Interventional navigation with application of three-dimentional ultrasound with contrast enhancement

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment, namely to systems of diagnostic visualisation with ultrasound. Method lies in introduction of contrast-enhancing preparation into monitored tissue, obtaining, during period of preparation action, support 3D CEUS volume and information of monitoring and picture in real time of monitored tissue, formation of multiplanar picture reconstruction of (MPR) with contrast enhancement (CEUS), for one of obtained pictures in real time, representation of obtained picture in real time, showing instrument within required part, and corresponding picture MPR CEUS for interventional navigation, after expiration of the period of contrast enhancement action. In the second version of method picture MPR CEUS is spatially registered with corresponding obtained images in real time. In the third version of method implementation maximal intensity projection (MIP) is formed as function of, at least, obtained 3D CEUS volume and information of monitoring and pictures in real time and is represented with instrument within required part. System contains ultrasound scanner, made with possibility of introduction of contrast -enhancing preparation into monitored tissue, obtaining support 3D CEUS volume and information of monitoring and formation of corresponding multiplanar picture reconstruction (MPR) with contrast enhancement (CEUS), and representation device, connected with it for representation of obtained pictures in real time.

EFFECT: application of the invention makes it possible to increase accuracy of aiming in interventional procedures without necessity to change course of work or switch to other module of visualisation.

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In this application claims the priority of previously filed provisional application entitled "INTERVENTIONAL NAVIGATION USING three-DIMENSIONAL ULTRASOUND WITH CONTRAST ENHANCEMENT", Jochen Kruecker, and others, the serial number 60/988472, filed November 16, 2007, and delivered to the assignee of the present invention.

The present invention has been made in pursuance of the Agreement, Cooperative Research and Development of the public Health Service of the United States (CRADA No. NCI-NIHCC-01864). The United States government may have certain rights to this invention.

These implementation options are generally to systems ultrasonic diagnostic imaging and, in particular, to a method and device for interventional navigation using 3D ultrasound with contrast enhancement (CEUS).

Ultrasound imaging is one of the main ways hover over the image for a variety of minimally invasive and interventional procedures. In particular, the majority of needle biopsies and ablaze using needles perform the move on the ultrasound. The advantages of ultrasonography include the ability to visualize in real-time, low cost, flexibility in application, and that does not use ionizing radiation is giving. However, the non-amplified ultrasound, including the commonly used ultrasound image based on the scale of levels of gray color, it may be unsuitable for imaging a particular purpose (e.g., tumors) with desired contrast and, in some cases, may not visualize the goal. In these cases, the placement of the needle becomes very difficult and leads to inaccuracies, since it is associated with visualization purposes using different modes and intelligent transmission location of the tumors in ultrasonic images in real-time based on anatomical landmarks near neoplasms identified in both rendering modes. The result may be false-negative biopsy, unsuccessful therapy of tumors and, in General, poor therapeutic results.

Ultrasound imaging with contrast enhancement (CEUS) is another form of ultrasonic imaging, which relates to ultrasonic imaging after intravenous injection of funds for contrast ultrasound (for example, Definity®, Bristol-Myers Sqibb). Modern ultrasound scanners used specific rendering modes to take advantage of nonlinear acoustic characteristics of the means of contrast, thus, highlighting only the fabric stacked to the trustnet. Received, as a result, the image is called "contrast" and has a very different appearance compared with low-contrast images. It is possible to visualize tissue after injection of contrast in normal mode based on the scale of levels of gray. In the latter case, we obtain, as a result, the image is called the "image of tissue" and looks similar to the images based on the scale of levels of gray color obtained without injection of contrast, showing only a slight strengthening in the areas of absorption contrast.

It is noted that CEUS can provide better visualization of tumors, vascularity and other tissues of interest, compared with an ultrasonic imaging without contrast enhancement. However, the contrast is increased after bolus injection is temporary and usually disappears in a few minutes. Such a time limit in a few minutes is often insufficient time to perform the desired procedure (for example, placing a needle biopsy or ablaze). In other words, for guidance during interventional procedures, such as needle placement for biopsy and removal, the time gap enhancement is insufficient compared with the time required to comply with the Oia interventional procedures. You can perform a second injection means contrast to prolong the effect of the gain, but this may still be insufficient to complete the required procedures.

Additional limitations of the methods of the prior art associated only with the prior CEUS volume, include, for example, that the position of the subsequent ultrasound image of the tissue in real time, obtained during the interventional procedure is relatively unknown prior CEUS volume, and it must be evaluated and, thus, this leads to inaccuracies. In addition, the movement of the tissue complicates the estimation of the target location based on previously received CEUS volume.

Accordingly, requires improved method and system to overcome the disadvantages existing in the prior art.

Fig. 1 is a partial block diagram of a system for implementing the method of interventional navigation using 3D ultrasound with contrast enhancement in accordance with one embodiment of the invention according to the present disclosure;

Fig. 2 is a partial block diagram illustrating the conversion between different coordinate systems corresponding to the method of interventional navigation is tion using 3D CEUS, in accordance with a variant embodiment of the invention according to the present disclosure;

Fig. 3 is a view of a display device illustrating performed next to each other displaying tissue in real time and a corresponding image multiplanar reconstruction (MPR) CEUS in accordance with one embodiment of the invention according to the present disclosure; and

Fig. 4 is a view of a display device illustrating the display of the tissue in real time and a corresponding image CEUS MPR with translucent overlay in accordance with another embodiment of the invention according to the present disclosure.

In the figures similar digital reference positions refer to similar elements. In addition, it should be noted that the figures may not be drawn to scale.

Embodiments of the invention in accordance with the present disclosure provide a system and method of using ultrasound imaging with contrast enhancement (CEUS) for guidance on the images during interventional procedures. In particular, embodiments of the invention according to the present disclosure mainly provide a method and system for use CEUS to improve the accuracy of the guidance in interventional procedures without having changed who I progress or completely switch to another rendering mode.

The system and method disclosed herein include a system of spatial tracking made with the possibility of tracking the position of the ultrasonic probe. Using the tracking system allows positioning 3D CEUS volume at the beginning of the interventional procedure. In one embodiment of the invention, the 3D volume of tissue also receive at the same time with 3D CEUS volume, as will be discussed later. After that, during the interventional procedure, the spatial tracking of the ultrasound probe is used to combine the display of the current generated in real-time ultrasonic image of the tissue with the corresponding multiplanar reconstruction (MPR) CEUS, and the corresponding MPR get from the original 3D CEUS volume. The movement of the fabric between the receipt of the original 3D CEUS volume and ultrasonic imaging of tissue in real time is corrected through image-based registration between the ultrasound image of the tissue in real-time 3D ultrasound volume of tissue obtained together with the original 3D CEUS volume. Combined display of (i) the corresponding MPR derived from the source CEUS volume, and (ii) ultrasonic image of the tissue without contrast enhancement in real time mainly allows to combine the visualization of p is the position of the needle and the location of the target and, thus, you can direct the needle to the target during the interventional procedure after completion of the amplification of a means of contrast.

Referring to the drawings, Fig. 1 is a block diagram of a system 10 for interventional navigation using three-dimensional ultrasound with contrast enhancement in accordance with one embodiment of the invention according to the present disclosure. The system 10 includes an ultrasound scanner (US) 12, equipped and/or connected to the probe 14 ultrasonic imaging. In one embodiment of the invention ultrasound scanner 12 includes, for example, iU22 ultrasound scanner, commercially available Philips Medical Systems. The probe 14 visualization includes any suitable probe the three-dimensional ultrasonic imaging. Additionally, ultrasound scanner 12 includes a device 16, the display of the scanner. In addition, ultrasound scanner 12 is configured to simultaneously obtain contrast images and images of the tissue. Ultrasound scanner 12 is additionally configured to transmit images in real time, for example, by streaming the data to the workstation 18. For example, the image transmission in real time can be performed using the iU22 ultrasound scanner using PR is the software "Digital Navigation Link. Although illustrated separately from the ultrasonic scanner 12, the workstation 18 may also be integrated in the ultrasonic scanner 12 and to be a part of it.

Referring again to Fig. 1, the workstation 18 includes a device 20 of the display workstation. During operation of the ultrasound scanner 12, the probe 14 and the workstation 18 is used together with the patient 22 with the anatomy, which is an object for this ultrasonic diagnostic studies and/or appropriate treatment or medical procedure, and the patient 22 is located on the table 24 for the patient. Ultrasound scanner 12 is made with contrast ultrasound image and ultrasound image of the tissue, for example, in "parallel" mode, corresponding ParameterName obtaining contrasting frame and frame fabric, and send both images on the workstation 18. Workstation 18 executes software to provide workflow, as will be discussed later.

The system 10 for interventional navigation using three-dimensional ultrasound with contrast enhancement also involves tracking the position in accordance with a variant embodiment of the invention according to the present disclosure. The system 10 upgraded twoway through integration with external system 26 track (TS). The external system 26 track includes generator 28 field tracking made with the possibility of creating a field tracking, generally denoted by the reference position 30. The sensor 32 is attached to the ultrasound probe 14, and due to the fact that the sensor is placed in the area of the field sensor 30, the position and orientation of the sensor can be tracked by the system 26 tracking. In one embodiment of the invention, the workstation 18 is connected to the system 26 tracking and configured to transmit information security and/or security commands tracking between the workstation 18 and the system 26 tracking in accordance with the requirements of this interventional navigation or implementation. System 26 tracking may include any appropriate tracking system, such as electromagnetic system "Aurora", manufactured by Northern Digital Inc., Waterloo, Canada. In another embodiment of the invention, the system 26 tracking includes an optical tracking system in which the generator 28 field tracking includes, for example, a camera for optical tracking of the ultrasound probe 14 within fields 30 tracking, the corresponding optical field of view. Such an optical tracking system may include, for example, a system of "Polaris", manufactured by Northern Digital Inc., Waterloo, Canada./p>

In the system 10 shown in Fig. 1, the external system (TS) 26 track is nearly or directly from the patient 22. The sensor (S) 32 position with six degrees of freedom (6DoF) sensor attached to the ultrasound probe 14, and the generator 28 field tracking is located so that the position of the probe can be tracked within a field of 30 tracking.

Work station 18 also includes software contained on computer-readable storage medium and loaded into memory referred to the workstation, and the software includes commands executed by the processor of the workstation to (i) obtain and maintain at least one of the 3D CEUS volume together with the coordinates of the tracking system for this volume provided by the sensor 32, and (ii) receiving and processing the coordinate sensor tracking in real time, and use the coordinate sensor tracking in real time to calculate and display multiplanar reconstructions (MPR), at least one of the received and stored 3D CEUS volume so that the corresponding MPR shows the same fabric as the last received image of the tissue in real time.

In one embodiment of the invention ultrasound scanner 12 is configured to receive, and ne is Adachi CEUS image/volume and image/volume of tissue at a time. In this embodiment of the invention, the software of the workstation 18 additionally contains commands that are executed by the processor of the workstation 18, (iii) obtain and maintain at the same time, 3D CEUS volume and 3D volumes of tissue together with the corresponding coordinate system of the tracking volume provided by the sensor 32; and (iv) receiving and processing the coordinate sensor tracking in real time, and use the coordinate sensor tracking in real-time image-based registration of low-contrast image of the tissue in real-time 3D volume of tissue obtained simultaneously with 3D CEUS volume, the resulting conversion register is used to calculate and display the MPR for the source of the received and stored 3D CEUS volume so that the CEUS MPR shows the same fabric as the last received image of the tissue in real time.

In one embodiment of the invention the system and method include the use of ultrasound scanner 12, is made with the possibility of obtaining 3D images in real-time contrast-mode or tissue, and is made with the possibility of streaming (real-time) image data to the workstation 18 (or another system, the example by means of a suitable communication network). In this embodiment of the invention, the method assumes that the patient is able to perform a respiratory team, and able to perform reproducible breath. In addition, the software running on the workstation 18, made with the ability to communicate with different hardware (for example, tracking system, an ultrasound scanner, and so on), using electronic data transmission in real time.

In one example, the workflow of the patient 22, which will be operated ablation using a needle with ultrasound guidance, is located on the table 24 for the study. The sensor 32 provisions attached to the ultrasound probe 14. The transmitter/receiver 28 system 26 tracking should be located close to the patient 22 so that the ultrasonic probe 14 with the attached sensor 32 provisions been in the field 30 overview of the transmitter/receiver 28 during the ultrasound imaging for the procedure. Ultrasound scanner 12 source configured or is set to contrast visualization, and intravenous bolus injection of funds contrast is injected to the patient 22. After enhancing the contrast becomes visible on the ultrasound image displayed on the device 16 displays is Azania, receive three-dimensional (3D) CEUS scan covering the tumor or area of interest. 3D CEUS volume and corresponding to the positions of the probe are transmitted in the navigation workstation 18. To render after the disappearance of the enhancement of two-dimensional or three-dimensional ultrasonic image of the tissue in real time and the corresponding data of the probe position data are continuously transmitted (that is, streamed) to the workstation 18. Based on the current location of the transmitter calculates the current position of the ultrasonic image of the tissue relative to the source of the received 3D CEUS image (also called pre-obtained 3D CEUS image). The device 20 display workstation current ultrasound image of tissue in real time is displayed together with the corresponding multiplanar reconstruction (MPR) (or other visualization) CEUS image. This allows you to localize the needle in the image of tissue in real time, as well as to localize the tumor CEUS in the image, and, thus, make it possible to move the needle to the tumor, and the tumor may be visible in the image of tissue in real time.

Fig. 2 is a partial block diagram illustrating the conversion is between different coordinate systems, the corresponding system of interventional navigation using 3D ultrasound with contrast enhancement, shown in Fig. 1, in accordance with a variant embodiment of the invention according to the present disclosure. In particular, Fig. 2 is an illustration of the transformations between the coordinate systems 2D ultrasound image and a 3D ultrasound image, sensor tracking, attached to the ultrasound probe tracking system. In one embodiment of the invention Fig. 2 illustrates the relationship of transformations between 6 DoF position sensor, the tracking system and the corresponding ultrasound frame.

The transformation T_trackingdescribes the current position and orientation (also called "position") of the tracking sensor 14 with respect to the system (26, 28) tracking. In other words, the transformation T_trackingdescribes the relationship between the coordinate system system_trackingtracking and coordinate system of the sensor With_sensortracking. The transformation T_trackingprovided by the tracking system and work station 18 receives, for example, continuously in real time or on demand for the implementation of interventional procedures in accordance with a variant embodiment of the invention according to the present disclosure. Change the s T _calibrationdescribes the relationship between the system C_3DUSthe coordinates of a 3D ultrasound image (i.e. coordinates waxes)_sensorcoordinate sensor 32 tracking attached to the probe 14.

The transformation T_calibrationis determined in one-time calibration procedure and remains fixed for a given sensor 32 tracking, rigidly attached to the ultrasound probe 14, is re-calibrated at shift and/or change of the probe and/or probe. Finally, the transformation T_2DUS→3DUSdescribes the relationship between the system C_2DUSthe 2D ultrasound image and the system C_3DUSthe coordinates of a 3D ultrasound image (i.e. coordinates waxes). That is, the conversion between coordinate systems for tracked obtain the 2D ultrasonic image and a 3D ultrasound image is provided by T_2DUS→3DUS. Thus, the transformation T_2DUS→3DUSperforms conversion of pixel coordinates to 2D image coordinates of the voxels of the 3D image, the transformation T_calibrationconverts coordinates of the voxels of the 3D image in the coordinates of the sensor, and T_trackingperforms coordinate transformation of the sensor coordinates of the tracking system. Note that T_trackingdepict is to place a position information in real-time sensor 32, provided by the system (26, 28) tracking.

In accordance with one embodiment of the invention, obtaining CEUS image represents the following process. After injection of the contrast of the navigation software running on the workstation requests a specialist in ultrasonic echography to find the position of the probe, which visualizes the purpose of neoplasms in 3D CEUS mode. All 3D images from the scanner and all position data from the sensor data are continuously transmitted via streaming on the workstation. If you receive such an image and confirmed on the workstation, then the image will be saved on the workstation along with the corresponding position of the T_trackingprobe provided by the sensor tracking. A coordinate reference system, assigned to 3D CEUS volume, is the coordinate system of the tracking system, which is stationary during the entire procedure. Referring to the illustration shown in Fig. 2, the conversion from 3D CEUS coordinates waxes in the coordinates of the tracking system is provided as follows:

T_3DCEUS=T_calibration∙T_{tracking 3DCEUS}

Additionally, embodiments of the invention in accordance with the present disclosure provide a user hovers over the image in the following way. After receiving 3D CEUS at travelway the scanner switches to 2D mode imaging for guidance in the image. It is known that the transformation T_2DUS→3DUSbetween the 2D image and the coordinates of a 3D image-based visualization algorithms used in ultrasonic scanner. Thus, using current data T_trackingtracking of the sensor monitoring the position of the current 2D ultrasound image of tissue within CEUS reference image obtained with T_{tracking 3DCEUS}can be determined using the following transformation:

T_2DUS→3DUS=T_2DUS→3DUS∙T_calibration∙T_tracking∙(T_3DCEUS)^-1

=T_2DUS→3DUS∙T_calibration∙T_tracking∙(T_{tracking 3DCEUS})^-1∙(T_calibration)^-1

The workstation will use this relationship to obtain real-time MPR 3D CEUS image that corresponds to the current position of the 2D image of the tissue. In one embodiment of the invention, both images are displayed simultaneously, or in another embodiment, the invention display a semi-transparent overlay with transparency, user-defined device 20 display workstation. Fig. 3 is an illustration of the simultaneous display 36 of the image 38 of the tissue in real time, showing put the needle 40 and display 42 with is the fact that MPR 44, obtained from previously received CEUS volume, showing the target 46, highlighted by enhancing contrast. Fig. 4 is an illustration of a semi-transparent overlay 48 of the same fabric and contrasting images that are marked in Fig. 4 reference position 50.

In accordance with another embodiment of the invention, the method includes receiving multiple 3D CEUS volume. That is, while obtaining 3D CEUS volume, instead of saving on the workstation 18 only one volume, showing the fabric with contrast enhancement, interest, preserve the temporal sequence of volumes and information about their respective positions. Then the method can determine the dynamics of the absorption contrast (for example, the inflow or outflow), which is also important from the point of view of the diagnostic indicator. The method further comprises (a) simultaneously displaying not a single CEUS MPR image of the tissue in real time, and the joint mapping of the set of MPR full time sequence as a "movie". Additionally, the method also includes (b) data processing time sequence to create a volumetric maps are important from the point of view of diagnostics parameters, for example, the time constant of the flow, and then a simultaneous display of the MPR this kartipanya with the image of the tissue in real-time during the interventional procedure.

In another embodiment of the invention the method includes the use of alternate visualization purposes. That is, instead of simultaneous display or overlay MPR for 3D CEUS volume image of tissue, the target volume of interest (VOI), segmented from the 3D CEUS volume after receiving CEUS. This target VOI includes, for example, scope, covering the region with the most intensive strengthening tissue in 3D CEUS volume. In this embodiment of the invention, during the interventional procedure, only the corresponding cross-section of the VOI, as defined by the current position of the tracking will be superimposed on the image of the tissue in real time.

In another embodiment of the invention the method includes the use of 3D visualization in real-time during execution guidance. That is, instead of using 2D imaging for guidance, the method uses a 3D mouse in real time. In this case, instead of forming multiple MPR, use other renderers, for example, maximum intensity projection (MIP). Projection MIP can be computed using the same set of transformations described above in the discussion of embodiments of the invention.

In yet another embodiment, the invention method uses the obtaining 3D CEUS not in p is real-time. In this embodiment of the invention, for example, if the 3D CEUS in real time is not available, then the control CEUS volume can also be formed by tracking 2D ultrasonic probe, streaming workstation all frames of 2D image and the corresponding tracking data, obtain a "sweep" in the target field after the injection of contrast, and reconstructing 3D CEUS volume based on 2D images and data tracking.

In yet another embodiment of the invention the method includes the use of image-based registration for motion correction. In this embodiment of the invention described above joint imaging of tissue in real time, the corresponding MPR 3D CEUS is accurate only when the patient or the rendered body does not commit movements between getting 3D CEUS volume and obtaining images of the tissue in real-time. To improve accuracy in the presence of tissue motion method in accordance with the variants of implementation of the present invention additionally includes, for example, one of the following motion correction. The first correction method includes simultaneously receiving 3D CEUS image and a 3D image of the tissue. This method of motion correction uses simultaneous dual receive the ie rendering for example, how is it possible to do real-time in 2D mode on modern scanners such as the Philips iU22, and enables simultaneous 3D getting not in real time, as described above. The second method of correction movement includes image-based registration of the current 2D image of the tissue (or the latest 2D image tissue in the number N of pieces, and N is a small value, for example 10) with a 3D image of the tissue obtained simultaneously with 3D CEUS image. The coordinates of the tracking associated with 2D images, serve as a source of provisions for registration (i.e. assuming that the motion of the body is missing). Registration as such may use different optimizers and similarity criteria, such as the optimizer Gauss-Newton and the similarity criterion based on the sum of squared differences. The result is the transformation T_2DUS→3D. Because 3D CEUS image and the image of tissue were obtained at the same time, their coordinate systems are identical, and the same transformation can be used to convert the current 2D coordinates to 3D CEUS coordinates.

As discussed herein, the system and method in accordance with a variant embodiment of the invention according to the present invention used with the system of spatial tracking to track the position of the ultrasonic probe and the hover image in interventional procedures during ultrasound imaging with contrast enhancement (CEUS). At the beginning of the interventional procedure, 3D CEUS volume at any given time with conventional 3D ultrasound image of tissue. During the procedure, the spatial tracking of the ultrasound probe is used to combine the display of the current ultrasound image of the tissue in real time with the appropriate multiplanar reconstruction (MPR) of the 3D CEUS volume, obtained at the beginning of the procedure (also referred to herein as the previously obtained 3D CEUS volume). The movement of the fabric between getting 3D CEUS obtained at the beginning of the procedure, and visualization in real time, received later or after the beginning of the procedure, is corrected through image-based registration between the 3D image of the tissue in real-time 3D image of the tissue, jointly produced with 3D CEUS at the beginning of the procedure. Joint mapping prior CEUS and, in particular, multiplanar reconstruction (MPR), prior CEUS, and MPR corresponds to a given image of tissue in real-time and non-contrast ultrasound in real time enables collaboration visualization of the needle position and location purposes and, thus, allows you to direct the needle to the target. As discussed above, CEUS can provide better visualization of tumors, vascularity other tissues, of interest, in comparison with ultrasonic visualization without enhancement. As such, the contrast is increased after bolus injection is temporary and usually disappears in a few minutes. For guidance during interventional procedures, such as placement of a needle for biopsy and ablation time period enhancement is insufficient. However, embodiments of the invention according to the present disclosure mainly provide a system and method that overcomes this limitation.

Accordingly, it should be understood that the method of interventional navigation using 3D ultrasound imaging with contrast enhancement (CEUS), disclosed in this document, includes the steps are: get the reference 3D CEUS volume and tracking information for the desired portion of the anatomy of the subject interventional procedure using the instrument during the period the funds enhancement introduced into the desired portion of the anatomy; images are fabrics that are monitored in real time during the interventional procedure; form at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR), at least one of the received images of tissue, about liivamagi in real time during interventional procedures as a function of the reference 3D CEUS volume and tracking information; displaying at least one of the obtained images of the tissue that is being tracked in real time, and displayed the image of tissue that is being tracked in real time, includes at least an image of the instrument within the desired portion of the anatomy; and display at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR), which corresponds to the displayed image of the tissue that is being tracked in real time with image CEUS MPR includes the MPR image with contrast enhancement, obtained from the reference 3D CEUS volume, and also includes a target volume of interest, thereby providing simultaneous display of image information with contrast enhancement and image information fabric that are useful for interventional navigation, at least after the expiry of the validity period means enhancement.

In accordance with another embodiment of the invention, receiving the reference 3D CEUS volume includes simultaneously receiving at least one pair of tracked 3D ultrasound contrast images and images of the tissue. Additionally, at least one pair of tracking is by 3D ultrasound contrast image and image tissue contains the original ultrasound contrast image and the corresponding original image tissue, captured essentially simultaneously and automatically registered with each other.

In another embodiment of the invention the interventional procedure includes the first part of the procedure that takes place before the expiry of the validity period of enhancement, and the second part of the procedure that takes place after the expiry of the validity period of enhancement. In yet another embodiment of the invention, at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement spatially registered with a corresponding one of the received images of the tissue that is being tracked in real-time. In another embodiment of the invention, the image of tissue that is being tracked in real time, and the corresponding CEUS MPR displayed next to each other. In yet another embodiment of the invention the image of the tissue that is being tracked in real time and the corresponding reference image CEUS MPR displayed together on the same display device. In the latter case, the image of tissue that is being tracked in real time, and the corresponding CEUS MPR can be additionally displayed in the form of patterns with overlap so that one image is superimposed on another image. Next, the structure of the overlay can the t to contain a single image, which is translucent with respect to another image.

In accordance with another embodiment of the invention, instead of forming at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR) for at least one of the obtained images of the tissue that is being tracked in real time during interventional procedures, and instead of displaying the obtained images of the tissue that is being tracked in real time, the method comprises steps in which: form the maximum intensity projection (MIP) as a function of at least one pair of 3D tracked in real-time ultrasound contrast images and images of the tissue; display the maximum intensity projection (MIP), at least one of the received 3D image of the tissue that is being tracked in real time, and display the MIP image of the tissue that is being tracked in real time, includes at least an image of the instrument within the desired portion of the anatomy; and display at least one corresponding projection of the maximum intensity of the ultrasound image with contrast enhancement (MIP CEUS), which corresponds to the displayed MIP at least one of the received 3D image of the tissue from livemojo in real time, moreover, the MIP image CEUS includes the MIP image with contrast enhancement of the target volume of interest, thereby providing a simultaneous display, useful for interventional navigation, at least after the expiry of the validity period of enhancement.

In another embodiment of the invention, in the absence of 3D ultrasound in real time, the reference 3D CEUS volume gain by tracking 2D ultrasonic probe, receive a sequence of frames of 2D contrast image and a 2D image of the tissue and the corresponding tracking data when deploying tracked 2D ultrasound probe over the desired area of the anatomy after insertion enhancement, stream obtained sequences of 2D contrast images and 2D images of the tissue and the corresponding tracking data on the workstation, and reconstructing the reference 3D CEUS volume on the workstation based on the received 2D contrast images and 2D images of tissue and related data tracking.

In yet another embodiment of the invention, receiving the reference 3D CEUS volume involves the use of a spatial tracking made with the possibility of tracking the position of the ultrasonic probe used Tripolitania reference 3D CEUS volume, moreover, the tracking system allows you to define the location and orientation of the reference 3D CEUS volume; and the tracking system is additionally configured to capture images of tissue during interventional procedures. The method further comprises steps in which: adjust the movement of the tissue within the desired portion of the anatomy that may arise between (i) the time of receipt of the reference 3D CEUS volume, and (ii) obtaining at least one image of the tissue that is being tracked in real-time. Further, the correction movement of the tissue involves the use of image-based registration between (a) 3D image of the tissue that is being tracked in real time, and (b) ultrasound image of tissue pairs tracked 3D ultrasound contrast images and images of tissue.

In accordance with another embodiment of the invention, receiving the reference 3D CEUS volume and tracking information includes obtaining a time sequence of 3D CEUS volume and relevant information tracking, and in which the formation of at least one relevant image CEUS MPR includes forming a temporal sequence of images CEUS MPR, and in which the display of the received image of the tissue that is being tracked in real time, and is Librairie, at least one of the related images CEUS MPR includes joint image display MPR CEUS and images of the tissue in real time as the data time series. The method further comprises steps, in which process the data time series to create a volumetric maps are important from the point of view of diagnostics parameters, and displaying three-dimensional joint card with (i) images CEUS MPR and (ii) images of tissue in real time. Additionally, significant from the point of view of diagnosis parameters may include, at least, the time constant inflow of funds contrast.

In yet another embodiment of the invention the method further comprises the steps on which segments of the target volume of interest from the reference 3D CEUS volume and the target volume of interest includes the area of the most intensive strengthening tissue; and a display segment corresponding to the cross section of the target volume of interest, instead of displaying the at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR), which corresponds to the displayed image of the tissue that is being tracked in real time, and perform overlay Sigma is the corresponding cross section of the target volume, interest on the displayed image of the tissue that is being tracked in real time.

In accordance with another embodiment of the invention, a method of interventional navigation using 3D ultrasound imaging with contrast enhancement (CEUS) includes the steps are: get the reference 3D CEUS volume and tracking information for the desired portion of the anatomy, which is exposed to the interventional procedure using the tool, and the production is performed in the period funds enhancement introduced into the desired portion of the anatomy, and obtaining the reference 3D CEUS volume includes simultaneously receiving at least one pair of tracked 3D ultrasound contrast images and images of the tissue; images are fabrics that are tracked in real-time, during the interventional procedure; form at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR) for at least one of the obtained images of the tissue that is being tracked in real time, during the interventional procedure, as a function of the reference 3D CEUS volume and tracking information, and at least one corresponding multiplanar reconstruction of ultrasound images to strastnym increased spatial registers with a corresponding one of the received images of the tissue, tracked in real time, displays the obtained image of the tissue that is being tracked in real time, and displayed the image of tissue that is being tracked in real time, includes at least an image of the instrument within the desired portion of the anatomy; and display at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR), which corresponds to the displayed image of the tissue that is being tracked in real time with image CEUS MPR includes the MPR image with contrast enhancement, obtained from the reference 3D CEUS volume, and includes the target volume, of interest, thereby providing simultaneous display of image information with contrast enhancement and image information fabric that are useful for interventional navigation, at least after the expiry of the validity period of enhancement.

In yet another embodiment of the invention, the system for interventional navigation using 3D ultrasound imaging with contrast enhancement (CEUS) includes: a device for ultrasonic imaging, configured to (i) provide the reference 3D CEUS volume and tracking information for the desired portion of the anatomy, which is conventional the procedure using the tool, moreover, the above-mentioned device for ultrasonic imaging is additionally configured to receive the reference 3D CEUS volume and tracking information within the validity period of a means of enhancing the contrast introduced into the desired portion of the anatomy, (ii) produce images of the tissue that is being tracked in real time, during the interventional procedure, and (iii) forming at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR) for at least one of the obtained images of the tissue that is being tracked in real time, during the interventional procedure, as a function of the reference 3D CEUS volume and the tracking information; and a display device connected with the said device for ultrasonic imaging, and configured to display (i) obtained images of the tissue that is being tracked in real time, and the displayed image of the tissue that is being tracked in real time, include at least the image of the instrument within the desired portion of the anatomy, and (ii)at least one corresponding multiplanar reconstruction of ultrasound images with contrast enhancement (CEUS MPR), which corresponds to the displayed image of the tissue that is being tracked in real time, and the picture is their CEUS MPR includes the MPR image with contrast enhancement, obtained from the reference 3D CEUS volume, and includes a target volume of interest, thereby providing simultaneous display of image information with contrast enhancement and image information fabric that are useful for interventional navigation, at least after the expiry of the validity period of enhancement.

As discussed herein, embodiments of the invention according to the present disclosure can be applied based on the ultrasound you hover over the image for diagnostic and therapeutic medical procedures. For example, embodiments of the invention according to the present disclosure can improve the hover needle procedures for biopsy and ablation. Additionally, embodiments of the invention according to the present disclosure mainly overcome limitations and disadvantages existing in-based ultrasound guidance for procedures, such as limited rendering or not rendering some neoplasms/objectives; low accuracy when the procedure is executed, if the target location is estimated based on the method prior (different from the previously received CEUS, as described in relation to the embodiments of the invention in accordance with the present is accretia); and short duration enhance contrast when imaging using CEUS, which is insufficient for performing this interventional procedure.

Despite the fact that have been described only a few exemplary embodiments of the invention, specialists in the art it will be clear that it is possible to make many modifications to the exemplary embodiments of the invention without going beyond the nature and advantages of embodiments of the invention according to the present disclosure. Accordingly, it is assumed that all such modifications are included in the scope of claims of the embodiments of the invention according to the present disclosure defined by the following claims. It is assumed that the tools and features presented in the claims cover the structures described herein as capable of performing the specified functions, and also cover not only structural equivalents, but also equivalent structures.

Additionally, any reference position, in parentheses, one or more of the claims should not be construed as limiting the above-mentioned claims. The words "includes" or "contains" and the like does not exclude the presence of elements or steps other than those, Thu is presented in any of the claims or in the description as a whole. A single mention of any element does not exclude multiple references to this element, and Vice versa. One or more embodiments of the invention can be implemented by means of hardware comprising several distinct elements, and/or by means of a computer programmed accordingly. In the claim, in which the claimed device, and in which enumerates several means, several of these means can be implemented by means of one and the same item of hardware. The fact that certain characteristics cited in various dependent clauses, does not indicate that the combination of these characteristics cannot be used to obtain the best benefits.

1. Method interventional navigation using 3D ultrasound imaging with contrast enhancement (CEUS) during the interventional procedure using the instrument containing phases in which:
enter the tool enhancement in the monitored tissue, including the desired portion of the anatomy;
receive, during the period the funds enhance contrast, the reference 3D CEUS volume and tracking information for the required parts and images in real-time tracked tissue;
form multiplanar reconstruction image is of (MPR) with contrast enhancement (CEUS), at least one of the acquired images in real time as a function of the reference 3D CEUS volume and tracking information;
display the acquired image in real time, showing the instrument within the desired part, and the corresponding image MPR CES for interventional navigation, at least after the expiry of the validity period of enhancement.

2. The method according to claim 1, wherein the step of obtaining includes simultaneously receiving at least one CEUS images and images in real-time tracked tissue image pair.

3. The method according to claim 2, wherein the pair of images includes at least the source CEUS image and the corresponding original image in real-time tracked tissue images captured essentially simultaneously and automatically registered with each other.

4. The method according to claim 1, wherein the interventional procedure includes the first part, which takes place before the expiry of the validity period of enhancement, and the second part, which takes place after the expiry of the validity period of enhancement.

5. The method according to claim 1, in which the image CEUS MPR spatial register with the corresponding images in real time.

6. The method according to claim 1, in which the image in real time and according to dtweedie image CEUS MPR displayed next to each other.

7. The method according to claim 1, in which the image in real time and the corresponding reference image CEUS MPR displayed together on the same display device.

8. The method according to claim 7, in which the image in real time and the corresponding image CEUS MPR appear as patterns with overlap so that one image superimposed on another image.

9. The method according to claim 8, in which in the above-mentioned structure to overlay one image is semi-transparent with respect to another image.

10. The method according to claim 1, wherein the step of obtaining includes:
tracking 2D ultrasonic probe,
the deployment of tracked 2D ultrasound probe over the required to obtain a sequence of 2D contrast images and images of the tissue and the corresponding tracking data;
the stream is received sequence of 2D contrast images and images of the tissue and the corresponding tracking data on the workstation, and
reconstruct the reference 3D CEUS volume on the workstation based on the obtained sequence of 2D contrast images and images of the tissue and the corresponding tracking data.

11. The method according to claim 1, wherein the step of obtaining includes a step of tracking the position of the ultrasonic probe to be used when retrieving the reference 3D CEUS volume is by using a tracking system to determine the location and orientation of the reference 3D CEUS volume and tracking of the received images of the tissue during interventional procedures.

12. The method according to claim 11, further containing a stage, on which the adjusting movement of the tissue within the desired portion of the anatomy that occur between the time of receipt of the reference 3D CEUS volume and the time of receipt of at least one image in real time.

13. The method according to item 12, in which the correction stage includes a stage on which use image-based registration between a pair of images including the image in real time and the image CEUS.

14. The method according to claim 1, in which the reference 3D CEUS volume contains a temporal sequence of 3D CEUS volume, and in which the image CEUS MPR contains a temporal sequence of images CEUS MPR, and in which the step of displaying further includes the step, which together reflect the image CEUS MPR and images in real time as the data time sequence.

15. The method according to 14, further containing a stage, on which:
process data time sequence to create a volumetric map, and together represent volumetric map with images CEUS MPR and images in real time.

16. The method according to item 15, in which the three-dimensional map contains at least the time constant inflow of funds contrast.

17. The method according to claim 1, further comprising stages, which are:
the segment is irout of the reference 3D CEUS volume to the desired part, having the region with the most intensive strengthening of the fabric;
display segment of the cross-section of the desired part, instead of the image CEUS MPR, which corresponds to the currently displayed image in real-time tracked tissue; and perform overlay segment cross-section on the image displayed in real time.

18. Method interventional navigation using 3D ultrasound imaging with contrast enhancement (CEUS) during the interventional procedure using the instrument containing phases in which:
enter the tool enhancement in the monitored tissue, including the desired portion of the anatomy;
receive, during the period the funds enhance contrast, the reference 3D CEUS volume and tracking information for the required parts and images in real-time tracked tissue;
form multiplanar the image reconstruction (MPR) with contrast enhancement (CEUS), for at least one of the acquired images in real time as a function of the reference 3D CEUS volume and tracking information, and the image CEUS MPR spatial registers with corresponding images obtained in real time;
display the acquired image in real time, showing the instrument within the desired part and the corresponding image MPRCEUS for interventional navigation at least, after the expiry of the validity period of enhancement.

19. System for interventional navigation using 3D ultrasound imaging with contrast enhancement (CEUS) during the interventional procedure using the instrument containing:
ultrasound scanner, is configured to:
input means to enhance the contrast in the monitored tissue, including the desired portion of the anatomy;
receiving, during the validity period of a means of enhancing the contrast of the reference 3D CEUS volume and tracking information for the required parts and images in real-time tracked tissue; and forming at least one corresponding multiplanar the image reconstruction (MPR) with contrast enhancement (CEUS), for at least one of the acquired images in real time as a function of the reference 3D CEUS volume and tracking information; and
a display device, coupled with an ultrasound scanner, and configured to display the received images in real time, showing the instrument within the desired part, and the related images CEUS MPR for interventional navigation, at least after the expiry of the validity period of enhancement.

20. Method interventional navigation using 3D ultrasound imaging to counter the local enhancement (CEUS) during interventional procedures using the tool, containing phases in which:
enter the tool enhancement in the monitored tissue, including the desired portion of the anatomy;
receive, during the period the funds enhance contrast, the reference 3D CEUS volume and tracking information for the required part, and images in real-time tracked tissue;
form the maximum intensity projection (MIP) as a function of at least the received 3D CEUS volume and tracking information and images in real time;
displays the maximum intensity projection (MIP), showing the instrument within the desired part, and the corresponding image MIP CEUS for interventional navigation, at least after the expiry of the validity period of enhancement.