HK1141962B - Imaging probe with combined ultrasound and optical means of imaging - Google Patents

Description

Imaging probe with combined ultrasound and optical imaging means

Cross Reference to Related Applications

This patent application is related to and claims priority from U.S. provisional patent application No.60/881,169 entitled "IMAGING PROBE", filed in english on day 19, month 1, 2007, which application is incorporated herein by reference in its entirety.

Technical Field

The present invention relates generally to the field of imaging mammalian tissues and structures by high resolution imaging using combined high frequency ultrasound (IVUS) and optical imaging methods such as Optical Coherence Tomography (OCT), and to the precise co-registration of images obtained from ultrasound image signals and optical image signals during scanning of a region of interest.

Background

High resolution imaging of the interior of the human body (or for skin or ophthalmic applications not limited to interior) is used for a variety of purposes, including any of the following: i) assessing tissue structure and anatomical structure and components; ii) planning and/or guiding an intervention on a localized region of the human body; and iii) assessing the outcome of the intervention that alters the structure, composition or other characteristics of the local region. High resolution imaging in this particular case refers to high frequency ultrasound and optical imaging methods. For the purposes of the present invention, high frequency ultrasound refers generally to imaging at frequencies greater than 3MHz, and more typically in the range of 9 to 100 MHz.

High frequency ultrasound is very useful for intravascular and intracardiac procedures. For these applications, the ultrasound sensor is incorporated into a catheter or other device that can be inserted into the human body. As an example, two particularly important embodiments of high frequency ultrasound are intravascular ultrasound (IVUS) for imaging blood vessels and intracardiac echocardiography (ICE) for imaging the heart chamber. Both ICE and IVUS are minimally invasive and involve the placement of one or more ultrasound transducers within the blood vessels or heart chambers to acquire high quality images of these structures.

Optical imaging methods based on fiber optic technology used in the medical field include optical coherence tomography, angioscope, near infrared spectroscopy, Raman spectroscopy, and fluorescence spectroscopy. These methods generally require the use of one or more optical fibers for transmitting optical energy along an axis between the imaging location and the imaging detector. Optical coherence tomography is an optical simulation of ultrasound and provides imaging resolution on the order of 1-30 microns, but in most cases does not penetrate as deeply into tissue as ultrasound does. Optical fibers may also be used to deliver energy to therapeutic procedures such as laser ablation of tissue and photodynamic therapy.

Other imaging modalities associated with the present invention include angioscopes, endoscopes, and other similar imaging mechanisms that image a location within a patient's body based on the back reflection of light through a probe and the acquisition of images.

High resolution imaging devices have been implemented in a variety of forms for assessing a number of different regions of mammalian anatomy, including the gastrointestinal system, the cardiovascular system (including coronary, peripheral, and neurovasculature), the skin, the eye (including the retina), the urogenital system, breast tissue, liver tissue, and others. As an example, imaging of the cardiovascular system using high frequency ultrasound or optical coherence tomography has been developed to assess the structure and composition of arterial plaque.

High resolution imaging has been used to measure vessel or plaque shape, blood flow through diseased arteries, and the effects of interventions on arterial plaque (e.g., by atherectomy, angioplasty, and/or stenting). Attempts have also been made to use high resolution imaging to identify vascular damage that has not caused clinical symptoms but is at increased risk of rupture or erosion and causing severe myocardial infarction. These so-called "vulnerable plaques" are areas of major interest because the prospect of treating such plaques to address adverse clinical events in advance is conceptually attractive.

Chronic total occlusion lesions are a specific subset of vascular lesions in which the entire lumen of the vessel is occluded for a period of about one month (based on angiography of the lesion). Most intravascular imaging modalities are "side-viewing" and require a passage for the intravascular imaging device to pass through the lesion. For imaging chronic total occlusion lesions, high resolution imaging methods would be more useful if they could be adapted for "forward view" rather than "side view" configurations.

Some of these high resolution imaging devices rely on the use of a rotating shaft to transmit torque to the imaging device near the distal end of the probe. These rotating shafts are typically long, thin, and flexible so that they can be transported through anatomical conduits, such as the vasculature, genitourinary tract, respiratory tract, and other such body cavities. Ideally, when a continuous torque is applied to the cable in a particular direction, the torque cable develops a characteristic with a close relationship between the degrees of rotation of its proximal and distal ends. This enables a simplified design of the ultrasound catheter by making the angle of rotation at the distal end of the torque cable (inside the body) a reasonable approximation of the angle of rotation at the proximal end of the torque cable (outside the body).

The rotation of the torque cable or shaft at the location where imaging occurs may be different than the rotation occurring at the proximal end of the torque cable or shaft. This is particularly the case when the flexible shaft is being conveyed at least partially through a curved channel due to inertia and friction between the rotating and stationary components of the imaging shaft. The assumption that the rotational speeds of the proximal and distal ends of the rotating shaft are equal to each other is unlikely to be valid if the rotational speeds change over time. The adverse consequence of not knowing the true angular velocity of the imaging probe at the point where the imaging beam is directed to the tissue results in non-uniform rotational distortion (NURD). NURD can cause significant distortion of the image and is accompanied by a reduction in the accuracy of the image geometry. Knowledge of a more accurate estimate of the true rotational speed of the distal rotating shaft or an imaging assembly connected to the rotating shaft can help overcome this distortion by providing more accurate information for image reconstruction. When more than one imaging modality is implemented on the imaging probe (e.g., combined ultrasound and optical imaging), a better estimation of the rotation speed also helps to improve the accuracy of the image co-registration.

Although the use of more than one form of imaging technology (e.g., ultrasound and optical) has proven valuable in medical applications for high resolution imaging, they are not typically used in series. As described in the related art summary below, there are a variety of combinations designed for optical and ultrasound technologies. However, limitations in these designs have hampered their acceptance.

That is, designs incorporating optical and ultrasound techniques that deviate the ultrasound and optical imaging mechanisms, such as described by Maschke in U.S. patent 7289842, result in the acquisition of misregistered ultrasound and optical signals. Registration of data from these two imaging devices requires movement of the imaging mechanism and is prone to registration errors due to: (i) non-uniform rotational distortion (NURD), (ii) object motion that occurs between successive images at the same location using both imaging devices, (iii) variability of the imaged object, and (iv) difficulty in accurately tracking the imaging device location. All of these effects result in inaccurate co-registration, thereby limiting the usefulness of data acquisition from both imaging devices.

Brief description of the related Art

Yock (U.S. patent No.4794931) describes a catheter-based system for intravascular ultrasound for providing high resolution imaging of intravascular structures. The system includes a sheath having an ultrasonic sensor within the sheath near the distal end of the long torque cable. As the motor rotates the torque cable and ultrasound sensor assembly, a 2D cross-sectional image of the anatomical structure (e.g., blood vessel) may be generated. The linear translation of the catheter or torque cable and the ultrasound transducer in combination with the rotational motion of the ultrasound transducer allows a series of 2D images to be acquired along the length of the catheter.

Milo et al (U.S. Pat. No.5,429,136) and Lenker et al (U.S. Pat. Nos. 6,110,121 and 6,592,526) describe reciprocating and vibrating devices for scanning an ultrasound imaging beam in a circumferential or longitudinal direction at the end of a catheter. The reciprocating or vibrating means eliminates the need to use mechanisms such as slip rings to provide electrical connections to the probe that is rotated in a particular direction for several weeks, for example more than one or two rotations. Similarly, certain implementations of optical imaging may avoid the use of optical rotary joints by reciprocating or vibrating devices.

Liang et al (us patents 5,606,975 and 5,651,366) describe a forward looking intravascular ultrasound delivery device in which ultrasound is directed toward a mirror that causes an ultrasound beam to be transmitted at an angle to the longitudinal axis of a rotating torque cable advancing within the vasculature. Liang et al also describes a means of changing the deflection angle of the mirror using a micro-motor, gear clutch mechanism, steering cable or bimorph element such as shape memory alloy, piezoelectric column or conductive polymer. Fig. 13 of us patent 5,651,366 shows a schematic diagram of a front view ultrasound probe incorporating an optical fiber that delivers laser ablation energy in a direction coaxial with the ultrasound imaging beam via an optical fiber and a mirror, but does not involve combined optical and acoustic imaging or provide an optical focusing element that is advantageous for imaging purposes.

The use of intravascular ultrasound (IVUS) has become widespread, and there are many improvements and modifications to this technique. A flexible torque cable (Crowley, U.S. patent 4951677) improves the fidelity with which rotational torque is transmitted along the length of an IVUS catheter, minimizing the artifact known as non-uniform rotational distortion.

The centre frequency of the IVUS is in the range of 3 to 100MHz, more typically in the range of 20 to 50 MHz. Higher frequencies provide higher resolution but result in poorer signal penetration and thus a smaller viewing area. The penetration depth ranges from less than 1 millimeter to several centimeters depending on a number of parameters such as the center frequency and shape of the sensor, the attenuation of the medium through which the imaging is produced, and the particular implementation specifications that affect the signal-to-noise ratio of the system.

Variations of high frequency ultrasound exist in which the signal acquisition and/or analysis of the backscattered signals is modified to facilitate obtaining or deriving further information about the imaged tissue. These include: elastography, in which strain in tissue is assessed when the tissue is compressed under different blood pressures (de Korte et al, Circulation, 4/9/2002, 105 (14): 1627-30); doppler imaging, which assesses motion (e.g., blood flow in an anatomical structure); virtual histology, which attempts to deduce the composition of tissue by radio frequency characteristics of the backscattered signal in conjunction with pattern recognition algorithms (Nair, U.S. patent 6,200,268); second harmonic imaging (Goertz et al, 8.2006, published on Invest radio; 41 (8): 631-8), and others. Each of these imaging modalities can be improved by the apparatus described herein.

Ultrasonic sensors themselves have also been considerably improved, including the use of single crystal ultrasonic sensors as well as composite ultrasonic sensors.

Hospack et al (WO/2006/121851) describes a front view ultrasonic sensor that uses a capacitive micromachined ultrasonic sensor (CMUT) and a reflective surface.

Tearney et al (U.S. patent 6,134,003) describe embodiments that enable optical coherence tomography to provide higher resolution imaging than is readily available by high frequency ultrasound or IVUS.

Boppart et al (U.S. patent 6,485,413) describe various embodiments of optical coherence tomography, including forward view delivery tools. Optical fibers or gradient index (GRIN) lenses may be provided by mechanisms such as motors, piezoelectrics, movable wires, expansion devices, and other mechanisms.

Mao et al (Appl Opt.2007, 8/10; 46 (23): 5887-94) describe a method of making an ultra-small OCT probe by a single mode fiber connected to a short length of GRIN fiber that acts as a lens. The introduction of an optical spacer between the fiber and the lens can change the working distance of the fiber-lens system. In addition, adding a short length of uncovered fiber at the distal end and beveling the uncovered fiber at an angle may add a deflecting element at the end of the fiber-lens system. Such a deflection element enables side view imaging, which can also be realized by means of small prisms or mirrors.

Variations of Optical Coherence Tomography (OCT) include polarity-sensitive OCT (PS-OCT), where the birefringence properties of tissue components can be exploited to obtain additional information about structure and composition; spectroscopic OCT, which similarly provides improved information about the composition of the imaged structure; doppler OCT, which provides information about flow and motion; elastography via OCT; and Optical Frequency Domain Imaging (OFDI), which allows imaging data to be acquired significantly more quickly and thereby enables imaging to be produced over a larger volume of interest in a shorter time. Also, each of these imaging modalities can be improved by the present invention.

In addition to OCT, there are a variety of other fiber-based imaging modalities. Amundson et al describe a system that images through blood by infrared light (U.S. Pat. No.6,178,346). The range of the electromagnetic spectrum used in the imaging system is selected to optimize the penetration of blood, allowing optical imaging through blood similar to that provided by angioscopy in the visible spectrum, but without the need to flush blood out of the imaging area.

Dewhurst (U.S. patent 5,718,231) describes a forward looking probe for intravascular imaging in which an optical fiber is advanced through an ultrasound transducer to illuminate target tissue directly in front of the probe tip. The light then interacts with the target tissue and produces ultrasound waves that are received by the ultrasound sensor, and the image is a photoacoustic image only when the system is not set to receive and process optical images. The ultrasonic transducer used in the Dewhurst device is limited to a polymer piezoelectric film, such as a PVDF film, and is only used to receive ultrasonic energy, without converting the electrical energy to ultrasound.

Angioscopy, endoscopy, bronchoscopy, and a variety of other imaging devices have been described that allow visualization of internal conduits and structures within the mammalian body, such as blood vessels, gastrointestinal lumens, and the pulmonary system, based on the principle of illuminating an area within the human body near the distal end of a rigid or flexible shaft. The image is then generated by placing a photodetector array (e.g., a CCD array) near the end of the shaft or by having a bundle of optical fibers transmit light received from the distal end of the shaft to the distal end, where the photodetector array or other system allows the operator to generate or view an image display of the illuminated area. Among other disadvantages, fiber optic bundles occupy a large volume and reduce the flexibility of the shaft.

Other forms of fiber-based minimally invasive assessment for anatomical structures include Raman spectroscopy as described by Motz et al (J Biomed Opt.3-4 months 2006; 11(2)), near infrared spectroscopy as described by Caplan et al (J Am Coll Cardiol.2006, 4 months 18; 47(8 suppl): C92-6), and fluorescence imaging, such as labeled fluorescence imaging of proteolytic enzymes in tumors (radiology.2004, 6 months 231 (3): 659-66).

The ability to combine ultrasound and optical coherence tomography onto a single catheter is highly advantageous. Kubo et al focused on in vivo studies of coronary arteries using OCT, IVUS and angioscopy to assess lesion morphology leading to severe myocardial infarction (Journal of American College of Cardiology, Sept 4, 2007, 10 (50): 933-39). They point out that it is beneficial to use each of these modalities for imaging. However, since catheters that combine these functions are not currently in commercial use, they must use separate catheters for each of the IVUS, OCT, and angioscopic imaging modalities in order to perform their studies. Earlier, a comparison was made between OCT, conventional IVUS and a variant known as integrated backscatter IVUS on coronary heart disease cadaver samples using a single probe as both OCT and IVUS components. Brezinski et al (Heart, 1997 May; 77 (5): 397-. The OCT probe in the latter study is not suitable for living body use.

Optical coherence tomography generally has higher resolution than ultrasound and has the potential to be able to better identify certain structures or components in blood vessels and other tissues than ultrasound. For example, fibrous cap thickness or the presence of inflammation or necrotic regions near the surface of an artery may be better addressed with optical coherence tomography. However, optical coherence tomography is limited by its small penetration depth (on the order of 500 to 3000 microns) in most biological media. Most such media are not optically transparent.

At the same time, ultrasound has the ability to better penetrate biological media such as blood and soft tissue and its penetration depth typically extends a few millimeters or centimeters beyond that of optical coherence tomography. The ability to image by an imaging method using a combined imaging device provides advantages with respect to the selection of a desired resolution and penetration depth. Furthermore, most of the information acquired by optical coherence tomography is complementary to most of the information acquired by ultrasound, and analysis or display of the information acquired by both methods will improve the ability to better understand the tissue (e.g., with respect to its composition) that needs to be measured.

These differences between IVUS and OCT are well known in the art. Masshke (U.S. patent publication No. 2006/0116571 to U.S. patent application No. 11/291,593) describes an embodiment of a guide wire to which both OCT and IVUS imaging sensors are secured. Said invention has several drawbacks. The guidewire is typically 0.014 "to 0.035" (about 350 microns to 875 microns) in diameter, while the ultrasound transducer is typically at least 400 microns and larger for frequencies in the 20 to 100MHz range. If the sensor is too small, the beam may not be sufficiently focused and have poor signal characteristics. In masshke, the IVUS and OCT imaging mechanisms are set at different positions along the length of the guide wire and a disadvantage of this type of configuration (IVUS and OCT imaging devices set at different positions along the length of the imaging axis) is that it does not allow optimal joint registration of the images.

Masshke (us patent 7,289,842) describes an imaging system that combines IVUS and OCT onto a catheter, where the IVUS and OCT imaging elements are moved longitudinally along the length of the catheter, which is rotated about its longitudinal axis, relative to each other. Masshke also describes generating an image in which the central portion of the image is derived substantially from the output of the higher resolution OCT imaging portion of the system, while the outer portions of the image are derived substantially from the output of the ultrasound imaging portion of the system, thereby taking advantage of the greater depth of penetration of ultrasound and the higher resolution of OCT for tissue near the catheter.

Park et al (U.S. patent application 11/415,848) also generally relates to an idea of combining IVUS and OCT imaging onto a single catheter.

However, the integrated approach for combined acoustic and optical imaging (e.g., combined IVUS and OCT imaging) on a single device is not trivial. Having the optical imaging elements and the acoustic imaging elements longitudinally separated from each other on the catheter that primarily rotates does not provide an ideal configuration for combined imaging. A more desirable configuration is to be able to acquire high quality acoustic and optical signals from which ultrasound and optical based images are formed, while enabling the acoustic and optical images to be registered with one another in a more accurate manner.

For example, by simply positioning the IVUS imaging element to coincide with the OCT imaging element along the length of the catheter, the imaging plane centers of the IVUS and OCT images will be separated from each other by a distance of at least about half the length of the ultrasound transducer and half the length of the optical imaging element.

Mechanical IVUS sensors used for vascular imaging typically exceed 400 microns in length. The separation distance between the IVUS and OCT imaging planes (such as in the configuration proposed by masshke) would require a separation distance of at least 250 microns between the optical and acoustic imaging planes. Typically, the mechanical IVUS rotates at 30 frames per second and the pull back rate is 0.5mm/s, which means that for a given point in time t0, at least 15 images or 500 milliseconds are walked within the time the more remotely located imaging device moves to the same position that the more closely located imaging device was originally at time t 0. This separation of hundreds of milliseconds or rotations of the imaging probe makes it difficult to accurately register the imaging data of one imaging method with another.

This is particularly relevant given that unintentional lateral and longitudinal displacement of the catheter within the body lumen, such as displacement due to cardiac contraction and pulsatile blood flow, occurs during this period of time. Non-uniform rotational distortion (NURD) can also affect the ability to accurately register images acquired through multiple rotations away from each other. Any inaccuracy in the registration of the two sets of data can be of great importance when considering the ability to detect important pathologies such as the size of affected plaques. Dramatic differences in the appearance of components of arterial plaque (e.g., the thickness of the fibrous cap, the presence of calcified nodules, or the extent of atheromatous deposits) can be observed down to several hundred microns along the length of the vessel. Similarly, small but potentially relevant branches of an anatomical conduit (e.g., a blood vessel) may have dimensions on the order of less than 100 microns.

None of the previous experiments and implementations of IVUS and OCT, or other combinations of acoustic and optical imaging, have been able to achieve good accuracy in registration of imaging data from two or more imaging devices in a manner suitable for minimally invasive imaging (e.g., intravascular imaging).

To the best of the inventors' knowledge, none of the previous experiments and implementations of IVUS and OCT, or other combinations of acoustic and optical imaging, have been able to achieve good accuracy in registration of imaging data from two or more imaging devices in a manner suitable for minimally invasive imaging (e.g., intravascular imaging).

It would be highly advantageous to provide a high resolution imaging probe that combines acoustic and optical imaging onto a "front view" probe rather than a "side view" probe. It would also be useful to provide a similar probe that can be viewed backwards, or from multiple angles in a typical side-viewing configuration.

It would also be advantageous to provide a high resolution imaging probe that combines ultrasound imaging with one or more optical imaging devices.

It would also be advantageous to provide a minimally invasive imaging probe that can be used for photoacoustic imaging or sonoluminescence imaging.

It would also be advantageous to provide minimally invasive imaging devices, wherein one of the imaging devices provides useful information about the direction from which the other imaging device acquired imaging data.

Disclosure of Invention

Embodiments of an imaging probe are provided that combine acoustic and optical imaging devices in a manner that enables simultaneous imaging by two or more imaging methods. This embodiment enables the method to perform accurate joint registration of images obtained in various forms. In some embodiments, the present invention provides embodiments that combine acoustic imaging devices with the delivery of therapeutic energy (e.g., ultraviolet light for photodynamic therapy or laser energy for ablative methods).

The present invention also provides embodiments that use one imaging modality to assist in the reconstruction of a second imaging modality. This more particularly relates to monitoring the position or orientation of components within an imaging probe, which then determines the position or orientation of the imaging region.

The present invention provides a method of combining high frequency ultrasound and optical coherence tomography into a combined imaging system.

The present invention provides a novel apparatus for implementing a combined ultrasound and optical imaging system in which the space being scanned includes the region in front of or behind the location of the imaging sensor.

The present invention provides the ability to acquire images similar to those produced by angioscopy, endoscopy, and similar imaging techniques through a single optical fiber or a small number of optical fibers along with a means to acquire ultrasound images. These optical images can also be obtained using infrared and/or visible wavelengths

The present invention provides apparatus for combining high frequency ultrasound with optical coherence tomography, wherein the space scanned comprises a region in front of or behind the location of the imaging sensor.

Embodiments of the present invention are also capable of scanning a region for imaging purposes or delivering therapeutic energy to a region reached by a shaft, wherein a change in the speed of rotation of the shaft causes a change in the direction of the transmitter and/or receiver of acoustic and/or optical energy.

The present invention also lends itself to certain high resolution imaging modalities that use acoustic energy to produce optical energy (sonoluminescence imaging) or optical energy to produce acoustic energy (photoacoustic imaging).

An embodiment of the present invention provides an imaging probe for being inserted into a human body lumen and a cavity, the imaging probe being used for imaging the inside of the human body lumen and the cavity or imaging the outer surface of the human body, the imaging probe comprising:

a) an elongate hollow shaft having a longitudinal axis, the elongate hollow shaft having a distal end portion, a proximal end portion and an elongate intermediate portion, an imaging assembly disposed in the elongate hollow shaft distal to the proximal end portion, the imaging assembly being connected to a first end of an imaging catheter extending through the elongate hollow shaft and connected at a second end thereof to an image processing and display system through the proximal end portion, the imaging catheter including an optical fiber having a distal end and the imaging assembly including an optical emitter/collector including a light directing and receiving device associated with the distal end of the optical fiber for directing light imaging energy out of the distal end of the optical fiber and receiving reflected light imaging energy signals and directing the received reflected light imaging energy signals back to the image processing and display system, the imaging assembly includes an ultrasound sensor that transmits and receives ultrasound imaging energy, and the imaging catheter includes electrical conductors for electrically connecting the ultrasound sensor to an ultrasound signal generator and the image processing and display system;

b) the imaging assembly includes a scanning mechanism configured to convey light from the optical emitter/collector and ultrasound from the ultrasound sensor along a path out of the elongate hollow shaft, the ultrasound sensor and optical emitter/collector being positioned and oriented relative to each other such that precise joint registration of ultrasound and optical images can be performed during scanning of a region of interest;

c) a drive mechanism for imparting motion to the imaging catheter and the imaging assembly;

d) a controller connected to the drive mechanism and the image processing and display system and configured to process images obtained from ultrasound imaging and optical imaging during scanning of a region of interest and to co-register ultrasound images and optical images; and

e) a display device for displaying the co-registered images.

A further understanding of the functional and advantageous aspects of the present invention may be realized by reference to the following detailed description and drawings.

Drawings

Preferred embodiments of the present invention will now be described, by way of example only, with reference to the accompanying drawings.

FIG. 1 is a schematic diagram of an imaging system including an ultrasound imaging component and an optical imaging component;

FIG. 2 is a perspective view of a flexible imaging probe having an adapter, a catheter, and an imaging assembly;

FIG. 2a is a cross-sectional view of the middle of the imaging probe of FIG. 2 taken along the dashed line;

FIG. 2b is an enlarged perspective view of the distal region of the imaging probe of FIG. 2;

FIG. 2c shows a schematic of how the rotating and non-rotating components of the imaging probe can be connected to the rest of the imaging system via an adapter;

FIG. 2d is a perspective view of an example of the rotating and non-rotating components of the probe connected to the adapter;

figures 3a to 3e are representative of a general imaging catheter configuration described in the prior art;

FIG. 3a illustrates one embodiment of an over-the-wire configuration for an outer sheath that incorporates an imaging probe when having a guidewire lumen;

figure 3b shows a cross-sectional view through an imaging probe illustrating a guidewire lumen configuration;

FIG. 3c illustrates a quick access configuration for an outer sheath that is engaged with an imaging probe when a guidewire lumen is present;

FIG. 3d shows a cross-sectional view through a portion of the imaging probe that does not contain a guidewire lumen;

FIG. 3e shows a cross-sectional view through a portion of the imaging probe containing the guidewire lumen;

FIGS. 4a to 4l are examples of an ultrasonic sensor and means for deflecting the imaging light path, the sensor including an aperture for allowing optical energy to be transmitted through the sensor so that the optical and acoustic imaging regions are precisely aligned with each other;

FIGS. 5a to 5f are examples of ultrasonic sensors that do not include means for deflecting the imaging ray path, the sensors including apertures for allowing optical energy to be transmitted through the sensor so that the optical and acoustic imaging regions are precisely aligned with each other;

fig. 6a to 6c show a representative acoustic sensor configuration in which there is no hole in the sensor of fig. 6 a. FIGS. 6d through 6f show representative simulation results of the effect of placing holes through an ultrasonic sensor on the acoustic beam pattern produced by the ultrasonic sensor, where FIG. 6d has no holes;

figures 7a to 7e show examples of ultrasonic transducers having optical devices on top of or recessed within the acoustic transducer for transmitting and/or receiving optical imaging energy;

FIG. 8a is a perspective view of an imaging assembly adapted for lateral viewing by acoustic and optical imaging;

FIG. 8b is a side view of the imaging assembly of FIG. 8 a;

figures 8c to 8e are end views of the imaging assembly of figure 8a in different rotational positions;

fig. 9a to 9c show a configuration in which the optical imaging transmitter/receiver is embedded in the backing material 435 of the acoustic sensor;

FIGS. 10a to 10e are similar to FIGS. 8b to 8e and show the imaging assemblies rotated in a reciprocating manner rather than in a single rotational direction;

FIG. 11 shows a perspective view of an imaging probe in which the primary motion is longitudinal motion in which the surfaces swept by the beams and acoustic beams are two coplanar rectangles;

FIG. 12 shows a perspective view of an embodiment of an imaging probe in which the optical imaging system is configured to tilt the optical imaging beams such that the imaging beams substantially converge or overlap;

FIG. 13 is a cross-sectional view of an imaging assembly adapted for lateral viewing using acoustic and optical imaging;

FIG. 14a is a cross-sectional view of an imaging assembly adapted for forward viewing using acoustic and optical imaging;

FIG. 14b is a cross-sectional view of an imaging assembly adapted for frontal viewing using acoustic and optical imaging, wherein artificial muscle polymers may be used to deform the distal region of the imaging probe;

FIG. 15a is a cross-sectional view of an imaging assembly adapted for side viewing using acoustic and optical imaging, the assembly using reflective components to direct the optical and acoustic beams in a lateral direction;

15 b-15 c are similar to FIG. 15a, but with the reflective members mounted about pivot points so that the optical and acoustic beams can be scanned in the lateral direction at variable angles;

FIG. 16a is a cross section of an embodiment of an imaging probe using tiltable components in which the tilting motion is regulated by centripetal acceleration due to rotational motion of the imaging assembly about a longitudinal axis;

FIG. 16b is a view along line 16b-16b of FIG. 16 a;

FIG. 16c is a cross section of the imaging probe of FIG. 16a, but with the tiltable component at a different angle during use;

FIG. 16d is a view along line 16d-16d in FIG. 16 c;

FIG. 17a is a perspective view of a deflectable member comprising a flat optically reflective layer and a shaped acoustically reflective layer;

FIGS. 17b to 17d show cross-sections of the deflection member of FIG. 17 a;

FIG. 18a is a perspective view of an ultrasonic imaging sensor having two optical imaging transmitters/receivers passing through two separate optical transmission channels in the acoustic sensor;

FIG. 18b is a perspective view of an embodiment of an imaging probe having an ultrasonic imaging sensor with two optical imaging transmitters/receivers disposed in alignment with the primary rotational movement of the imaging assembly;

FIG. 18C is a view along arrow C of FIG. 18 b;

FIG. 19 is a schematic diagram of a system in which two optical imaging systems are connected to the same optical imaging waveguide by an optical routing loop;

FIGS. 20a and 20b show sector-shaped patterns for simultaneously displaying portions of two or more images in co-registration with each other;

21a and 21b show arbitrary patterns for simultaneously displaying portions of two or more images in co-registration with each other;

FIG. 22 is a schematic diagram of a display that transitions over time from one co-registered image to another;

figures 23a and 23b show how a feature in a first image can be mapped to a feature in another image co-registered with the first image;

24a and 24b show how a contour feature in a first image can be mapped into another image co-registered with the first image, and vice versa; and

fig. 25a and 25b provide schematic diagrams showing how a composite image can be constructed from two or more co-registered sets of imaging data.

Detailed Description

Without limitation, much of the system described herein refers to an imaging probe capable of imaging by both optical and acoustic means. As required, embodiments of the present invention are disclosed herein. However, the disclosed embodiments are merely exemplary, and it should be understood that the invention may be embodied in various and alternative forms.

The figures are not drawn to scale and some features are exaggerated or minimized to show details of particular elements while related elements may be omitted to prevent obscuring novel portions. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present invention. For purposes of teaching and not limitation, the illustrated embodiments relate to imaging probes capable of imaging by optical and acoustic means.

As used herein, the term "about," when used in conjunction with a range of dimensions, temperatures, or other physical properties or characteristics, is meant to encompass minor variations that exist in the upper and lower limits of the range of dimensions, thereby not excluding embodiments in which, on average, most of the dimensions are satisfied, but in which statistically dimensions may be outside of that region. For example, in embodiments of the present invention, component dimensions of an imaging probe are given, but it should be understood that these are not meant to be limiting.

As used herein, the phrase "joint registration of images" refers to the process of identifying a subset of imaging data acquired by one imaging device and a subset of imaging data acquired with another imaging device, wherein the identified imaging data from the two devices is acquired by detecting a form of imaging energy (e.g., photons or ultrasound) from the same object (or tissue in the case of the present invention). Each joint registration point in the first subset can then be mapped to a corresponding point in the second subset, such that two points from the two different imaging devices are considered to be acquired from similar lesion areas of the imaged object (or tissue).

Successful and accurate co-registration of images or portions of images between images acquired using two or more imaging devices is useful because it provides multiple opportunities to assess features of interest of an imaged object by more than one imaging device.

FIG. 1 illustrates an overview of an exemplary imaging system, generally designated 10, constructed in accordance with the present invention. The system includes an imaging probe 12, the probe 12 being connected via an adapter 14 to an image processing and display system 16. The image processing and display system 16 includes the necessary hardware to support one or more of the following imaging modalities: 1) ultrasound, 2) optical coherence tomography, 3) angioscopy, 4) infrared imaging, 5) near infrared imaging, 6) Raman spectroscopy imaging, and 7) fluorescence imaging.

The implementation of optical coherence tomography, ultrasound, angioscopy, and infrared imaging loops has been described in the prior art.

The system described herein further generally includes a controller and processing unit 18 to facilitate coordinated behavior of the various functional units of the system, and may further include a display and/or user interface, and may further include electrode sensors to acquire electrocardiogram signals from the body of the patient being imaged. The electrocardiogram signal may be used to time the acquisition of imaging data in situations where heart motion may have an effect on image quality. The optical circuitry and electronics 21 forming the image processing and display system, if included in a particular embodiment of the present invention, may include any or all of the following components: interferometer components, one or more optical reference arms, optical multiplexers, optical demultiplexers, light sources, light detectors, spectrometers, piezoelectric filters, timing circuitry, analog-to-digital converters, and other components known to implement any of the optical imaging techniques described in the background and prior art sections. The ultrasound circuit 20 may include any or all of the following components: pulse generators, electronic filters, analog-to-digital converters, parallel processing arrays, envelope detection, amplifiers including time gain compensation amplifiers, and other components known to implement any of the acoustic imaging techniques described in the background and prior art sections.

The controller and processing unit 18, if included in a particular embodiment of the present invention, serves a variety of purposes and the components will be significantly adapted according to the needs of a particular imaging system. The controller and processing unit 18 may include one or a combination of motor drive controllers, data storage components (e.g., memory, hard disk, removable storage devices, readers and recorders for portable storage media such as CDs and DVDs), position detection circuitry, timing circuitry, cardiac gating functionality, volumetric image processors, scan converters, and other devices. Optionally, a display and user interface 22 may also be provided for real-time display or display of data at a time after the time of imaging data acquisition.

Imaging probe 12 includes an imaging assembly 30 near its distal end 32, an optional catheter 34 along most of its length, and a connector 36 at its proximal end 38. For the purposes of the present invention, imaging assembly 30 generally refers to the components of imaging probe 12 from which signals (acoustic or optical or both) are collected for imaging of a region proximate imaging assembly 30. The imaging assembly 30 includes at least one or more imaging energy emitters and at least one or more imaging energy receivers. For the purposes of the present invention, "imaging energy" refers to both optical and acoustic energy. Specifically, light refers to electromagnetic waves covering ultraviolet, visible, and infrared spectral wavelengths. For example, for acoustic imaging, the imaging assembly 30 includes an ultrasonic sensor that is both a transmitter of acoustic energy and a receiver of acoustic energy.

For optical imaging, the optical assembly 30 generally includes a distal end of an optical fiber, and a combination of optical components, such as lenses (e.g., ball or GRIN lenses), that collectively function as an optical receiver and may function as an optical transmitter. Mirrors and/or prisms are often incorporated as part of the optical transmitter and/or receiver. The imaging assembly 30, connector 36, and/or imaging catheter 34 may be liquid-filled (e.g., saline) and flushable.

The imaging probe 12 may contain ports at one or more points along its length to facilitate flushing. For optical imaging, a gas-filled imaging probe 12 may be considered. Preferably, the gas consists essentially of carbon dioxide or other readily soluble gas. Alternatively, the imaging assembly may be partitioned such that there is at least one gas-filled partition or lumen for optical imaging and at least one liquid-filled partition or cavity for acoustic imaging.

The imaging catheter 34 comprises at least one optical waveguide or at least one wire (preferably two or more) connecting the transmitter and/or receiver to the adapter via a connector. Imaging catheter 34 may also be used as a mechanical force transfer mechanism for rotating or translating the imaging assembly. For example, imaging catheter 34 may include an optical fiber wrapped with two layers of wire insulated from each other. The imaging catheter 34 may be further enhanced by other structural features, such as helically wound wires or other designs for constructing imaging torque cables for rotating the scanning mechanism, as described in the related art.

The adapter 14 facilitates the transfer of signals in any fiber and/or wire to the appropriate image processing unit. The adapter 14 may also incorporate a pullback mechanism 49 (fig. 2d) or a reciprocating push-pull mechanism to facilitate longitudinal translation of the imaging assembly. Such longitudinal translation of the imaging assembly 30 may occur in conjunction with longitudinal translation of the outer shaft about the imaging catheter 34, or within a relatively stationary outer shaft.

Additional sensors may be incorporated as part of the adapter 14, such as a position sensing circuit, for sensing the rotational angle of rotating components within the imaging probe 12. The imaging probe 12 may also include a memory component, such as an EEPROM or other programmable memory device, that includes information about the imaging probe to the rest of the imaging system. For example, it may include instructions regarding the specification identification of the imaging probe 12, and may also include calibration information regarding the probe 12.

While accurate calibration of acoustic and optical imaging data is highly desirable, it is important to recognize the need to optimize the geometry of the minimally invasive probe so that it can be as small as reasonably possible to achieve its intended purpose. Current IVUS and ICE probes are about 0.9 to 2mm in diameter and the smaller size of the probe can be delivered farther in the vessel tree of the coronary anatomy as the vessel size tapers. Thus, the smaller size generally allows access to most coronary anatomies. It is therefore desirable to enable probe embodiments that combine optical imaging and acoustic imaging to image in configurations that minimize certain dimensions of the probe (e.g., probe diameter).

Fig. 2 is a perspective view of a flexible catheter containing an optical fiber 40 and a coaxial wire 50. The proximal connector contains an optical fiber 40, which optical fiber 40 is receivable by the adapter to optically connect the imaging fiber 40 to the optical imaging system "back end". There is also an electrical connector 56 that allows one or more electrical conduits to be connected to the ultrasound circuitry and/or the controller and processing unit. In embodiments where the imaging catheter is rotated about its longitudinal axis, it may be desirable to connect the rotating component of the imaging fiber to a relatively stationary fiber that is connected to the back end 21 of the optical imaging system. The connection of the rotating fiber optic probe can be accomplished by a fiber optic rotary joint that cooperates as part of the proximal connector of the imaging probe 10 or as part of the adapter 14. Similarly, in embodiments in which the imaging catheter is rotated about its longitudinal axis, it may be desirable to connect the wires that rotate with the imaging catheter to the relatively stationary conductors of the ultrasound circuit 20 and/or the controller and processing unit 18, preferably by slip rings (slip rings). These slip rings can be incorporated as part of the proximal connector of the imaging probe 36 or as part of the adapter 14.

Figure 2a shows a cross-sectional view of the middle of the imaging probe of figure 2 taken along the dashed lines showing the optical fiber 40, guidewire port 44 and guidewire 42, the imaging catheter 34, the imaging catheter lumen 46, the hollow sheath 48, the flexible elongate shaft (made of a physiologically compatible material and having a diameter suitable to allow insertion of the hollow elongate shaft into body lumens and cavities), and the coaxial wire 50. The enlarged detail view of the end of the imaging probe 10 shown in figure 2b shows the distal end of the guide wire 42 extending beyond the end of the outer sheath 48 and the irrigation port 54 at the end of the outer sheath 48. In fig. 2, the proximal end of the imaging probe 10 includes a connector assembly 36 and another guide wire port 55, the guide wire 42 being inserted into the guide wire port 55, the connector assembly 36 including a flush port 58 and electrical contacts 56 along the connector body.

Figure 2c shows a schematic view of how the rotating and non-rotating parts of the imaging probe can be connected to the rest of the imaging system via an adapter. Figure 2d schematically shows how the rotating parts of the imaging probe can be connected to the rotating parts of the adapter. The various rotating components may be electrically, optically, and/or mechanically coupled by connectors and other configurations known in the art. Similarly, the non-rotating component of the imaging probe may be connected to the non-rotating component of the adapter 14. The adapter 14 may include slip rings, optical rotary joints, and other means of electrically or optically connecting the rotating component to the non-rotating component and enabling the necessary electrical and optical signal communication with the rest of the system.

A dual fiber optic rotary joint can also be used, but the joint is much more complex. The electrical connection between any conductors secured to the rotating components in the imaging probe 12 may be connected to the non-rotating conductive elements via metallic slip rings and springs, metallic slip rings and brushes, or other generally known methods of making conductive contact between stationary and rotating conductors.

Although electrical, optical and mechanical connections are shown separately in fig. 2d, it is possible to reduce the number of connectors that must be individually connected between the probe and adapter with fewer connectors by combining multiple connectors into a combined connector, as required by particular embodiments.

FIG. 3a shows one embodiment of an inline configuration for the outer sleeve 47, and FIG. 3b shows a cross-section of the outer sleeve 47 through the portion containing the imaging assembly 30 along vertical lines 3b-3b in FIG. 3 a.

Figure 3c shows another embodiment of the outer sheath 60, which outer sheath 60 is a "quick-change" configuration for the outer sheath, which may be combined with an imaging probe if a guide wire is required. The sleeve 60 in fig. 3c includes the access port 55 shown in fig. 2. Fig. 3d shows a cross-section of the "quick-change" configuration 60 along line 3d-3d in fig. 3c through a portion near the access port 55 for guiding the wire. Fig. 3e shows a cross-section along the line 3e-3e in fig. 3 c.

The present invention describes a number of embodiments by which accurately registered ultrasound and optical images can be formed. The simplest conceptual approach is to align the paths of the ultrasound and optical imaging beams collinearly with each other.

Referring to fig. 4a, there is provided an imaging subassembly 399 arranged to allow imaging in the same direction by acoustic and optical means, thereby utilizing an acoustic sensor that allows light energy to travel through a channel in the sensor. Importantly, the probe 399 employs an acoustic sensor 402, which sensor 402 is modified to have an optical transmission channel through its substrate. The acoustic sensor 402 may be any type of ultrasonic sensor known in the art, such as a piezoelectric element (e.g., PZT or PVDF), a composite sensor, or a single crystal sensor.

The electrical contacts 400 are directed to conductive layers 401 on either side of the acoustic substrate 402 of the sensor. The optical fiber 403 provides an optical conduit for enabling optical imaging. One or more matching layers may be added to the emitting surface of the sensor, such as an epoxy layer (e.g., a silver or copper conductive epoxy layer, which may also functionally serve as one or both electrodes to drive the sensor), or a polymer (e.g., parylene or PVDF).

The optical delivery channel 407 is made by any of a variety of techniques, such as precision drilling, laser ablation, photolithography, including structures in the mold used to create the openings, and other means. Precision drilling involves the use of drill bits, such as diamond or carbide drill bits specifically designed for cutting through hard materials. High precision spindles, such as air spindles, may help to perform drilling techniques accurately and efficiently. A laser source may be used to ablate a channel through the substrate. Exemplary laser sources include YAG or excimer lasers.

Alternatively, if the acoustic sensor 402 is formed from an initially tacky substrate, the protective member may be embedded in the piezoelectric material during formation of the piezoelectric sensor 402. The protective component can then be removed mechanically or by exposure to a solvent. For example, polystyrene cylinders may be used for the protective member, which may then be lost by dissolution in acetone. Alternatively, if the piezoelectric material 402 is formed from an initially viscous substrate, the removable mandrels may be introduced into the material during formation of the piezoelectric sensor and removed after the piezoelectric material has partially or substantially hardened.

Conductive layers 401 on either side of the piezoelectric material 402 are incorporated as needed for applying a voltage to the piezoelectric. The opening 407 is directly connected to the optical waveguide 403 or is connected to the optical waveguide 403 through one or more mirrors 404 or prisms 397 and one or more lenses 405. If any optical components are contained in the opening, a damping, insulating layer (see fig. 4l) of flexible material 406, such as silicon or a polymer, may separate the optical components from the acoustic substrate 402 to act as an electrical insulator or to minimize the transmission of stresses generated by the acoustic substrate 402 to the optical components.

As shown in fig. 4b, light from the fiber may be directed toward a mirror (or prism) 404, which mirror 404 deflects the light from the fiber and passes through an optical transmission channel 407. Alternatively, as shown in FIG. 17c, a prism 397 may be used to deflect the light and pass through the optical transmission channel. The prism 397 may deflect the light as a result of total internal reflection or with the aid of a reflective coating on its deflecting surface 419. The prism 397 may be a separate optical component fixed in place along the optical path. For example, it may be glued in place on the fiber ends, on the lens or on the spacer by means of a gluing method (e.g. a UV-curable glue). Alternatively, connecting an unclad fiber along an optical pathway and cutting off a section of the unclad fiber at a desired length can be used to make a prism. A section of the clad fiber may be cut and/or polished to achieve a desired angle. Mao describes this method in the previously cited references.

Referring also to fig. 4c, optically transparent windows 409 are optionally provided at the ends of the optical transmission channel 407, and any unoccupied space within the channel is filled with a gas, a fluid, or an optically transparent material, such as glass or any of a number of transparent polymers known in the art. The purpose of the windows 409 is to prevent the creation or retention of unwanted bubbles in the channel 407 and to protect components in the optical transmission channel 407.

As shown in fig. 4d, it may be desirable to have a gas in channel 407 rather than a fluid or solid material to increase the refractive power of certain optical components, such as curved lens 424 (which may be a ball lens).

As shown in fig. 4 e-4 g, a GRIN lens 405 or other optical component may be positioned adjacent the distal end of the optical fiber 403 between the optical fiber 403 and a deflecting mirror or prism 404 along the optical path. In this case, the opening in the acoustic substrate 402 may not have any optical components and merely contain an optically transparent material or be covered by the window 409. Alternatively, the GRIN lens 405 or other optical component may be in the optical transmission channel 407 of the acoustic substrate 402, as shown in fig. 4g to 4 l. The above-mentioned sleeve of insulating material 406 may surround the GRIN lens 405 or other optical components within the opening 407 as shown in fig. 4l to provide mechanical isolation or electrical isolation from the acoustic substrate 402.

Referring to fig. 4f, an optical spacer 433 is located between the distal end of the optical fiber 403 and the GRIN lens 405. The optical spacer element 433 may comprise an optically transparent medium such as an unclad fiber, glass, plastic, gas-filled gap, or fluid-filled gap. The use of optical spacer elements 433 helps to reduce the precision required for alignment and sizing of the optical components to achieve a desired focal length.

Alternatively, referring to fig. 4g, the path length of the prism 397 or mirror may be provided as all or part of the optical separation between the distal end of the optical fiber and the lens 405. An advantage of replacing a portion of the functional optical spacer with the distance that the light rays must travel through the mirror or prism 397 is that the focusing element (e.g., GRIN lens 405 or other lens) is closer to the area being imaged, thereby increasing the effective working distance of the optical imaging system. In some cases, the lens 405 may be offset from either edge of the optical transmission channel to achieve a desired depth of focus, as shown in fig. 4 h.

In other embodiments, it may be beneficial to have one or more optical elements of the optical path (e.g., element 434 in fig. 4 i) extend beyond the exterior surface of the acoustic sensor in order to achieve the desired performance of the optical imaging technique. This is especially important when the acoustic substrate 402 is very thin (e.g., for very high ultrasonic frequencies) or when the effective working distance of the optical imaging technique is greater than the working distance provided by placing all of the optical components below the emitting surface of the acoustic sensor.

It is also important to recognize that the optical circuit may be remote from the surface of the acoustic sensor 402. By way of example, as shown in the embodiment shown in fig. 4j, it may be desirable to insert some backing material 435 between the optical fiber 403 or other optical component proximate to the deflecting mirror or prism 397 and the acoustic sensor 402 to minimize back reflections from the optical component.

The propagation direction of the acoustic and optical imaging energy may be other than perpendicular to the imaging probe longitudinal axis. In fact, a slight angular offset of a few degrees is desired to minimize back reflections from the jacket surrounding the probe. Figure 4k shows an embodiment of a probe incorporating optical and acoustic imaging means, said means being aligned at an angle non-normal to the longitudinal axis of the probe.

The embodiment of the probe 500 shown in FIG. 5a is structurally configured such that acoustic and optical imaging sensors can be combined for viewing without the need for components such as the mirror 404 in FIG. 4b or the prism 497 in FIG. 4 c. The head portions of the probe 500 containing the piezoelectric material 402 for the acoustic sensor and the conductive layers 401 on either side of the piezoelectric material 402 are aligned along the longitudinal axis of the optical fiber 403 and the probe is arranged so that the acoustic and optical signals are emitted in an axial manner relative to the fiber axis rather than perpendicularly as shown in figure 4 a.

The embodiment shown in fig. 5b is similar to the embodiments shown in fig. 4b and 4 c. Fig. 5c is similar to the embodiment shown in fig. 4 d. The embodiment shown in fig. 5d is similar to the embodiment shown in fig. 4 e. The embodiment shown in fig. 5e is similar to the embodiments shown in fig. 4f and 4 g. The embodiment shown in fig. 5f is similar to the embodiment shown in fig. 4 i.

Fig. 6a shows the geometry of the emitting surface of a square sensor 402. It should be appreciated that the geometry of the emitting surface of the acoustic sensor 402 is not limited to a square shape and may be any of a variety of shapes, such as rectangular, circular, elliptical, and any other desired shape. Fig. 6b shows a square sensor with a hole 407 in the center, while fig. 6c shows a glass rod 501 in the hole 407 of the square sensor.

The simulated beam profile results using the acoustic beam simulation software are shown in fig. 6d to 6f, corresponding to the sensor shapes in fig. 6a to 6c, respectively. As shown, there is considerable similarity in the beam profiles of the various configurations, providing evidence that: an ultrasonic sensor adapted to allow passage for optical transmission can produce an acceptable ultrasonic beam profile suitable for imaging purposes.

A simpler way to align the optical and acoustic imaging devices is to place the optical fiber near the surface of the acoustic sensor 402, without passing through the sensor 402 itself. Fig. 7A shows a probe 510 that includes an acoustic sensor 402, with the distal end of the optical imaging loop 428 placed over the acoustic sensor 402. The distal end portion of the optical imaging loop 428 comprises the distal end of the optical fiber 403, as well as any optical components, such as optical isolator 433, lenses, such as GRIN lens 405, mirror 404, or prism 397, that are capable of transmitting or collecting optical imaging energy. The distal end of the optical imaging loop 428 may be directly fixed to the acoustic sensor 402 or supported by a support near the acoustic sensor 402. The distal end of the optical imaging loop 428 may affect the acoustic signal generated and/or received by the acoustic sensor 402 because the distal end is directly in the path of a portion of the acoustic beam emitted by the sensor 402. However, most of the energy of the acoustic beam does not travel through the optical imaging device 403 and thus remains relatively unaffected.

Furthermore, the signal processing means preferably comprises signal subtraction for removing signal portions representing early time portions of the echo signal, thereby removing reflections from interfaces close to the surface of the acoustic sensor.

Fig. 7b shows a perspective view of an imaging probe 512, which is a variation of the system of fig. 7a, in which the distal end of the optical imaging loop 428 is recessed into the surface of the sensor 402, thereby exhibiting a sensor-nonfunctional recess, such that acoustic beams transmitted or sensed by the acoustic sensor 402 do not substantially propagate through the overlying imaging light 403. A top view of this embodiment is shown in fig. 7 c. The portion of the sensor 402 that exhibits non-functionality may be rendered non-functional by removing a portion of the sensor 402 that is located below the distal end of the optical imaging loop 428 (as shown in fig. 7 b), or by electrically isolating the portion of the electrode below the optical imaging device. Removal can be accomplished by a variety of methods, including using a dicing saw to cut a channel through the sensor 402. Furthermore, the removal of the channel enables consideration of recessing the distal portion of the optical imaging device into the channel.

FIG. 7c shows a top view of the transmit/receive surface of the probe 510 shown in FIG. 7b, which surrounds the distal end of the optical imaging loop 428.

Fig. 7d shows an imaging probe 516 that uses a composite sensor for an acoustic imaging device. In this case, the composite sensor is a sensor that includes more than one signal producing element or strut 520. The composite sensor in fig. 7d comprises four pillars 520. The channels 522 between the struts 520 leave channels 522 for one or more distal ends of the optical imaging loop 428 to be disposed within range of the compound acoustic sensor. The distal end of the optical imaging loop 428 need not be recessed into the channel 522, but may instead rest on or above the surface of the acoustic sensor 402. The conductive connection 400 between the upper conductive surfaces of the posts 520 allows the posts to be actuated simultaneously. The channel 522 may be filled with a filler material, such as a polymer or epoxy, to increase the mechanical stability of the composite sensor or to help secure the optical imaging device in place.

Figure 7e shows a top view of the imaging probe 516 with the distal end of the optical imaging circuit 428 disposed within the center of the post 520. Any implementation for the distal portion of the optical imaging loop 428 (e.g., any combination of optical fiber, spacer, GRIN lens, ball lens, air gap, transparent window), such as those shown in fig. 4, may be used in the implementations described in fig. 7 a-7 e.

As part of most mechanical scanning mechanisms used for imaging, there is a dominant motion associated with the scanning mechanism that defines the geometric path swept by the imaging beam. For example, in imaging systems that scan an area using rotational motion, there is typically a circular or conical surface swept by the imaging beam, where the center of the circular or conical surface is approximately on the axis of rotation, as occurs in current implementations of mechanically scanned intravascular ultrasound. The dominant motion in this case is a rotational motion.

Alternatively, if the imaging transmitter/receiver is translated along the longitudinal axis, the imaging beam will sweep across a flat surface and the plane defined by the surface will include the translation axis. The dominant motion in this case is longitudinal translation.

If the imaging transmitter/receiver is simultaneously rotated about the longitudinal axis of the probe and moved along a path substantially parallel to the longitudinal axis of the probe, the imaging beam will sweep across the surface defined by the helical shape.

Co-registered images with good accuracy can be produced by multiple acoustic and/or optical imaging devices without necessarily having to make two or more imaging beams simultaneously collinear. This may be achieved by having one or more imaging beams follow the path of the preceding beam. The software or circuitry may use the information of the speed and direction of movement of the scanning mechanism over time to subsequently register the image produced by one imaging device with another.

For example, if the path of one imaging beam closely follows the path of the other imaging beam (the preceding beam) in a short time, it can be assumed that the regions scanned by the two devices are similar enough so that the two images are accurately co-registered with each other. The accuracy of registration between the two images can be affected by the delay of the second beam following the first beam. If the delay is relatively small, inaccuracies in the co-registration of two images that may occur during this time period may be minimized. Such inaccuracies may include inaccuracies caused by tissue motion (e.g., caused by cardiac or respiratory motion), inadvertent probe motion, physiological changes (e.g., blood flow), and scanning mechanism fidelity inaccuracies. The time delay (which can itself vary over time) can be used for the registration process of different images.

Fig. 8a shows an example of an imaging assembly 530 comprising an acoustic imaging device and an optical imaging device. The dominant scanning motion is a rotational motion about a longitudinal axis that is along the length of the imaging probe. As shown, acoustic imaging beam 532 and optical imaging beam 534 sweep a path that is substantially circular. If the imaging beam is not aligned perpendicular to the longitudinal axis, but at an angle other than 90 degrees to the longitudinal axis, the path swept by the imaging beam will actually be conical. If longitudinal translation is combined with rotational motion, the two beams will follow a generally helical path.

FIG. 8b shows a side view of the combined imaging probe 530 with the acoustic beam 532 traveling in one direction (up the figure) and the optical imaging beam 534 traveling out of the plane of the paper (toward the reader). In this case, the beam 534 and the acoustic beam 532 are oriented 90 degrees with respect to each other at any instant.

Figures 8c through 8e show a time series of rotational movements of the imaging probe 530 that may occur at the distal end of the imaging probe. In this example, the optical imaging beam 534 leads the acoustic imaging beam 532 by a 90 degree rotation. At a constant frame rate of 30 frames per second, the delay required for the following beam to become collinear with the previous position of the leading beam may be less than 9 milliseconds, a shorter period of time than artifacts that may occur due to the motion of the heart experienced by the intravascular catheter.

In view of the importance of minimizing the space occupied by components and assemblies in minimally invasive imaging devices, it is desirable to recess certain components. For example, referring to fig. 9a, the imaging probe 540 has been positioned such that the distal end of the optical imaging loop 428 is recessed into the backing 435 of the acoustic sensor 402. The recess not only achieves high efficiency in space usage, but also provides a means for securing the distal end of the optical imaging loop 428 into the acoustic sensor 402.

The purpose of the backing material 435 on the acoustic sensor 402 is to attenuate the signal generated from the back surface of the piezoelectric material 402 so that the image is not formed by the energy emitted from the back surface of the acoustic sensor 402 provided with the optical emitter/receiver 403, but only by the energy emitted from the primary emitting surface (top surface) for the acoustic signal of the sensor 402. Recessing the optical or other components into backing material 435 may cause the optical or other components to reflect signals back to acoustic sensor 402, which may create imaging artifacts.

Fig. 9b shows a deflection surface 544 within which the optical transmitter/receiver 403 is placed for deflecting acoustic energy that might otherwise reach the optical transmitter/receiver 403 and deflecting that energy laterally (substantially parallel to the surface of the acoustic sensor 402) so as to minimize the amount of energy reflected back toward the sensor 402. The deflecting surface 544 may be made of a hard substance, such as glass or steel.

Fig. 9c shows an implementation where the distal end of the optical imaging loop 428 itself has a surface 545 that deflects acoustic energy substantially laterally, without the need for additional deflecting material as shown in fig. 9 b.

For embodiments of the imaging probe in which the imaging beam is scanned due to rotational motion, it is not necessary that the rotational speed be kept constant or even in the same direction. There may be a return motion in which the imaging assembly is rotated in one direction and then stopped and rotated in the opposite direction. In this case, the preceding and following bundles may exchange roles with each other.

For example, in FIG. 10a, as the imaging assembly rotates in a counterclockwise direction, the acoustic beam 532 initially follows the beam 534. The acoustic beam 532 continues to follow the swept path of the beam 534 as shown in figure 10b until the rotational speed of the imaging probe reaches zero (as shown in figure 10 c). Once the direction of rotation is changed to the opposite direction, the acoustic beam 532 becomes the leading beam and the beam follows (as shown in fig. 10d and 10 e). This movement can change direction as many times as necessary, with the definition of the preceding sensor beam and the following sensor beam changing.

Figure 11 shows an imaging probe 540 where the dominant motion is back and forth longitudinal motion along arrow 541 where the surfaces swept by the beam 534 and the beam 532 are two coplanar rectangles. As the imaging assembly moves proximally (to the left in fig. 11), the optical imaging number 534 leads the acoustic imaging beam 532. The opposite is true for distal translation (right in fig. 11). The longitudinal movement may also be reciprocating.

For a longitudinal dominant motion or a rotational dominant motion, it should be understood that additional motions may be combined with the dominant motion. For example, a slow translation (e.g. 10mm/s or lower, typically 1mm/s or lower) may be added to the fast rotational scanning motion (e.g. 360 degrees per second or faster, typically 3600 degrees per second or faster) to acquire 2D cross-sectional images at different longitudinal positions.

Similarly, slow rotational motion (e.g., less than 360 degrees per second, typically less than 30 degrees per second) can be added to the rapid reciprocating longitudinal motion sequence (on average more than 0.1mm/s, more typically more than 1mm/s), thereby producing a series of longitudinal images acquired at different orientations about the longitudinal axis of the imaging probe. The alignment of the various imaging elements at the distal end is arranged such that during a primary motion one imaging bundle will follow another while the ability to accurately register images one above the other is not significantly affected by the addition of a relatively slow secondary motion. Although the absolute numbers for slow and fast movements in rotation and translation are presented above, the relative magnitudes of these movements are more important.

Collinear alignment of the beam and acoustic beam (as shown in the embodiments shown in figures 4a to 5 f) provides very accurate registration of the optical and acoustic images. Alternative embodiments of the probe are configured to substantially overlap the optical and acoustic beams with each other by tilting the optical imaging transmitter/receiver towards the path of the acoustic beam or by tilting the acoustic imaging transmitter towards the path of the optical imaging beam. Fig. 12 shows such an embodiment of imaging probe 546, where the distal end of optical imaging loop 428 is disposed such that optical imaging beam 534 is tilted towards acoustic imaging beam 532, and vice versa. This provides a simpler construction method of aligning the beam with the acoustic beam than that shown in figures 4a to 5f, but allows the two imaging means to provide what is a rather precise overlap over a portion of the two imaging beams. In particular, embodiments are useful in which the beams are aligned such that they overlap over a large portion of the focal range.

Fig. 13 shows an embodiment of an imaging probe 550 configured to simultaneously image from the same origin in the same basic orientation using an acoustic device and an optical device. At least one optical fiber 410 and an electrical circuit 411 (e.g., a pair of coax wires) are located within the imaging catheter 560 and travel to the imaging assembly 562. The imaging assembly 562 includes an acoustic sensor 412, the sensor 412 configured for imaging in a substantially lateral viewing direction (indicated by arrow 420). The imaging assembly 562 also includes a distal end of an optical imaging loop 564 that is configured to image in a substantially lateral viewing direction (indicated by arrow 421).

The distal ends of the acoustic sensor 412 and the optical imaging circuit 564 are configured such that they can be imaged in two or more separate directions at any one time within the same cross-section that is substantially perpendicular to the axis 423 about which the imaging assembly 562 rotates. Thus, given a minimum translation of the imaging assembly 562 while the imaging assembly is rotating, the imaging data collected by the optical transmitter/receiver 564 can be co-registered with the imaging data collected by the acoustic sensor 412. For example, if the acoustic and optical devices are configured to image in directions 180 degrees relative to each other about the longitudinal axis, as shown in fig. 13, the area imaged by the acoustic sensor 412 at one point in time will be substantially the same as the area imaged by the distal end of the optical imaging loop 564 after one half revolution of the imaging assembly 562. Similarly, if imaging beams 420 and 421 form a similar angle other than 180 degrees with the longitudinal axis, they will both sweep a substantially coincident conical path and thus enable joint registration.

The embodiment of the probe 570 shown in figures 14a and 14b is configured such that IVUS and OCT can be combined and viewed anteriorly through a deformable member. At least one optical fiber 410 and one electrical circuit 411 (e.g., a pair of coaxial wires) are located within the imaging catheter 578 and travel to the imaging assembly 572. The acoustic sensor 412 is configured for imaging in a substantially lateral viewing direction (indicated by arrow 413). The distal end of the optical imaging loop 574 is configured for imaging in a substantially forward viewing direction (indicated by arrow 414).

The distal end of the optical imaging loop 574 generally comprises the distal end of the optical fiber 410 in combination with a lens 415, such as a GRIN lens and optional spacer (not shown). Imaging circuit 578 includes an artificial muscle actuator having properties that enable deformation upon application of a voltage. Figure 14b shows how the imaging angle changes if the artificial muscle actuator gets deformed, while figure 14a shows the shape of the probe when no voltage is applied to the actuator.

Embodiments of the present imaging probe may be configured to utilize the deflection member to enable larger sensors to be used in the probe. Alternatively, the deflector may be pivoted and connected to the pivoting mechanism, thereby enabling an additional degree of freedom in the scanning mechanism. For example, the scanning mechanism may facilitate 2D imaging or may enhance a 2D imaging system to a 3D imaging system. Alternatively, the deflector may be translated along the longitudinal axis to change the depth of focus of the imaging system.

Fig. 15a shows an embodiment of an imaging assembly 590 that includes a deflector 592 for deflecting optical and/or acoustic imaging energy into a substantially radial direction. The deflecting member 592 is made of one or more reflective materials. Optically reflective materials include polished or sputtered metals such as stainless steel, gold, silver, and platinum.

Acoustically reflective materials include stainless steel and other metals, quartz and other crystals, glass, and hard polymers. Figure 15b shows another embodiment of an imaging assembly 600 that includes a deflector 602 that pivots about a pivot point 604 and thereby allows the angle between the imaging beam and the longitudinal axis of the imaging probe to be changed. The imaging assembly 600 can be configured such that the deflector 602 can change position by being connected to a variety of mechanisms, including mechanisms utilizing centripetal motion, magnetic forces, cable mechanisms, rheological forces, piezoelectric drives, small motors, and others.

Fig. 15c shows an embodiment of the arrangement of fig. 15b, where the cantilever 901 is mounted on a cantilever mount 902 and the range of motion of the deflector is limited by the minimum stop 82 and the maximum stop 80. This example has the following properties: the imaging angle changes due to changes in rotational movement of the imaging assembly about the longitudinal axis of the probe. At rest or low rotational speeds, the cantilever wire pushes the deflector 602 around the pivot point of the deflector 602, thereby bringing the deflector 602 into contact with the stop 80. At higher rotational speeds, centripetal acceleration causes the deflector 604 to pivot away from the stop 80. As the centripetal acceleration continues to overcome the restoring force applied to the deflector 602 by the cantilever 901, the deflector eventually comes into contact with the stop 82. In this embodiment, an imaging assembly 600 having a 3D scanning mechanism is implemented.

Fig. 16a shows an embodiment of the distal end portion of the imaging probe 100 capable of acoustic and optical imaging in a substantially forward viewing direction. Fig. 16a shows an embodiment of the distal end 29 of the imaging probe containing the imaging assembly 30, the imaging assembly 30 including a tiltable component 70, wherein the tiltable component is a disk mounted on a pivoting mechanism (e.g., a pin 72) that extends through the disk 70. The pivot mechanism 72 defines the tilt axis of the tiltable plate 70. The disc body 70 will remain in any home position when the imaging assembly 30 is at rest. However, as the imaging assembly 30 rotates, the disk 70 will align itself such that the normal to the plane defined by the surface of the disk 70 is substantially parallel to the longitudinal axis 75. When the imaging assembly 30 is rotated, the disk 70 has two preferred orientations that are rotated 180 degrees apart about the tilt axis.

For purposes of this specification, the tilt angle refers to the angle between the longitudinal axis 75 and an imaginary axis through the tiltable component 70 that is parallel to the longitudinal axis 75 when the tiltable component 70 is in one of its preferred orientations. By way of example, when the tiltable component 70 is in the preferred orientation, the tilt angle is about zero. If the tiltable component 70 tilts away from its preferred orientation due to external forces (e.g., gravity, magnetic forces, electrostatic forces, friction with other moving elements or fluids, compressive forces, normal forces, or any other source of incompletely opposing moments about the tilt axis on the tiltable component 70), the tilt angle will increase.

One or more mechanisms for causing the tilt angle of the tiltable component 70 to increase may be included in the imaging assembly 30. For the purposes of the present invention, such a mechanism is referred to as a return mechanism. A torsion spring 76 (shown in fig. 16a and 16 c), a cantilever lever, or a compression spring may be used as the return mechanism, with one end of the torsion spring 76 mechanically contacting the tiltable component 70 and the other end mechanically contacting another portion of the imaging probe 100, such as the body of the imaging assembly 30.

Alternatively, magnetic, electrostatic, hydraulic or other mechanisms capable of applying a torque on the tiltable component about the tilt axis may be applied. Other examples of mechanisms that can be used to provide a restoring force include tension from an elastomer (e.g., rubber, polyurethane, silicone, fluoroelastomers, thermoplastic elastomers, and many other materials) or by using a cantilever spring or foil (e.g., a spring or foil made of platinum, nitinol, steel, or other suitable material). In very few embodiments of imaging devices, inter-molecular forces (e.g., electrostatic forces) and van der waals forces between components of the imaging assembly may become significant even in the absence of an applied external voltage. Thus, the inherent intermolecular forces between the tiltable component and the structures proximate to the tiltable component (e.g., the stops 80 and 82 described below) are sufficient to provide a net restoring force. For example, a stop comprising a surface made of PVC or LDPE can provide sufficient attraction between the tiltable component and the stop.

One or more stops 80 and 82 may limit the range of tilt angles of the tiltable component 70. For example, the post or lip 80 may be a post or rim extending from the sleeve 84 of the imaging assembly 30 as a stop that prevents the tilting member 70 from further changing its tilt angle when the tilting member 70 comes into contact with the stop 80. Thus, the stop may be used to limit the tilt angle from exceeding a maximum value determined by the position of the stop. In various embodiments, the maximum tilt angle is the tilt angle achieved when the imaging assembly 30 is at rest and at a low rotational speed.

Additional or alternative stops 82 may be included for producing a minimum tilt angle that will be achieved when the tiltable component 70 is at a rotational speed at the upper end of the operating range. In fact, there are many instances where there is no significant benefit in allowing the tilt angle to reach zero, as will become apparent in the following description of specific embodiments. Figure 16c shows the tiltable component striking the second stop at higher rotational speeds of the imaging assembly to limit its range of motion.

The imaging assembly may include an optical emitter and associated optics and an ultrasound sensor. The ultrasonic transducer 88 is mounted at the end of a miniature coaxial cable 89 and the lens 92 and mirror 94 are mounted at the end of a fiber optic cable 96 in the imaging assembly 30 of figures 16a to 16d and the optical and ultrasonic transmitter are arranged to focus the imaging energy onto the tiltable component 70. The ultrasonic sensor 88 and optical emitter may direct imaging energy directly to the tiltable component 70. Alternatively, one of the embodiments capable of performing collinear optical and acoustic imaging (as shown in fig. 4 a-4 k or fig. 5 a-5 f) can direct imaging energy directly to the tiltable component 70.

The imaging energy is then deflected by an energy deflecting member mounted on the tiltable component 70. For ultrasonic imaging, the energy deflecting member (tiltable member 70) may comprise an acoustically reflective surface, such as a solid metal surface (e.g., stainless steel) or a crystal surface, such as quartz crystal or glass. For optical imaging, the energy deflecting component (tiltable component 70) can comprise an optically reflective surface, such as a mirror made of polished metal, metalized polymer (e.g., metalized biaxially oriented polyethylene terephthalate (Mylar)), sputtered or electrochemically deposited metal or foil. Metals commonly used to make mirrors include aluminum, silver, steel, gold, or chromium.

Alternatively, the energy deflecting member is made of a transparent refractive material (e.g., glass, pure polymer, and other materials) and deflects the imaging energy in a manner similar to a prism. Preferably, the transmitter and/or receiver are mounted on a component of the imaging assembly which co-rotates with the imaging assembly. However, it is also possible to mount the transmitter and/or receiver on components of the imaging probe that do not co-rotate with the imaging assembly when the energy deflection mechanism within the imaging assembly rotates. This may be accomplished by mounting the transmitter and/or receiver on a housing or by separating the imaging assembly into two or more subassemblies (one of which rotates and includes the tiltable component 70).

For ultrasound and optical coherence tomography, the ability to adjust the propagation angle of the emitted and/or received imaging energy, when combined with the rotational motion of the imaging assembly, allows scanning of a 3D space. For both angioscopic and infrared imaging, the ability to adjust the angle of propagation of the emitted and/or received imaging energy, when combined with the rotational motion of the imaging assembly, allows for the use of a single optical fiber rather than requiring a bundle of optical fibers or an array of photosensitive elements to produce an image. This improvement allows greater flexibility and/or further miniaturization of the imaging device.

Further details of various scanning mechanisms that may be used in the IMAGING PROBE disclosed herein are disclosed in co-pending application No.11/.. to be filed concurrently with the present application, entitled "scanning mechanism FOR an IMAGING PROBE" which is hereby incorporated by reference in its entirety.

Where the energy deflecting member comprises a reflective surface, the reflective surface need not be flat. For example, in the case of acoustic imaging, it is advantageous to have the acoustic reflective surface with a profile, such as a parabolic or spherical profile, so that the acoustic beam can be focused by the reflective surface and thereby improve the lateral resolution of the acoustic imaging system. Further, in the case where the tilting member deflects the acoustic and optical energy by reflection, the surface of the acoustic reflector does not have to be a surface that reflects the optical energy.

For example, while it is advantageous to have an acoustically reflective surface with a profile (e.g., a parabolic profile), it is preferable to have a flat surface for redirection of optical imaging energy. This may be achieved by contouring one surface of the acoustically reflective surface (e.g., a stainless steel disk) to have a parabolic shape, as shown in fig. 17a to 17d, which show a tiltable deflection member having an optically reflective surface that is different from the acoustically reflective surface.

Fig. 17a is a perspective view of a deflector having a hole in a side for receiving a pin about which the deflector can pivot within the imaging assembly. Figure 17b shows a cross section through the deflector near its centre. The holes for receiving the pins 465 can be seen. The top layer is a flat optically reflective layer 461. Below the optically reflective layer is a substantially acoustically transparent layer 462, the transparent layer 462 being located between the optically reflective layer and an acoustically reflective substrate 463. Fig. 17c and 17d show cross-sectional views of such a deflector at different points from the center of the disc.

Such deflectors can be constructed by using a disk of acoustically reflective material (e.g., stainless steel) and drilling the necessary holes or recesses to enable the final installation of the deflector into the imaging assembly. A parabolic or spherical recess may be made in one face of the tray body. The serrated surface may then be filled with an acoustically transparent medium, such as TPX. A thin layer of gold, silver or chromium may be sputter deposited onto the exposed flat polymer surface to serve as an optically reflective surface. Such a membrane is on the order of 300 angstroms to 20,000 angstroms such that it is sufficiently thin such that its mechanical properties allow acoustic energy to be transmitted through the membrane while providing an optically reflective surface.

The result of this manufacturing process is the production of a layered reflector that reflects acoustic energy from a contoured surface to achieve a desired focusing effect while optical energy is reflected by a flat surface. Another advantage of this structure is: optical and acoustic imaging can be produced in configurations where optical and acoustic imaging energy travels through the same fundamental space, thereby facilitating joint registration of optical and acoustic images and minimizing the amount of space required within the imaging assembly to accommodate more than one imaging modality.

In some embodiments, such as the assembly shown in fig. 16a and 16c, it may be useful to measure parameters useful for reconstructing 2D and 3D images using just one of the imaging modalities. For example, in the case of a volumetric imaging probe that uses a deflectable member, it is desirable to use OCT to accurately measure the angle of inclination of the deflectable member. Thus, ultrasound images can be generated with tilt angle information derived from the OCT data (e.g., the tilt angle of the tiltable component 70 in fig. 16 a) without having to use the OCT data to generate a corresponding OCT image of the region outside the imaging probe.

In some embodiments, it is desirable to use more than one method for optical imaging in an intravascular imaging system. For example, OCT and angioscopy can be useful combinations. Fig. 18a shows an ultrasound imaging sensor 402 with two distal ends of an optical imaging loop 428 passing through two separate optical transmission channels in the acoustic sensor. Fig. 18b and 18c show an acoustic imaging sensor in which the two distal ends of the optical imaging loop 428 are arranged such that they are aligned along the primary rotational movement of the imaging assembly. These are examples of the use of more than one optical imaging transmitter/receiver at the distal end of the imaging probe. Such an embodiment may require the use of a multi-channel optical rotary joint if the imaging probe uses a large range of rotational motion about its longitudinal axis as part of the scanning mechanism.

Alternatively, the optical imaging light source and/or detector for part of the imaging system may be mounted on the rotating part of the imaging probe and connected to the imaging system by slip rings or wireless communication. The battery may optionally be used as a source of electrical power on the rotating portion of the probe or on the adapter to minimize the number of slip rings required. The illumination source and light detector may be disposed at the proximal end of the imaging probe and may be disposed so that they rotate with the rest of the imaging catheter 34 about the longitudinal axis of the probe, thereby eliminating the need for additional optical connectors between the imaging probe and the adapter. This is because: the complexity of rotating the optical joint can increase significantly if more than one optical fiber is included to connect the probe to the rest of the system.

If the imaging probe uses only a reciprocating rotational motion over a small angular range (e.g., less than two full revolutions), or no rotational motion at all, then there is no need to use an optical rotary joint, thereby simplifying the task of connecting the optical elements of the optical probe to image processing and display hardware.

In another embodiment, the same imaging transmitter/receiver distal to the distal end of the imaging probe and optical routing circuitry, such as switches, multiplexers, demultiplexers, prisms, diffraction gratings, couplers, and/or circulators, may be used, thereby using the same optical fiber and distal end optics for more than one imaging modality. Fig. 19 shows a schematic diagram of a system in which two optical imaging systems 211 are connected to the same optical imaging waveguide 212 via an optical routing loop (including one or more of the components listed above). If the imaging probe 12 requires a large range of rotational motion as part of its scanning mechanism, the waveguide can be connected to the imaging probe via an optical rotary joint 213. The distal end of the optical imaging loop 428 may include any combination of optical fibers, spacers, mirrors, prisms, ball lenses, GRIN lenses, and air gaps and transparent windows mentioned elsewhere in this disclosure to enable optical imaging. Although many optical imaging elements (e.g., waveguides and lenses) are designed to operate optimally for a particular wavelength range (e.g., the infrared vs visible spectrum), the performance of an optical fiber or other optical component designed for one range is often still sufficient to provide information using light in the other spectrum.

Thus, imaging using more than one wavelength range may occur simultaneously. Alternatively, the imaging waveguide may be used at different time intervals for different imaging modalities by an optical switch, multiplexer, demultiplexer in the optical routing loop 210, or by simply timing the use of the optical waveguide at different time intervals for different imaging modalities.

Although for most embodiments, optical fiber is the preferred optical waveguide 212, it is desirable to use an alternative form of optical waveguide that may be more spatially efficient than optical fiber. For example, fine optical channels having a maximum diameter on the order of 3 to 500 microns, and preferably on the order of 4 to 125 microns, may be formed within the catheter during extrusion. A fluid medium having a high refractive index may be introduced into the optical channel, for example by injection. Such fluid media may include adhesives or epoxies specifically designed for use with optical components.

The fluid medium may also be curable, for example in the case of a UV curable adhesive. An optically transparent channel filled with a high index material is surrounded by a low index extruded catheter material, the creation of which substantially replicates the functionality of including an optical fiber, but enables a somewhat more efficient use of space within the catheter because it does not require a separate cover layer. Optimal use of the space within the catheter is often important in view of the minimally invasive nature of the catheter and the limited space available within the catheter deployment area.

Another mode of operation for the present invention is to use a sensor that combines acoustic transduction with an optical sensor, where the transmitted energy is in one form and the received energy is in another form. For example, photoacoustic imaging includes the transfer of light-based energy to the imaged region. The photons interact with the imaged region and produce acoustic energy as part of their interaction with the propagation medium. This acoustic energy is typically in the form of ultrasonic waves and can be detected by an ultrasonic sensor. It is clear that aligning and using an optical transmitter in conjunction with an acoustic receiver is a good arrangement to enable photoacoustic imaging. Ultrasound sensors having openings for optical imaging or allowing substantial overlap of acoustic and optical imaging regions enable photoacoustic imaging, such as those shown in fig. 4a to 4k and 5a to 5f or fig. 12.

Similarly, sonoluminescence imaging involves the delivery of Ultrasound-based energy to the imaged area (Daniels and Price, Ultrasound in Medicine and Biology 1991: 17 (3): 297-308). The acoustic energy interacts with the imaged region and produces photons as part of their interaction with the propagation medium. Some of the photons are directed back toward the acoustic energy source. Clearly, aligning and using an ultrasonic sensor with an acoustic receiver is a good configuration to enable sonoluminescence imaging.

The implementation of acoustic and optical imaging elements with the imaging beams collinear or substantially overlapping enables sonoluminescence imaging, such as those shown in fig. 4a to 4k and 5a to 5f or fig. 12.

Referring again to FIG. 1, imaging probe 12 (which may include any of the embodiments of acoustic and optical sensors discussed herein) and its components may have a variety of sizes and characteristics depending on the anatomical location and purpose for which imaging probe 12 is intended to be used for imaging. For example, for use in the cardiovascular system (including the heart chamber), the imaging probe 12 is preferably elongate and flexible, having a length in the range of 5 to 3000mm, preferably 300mm to 1600 mm. The imaging catheter 34 and imaging assembly 30 may have a maximum cross-sectional dimension in the range of 200 microns to 10mm, preferably in the range of 500 microns to 5 mm. The sheath 48 may surround both the imaging catheter 34 and the imaging assembly 30. This will cause the imaging catheter 34 and imaging assembly 30 to rotate within the sheath while mechanically isolating the rotational movement of these two components from the surrounding tissue.

In yet another embodiment, the use of the imaging probe 10 in the gastrointestinal system generally has an elongated and flexible imaging probe 10 with a length in the range of 100mm to 2000mm, preferably 300mm to 1500 mm. The maximum cross-sectional dimension typically ranges from 3mm to 20 mm.

In yet another embodiment, the use of the imaging probe 12 to image soft tissue through a percutaneous device results in a rigid shaft for the imaging probe. The outer casing may be replaced by a rigid hollow shaft, such as stainless steel tubing, although a variety of other polymers, metals, and even ceramics are functionally suitable.

In yet another embodiment, the use of the imaging probe 10 in an intraoperative neurosurgical setting typically has a short and semi-flexible imaging probe 10 ranging from 50mm to 200mm in length. Preferably, the surgeon is able to bend and shape the probe during treatment, thereby providing an optimal path from the extracranial space to the imaged intracranial target. The maximum cross-sectional dimension is 200 microns to 5mm, preferably 500 microns to 3 mm.

In yet another embodiment, the use of the imaging probe 10 in an interventional neurovascular setting typically has a long and ultra-flexible imaging probe 10 with a length in the range of 200mm to 4000mm, preferably 1300mm to 2000 mm. The maximum cross-sectional dimension is 200 microns to 5mm, preferably 500 microns to 3 mm. The distal end of the probe preferably has shape memory to enhance navigation through the neurovasculature.

Embodiments of the present invention may be used with or incorporated into devices for intervention, such as devices for cardiovascular intervention, such as angioplasty balloons, atherectomy devices, stent delivery systems, or local drug delivery systems. This embodiment may also be used with or incorporated into a device that facilitates biopsy, radio frequency ablation, cauterization, brachytherapy, cryotherapy, laser ablation, or sonic ablation.

In particular, laser or acoustic ablation of tissue using current devices can be facilitated by using image scanning mechanisms to direct higher power optical or acoustic energy to the target area. For example, while imaging a region of a blood vessel using OCT or an ultrasound embodiment of the imaging probe described in the present invention, the region to deliver therapy may be selected through a user interface. Subsequently, powerful energy pulses may be delivered from time to time as the scanning mechanism is oriented to carry energy in the desired direction. For example, pulses of laser energy may be transmitted along the same optical fiber used for optical imaging, deflected by the deflection member in those embodiments that include the deflection member, and advanced toward the target tissue to achieve the desired effect. The pulse timing of the laser energy is coordinated with the scan pattern achieved by the imaging probe to direct the energy to the target area.

The opportunity to acquire precisely registered images of two or more high resolution imaging modalities provides important information that may be more useful than can be obtained with a single imaging modality. Maschke et al describe a complex imaging modality in which the interior of the intravascular image consists of OCT imaging information and the exterior of the intravascular image consists of IVUS imaging information. This takes advantage of the higher resolution images obtained by OCT, as well as the higher penetration of IVUS. However, the reliability of the overlay in IVUS and OCT images is limited by the inaccuracy of IVUS and OCT imaging registration, which occurs when using the configuration of IVUS and OCT imaging elements described by Maschke and is substantially overcome by the various embodiments of the present invention.

An alternative form of combined IVUS and OCT images includes dividing the image into sectors, with alternate sectors being displayed with alternate imaging devices, as shown in figure 20 a. The first image 231 and the second image 232 may be used to form a combined image 234, wherein the first and second images are images co-registered with each other and acquired by different means, the segment 233 of the first image replacing the segment of the second image. Optionally, the boundary 235 defining the sector 233 may be rotated over time about the center of the image, thereby providing a dynamic image for identifying features in the first and second co-registered images. Fig. 20b shows the time course of the rotation of the boundary 235 around the center of the combined image 234.

Alternatively, the user may specify which part of them wish to be one image and which part of them wish to be the other image by identifying a closed contour in the second image as shown in fig. 21a or by identifying a space 237 between two closed contours in the second image as shown in fig. 21 b.

Alternatively, displaying the first image 231 and the second image 232 at the same position on the screen as separate layers and changing the transparency of the preceding layers may effectively provide a method of combining images. Alternatively, the order of the layers may be changed over time, for example by advancing an IVUS image at one time interval and advancing an OCT image at a subsequent time interval, as shown in figure 22.

It is an object of the present invention to be able to identify certain features of interest in the first image 231 and to send information of these features (e.g., their location, shape, signal characteristics or composition) to the second image 232 in precise co-registration with the first image 231. The geometric features include specific points, contours or 2D regions in the image. As shown in fig. 23a, the user can manually identify a point 238, contour or region in the first image through the user interface of the imaging system (e.g., with a mouse or keyboard) and cause the geometric point 238 to appear in the second image 232 in co-registration with the first image 231, as shown in fig. 23 b. The availability of one or more other images that are registered in precise association with the first image enables any or all of the geometric features in the first image to be added to the other images.

By way of example, the user may identify the internal boundary of a blood vessel or the trailing edge of a fibrous cap in an OCT image. Figure 24a shows an outline representing an internal boundary 241 identified in the schematic representation of the OCT image (first image). Similarly, the outer boundary 242 of the vessel wall (typically defined by an outer elastic lamina) can be identified in the IVUS image (second image). Contours representing the vessel interior boundary 241 or the posterior edge of the fibrous cap may then be added to the corresponding IVUS image. Similarly, the outer boundary 242 of the vessel wall (typically defined by an outer elastic lamina) can be identified in the IVUS image. Contours representing the assessed outer boundaries in the IVUS image may be added to the OCT image. Fig. 24b shows the inner and outer borders on the first and second images.

Although the internal boundaries of the vessel are easily identified on most IVUS images, the OCT generated contours will in most cases be more accurate. Further, OCT is considered to be a fibrous cap that is more conducive to identifying plaque, in part because of its higher resolution. However, IVUS can see deeper into most vascular tissue and can provide a better assessment of the outer vessel wall.

Geometric features include features observed in a 3D data set, such as surfaces or spaces. The surfaces and spaces observed in the 3D image data set may be added to the other 3D imaging data set if the two imaging data sets are accurately registered.

The geometric features of interest need not be identified manually. Features in the image data set can be identified in an automatic or semi-automatic manner, thereby minimizing user intervention. For example, a variety of boundary detection methods are cited in the IVUS literature (e.g., Klingenstith, IEEE Transactions on Medical Imaging, 2000; 19: 652-. Automatic boundary detection methods analyze an image to identify contours that have some predetermined meaning. Semi-automatic methods are similar, but require some user intervention to provide a starting point for the boundary detection algorithm or to improve the results produced by the algorithm.

Other feature detection algorithms are contemplated that identify features other than boundaries. For example, high intensity/bright regions in the ultrasound image are followed by dark regions in the same direction as the imaging beams, which are often referred to as "shadows," and most of the time occur when the imaged region includes calcium (e.g., from old arteriosclerosis or malignant effects) or metal (e.g., from an intravascular stent or other implant). Similarly, high intensity regions in vascular OCT imaging, which are suggestive of necrotic material in the vessel wall, are followed by rapid but continuous signal attenuation acquired along the same imaging path. These regions can be detected by algorithms and identified in their respective images. Once such features are identified in their respective images, their position and shape can be added to other accurately co-registered images.

In some embodiments of the present invention, it may be desirable to make some adjustments to one or more of the images to further improve the joint registration. Although many embodiments of the present invention improve the accuracy of acquiring imaging data by one or more imaging methods, it is advantageous to further adjust the images to improve the accuracy of the joint registration process. For example, ultrasound images are produced assuming a constant speed of sound through all tissues, while OCT assumes a constant speed of light through all tissues.

In reality, however, these velocities vary slightly depending on the composition of the tissue through which the various imaging energies propagate. Thus, prior to completing the joint registration process of one or more images, it may be desirable to deform or bend the one or more images by identifying certain features in the two or more images to be jointly registered and using these features to guide the deformation process. Any point, contour or other feature identified in all images to be co-registered can be used to drive the deformation process. Ultrasound images are typically formed by displaying a grayscale representation of the intensity of ultrasound signals reflected from approximate anatomical locations corresponding to individual volume elements in the image. Similarly, OCT images are typically formed by displaying a grayscale representation of the intensity of light reflected from the approximate anatomical locations corresponding to the individual volume elements in the image.

In addition to the intensity information of various locations in the ultrasound or OCT image, there are a number of other features in the ultrasound or OCT image that are very helpful for the analysis derived from the combined imaging.

Image displays derived from ultrasound signals based on features other than sample intensity in the image are well known in the art. Nair et al (Circulation 2002; 106 (17): 2200-. Each region is assigned a tissue type based on histological analysis of the blood vessel. The ultrasound-derived parameters as well as the histological classification of the respective regions are input to a pattern recognition machine for generating an algorithm which is then used for classifying the tissue in vivo according to its plurality of ultrasound signal characteristics. Some characteristics for analysis include frequency domain parameters within a defined frequency range, such as maximum power, frequency of maximum power, minimum power, frequency of minimum power, slope, y-intercept, mid-range adaptation, and integrated backscatter. The generated image comprises a topographical map of the vessel cross-section and a discrete number of colors, where each color represents a single tissue type. Wilson et al describe measuring the frequency domain attenuation of ultrasound signals in IVUS images and overlaying a color map of the attenuation slope onto a conventional IVUS image to identify regions believed to correspond to a particular type of pathology.

Similarly, features of interest may be measured or identified in the optical image, thereby producing images other than intensity-based images. Parameters or other characteristics that may be used to generate such an image include attenuation, polarization sensitivity, detected edges, spectroscopic information, and others.

Since the present invention enables highly accurate joint registration, images can be generated based on features or signal characteristics measured by more than one imaging modality. For example, a composite image may be produced by obtaining a color map of the most likely tissue components within the vessel wall using an inner boundary 245 identified by OCT, an outer boundary 246 identified by IVUS, and a pattern recognition system that combines the acoustic signal characteristics with the optical signal characteristics of the focal region of the image data set to produce a composite image, thereby improving the ability to identify important components within the vessel wall, such as calcareous, fibrous, atheromatous, thrombogenic, metallic, and non-diseased regions.

Fig. 25 shows a schematic representation of an inner boundary 245 identified by OCT, an outer boundary 246 identified by IVUS in a second image, and a region of interest 247 for analysis of OCT and ultrasound signal characteristics. As shown in fig. 25b, the signal properties 248 from the more than one imaging modality of the co-registered region of interest are used to produce an assessment of the composition of one or more pixels in the composite image corresponding to the region of interest being analyzed. The assessments may be formed by a pattern recognition system 249 that is trained using methods known in the art. Geometric features 249 identified in the co-registered images may also optionally be included in the composite image. The process of assessing the composition of the region of interest may be repeated multiple times over different regions of interest to produce a composite image.

Furthermore, software and image processing algorithms that enable analysis of the combined imaging device need not be on the acquisition station. Once the imaging data is acquired, the imaging data may be transmitted, allowing analysis to be performed off-line on a separate set of one or more processing units.

The combined IVUS/OCT scanning device disclosed herein may include a rotary encoder. Further details of optical encoders that may be used with the combined IVUS/OCT scanning device are disclosed in co-pending application No.11/.

Briefly described, and with reference to fig. 26a through 26e, an imaging probe may incorporate an encoder designed for use with an elongate imaging probe that uses a rotating shaft (e.g., imaging catheter 34) as part of its scanning mechanism, the use of which may be generalized for use with any device that uses long, flexible cables for torque transfer where uneven rotational distortion may occur and an accurate estimate of rotational motion is required. In particular, it is most suitable for use with flexible torque transfer systems where the outer diameter of the torque cable is relatively small (e.g. less than 4mm) and long (e.g. longer than 5cm), so that conventional rotary encoding systems will not provide the desired angular resolution or be insufficiently compact for the desired application.

Fig. 26a shows a longitudinal cross-section of the proximal and distal ends of an elongate imaging device 450 having a torque transfer shaft 451, the torque transfer shaft 451 being mechanically connected to a torque source 452. The torque source 452 may be a motor, a handle manually turned by an operator, or any other such device. The torque transfer shaft 452 transfers torque to a functional end 454 of the device, which functional end 454 may be an energy delivery device, a needle, an atherectomy head, or any of a variety of other tools. In fig. 26c, the wall of the casing 453 is shown surrounding the transfer shaft and is shown closing the functional end of the device, but embodiments are also possible in which the casing is open or has an opening near the functional end. The optical fiber 455 is shown included as part of the outer sleeve 453 for enabling the emitted light, the detected light, or both to travel to or from the coded interface 104, the coded interface 104 being distal to the proximal end of the interface transmission sleeve. In fig. 26a, the cylindrical coded interface body 180 in this case is attached to the rotating part of the device while the fiber is relatively stationary. The optical fiber 455 may be included as part of the extrusion of the outer jacket 453, as shown, or added to the inner or outer surface of the jacket and anchored to the jacket 453 by methods known in the art, such as bonding or surrounding the optical fiber and jacket with an additional layer of heat shrinkable material. The optical fiber 455 is terminated using any necessary distal optics 115, such as optical spacers, lenses, and/or deflection mechanisms 172 (e.g., prisms or mirrors) that direct light to the encoding interface 104. The encoding interface 104 in fig. 26a may be similar to the encoding interface on the body of the cylindrical encoding interface disclosed in the above-mentioned co-pending application, co-pending application entitled "MEDICAL IMAGING product program code engine".

The coding interface 104 in fig. 26b is similar to the coding interface on the cylindrical coding interface body of the above-mentioned pending application. Since the encoded optical circuit used in the embodiment of fig. 14a and 14b is not mounted to or directly connected to the torque transmitting shaft, there is no need to have an optical rotary joint along the optical encoded circuit.

Fig. 26c shows a cross-sectional view of the device 450 of fig. 26b through a schematic cross-section of line 14c-14 c. One or more optical fibers 455 for the encoding system may be incorporated into the jacket 453.

Thus, by replacing the imaging assembly 30 WITH the functional end of any of the embodiments of figures 26a through 26d and replacing the imaging catheter 34, which is adapted to carry electrical or optical signals, WITH the torque transfer shaft 451, the embodiment of the ROTARY ENCODER disclosed in the above-mentioned co-pending application No. 11/....... entitled "MEDICAL IMAGING PROBE WITH ROTARY ENCODER" can be incorporated into the imaging PROBE 12.

The terms "comprising," "including," and "containing" as used herein are to be construed as inclusive and open ended, and not exclusive. In particular, the terms "comprises," "comprising," and variations thereof, when used in this specification including the claims, mean that the specified features, steps, or components are included. These terms are not to be interpreted to exclude the presence of other features, steps or components.

The foregoing description of the preferred embodiments of the invention is provided to explain the principles of the invention and not to limit the invention to the particular embodiments shown. It is intended that the scope of the invention be defined by all of the embodiments encompassed within the scope of the claims and their equivalents.

Claims (23)

1. An imaging probe for insertion into a body cavity, the imaging probe for imaging an interior of the body cavity or an exterior surface of a human body, the imaging probe comprising:

a) an elongate hollow shaft having a longitudinal axis, the elongate hollow shaft having a distal end portion, a proximal end portion and an elongate intermediate portion, an imaging assembly disposed in the elongate hollow shaft distal to the proximal end portion, the imaging assembly being connected to a first end of an imaging catheter extending through the elongate hollow shaft and connected at a second end thereof to an image processing and display system through the proximal end portion, the imaging catheter including an optical fiber having a distal end and the imaging assembly including an optical emitter/collector including a light directing and receiving device associated with the distal end of the optical fiber for directing light imaging energy out of the distal end of the optical fiber and receiving reflected light imaging energy signals and directing the received reflected light imaging energy signals back to the image processing and display system, the imaging assembly includes an ultrasound sensor including an acoustic substrate and a backing material, the ultrasound sensor emitting and receiving ultrasound imaging energy, and the imaging catheter including electrical conductors for electrically connecting the ultrasound sensor to an ultrasound signal generator and the image processing and display system, and wherein the optical emitter/collector is embedded in the backing material;

b) the imaging assembly includes a scanning mechanism configured to convey light from the optical emitter/collector and ultrasound from the ultrasound sensor along a path out of the elongate hollow shaft, the ultrasound sensor and optical emitter/collector being positioned and oriented relative to each other such that precise joint registration of ultrasound and optical images can be performed during scanning of a region of interest;

c) a drive mechanism for imparting motion to the imaging catheter and the imaging assembly;

d) a controller connected to the drive mechanism and the image processing and display system and configured to process images obtained from ultrasound imaging and optical imaging during scanning of a region of interest and to co-register ultrasound images and optical images; and

e) a display device for displaying the co-registered images.

2. The imaging probe of claim 1, wherein the drive mechanism for imparting the motion is a rotary drive mechanism for imparting rotary motion about the longitudinal axis.

3. The imaging probe according to claim 2, wherein the rotational movement is performed at an angular velocity and the angular velocity is adjusted by an adjusting means for the rotational drive mechanism.

4. The imaging probe of claim 1, wherein the motion is a reciprocating translational motion of the imaging assembly in an elongate hollow shaft.

5. The imaging probe of claim 1, wherein the optical emitter/collector and the ultrasound sensor are positioned and oriented relative to each other such that ultrasound imaging energy and optical imaging energy can be received simultaneously from substantially the same direction along substantially the same propagation path.

6. The imaging probe of claim 1, wherein the optical emitter/collector and the ultrasound sensor are positioned and oriented relative to each other such that a region of interest can be imaged with a delay between obtaining an ultrasound image signal and obtaining an optical image signal, wherein a path scanned by a first imaging energy beam is predominantly followed by a selected second imaging energy beam, wherein the first imaging energy beam is selected from the group of: i) a light imaging energy beam, and ii) an ultrasound imaging energy beam, and wherein the second imaging energy beam is an imaging energy beam in the set that is not selected as the first imaging energy beam, wherein the dominant mode is: during a time interval starting at an initial time instant, the axis of the second imaging energy beam does not move itself further away from the initial axis of the first imaging energy beam at said initial time instant.

7. The imaging probe of claim 1, wherein the optical emitter/collector comprises focusing and collecting optics for focusing light emitted from the distal end of the optical fiber to the region of interest being imaged and for collecting light reflected from the region of interest.

8. The imaging probe of claim 1, wherein the ultrasound transducer has a surface area through which the ultrasound signal is emitted, and wherein the ultrasound transducer has an optical transmission channel located therein and wherein the optical emitter/collector is located in the optical transmission channel for emitting light through the optical transmission channel such that the emitted ultrasound signal and the emitted light simultaneously scan the region of interest.

9. The imaging probe of claim 1, wherein the ultrasound transducer has a surface area through which ultrasound signals are emitted, and wherein the optical emitter/collector is mounted relative to the ultrasound transducer so as to emit light at a preselected angle relative to a direction of ultrasound signal emission such that the emitted ultrasound signals and the emitted light scan the region of interest at different times.

10. The imaging probe of claim 9, wherein the preselected angle is selected from the group of 90 degrees, 135 degrees, or 180 degrees.

11. The imaging probe of claim 1, wherein the optical emitter/collector is a first optical emitter/collector, including at least a second optical emitter/collector configured to emit light at a predetermined angle relative to the first optical emitter/collector such that the light emitted by the first optical emitter/collector and the light emitted by the second optical emitter/collector scan the region of interest at different times.

12. The imaging probe of claim 11, wherein the first optical emitter/collector and the at least second optical emitter/collector are embedded in the ultrasound sensor.

13. The imaging probe of claim 3, wherein the optical emitter/collector and ultrasound sensor are coaxially aligned so as to emit in the same general direction for simultaneously scanning the same region of interest, wherein the scanning mechanism comprises a reflective member mounted to reflect the light from the optical emitter/collector and the ultrasound signal from the ultrasound sensor.

14. The imaging probe according to claim 13 wherein said reflective member is a movable reflective member, wherein said movable reflective member is mounted in such a way that a variable angle of said movable reflective member is a function of said angular velocity.

15. The imaging probe of claim 14, wherein the reflective member comprises an acoustically reflective layer and an optically reflective layer, wherein the acoustically reflective layer and the optically reflective layer are separate layers.

16. The imaging probe of claim 15, wherein the acoustically reflective layer is contoured to focus the ultrasound imaging energy.

17. The imaging probe according to claim 14, wherein the movable reflective member is pivotally mounted in the imaging assembly along a pivot axis perpendicular to the longitudinal axis.

18. The imaging probe of any of claims 1 to 17, wherein the optical imaging energy is used to achieve imaging by optical coherence tomography.

19. The imaging probe of any of claims 1 to 17, wherein the optical imaging energy is visible light.

20. The imaging probe of any one of claims 1 to 17, wherein the optical imaging energy is infrared light.

21. The imaging probe of any of claims 1 to 17, comprising a rotary encoder mechanism connected to the imaging assembly and the controller, and wherein the rotary motion of the imaging assembly is detected by the rotary encoder, and wherein the image processing and display system is arranged to derive an imaging angle using the detected rotary motion.

22. The imaging probe of any of claims 1 to 17, wherein the body cavity comprises a body cavity made by manual means.

23. The imaging probe of any of claims 1 to 17, wherein the body cavity is a body lumen.