Target site selection, entry and update with automatic remote image annotation

Abstract

Fluoroscopic imaging of a patient's heart is performed by positioning a patient in a sterile field and imaging the heart using a x-ray fluoroscopy system within the sterile to produce a two-dimensional image. The two-dimensional image is simultaneously displayed on an operative display within or adjacent the sterile filed and on a display of a remote image processor outside the operative field. The two-dimensional image of the remote display is manually marked or annotated to show anatomical or treatment information which is simultaneously shown on the operative display.

1 . A method for providing images of a patient's heart during a procedure, said method comprising:
 receiving a three-dimensional (3D) image of a heart of the patient taken outside of an operative field;   receiving two orthogonal two-dimensional (2D) images of the heart taken within an operative field;   simultaneously displaying the 2D images on both an operative display within or adjacent the operative field and on a remote display outside the operative field;   superimposing at least a portion of the 3D image of the heart on the 2D images on remote display;   receiving one or more marks on the superimposed image displayed on the remote display, the one or more marks indicating treatment information for the heart, thereby generating a marked superimposed image; and   simultaneously displaying the marked superimposed image on both the operative display and the remote display to show the treatment information.   
     
     
         2 . (canceled) 
     
     
         3 . The method according to  claim 1 , wherein the 2D images comprise x-ray fluoroscopic images. 
     
     
         4 . The method according to  claim 1 , wherein the 2D images comprise two orthogonal ventriculogram images. 
     
     
         5 . The method according to  claim 4 , wherein the two orthogonal ventriculogram images comprises a first ventriculogram image with a right anterior oblique view of the heart and a second ventriculogram image with a left anterior oblique view of the heart. 
     
     
         6 . The method according to  claim 4 , wherein the two orthogonal ventriculogram images are obtained after dye is injected into the heart and x-ray fluoroscopic images of the heart are taken. 
     
     
         7 .- 20 . (canceled) 
     
     
         21 . A method for providing images of a patient's heart during a procedure, said method comprising:
 receiving a three-dimensional (3D) image of a heart of the patient taken outside of an operative field;   receiving at least one ventriculogram image of the heart taken within an operative field;   simultaneously displaying the at least one ventriculogram image on both an operative display within or adjacent the operative field and on a remote display outside the operative field;   superimposing at least a portion of the 3D image of the heart on the at least one ventriculogram image on remote display;   receiving one or more marks on the superimposed image displayed on the remote display, the one or more marks indicating treatment information for the heart, thereby generating a marked superimposed image; and   simultaneously displaying the marked superimposed image on both the operative display and the remote display to show the treatment information.   
     
     
         22 . (canceled) 
     
     
         23 . The method according to  claim 21 , wherein the at least one ventriculogram image comprises at least one x-ray fluoroscopic image. 
     
     
         24 . The method according to  claim 21 , wherein the at least one ventriculogram image images comprise two orthogonal ventriculogram images. 
     
     
         25 . The method according to  claim 24 , wherein the two orthogonal ventriculogram images comprises a first ventriculogram image with a right anterior oblique view of the heart and a second ventriculogram image with a left anterior oblique view of the heart. 
     
     
         26 . The method according to  claim 24 , wherein the two orthogonal ventriculogram images are obtained after dye is injected into the heart and x-ray fluoroscopic images of the heart are taken. 
     
     
         27 .- 40 . (canceled) 
     
     
         41 . A method for providing images of a patient's heart during a procedure, said method comprising:
 receiving a three-dimensional (3D) image of a heart of the patient taken outside of an operative field;   receiving at least one two-dimensional (2D) image of the heart taken within an operative field;   simultaneously displaying the at least one 2D image on both an operative display within or adjacent the operative field and on a remote display outside the operative field;   superimposing at least a portion of the 3D image of the heart on the at least one 2D image on remote display;   generating one or more target treatment locations in the heart based on two or more of an infarct location in the heart, an infarct size in the heart, a distance from an infarct in the heart, a wall thickness of the heart, bioelectric activity of the heart, or a location of a previous biopsy or therapeutic delivery;   placing one or more marks on the superimposed image displayed on the remote display based on the generated one or more target treatment locations, thereby generating a marked superimposed image; and   simultaneously displaying the marked superimposed image on both the operative display and the remote display to show the treatment information.   
     
     
         42 .- 50 . (Canceled) 
     
     
         51 . The method according to  claim 41 , wherein the one or more marks further comprise one or more markings to indicate or outline the heart or a region thereof. 
     
     
         52 . (canceled) 
     
     
         53 . The method according to  claim 41 , wherein the one or more marks further comprise one or more markings for one or more regions to avoid treating. 
     
     
         54 . (canceled) 
     
     
         55 . The method according to  claim 41 , wherein the one or more target treatment regions in the heart comprise one or more target injection sites for a biotherapeutic. 
     
     
         56 .- 59 . (Canceled) 
     
     
         60 . The method according to  claim 41 , further comprising recalculating the one or more target treatment locations after treatment of the heart based on the treatment information showed by the marked superimposed image displayed on the operative display. 
     
     
         61 . A method for providing images of a patient's heart during a procedure, said method comprising:
 receiving a three-dimensional (3D) image of a heart of the patient taken outside of an operative field;   receiving at least one two-dimensional (2D) image of the heart taken within an operative field;   simultaneously displaying the at least one 2D image on both an operative display within or adjacent the operative field and on a remote display outside the operative field;   superimposing at least a portion of the 3D image of the heart on the at least one 2D image on remote display;   generating one or more target treatment locations in the heart;   placing one or more marks on the superimposed image displayed on the remote display based on the generated one or more target treatment locations, thereby generating a marked superimposed image;   simultaneously displaying the marked superimposed image on both the operative display and the remote display to show the treatment information; and   recalculating the one or more target treatment locations after treatment of the heart based on the treatment information showed by the marked superimposed image displayed on the operative display.   
     
     
         62 .- 70 . (Canceled) 
     
     
         71 . The method according to  claim 61 , wherein the one or more marks further comprise one or more markings to indicate or outline the heart or a region thereof. 
     
     
         72 . (canceled) 
     
     
         73 . The method according to  claim 61 , wherein the one or more marks further comprise one or more markings for one or more regions to avoid treating. 
     
     
         74 . (canceled) 
     
     
         75 . The method according to  claim 61 , wherein the one or more target treatment regions in the heart comprise one or more target injection sites for a biotherapeutic. 
     
     
         76 .- 79 . (canceled) 
     
     
         80 . The method according to  claim 61 , wherein the one or more target treatment locations in the heart are generated based on two or more of an infarct location in the heart, an infarct size in the heart, a distance from an infarct in the heart, a wall thickness of the heart, bioelectric activity of the heart, or a location of a previous biopsy or therapeutic delivery.