Systems and methods for automated catheter tracking

Abstract

The present disclosure provides a medical treatment system for guiding an imaging catheter in relation to a treatment catheter. The system comprises a treatment catheter, an imaging catheter with an imaging plane, and an electronic processor. The processor determines positions for both catheters and a desired intersection plane for the treatment catheter. Based on these determinations, the processor calculates a third position for the imaging catheter that aligns its imaging plane with the desired intersection plane. The system can generate instructions for manual guidance or automatically move the imaging catheter to the optimal position. Additionally, the system can process three-dimensional image data from the imaging catheter to automatically select two-dimensional slices based on the treatment catheter's position. The system improves visualization during medical procedures, potentially enhancing patient outcomes and reducing operator workload.

Description

Attorney Docket No. A0013538US01 (0116-US01)SYSTEMS AND METHODS FOR AUTOMATED CATHETER TRACKINGBACKGROUND

[0001] The present disclosure relates to medical imaging and treatment systems, and more particularly to systems and methods for automatically tracking and positioning an imaging catheter relative to a treatment catheter during a medical procedure.SUMMARY

[0002] Physicians performing ablation and other catheter-based treatments must be able to adequately visualize the catheter and the treatment site to ensure good outcomes. Traditional methods of visualization, (e.g., using fluoroscopy or external ultrasound) provide limited visualization of soft tissues and require manual alignment of multiple devices and equipment.

[0003] Attempts to address these problems involve intracardiac echocardiography (ICE) systems, which typically utilize two-dimensional imaging. However, two-dimensional imaging planes must be properly aligned to provide adequate visualization during procedures. This requires manual manipulation of the ICE catheter to obtain optimal views of the target anatomy and interventional devices. This manipulation can be challenging and time-consuming, often requiring a dedicated operator to continuously adjust the ICE catheter position and orientation throughout a procedure. Additionally, in many instances the imaging is related to another catheter being navigated in the heart, such that the manipulation of the ICE catheter must be coordinated with manipulation of the other catheter as handled by another operator, adding to the complexity. The limitations of 2D ICE imaging can lead to suboptimal visualization in complex cases.

[0004] More recently, four-dimensional (4D) ICE systems have been developed that can acquire volumetric ultrasound data, allowing for multi-planar reconstruction and 3D visualization capabilities. While 4D ICE provides more comprehensive imaging, extracting the most relevant 2D views from the volumetric dataset remains a manual process that can be difficult to optimize in real-time during interventional procedures.MBF\215364\0116\52094841.vl-ll / 16 / 25 1Attorney Docket No. A0013538US01 (0116-US01)

[0005] To address these technical problems, systems and methods are provided herein for automated tracking of treatment catheters to provide improved visualization to clinicians during procedures. The present disclosure provides various techniques for automatically following treatment catheters with images gathered via ICE catheters to improve the quality and timeliness of images captured during treatment procedures.

[0006] Examples presented herein utilize an imaging catheter, such as an ICE catheter, in conjunction with a treatment catheter to provide improved visualization and guidance during medical procedures.

[0007] In some embodiments presented herein, electromagnetic (EM) sensors are integrated into ICE catheters. According to some embodiments, tracking systems use these sensors to determine the position and orientation of the views gathered via ICE catheter relative to the treatment catheter throughout a procedure. For example, the ICE catheter may be left mainly stationary to capture a “wedge” of imaging data that includes a treatment catheter, where aspects of this disclosure relate to selecting one or more slices of this wedge that provide desired visualization and / or guidance (e.g., as the treatment catheter moves within this wedge). Additionally, or alternatively, guidance and / or robotic assistance may be provided to keep the ICE catheter in a desirable position for capturing useful images. Examples presented herein improve the precision and efficiency of procedures by ensuring the provided graphical data as gathered via the ICE catheter consistently follows the treatment catheter (whether by selecting different slices of a wedge and / or by having an ICE catheter move), providing optimal imaging and reducing the need for manual adjustments by the physician.

[0008] Examples described herein automatically align the imaging plane of the imaging catheter with a desired intersection plane of the treatment catheter. This alignment can be achieved through various means, including electromagnetic tracking, computer image analysis, or mechanical coupling of the catheters. The system can provide instructions to an operator for manual adjustment of the imaging catheter or automatically move the imaging catheter to the optimal position.

[0009] Aspects presented herein also provide for processing three-dimensional image data acquired by the imaging catheter. Image data is processed in light of the position of the treatmentMBF\215364\0116\52094841.vl-ll / 16 / 25 2Attorney Docket No. A0013538US01 (0116-US01) catheter to automatically select and display optimal two-dimensional slices for operators. This feature enhances the physician's ability to visualize the treatment area and guide the procedure.

[0010] Additional aspects of the invention include the integration of electroanatomical mapping system data, contact sensing, and impedance measurements to further refine the selection of imaging planes.

[0011] Embodiment and aspects presented herein reduce the cognitive load on operators, improve real-time visualization, and enhance patient outcomes through more precise therapy delivery.

[0012] In some aspects, the techniques described herein relate to a medical treatment system, the system including: a treatment catheter; an imaging catheter being configured to capture images along an imaging plane; an electronic processor coupled to the treatment catheter, and the imaging catheter, and configured to: determine a first position for the treatment catheter; determine a second position for the imaging catheter; determine a desired intersection plane for the treatment catheter; determine, based on the first position, the second position, and the desired intersection plane, a third position for the imaging catheter that would result in the imaging plane aligning with the desired intersection plane; generate an instruction for guiding the imaging catheter from the second position to the third position; and provide the instruction to an operator of the imaging catheter.

[0013] In some aspects, the techniques described herein relate to a medical treatment system, the system including: a treatment catheter; an imaging catheter having an imaging plane; an electronic display; an electronic processor coupled to the treatment catheter, the imaging catheter, and the electronic display, and configured to: determine a first position for the treatment catheter; determine a second position for the imaging catheter; determine a desired intersection plane for the treatment catheter; determine, based on the first position, the second position, and the desired intersection plane, a third position for the imaging catheter that would result in the imaging plane aligning with the desired intersection plane; and automatically move the imaging catheter from the second position to the third position.

[0014] In some aspects, the techniques described herein relate to a medical treatment system, the system including: a treatment catheter; an imaging catheter having an imaging plane; an electronic display; wherein the treatment catheter and the imaging catheter are coupled such thatMBF\215364\0116\52094841.vl-ll / 16 / 25 3Attorney Docket No. A0013538US01 (0116-US01) the imaging plane of the imaging catheter aligns with a desired intersection plane of the treatment catheter as the treatment catheter is moved within a patient.

[0015] In some aspects, the techniques described herein relate to a medical treatment system, the system including: an imaging catheter configured to acquire three-dimensional image data of a treatment region; a treatment catheter configured to deliver therapy to a target tissue in the treatment region; an electronic processor coupled to the imaging catheter and the treatment catheter, the electronic processor configured to: receive the three-dimensional image data from the imaging catheter; determine a position of the treatment catheter relative to the imaging catheter; and automatically select a two-dimensional slice of the three-dimensional image data based on the position of the treatment catheter relative to the imaging catheter.

[0016] The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, advantages, and implementations of the techniques described in this disclosure will become apparent by consideration of the detailed description and accompanying drawings, and from the claims.BRIEF DESCRIPTION OF THE DRAWINGS

[0017] The accompanying figures, where like reference numerals refer to identical or functionally similar elements throughout the separate views, together with the detailed description below, are incorporated in and form part of the specification, and serve to further illustrate embodiments, examples, aspects, and features of concepts that include the claimed subject matter and explain various principles and advantages of those implementations, embodiments, examples, aspects, and features.

[0018] Before any examples are explained in detail, it is to be understood that the examples presented herein are not limited in their application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. The examples are capable of other embodiments and of being practiced or of being carried out in various ways. For ease of description, the example systems presented herein may be illustrated with a single exemplar of each of its component parts. Some examples may not describe or illustrate all components of the systems. Other example embodiments may includeMBF\215364\0116\52094841.vl-ll / 16 / 25 4Attorney Docket No. A0013538US01 (0116-US01) more or fewer of each of the illustrated components, may combine some components, or may include additional or alternative components.

[0019] FIG. 1 illustrates a block diagram of a medical system, according to aspects of the present disclosure.

[0020] FIG. 2 illustrates a block diagram of an electronic computing device, according to an embodiment.

[0021] FIG. 3 illustrates a flowchart of a method for guiding an imaging catheter, according to aspects of the present disclosure.

[0022] FIG. 4 illustrates a flowchart of a method for automatically positioning an imaging catheter, according to an embodiment.

[0023] FIG. 5 illustrates a flowchart of a method for processing three-dimensional image data, according to aspects of the present disclosure.

[0024] FIG. 6 illustrates aspects of the operation of the medical system of FIG. 1, according to an embodiment.

[0025] FIG. 7 illustrates a schematically illustrates a composite view of ultrasound imaging data, according to aspects of the present disclosure.

[0026] FIG. 8 illustrates a two-dimensional ultrasound image of a treatment region, according to an embodiment.

[0027] Skilled artisans will appreciate that elements in the figures are illustrated for simplicity and clarity and have not necessarily been drawn to scale. For example, the dimensions of some of the elements in the figures may be exaggerated relative to other elements to help to improve understanding of examples, aspects, and features illustrated.

[0028] For ease of description, some or all of the example systems presented herein are illustrated with a single exemplar of each of its component parts. Some examples may not describe or illustrate all components of the systems. Other example implementations may include more or fewer of each of the illustrated components, may combine some components, or may include additional or alternative components.MBF\215364\0116\52094841.vl-ll / 16 / 25 5Attorney Docket No. A0013538US01 (0116-US01)

[0029] In some instances, the apparatus and method components have been represented where appropriate by conventional symbols in the drawings, showing only those specific details that are pertinent to understanding the of various embodiments, examples, aspects, and features so as not to obscure the disclosure with details that will be readily apparent to those of ordinary skill in the art having the benefit of the description hereinDETAILED DESCRIPTION

[0030] Specific embodiments of the present disclosure are now described with reference to the figures. The terms “distal” and “proximal” are used in the following description with respect to a position or direction along the primary (long) axis of a minimally invasive device, such as a catheter, relative to the portion of the device that is manipulated by the treating clinician.“Distal” or “distally” are a position distant from or in a direction away from the portion of the device that is manipulated by the clinician. “Proximal” and “proximally” are a position near or in a direction toward the portion of the device that is manipulated by the clinician.

[0031] FIG. 1 illustrates an example medical system 100, which is suitable for performing medical procedures (e.g., cryoablation, radiofrequency ablation, pulsed field ablation, drug delivery) using medical devices such as focal catheters, balloon catheters, basket catheters, loop catheters, lattice catheters, and the like. The system 100 may be configured to perform cardiac procedures as well as procedures other parts of the body, such as in the renal arteries, and / or in other vessels, including the celiac trunk and its branches, the splenic artery and its branches, the common hepatic artery and its branches, the left gastric artery and its branches, the superior and inferior mesenteric arteries and their branches, and the pulmonary artery and its branches.

[0032] The medical system 100 includes a treatment system 102, an ultrasound system 104, a tracking system 106, and an electronic computing device 110. The components of the system 100 are physically, electronically, and / or communicatively coupled as appropriate and are configured to be operated by one or more medical personnel to deliver treatment to a patient positioned on the table 112 (e.g., an operating table or other table suitable for use during a surgical procedure).

[0033] The treatment system 102 includes a treatment catheter 114. The treatment catheter 114 is a highly flexible treatment device that is suitable for passage through the vasculature. In some instances, efficacy of a procedure using the treatment catheter 114 is dependent uponMBF\215364\0116\52094841.vl-ll / 16 / 25 6Attorney Docket No. A0013538US01 (0116-US01) navigating the treatment catheter 114 to one or more specific treatment sites, and / or on achieving one or more specific configurations relative to the treatment site once navigated to the treatment site(s). The treatment catheter 114 may be adapted for use with a radiofrequency generator (e.g., to deliver radiofrequency ablation (RFA) therapy), a pulsed field generator (e.g., to deliver pulsed field ablation (PF A) therapy), or a coolant delivery system (e.g., to deliver cryoablation therapy). Other examples of the treatment catheter 114 include variants for delivering laser ablation, high-intensity focused ultrasound ablation, and other types of ablation therapy. In the example illustrated, the treatment catheter 114 has an elongate body 116 having a proximal portion 118 and a distal portion 120. The distal portion 120 includes a treatment element 124. The proximal portion 118 of the treatment catheter 114 is mated to a handle 122 that can include elements such as levers or knobs for manipulating the elongate body 116 and the treatment element 124. In some embodiments, the handle and its elements may be operated partially or fully autonomously (e.g., through the use of computer-guided robotics). In the illustrated example, the treatment catheter 114 is a lattice catheter for delivering radiofrequency and pulsed field ablation therapy. However, the systems and methods described herein are not limited in their application to medical systems incorporating lattice catheters. The embodiments described herein are applicable to other types of treatment catheters. For example, in some embodiments, the treatment catheter 114 may be a delivery system that does not provide ablation therapy, but rather delivers a drug or device to the targeted location (e.g., a heart valve or gene delivery).

[0034] The elongate body 116 (also referred to herein as a “shaft”) is sized and configured to be passable through a patient’s vasculature and / or positionable proximate to the area of target tissue, and may include one or more lumens disposed within the elongate body 116 that provide mechanical, electrical, and / or fluid communication between the proximal portion 118 of the elongate body 116 and the distal portion 120 of the elongate body 116. In some aspects, the elongate body 116 includes a guidewire lumen through which a guidewire or other system components may be located and extended from the distal portion 120 of the treatment catheter 114. The elongate body 116 is configured to facilitate the navigation of the treatment catheter 114 within a patient’s body. In one aspect, the distal portion 120 of the elongate body 116 is flexible and deflectable to allow for more desirable positioning proximate to an area of target tissue (e.g., positioning within the pulmonary veins, the ventricles, the Cavo tricuspid isthmus, and the like). To access an area of target tissue, the treatment catheter 114 may be insertedMBF\215364\0116\52094841.vl-ll / 16 / 25 7Attorney Docket No. A0013538US01 (0116-US01) through one or more blood vessels, such as, for example, one or more femoral veins, or other points of access including arterial access.

[0035] The distal portion 120 also includes one or more tracking elements 126, which work in concert with the tracking system 106 to locate the treatment catheter 114 in three-dimensional space. Tracking elements 126 may be elements that increase the ability for the treatment catheter 114 to be identified. For example, tracking elements 126 may be elements that increase the ability to reflect ultrasound waves generated by ultrasound system 104. For purposes of discussion, tracking elements 126 are discussed as electromagnetic tracking sensors. In examples, where tracking elements 126 are electromagnetic tracking sensors, the tracking system 106 controls an electromagnetic (EM) field generator 128, which is positioned on or under the table 112, to track the positions of one or more instruments within the body of a patient during a procedure. The EM field generator 128 is configured to generate one or more magnetic fields (e.g., multiple fields that are multiplexed in time and / or frequency) in and around a patient during a procedure. As such, as the one or more tracking elements 126 move through the magnetic field, the tracking system receives data from the sensors to determine the translation, orientation (e.g., roll, pitch, yaw), and / or shape of the distal portion 120. The EM field generator 128 may include various components, such as a specially designed pad to be placed under, or integrated into, the table 112. One example of such an EM tracking system is included in the AFFERA™ system produced by Medtronic™.

[0036] The system 100 (e.g. the electronic computing device 110) uses data from the tracking system 106, as well as data from other sensors (e.g., impedance sensors, force sensors, and the like) to performs electro-anatomical mapping of the heart during a procedure.

[0037] The ultrasound system 104 uses ultrasound techniques to image a patient’s body during the procedure to visualize the location of instruments, such as the treatment catheter 114, inside the patient’s body. The ultrasound system 104 includes an imaging catheter 130. The imaging catheter 130 is a highly flexible treatment device that is suitable for passage through the vasculature. In the example illustrated, the treatment catheter 130 has an elongate body 132 (e.g., a “shaft”) having a proximal portion 134 and a distal portion 136. The distal portion 136 includes an imaging element 140. In one example, the imaging catheter is an Intracardiac Echocardiography (“ICE”) catheter. An ICE catheter is a specialized medical device thatMBF\215364\0116\52094841.vl-ll / 16 / 25 8Attorney Docket No. A0013538US01 (0116-US01) provides high-resolution real-time visualization of cardiac anatomy through ultrasound imaging. In some embodiments, the imaging element 140 is a single rotatable (e.g., with a motor) ultrasonic transducer configured to provide three-dimensional images of a volume of tissue. In some embodiments, the imaging element 140 is comprised of multiple ultrasonic transducers (e.g., a linear phased array) configured to provide perpendicular sector (two-dimensional) views. In some embodiments, the imaging element 140 is comprised of multiple ultrasonic transducers (e.g., a two-dimensional array) configured to image a three-dimensional volume.

[0038] Similar to the treatment catheter 114, the imaging catheter 130 may include one or more EM tracking elements 142 embedded within or attached to the distal portion 136. The tracking elements 142 are used by the tracking system 106 to determine the position of the distal portion 136. As described further herein, the system 100 is configured to control the imaging catheter 130, the ultrasound system 104, and / or the electronic computing device 110 to follow the treatment catheter 114 in order to provide preferred views of the treatment catheter 114 during a procedure.

[0039] The proximal portion 134 of the imaging catheter 130 is mated to a handle 138 that can include elements such as levers or knobs for manipulating the elongate body 132 and the imaging element 140. In some embodiments, the handle and its elements may be operated partially or fully autonomously (e.g., through the use of computer-guided robotics).

[0040] In some aspects, the components of the system 100 are controlled by the electronic computing device 110, described more particularly with respect to FIG. 2. As illustrated in FIG. 1, the electronic computing device 110 is coupled to the treatment system 102, the ultrasound system 104, the tracking system 106, and a database 162. In the illustrated example, these components are communicatively coupled by a communication network 160. The communication network 160 may include, for example, one or more cables, a local area network, a wide area network, a wireless network, such as Wi-Fi™ or Bluetooth™, or combinations of the foregoing. In some implementations, some components of the system 100, including the electronic computing device 110, may be parts of an integrated system.

[0041] In one implementation, the database 162 is configured to store patient data associated with one or more patients. Patient data may include, for example, an age associated with a patient, a computed tomography scan associated with a patient, a gender associated with aMBF\215364\0116\52094841.vl-ll / 16 / 25 9Attorney Docket No. A0013538US01 (0116-US01) patient, a medical history associated with a patient, a combination of the foregoing, or the like. In some implementations, the database 162 is configured to store one or more surgical plans (e.g., relating to procedures to be performed by the system 100).

[0042] The electronic computing device 110 is configured to display images and other data on a display 164. The display 164 is a suitable display for presenting medical images, as described herein. The display 164 may be touch sensitive and / or voice activated, enabling display 164 to serve as both an input and output device. The display 164 is configured to output instructions, images, and messages relating to at least one of a performance, position, orientation, or trajectory of the treatment catheter 114, the imaging catheter 130, or both. Further, the display 164 can be configured to output information regarding the treatment catheter 114 (e.g., model number, type, size, and the like) as well as other data (e.g., patient data related to a surgical procedure).

[0043] FIG. 2 schematically illustrates an electronic computing device 110 of the system of FIG. 1, according to some examples. The electronic computing device 110 includes an electronic processor 205 (e.g., a programmable electronic microprocessor, microcontroller, or similar device), a memory 210 (e.g., non-transitory, computer or machine-readable memory), an input device 215, and an output device 220. The input device 215 may be, for example, a keypad, a keyboard, a mouse, a touchscreen (e.g., as part of the output device 220), a microphone, a camera, a Universal Serial Bus (“USB”) port, or the like. The output device 220 may be, for example, a speaker, a touchscreen, a liquid crystal display (“LCD”), a light-emitting diode (“LED”) display, an organic LED (“OLED”) display, an electroluminescent display (“ELD”), or the like. It should be understood that, while the electronic computing device 110 is illustrated as including a single input device 215 and a single output device 220, the electronic computing device 110 may include multiple input devices and multiple output devices, and / or multiple devices that combine input and output functions. The electronic processor 205 is communicatively connected to the memory 210, the input device 215, and the output device 220. In some implementations, the electronic processor 205, in coordination with the memory 210, is configured to implement, among other things, the methods described herein.

[0044] In some implementations, the electronic computing device 110 is configured to implement one or more machine learning models. Machine learning generally refers to the ability of a computer to learn to perform a task without being explicitly programmed to do so. In someMBF\215364\0116\52094841.vl-ll / 16 / 25 10Attorney Docket No. A0013538US01 (0116-US01) embodiments, a computer program (e.g., a machine learning engine) is configured to construct an algorithm based on inputs. Supervised learning involves presenting a computer program with example inputs and their desired outputs. The computer program is configured to learn a general rule that maps the inputs to the outputs from the training data it receives. Example machine learning engines include decision tree learning, association rule learning, artificial neural networks, classifiers, inductive logic programming, support vector machines, clustering, Bayesian networks, reinforcement learning, representation learning, similarity and metric learning, sparse dictionary learning, and genetic algorithms. Using all of these approaches, a computer program can ingest, parse, and understand data and progressively refine algorithms for data analytics.

[0045] FIG. 3 illustrates a method 300 for guiding an imaging catheter in relation to a treatment catheter. The method 300 may be implemented by the electronic processor 205 of the electronic computing device 110.

[0046] The method 300 includes a step 302 of determining a first position for the treatment catheter 114. In some cases, the electronic processor 205 may determine the first position using data from the tracking system 106. As used herein, the term “position,” as it pertains to a catheter or other medical instrument, may include translation, orientation, and / or shape information. A position for a may be defined with respect to an external coordinate system such as the table 112 or may be defined with respect to the distal end of the treatment catheter 114 or the imaging catheter 130.

[0047] The method 300 includes a step 304 of determining a second position for the imaging catheter 130. The electronic processor 205 may determine the second position using data from the tracking system 106 or through computer image analysis of ultrasound data from the imaging catheter 130.

[0048] In a step 306, the electronic processor 205 determines a desired intersection plane for the treatment catheter 114. As used herein, the term "desired intersection plane" may refer to a two-dimensional plane in three-dimensional space that intersects with a treatment catheter at a specific location (e.g., where it contacts tissue targeted for treatment) and orientation. This plane may be selected to provide an optimal view of the treatment catheter and surrounding tissue during a medical procedure. The desired intersection plane may be determined based on variousMBF\215364\0116\52094841.vl-ll / 16 / 25 11Attorney Docket No. A0013538US01 (0116-US01) factors, such as the position and orientation of the treatment catheter, the anatomy of the target tissue, parameters specific to the patient, previous efforts of the procedure (e.g., where a threshold number of failed attempts at a maneuver causes a new desired intersection plane), preferences of one or more of the practitioner, and the goals of the medical procedure. In some aspects, the desired intersection plane may be perpendicular to the longitudinal axis of the treatment catheter at its distal end, while in other aspects, it may be angled to capture specific anatomical features or treatment areas. The desired intersection plane may be dynamically updated as the treatment catheter moves within the patient's body to maintain optimal visualization throughout the procedure.

[0049] The method 300 includes a step 308 where the electronic processor 205 determines a third position for the imaging catheter 130 based on the first position, the second position, and the desired intersection plane. The third position may be calculated to result in the imaging plane of the imaging catheter 130 aligning with the desired intersection plane.

[0050] As used herein, the term "imaging plane" may refer to a two-dimensional cross- sectional area captured by the imaging element of an imaging catheter. The imaging plane represents the specific region or slice of tissue that is visualized by the imaging catheter at a given moment. For an ultrasound-based imaging catheter, such as an ICE catheter, the imaging plane may correspond to the area insonified by the ultrasound waves emitted and received by the imaging element. The orientation and position of the imaging plane within the patient's body may be adjustable by manipulating the imaging catheter, allowing for visualization of different anatomical structures and medical devices from various angles and perspectives during a procedure.

[0051] In some cases, the electronic processor 205 may also determine a first position including both a first translation and a first orientation for the treatment catheter 114 and a second position including both a second translation and a second orientation for the imaging catheter 130. The electronic processor 205 may then determine, based on one or more of the first translation, the second translation, the first orientation, the second orientation, and the desired intersection plane, one or both of the third translation and a third orientation for the imaging catheter 130 that would result in the imaging plane aligning with the desired intersection plane.MBF\215364\0116\52094841.vl-ll / 16 / 25 12Attorney Docket No. A0013538US01 (0116-US01)

[0052] The method 300 includes a step 310 where the electronic processor 205 generates an instruction (e.g., a plan, suggestion, or guidance to be provided to an operator) for guiding the imaging catheter 130 from the second position to the third position. This instruction may include specific movements or adjustments needed to achieve the desired alignment.

[0053] In a step 312, the electronic processor 205 provides the generated instruction to an operator of the imaging catheter 130. The electronic processor 205 may provide the instruction through various means. In some cases, the electronic processor 205 may present the instruction on the display 164. For example, the electronic processor 204 may display on the display 164 visual indicia based in part on the third position for guiding the imaging catheter from the second position to the third position. In other cases, the electronic processor 205 may illuminate a control on the handle 138 of the imaging catheter 130, provide haptic feedback, or generate audio instructions.

[0054] The method 300 optimizes imaging during medical procedures by automatically determining the optimal position for the imaging catheter 130 relative to the treatment catheter 114 and providing guidance to achieve this position. This approach may improve visualization of the treatment area and potentially enhance the efficiency and effectiveness of the medical procedure.

[0055] FIG. 4 illustrates a method 400 for automatically positioning an imaging catheter relative to a treatment catheter. The method 400 may be implemented by the electronic processor 205 of the electronic computing device 110.

[0056] The method 400 includes a step 402 of determining a first position for the treatment catheter 114. In some cases, the electronic processor 205 may determine the first position using data from the tracking system 106. For example, the tracking system 106 may utilize electromagnetic tracking to locate the position of one or more electromagnetic sensors embedded in the treatment catheter 114. The electronic processor 205 may receive this positional data from the tracking system 106 and process it to determine the precise location of the treatment catheter 114 within the patient's body. Additionally, the electronic processor 205 may combine data from multiple sensors on the treatment catheter 114 to determine not only its position but also its orientation in three-dimensional space. In some aspects, the electronic processor 205 may also incorporate data from other sources, such as impedance measurements or image analysis ofMBF\215364\0116\52094841.vl-ll / 16 / 25 13Attorney Docket No. A0013538US01 (0116-US01) fluoroscopic or ultrasound images, to refine and verify the position determination of the treatment catheter 114.

[0057] The method 400 includes a step 404 of determining a second position for the imaging catheter 130. The electronic processor 205 may determine the second position using data from the tracking system 106 or through computer image analysis of ultrasound data from the imaging catheter 130.

[0058] In a step 406, the electronic processor 205 determines a desired intersection plane for the treatment catheter 114.

[0059] The method 400 includes a step 408 where the electronic processor 205 determines a third position for the imaging catheter 130 based on the first position, the second position, and the desired intersection plane. The third position may be calculated to result in the imaging plane of the imaging catheter 130 aligning with the desired intersection plane.

[0060] In a step 410, the electronic processor 205 automatically moves the imaging catheter 130 from the second position to the third position. This step differs from the manual guidance method by eliminating the need for operator intervention to reposition the imaging catheter 130.

[0061] In some cases, the electronic processor 205 may automatically move the imaging catheter 130 by controlling the handle 138 of the imaging catheter 130. The electronic processor 205 may send signals to motorized components within the handle 138 to guide the imaging catheter 130 from the second position to the third position.

[0062] In some cases, the electronic processor 205 may automatically move the imaging catheter 130 by controlling an articulable shaft of the imaging catheter 130. The articulable shaft may include steerable segments that can be manipulated by the electronic processor 205 to achieve the desired positioning.

[0063] In some cases, the electronic processor 205 may automatically move the imaging catheter 130 by controlling an articulable sheath housing the imaging catheter 130 or other devices (e.g., wires, needles, and other instruments). The articulable sheath may be steered by the electronic processor 205 to guide the imaging catheter 130 to the third position.

[0064] The automatic positioning of the imaging catheter 130 may offer several advantages in medical procedures. The electronic processor 205 may automatically position the imagingMBF\215364\0116\52094841.vl-ll / 16 / 25 14Attorney Docket No. A0013538US01 (0116-US01) catheter 130 before ablation, ensuring optimal visualization of the treatment area. This may improve the accuracy and efficiency of the procedure.

[0065] In some cases, the imaging catheter 130 may be controlled by a robotic system to automatically follow the treatment catheter 114. This automated following may maintain consistent, high-quality imaging throughout the procedure, potentially reducing procedure time and improving outcomes. The steps of the method 300 may also be performed substantially in reverse order as well. For example, the imaging catheter 130 could be positioned first, and a desired view of the targeted anatomy may be determined and acquired. Subsequently, the treatment catheter 114 could be made to travel to that targeted anatomy, based on the location of the imaging catheter 130.

[0066] The method 400 for automatically positioning the imaging catheter 130 may enhance the overall effectiveness of medical procedures by providing consistent, optimal imaging without requiring manual adjustment. This automation may allow medical professionals to focus more on the treatment aspects of the procedure, potentially leading to improved patient outcomes.

[0067] FIG. 5 illustrates a method 500 for processing three-dimensional image data from an imaging catheter. The method 500 may be implemented by the electronic processor 205 of the electronic computing device 110.

[0068] The method 500 includes a step 502 of receiving the three-dimensional image data from the imaging catheter 130. In some cases, the imaging catheter 130 may be an intracardiac echocardiography (ICE) catheter with a two-dimensional array of ultrasound transducer elements configured to acquire volumetric ultrasound data over a substantially wedge-shaped field of view. As shown in FIG. 6, the imaging catheter 130 may be positioned to acquire three- dimensional image data of a treatment region 602 of, for example, a heart (e.g., to acquire three- dimensional image data of the cardiac structures and any treatment devices present). As illustrated, in this example, the treatment catheter 114 is configured and positioned to deliver therapy to a target tissue 604.

[0069] The method 500 includes a step 504 of determining the position of the treatment catheter 114 relative to the imaging catheter 130. In some cases, the electronic processor 205 may determine the relative positions using data from the tracking system 106. In other cases, theMBF\215364\0116\52094841.vl-ll / 16 / 25 15Attorney Docket No. A0013538US01 (0116-US01) electronic processor 205 may use computer image analysis of the three-dimensional image data to determine the position of the treatment catheter 114.

[0070] The method 500 includes a step 506 of automatically selecting a two-dimensional slice of the three-dimensional image data based on the position of the treatment catheter 114 relative to the imaging catheter 130. This step allows for the extraction of a relevant two-dimensional view from the three-dimensional dataset. In some examples, steps 504 and 506 may be repeated in a loop as the treatment catheter 114 is moved through the three-dimensional area being captured by the imaging catheter 130. Put differently, the imaging catheter 130 may be completely stationary, and different slices of the three-dimensional wedge of images may be selected to assist the positioning of the treatment catheter 114.

[0071] In some aspects, various techniques may be employed to extract the two-dimensional slice from the three-dimensional image data. In some instances, the electronic processor 205 may determine a surface (e.g., an endocardial surface) from the three-dimensional image data, and combine this information with relative location information to determine a two-dimensional slice. In one example, this could be a slice such that the image plane passes though a point on the treatment catheter (such as a point on the catheter shaft) and a nearest point on the derived surface. Other techniques for two-dimensional slice extraction may include planar slicing, multi- planar reconstruction (MPR), and curved planar reformation (CPR). For example, as the treatment catheter 114 is navigated, different slices that show different anatomical features may be selected, as these different features may provide different reference points that will assist in navigating the treatment catheter 114. For another example, physician preferences that are unique to the current attending physician may be used in identifying relevant slices to depict. For another example, parameters unique to the procedure (e.g., an angle that the treatment catheter should define relative to the tissue, and / or an amount of distance or force applied between the tissue and a treatment element of the treatment catheter 114) may be used to determine a slice to provide. In some aspects, machine learning-based approaches may be used. For example, in some implementations, the electronic processor 205 may utilize trained neural networks or other machine learning models to identify the most clinically relevant two-dimensional slice from the three-dimensional data, taking into account the position of the treatment catheter 114 and other contextual information. Of course, a combination of approaches may be used. The chosenMBF\215364\0116\52094841.vl-ll / 16 / 25 16Attorney Docket No. A0013538US01 (0116-US01) technique may also be dynamically adjusted during the procedure to maintain optimal visualization as the positions of one or both of the catheters change.

[0072] In some aspects, the electronic processor 205 may utilize contact data, for example from a contact force sensor, to refine the selection of the two-dimensional slice, potentially providing improved visualization of the treatment catheter's interaction with the target tissue. The contact data may indicate the level of contact between the treatment catheter and the tissue, which can be valuable for assessing the effectiveness of the treatment. Contact data may also be used to extrapolate orientation information for the treatment element of the treatment catheter relative to the tissue. In some aspects, contact data could represent a distance measurement. For example, the electronic processor 205 may acquire a strict distance measurement between a known position on the treatment catheter 114 and the targeted tissue (e.g., the endocardial wall), with, for example, the distance displayed as simply as a caliper, which changes in real time, or lights up the catheter when the distance between the catheter and the tissue is substantially 0mm. In some examples, the distance could be measured by analyzing images received from the imaging catheter 130 or another imaging source.

[0073] Additionally or alternatively, the electronic processor 205 may incorporate impedance data in the slice selection process. Impedance measurements can provide information about tissue characteristics and contact, which may enhance the ability to identify areas of tissue contact. The integration of these additional data sources with the positional information may allow for more comprehensive and informative two-dimensional views to be automatically generated during the procedure. By considering multiple parameters such as position, contact force, and impedance, the system may be able to select optimal imaging planes that highlight the most relevant aspects of the treatment catheter's interaction with the target tissue.

[0074] In some cases, the electronic processor 205 may be configured to display the selected two-dimensional slice on the display 164. This may provide the operator with an optimal view of the treatment catheter 114 and surrounding tissue during the procedure.

[0075] In some cases, the electronic processor 205 may be configured to automatically select a second two-dimensional slice of the three-dimensional image data. The second two- dimensional slice may be perpendicular to the first two-dimensional slice. The electronicMBF\215364\0116\52094841.vl-ll / 16 / 25 17Attorney Docket No. A0013538US01 (0116-US01) processor 205 may display both the first and second two-dimensional slices on the display 164, providing multiple perspectives of the treatment area.

[0076] In some cases, the electronic processor 205 may be configured to segment the three- dimensional ultrasound image data to identify boundaries of anatomical structures in the treatment region. The electronic processor 205 may then automatically select the two- dimensional slice based on the position of the treatment catheter 114 relative to the imaging catheter 130 and the identified boundaries of the anatomical structures.

[0077] In some cases, the electronic processor 205 may be configured to receive a three- dimensional map of an anatomical structure in the treatment region from an electroanatomical mapping system. The electroanatomical mapping system may utilize various techniques to generate the three-dimensional map, such as electromagnetic mapping, impedance-based mapping, or a combination of modalities. For cardiac ablation procedures, the electroanatomical mapping system may create detailed electroanatomical maps of the heart chambers, including voltage maps, activation maps, and anatomical reconstructions. These maps may be generated by recording electrical signals from multiple points within the heart using specialized mapping catheters or, in some instances, using the treatment catheter 114 during a mapping operation prior to treatment. The electronic processor 205 may then automatically select the two- dimensional slice based on the position of the treatment catheter 114 relative to the imaging catheter 130 and the three-dimensional map. This integration of mapping data with real-time imaging may allow for more precise navigation and therapy delivery during complex cardiac procedures.

[0078] In some cases, the electronic processor 205 may overlay a device avatar on the ultrasound image to indicate the position of the treatment catheter 114. This may enhance visualization of the treatment catheter 114 within the context of the surrounding anatomy.

[0079] In some cases, the electronic processor 205 may combine voltage map data from a mapping system with the ultrasound imaging data. This integration of data may provide additional context for the operator during the procedure.

[0080] In some cases, the electronic processor 205 may be configured to determine a present position of the imaging catheter 130 and a second position for the imaging catheter 130 based on a desired imaging plane and the present position of the imaging catheter 130. The electronicMBF\215364\0116\52094841.vl-ll / 16 / 25 18Attorney Docket No. A0013538US01 (0116-US01) processor 205 may then automatically guide the imaging catheter 130 to the second position and automatically select the two-dimensional slice of the three-dimensional image data based on the position of the treatment catheter 114 relative to the second position of the imaging catheter 130. In some embodiments, a clinician may define a location to which they would like the catheter(s) to travel. For example, the clinician may input the location on an ultrasound image or anatomical map (e.g., using a touchscreen display or another suitable input device 215) and those coordinates can be used to direct the catheters to that region via robotically driven mechanisms.

[0081] The method 500 for processing three-dimensional image data may enhance the effectiveness of medical procedures by providing optimal visualization of the treatment catheter 114 and surrounding anatomy. By automatically selecting and displaying relevant two- dimensional slices, the method 500 may improve the operator's ability to navigate and position the treatment catheter 114 accurately within the patient's body.

[0082] FIG. 6 illustrates a view of the treatment catheter 114 and the imaging catheter 130 positioned to image the operation of the imaging catheter 130 within a patient. The treatment region 602 may be, for example, within a chamber of the heart, with the target tissue 604 shown within the treatment region 602.

[0083] The treatment catheter 114 extends into the treatment region 602 and may be positioned near the target tissue 604. The treatment element 124 is used for delivering therapy to the target tissue 604.

[0084] The imaging catheter 130 may also extend into the treatment region 602. The imaging catheter 130 may be positioned to provide imaging of the treatment region 602 and the target tissue 604. The distal portion 136 of the imaging catheter 130 is oriented to capture images of the area where the treatment catheter 114 interacts with the target tissue 604.

[0085] In some cases, the imaging catheter 130 and the treatment catheter 114 may be magnetically coupled. The tracking elements 126 in the treatment catheter 114 and the tracking elements 142 in the imaging catheter 130 may allow the tracking system 106 to determine the relative positions of the catheters within the treatment region 602.

[0086] In some cases, the imaging catheter 130 and the treatment catheter 114 may be mechanically coupled. This mechanical coupling may ensure that the imaging catheter 130MBF\215364\0116\52094841.vl-ll / 16 / 25 19Attorney Docket No. A0013538US01 (0116-US01) maintains a specific orientation relative to the treatment catheter 114 as the catheters are moved within the treatment region 602.

[0087] The treatment catheter 114 and the imaging catheter 130 may be coupled such that the imaging plane of the imaging element 140 aligns with a desired intersection plane of the treatment catheter 114 as the treatment catheter 114 is moved within the treatment region 602. This coupling may allow for consistent and optimal imaging of the treatment catheter 114 and the target tissue 604 throughout the procedure.

[0088] In some cases, the imaging catheter 130 and the treatment catheter 114 may be deployed in a single sheath. The single sheath may guide both catheters into the treatment region 602, potentially simplifying the insertion process and maintaining a desired spatial relationship between the catheters.

[0089] The arrangement of the treatment catheter 114 and the imaging catheter 130 within the treatment region 602 may allow for simultaneous treatment and imaging of the target tissue 604.

[0090] FIG. 7 illustrates a composite view of ultrasound imaging data obtained from an intracardiac echocardiography (ICE) catheter. The composite view includes a three-dimensional view 702 and multiple two-dimensional slices 704 derived from the three-dimensional ultrasound data.

[0091] The three-dimensional view 702 may be shown in a portion of the display 164, such as the lower right quadrant. The three-dimensional view 702 may provide a representation of the volumetric ultrasound data acquired by the imaging element 140 of the imaging catheter 130, displaying the spatial relationships of cardiac structures within the field of view.

[0092] The two-dimensional slices 704 may be extracted from the three-dimensional ultrasound data and displayed in other portions of the display 164. The two-dimensional slices 704 may represent different planar views through the volumetric data, allowing for detailed examination of specific cardiac structures and tissues from various angles.

[0093] The two-dimensional slices 704 may display grayscale ultrasound images of cardiac anatomy. The varying shades of gray in these images may correspond to different tissue densities and structures within the heart. Brighter areas may typically represent more echogenic structures, while darker areas may indicate fluid-filled spaces or less dense tissues.MBF\215364\0116\52094841.vl-ll / 16 / 25 20Attorney Docket No. A0013538US01 (0116-US01)

[0094] The combination of the three-dimensional view 702 and multiple two-dimensional slices 704 may allow for comprehensive visualization of cardiac structures. This multi-view approach may enable clinicians to analyze cardiac anatomy and potentially guide interventional procedures by providing both overall spatial context and detailed cross-sectional information.

[0095] In some cases, the electronic processor 205 may control the display 164 to present the composite view of ultrasound imaging data. The electronic processor 205 may receive the three- dimensional ultrasound data from the imaging catheter 130 and process the data to generate the three-dimensional view 702 and extract the two-dimensional slices 704.

[0096] In some cases, when the imaging catheter 130 may be in a third position, as determined by the method 400, the electronic processor 205 may receive an image of the treatment catheter 114 from the imaging catheter 130. The electronic processor 205 may then incorporate the image of the treatment catheter 114 into the composite view, potentially highlighting the position of the treatment catheter 114 within the cardiac structures.

[0097] The composite view of ultrasound imaging data may provide clinicians with a comprehensive understanding of the spatial relationships between the treatment catheter 114, the target tissue 604, and surrounding cardiac structures. This enhanced visualization may potentially improve the accuracy and efficiency of cardiac procedures performed using the medical system 100.

[0098] FIG. 8 illustrates a two-dimensional ultrasound image 802 of a treatment region within a patient's body. The two-dimensional ultrasound image 802 shows a cross-sectional view of anatomical structures and the treatment catheter 114. The treatment catheter 114 is visible as a bright spot in the lower portion of the two-dimensional ultrasound image 802. The surrounding tissue appears as varying shades of gray, representing different densities and structures within the body.

[0099] In some cases, the electronic processor 205 may determine the position of the imaging catheter 130 using computer image analysis of the two-dimensional ultrasound image 802. The electronic processor 205 may analyze image features, contrast, and known anatomical landmarks to determine the position and orientation of the imaging catheter 130 relative to the surrounding structures.MBF\215364\0116\52094841.vl-ll / 16 / 25 21Attorney Docket No. A0013538US01 (0116-US01)

[0100] The example two-dimensional ultrasound image 802 may be useful in guiding medical procedures by providing real-time visualization of the treatment catheter 114 in relation to the surrounding anatomy. Such images may allow medical professionals to accurately navigate the treatment catheter 114, assess its position relative to the target tissue 604, and monitor the progress of the procedure. By incorporating additional data sources such as contact force and impedance, the electronic processor 205 may enhance the utility of these images, potentially improving the precision and effectiveness of the medical procedure.

[0101] In some aspects, image capture (e.g., by the imaging catheter 130) during various phases of the cardiac cycle to enable an ultrasound-generated 3D model of the heart (e.g., from capturing various planes) that “beats” when presented on a screen. For example, the multiple slices at multiple time points in the cardiac cycle can be stitched together to emulate motion. The feature can be integrated with the system 100 to provide, in one example, a beating heart navigation system.

[0102] In the foregoing specification, specific embodiments have been described. However, one of ordinary skill in the art appreciates that various modifications and changes can be made without departing from the scope of the invention as set forth in the claims. Accordingly, the specification and figures are to be regarded in an illustrative rather than a restrictive sense, and all such modifications are intended to be included within the scope of present teachings. The benefits, advantages, solutions to problems, and any element(s) that may cause any benefit, advantage, or solution to occur or become more pronounced are not to be construed as a critical, required, or essential features or elements of any or all the claims. The invention is defined solely by the appended claims including any amendments made during the pendency of this application and all equivalents of those claims as issued.

[0103] In this document, relational terms such as first and second, top and bottom, and the like may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. The terms “comprises,” “comprising,” “has,” “having,” “includes,” “including,” “contains,” “containing,” or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises, has, includes, contains a list of elements does not include only those elements but may include other elementsMBF\215364\0116\52094841.vl-ll / 16 / 25 22Attorney Docket No. A0013538US01 (0116-US01) not expressly listed or inherent to such process, method, article, or apparatus. An element proceeded by “comprises ... a,” “has ... a,” “includes ... a,” or “contains ... a” does not, without more constraints, preclude the existence of additional identical elements in the process, method, article, or apparatus that comprises, has, includes, contains the element. Unless the context of their usage unambiguously indicates otherwise, the articles “a,” “an,” and “the” should not be interpreted as meaning “one” or “only one.” Rather these articles should be interpreted as meaning “at least one” or “one or more.” Likewise, when the terms “the” or “said” are used to refer to a noun previously introduced by the indefinite article “a” or “an,” “the” and “said” mean “at least one” or “one or more” unless the usage unambiguously indicates otherwise.

[0104] The terms “substantially,” “essentially,” “approximately,” “about,” or any other version thereof, are defined as being close to as understood by one of ordinary skill in the art, and in one non-limiting embodiment the term is defined to be within 10%, in another embodiment within 5%, in another embodiment within 1% and in another embodiment within 0.5%. The term “one of,” without a more limiting modifier such as “only one of,” and when applied herein to two or more subsequently defined options such as “one of A and B” should be construed to mean an existence of any one of the options in the list alone (e.g., A alone or B alone) or any combination of two or more of the options in the list (e.g., A and B together).

[0105] A device or structure that is “configured” in a certain way is configured in at least that way but may also be configured in ways that are not listed.

[0106] The terms “mounted,” “coupled,” “coupling,” or “connected” as used herein can have several different meanings depending on the context in which these terms are used. The terms may be used broadly and encompass both direct and indirect mounting, connecting, and coupling, and may have a mechanical or electrical connotation. For example, as used herein, the terms mounted, coupled, coupling, or connected can indicate that two elements or devices are directly connected to one another or connected to one another through intermediate elements or devices via an electrical element, electrical signal or a mechanical element depending on the particular context. Electronic communications and notifications described herein may be performed using any known or future-developed means including wired connections, wireless connections, etc.MBF\215364\0116\52094841.vl-ll / 16 / 25 23Attorney Docket No. A0013538US01 (0116-US01)

[0107] Also, it should be understood that the illustrated components, unless explicitly described to the contrary, may be combined or divided into separate software, firmware, and / or hardware. For example, instead of being located within and performed by a single electronic processor, logic and processing described herein may be distributed among multiple electronic processors. Similarly, one or more memory modules and communication channels or networks may be used even if embodiments described or illustrated herein have a single such device or element. Also, regardless of how they are combined or divided, hardware and software components may be located on the same computing device or may be distributed among multiple different devices. Accordingly, in this description and in the claims, if an apparatus, method, or system is claimed, for example, as including a controller, control unit, electronic processor, computing device, logic element, module, memory module, communication channel or network, or other element configured in a certain manner, for example, to perform multiple functions, the claim or claim element should be interpreted as meaning one or more of such elements where any one of the one or more elements is configured as claimed, for example, to make any one or more of the recited multiple functions, such that the one or more elements, as a set, perform the multiple functions collectively.

[0108] It will be appreciated that some embodiments may be comprised of one or more electronic processors such as microprocessors, digital signal processors, customized processors, and field programmable gate arrays (FPGAs) and unique stored program instructions (including both software and firmware) that control the one or more processors to implement, in conjunction with certain non-processor circuits, some, most, or all of the functions of the method and / or apparatus described herein. Alternatively, some or all functions could be implemented by a state machine that has no stored program instructions, or in one or more application specific integrated circuits (ASICs), in which each function or some combinations of certain of the functions are implemented as custom logic. Of course, a combination of approaches could be used.

[0109] Moreover, some embodiments may be implemented as a computer-readable storage medium having computer readable code stored thereon for programming a computer (e.g., comprising an electronic processor) to perform a method as described and claimed herein. Examples of such computer-readable storage media include, but are not limited to, a hard disk, a CD-ROM, an optical storage device, a magnetic storage device, a ROM (Read Only Memory), aMBF\215364\0116\52094841.vl-ll / 16 / 25 24Attorney Docket No. A0013538US01 (0116-US01)PROM (Programmable Read Only Memory), an EPROM (Erasable Programmable Read Only Memory), an EEPROM (Electrically Erasable Programmable Read Only Memory) and a Flash memory. In the context of this document, a computer-usable or computer-readable medium may be any medium that can contain, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device.

[0110] It is expected that one of ordinary skill, notwithstanding possibly significant effort and many design choices motivated by, for example, available time, current technology, and economic considerations, when guided by the concepts and principles disclosed herein will be readily capable of generating software instructions and programs for carrying out operations of various example embodiments with minimal experimentation. For example, computer program code may be written in an object-oriented programming language, a conventional procedural programming language, or another appropriate programming language. The program code may execute entirely on a computer, partly on the computer, as a stand-alone software package, partly on the computer and partly on a remote computer or server or entirely on the remote computer or server, connected by one or more networks.

[0111] The following paragraphs provide various examples of the embodiments disclosed herein.

[0112] Example 1. A medical treatment system, the system comprising: a treatment catheter; an imaging catheter being configured to capture images along an imaging plane; an electronic processor coupled to the treatment catheter, and the imaging catheter, and configured to: determine a first position for the treatment catheter; determine a second position for the imaging catheter; determine a desired intersection plane for the treatment catheter; determine, based on the first position, the second position, and the desired intersection plane, a third position for the imaging catheter that would result in the imaging plane aligning with the desired intersection plane; generate an instruction for guiding the imaging catheter from the second position to the third position; and provide the instruction to an operator of the imaging catheter.

[0113] Example 2. The medical treatment system of example 1, wherein: the imaging catheter includes an electromagnetic sensor; and the electronic processor is further configured to determine the position of the imaging catheter using electromagnetic sensing.MBF\215364\0116\52094841.vl-ll / 16 / 25 25Attorney Docket No. A0013538US01 (0116-US01)

[0114] Example 3. The medical treatment system of example 1, wherein the electronic processor is further configured to determine the position of the imaging catheter using computer image analysis.

[0115] Example 4. The medical treatment system of any of examples 1 through 3, wherein first position for the treatment catheter and the second position for the imaging catheter each include at least one selected from a group consisting of a translation, an orientation, and a shape.

[0116] Example 5. The medical treatment system of any of examples 1 through 4, wherein the electronic processor is further configured to determine the third position by determining at least one selected from a group consisting of a translation, an orientation, and a shape for the imaging catheter that would result in the imaging plane aligning with the desired intersection plane.

[0117] Example 6. The medical treatment system of any of examples 1 through 5, wherein the electronic processor is configured to provide the instruction to the operator of the imaging catheter by performing at least one selected from a group consisting of presenting the instruction on an electronic display, illuminating a control of a handle of the imaging catheter, providing a haptic feedback, and generating audio.

[0118] Example 7. The medical treatment system of any of examples 1 through 6, further comprising an electronic display; wherein the electronic processor is further configured to provide the instruction to an operator of the imaging catheter by controlling the electronic display to present visual indicia, based on the instruction and the third position, for guiding the imaging catheter from the second position to the third position.

[0119] Example 8. The medical treatment system of any of examples 1 through 7, further comprising an electronic display; wherein the electronic processor is further configured to: when the imaging catheter is in the third position, receive an image of the treatment catheter from the imaging catheter; and control the electronic display to present the image.

[0120] Example 9. The medical treatment system of any of examples 1 through 8, wherein the imaging catheter is an intracardiac echocardiography (ICE) catheter.

[0121] Example 10. A medical treatment system, the system comprising: a treatment catheter; an imaging catheter having an imaging plane; an electronic display; an electronic processor coupled to the treatment catheter, the imaging catheter, and the electronic display, andMBF\215364\0116\52094841.vl-ll / 16 / 25 26Attorney Docket No. A0013538US01 (0116-US01) configured to: determine a first position for the treatment catheter; determine a second position for the imaging catheter; determine a desired intersection plane for the treatment catheter; determine, based on the first position, the second position, and the desired intersection plane, a third position for the imaging catheter that would result in the imaging plane aligning with the desired intersection plane; and automatically move the imaging catheter from the second position to the third position.

[0122] Example 11. The medical treatment system of example 10, wherein the electronic processor is configured to automatically move the imaging catheter by controlling a handle of the imaging catheter to guide the imaging catheter from the second position to the third position.

[0123] Example 12. The medical treatment system of any of examples 10 and 11, wherein the electronic processor is configured to automatically move the imaging catheter by controlling an articulable shaft of the imaging catheter to guide the imaging catheter from the second position to the third position.

[0124] Example 13. The medical treatment system of any of examples 10 through 12, wherein the electronic processor is configured to automatically move the imaging catheter by controlling an articulable shaft housing the imaging catheter to guide the imaging catheter from the second position to the third position.

[0125] Example 14. A medical treatment system, the system comprising: a treatment catheter; an imaging catheter having an imaging plane; an electronic display; wherein the treatment catheter and the imaging catheter are coupled such that the imaging plane of the imaging catheter aligns with a desired intersection plane of the treatment catheter as the treatment catheter is moved within a patient.

[0126] Example 15. The medical treatment system of example 14, wherein the imaging catheter and the treatment catheter are electromagnetically coupled.

[0127] Example 16. The medical treatment system of example 14, wherein the imaging catheter and the treatment catheter are mechanically coupled.

[0128] Example 17. The medical treatment system of example 14, wherein the imaging catheter and the treatment catheter are deployed in a single sheath.MBF\215364\0116\52094841.vl-ll / 16 / 25 27Attorney Docket No. A0013538US01 (0116-US01)

[0129] Example 18. A medical treatment system, the system comprising: an imaging catheter configured to acquire three-dimensional image data of a treatment region; a treatment catheter configured to deliver therapy to a target tissue in the treatment region; an electronic processor coupled to the imaging catheter and the treatment catheter, the electronic processor configured to: receive the three-dimensional image data from the imaging catheter; determine a position of the treatment catheter relative to the imaging catheter; and automatically select a two- dimensional slice of the three-dimensional image data based on the position of the treatment catheter relative to the imaging catheter.

[0130] Example 19. The medical treatment system of example 18, wherein the electronic processor is further configured to display the two-dimensional slice on an electronic display.

[0131] Example 20. The medical treatment system of any of examples 18 through 19, wherein the electronic processor is further configured to: segment the three-dimensional image data to identify boundaries of an anatomical structure in the treatment region, and automatically select the two-dimensional slice based on the position of the treatment catheter relative to the imaging catheter and the identified boundaries of the anatomical structure.

[0132] Example 21. The medical treatment system of any of examples 18 through 20, wherein the electronic processor is further configured to: receive, from a mapping system, a three- dimensional map of an anatomical structure in the treatment region, and automatically select the two-dimensional slice based on the position of the treatment catheter relative to the imaging catheter and the three-dimensional map.

[0133] Example 22. The medical treatment system of any of examples 18 through 21, further comprising: an electromagnetic tracking system, wherein the imaging catheter and the treatment catheter each comprise one or more electromagnetic sensors; and wherein the electronic processor receives the position of the treatment catheter relative to the imaging catheter from the electromagnetic tracking system.

[0134] Example 23. The medical treatment system of any of examples 18 through 22, wherein the electronic processor is further configured to: automatically select a second two-dimensional slice of the three-dimensional image data; and display the two-dimensional slice and second two- dimensional slice on an electronic display; wherein the second two-dimensional slice is perpendicular to the two-dimensional slice.MBF\215364\0116\52094841.vl-ll / 16 / 25 28Attorney Docket No. A0013538US01 (0116-US01)

[0135] Example 24. The medical treatment system of any of examples 18 through 23, wherein the electronic processor is further configured to: receive contact data indicating contact between the treatment catheter and the target tissue, and automatically select the two-dimensional slice based on the position of the treatment catheter relative to the imaging catheter and the contact data.

[0136] Example 25. The medical treatment system of example 24, wherein the contact data is received from a force sensor.

[0137] Example 26. The medical treatment system of example 24, wherein the contact data is determining a distance between a known position on the treatment catheter and the targeted tissue.

[0138] Example 27. The medical treatment system of any of examples 18 through 26, wherein the electronic processor is further configured to: receive impedance data indicating contact between the treatment catheter and the target tissue, and automatically select the two- dimensional slice based on the position of the treatment catheter relative to the imaging catheter and the impedance data.

[0139] Example 28. The medical treatment system of any of examples 18 through 27, wherein the imaging catheter is an intracardiac echocardiography (ICE) catheter.

[0140] Example 29. The medical treatment system of example 28, wherein the ICE catheter includes a two-dimensional array of ultrasound transducer elements configured to acquire volumetric ultrasound data over a substantially wedge-shaped field of view.

[0141] Example 30. The medical treatment system of any of examples 18 through 29, wherein the treatment catheter comprises an echogenic feature disposed on a distal end to enhance visibility of the treatment catheter in ultrasound images.

[0142] Example 31. The medical treatment system of any of examples 18 through 30, wherein the electronic processor is further configured to: determine a present position of the imaging catheter; determine a second position for the imaging catheter based on a desired imaging plane and the present position of the imaging catheter; automatically guide the imaging catheter to the second position; and automatically select the two-dimensional slice of the three-dimensionalMBF\215364\0116\52094841.vl-ll / 16 / 25 29Attorney Docket No. A0013538US01 (0116-US01) image data based on the position of the treatment catheter relative to the second position of the imaging catheter

[0143] Various features and advantages of the embodiments presented herein are set forth in the following claims.MBF\215364\0116\52094841.vl-ll / 16 / 25 30

Claims

Attorney Docket No. A0013538US01 (0116-US01)CLAIMSWhat is claimed is:

1. A medical treatment system (100), the system (100) comprising: a treatment catheter (114); an imaging catheter (130) being configured to capture images along an imaging plane; an electronic processor (205) coupled to the treatment catheter (114), and the imaging catheter (130), and configured to: determine a first position for the treatment catheter (114); determine a second position for the imaging catheter (130); determine a desired intersection plane for the treatment catheter (114); determine, based on the first position, the second position, and the desired intersection plane, a third position for the imaging catheter (130) that would result in the imaging plane aligning with the desired intersection plane; generate an instruction for guiding the imaging catheter (130) from the second position to the third position; and provide the instruction to an operator of the imaging catheter (130).

2. The medical treatment system (100) of claim 1, wherein: the imaging catheter (130) includes an electromagnetic sensor; and the electronic processor (205) is further configured to determine the position of the imaging catheter (130) using electromagnetic sensing.

3. The medical treatment system (100) of claim 1, wherein the electronic processor (205) is further configured to determine the position of the imaging catheter (130) using computer image analysis.MBF\215364\0116\52094841.vl-ll / 16 / 25 31Attorney Docket No. A0013538US01 (0116-US01)4. The medical treatment system (100) of any of claims 1 through 3, wherein first position for the treatment catheter (114) and the second position for the imaging catheter (130) each include at least one selected from a group consisting of a translation, an orientation, and a shape.

5. The medical treatment system (100) of any of claims 1 through 4, wherein the electronic processor (205) is further configured to determine the third position by determining at least one selected from a group consisting of a translation, an orientation, and a shape for the imaging catheter (130) that would result in the imaging plane aligning with the desired intersection plane.

6. The medical treatment system (100) of any of claims 1 through 5, wherein the electronic processor (205) is configured to provide the instruction to the operator of the imaging catheter (130) by performing at least one selected from a group consisting of presenting the instruction on an electronic display (164), illuminating a control of a handle (138) of the imaging catheter (130), providing a haptic feedback, and generating audio.

7. The medical treatment system (100) of any of claims 1 through 6, further comprising an electronic display (164); wherein the electronic processor (205) is further configured to provide the instruction to an operator of the imaging catheter (130) by controlling the electronic display (164) to present visual indicia, based on the instruction and the third position, for guiding the imaging catheter (130) from the second position to the third position.

8. The medical treatment system (100) of any of claims 1 through 7, further comprising an electronic display (164); wherein the electronic processor (205) is further configured to: when the imaging catheter (130) is in the third position, receive an image of the treatment catheter (114) from the imaging catheter (130); and control the electronic display (164) to present the image.

9. The medical treatment system (100) of any of claims 1 through 8, wherein the imaging catheter (130) is an intracardiac echocardiography (ICE) catheter.MBF\215364\0116\52094841.vl-ll / 16 / 25 32Attorney Docket No. A0013538US01 (0116-US01)10. A medical treatment system (100), the system (100) comprising: a treatment catheter (114); an imaging catheter (130) having an imaging plane; an electronic display (164); an electronic processor (205) coupled to the treatment catheter (114), the imaging catheter (130), and the electronic display (164), and configured to: determine a first position for the treatment catheter (114); determine a second position for the imaging catheter (130); determine a desired intersection plane for the treatment catheter (114); determine, based on the first position, the second position, and the desired intersection plane, a third position for the imaging catheter (130) that would result in the imaging plane aligning with the desired intersection plane; and automatically move the imaging catheter (130) from the second position to the third position.

11. The medical treatment system (100) of claim 10, wherein the electronic processor (205) is configured to automatically move the imaging catheter (130) by controlling a handle (138) (122) of the imaging catheter (130) to guide the imaging catheter (130) from the second position to the third position.

12. The medical treatment system (100) of any of claims 10 and 11, wherein the electronic processor (205) is configured to automatically move the imaging catheter (130) by controlling an articulable shaft of the imaging catheter (130) to guide the imaging catheter (130) from the second position to the third position.

13. The medical treatment system (100) of any of claims 10 through 12, wherein the electronic processor (205) is configured to automatically move the imaging catheter (130) by controlling an articulable shaft housing the imaging catheter (130) to guide the imaging catheter (130) from the second position to the third position.MBF\215364\0116\52094841.vl-ll / 16 / 25 33Attorney Docket No. A0013538US01 (0116-US01)14. A medical treatment system (100), the system (100) comprising: a treatment catheter (114); an imaging catheter (130) having an imaging plane; an electronic display (164); wherein the treatment catheter (114) and the imaging catheter (130) are coupled such that the imaging plane of the imaging catheter (130) aligns with a desired intersection plane of the treatment catheter (114) as the treatment catheter (114) is moved within a patient.

15. The medical treatment system (100) of claim 14, wherein the imaging catheter (130) and the treatment catheter (114) are electromagnetically coupled.

16. The medical treatment system (100) of claim 14, wherein the imaging catheter (130) and the treatment catheter (114) are mechanically coupled.

17. The medical treatment system (100) of claim 14, wherein the imaging catheter (130) and the treatment catheter (114) are deployed in a single sheath.MBF\215364\0116\52094841.vl-ll / 16 / 25 34Attorney Docket No. A0013538US01 (0116-US01)18. A medical treatment system (100), the system (100) comprising: an imaging catheter (130) configured to acquire three-dimensional image data of a treatment region (602); a treatment catheter (114) configured to deliver therapy to a target tissue (604) in the treatment region (602); an electronic processor (205) coupled to the imaging catheter (130) and the treatment catheter (114), the electronic processor (205) configured to: receive the three-dimensional image data from the imaging catheter (130); determine a position of the treatment catheter (114) relative to the imaging catheter (130); and automatically select a two-dimensional slice of the three-dimensional image data based on the position of the treatment catheter (114) relative to the imaging catheter (130).

19. The medical treatment system (100) of claim 18, wherein the electronic processor (205) is further configured to display (164) the two-dimensional slice on an electronic display (164).

20. The medical treatment system (100) of any of claims 18 through 19, wherein the electronic processor (205) is further configured to: segment the three-dimensional image data to identify boundaries of an anatomical structure in the treatment region (602), and automatically select the two-dimensional slice based on the position of the treatment catheter (114) relative to the imaging catheter (130) and the identified boundaries of the anatomical structure.

21. The medical treatment system (100) of any of claims 18 through 20, wherein the electronic processor (205) is further configured to: receive, from a mapping system (100), a three-dimensional map of an anatomical structure in the treatment region (602), and automatically select the two-dimensional slice based on the position of the treatment catheter (114) relative to the imaging catheter (130) and the three-dimensional map.MBF\215364\0116\52094841.vl-ll / 16 / 25 35Attorney Docket No. A0013538US01 (0116-US01)22. The medical treatment system (100) of any of claims 18 through 21, further comprising: an electromagnetic tracking system (100), wherein the imaging catheter (130) and the treatment catheter (114) each comprise one or more electromagnetic sensors; and wherein the electronic processor (205) receives the position of the treatment catheter (114) relative to the imaging catheter (130) from the electromagnetic tracking system (100) (106).

23. The medical treatment system (100) of any of claims 18 through 22, wherein the electronic processor (205) is further configured to: automatically select a second two-dimensional slice of the three-dimensional image data; and display (164) the two-dimensional slice and second two-dimensional slice on an electronic display (164); wherein the second two-dimensional slice is perpendicular to the two-dimensional slice.

24. The medical treatment system (100) of any of claims 18 through 23, wherein the electronic processor (205) is further configured to: receive contact data indicating contact between the treatment catheter (114) and the target tissue (604), and automatically select the two-dimensional slice based on the position of the treatment catheter (114) relative to the imaging catheter (130) and the contact data.

25. The medical treatment system (100) of claim 24, wherein the contact data is received from a force sensor.

26. The medical treatment system (100) of claim 24, wherein the contact data is determining a distance between a known position on the treatment catheter (114) and the targeted tissue.MBF\215364\0116\52094841.vl-ll / 16 / 25 36Attorney Docket No. A0013538US01 (0116-US01)27. The medical treatment system (100) of any of claims 18 through 26, wherein the electronic processor (205) is further configured to: receive impedance data indicating contact between the treatment catheter (114) and the target tissue (604), and automatically select the two-dimensional slice based on the position of the treatment catheter (114) relative to the imaging catheter (130) and the impedance data.

28. The medical treatment system (100) of any of claims 18 through 27, wherein the imaging catheter (130) is an intracardiac echocardiography (ICE) catheter.

29. The medical treatment system (100) of claim 28, wherein the ICE catheter includes a two-dimensional array of ultrasound transducer elements configured to acquire volumetric ultrasound data over a substantially wedge-shaped field of view.

30. The medical treatment system (100) of any of claims 18 through 29, wherein the treatment catheter (114) comprises an echogenic feature disposed on a distal end to enhance visibility of the treatment catheter (114) in ultrasound images.

31. The medical treatment system (100) of any of claims 18 through 30, wherein the electronic processor (205) is further configured to: determine a present position of the imaging catheter (130); determine a second position for the imaging catheter (130) based on a desired imaging plane and the present position of the imaging catheter (130); automatically guide the imaging catheter (130) to the second position; and automatically select the two-dimensional slice of the three-dimensional image data based on the position of the treatment catheter (114) relative to the second position of the imaging catheter (130).MBF\215364\0116\52094841.vl-ll / 16 / 25 37

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