Image driven intervention and robotic: Cardiovascular imaging, navigation and intervention: Hybrid imaging and therapeutics

The abilities to identify a target through imaging and to navigate through the blood vessels and interrogate the vessel wall are core technical competencies in cardiovascular medicine. The imaging modalities used in the cardiovascular space include ultrasound, intravascular imaging, real-time X-ray (fluoroscopy), magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) scanning. When merged, these imaging components provide a 3-dimensional (3D) functional view of a vessel and the pathway for an interventional system to access and to target a lesion. In addition to this fused imaging, other components are integral to intravascular navigation, including spatial awareness of the imaging system that builds on the fused images and the ability to steer a catheter based on that knowledge. Hybrid procedural rooms where fluoroscopy, cross-sectional imaging, and post-processing systems are concomitantly available allow for integration of real-time anatomy with real-time images and previously acquired images. Once this fused imaging array is linked to a robotically driven catheter that can maintain stability, follow center line flow and articulate in a 3D space, one has achieved a hybrid integrated therapeutic system which is capable of complex interventions. At present, cardiac, neurovascular, and endovascular interventions can be markedly enhanced by such integrated hybrid imaging. The potential to extend the fundamentals of the hybrid systems into other medical fields is significant, as is the potential to build more rapid computational capabilities to take the systems to the next level and further minimize the human operator/device interface.