Systems and methods for improved visualization during minimally invasive procedures

Abstract

Systems and methods are provided for performing a minimally invasive procedure in an automated or semi-automated fashion, where an imaging probe having an imaging modality compatible with the presence of an intraluminal medium is employed to record images that are processed to identify regions of interest and direct a medium displacement operation during a subsequent minimally invasive operation that benefits from the displacement of the intraluminal medium. The minimally invasive operation may include recording images with a second imaging modality, or may be a therapeutic treatment. The method is may be performed in real-time, where images obtained from the first imaging modality are processed in real time to determine whether or not the minimally invasive operation is to be performed at a given position.

Therefore what is claimed is: 
     
       1. A method of directing a medium displacement operation for performing a medical procedure, the method comprising the steps of:
 obtaining a first set of images from a first imaging modality when a first translation operation of a functional component of an imaging probe is performed;   spatially correlating the first set of images with an associated position of the functional component of the imaging probe, wherein the first imaging modality is compatible with a presence of a displaceable medium;   processing the first set of images and identifying a region of interest; and   directing a medium displacement operation while a second translation operation of the functional component of the imaging probe is performed over the region of interest;   wherein the medical procedure is performed within the region of interest during the medium displacement operation.   
     
     
       2. The method according to  claim 1  wherein the imaging probe comprises an additional imaging modality compatible with a presence of the displaceable medium, the method further comprising the steps of:
 obtaining an additional set of images from the additional imaging modality when the first translation operation is performed, and wherein the additional set of images are spatially correlated with the position of the functional component of the imaging probe; and 
 processing the additional set of images and further identifying the region of interest. 
 
     
     
       3. The method according to  claim 1  further comprising the steps of:
 processing the first set of images and identifying an additional region of interest; 
 directing an additional medium displacement operation while an additional translation operation is performed over the additional region of interest; and 
 wherein an additional medical procedure is performed within the additional region of interest during the additional medium displacement operation. 
 
     
     
       4. The method according to  claim 1  wherein the first imaging modality is selected from the group consisting of grayscale IVUS, radio-frequency IVUS, Virtual Histology™, integrated backscatter, iMap™ elastography, NIR spectroscopy, sono-luminescent imaging, microbubble enhanced IVUS, targeted microbubble enhanced IVUS, photo-acoustic imaging, fluorescence spectroscopy, biosensors, and ion-selective field effect transistors. 
     
     
       5. The method according to  claim 1  wherein the medical procedure includes the steps of obtaining a second set of images obtained from a second imaging modality while the medium displacement operation is performed, and spatially correlating the second set of images with an associated position of the functional component of the imaging probe. 
     
     
       6. The method according to  claim 5  further comprising processing the first set of images and the second set of images to spatially correlate the first set of images with the second set of images. 
     
     
       7. The method according to  claim 5  wherein the second imaging modality is selected from the group consisting of OCT, angiography, angioscopy, NIR spectroscopy. Raman spectroscopy, IVUS, radio-frequency IVUS, elastography, sono-luminescent imaging, microbubble enhanced IVUS, targeted microbubble enhanced IVUS, fluorescence spectroscopy, and photo-acoustic imaging. 
     
     
       8. The method according to  claim 1  wherein the medium displacement operation comprises the step of providing a flushing solution including a contrast medium, wherein the method further comprises the step of determining an adequacy of the medium displacement operation using an external imaging modality. 
     
     
       9. A method of directing a medium displacement operation for performing a medical procedure, the method comprising the steps of:
 a) obtaining one or more images from a first imaging modality of an imaging probe, wherein the first imaging modality is compatible with a presence of blood;   b) processing the one or more images to identify a region of interest; and   c) if a region of interest is identified, directing a medium displacement operation and performing a medical procedure within the region of interest while the medium displacement operation is performed.   
     
     
       10. The method according to  claim 9  further comprising the steps of:
 d) translating a functional component of the imaging probe to a new position, and 
 e) repeating steps a) through c). 
 
     
     
       11. The method according to  claim 9  wherein a functional component of the imaging probe is translated while performing any one or more of steps a), b) and c). 
     
     
       12. The method according to  claim 9  wherein the medical procedure includes obtaining one or more images from a second imaging modality. 
     
     
       13. The method according to  claim 12  further comprising the step of processing the one or more images obtained from the first imaging modality and one or more images obtained from the second imaging modality to spatially correlate one or more images obtained from the first imaging modality with the one or more images obtained from the second imaging modality. 
     
     
       14. The method according to  claim 12  further comprising the step of processing the one or more images obtained from the second imaging modality in real-time to determine a measure of a quality of the one or more images obtained from the second imaging modality. 
     
     
       15. The method according to  claim 14  further comprising the steps of:
 identifying when suboptimal imaging data has been acquired using the second imaging modality and providing a notification that a fault has occurred; and 
 obtaining an additional set of images using the second imaging modality. 
 
     
     
       16. The method according to  claim 9  further comprising the step of providing an image acquisition triggering signal to an external imaging apparatus during one or more of the first translation operation and the second translation operation for correlating acquisition of images obtained by the external imaging apparatus with the relative position of the imaging probe. 
     
     
       17. A method of directing a medium displacement operation for performing a medical procedure with a probe, the method comprising the steps of:
 obtaining, with an external imaging apparatus, one or more images of a region within which the medical procedure is to be performed;   identifying a region of interest within the one or more images;   translating a functional component of the probe to the region of interest while obtaining one or more additional images with the external imaging apparatus; and   directing a medium displacement operation while performing a translation operation associated with the functional component of the probe within the region of interest.   
     
     
       18. A method of directing a medium displacement operation for performing a medical procedure, the method comprising the steps of:
 obtaining a set of measurements from a non-imaging detection modality when a first translation operation of a functional component of a probe is performed;   spatially correlating the set of measurements with an associated position of the functional component of the probe, wherein the non-imaging detection modality is compatible with a presence of a displaceable medium;   processing the set of measurements and identifying a region of interest; and   directing a medium displacement operation while a second translation operation of the functional component of the probe is performed over the region of interest;   wherein the medical procedure is performed within the region of interest during the medium displacement operation.   
     
     
       19. A method of directing a medium displacement operation for performing a medical imaging procedure, the method comprising the steps of:
 a) obtaining one or more measurements from a non-imaging detection modality of a probe, wherein the non-imaging detection modality is compatible with a presence of a displaceable medium;   b) processing the one or more measurements to identify a region of interest; and   c) if a region of interest is identified, directing a medium displacement operation and performing a medical procedure while the medium displacement operation is performed.   
     
     
       20. A method of directing a medium displacement operation for performing a medical procedure, the method comprising the steps of:
 employing an imaging probe to obtain a set of images using a first imaging modality in the absence of a first translation operation, wherein the first imaging modality imaging probe is compatible with a presence of blood;   processing the set of images and identifying a region of interest;   directing a medium displacement operation to displace the blood; and   performing a medical procedure within the region of interest during the medium displacement operation.   
     
     
       21. The method according to  claim 20  wherein the imaging probe employs a scanning mechanism for varying an imaging angle when collecting the set of images. 
     
     
       22. The method according to  claim 21  wherein the imaging probe is configured for imaging in a forward-looking direction, and where the set of images are obtained in the forward-looking direction. 
     
     
       23. The method according to  claim 20  wherein the imaging probe comprises an array of ultrasound transducers and wherein the set of images are obtained using electronic beam steering. 
     
     
       24. A method of directing a medium displacement operation during a medical procedure involving an imaging probe, the imaging probe including an imaging assembly configured to obtain images according to a first imaging modality and a second imaging modality, and wherein the first imaging modality is compatible with a presence of a displaceable medium, the method comprising the steps of:
 obtaining a first set of images from the first imaging modality during a first translation operation of the imaging assembly of the imaging probe, wherein the first translation operation is performed in the presence of the displaceable medium;   spatially correlating the first set of images with an associated position of the imaging assembly;   processing the first set of images to identify a region of interest;   obtaining a second set of images with the second imaging modality during a second translation of the imaging assembly, such that the second set of images pertain to the region of interest, wherein the second translation operation comprises a linear translation operation; and   while obtaining the second set of images:
 processing the second set of images in real time to obtain an image quality measure associated therewith, the image quality measure being generated by processing an intraluminal image region within which displacement of the displaceable medium is desired, such that the image quality measure is dependent on an amount of the displaceable medium residing within the intraluminal image region; and 
 controlling a medium displacement apparatus based on feedback associated with the image quality measure, such that displacement of the displaceable medium is achieved within the intraluminal image region, thereby improving the image quality of the second set of images. 
   
     
     
       25. The method according to claim 24 wherein the intraluminal image region is a sector of an intraluminal region. 
     
     
       26. The method according to claim 24 wherein the first imaging modality is intravascular ultrasound and the second imaging modality is optical coherence tomography. 
     
     
       27. The method according to claim 24 wherein the medium displacement apparatus is controlled to vary one or more of a rate of delivery of flush solution, a volume of flush solution, a time profile of amount flushed, and a volume of inflation for a displacement balloon. 
     
     
       28. The method according to claim 24 wherein the medium displacement apparatus is controlled to minimize one or more aspects of a medium displacement operation. 
     
     
       29. The method according to claim 28 wherein the one or more aspects are selected from the group consisting of a time of a displacement operation, a rate of delivery of a flush solution, and a volume of flush solution. 
     
     
       30. The method according to claim 24 wherein the medium displacement apparatus is controlled based on a comparison of the image quality measure to a pre-determined criterion. 
     
     
       31. The method according to claim 30 further comprising interrupting the second translation operation when the image quality measure fails to meet the pre-determined criterion. 
     
     
       32. The method according to claim 24 wherein the displaceable medium is blood. 
     
     
       33. The method according to claim 24 wherein the presence of the displaceable medium is detected based on spectral analysis. 
     
     
       34. The method according to claim 24 further comprising the step of monitoring a parameter related to medium displacement. 
     
     
       35. The method according to claim 34 further comprising alerting an operator or sending a control signal to the medium displacement apparatus when the parameter does not lie within a pre-determined range of values. 
     
     
       36. The method according to claim 24 wherein the first set of images are processed by processing three-dimensional image data. 
     
     
       37. The method according to claim 24 wherein the step of identifying the region of interest comprises comparing the first set of images to known or expected properties. 
     
     
       38. The method according to claim 37 wherein the known or expected properties are spatial profiles and/or tissue types of one or more of normal anatomical features, pathological anatomical features, and medical implants. 
     
     
       39. The method according to claim 24 wherein the step of processing the first set of images includes one of determining a spatial profile of a detected border, a tissue type, and a temperature profile. 
     
     
       40. The method according to claim 24 wherein the region of interest includes a substance or feature selected from the group consisting of plaque, thrombus, branch points, lesions, calcifications, stents, brachytherapy implants, stenoses, areas of vessel wall thickening, lipid cores, necrotic regions, fibrous caps, dissections, microbubbles, targeted microbubbles, vascular lesions, and a combination thereof.