CN108175502B - Bronchoscope electromagnetic navigation system - Google Patents
Bronchoscope electromagnetic navigation system Download PDFInfo
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- CN108175502B CN108175502B CN201711229695.0A CN201711229695A CN108175502B CN 108175502 B CN108175502 B CN 108175502B CN 201711229695 A CN201711229695 A CN 201711229695A CN 108175502 B CN108175502 B CN 108175502B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/08—Detecting, measuring or recording devices for evaluating the respiratory organs
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
Abstract
The embodiment of the application provides a bronchoscope electromagnetic navigation system, including registration module, navigation module and display module, the position image of the bronchus in the CT image that matches through registration module, the location sensor in the navigation module acquires the real-time position coordinate of bronchoscope, control unit in the navigation module is according to real-time position coordinate and central line, confirm the correct coordinate that real-time position coordinate corresponds in the position image, the display module, show CT image, the position image, real-time position coordinate and correct coordinate, in this process, accurate navigation through registration of registration module and navigation module, realize the accurate electromagnetic navigation in the bronchial tree.
Description
Technical Field
The embodiment of the application relates to the field of electromagnetic navigation, in particular to a bronchoscope electromagnetic navigation system.
Background
At present, bronchoscopy is one of important diagnosis and treatment means for respiratory diseases, and can be used for directly and visually observing the trachea and the bronchial lumens and simultaneously performing biopsy to correctly diagnose the diseases; bronchoscopes can be used for treating lung diseases, such as sputum suction, local hemostasis, removal of new organisms and the like; it can also be administered topically for better therapeutic effect. When the lesion position needs to pass through multiple bronchial tree branches, only the current bronchoscope image is not enough to assist a doctor to judge a path to the lesion, so that the difficulty of operation is increased.
Disclosure of Invention
The embodiment of the application provides a bronchoscope electromagnetic navigation system, which judges a path reaching a lesion under the guidance of a virtual three-dimensional bronchial tree displayed by a computer and the position of a current tracking and positioning catheter.
In a first aspect, an embodiment of the present application provides a bronchoscope electromagnetic navigation system, including: a registration module, a navigation module, and a display module, wherein,
the registration module is used for matching a Computed Tomography (CT) image of a preoperative patient lung region with a bronchial image of the patient lung region during operation to construct a position image of the patient bronchus in the CT image;
the navigation module includes: a navigation unit and a control unit, wherein,
the navigation unit is coupled with the control unit and can move in a bronchial tree of the lung region of the patient along with a bronchoscope, and a positioning sensor is arranged in the navigation unit and used for acquiring real-time position coordinates of the bronchoscope;
the control unit is used for determining correct coordinates corresponding to the real-time position coordinates in the position image according to the real-time position coordinates and a central line, wherein the central line is a straight line passing through any bifurcation point in the bronchial tree, and the central line is at least one;
the display module, coupled to the registration module and the navigation module, is configured to display the CT image, the location image, the real-time location coordinates, and the correct coordinates.
In a possible implementation manner, the bronchoscope electromagnetic navigation system further includes:
a breath sensor disposed within the bronchoscope and coupled to the registration module for acquiring first data, the first data including data of a lower airway of the patient at least two breath moments;
the positioning sensor is further coupled to the registration module and used for acquiring second data, wherein the second data is data of a lower airway of the patient at the breathing moment;
the registration module is specifically configured to divide the first data into at least two types according to the second data, determine minimum error data corresponding to original image data of the CT image from the at least two types of data, and obtain a position image of a bronchus of the patient in the CT image according to the minimum error data and a bronchus image of the lung region of the patient during an operation.
In a possible implementation manner, the control unit is specifically configured to adopt a center line correction algorithm to correct and project a distance from the real-time position coordinate to the center line onto the center line, so as to determine the correct coordinate.
In a possible implementation manner, the bronchoscope electromagnetic navigation system further includes: and the cardiopulmonary respiration detector is coupled with the control unit and used for detecting the respiration and heartbeat cycles of the patient.
In a possible implementation manner, the cardiopulmonary respiration detector further comprises a resuscitation device, which is used for accurately finding the heart of the patient and rescuing the patient when the heartbeat of the patient stops.
In a possible implementation manner, the bronchoscope electromagnetic navigation system further includes:
an electromagnetic field emission module for generating an electromagnetic field, coupled to the control unit;
the control unit is further used for controlling the electromagnetic field emission module to generate the electromagnetic field.
In a possible implementation manner, the navigation module is further configured to receive the electromagnetic wave emitted by the electromagnetic field emission module, and the control unit accurately displays the position of the navigation unit in the trachea of the patient on the display module.
In one possible implementation, the positioning sensor is an optical sensor, a 6-degree-of-freedom electromagnetic positioning sensor, or an ultrasonic sensor.
In one possible implementation, the output signal of the positioning sensor is a video signal, an image signal or a coordinate signal.
In one possible implementation, the display module displays video images, still images, or coordinates.
The bronchoscope electromagnetic navigation system provided by the embodiment of the application comprises a registration module, a navigation module and a display module, wherein the position image of a bronchus matched by the registration module in a CT image is obtained, a positioning sensor in the navigation module acquires real-time position coordinates of the bronchoscope, a control unit in the navigation module determines correct coordinates corresponding to the real-time position coordinates in the position image according to the real-time position coordinates and a central line, and the display module displays the CT image, the position image, the real-time position coordinates and the correct coordinates.
Drawings
Fig. 1 is a schematic structural diagram of a bronchoscope electromagnetic navigation system according to an embodiment of the present disclosure;
FIG. 2 is a schematic view of a registered navigation system used in the bronchoscope electromagnetic navigation system of the present application;
FIG. 3 is a flowchart of the bronchoscope electromagnetic navigation system registration process of the present application;
FIG. 4 is a schematic view of center line correction during navigation of the bronchoscope electromagnetic navigation system of the present application;
fig. 5 is a schematic structural diagram of a bronchoscope electromagnetic navigation system according to another embodiment of the present application.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are some embodiments of the present application, but not all embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application. The following detailed description of specific embodiments, structures, features, and operations according to the present application are described in connection with the accompanying drawings and preferred embodiments.
The terms "first," "second," "third," and "fourth," etc. in the description and claims of this application and in the accompanying drawings, if any, are used for distinguishing between different objects and not for describing a particular order. Furthermore, the terms "comprising" and "having," as well as any variations thereof, are intended to cover non-exclusive inclusions. For example, a process, method, system, article, or apparatus that comprises a list of steps or elements is not limited to only those steps or elements listed, but may alternatively include other steps or elements not listed, or inherent to such process, method, article, or apparatus.
Reference in the specification to "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment can be included in at least one embodiment of the specification. The appearances of the phrase in various places in the specification are not necessarily all referring to the same embodiment, nor are separate or alternative embodiments mutually exclusive of other embodiments. It is explicitly and implicitly understood by one skilled in the art that the embodiments described herein can be combined with other embodiments.
Additionally, as used in the specification and claims, certain terms are used to refer to particular components. Those skilled in the art will appreciate that manufacturers may refer to a component by different names. This specification and claims do not intend to distinguish between components that differ in name but not function. In the following description and in the claims, the terms "include" and "comprise" are used in an open-ended fashion, and thus should be interpreted to mean "include, but not limited to. "substantially" means within an acceptable error range, and a person skilled in the art can solve the technical problem within a certain error range to substantially achieve the technical effect. Furthermore, the terms "coupled" or "electrically connected" are intended to encompass any direct or indirect electrical coupling. Thus, if a first device couples to a second device, that connection may be through a direct electrical connection, or through an indirect electrical connection via other devices and couplings. The description which follows is a preferred embodiment of the present application, but is made for the purpose of illustrating the general principles of the application and not for the purpose of limiting the scope of the application. The protection scope of the present application shall be subject to the definitions of the appended claims.
The bronchoscope electromagnetic navigation system is suitable for being matched with the bronchoscope to conduct navigation operation on the bronchial path on the basis of CT images of lung regions.
Fig. 1 is a schematic structural diagram of a bronchoscope electromagnetic navigation system according to an embodiment of the present disclosure. As shown in fig. 1, a bronchoscope electromagnetic navigation system 1 provided by an embodiment of the present application includes a registration module 10, a navigation module 20, and a display module 30, wherein the registration module 10 is configured to match a computed tomography CT image of a lung region of a preoperative patient with a bronchial image of the lung region of the patient during an operation to construct a position image of a bronchus of the patient in the CT image; the navigation module 20 includes a navigation unit 210 and a control unit 220, wherein the navigation unit 210 is coupled to the control unit 220 and can move in the bronchial tree of the lung region of the patient according to the bronchoscope, a positioning sensor 2110 is disposed in the navigation unit 210, the positioning sensor 2110 is configured to obtain a real-time position coordinate of the bronchoscope, the real-time position coordinate can be calculated according to a depth and an angle of the bronchoscope inserted into the trachea, which are obtained by the positioning sensor 2110, the control unit 220 is configured to determine a correct coordinate corresponding to the real-time position in the position image of the bronchus in the CT image, which is matched by the registration module 10, according to the real-time position coordinate obtained by the positioning sensor 2110 and a center line, wherein the center line is a straight line passing through any bifurcation point in the bronchial tree, in a normal case, the center line is at least one, and the display module 30 is coupled to the registration module 10 and the navigation module 20, and is configured to display the CT image imported into the registration module 10, the position image matched by the registration module 10, the real-time position coordinates acquired by the positioning sensor in the navigation module 20, and the correct coordinates finally determined by the control unit 220.
Generally, registration navigation according to preoperative CT causes navigation deviation due to respiratory motion of a patient and other reasons, for example, in 4, 5 grade bronchus, real-time position coordinates acquired by a positioning sensor on a positioning catheter in an intraoperative bronchoscope are converted into position images matched with preoperative CT images and bronchial images, and the real-time position coordinates are found not in the position images matched with the bronchial images in the CT images, namely, not in the lumen of the bronchus. At the moment, the electromagnetic navigation prompts reach the focus, and the result is a certain distance away from the focus, even because of deviation, the navigation fails due to the inconsistency between the navigation path and the actual path, so that the doctor makes a misjudgment. The reasons for navigation deviation or failure are generally as follows: the first reason is that the registration matrix is not accurate in the beginning (1-2 grade bronchus), and is not updated in the later stage (4-5 grade bronchus); the second reason is that the trachea deforms due to the entry of the bronchoscope; and thirdly, the respiratory motion of the patient causes deviation. The three reasons are mutually influenced and are technical problems which cannot be solved by the existing method.
The bronchoscope electromagnetic navigation system provided by the embodiment of the disclosure uses an optimized registration method, and combines a navigation mode of central line matching with positioning sensors installed on the bronchoscope, such as an optical sensor and a 6-degree-of-freedom electromagnetic positioning sensor, and the acquired real-time position coordinates of the bronchoscope inserted into the trachea realize accurate electromagnetic navigation in the bronchial tree. Further, the output signal of the positioning sensor 2110 is a video signal, an image signal or a coordinate signal; accordingly, the display module 30 displays video images, still images, or coordinates.
The bronchoscope electromagnetic navigation system provided by the embodiment of the disclosure comprises a registration module, a navigation module and a display module, wherein a position image of a bronchus matched by the registration module in a CT image is obtained, a positioning sensor in the navigation module obtains a real-time position coordinate of the bronchoscope, a control unit in the navigation module determines a correct coordinate corresponding to the real-time position coordinate in the position image according to the real-time position coordinate and a central line, and the display module displays the CT image, the position image, the real-time position coordinate and the correct coordinate.
The two most important technical modules of electromagnetic navigation are: registration (matching preoperative CT with intraoperative bronchial tree), and navigation (returning the position of intraoperative bronchial tree obtained in real time to the coordinate system in preoperative CT to prompt the position of preoperative CT of the current sensor). Errors in registration and navigation will simultaneously determine the accuracy of electromagnetic navigation. The registration process and the navigation process of the bronchoscope electromagnetic navigation system provided by the embodiment of the present application are respectively described in detail below.
First, a registration process.
Fig. 2 is a schematic view of registration navigation used by the bronchoscope electromagnetic navigation system, and fig. 3 is a flowchart of registration of the bronchoscope electromagnetic navigation system.
Referring to fig. 2, in the embodiment of the present application, the registration module 10 updates a matching CT image in real time and a position image of a bronchus of a patient in a CT image, which is constructed from a bronchus image of a lung region of the patient during an operation, bronchoscope parameters are also updated in real time, a positioning sensor acquires real-time position coordinates of a bronchoscope in real time, and the navigation module 20 performs precise navigation.
Referring to fig. 1 again, in the embodiment of the present application, the bronchoscope electromagnetic navigation system further includes a respiration sensor 40 disposed in the bronchoscope and coupled to the registration module, for acquiring first data, where the first data includes data of the bronchi of the patient at least two respiration times; the positioning sensor 2110, further coupled to the registration module, for acquiring second data, the second data being data of the lower airway at the time of the patient's breathing; the registration module 10 is specifically configured to divide the first data into at least two types according to the second data, determine minimum error data corresponding to original image data of the CT image from the at least two types of data, and obtain a position image of a bronchus of the patient in the CT image according to the minimum error data and a bronchus image of the lung region of the patient during an operation.
Referring to fig. 3 again on the basis of fig. 1, the control unit 220 divides the first data acquired by the respiratory sensor 40 into 11 classes, such as class 0 data to class 10 data in the figure, according to the second data acquired by the positioning sensor 2110, and then the registration module 10 finds the data with the minimum error corresponding to the original image data of the CT image from the 11 classes of data, where the error of each class of data in the original image data of the CT image and the class 0 data to the class 10 data is respectively marked as error (0) to error (10). Assuming that data with the minimum error corresponding to original image data of the CT image in 11 data is K-th class data, wherein K is greater than or equal to 0 and less than or equal to 10, and K is an integer, and according to the data with the minimum error and a bronchial image of a lung region of the patient in an operation, a position image of a bronchial tube of the patient in the CT image is obtained.
In the registration process, the breathing moments of the CT before the operation are considered, the point sets of all the breathing moments are classified in the operation, and the point set with the minimum registration error is found to be used as the registration point set for registration.
Second, a navigation process.
In this embodiment of the application, the control unit 220 is specifically configured to adopt a center line correction algorithm to correct and project the distance from the real-time position coordinate to the center line onto the center line, so as to determine the correct coordinate. Specifically, please refer to fig. 4.
Fig. 4 is a schematic diagram of center line correction in the navigation process of the bronchoscope electromagnetic navigation system, please refer to fig. 4: starting from the "root", each solid line represents a centerline, P _ BK represents the coordinates of the kth bifurcation in the bronchial tree, e.g., P _ B1 represents the coordinates of the 1 st bifurcation in the bronchial tree, P _ B2 represents the coordinates of the 2 nd bifurcation in the bronchial tree, and P _ B3 represents the coordinates of the 3 rd bifurcation in the bronchial tree.
P _ C: the coordinates of the positioning sensor are converted into coordinates in a position image coordinate system matched with the CT image and the bronchial tree image after passing through the registration process. In the embodiment of the present application, the centerline correction is to pull down P _ C on the correct branch, and calculate the displacement on the centerline correctly, i.e. the solid line in the figure. The center line correction algorithm flow is as follows:
And 2, calculating a point set (P _1, P _2, … …, P _ N) with the distance from P _ C to P _ N being less than or equal to MD as a candidate point set, and simultaneously calculating the distance (P _ C-P _1, P _ C-P _2, … …, P _ C-P _ N).
And 3, calculating the direction of the point set (P _1, P _2, … … P _ N) and recording the direction as (D1, D2, … …, DN). Wherein, the direction of P _1 is the tangential direction passing through P _1, and the direction of P _2 is the tangential direction … … passing through P _2
And 4, calculating an included angle between the direction of the point set P _ C and the direction of the point set (P _1, P _2, … …, P _ N), and recording the included angle as (D _1, D _2, … …, D _ N).
And 5, calculating the central line path distance from the point set (P _1, P _2, … …, P _ N) to P _ K, and recording as (M1, M2, … …, MN).
Step 6, constructing a cost function: COST (P _ H) ═ 1/3 × (P _ C _ P _ K/(P _ C-P _1+ P _ C-P _2+ … + P _ C-P _ N)) +1/3 × (D _ K/(D _1+ D _2+ … + D _ N) +1/3 × (M1/(M1+ M2+ … + MN)).
Step 7, MIN (COST (P _ H)), find the minimum COST, record this point as P _ H.
As can be seen in the above example, P _1 is the point in the set of points where the cost function is minimal. Now we need to consider whether the displacements of P _1 and P _ K are correct. At this time, we need to verify the bronchoscope insertion displacement distance D by an optical sensor (e.g. an optical mouse sensor attached to the bronchoscope, etc.), that is: if D (P _1, P _ K) is greater than D, P _1+ (D (P _1, P _ K) -D), otherwise P _1- (D (P _1, P _ K) -D).
In the navigation process, a center line correction algorithm is added to reduce navigation errors, and meanwhile, a positioning sensor, such as an optical sensor and the like, is used for correcting and projecting the obtained real-time position coordinates to the correct position on the center line.
Fig. 5 is a schematic structural diagram of a bronchoscope electromagnetic navigation system according to another embodiment of the present application. Referring to fig. 5, the bronchoscope electromagnetic navigation system provided in this embodiment further includes, on the basis of fig. 1: a cardiopulmonary respiration detector 50, coupled to the control unit, for detecting the respiration and heartbeat cycles of the patient.
Further, the cardiopulmonary respiration detector 50 further includes a resuscitation device, which is used to accurately find the heart of the patient and rescue the patient when the heartbeat of the patient is stopped.
Referring to fig. 5 again, the bronchoscope electromagnetic navigation system provided in the embodiment of the present application further includes: an electromagnetic field emitting module 60, coupled to the control unit, for generating an electromagnetic field, wherein the control unit 220 is further configured to control the electromagnetic field emitting module 60 to generate the electromagnetic field.
Further, the navigation module 20 is further configured to receive the electromagnetic wave emitted by the electromagnetic field emission module 60, and the control unit 220 accurately displays the position of the navigation unit 210 in the trachea of the patient on the display module 30.
Those of ordinary skill in the art will understand that: all or a portion of the steps of implementing the above-described method embodiments may be performed by hardware associated with program instructions. The program may be stored in a computer-readable storage medium. When executed, the program performs steps comprising the method embodiments described above; and the aforementioned storage medium includes: various media that can store program codes, such as ROM, RAM, magnetic or optical disks.
Finally, it should be noted that: the above embodiments are only used for illustrating the technical solutions of the present application, and not for limiting the same; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; and the modifications or the substitutions do not make the essence of the corresponding technical solutions depart from the scope of the technical solutions of the embodiments of the present application.
Claims (9)
1. A bronchoscope electromagnetic navigation system, comprising: a registration module, a navigation module, and a display module, wherein,
the registration module is used for matching a Computed Tomography (CT) image of a preoperative patient lung region with a bronchial image of the patient lung region during operation to construct a position image of the patient bronchus in the CT image;
the navigation module includes: a navigation unit and a control unit, wherein,
the navigation unit is coupled with the control unit and can move in a bronchial tree of the lung region of the patient along with a bronchoscope, and a positioning sensor is arranged in the navigation unit and used for acquiring real-time position coordinates of the bronchoscope;
the control unit is used for determining correct coordinates corresponding to the real-time position coordinates in the position image according to the real-time position coordinates and a central line, wherein the central line is a straight line passing through any bifurcation point in the bronchial tree, and the central line is at least one;
the display module, coupled to the registration module and the navigation module, is configured to display the CT image, the location image, the real-time location coordinates, and the correct coordinates;
a breath sensor disposed within the bronchoscope and coupled to the registration module for acquiring first data, the first data including data of a lower airway of the patient at least two breath moments;
the positioning sensor is further coupled to the registration module and used for acquiring second data, wherein the second data is data of a lower airway of the patient at the breathing moment;
the registration module is specifically configured to divide the first data into at least two types according to the second data, determine minimum error data corresponding to original image data of the CT image from the at least two types of data, and construct a position image of a bronchus of the patient in the CT image according to the minimum error data and a bronchus image of a lung region of the patient during an operation.
2. The system of claim 1,
the control unit is specifically configured to correct and project the distance from the real-time position coordinate to the center line onto the center line by using a center line correction algorithm, so as to determine the correct coordinate.
3. The system of claim 1, further comprising: and the cardiopulmonary respiration detector is coupled with the control unit and used for detecting the respiration and heartbeat cycles of the patient.
4. The system of claim 3, wherein the cardiopulmonary respiration detector further comprises a resuscitation device for accurately locating the heart of the patient and rescuing the patient during the sudden cardiac arrest of the patient.
5. The system of claim 1, further comprising:
an electromagnetic field emission module for generating an electromagnetic field, coupled to the control unit;
the control unit is further used for controlling the electromagnetic field emission module to generate the electromagnetic field.
6. The system of claim 5, wherein the navigation module is further configured to receive the electromagnetic wave emitted from the electromagnetic field emission module, and the control unit is configured to display the position of the navigation unit in the trachea of the patient on the display module accurately.
7. The system of claim 1, wherein the positioning sensor is an optical sensor, a 6-degree-of-freedom electromagnetic positioning sensor, or an ultrasonic sensor.
8. The system of claim 1, wherein the output signal of the positioning sensor is a video signal, an image signal, or a coordinate signal.
9. The system of claim 1, wherein the display module displays a video image, a still image, or coordinates.
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| CN109620303B (en) * | 2018-11-26 | 2022-09-02 | 苏州朗开医疗技术有限公司 | Lung auxiliary diagnosis method and device |
| CN110313886A (en) * | 2019-08-02 | 2019-10-11 | 哈尔滨理工大学 | The intelligence of children's Fibrobronchoscopy checks and interventional therapy device |
| CN113116475B (en) * | 2020-12-31 | 2023-06-20 | 杭州堃博生物科技有限公司 | Transcatheter navigation processing method, device, medium, equipment and navigation system |
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| CN106821498A (en) * | 2015-12-07 | 2017-06-13 | 柯惠有限合伙公司 | It is integrated with visualization, navigation and the planning of the airway wall and cone beam computer tomography of electromagnetic navigation |
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