CN115607279A - Hard tissue registration method, device and system - Google Patents
Hard tissue registration method, device and system Download PDFInfo
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- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
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- A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
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Abstract
The specification provides a hard tissue registration method, a hard tissue registration device and a hard tissue registration system, wherein the method comprises the following steps: designing and manufacturing a solid negative model according to the shot image of the hard tissue, enabling a first surface of the negative model to be attached and matched with a target surface of the hard tissue model, and determining a registration matrix according to a first coordinate of a mark point on the negative model in an image coordinate system and a second coordinate in the target coordinate system. According to the scheme, the hard tissue model is established according to the image of the hard tissue, then the negative model is determined according to the hard tissue model, the registration operation is carried out by means of the negative model, the fast registration can be realized only by acquiring the coordinates of 3 points at least, the requirement on an operating doctor is low, and the registration efficiency is high.
Description
Technical Field
The present disclosure relates to the field of medical device technologies, and in particular, to a method, an apparatus, and a system for hard tissue registration.
Background
The operation navigation is to accurately correspond the image data before or during the operation of the patient to the anatomical structure of the patient on the operation bed, track the surgical instrument during the operation and update and display the position of the surgical instrument on the image of the patient in real time in the form of a virtual probe, so that a doctor can clearly know the position of the surgical instrument relative to the anatomical structure of the patient, and the surgical operation is quicker, more accurate and safer. The operation of achieving "accurate correspondence of pre-or intra-operative patient image data to the patient anatomy on the operating bed" is referred to as registration. Registration is a key step in achieving surgical navigation.
Currently, the prior art generally adopts the following methods for registration: before operation, a hard tissue model of a patient is obtained by utilizing CT segmentation reconstruction of the patient; during operation, a pointed probe tracked by an optical tracking system is used to acquire a point cloud of a hard tissue surface, as shown in fig. 1, and then the point cloud is registered to a hard tissue model obtained by preoperative segmentation, so that a transformation relation between a preoperative CT coordinate system and an intraoperative patient hard tissue coordinate system can be obtained.
The prior art has the following problems: when the probe is used for acquiring the point cloud on the surface of the hard tissue in the operation, the guidance of a navigation screen is needed, the problem of hand-eye coordination exists, and a longer learning curve is needed, so that the requirement on an operating doctor is higher; in order to meet the requirement of registration, 30-40 points need to be acquired for registration, and the acquired points have the requirement of distribution range and sequence, so that the time consumption is long, and the operation efficiency is influenced.
Disclosure of Invention
The embodiment of the application aims to provide a hard tissue registration method, a hard tissue registration device and a hard tissue registration system, so as to solve the problems that the existing registration method has high requirements on surgeons and consumes long time.
A first aspect of the present specification provides a registration method of hard tissues, comprising: acquiring first coordinates of a plurality of mark points on the negative model under an image coordinate system; the first surface of the negative model is in fit matching with the target surface of the hard tissue model; the image coordinate system is determined when the image of the hard tissue is shot before an operation, and the negative model and the mark points on the negative model are designed and manufactured according to the image of the hard tissue; after the first surface of the negative model is attached to the target surface of the hard tissue, acquiring second coordinates of each mark point in a target coordinate system; and determining a registration matrix of the image coordinate system and the target coordinate system according to the first coordinate and the second coordinate.
In some embodiments, the marker point is located on a second surface of the negative model, the second surface being disposed opposite the first surface.
In some embodiments, a first interface is disposed on a second surface of the negative model, the first interface is used for mounting a target, and the target is used for determining second coordinates of each marking point in the target coordinate system during operation; alternatively, the second surface of the negative model is integrally provided with a target protruding from the second surface.
In some embodiments, determining a registration matrix of the image coordinate system and the target coordinate system from the first and second coordinates comprises: determining a first transformation matrix between the first coordinate and the second coordinate by using a least square method; calculating a third coordinate obtained by transforming the first coordinate of each mark point by using the first transformation matrix; judging whether the difference between the third coordinate and the second coordinate of each mark point reaches a preset condition or not; and if so, taking the first transformation matrix as a registration matrix of the image coordinate system and the target coordinate system.
In some embodiments, acquiring the second coordinates of each marker point in the target coordinate system includes: acquiring fourth coordinates of each mark point determined before the operation under the negative model coordinate system; acquiring poses of the target on the negative model and the target of the target coordinate system under the target coordinate system respectively; a target protruding from the second surface is arranged on the second surface of the negative model, and the second surface is arranged opposite to the first surface; determining a second transformation matrix from the negative model coordinate system to the target coordinate system according to the poses of the target on the negative model and the target of the target coordinate system in the target coordinate system respectively; and transforming the fourth coordinates of each mark point to the target coordinate system according to the second transformation matrix to obtain second coordinates of each mark point in the target coordinate system.
In some embodiments, acquiring the second coordinates of each marking point in the target coordinate system comprises: acquiring a fifth coordinate of each target point of the target on the negative model under an image coordinate system; the second surface of the negative model is provided with a target protruding out of the second surface, and the second surface is arranged opposite to the first surface; establishing a negative model target coordinate system based on a fifth coordinate of each target point on the negative model target under the image coordinate system, and determining a third transformation matrix from the image coordinate system to the negative model target coordinate system; acquiring poses of a target of a negative model and a target of the target coordinate system under the target coordinate system respectively; determining a fourth transformation matrix from the negative model target coordinate system to the target coordinate system according to the poses of the target of the negative model and the target of the target coordinate system in the target coordinate system respectively; and taking the target points on the negative model target as mark points, and transforming the fifth coordinate of each target point of the negative model target under the image coordinate system to the second coordinate of each mark point under the target coordinate system according to the third transformation matrix and the fourth transformation matrix.
In some embodiments, before acquiring the poses of the target of the negative model and the target of the target coordinate system respectively in the target coordinate system, the method further includes: obtaining a first positional relationship between a checkpoint on a second surface of the negative model and a target of the negative model; the first positional relationship is determined preoperatively; after the negative model is attached to the target surface of the hard tissue, acquiring a second position relation between the check point and the target on the negative model; and under the condition that the deviation of the first position relation and the second position relation is within a second preset threshold range, acquiring the poses of the target on the negative model and the target of the target coordinate system respectively under the target coordinate system.
In some embodiments, before acquiring the first coordinates of the plurality of marked points on the negative model in the image coordinate system, the method further includes: acquiring an image of the hard tissue; reconstructing a three-dimensional model image of the hard tissue according to the image of the hard tissue; marking a target surface exposed during surgery on the three-dimensional model image of the hard tissue, and determining the three-dimensional model image of the negative model according to the marked target surface.
A second aspect of the present specification provides a hard tissue registration apparatus comprising: the first acquisition unit is used for acquiring first coordinates of a plurality of mark points on the negative model under an image coordinate system; the first surface of the negative model is in fit matching with the target surface of the hard tissue model; the image coordinate system is determined when the image of the hard tissue is shot before an operation, and the negative model and the mark points on the negative model are designed and manufactured according to the image of the hard tissue; the second acquisition unit is used for acquiring second coordinates of each mark point in a target coordinate system after the first surface of the negative model is attached to the target surface of the hard tissue; and the first determining unit is used for determining a registration matrix of the image coordinate system and the target coordinate system according to the first coordinate and the second coordinate.
In some embodiments, the marker point is located on a second surface of the negative model, the second surface being disposed opposite the first surface.
In some embodiments, a first interface is disposed on a second surface of the negative model, the first interface is used for mounting a target, and the target is used for determining second coordinates of each marking point in the target coordinate system during operation; alternatively, the second surface of the negative model is integrally provided with a target protruding from the second surface.
In some embodiments, the first determination unit comprises: a first determining subunit, configured to determine a first transformation matrix between the first coordinate and the second coordinate by using a least square method; the first calculation subunit is used for calculating a third coordinate obtained by transforming the first coordinate of each mark point by using the first transformation matrix; a judging subunit, configured to judge whether a difference between the third coordinate and the second coordinate of each marker reaches a predetermined condition; and the second determining subunit is used for taking the first transformation matrix as a registration matrix of the image coordinate system and the target coordinate system if the first transformation matrix is the registration matrix.
In some embodiments, the second acquisition unit comprises: the first acquisition subunit is used for acquiring fourth coordinates of each mark point determined before the operation in the negative model coordinate system; the second acquisition subunit is used for acquiring the poses of the target on the negative model and the target of the target coordinate system in the target coordinate system respectively; a target protruding from the second surface is arranged on the second surface of the negative model, and the second surface is arranged opposite to the first surface; a third determining subunit, configured to determine, according to respective poses of the target on the negative model and the target in the target coordinate system, a second transformation matrix from the negative model coordinate system to the target coordinate system; and the first transformation subunit is used for transforming the fourth coordinate of each mark point to the target coordinate system according to the second transformation matrix to obtain a second coordinate of each mark point in the target coordinate system.
In some embodiments, the second acquisition unit comprises: the third acquisition subunit is used for acquiring a fifth coordinate of each target point of the target on the negative model under the image coordinate system; the second surface of the negative model is provided with a target protruding out of the second surface, and the second surface is arranged opposite to the first surface; the fourth determining subunit is configured to establish a negative model target coordinate system based on a fifth coordinate of each target point on the negative model target in the image coordinate system, and determine a third transformation matrix from the image coordinate system to the negative model target coordinate system; the fourth acquisition subunit is used for acquiring poses of a target of the negative model and a target of the target coordinate system in the target coordinate system respectively; a fifth determining subunit, configured to determine, according to respective poses of the target of the negative model and the target of the target coordinate system in the target coordinate system, a fourth transformation matrix from the negative model target coordinate system to the target coordinate system; and the second transformation subunit is used for transforming a fifth coordinate of each target point of the negative model target under the image coordinate system to a second coordinate of each mark point under the target coordinate system according to the third transformation matrix and the fourth transformation matrix by taking the target point on the negative model target as a mark point.
In some embodiments, the second obtaining unit further comprises: a fifth acquiring subunit, configured to acquire a first positional relationship between the check point on the second surface of the negative model and the target of the negative model; the first positional relationship is determined preoperatively; a sixth acquiring subunit, configured to acquire a second positional relationship between the check point and the target on the negative model after the negative model is attached to the target surface of the hard tissue; the fourth acquiring subunit executes the acquiring of the poses of the target on the negative model and the target of the target coordinate system respectively in the target coordinate system, in a case where a deviation of the first positional relationship from the second positional relationship is within a second predetermined threshold range.
In some embodiments, the apparatus further comprises: a third acquisition unit configured to acquire an image of the hard tissue; the reconstruction unit is used for reconstructing a three-dimensional model image of the hard tissue according to the image of the hard tissue; and the marking unit is used for marking a target surface exposed during surgery on the three-dimensional model image of the hard tissue and determining the three-dimensional model image of the negative model according to the marked target surface.
A third aspect of the present specification provides a navigation dolly for performing the hard tissue registration method according to any one of the first aspect.
A fourth aspect of the present specification provides a registration system for hard tissue, comprising: the probe and the optical tracking system are used for acquiring the coordinates of a target point; a controller for performing the hard tissue registration method of any one of the first aspect.
A fifth aspect of the present description provides a computer storage medium storing computer program instructions which, when executed, implement the steps of the method of any one of the first aspects.
According to the hard tissue registration method, device and system provided by the specification, the hard tissue model is established according to the image of the hard tissue, then the negative model is determined according to the hard tissue model, the registration operation is performed by means of the negative model, the registration can be realized only by acquiring the coordinates of 3 points at least, the requirement on an operator is low, and the registration efficiency is high.
Drawings
In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly introduced below, it is obvious that the drawings in the following description are only some embodiments described in the present application, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.
FIG. 1 shows a schematic distribution of points acquired on a three-dimensional model of a hip joint (i.e., a hard tissue model) reconstructed from CT images when prior art registration of the hip joint is performed;
FIG. 2 shows a schematic view of a surgical robotic system;
FIG. 3 illustrates a flow chart of a hard tissue registration method provided herein;
FIG. 4 shows a schematic view of a hip joint model and its negative model;
FIG. 5 shows a schematic representation of the preservation of soft tissue space between a hip joint model and its negative model;
FIG. 6 shows a schematic view of a negative model;
FIG. 7 shows a schematic representation of segmentation and surface reconstruction of a CT image of hard tissue;
FIG. 8 shows a schematic view of the negative model placement of the hip joint in registration;
FIG. 9 is a schematic diagram showing registration using the negative model of FIG. 6;
FIG. 10 shows a schematic structural diagram of another negative model;
FIG. 11 shows a schematic view of the assembly of the negative model of FIG. 10 with a target;
figure 12 shows a schematic view of registration with an assembly of targets using the negative model of figure 11;
FIG. 13 shows a schematic structural diagram of another negative model;
FIG. 14 is a schematic representation of preoperatively determined target point coordinates using the negative model of FIG. 13 for registration;
fig. 15 shows a schematic representation of registration using the negative model shown in fig. 13.
Detailed Description
In order to make those skilled in the art better understand the technical solutions in the present application, 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 only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the present application without making creative efforts shall fall within the protection scope of the present application.
Hard tissues such as bones and teeth have irregular shapes and complex surface structures, so that the registration method is complex. The specification provides a hard tissue registration method, which is skillfully designed and realizes registration by means of an auxiliary module.
The hard tissue registration method provided in the present specification can be used in the surgical robot system shown in fig. 2, in which 11 denotes a surgical cart, 12 denotes a robot arm, 21 denotes a tool target, 22 denotes a femur target, 23 denotes a pelvis target, 24 denotes a base target, 31 denotes an osteotomy guide tool, 41 denotes a navigation device, 42 denotes an auxiliary display, 51 denotes a controller in the navigation cart, 52 denotes a main display, 53 denotes a keyboard, 61 denotes a femur, 62 denotes a pelvis, 63 denotes a patient, and 71 denotes an operating table.
The general procedure for the procedure in the examples is as follows:
the doctor guides the preoperative scheme of the patient into a computer, the preoperative planning step mainly comprises the steps of obtaining patient image data, image segmentation, image three-dimensional reconstruction, anatomical landmark point marking, prosthesis positioning and the like, the preoperative planning data mainly comprises osteotomy position coordinates, prosthesis model numbers, prosthesis installation positions and the like, and the computer comprises a main display 52, a keyboard 53 and a controller 51 positioned in a navigation trolley.
The operation trolley and the navigation trolley are placed at proper positions beside a sickbed, and a pelvic bone marker 23, a femoral bone marker 22, a base marker 24, a sterile bag, an osteotomy guiding tool 31, a tool marker 21 and the like are installed.
The doctor uses the optical tracking probe point to obtain the characteristic points of the pelvis and the femur of the patient, the optical tracking system respectively records the positions of the characteristic points of the bones of the patient by taking markers of the pelvis and the femur as the reference, and sends the positions of the characteristic points of the bones to the computer, then the computer obtains the corresponding relation between the actual positions of the pelvis and the femur and the CT image position of the pelvis and the femur through the rapid registration algorithm of the invention, and the actual positions of the pelvis and the femur are linked with the corresponding markers arranged on the pelvis and the femur, so that the markers of the pelvis and the femur can track the actual positions of the bones in real time.
The doctor carries out intraoperative adjustment and confirmation on the preoperative surgical scheme based on the actual condition in the operation.
The navigation device 41 sends the planned osteotomy coordinates to the robotic arm, which positions the osteotomy location via the tool markers 21 and moves to a predetermined location, so that the surgeon can perform the osteotomy and drilling operations via the osteotomy guide tool 31 using a tool such as an electric drill.
The hard tissue registration method provided by the present specification can be used for the navigation device 41 in the surgical robot system.
As shown in fig. 3, the present specification provides a hard tissue registration method, including the following steps:
s110: and acquiring first coordinates of a plurality of mark points on the negative model in an image coordinate system.
The negative model is a hard solid model, and the first surface of the negative model is in snug fit with the target surface of the hard tissue model.
The target surface of the hard tissue model refers to the surface of the hard tissue model corresponding to the hard tissue exposed during the operation. In the present specification, "exposed to the outside" means that, during an operation, a soft tissue on a target tissue surface is cut and pulled apart so that a hard tissue can be contacted by an instrument at the distal end of a robot arm of a surgical robot, and at this time, a surface region of the hard tissue that can be observed by an image capturing unit mounted on the surgical robot is the target surface "exposed to the outside".
Fig. 4 shows a schematic view of a hip joint model and its negative model. Wherein 1 denotes a hard tissue model, that is, a hip joint model, and 2 denotes a negative model, and it can be seen from fig. 4 that the left side surface of the negative model 2 is fitted to the right lower surface of the hip joint model without a gap and without coincidence.
When the hard tissue model is obtained by utilizing the CT image segmentation and reconstruction of a patient, because the CT does not contain cartilage, enough space needs to be reserved for the cartilage part of the skeleton when the negative model is designed, and the situation that the negative model cannot be attached to the surface of the hard tissue during the operation is avoided. As shown in fig. 5, 1 denotes a hard tissue model, i.e., a hip joint model, 3 denotes a negative model, 2 denotes possible cartilage, and 4 denotes a cartilage space reserved when designing the negative model.
The image coordinate system can be a coordinate system established when the image is shot, or can be a coordinate system adopted when the hard tissue model is reconstructed, and the negative model and the mark points on the negative model are designed and manufactured according to the shot image of the hard tissue.
In some embodiments, the negative model is designed by: and reconstructing a three-dimensional model image of the hard tissue according to the image of the hard tissue, marking a target surface exposed during surgery on the three-dimensional model image of the hard tissue, and determining a three-dimensional model image of the negative model according to the marked target surface. The detailed description of the design method may be referred to as steps S130, S140, and S150 hereinafter.
After the three-dimensional model image of the negative model is designed, the positions of the marking points can be designed on the three-dimensional model image. The reconstructed three-dimensional model image of the hard tissue and the three-dimensional model image for creating the negative model are in the same three-dimensional coordinate system (hereinafter referred to as a design coordinate system). The coordinates of the marked points on the negative model in the design coordinate system are known. On the basis, the first coordinate of the mark point on the negative model three-dimensional model image in the image coordinate system can be determined according to the transformation relation between the design coordinate system and the image coordinate system.
The number of the marking points on the negative model is at least three, and the marking points are not on the same straight line, so that the pose of the negative model can be uniquely positioned through the marking points. These points are dispersed as much as possible over the entire upper second surface of the negative model, which is the surface opposite the first surface. As shown in fig. 6, a denotes a first surface of the negative model, and B denotes a second surface. 1. The small circles next to 2 and n represent mark points, and 1, 2 and n are the reference numbers of the mark points.
In some embodiments, designing and making the negative model may be performed by other devices, the surgical robotic system only having to perform the steps at the time of surgery. While in some embodiments, the design operation of the negative model may also be performed by a surgical robotic system, then the following steps S140, S150, and S160 may also be included before S110.
S140: images of hard tissue are acquired.
The image here generally refers to an image obtained by imaging a hard tissue by using an imaging principle such as CT imaging, X-ray imaging, ultrasonic imaging, or magnetic imaging before or during a surgery, and these images are generally two-dimensional images.
S150: and reconstructing a three-dimensional model image of the hard tissue according to the image of the hard tissue.
Specifically, after the image of the hard tissue is obtained, the image of the hard tissue may be segmented first to obtain all pixels included in the image of the hard tissue, and the segmentation result is reconstructed to obtain the surface structure of the hard tissue. Fig. 7 shows a schematic representation of the segmentation and surface reconstruction of a CT image of hard tissue. The reconstruction of a three-dimensional model image of hard tissue from an image of hard tissue is within the reach of the person skilled in the art and will not be described in detail in this specification for this method.
S160: marking the target surface exposed during operation on the three-dimensional model image of the hard tissue, and determining the three-dimensional model image of the negative model according to the marked target surface.
Step S160 may be performed before surgery, and the "target surface exposed during surgery" is a surface region estimated preoperatively and possibly exposed during surgery, or a surface region planned to be exposed during preoperative surgical planning. That is, S160 may mark the target surface exposed during the "expected" surgery on the three-dimensional model image of the hard tissue.
Step S160 may also be performed during the operation, and then the "target surface exposed during the operation" is the surface area that has been exposed during the actual operation, that is, S160 may be the hard tissue area that is marked on the three-dimensional model image of the hard tissue and is "actually" exposed during the operation.
In the present specification, "exposed to the outside" means that, during an operation, a soft tissue on a target tissue surface is cut and pulled apart so that a hard tissue can be contacted by an instrument at the distal end of a robot arm of a surgical robot, and at this time, a surface region of the hard tissue that can be observed by an image capturing unit mounted on the surgical robot is the target surface "exposed to the outside".
In some embodiments, the surgical robot system further includes a 3D printer, and the operation of making the negative model of the hard tissue model may also be performed by the surgical robot system, that is, after S160, the 3D printer may be further controlled to print the negative model.
In some embodiments, as shown in fig. 6, the negative model used in the hard tissue registration method provided by the present description includes a first surface a, a second surface B, and a mark point, wherein the second surface B is disposed opposite to the first surface a, and the mark point is located on the second surface B of the negative model. Of course, the negative model may have other surfaces besides the first surface a and the second surface B, and the present solution does not limit the shapes of the other surfaces (including the second surface B) except the first surface a.
In some embodiments, as shown in fig. 10, the negative model adopted by the hard tissue registration method provided by the present description may be further based on the negative model shown in fig. 6, and a first interface P is disposed on the second surface B of the negative model, and the first interface P is used for mounting a target with a rod-shaped body before or during surgery, and the target is used for determining the second coordinates of each marking point in the target coordinate system during surgery. The target may comprise a rod-shaped body and a target point arranged at a first end of the rod-shaped body, and a second end of the rod-shaped body is provided with a second interface matched with the first interface. The specific form of the first interface P may be a groove with threads on the inner side as shown in fig. 10, or a stud protruding from the second surface B, or may be other forms as long as it matches with the second interface on the target, and the description does not limit the specific structure of the first interface. Fig. 11 shows a schematic diagram after the target is mounted to the negative model shown in fig. 10, wherein M2 represents the negative model shown in fig. 10, C represents the target, C1 represents a rod-shaped body constituting the target, and C2 represents a labeled point of the target and a labeled surface on which the labeled point is located.
The rod-shaped body C1 on the target C can enable the target C to be still exposed out under the condition that the mark points on the second surface B of the negative model are covered by soft tissues after the target C is installed on the negative model.
In some embodiments, as shown in fig. 13, the negative model used in the hard tissue registration method provided in the present description may be further based on the negative model shown in fig. 6, and a target protruding from the second surface is integrally disposed on the second surface B of the negative model. The target may include a rod and a target point disposed at a first end of the rod, a second end of the rod being integrally disposed on a second surface of the negative model. The rod-shaped body on the target can enable the target to be exposed after the target is installed on the negative model, and under the condition that the mark points on the second surface of the negative model are covered by soft tissues, the target point (the target point refers to the mark points on the target) can still be exposed. It can be seen that the negative model shown in fig. 13 differs from the negative model shown in fig. 10 in that the targets of the negative model shown in fig. 13 are integrally provided on the negative model.
Under the condition that the negative model target and the negative model are integrally arranged, when the coordinate of the target point on the negative model target under the target coordinate system needs to be determined, a mark point entity is usually required to be installed at the position of a mark point on the manufactured negative model entity, a mark ball can be used as the mark point entity, and the material of the mark ball is usually determined according to the acquisition mode of the intraoperative coordinate. For example, the labeled spots may be metal beads, fluorescent beads, or the like.
Fig. 13 shows a structural diagram of a negative model in which a target is integrated with the negative model, wherein f1, f2, f3 and f4 represent target positions, and fig. 14 shows a schematic diagram of the negative model shown in fig. 13 after a ball capable of being tracked is installed at the target position.
S120: and acquiring second coordinates of each mark point in a target coordinate system after the first surface of the negative model is attached to the target surface of the hard tissue.
The target coordinate system may be a coordinate system used for controlling the operation of the surgical robot.
The target coordinate system can be a coordinate system established based on any one fixed point during operation, and a pelvis coordinate system can be established based on one point on the pelvis when the pelvis is operated and is taken as the target coordinate system; when the femur is operated, a femur coordinate system can be established based on one point on the femur, and the femur coordinate system is taken as a target coordinate system; when performing surgery on the tibia, a tibia coordinate system may be established based on a point on the tibia, and the tibia coordinate system may be used as a target coordinate system.
In some embodiments, in order to obtain the pose coordinates of the target portion on the patient in the robot coordinate system during the operation, the pose coordinates of a fixed point on the patient in the robot coordinate system may be determined, and then the pose of the target portion on the patient with respect to a fixed point on the patient may be determined, based on which the pose coordinates of the target portion on the patient in the robot coordinate system may be obtained through a coordinate transformation method. For example, in fig. 8, X represents a pelvis, Y represents a femur, Z represents a skin incision, and M1 represents a negative model shown in fig. 6, when an operation is performed near the hip joint, the patient is in a lying state, and the pelvis is in a fixed posture, a pelvis coordinate system can be established at any point on the pelvis, and then the posture coordinates of the target portion on the patient in the pelvis coordinate system can be determined. In this case, the pelvic coordinate system can be used as the target coordinate system.
S130: and determining a registration matrix of the image coordinate system and the target coordinate system according to the first coordinate and the second coordinate.
After the first coordinates of the plurality of marking points on the negative model in the image coordinate system and the second coordinates of the plurality of marking points in the target coordinate system are known, registration can be carried out according to the first coordinates and the second coordinates.
According to the hard tissue registration method provided by the specification, the hard tissue model is established according to the image of the hard tissue, then the negative model is determined according to the hard tissue model, registration operation is performed by means of the negative model, fast registration can be achieved only by collecting coordinates of 3 points at least, the requirement on an operating doctor is low, and the registration efficiency is high.
In some embodiments, step S20 may employ scheme a: and acquiring second coordinates of each marking point on the negative model under the target coordinate system one by one through the probe.
For example, as shown in fig. 9, coordinates of the marking point on the negative model in the probe coordinate system may be collected by the probe that can be tracked, and then the coordinates of the marking point in the probe coordinate system are transformed into coordinates in the pelvic coordinate system according to the transformation relationship between the probe coordinate system and the pelvic coordinate system (i.e., the target coordinate system). In fig. 9, X denotes a pelvis, Y denotes a femur, Z denotes a skin incision, M1 denotes a negative model shown in fig. 6, T denotes a probe, Q denotes a target of a pelvis coordinate system, and the pelvis coordinate system is set as the target coordinate system.
In some embodiments, step S20 may employ a B scheme, namely: the fourth coordinate of the marking point under the negative model coordinate system is determined before operation, then the position relation between the target of the negative model coordinate system and the target of the target coordinate system is determined during operation, the transformation relation between the negative model coordinate system and the target coordinate system is determined, and the fourth coordinate is transformed under the target coordinate system based on the transformation relation to obtain the second coordinate. Accordingly, S20 may include the following steps B1 to B4.
B1: and acquiring a fourth coordinate of each mark point in a negative model coordinate system.
B2: and acquiring the poses of the target on the negative model and the target of the target coordinate system respectively under the target coordinate system.
The negative model coordinate system may be a coordinate system established according to any point on the negative model, and the target on the negative model is the target of the negative model coordinate system.
The pose of the target on the negative model is obtained, after the negative model is attached to the target surface of a hard tissue in an operation, the tracked probe is adopted to collect the coordinates of the mark points on the target of the negative model under the probe coordinate system, then the coordinates of the mark points on the target of the negative model under the probe coordinate system are transformed to the target coordinate system according to the transformation relation between the probe coordinate system and the target coordinate system, and the pose of the target on the negative model under the target coordinate system is further determined according to the coordinates of the mark points on the target of the negative model under the target coordinate system.
The pose of the target of the object coordinate system is typically determined at the time the object coordinate system is established.
B3: and determining a second transformation matrix from the negative model coordinate system to the target coordinate system according to the poses of the target on the negative model and the target of the target coordinate system in the target coordinate system respectively.
B4: and transforming the fourth coordinates of each marking point to the target coordinate system according to the second transformation matrix to obtain second coordinates of each marking point in the target coordinate system.
The scheme B can be suitable for the situation that the target of the negative model and the negative model are integrally arranged, and can also be suitable for the situation that the target and the negative model are arranged in a split mode.
Fig. 12 can show a schematic diagram of determining the coordinates of the marked point on the negative model in the target coordinate system according to the above steps B1 to B4, wherein X represents the pelvis, Y represents the femur, Z represents the skin incision, Q represents the target of the pelvis coordinate system, and M2+ C represents the assembly of the negative model and the target shown in fig. 11.
Fig. 15 may show another schematic diagram for determining the coordinates of the marker points on the negative model in the target coordinate system according to the above steps B1 to B4, wherein X represents the pelvis, Y represents the femur, Z represents the skin incision, Q represents the target of the pelvis coordinate system, and M3 represents the negative model shown in fig. 13 or fig. 14.
In the steps B1 to B4, the target is arranged on the negative model, so that the coordinates of the mark points on the negative model under the target coordinate system can be predetermined before the operation, and then the preoperatively determined coordinates of the mark points on the negative model under the negative model coordinate system are converted into the coordinates under the target coordinate system through the negative model target and the target of the target coordinate system during the operation, so that the pose of the exposed target only needs to be determined during the operation, the coordinates of the mark points under the target coordinate system can still be conveniently obtained under the condition that the mark points on the second surface of the negative model are covered by soft tissues, and the difficulty of the complex operation is reduced.
In some embodiments, step S20 may employ a C scheme, namely: when the negative model is designed according to the image, the targets of the negative model can be arranged together, so that the coordinates of the target point on the target of the negative model under the image coordinate system can be known. Establishing a target coordinate system based on the coordinates of the target point on the target of the negative model under the image coordinate system, and calculating the transformation relation between the negative model target coordinate system and the image coordinate system before operation; during operation, the pose of the negative model target and the pose of the pelvis target can be determined, and the transformation relation between the negative model target coordinate system and the pelvis coordinate system is determined according to the pose, so that the transformation relation between the image coordinate system and the pelvis coordinate system can be determined. Accordingly, S20 includes the following steps C1 to C5:
c1: and acquiring a fifth coordinate of each target point of the target on the negative model under the image coordinate system.
In step C1, the target on the negative model may be integrally provided with the negative model or may be separately provided. Under the condition of integrated arrangement, a negative model target is integrated when the negative model is designed. When the split type negative model is arranged, the position and even the structure of the negative model target can be designed together when the negative model is designed, so that the negative model target entity and the negative model entity have a unique position relationship after being assembled.
C2: and establishing a negative model target coordinate system based on the fifth coordinate of each target point on the negative model target under the image coordinate system, and determining a third transformation matrix from the image coordinate system to the negative model target coordinate system.
C3: and acquiring the poses of the target of the negative model and the target of the target coordinate system in the target coordinate system respectively.
C4: and determining a fourth transformation matrix from the target coordinate system of the negative model to the target coordinate system according to the poses of the target of the negative model and the target of the target coordinate system in the target coordinate system respectively.
C5: and taking the target points on the negative model target as the mark points, and transforming the fifth coordinate of each target point of the negative model target under the image coordinate system to the second coordinate of each mark point under the target coordinate system according to the third transformation matrix and the fourth transformation matrix.
Fig. 12 can show a schematic diagram of the determination of the coordinates of the marker points on the negative model in the target coordinate system according to the above steps B1 to B4, wherein X denotes the pelvis, Y denotes the femur, Z denotes the skin incision, Q denotes the target of the pelvis coordinate system, and M2+ C denotes the assembly of the negative model and the target shown in fig. 11.
Fig. 15 may show another schematic diagram for determining the coordinates of the marker points on the negative model in the target coordinate system according to the above steps B1 to B4, wherein X represents the pelvis, Y represents the femur, Z represents the skin incision, Q represents the target of the pelvis coordinate system, and M3 represents the negative model shown in fig. 13 or fig. 14.
In the steps C1 to C5, the targets are arranged together when the negative model is designed under the image coordinate system, so that the negative model target coordinate system can be established in advance before the operation, and the transformation relation from the image coordinate system to the negative model target coordinate system is determined, so that the pose of the exposed target is determined only during the operation, and the coordinates of the mark point under the target coordinate system can be conveniently obtained under the condition that the mark point on the second surface of the negative model is covered by soft tissue, thereby reducing the difficulty of the complex operation.
In the above-mentioned solution C, considering that the material of the negative model may cause the target of the negative model to deform due to the acting force of the soft tissue on the hard tissue and other factors, thereby affecting the registration result, when designing the negative model, a check point (e.g., the check point P in fig. 13 and 14) is also set on the second surface of the negative model, so that the relative position relationship between the check point and the negative model target in the image coordinate system can be known, and whether the relative position relationship between the negative model target and the negative model changes or not can be determined according to the relative position relationship. The second coordinate determined by the above scheme C can meet the requirement of accuracy only in the case of no change or little change.
Correspondingly, before the step C3 is executed, the following steps are further included:
d1: obtaining a first positional relationship between a check point on a second surface of the negative model and a target of the negative model; the first positional relationship is determined preoperatively.
D2: after the negative model is attached to the target surface of the hard tissue, a second positional relationship between the check point and the target on the negative model is obtained.
D3: in the case where the deviation of the first positional relationship from the second positional relationship is within the second predetermined threshold range, the above-described step C3 is executed.
In some embodiments, the fitting degree of the negative model to the hard tissue may be manually determined and continuously adjusted in S30, until the fitting degree is manually determined to meet the requirement, the registration matrix is determined directly according to the second coordinate and the third coordinate.
In some embodiments, S30 may also be performed by the controller to determine whether the negative model fits the hard tissue as desired, and determine the registration matrix. In response, S30 may comprise the steps of:
s31: a first transformation matrix between the first and second coordinates is determined using a least squares method.
S32: and calculating a third coordinate obtained by transforming the first coordinate of each mark point by using a first transformation matrix.
In general, during the registration, the first coordinate and the second coordinate of each of the plurality of mark points cannot be accurately registered, so that a very precise transformation matrix cannot be obtained. The transformation matrix may be determined by an optimization method such as a least squares method, and the optimization is aimed at minimizing the difference between the third coordinate and the second coordinate.
The difference between the third coordinate and the second coordinate of each marking point can be the sum of absolute values of differences between the third coordinate and the first coordinate of each marking point, namely (d 1+ d2+ \8230; + dn)/n; or the sum of squares of the difference between the third coordinate and the first coordinate of each marker point, (d 1) 2 +d2 2 +…+dn 2 ) Where d1 represents a difference between the third coordinate and the first coordinate of the first marking point, d2 represents a difference between the third coordinate and the first coordinate of the first marking point, and dn represents a difference between the third coordinate and the first coordinate of the first marking pointAnd the difference value between the third coordinate and the first coordinate of one mark point, wherein n is the number of the mark points.
S33: and judging whether the difference between the third coordinate and the second coordinate of each marking point reaches a preset condition or not.
The predetermined condition may be that a difference between the third coordinate and the second coordinate is within a first predetermined threshold range, or that when the pose of the negative model attached to the hard tissue is adjusted multiple times, and the registration method is performed, the difference corresponding to each adjustment is relatively constant, i.e., is difficult to reduce again.
S34: and if so, taking the first transformation matrix as a registration matrix.
Since the negative model is designed according to the structure of the hard tissue, for example, as shown in fig. 8, 9, 12 and 15, the negative model is designed according to the bone structure of the hip joint, only one pose relationship can ensure the perfect fit between the negative model and the hard tissue under normal conditions, and the perfect fit is difficult to achieve. Generally, it is necessary to perform the registration method and the position relationship between the negative model and the hard tissue many times, so that the accuracy of the registration matrix can meet the requirement.
The present specification provides a hard tissue registration apparatus, which can be used to implement the hard tissue registration method shown in fig. 3. The device comprises: the device comprises a first acquisition unit, a second acquisition unit and a first determination unit.
The first acquisition unit is used for acquiring first coordinates of a plurality of mark points on the negative model in an image coordinate system; the first surface of the negative model is in fit matching with the target surface of the hard tissue model; the image coordinate system is determined when the image of the hard tissue is shot before the operation, and the negative model and the mark points on the negative model are designed and manufactured according to the image of the hard tissue.
The second acquisition unit is used for acquiring second coordinates of each mark point in a target coordinate system after the first surface of the negative model is attached to the target surface of the hard tissue.
And the first determining unit is used for determining a registration matrix of the image coordinate system and the target coordinate system according to the first coordinate and the second coordinate.
In some embodiments, the marker point is located on a second surface of the negative model, the second surface being disposed opposite the first surface.
In some embodiments, a first interface is disposed on a second surface of the negative model, the first interface is used for installing a target, and the target is used for determining second coordinates of each marking point under the target coordinate system during operation; alternatively, the second surface of the negative model is integrally provided with a target protruding from the second surface.
In some embodiments, the first determination unit comprises: a first determining subunit, configured to determine a first transformation matrix between the first coordinate and the second coordinate by using a least square method; the first calculation subunit is used for calculating a third coordinate obtained by transforming the first coordinate of each mark point by using the first transformation matrix; a judging subunit, configured to judge whether a difference between the third coordinate and the second coordinate of each marker reaches a predetermined condition; and the second determining subunit is used for taking the first transformation matrix as a registration matrix of the image coordinate system and the target coordinate system if the first transformation matrix is the registration matrix.
In some embodiments, the second obtaining unit includes: the first acquisition subunit is used for acquiring fourth coordinates of each mark point determined before the operation in the negative model coordinate system; the second acquisition subunit is used for acquiring poses of the target on the negative model and the target of the target coordinate system respectively under the target coordinate system; a target protruding from the second surface is arranged on the second surface of the negative model, and the second surface is arranged opposite to the first surface; the third determining subunit is configured to determine, according to poses of the target on the negative model and the target of the target coordinate system in the target coordinate system, a second transformation matrix from the negative model coordinate system to the target coordinate system; and the first transformation subunit is used for transforming the fourth coordinates of each mark point to the target coordinate system according to the second transformation matrix to obtain the second coordinates of each mark point in the target coordinate system.
In some embodiments, the second obtaining unit includes: the third acquisition subunit is used for acquiring fifth coordinates of each target point of the target on the negative model under the image coordinate system; a target protruding from the second surface is arranged on the second surface of the negative model, and the second surface is arranged opposite to the first surface; the fourth determining subunit is configured to establish a negative model target coordinate system based on a fifth coordinate of each target point on the negative model target in the image coordinate system, and determine a third transformation matrix from the image coordinate system to the negative model target coordinate system; the fourth acquisition subunit is used for acquiring poses of a target of the negative model and a target of the target coordinate system in the target coordinate system respectively; a fifth determining subunit, configured to determine, according to respective poses of the target of the negative model and the target of the target coordinate system in the target coordinate system, a fourth transformation matrix from the negative model target coordinate system to the target coordinate system; and the second transformation subunit is used for transforming a fifth coordinate of each target point of the negative model target under the image coordinate system to a second coordinate of each mark point under the target coordinate system according to the third transformation matrix and the fourth transformation matrix by taking the target point on the negative model target as a mark point.
In some embodiments, the second obtaining unit further comprises: a fifth obtaining subunit, configured to obtain a first positional relationship between the check point on the second surface of the negative model and the target of the negative model; the first positional relationship is determined preoperatively; a sixth acquiring subunit, configured to acquire a second positional relationship between the check point and the target on the negative model after the negative model is attached to the target surface of the hard tissue; in a case where a deviation of the first positional relationship from the second positional relationship is within a second predetermined threshold range, the fourth acquisition subunit performs the acquisition of the poses of the target on the negative model and the target of the target coordinate system respectively in the target coordinate system.
In some embodiments, the apparatus further comprises: a third acquiring unit for acquiring an image of the hard tissue; the reconstruction unit is used for reconstructing a three-dimensional model image of the hard tissue according to the image of the hard tissue; and the marking unit is used for marking a target surface exposed during surgery on the three-dimensional model image of the hard tissue and determining the three-dimensional model image of the negative model according to the marked target surface.
The present description provides a navigation trolley that can be used to implement the hard tissue registration method described in fig. 3.
The present description provides a registration system for hard tissue comprising a controller, a probe, and an optical tracking system. The probe and the optical tracking system are used for acquiring the coordinates of a target point; the controller is used to perform the hard tissue registration method shown in fig. 3.
The present specification provides a computer storage medium having computer program instructions stored thereon which, when executed, implement the steps of the method of figure 3.
It will be understood by those skilled in the art that all or part of the processes of the methods of the embodiments described above can be implemented by a computer program, which can be stored in a computer-readable storage medium, and when executed, can include the processes of the embodiments of the methods described above. The storage medium may be a magnetic Disk, an optical Disk, a Read-Only Memory (ROM), a Random Access Memory (RAM), a Flash Memory (Flash Memory), a Hard Disk (Hard Disk Drive, abbreviated as HDD), a Solid State Drive (SSD), or the like; the storage medium may also comprise a combination of memories of the kind described above.
All the embodiments in the present specification are described in a progressive manner, and the same and similar parts among the embodiments are referred to each other, and each embodiment focuses on the differences from other embodiments. In particular, for the hardware + program class embodiment, since it is substantially similar to the method embodiment, the description is simple, and the relevant points can be referred to the partial description of the method embodiment.
The foregoing description has been directed to specific embodiments of this disclosure. Other embodiments are within the scope of the following claims. In some cases, the actions or steps recited in the claims can be performed in a different order than in the embodiments and still achieve desirable results. In addition, the processes depicted in the accompanying figures do not necessarily require the particular order shown, or sequential order, to achieve desirable results. In some embodiments, multitasking and parallel processing may also be possible or may be advantageous.
Those skilled in the art will also appreciate that, in addition to implementing the controller as pure computer readable program code, the same functionality can be implemented by logically programming method steps such that the controller is in the form of logic gates, switches, application specific integrated circuits, programmable logic controllers, embedded microcontrollers and the like. Such a controller may therefore be considered as a hardware component, and the means included therein for performing the various functions may also be considered as a structure within the hardware component. Or even means for performing the functions may be regarded as being both a software module for performing the method and a structure within a hardware component.
The above description is only an example of the embodiments of the present disclosure, and is not intended to limit the embodiments of the present disclosure. Various modifications and alterations to the embodiments described herein will be apparent to those skilled in the art.
Claims (12)
1. A method of hard tissue registration, comprising:
acquiring first coordinates of a plurality of mark points on the negative model under an image coordinate system; the first surface of the negative model is in fit matching with the target surface of the hard tissue model; the image coordinate system is determined when the image of the hard tissue is shot before an operation, and the negative model is designed and manufactured according to the image of the hard tissue;
after the first surface of the negative model is attached to the target surface of the hard tissue, acquiring second coordinates of each mark point in a target coordinate system;
and determining a registration matrix of the image coordinate system and the target coordinate system according to the first coordinate and the second coordinate.
2. The method of claim 1, wherein the marker point is located on a second surface of the negative model, the second surface being disposed opposite the first surface.
3. The method of claim 2, wherein the second surface is provided with a first interface for mounting a target for determining second coordinates of each marker point in the target coordinate system at the time of surgery;
alternatively, the second surface of the negative model is integrally provided with a target protruding from the second surface.
4. The method of claim 1, wherein determining a registration matrix of the image coordinate system and the target coordinate system from the first and second coordinates comprises:
determining a first transformation matrix between the first coordinate and the second coordinate by using a least square method;
calculating a third coordinate obtained by transforming the first coordinate of each mark point by using the first transformation matrix;
judging whether the difference between the third coordinate and the second coordinate of each mark point reaches a preset condition or not;
and if so, taking the first transformation matrix as a registration matrix of the image coordinate system and the target coordinate system.
5. The method of claim 1, wherein obtaining second coordinates of each marker point in the target coordinate system comprises:
acquiring fourth coordinates of each mark point determined before the operation under the negative model coordinate system;
acquiring poses of the target on the negative model and the target of the target coordinate system under the target coordinate system respectively; a target protruding from the second surface is arranged on the second surface of the negative model, and the second surface is arranged opposite to the first surface;
determining a second transformation matrix from the negative model coordinate system to the target coordinate system according to the poses of the target on the negative model and the target of the target coordinate system under the target coordinate system respectively;
and transforming the fourth coordinates of each mark point to the target coordinate system according to the second transformation matrix to obtain second coordinates of each mark point in the target coordinate system.
6. The method of claim 1, wherein obtaining second coordinates of each marker point in the target coordinate system comprises:
acquiring a fifth coordinate of each target point of the target on the negative model under an image coordinate system; a target protruding from the second surface is arranged on the second surface of the negative model, and the second surface is arranged opposite to the first surface;
establishing a negative model target coordinate system based on a fifth coordinate of each target point on the negative model target under the image coordinate system, and determining a third transformation matrix from the image coordinate system to the negative model target coordinate system;
acquiring poses of a target of a negative model and a target of the target coordinate system under the target coordinate system respectively;
determining a fourth transformation matrix from the negative model target coordinate system to the target coordinate system according to the poses of the target of the negative model and the target of the target coordinate system in the target coordinate system respectively;
and taking the target points on the negative model target as mark points, and transforming the fifth coordinate of each target point of the negative model target under the image coordinate system to the second coordinate of each mark point under the target coordinate system according to the third transformation matrix and the fourth transformation matrix.
7. The method of claim 6, further comprising, prior to obtaining the poses of the target of the negative model and the target of the target coordinate system in the target coordinate system, respectively:
obtaining a first positional relationship between a checkpoint on a second surface of the negative model and a target of the negative model; the first positional relationship is determined preoperatively;
after the negative model is attached to the target surface of the hard tissue, acquiring a second position relation between the check point and the target on the negative model;
and under the condition that the deviation of the first position relation and the second position relation is within a second preset threshold range, acquiring the poses of the target on the negative model and the target of the target coordinate system respectively under the target coordinate system.
8. The method of claim 1, further comprising, prior to obtaining the first coordinates of the plurality of marker points on the negative model in the image coordinate system:
acquiring an image of the hard tissue;
reconstructing a three-dimensional model image of the hard tissue according to the image of the hard tissue;
marking a target surface exposed during surgery on the three-dimensional model image of the hard tissue, and determining the three-dimensional model image of the negative model according to the marked target surface.
9. A hard tissue registration device, comprising:
the first acquisition unit is used for acquiring first coordinates of a plurality of mark points on the negative model in an image coordinate system; the first surface of the negative model is in fit matching with the target surface of the hard tissue model; the image coordinate system is a coordinate system determined when the image of the hard tissue is shot before an operation, and the negative model and the mark points on the negative model are designed and manufactured according to the image of the hard tissue;
the second acquisition unit is used for acquiring second coordinates of each mark point in a target coordinate system after the first surface of the negative model is attached to the target surface of the hard tissue;
and the first determining unit is used for determining a registration matrix of the image coordinate system and the target coordinate system according to the first coordinate and the second coordinate.
10. An image trolley characterized by performing the hard tissue registration method of any one of claims 1 to 8.
11. A hard tissue registration system, comprising:
the probe and the optical tracking system are used for acquiring the coordinates of a target point;
a controller for performing the hard tissue registration method of any one of claims 1 to 8.
12. A computer storage medium, characterized in that it stores computer program instructions which, when executed, implement the steps of the method of any one of claims 1 to 8.
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| CN116363184B (en) * | 2023-05-26 | 2023-10-03 | 杭州三坛医疗科技有限公司 | Hip joint position registration method and device, electronic equipment and storage medium |
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