasonic probe overlaid on the coordinate system and positioned and oriented relative to the first indicator to indicate the movement. The processor circuit is further configured to output the graphical representation to the user display.

[0013] Further aspects, features, and advantages of the present disclosure will become apparent from the following detailed description.

[0014] Exemplary embodiments of the present disclosure are described with reference to the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0015]

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DETAILED DESCRIPTION OF THE INVENTION

[0016] For the purpose of facilitating an understanding of the principles of the present disclosure, reference is now made to the embodiments shown in the drawings and the principles of the present disclosure will be described using specific language. However, it is understood that no limitation to the scope of the present disclosure is intended. Any changes and further modifications to the described apparatus, system, and method, as well as any further applications of the principles of the present disclosure, are fully contemplated and included within the present disclosure as would be normally contemplated by one of ordinary skill in the art to which the present disclosure pertains. In particular, it is fully contemplated that the features, components, and / or steps described with respect to one embodiment can be combined with the features, components, and / or steps described with respect to other embodiments of the present disclosure. However, for the sake of brevity, numerous repetitions of these combinations are not separately described.

[0017] FIG. 1 shows in block diagram form an ultrasonic system 100 according to an embodiment of the present disclosure. The ultrasonic probe 10 has a transducer array 12 that includes a plurality of ultrasonic transducer elements or acoustic elements. In some examples, the array 12 can include any number of acoustic elements. For example, the array 12 can include between one acoustic element and 100,000 acoustic elements, including values such as two acoustic elements, four acoustic elements, 36 acoustic elements, 64 acoustic elements, 128 acoustic elements, 300 acoustic elements, 812 acoustic elements, 3000 acoustic elements, 9000 acoustic elements, 30,000 acoustic elements, 65,000 acoustic elements, and / or other values larger and smaller. In some examples, the acoustic elements of the array 12 can be arranged in any suitable configuration, such as a linear array, a planar array, a curved array, a curvilinear array, a circumferential array, an annular array, a phased array, a matrix array, a one-dimensional (1D) array, a 1.X dimensional array (e.g., 1.5D array), or a two-dimensional (2D) array. The array of acoustic elements (e.g., one or more rows, one or more columns, and / or one or more orientations) can be controlled and activated uniformly or independently. The array 12 can be configured to acquire one-dimensional, two-dimensional, and / or three-dimensional images of a patient's anatomical structure.

[0018] Although the present disclosure refers to synthetic aperture external ultrasonic images using an external ultrasonic probe, it will be understood that one or more aspects of the present disclosure can be implemented in any suitable ultrasonic imaging probe or system, including an external ultrasonic probe and an intravascular ultrasonic probe. For example, aspects of the present disclosure can be implemented in an ultrasonic imaging system using a mechanically scanned external ultrasonic imaging probe, an intracardiac (ICE) echocardiography catheter and / or a transesophageal echocardiography (TEE) probe, a rotational intravascular ultrasonic (IVUS) imaging catheter, a phased array IVUS imaging catheter, a transthoracic echocardiography (TTE) imaging device, or any other suitable type of ultrasonic imaging device.

[0019] Referring back to FIG. 1, the acoustic elements of the array 12 can include one or more piezoelectric / piezoresistive elements, lead zirconate titanate (PZT), piezoelectric micromachined ultrasonic transducer (PMUT) elements, capacitive micromachined ultrasonic transducer (CMUT) elements, and / or any other suitable type of acoustic element. One or more acoustic elements of the array 12 communicate (e.g., are electrically coupled) with the electronic circuit 14. In some embodiments, such as the embodiment of FIG. 1, the electronic circuit 14 can include a microbeamformer (μBF). In other embodiments, the electronic circuit includes a multiplexer circuit (MUX). The electronic circuit 14 is disposed within the probe 10 and communicatively coupled to the transducer array 12. In some embodiments, one or more components of the electronic circuit 14 can be disposed within the probe 10. In some embodiments, one or more components of the electronic circuit 14 can be disposed within a computing device or processing system 28. The computing device 28 can be or include a processor, such as one or more processors that communicate with a memory. As further described below, the computing device 28 can include a processor circuit as shown in FIG. 2. In some aspects, some components of the electronic circuit 14 are disposed within the probe 10 and other components of the electronic circuit 14 are disposed within the computing device 28. The electronic circuit 14 can include one or more electrical switches, transistors, programmable logic devices, or other electronic components configured to couple and / or sequentially switch a plurality of inputs to transmit signals from each of the plurality of inputs via one or more common communication channels. The electronic circuit 14 can be coupled to the elements of the array 12 by a plurality of communication channels. The electronic circuit 14 is coupled to a cable 16 that transmits signals, including ultrasonic imaging data, to the computing device 28.

[0020] In the computing device 28, the signals are digitized and combined with the channels of the system beamformer 22 that appropriately delays each signal. The delayed signals are then combined to form a received beam that is coherently steered and focused. The system beamformer may comprise electronic hardware components, hardware controlled by software, or a microprocessor that executes a beamforming algorithm. In this regard, the beamformer 22 may be referred to as an electronic circuit. In some embodiments, the beamformer 22 may be a system beamformer such as the system beamformer 22 of FIG. 1, or a beamformer implemented by circuitry within the ultrasonic probe 10. In some embodiments, the system beamformer 22 operates in conjunction with a microbeamformer (e.g., electronic circuitry 14) disposed within the probe 10. The beamformer 22 can be an analog beamformer in some embodiments, or a digital beamformer in some embodiments. In the case of a digital beamformer, the system includes an A / D converter that converts the analog signals from the array 12 into digitized echo data that is sampled. The beamformer 22 generally includes one or more microprocessors, shift registers, and / or digital or analog memories for processing the echo data into coherent echo signal data. The delay is brought about by various means such as the write / read interval of data temporarily stored in memory during sampling of the received signal, or the length or clock rate of a shift register as described in U.S. Patent No. 4,173,007 (McKeighen et al.). Further, in some embodiments, the beamformer can apply appropriate weights to each of the signals generated by the array 12. The beamformed signals from the image field are processed by the signal and image processor 24 to generate a 2D or 3D image for display on the image display 30. The signal and image processing apparatus 24 may comprise electronic hardware components, hardware controlled by software, or a microprocessor that executes an image processing algorithm.It generally also includes special hardware or software that processes the received echo data into image data for an image in a desired display format, such as a scan converter. In some embodiments, the beamforming function can be split among different beamforming components. For example, in some embodiments, system 100 can be disposed within probe 10 and include a microbeamformer that communicates with system beamformer 22. The microbeamformer can perform preliminary beamforming and / or signal processing that can reduce the number of communication channels required to transmit the received signals to computing device 28.

[0021] Control of ultrasound system parameters such as scan mode (e.g., B-mode, M-mode), probe selection, beam steering and focusing, and signal and image processing is performed under the control of system controller 26 coupled to various modules of system 100. System controller 26 can be formed by an application specific integrated circuit (ASIC) or a microprocessor circuit and a software data storage device such as RAM, ROM, or a disk drive. In the case of probe 10, a portion of this control information is provided from computing device 28 to electronic circuit 14 via cable 16 and can adjust electronic circuit 14 for the operation of the array required for a particular scan procedure. The user inputs these operating parameters by means of user interface device 20.

[0022] In some embodiments, image processing device 24 is further configured to generate images in different modes that are either further analyzed or output to display 30. For example, in some embodiments, an image processor can be configured to compile a B-mode image, such as a live B-mode image of a patient's anatomical structure. In other embodiments, image processing device 24 is configured to generate or compile an M-mode image. An M-mode image can be described as an image showing the temporal changes of an anatomical structure imaged along a single scan line.

[0023] It is understood that the computing device 28 may comprise a computer processor, an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), a capacitor, a resistor, and / or other electronic devices, software, or a combination of hardware and software such as a hardware circuit. In some embodiments, the computing device 28 is a single computing device. In other embodiments, the computing device 28 comprises separate computer devices that communicate with each other.

[0024] The computing device 28 further includes a guidance system 25 that is used to generate guidance commands for the user to move the ultrasonic probe 10 into a desired or selected posture and output a pose. The guidance system 25 may be configured to receive various inputs from the system, including inputs from the interface device 20, ultrasonic imaging data from the ultrasonic probe 10, the system beamformer 22, and / or the signal and image processing device 24. In some embodiments, the guidance system 25 is configured to receive from the interface device 20 an input corresponding to a view of a desired or selected anatomical structure. The desired or selected view of the anatomical structure includes or is associated with the desired or selected posture of the ultrasonic probe 10. The guidance system 25 can determine the current posture of the ultrasonic probe 10 based on the ultrasonic imaging data and / or position data from a positioning system or sensor (e.g., a medical positioning system (MPS), an optical image sensor, an accelerometer, a gyroscope). For example, in some embodiments, the guidance system 25 includes an optical imaging sensor such as a camera, and the position data includes an image of the ultrasonic probe positioned with respect to the patient. In this embodiment, the guidance system is configured to determine the posture of the ultrasonic probe with respect to the patient's anatomical structure by processing the image.

[0025] In one embodiment, the guidance system 25 determines the orientation of the ultrasonic probe 10 with respect to one or more physical dimensions of the anatomical structure. For example, the guidance system 25 can determine the orientation of the probe with respect to xyz coordinates, locking angles, fanning angles, rotation angles, etc. with respect to the anatomical structure. In some embodiments, the guidance system 25 uses an anatomical model to determine the current orientation of the ultrasonic probe 10. In some embodiments, the guidance system 25 is configured to determine the current orientation using various image processing techniques including artificial intelligence (AI), machine learning, deep learning, and / or neural network architectures. For example, in some embodiments, a convolutional neural network (CNN) is used. Based on the determined current orientation and the selected or desired orientation of the ultrasonic probe 10, the guidance system 25 calculates the movement to align the current orientation of the ultrasonic probe 10 to the desired orientation and outputs a graphical representation of that movement to the display 30.

[0026] FIG. 2 is a schematic diagram of a processor circuit 150 according to an embodiment of the present disclosure. The processor circuit 150 may be implemented in the computing device 28, signal and image processing device 24, controller 26, and / or probe 10 of FIG. 1. As shown, the processor circuit 150 may include a processor 160, a memory 164, and a communication module 168. These elements can communicate directly or indirectly with each other, for example, via one or more buses.

[0027] The processor 160 may include a central processing unit (CPU), a digital signal processor (DSP), an ASIC, a controller, an FPGA, another hardware device, a firmware device, or any combination thereof configured to execute the operations described herein. The processor 160 may also be implemented as a combination of computing devices, such as a combination of a DSP and a microprocessor, multiple microprocessors, one or more microprocessors cooperating with a DSP core, or any other such configuration.

[0028] Memory 164 can include a cache memory (e.g., the cache memory of processor 160), random access memory (RAM), magnetoresistive RAM (MRAM), read-only memory (ROM), field programmable gate array read-only memory (PROM), erasable field programmable gate array read-only memory (EPROM), electrically erasable field programmable gate array read-only memory (EEPROM), flash memory, solid state memory devices, hard disk drives, other forms of volatile and non-volatile memory, or combinations of different types of memory. In one embodiment, memory 164 includes a non-transitory computer-readable medium. Memory 164 can store instructions 166. When executed by processor 160, instructions 166 can include instructions that cause processor 160 to perform the operations described herein while referring to computing device 28 and / or probe 10 (FIG. 1). Instructions 166 may also be referred to as code. The terms “instructions” and “code” should be interpreted broadly to include any type of computer-readable statement. For example, the terms “instructions” and “code” may refer to one or more programs, routines, subroutines, functions, procedures, etc., and “instructions” and “code” can include a single computer-readable statement or many computer-readable statements.

[0029] Communication module 168 can include any electronic circuit and / or logic circuit for facilitating direct or indirect communication of data between computing device 28, probe 10, and / or display 30. In this regard, communication module 168 can be an input / output (I / O) device. In some instances, communication module 168 facilitates direct or indirect communication between various elements of processor circuit 150 and / or processing system 106 (FIG. 1A).

[0030] An ultrasound examiner may wish to obtain an ultrasound image representing a particular view or imaging plane of an organ (e.g., the apical view of the heart) in order to evaluate the condition of the organ and / or take measurements of the organ. However, the movements involved in positioning and orienting the probe can be complex and may involve adjustments in several degrees of freedom in three-dimensional space. Therefore, it can be difficult for an inexperienced ultrasound examiner to achieve the desired view. A guidance plan or procedure can be used to position the ultrasound probe at the desired position and orientation (i.e., pose). Accordingly, the present disclosure describes a guidance interface that displays movements related to the desired view in an intuitive manner with less mental transformation for the ultrasound examiner.

[0031] FIG. 3 is a flow diagram showing a method 200 for providing image-based guidance to achieve a desired view using an ultrasound probe and a display. It will be understood that method 200 may be performed using an ultrasound imaging device and / or an ultrasound imaging system such as system 100 shown in FIG. 1. For example, one or more steps of method 200 may be performed using guidance system 25 of system 100 as described above, which may include one or more features of processor circuit 150 described with respect to FIG. 2.

[0032] In step 210, the processor circuit of the guidance system receives ultrasound imaging data representing the field of view obtained by the ultrasound image transducer. The ultrasound imaging data can include raw analog ultrasound signals, digital ultrasound signals or data, filtered data, beamformed data, or any other suitable type of data. In some embodiments, the ultrasound imaging data may include B-mode data acquired by an imaging probe or imaging device. In some embodiments, the ultrasound imaging data may include Doppler data such as power Doppler or color Doppler, M-mode data, or any other suitable type of imaging data.

[0033] In step 220, the processor circuit receives an input indicating a desired posture of the ultrasonic transducer, where the desired posture represents the position and / or orientation of the ultrasonic transducer associated with a desired view such as an apical view of the heart. As described above, the desired posture can be represented by position information including values related to one or more physical dimensions or geometric parameters such as xyz coordinates, angles (e.g., sector sweep, rotation, rocking), spherical coordinates, cylindrical coordinates, etc. The desired posture and / or position information is stored in the memory of the processor circuit and can be called or retrieved from the memory in response to the receipt of the input.

[0034] The input can be received by a user interface device processor circuit, such as the user interface of system 100 shown in FIG. 1. In some embodiments, the user interface device comprises a touch screen display that presents a graphical display or interface that includes a list or selection of different cardiac echo image windows. In some embodiments, the user interface device comprises a touchless augmented reality display (e.g., glasses or a screen), such as the HOLOLENS display manufactured by Microsoft, Inc. FIG. 4A shows a graphical user interface 222 used to receive an input indicating a desired window. The graphical interface includes a schematic diagram 224 of the patient's anatomical structure and a plurality of window indicators 226 overlaid at corresponding positions of the anatomical structure 224 within the interface. The user can select the input by tapping on a window indicator 226 on the touch screen display, using a mouse, trackball, keyboard input, voice command, or any other suitable type of input. In some embodiments, when a window indicator 226 is selected, a set of views, typically defined by a scan protocol, is presented in the form of view indicators. For example, if the apical window is selected, the user may be provided with the option to switch between A4C, A2C, A3C, or A5C views by selecting the associated view indicator. In some embodiments, if no view selection is provided by the user, the system automatically selects a view that is available in the previously selected acoustic window and is commonly used or pre-defined. In some embodiments, when the user selects a window indicator 226, an example of a standard view is presented to the user. In some embodiments, the example standard view includes previously acquired images acquired in the window and / or view for which the exemplary standard view is selected. In some embodiments, the exemplary standard view is a description or illustration of the standard view. The exemplary standard view may be stored in a memory communicating with the processor.In some embodiments, indicator 226 includes a view indicator. In some embodiments, indicator 226 comprises a combination of a window indicator and a view indicator.

[0035] In some embodiments, an input for selecting a window and / or a view is automatically created using an image processing algorithm. For example, a processor circuit can determine the orientation of an ultrasonic transducer relative to a patient's anatomical structure by image processing of an ultrasonic imaging signal, and automatically select a window or a view based on the determined orientation. For example, the processor circuit can generate an input based on the view closest to that achieved by the ultrasonic transducer. In another example, the processor circuit can use a classification algorithm to determine the type of acoustic window and select such a window based on the prediction.

[0036] In some embodiments, when a desired orientation or view is received or determined by the processor circuit, the processor circuit outputs a user instruction for positioning the ultrasonic transducer at a particular location and / or orientation on the patient's anatomical structure. FIG. 4B shows an exemplary graphical user interface 232 showing a schematic diagram of a patient's anatomical structure and an ultrasonic probe or ultrasonic transducer positioned in a desired orientation relative to the patient's anatomical structure 224. The graphical user interface includes a text instruction corresponding to the indicator in the indicator 234 of the ultrasonic transducer. In some embodiments, the graphical user interface 232 includes only the indicator 234 or the text instruction of the ultrasonic transducer. In other embodiments, the user instruction includes an audible instruction, a tactile instruction, or any other suitable type of instruction.

[0037] In some embodiments, before the processor circuit receives the ultrasonic imaging data, an input indicating a desired pose or imaging plane is received. For example, an ultrasonic examiner can start an imaging procedure by selecting a desired window and / or view (e.g., an apical window and an A4C view), and then position the transducer to acquire ultrasonic imaging data. In some embodiments, the processor circuit is configured to receive a continuous stream of ultrasonic imaging data and can receive an input indicating a desired view simultaneously with the ultrasonic imaging data.

[0038] In step 230, the processor circuit determines a movement to align the current pose of the ultrasonic transducer to a desired pose based on the ultrasonic imaging data received in step 210 and the input received in step 220. In other words, step 230 includes determining a movement to achieve a view or pose related to the input received in step 220. In an exemplary embodiment, step 230 includes determining the current pose of the ultrasonic transducer by processing the ultrasonic imaging data. In some embodiments, the processor circuit uses artificial intelligence (AI), machine learning, and / or deep learning architectures to determine the current pose of the ultrasonic transducer. In one embodiment, a convolutional neural network (CNN) architecture is trained to predict the relative pose of the ultrasonic transducer with respect to a predetermined reference plane. Such algorithms are described, for example, in U.S. Provisional Patent Application No. 62 / 641,540, filed Mar. 12, 2018, entitled "Ultrasonic Image Plane Guide for Neural Networks and Related Apparatus, Systems, and Methods"; U.S. Provisional Patent Application No. 62 / 641,508, filed Mar. 12, 2018, entitled "Ultrasonic Imaging Plane Alignment Using Neural Networks and Related Devices, Systems, and Methods"; U.S. Provisional Patent Application No. 62 / 641,493, filed Mar. 12, 2018, entitled "Ultrasonic Imaging Dataset Acquisition for Neural Network Training and Related Apparatus, Systems, and Methods"; U.S. Provisional Patent Application No. 62 / 700,960, filed Jul. 20, 2018, entitled "Devices, Systems, Methods Related to Ultrasonic Imaging by Deep Learning"; U.S. Provisional Patent Application No. 62 / 906,368, filed Sep. 26, 2019, entitled "Automatic Closed-Loop Ultrasonic Plane Steering for Target Location in Ultrasonic Imaging and Related Devices, Systems, and Methods"; U.S. Provisional Patent Application No. 62 / 746,042, filed Oct. 16, 2018, entitled "Devices, Systems, and Methods Related to Deep Learning-Based Ultrasonic Image Guidance", the entire contents of each of which are incorporated herein by reference.

[0039] In that regard, FIG. 5 is a schematic diagram of an ultrasonic image 242 that has been processed according to an algorithm for determining the current pose of the ultrasonic transducer. The image 242 includes contours 244 of anatomical features such as organs, chambers of the heart, etc., which can be used to identify the current pose or view of the ultrasonic transducer in combination with anatomical features such as the mitral valve, aortic valve, septum, etc. The processor circuit may employ one or more of the above architectures, including AI, machine learning, deep learning, and / or neural networks. In some embodiments, the identified anatomical features may be compared to a model of the anatomical features to determine the current pose or view. In some embodiments, a state machine including a plurality of exemplary image frames associated with a plurality of different poses or views is used to determine the current pose or view of the ultrasonic transducer relative to the patient's anatomical features.

[0040] Using the current pose or view of the ultrasonic transducer determined by the processor circuit, the processor circuit determines the movement of the ultrasonic transducer to achieve the desired pose or view. The movement may include or can include some physical adjustments in one or more degrees of freedom. The movement can be determined by comparing the current pose to the desired pose. In that regard, the processor can determine a plurality of dimensional values related to the current pose, such as xyz coordinates, rotation angles, sector sweep angles, locking angles, etc. These dimensional values can then be compared to dimensional values related to the desired pose, such as xyz coordinates, rotation angles, sector sweep angles, locking angles, etc. Then, based on this comparison, the movement can be determined, for example, by subtracting the dimensional value of the current pose from the dimensional value of the desired probe. Thus, in some embodiments, the movement is determined based on a direct comparison of the current pose and the desired pose. In other embodiments, the movement is calculated by determining the current pose of the ultrasonic transducer in a reference coordinate system and comparing the current pose in the reference coordinate system to the desired pose in the reference coordinate system.

[0041] In step 240, the processor circuit generates a graphical representation of the movement determined in step 230. The graphical indicator may include a first indicator of the current orientation of the ultrasonic transducer and a second indicator of the desired orientation of the ultrasonic transducer that is oriented and disposed relative to the first indicator to indicate movement. One or both of the indicators may indicate movement such that one or more adjustments in one or more degrees of freedom are shown. In some embodiments, a plurality of adjustments in a plurality of degrees of freedom are indicated by the first and / or second indicators.

[0042] FIG. 6 is a schematic diagram of the movement of a plurality of ultrasonic transducers and a graphic indicator related to the movement. The shape of the graphical indicator can approximate or represent the ultrasonic transducer array of the ultrasonic transducer. The movement includes sliding, rocking, sweeping, fanning out, compressing, and rotating. Sliding involves a lateral translational movement of the transducer with the angular direction of the ultrasonic transducer remaining substantially unchanged. The sliding movement is shown as a lateral translation including a first indicator 310a of the ultrasonic transducer separated from a second indicator 310b representing a desired lateral position. Rocking involves a lateral tilt of the ultrasonic transducer along the lateral axis (i.e., the longer dimension) of the ultrasonic transducer. The rocking movement is shown using an inclination where the darker side of the indicator 312 represents the desired direction of rocking or tilting to achieve a desired posture or view. Sweeping involves a forward or backward translation of the ultrasonic transducer. The sweeping movement is indicated in the sweeping direction (e.g., forward / backward) by a first indicator 314a and a second indicator 314b separated from the first indicator 314a. Fanning involves a forward or backward tilt of the ultrasonic transducer along a lateral axis perpendicular to the lateral axis. The fanning out operation is shown in a similar manner to the representation of rocking in that the indicator 316 includes an inclination where the darker side of the indicator 316 represents the desired direction of fanning out or tilting to achieve a desired posture or view. Compression involves pushing the ultrasonic transducer into the patient along the vertical axis of the ultrasonic probe. Thus, compression involves applying an increasing force downward along the vertical axis to the ultrasonic probe. In contrast, decompression involves reducing the pressure or force applied to the patient by the ultrasonic probe. The compression movement is indicated by a contour displayed around the indicator 318 of the ultrasonic transducer. The decompression movement is indicated by a dashed contour around the indicator 321. In some embodiments, the thickness, width, color, or other visual aspects of the contour may correspond to the amount of compression / decompression required to achieve a desired view. The rotational movement involves rotating the ultrasonic transducer in a specific angular direction about the vertical axis of the ultrasonic probe.Rotational movement can be indicated by an indicator 320, such as a second indicator, being oriented or rotated in an angular direction related to a desired orientation relative to other indicators. In some embodiments, the indicator 320 representing rotation includes an arrow. However, in other embodiments, the indicator 320 does not include an arrow.

[0043] Referring again to FIG. 3, at step 250, the processor circuit outputs a graphical representation of the movement to a display that communicates with the processor circuit. In that regard, FIGS. 7 - 12 are exemplary graphical user interfaces that include graphical representations of movements determined to achieve a desired orientation or view according to aspects of the present disclosure. In some embodiments, when the processor circuit causes the user to place an ultrasonic transducer at a position shown in the graphical interface shown in FIGS. 4A and / or 4B, the processor circuit is configured to display the graphical user interfaces of FIGS. 7 through 12. The graphical user interfaces of FIGS. 7 through 12 are shown using a two - dimensional coordinate system, specifically a Cartesian plane. However, in other embodiments, other types of interfaces using various different coordinate systems (e.g., polar, cylindrical, spherical) can be shown.

[0044] FIG. 7 is an exemplary diagram of a graphical user interface 410 used in an ultrasonic image guidance procedure according to an aspect of the present disclosure. FIG. 7 shows a first indicator 412 of the current orientation of an ultrasonic transducer centered in a Cartesian coordinate system. In some aspects, initially showing the current orientation of the ultrasonic transducer at least at the center of the Cartesian plane advantageously provides more intuitive instructions for the operator to move the transducer. For example, in the approach centered on the transducer shown in FIG. 7, by following the indicator 412 displayed to move the transducer so that the operator of the transducer aligns the current orientation with the desired orientation, it may be possible to perform the indicated movement with less mental transformation or distortion. However, it will be understood that in other embodiments, the indicator 412 showing the initial or current view of the ultrasonic transducer may not be at the center of the Cartesian plane. For example, in some embodiments, a second indicator related to the desired orientation of the ultrasonic transducer is displayed at the center of the Cartesian plane.

[0045] FIG. 8 shows a graphical user interface 420 according to an aspect of the present disclosure. In that regard, FIG. 8, like FIG. 7, shows a first indicator 412 of the current and / or initial orientation of the ultrasonic transducer at the center of the Cartesian plane, and further includes a second indicator 414 associated with the desired orientation of the ultrasonic transducer spaced apart from the first indicator 412. In the illustrated embodiment, the first indicator 412 and the second indicator 414 have the same shape representing the shape of the ultrasonic transducer array. However, in some embodiments, one or both of the indicators may have different shapes. The second indicator 414 is laterally spaced from the first indicator 412 and represents an instruction to slide the ultrasonic transducer laterally to the right. The second indicator 414 further includes a gradient indicating a darker color on the right side of the second indicator, representing a rocking motion to the right along the horizontal axis of the ultrasonic transducer. Thus, the second indicator represents multiple types of movements (i.e., sliding and rocking) that can be performed simultaneously or separately by the operator. The graphical user interface 420 also has a third indicator 416 including a partially transparent tracking or movement path for moving the ultrasonic transducer from its initial or current orientation to the desired orientation. In some embodiments, the third indicator 416 comprises an arrow or another type of direction indicator. In other embodiments, the third indicator 416 is not shown.

[0046] In some embodiments, one or more of indicators 412, 414, 416 are updated by a processor circuit in response to the processor circuit detecting movement of the ultrasonic transducer. For example, in some embodiments, the processor circuit receives a continuous stream of ultrasonic imaging data, detects a change in the orientation of the ultrasonic transducer, and updates a first indicator 412 to provide a real-time view of the orientation of the ultrasonic transducer relative to a desired orientation. In some embodiments, a second indicator 414 may be displayed such that all movements or adjustments involved in achieving the desired orientation (e.g., slide, fan out, rock, sweep, etc.) are shown at once so that the position and / or orientation of the second indicator 414 relative to the Cartesian plane does not change. However, in other embodiments, one or more aspects such as the position, orientation, tilt, etc. of the second indicator 414 are updated incrementally or stepwise as the ultrasonic transducer progresses through different steps during navigation. In that regard, FIG. 9 shows a graphical user interface 430 in which the first and second indicators 412, 414 are updated in response to detecting that the ultrasonic transducer is moved as directed by the graphical user interface 420 of FIG. 8. Specifically, the first indicator 412 is shown in FIG. 9 as partially overlapping the second indicator 414. The second indicator 414 is also updated to represent subsequent movement commands that involve rotation of the ultrasonic transducer in a clockwise movement of approximately 120 degrees. Additionally, the second indicator 414 simultaneously shows a rocking motion due to a tilt applied across the horizontal axis of the second indicator 414.

[0047] When the operator completes the movement indicated by the indicators 412, 414 shown in FIGS. 8 and 9, the second indicator 414 is updated to instruct the operator to perform a fan-out movement as shown in the graphical user interface 440 of FIG. 10. The fan-out movement is represented by an inclination along the horizontal axis of the indicators 412 / 414 of the ultrasonic transducer. In some embodiments, the inclination includes multiple colors, darkness values, intensities, grayscale, patterns, or other visual features of the indicator. In some embodiments, the fan-out can be represented by other types of graphical indicators such as arrows, different shapes of indicators, and / or any other suitable type of graphical representation. When the desired posture is achieved so that an image of the desired imaging surface can be obtained, the graphical user interface 440 is updated to indicate that the movement is complete. FIG. 11 shows an updated graphical user interface 450 according to an embodiment of the present disclosure, where the movement is determined by the processor circuit to be complete. In the illustrated embodiment, only a single indicator 418 is shown in the desired posture. Since the movement is complete and the desired posture is achieved, no further visual indicator or graphic representation (e.g., inclination, arrow, partially transparent path) is shown. In some embodiments, the processor circuit is configured to provide other types of indicators for notifying the operator that the desired posture has been achieved, including visual indicators, audible indicators, and / or tactile indicators. For example, in some embodiments, a text indicator indicating that the desired posture has been achieved is displayed. In other embodiments, light is activated or a sound is reproduced by a speaker to indicate that the desired posture has been achieved.

[0048] In some cases, the processor circuit may not be able to determine the current orientation of the ultrasonic transducer, or may lose track of the current orientation of the ultrasonic transducer during movement. For example, in some instances, ribs or other anatomical features may block a portion of the field of view of the ultrasonic transducer. In other cases, the ultrasonic transducer may have insufficient contact or acoustic coupling with the patient such that the processor is unable to resolve anatomical features within the field of view. Accordingly, in some embodiments, the processor circuit is configured to update the graphical user interface to instruct the user to perform one or more movements that enable the processor circuit to determine the current orientation of the ultrasonic transducer. In that regard, FIG. 12 shows an exemplary embodiment of a graphical user interface 460 that includes a first indicator 412 disposed at the center of a Cartesian coordinate system and an instruction to move the ultrasonic transducer along an S-shaped path 422 to assist the processor circuit in determining the current orientation of the ultrasonic transducer relative to the patient's anatomical structure. In other embodiments, other types of paths are displayed, such as the path of FIG. 8, diagonal paths, lateral paths, longitudinal paths, circular paths, and the like. Further, in some embodiments, the graphical user interface 460 includes instructions for fanning, sweeping, locking, rotating, and / or compressing the ultrasonic transducer relative to the patient in the probe space. The instructions may also be provided in the anatomical space of the patient or the heart. For example, the user may be instructed to slide the probe to the left towards the sternum, or to rotate the probe slightly counterclockwise to align the probe marker with the right shoulder and stop as soon as the right ventricle comes into view. Instructions regarding patient positioning may also be provided. For example, if the image quality is poor (e.g., due to insufficient compression), the patient may be instructed to be placed in the supine position and the patient's left arm may be abducted to open the intercostal muscle space. Instructions regarding adjustment of imaging settings that may also affect the performance of the algorithm, such as depth, gain, TGC curve, etc., may also be provided.The graphical user interface 460 can be updated, for example, in response to a fault condition where ultrasonic images or imaging data analyzed by a processor circuit cannot be correlated with known views of a model or database, to indicate that the views cannot be automatically detected. Similarly, when the current view is detected again, the processor circuit can automatically update the graphical user interface 460 to indicate the next movement instruction in the guidance process.

[0049] Figures 13 through 15 show additional embodiments of the graphical user interface used in the ultrasonic guidance procedure. In that regard, FIG. 13 is a graphical user interface 500 in which a first indicator 512 corresponding to the current orientation of the ultrasonic transducer is spaced apart from the center of the Cartesian coordinate system, and a second indicator 514 corresponding to the desired orientation of the ultrasonic transducer is placed at the center of the Cartesian coordinate system. The graphical user interface 500 shown in FIG. 13 includes many similarities with the embodiments shown in FIGS. 7 through 12, including the current and desired orientations of the ultrasonic transducer, the shape of the indicators, the Cartesian coordinate system, and separate indicators 512, 514 for various movement inclinations and graphical representations. The graphical user interface 600 shown in FIG. 14 includes a gradient field 612 indicated by a plurality of gradually changing colors, shades, and / or patterns that can be similarly used to indicate movement. For example, the region 614 of the graphical user interface 600 can have a lighter color or shade that indicates to the operator to move the transducer towards the lighter region 614. As the user moves the transducer towards the region 614, the graphical user interface 600 can be updated such that the lighter region 614 becomes smaller and converges around the ultrasonic transducer. The shape of the lighter region 614 can indicate other types of movement such as fanning out, swaying, and / or rotating. FIG. 15 illustrates another embodiment of a graphical user interface 700 used in the ultrasonic guidance procedure in which arrows 716 are used to indicate different types of movement. In the illustrated embodiment, the arrows 716 are shown around a first indicator 712 representing the current orientation of the ultrasonic transducer and a second indicator 714 representing the desired orientation of the ultrasonic transducer. In that regard, the arrows can be used in addition to or instead of the indicators 712, 714.

[0050] Those skilled in the art will understand that the specific embodiments exemplified above are illustrative and are not intended to limit the scope of the present disclosure. In this regard, various modifications, substitutions, and / or combinations can be made to the above-described embodiments without departing from the scope of the present disclosure. One or more of the steps of the above-described method 200 can be performed by one or more components of an ultrasonic imaging system, such as a processor or processor circuit, a multiplexer, a beamformer, a signal processing unit, an image processing unit, or any other suitable component element of the system. For example, one or more of the steps described above can be performed by the processor circuit 150 described with respect to FIG. 2. The processing components of the system can be integrated within an ultrasonic imaging device included within an external console or can be distributed among various components of the system. One or more of the above-described examples of graphical user interfaces, indicators, and representations can be shown as two-dimensional and formatted for a two-dimensional display device, but the above-described graphical user interfaces, indicators, and representations can also include three-dimensional visualizations formatted for a three-dimensional display device, such as an augmented reality device, a virtual reality device, a 3D-capable monitor.

[0051] Those skilled in the art will recognize that the above-described apparatus, system, and method can be varied in various ways. Accordingly, those skilled in the art will understand that the embodiments encompassed by the present disclosure are not limited to the above specific exemplary embodiments. In this regard, while exemplary embodiments have been shown and described, a wide range of modifications, changes, and substitutions are contemplated in the foregoing disclosure. It is understood that such variations can be made without departing from the scope of the present disclosure. Accordingly, it is appropriate that the appended claims be construed broadly so as to be in conformity with the present disclosure.

Claims

1. An apparatus for guiding an ultrasonic imaging procedure, the apparatus comprising: A processor circuit configured to communicate with an ultrasonic transducer, the processor circuit: Receives an input related to a desired pose of the ultrasonic transducer from a user interface, the ultrasonic transducer is positioned in a current pose, the pose indicating the position and orientation of the ultrasonic transducer; Receives ultrasonic imaging data from the ultrasonic transducer representing a field of view of the ultrasonic transducer in the current pose; Based on the ultrasonic imaging data and the input, determines a movement for aligning the current pose of the ultrasonic transducer to the desired pose; Generates a graphical representation of the movement, the graphical representation comprising: A first indicator of the current pose of the ultrasonic transducer; and A second indicator of the desired pose of the ultrasonic transducer positioned and oriented relative to the first indicator to indicate the movement; Outputs the graphical representation to a display in communication with the processor circuit; Determines that the current pose of the ultrasonic transducer is aligned with the desired pose; and In response to determining that the current pose is aligned with the desired pose, saves an image frame to a memory of the processor circuit. A processor circuit configured as such. An apparatus having the processor circuit.

2. The processor circuit is configured to: Detect a change in the current pose of the ultrasonic transducer; and Based on the detected change in the current pose, update at least one of the first indicator or the second indicator of the graphical representation. The apparatus according to claim 1.

3. The processor circuit is configured to update the first indicator in real time based on the detected change in the current pose. The apparatus according to claim 2.

4. The processor circuit is configured to detect a change in the current pose of the ultrasonic transducer based on the ultrasonic imaging data using a machine learning algorithm. The apparatus according to claim 2.

5. The device further has a position sensor configured to acquire position data of the ultrasonic transducer, and the processor circuit is configured to detect a change in the current posture of the ultrasonic transducer based on the position data. The device according to claim 2.

6. The device according to claim 1, wherein the first indicator and the second indicator have the same shape.

7. The movement has two or more movements of the ultrasonic transducer including a lateral sliding movement, a sweeping movement, a swinging movement, a sector winding movement, a rotational movement, a compression movement, or a decompression movement, and the second indicator simultaneously graphically represents the two or more movements of the ultrasonic transducer. The device according to claim 1.

8. The device according to claim 1, wherein the user interface comprises a touch screen display, and the input is received based on a view selected on the touch screen display.

9. The device according to claim 1, wherein the second indicator has an inclination representing at least one of a swinging movement or a sector movement.

10. A method for guiding an ultrasonic imaging procedure, receiving, from a user interface, an input related to a desired posture of an ultrasonic transducer, wherein the ultrasonic transducer is positioned in a current posture, and the posture indicates a position and an orientation of the ultrasonic transducer; receiving ultrasonic imaging data representing a field of view of the ultrasonic transducer in the current posture from the ultrasonic transducer; determining a movement for aligning the current posture of the ultrasonic transducer to the desired posture based on the ultrasonic imaging data and the input; generating a graphical representation of the movement, the graphical representation comprising a first indicator of the current posture of the ultrasonic transducer, and a second indicator of the desired posture of the ultrasonic transducer positioned and oriented relative to the first indicator to indicate the movement ; outputting the graphical representation to a display; determining that the current posture of the ultrasonic transducer is aligned with the desired posture. In response to the step of determining that the current pose is aligned with the desired pose, a step of storing an image frame in a memory device A method having. **Claim 11** A step of detecting a change in the current pose of the ultrasonic transducer, and Based on the detected change in the current pose, a step of updating at least one of the first indicator or the second indicator of the graphical representation The method according to claim 10, further comprising. **Claim 12** The step of updating at least one of the first indicator or the second indicator includes the step of updating the first indicator in real time based on the detected change in the current pose. The method described. **Claim 13** The step of detecting a change in the current pose of the ultrasonic transducer includes the step of detecting a change in the current pose of the ultrasonic transducer based on the ultrasonic imaging data using a machine learning architecture. The method described. **Claim 14** The step of detecting a change in the current pose of the ultrasonic transducer includes the step of detecting a change in the current pose of the ultrasonic transducer based on position data received from a position sensor. The method described. **Claim 15** The method according to claim 10, wherein the first indicator and the second indicator have the same shape. **Claim 16** The movement includes two or more movements of the ultrasonic transducer, including a lateral sliding movement, a sweeping movement, a rocking movement, a fan-out movement, a rotational movement, or a compression movement, and the second indicator is the ultrasonic transducer. Graphically represents two or more movements of the above at the same time. The method described. **Claim 17** The method according to claim 10, wherein the second indicator has an inclination representing at least one of a rocking movement or a fan-out movement. **Claim 18** An ultrasonic imaging system, An ultrasonic probe having an ultrasonic transducer array, A user display configured to display a graphical user interface, A user interface device configured to receive one or more inputs, A processor circuit that communicates with the ultrasonic probe, the user interface device, and the user display, the processor circuit comprising: Receiving an input related to a desired orientation of the ultrasonic transducer from the user interface device, the ultrasonic transducer being positioned in a current orientation, the orientation indicating the position and orientation of the ultrasonic transducer; Receiving ultrasonic imaging data from the ultrasonic transducer representing a field of view of the ultrasonic transducer in the current orientation; Determining the current orientation of the ultrasonic probe based on the ultrasonic imaging data; Calculating a movement for aligning the current orientation of the ultrasonic probe to the desired orientation based on the current orientation and the desired orientation; Generating a graphical representation of the movement, the graphical representation comprising: A coordinate system; A first indicator of the current orientation of the ultrasonic probe overlaid on the coordinate system; A second indicator of the desired orientation of the ultrasonic probe overlaid on the coordinate system and positioned and oriented relative to the first indicator to indicate the movement; And; Outputting the graphical representation to the user display; A processor circuit configured as such; An ultrasonic imaging system having.

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