US-12616442-B2 - Systems, devices, and methods for coregistration of intravascular data to enhanced stent deployment x-ray images

US12616442B2US 12616442 B2US12616442 B2US 12616442B2US-12616442-B2

Abstract

A system includes a processor circuit in communication with an extraluminal imaging device and an intraluminal imaging device. The processor circuit obtains an enhanced stent deployment extraluminal image and a plurality of intraluminal images. The enhanced stent deployment extraluminal image and the each of the plurality of intraluminal images are associated with locations along a pathway. The pathway is overlaid over an extraluminal image. Based on the locations of the pathway, the processor circuit coregisters the plurality of intraluminal images to the enhanced stent deployment extraluminal image and outputs a screen display of one of the plurality of intraluminal images and the enhanced stent deployment extraluminal image with an indicator identifying the location at which the displayed intraluminal image was obtained. The processor circuit may also determine an expansion score for intraluminal images depicting the stent and identify regions of the stent corresponding to an expansions score below a threshold.

Inventors

Asher Cohen
Pei-Yin Chao
Ronald Christiaan HELMSTRIJD
Ehud Nachtomy

Assignees

PHILIPS IMAGE GUIDED THERAPY CORPORATION

Dates

Publication Date: 20260505
Application Date: 20221215

Claims (16)

1 . A system, comprising: a processor circuit configured for communication with an extraluminal imaging device and an intraluminal imaging device, wherein the processor circuit is configured to: obtain an enhanced stent deployment extraluminal image, wherein the enhanced stent deployment extraluminal image depicts a stent positioned within a body lumen of a patient, wherein a visual appearance of the stent in the enhanced stent deployment extraluminal image is enhanced relative to other portions of the enhanced stent deployment extraluminal image; receive a plurality of intraluminal images obtained by the intraluminal imaging device during the movement of the intraluminal imaging device within the body lumen, wherein a first set of the plurality of intraluminal images obtained during the movement through the stent depicts the stent, wherein the first set of the plurality of intraluminal images span multiple locations between a proximal end and a distal end of the stent; co-register the plurality of intraluminal images to a plurality of corresponding locations within the enhanced stent deployment extraluminal image; and output, to a display in communication with the processor circuit, a screen display comprising: the enhanced stent deployment extraluminal image; an intraluminal image area showing a first intraluminal image of the first set of the plurality of intraluminal images; and an intraluminal image location marker in the enhanced stent deployment extraluminal image, wherein the intraluminal image location marker is positioned at a first location of the multiple locations and over the stent in the enhanced stent deployment extraluminal image, wherein the first intraluminal image depicts the first location, wherein the intraluminal image location marker is configured to be moved by a user to the multiple locations, and wherein the intraluminal image area is configured to show other intraluminal images of the first set of the plurality of intraluminal images in response to the intraluminal image location marker being moved to the multiple locations.
2 . The system of claim 1 , wherein the processor circuit is configured to provide the enhanced stent deployment extraluminal image in the screen display, in response to automatically identifying a stent within the intraluminal image.
3 . The system of claim 1 , wherein the processor circuit is further configured to determine an expansion score for one or more of the plurality of intraluminal images.
4 . The system of claim 3 , wherein the processor circuit is configured to automatically identify the proximal end of the stent or the distal end of the stent within one or more of the plurality of intraluminal images.
5 . The system of claim 3 , wherein the processor circuit is configured to compare the expansion score of the one or more intraluminal images with a threshold expansion score.
6 . The system of claim 5 , wherein the processor circuit is configured to identify a second set of the plurality of intraluminal images corresponding to the expansion score exceeding the threshold expansion score.
7 . The system of claim 6 , wherein the screen display comprises an indicator identifying one or more locations within the stent deployment extraluminal image corresponding to the expansion score exceeding the threshold expansion score.
8 . The system of claim 1 , wherein the processor circuit is further configured to receive a plurality of extraluminal images, wherein the screen display further comprises an extraluminal image of the plurality of extraluminal images.
9 . The system of claim 8 , wherein the extraluminal imaging device comprises an x-ray imaging device, wherein the plurality of extraluminal images comprises an x-ray image, and wherein the enhanced stent deployment extraluminal image comprises an enhanced stent deployment x-ray image.
10 . The system of claim 1 , wherein the screen display further comprises a longitudinal view of the body lumen including the stent.
11 . The system of claim 10 , wherein the screen display comprises an indicator of a region of the stent in the longitudinal view corresponding to an expansion score that does not exceed a threshold expansion score.
12 . The system of claim 1 , wherein a length of body lumen depicted in the enhanced stent deployment extraluminal image comprises only a portion of the body lumen including the stent.
13 . The system of claim 1 , wherein intraluminal imaging device comprises an intravascular imaging catheter, wherein the body lumen comprises a blood vessel, and wherein the plurality of intraluminal images comprises a plurality of intravascular images.
14 . The system of claim 13 , wherein the intravascular imaging catheter is configured for intravascular ultrasound (IVUS), wherein the plurality of intravascular images comprises a plurality of IVUS images.
15 . The system of claim 1 , wherein the stent depicted in the enhanced stent deployment extraluminal image and in the first set of the plurality of intraluminal images is the same.
16 . A method, comprising: obtaining an enhanced stent deployment extraluminal image, wherein the enhanced stent deployment extraluminal image depicts a stent positioned within a body lumen of a patient, wherein a visual appearance of the stent in the enhanced stent deployment extraluminal image is enhanced relative to other portions of the enhanced stent deployment extraluminal image; receiving a plurality of intraluminal images obtained by an intraluminal imaging device during the movement of the intraluminal imaging device within the body lumen, wherein a first set of the plurality of intraluminal images obtained during the movement through the stent depicts the stent, wherein the first set of the plurality of intraluminal images span multiple locations between a proximal end and a distal end of the stent; co-registering the plurality of intraluminal images to a plurality of corresponding locations within the enhanced stent deployment extraluminal image; and outputting, to a display in communication with the processor circuit, a screen display comprising: the enhanced stent deployment extraluminal image; an intraluminal image area showing a first intraluminal image of the first set of the plurality of intraluminal images; and an intraluminal image location marker in the enhanced stent deployment extraluminal image, wherein the intraluminal image location marker is positioned at a first location of the multiple locations and over the stent in the enhanced stent deployment extraluminal image, wherein the first intraluminal image depicts the first location, wherein the intraluminal image location marker is movable by a user to the multiple locations, and wherein the intraluminal image area shows other intraluminal images of the first set of the plurality of intraluminal images in response to the intraluminal image location marker being moved to the multiple locations.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to and the benefit of U.S. Provisional Application No. 63/290,694, filed Dec. 17, 2021 and U.S. Provisional Application No. 63/331,299, filed Apr. 15, 2022, each of which is incorporated by reference herein in its entirety. TECHNICAL FIELD The present disclosure relates generally to co-registering data from different medical diagnostic modalities. In particular, intravascular data may be co-registered to enhanced stent deployment x-ray images and used to assess the success of a stent deployment procedure. BACKGROUND Physicians use many different medical diagnostic systems and tools to monitor a patient's health and diagnose medical conditions. Different modalities of medical diagnostic systems may provide a physician with different images, models, and/or data relating to internal structures within a patient. These modalities include invasive devices and systems, such as intravascular systems, and non-invasive devices and systems, such as x-ray systems, and computed tomography (CT) systems. Using multiple diagnostic systems to examine a patient's anatomy provides a physician with added insight into the condition of the patient. In the field of intravascular imaging, co-registration of data from invasive devices (e.g., intraluminal devices such as intravascular ultrasound (IVUS) devices or instantaneous wave-free ratio (iFR) devices) with images collected non-invasively (e.g., extraluminal images, such as those obtained via x-ray angiography) is a powerful technique for improving the efficiency and accuracy of vascular catheterization procedures. Co-registration identifies the locations of intravascular data measurements along a blood vessel by mapping the data to an angiography image of the vessel. A physician may then know exactly where in the vessel a measurement was made, rather than estimate the location. During a treatment procedure, a stent may be positioned within a patient's vessel at a constriction of the vessel to restore blood flow. Incorrect placement or insufficient expansion of a stent may lead to a failure to restore blood flow as well as complications post deployment. The physician has been limited to a view of an extraluminal image, such as a stent-enhanced image, to assess whether a stent was correctly positioned and/or expanded within the vessel. SUMMARY Embodiments of the present disclosure are systems, devices, and methods for co-registering intravascular data to enhanced stent deployment x-ray images. Aspects of the present disclosure advantageously provide a physician with information regarding the success of a stent deployment procedure. Specifically, aspects of the present disclosure help a physician confirm whether a stent is properly expanded after deployment as well as determine whether the stent was placed at a correct location longitudinally along a vessel so that a central portion of the stent is placed at or near the constriction of the vessel. For example, the physician is no longer limited to the extraluminal image, such as the stent-enhanced image, alone. Rather, the physician is additionally able to use intravascular data (e.g., intraluminal images, such as IVUS image) that have been co-registered with the stent-enhanced image to evaluate correct positioning and/or expansion of the stent. At a first step, a stent is positioned within a vessel while x-ray images of the vessel are acquired. The x-ray images are used to co-register the location of the stent, including the location of the stent after expansion, as well as to generate stent-enhanced images to enhance the view of the stent for the physician after stent expansion. Because radiopaque portions of the stent and/or delivery device are visible in the x-ray images, the location of the stent within the x-ray images is known throughout the procedure. After the stent is expanded, an intravascular ultrasound (IVUS) imaging device may be pulled through the vessel and the stent while x-ray images of the stented region are acquired. During the IVUS imaging procedure, because radiopaque portions of the imaging device appear within the x-ray images, the locations at which IVUS images were acquired may also be known. The locations of the stent and the locations of the intravascular imaging device are both coregistered to the same x-ray image. As a result, IVUS images, and any accompanying data, such as stent expansion scores, may be coregistered to the stent-enhanced images. Aspects of the present disclosure include displaying a stent boosted image with superimposed IVUS data, such as stent expansion scores. The IVUS data may also be superimposed on a longitudinal view of the vessel. These displays advantageously provide a physician with information regarding whether the stent was correctly placed and sufficiently expanded to both restore blood flow and reduce the risk of further complications related to the stent. An advantage of the present disclosure may