JP2000350733A - Positioning frame and operation navigating system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a stable structure which can be used even during an operation, to facilitate the loading and unloading even after photographing an inspection image, to make an operation possible in which the installation is possible with good reproducibility before the operation, to facilitate the detection of a marker's position from an inspection image, and to facilitate the identification with the marker's position on a frame installed to a subject. SOLUTION: This positioning frame is installed to a subject, and markers as a mark for the measurement of a position or a posture of the subject are arranged. In this case, engaging parts that engage with the uneven shape of the subject in at least 3 positions (an upper end of a right ear, an upper end of a left ear, and a nose), and 3 or above markers 5 to 11 arranged in required positions, that do not exist on a straight line, in which imaging is possible at least by an image either an X-ray image or an MRI image are provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a positioning frame for a surgical operation used for a surgical operation such as a brain surgery, and a surgical navigation apparatus.

[0002]

2. Description of the Related Art In a surgical operation such as a brain surgery, it is important to measure a positional relationship between a part of a subject to be operated on and a surgical tool used for the operation. At this time, defining the positional relationship between the subject and the surgical tool is called surgical calibration. As a method of the surgical calibration, for example, RHTay1or (ed.), Computer-In
Conventionally, a method using a localized frame has been devised as disclosed in MIT Press, 1996 (hereinafter referred to as Document 1).

[0003] Also, N. Hata, et a1, "Development of a
frame1ess and armless stereotactic neuronavigatio
n system with ultrasonographic registration, "Neur
osurgery, Vol.41, No.3, September 1997, pp.609-614
As disclosed in (hereinafter, referred to as Document 2), there is an attempt to mount a special positioning frame and use the frame to perform coordinate encoding between a subject and an inspection image.

[0004]

However, the method disclosed in the above-mentioned document 1 uses a metal fixing frame and screws a metal marker such as a screw from the body surface of the subject to fix the frame. Since the positioning is performed, a great deal of invasion is given to the subject.

In the method disclosed in Document 2, a positioning frame is formed of an acrylic material, the positioning frame is fixed by a left ear hole and a nose projection, and four metal cubes are placed on the positioning frame. Attach it, use it as a marker, fix the left ear hole and nose protrusion with silicone rubber, extract the marker from the CT image, probe its position on the subject with a probe, and perform actual surgery In the scene, it is a method of performing an operation while observing the marker position with an ultrasonic wave.

[0006] However, the method disclosed in Reference 2 has the following problems.

[0007] 1) Basically, a method of fixing a positioning frame to a subject by two parts is performed, so that positioning accuracy is poor.

2) Since the silicone rubber is fixed to the subject by pushing it into the left ear hole, it is difficult to reattach the subject with good reproducibility once the positioning frame is removed.

3) Since metal materials are used as markers, they cannot be used in MRI images.

[0010] 4) Since the shape of the metallic marker is a cube, the image in the inspection image greatly differs depending on the viewpoint, and it is difficult to define the probe position and the position in the inspection image.

5) Due to the large size of the frame, it is difficult to perform the operation with the frame attached during the operation, and it is possible to use a drape for maintaining a clean environment during the operation. Have difficulty.

On the other hand, Japanese Patent Application Laid-Open No. Hei 7-31834 proposes an auxiliary tool for performing positioning between different kinds of inspection images using a mouthpiece utilizing the tooth shape of a subject as a positioning frame.

However, this frame is basically used for positioning between different kinds of inspection images, and there are portions that are not suitable for use in actual surgery. For example, a connector such as an antenna is used from the mouthpiece to the upper part of the face, and a marker is attached to the tip of the connector. Therefore, it is difficult to perform an operation by draping over the frame. Also, in the case of endoscopic surgery from the nasal cavity, which has recently attracted attention, there is a structural problem that the connector at the center obstructs the endoscope that enters the nasal cavity. Furthermore, since the marker is located at the upper part of the mouthpiece, the vicinity of the oral cavity is the center, and three markers are arranged on the horizontal plane of the head. Because there is a problem in the positioning accuracy in the head, and because it does not cover the upper and central parts of the brain, even if a marker can be detected in the inspection image, the coordinate conversion parameters required for positioning from the upper part of the head to the central part Is more likely to cause a larger error.

The present invention has been made in view of the above points, and is 1) structurally stable that can be used even during surgery, and 2) can be easily attached and detached even after taking an examination image. 3) It is possible to perform surgery that can be mounted with high reproducibility before surgery, and 3) the marker position can be easily detected from the examination image, and the marker position on the frame mounted on the subject can be easily identified. An object of the present invention is to provide a positioning frame.

It is another object of the present invention to provide a surgical navigation apparatus that effectively utilizes such a positioning frame.

[0016]

In order to achieve the above object, a positioning frame according to the present invention is mounted on a subject and provided with a marker serving as a mark for measuring the position or posture of the subject. A positioning frame, at least at three places, which can be imaged with at least one of an X-ray image and an MRI image, and not on a straight line; And three or more markers arranged at predetermined positions.

That is, according to the positioning frame of the present invention, the frame can be fixed with good reproducibility by being fixed at at least three physical unevenness characteristic portions of the subject. The position of the marker in the inspection image can be easily detected by using, as the marker, a member having a shape or a material whose position is easily detected by a frequently used image inspection method. In addition, by stably fixing the marker, the frame is less likely to be displaced with respect to the subject even when drape is applied, and can be used during surgery.

[0018] The above-mentioned constituent physical irregularities include:
In the first embodiment to be described later, this corresponds to the upper end of the right ear, the upper end of the left ear, and the nose projection, but also includes the upper teeth and the inside of the ear.

Further, the surgical navigation apparatus according to the present invention has three or more markers which can be picked up by at least one of an X-ray image and an MRI image and are arranged at predetermined positions which are not linear. Image coordinate calculating means for obtaining the coordinates of a marker in an inspection image coordinate system fixed to this image from an image obtained by imaging the subject to which the positioning frame to be mounted is attached; the image coordinate calculating means; From the measurement results of the marker coordinates,
And a correspondence calculating means for obtaining a correspondence between the inspection image coordinate system and the space coordinate system.

That is, according to the surgical navigation apparatus of the present invention, by using the positioning frame as described above, the subject wears the frame to take an inspection image, and obtains the marker position in the inspection image space. Is detected, and the marker position on the frame mounted on the subject in the real space is measured, and the coordinates of both marker positions are encoded, thereby encoding the coordinates between the inspection image and the subject. With this configuration, it is possible to provide a surgical navigation apparatus that can easily and accurately position the subject and the examination image and that does not burden the subject or cause invasion.

The image coordinate calculation means and the correspondence relation calculation means can be equivalent to a personal computer or a general computer in an embodiment described later.

[0022]

Embodiments of the present invention will be described below with reference to the drawings.

[First Embodiment] FIG. 1A shows a positioning frame 1 according to a first embodiment of the present invention. The positioning frame 1 has a shape such that glasses or goggles are deformed, and includes a glasses-shaped main body 2, a right ear pad 3, and a left ear pad 4.

The positioning frame 1 in the form of glasses is provided with a plurality of markers having a shape whose shape is remarkably expressed in an inspection image. In the case of the first embodiment, seven markers 5, 6, 7, 8, as shown in FIG.
9, 10, and 11 are fixedly mounted.

FIG. 2A is a perspective view of a marker fixedly mounted on a positioning frame 1 in the shape of glasses.
2, an elevation view 13 and a side view 14.
Each of the markers 5 to 11 has a columnar structure as shown in FIG. 2A, and the outer shell portion 15 is made of a ceramic material such as an artificial bone which is prominently expressed by an X-ray image inspection method. It is formed with. A probe recess 17 is provided at the upper end of the marker, and the position of the marker can be measured by probing the recess 17 with a sensor probe or the like described later. The inside of the marker contains an internal solution 16 that is prominently expressed by the MRI imaging method. As this solution,
Copper sulfate based solutions are known to be effective, but are not limited to copper sulfate based solutions.

When only CT is used as the inspection image method, the entire columnar marker may be made of a ceramic material such as artificial bone. When only the MRI is used as the inspection image method, the outer shell 15 of the marker may not be made of a ceramic material, but may be made of a plastic or acrylic material which does not react with a copper sulfate solution. It does not matter.

FIG. 2B shows a marker in a case where the schematic shape of the marker is a cone. When the markers 5 to 11 are conical as described above, there is an advantage that the upper and lower portions of the marker can be easily identified and an advantage that the markers can be stably mounted on the positioning frame main body.

When the subject wears the positioning frame 1 having such a configuration, the positioning frame 1 is fixed by the left and right upper end portions of the subject and the nasal projection of the subject. Has become. Further, when the positioning frame 1 is not used, such as at the time other than the time of taking an inspection image or at the time of an operation, the positioning frame 1 can be removed from the subject.

When the eyeglass-shaped positioning frame 1 is mounted on the subject and is unstable, if the subject is unstable, FIG.
A material (for example, silicone rubber) which solidifies over time as shown in (1) is inserted between the glasses-shaped positioning frame 1 and the body surface of the subject, and is further laminated on the glasses-shaped positioning frame 1. By fixing in this way, it is possible to reliably fix to the subject. That is, FIG. 2 shows a temporally solidified material 18 attached to the forehead of the subject and a temporally solidified material 19 attached to the nose 20 of the subject.

Further, among the above seven markers 5 to 11,
The marker 8 near the center is displaced from the left-right symmetric position on the glasses-shaped positioning frame 1.
This is to make it possible to easily determine whether the coordinate system of the slice image is upward or downward by looking at the center marker 8 and the slice image of the subject's head on the inspection image. It is. That is, it is possible to easily determine which of the right-handed coordinate system and the left-handed coordinate system is being taken just by looking at the slice image.

Next, a surgical navigation apparatus using the positioning frame 1 having the above-described configuration will be described.

FIG. 1B is a block diagram showing a configuration according to the first embodiment of the present invention. X-ray (C
T) An inspection image capturing device 22 that captures an image or an MRI image and converts it into digital image data that can be processed by a computer, and a surgical navigation device 21 of the present invention.

The surgical navigation apparatus 21 includes a surgical tool or an observation tool 23 for actually performing or observing a surgical technique, a three-dimensional position sensor 24 for measuring the position and orientation of the surgical tool or the observation tool 23, A personal computer (P) that receives digital image data from the image photographing device 22, processes the data, and calculates various types of navigation information based on the data of the three-dimensional position sensor 24
C) 25, a monitor 26 for displaying navigation information and image information of the PC.

Before explaining the details of the surgical navigation apparatus 21 having such a configuration, first, terms used in the present invention will be briefly described.

"Coordinate system": In the present invention, several coordinate systems required for navigation are defined. Surgical tools (including observation tools) used for surgery include, for example, endoscopes, surgical microscopes,
It means general tools used for surgery, such as forceps and tweezers. A unique coordinate system can be considered for each of these surgical tools, and the three-dimensional position and orientation of the surgical tool can be defined using the coordinate system E. Here, it is assumed to represent coordinates in the coordinate system (xyz _{coordinates) E (x E, y E} , z E) with.

The examination image obtained by photographing the subject includes MR
Image sets such as I, CT, and SPECT can be considered. These three-dimensional structures can be constructed by integrating a plurality of two-dimensional slice images. Then, for this three-dimensional structure, the inspection image coordinate system P can be defined. The coordinate value in this coordinate system is P
_{(X P, y P, z} P) can be expressed by.

For example, an MRI image will be described as an example. In the case of an MRI image, an inspection image is generally taken along the body axis of the subject, and when the axis is defined as, for example, the Z axis, each slice image can be considered to constitute an xy plane. Therefore, the slice pitch in the z-axis direction is dz (mm / slice), and the image pixel resolution in the x-direction is dx (mm) with the horizontal direction of the slice image as the x-axis.
/ Pixel), and the image pixel resolution of the y-axis method is dy (mm / pixel) with the vertical direction of the slice image as the y-axis.
l), the x-axis, the y-axis, and the z-axis are defined with the inspection image shooting start position as the origin, for example, and the x, x, and
For the index (i, j, k) in the y and z axis directions,
The three-dimensional position in the inspection image is (idx, jdy, k
dz) can be defined. The coordinate system of the inspection image defined in this way is defined as an inspection image coordinate system P (x _P ,
y _P , z _P ).

Further, a coordinate system can be defined for a real space in which a subject actually exists. The real space coordinate system W can be considered as a reference coordinate system defined in the operating room. The coordinate values in this coordinate system _{W (x W, y W,} z W) is expressed by.

"Coordinate encoding": Coding a coordinate between a plurality of coordinate systems means defining a positional relationship between the coordinate systems. That is, encoding a certain coordinate system A and another coordinate system B means that the coordinate conversion from the coordinate system A to the coordinate system B (or the coordinate conversion from the coordinate system B to the coordinate system A) is defined. is there. More specifically, it may be said that a coordinate conversion parameter from the coordinate system A to the coordinate system B is calculated. Mathematically, given the homogeneous transformation matrix as the coordinate transformation parameters, the coordinate values in the coordinate system _{A (x A, y A,} z A) are coordinate values in the coordinate system B _(x B,
y _B, if corresponding to _{z B),} is expressed by 4 × 4 matrix represented by the following _B H _A.

[0040]

(Equation 1)

There are other methods for expressing these than the method using the homogeneous transformation matrix. For example, there are a method using a rotation matrix R and a translation vector t represented by the following equation, a method using a quaternion for the rotation matrix R, and the like.

[0042]

(Equation 2)

As the coordinate conversion parameter, any of the above methods may be used.

“Surgical navigation”: Surgical navigation means processing including surgical calibration and intraoperative navigation. That is, as shown in FIG. 3B, the PC 25 executing the surgical navigation process
First, a surgical calibration process is executed (step S1), and then an intraoperative navigation process is executed (step S2).

"Surgical calibration": This means a process of performing coordinate encoding between the examination image coordinate system and the real space coordinate system where the subject actually exists.

"Intraoperative navigation": The coordinate system of the surgical tool (including the observation tool) E and the real space coordinate system W in which the position and orientation of the subject are defined are coordinated every moment according to the movement of the surgical tool. 1) presenting a position and orientation relationship between a target point (or a target) as a target of an operation and an operating tool; or 2) performing an operation on an examination image coordinate system coordinated with a real space coordinate system. Presenting the position and orientation of the tool is called intraoperative navigation.

FIG. 4 shows the relationship between coordinate systems necessary for assuming intraoperative navigation. In the figure, there is a subject 27 to be subjected to surgery, a surgical tool 28 to be used for surgery, and the above-described three-dimensional position sensor 24 which is a sensor for measuring a three-dimensional position and orientation of the subject 27 and the surgical tool 28.
Including the inspection image coordinate system 29, the three-dimensional position sensor 24, and the object of the object 27 defined by the inspection image including the affected part of the object 27 to be operated on by the inspection image photographing device 22. A real space coordinate system 30 defined in the operating room and a surgical tool coordinate system 31 which is a coordinate system defined by the surgical tool 28 can be considered. In order to encode these coordinate systems, it is necessary to define coordinate conversion parameters between the coordinate systems, and coordinate conversion parameters defining the coordinate conversion 32 from the inspection image coordinate system 29 to the real space coordinate system 30. _W H _P, the coordinate transformation parameters _E H _W defining the coordinate transformation 33 from the real space coordinate system 30 to the surgical instrument coordinate system 31,
Coordinate transformation 3 from inspection image coordinate system 29 to surgical tool coordinate system 31
4 can be considered the coordinate transformation parameters _E H _P defining a.

FIG. 5 shows a basic flowchart of the intraoperative navigation process of step S2 executed by the PC 25.

[0049] That is, first checks whether to end the navigation process in該術(step S21), and if not yet completed, the coordinate transformation _W H _P from the inspection image coordinate system 29 to the real space coordinate system 30 Is calculated (step S2).
2). This utilizes the result obtained in the surgical navigation processing in step S1 described above.

[0050] Subsequently, to calculate the coordinate transformation _E H _W to the surgical instrument coordinate system 31 from the real space coordinate system 30 (step S2
3). For this purpose, the coordinate transformation is calculated by measuring the three-dimensional position and orientation of the surgical tool 28 using the three-dimensional position sensor 24 arranged in the real space.

Next, to calculate the coordinate transformation _E H _P from the inspection image coordinate system 29 to the surgical instrument coordinate system 31 (step S2
4). This is performed by using the results calculated in steps S22 and S23. _{Specifically,} to realize the multiplication of matrix _{E H P = E H W W} H P of 4 × 4.

[0052] Finally, by using the coordinate transformation _E H _P to the surgical instrument coordinate system 31 from the inspection image coordinate system 29 calculated at step S24, which (1) surgical instrument 28 is inspected image coordinate system 29 Position information, and (2) where the diseased part defined in the examination image coordinate system 29 is located in the surgical instrument coordinate system 31 to calculate navigation information necessary for the surgery. Is displayed on the monitor 26 (step S25).

The method of displaying the navigation on the monitor 26 is not the main part of the present invention and will not be described in detail. However, the intraoperative navigation method including coordinate coding will be described below. For example, two types of display methods when the endoscope is used as the surgical tool 28 will be described.

(1) First method: Surgery using three-view drawing
Middle navigation Endoscope coordinate system E (x_E, Y_E, Z_E)
Define and navigate the endoscope to the target
Think about what to do. At this time, the target is
Defined in the inspection image coordinate system 29
P0 (x_P0, Y_P0, Z_P0)
You. As shown in FIG. 6A, the endoscope is now
Considering the defined surgical tool coordinate system, the endoscope is
The endoscope 35 is described as A (x_EA, Y_EA, Z
_EA) And the other end to B (x_EB, Y_EB, Z_EB)
And At this time, the inspection image coordinates are
Coordinate transformation to system 29_PH_E= (_EH_P)^-1Use
And the positions of the distal ends A and B of the endoscope in the inspection image coordinate system 29
(X_PA, Y_PA, Z_PA), (X_PB, Y_PB, Z
_PB) Can be calculated by the following equation.

[0055]

(Equation 3)

Accordingly, as shown in FIG.
When configured in a three-view drawing of an xy plane 36, a yz plane 37, and a zx plane 38, a target point P0 ( _xP0 , y
_{P0, z P0)} and _{(x PA, y PA, z} PA), (x
_PB , _yPB , _zPB ) can be displayed on the three views. As shown in this figure, by displaying the three views, the operator can visually see the relative positional relationship between the surgical tool and the target point as the target.

(2) Second Method: Intraoperative Navigation Using Field-of-View Coordinate Transformation As shown in FIG. 6B, a surgical tool coordinate system 31 relating to an endoscope is defined, and a target object to be a target is defined. Consider navigating an endoscope. In this case, it is assumed that the target is to be defined in the test image coordinate system 29, in the test image coordinate system _{29 (x P, y P,} z P) are defined. On the other hand, the corresponding point in the two-dimensional image coordinate system (the visual field coordinate system 39) defined by the endoscope coordinate system E (the surgical tool coordinate system 31) and the endoscope visual field is defined by the position (u, v) in the image. When expressed, it is expressed by the following nonlinear function.

[0058]

(Equation 4)

Defining this non-linear function is called camera calibration work of the endoscope system.
"A versatilecamera ca1ibration technique for high
-accuracy 3D machine vision metro1ogy using off-th
e-shel TV cameras and lenses, "IEEE Journal of Rob
otics and Automation, Vol.3, No.4, p.323-344, Augu
Since it is described in st 1987., it will not be described here in detail.

In order to calculate a target point which is a target in the subject with respect to the visual field coordinate system 39 of the endoscope when the endoscope moves every moment in the real space, the real space coordinate system 30 is used.
By measuring the position of the endoscope in the three-dimensional position sensor 24. The measurement by the three-dimensional position sensor 24 is equivalent to calculating a coordinate conversion parameter from the real space coordinate system 30 to the endoscope coordinate system E (the surgical tool coordinate system 31). In other words, the calculating the coordinate transformation parameters _E H _W defined by the following equation.

[0061]

(Equation 5)

With this calculation, the position of the target target point defined in the inspection image coordinate system 29 in the endoscope coordinate system (the surgical tool coordinate system 31) is calculated by the following equation.

[0063]

(Equation 6)

Then, the position of the target target point defined in the inspection image coordinate system 29 in the endoscope visual field coordinate system 39 can be calculated by using this expression and the following expression.

[0065]

(Equation 7)

Accordingly, even if the position and orientation of the endoscope changes in the real space, the position of the target as a target can be displayed in the field of view of the endoscope, so that navigation becomes possible.

By applying the above basic operation,
A more complicated navigation display can be provided. For example, if the target is defined as a line drawing of the wire frame in the inspection image coordinate system 29, the position coordinates in the endoscope visual field coordinate system 39 are calculated for the two end points of each line drawing by the method described above, By connecting them with a straight line in the two-dimensional visual field, the wire frame model can be displayed in the endoscope visual field coordinate system 39.

FIG. 8A shows this state. That is, in FIG.
By superimposing the wireframe model 42 on the target 41, the position, size, unevenness and shape of the target 41 can be displayed. With such a display, the operator can more intuitively obtain a sense of the target 41.

In addition, by displaying a vector from the center of the endoscope field of view to the target point and the position in the field of view, even when the target point deviates from the field of view, the direction and distance can be presented. Becomes

As described above, regarding the intraoperative navigation processing,
Although briefly described above, the operation calibration processing in step S1 described above, which is the preceding processing, will be described below.

FIG. 9 shows the basic flow of this surgical calibration process.

First, the positioning frame 1 is mounted on the subject 27, and an inspection image is captured by the inspection image capturing device 22 (step S11). Next, a marker position is detected from the inspection coordinates (step S12). Here, the marker position means the three-dimensional position of each marker in the inspection image coordinate system 29. These positions are (x
_{P (i), y P (} i), z P (i)) ( where, i = 1,
2,..., N). In the positioning frame 1 shown in FIG. 1A, n = 7.

Thereafter, the marker position is measured in the real space where the subject 27 actually exists (step S13). this is,
With respect to the marker detected in step S12, the marker position in the real space coordinate system 30 where the subject 27 actually exists is measured by the three-dimensional position sensor 24, and the inspection image and the real space coordinate system 30 where the subject 27 actually exists are measured. By performing the coordinate encoding with the coordinate system 29, it can be regarded as an operation of aligning the position of the target (target) existing in the inspection image in the real space. The measured three-dimensional position is expressed as (x _W (i), y _W (i), z
_W (i)) (where i = 1, 2,..., N).

Then, the marker position (x _P (i), y _P ) in the inspection image coordinate system 29 detected in step S12
(I), z _P (i)) (where i = 1, 2,..., N) and the marker position (x
_{W (i), y W (} i), z W (i)) ( however, i = 1,
Using (2,..., N), the coordinate encoding is performed between the inspection image coordinate system 29 and the real space coordinate system 30 where the subject 27 actually exists (step S14). Specifically, a coordinate transformation 32 from the inspection image coordinate system 29 to the real space coordinate system 30 is defined.

Hereinafter, each of the above steps will be described in detail.
Here, a case will be described in which an MRI image is used as an inspection image, but, of course, almost the same processing can be performed when a CT image or the like is used as an inspection image.

First, step S11 will be described. That is, in step S11, the subject 27
Attach the positioning frame 1 to. Positioning frame 1
If the fixing of the positioning frame 1 is not reliable, the positioning frame 1 is adjusted using the temporally solidified materials 18 and 19 as shown in FIG. . After that, an inspection image is taken of the subject 27 to obtain inspection image data composed of a slice image group.

Next, step S12 will be described. That is, in step S12, a marker area is extracted from the inspection image data, and a marker position in the inspection image coordinate system 29 is calculated. Inspection image data is composed of a group of slice images.
An area corresponding to 11 is extracted.

For example, a case where a cylindrical marker as shown in FIG. 2A is used will be described.
Since the solution 16 that remarkably reacts with the MRI inspection image is enclosed in the circular marker, the marker region 43 is provided in the MRI slice image 4 as shown in FIG.
In 4, the brightness difference from the head region 45 of the subject becomes significant. Further, since the marker is mounted on the positioning frame 1, the marker is separated from the head region 45 of the subject 27 as a region. Based on such knowledge, an MRI image having a density within a certain range can be defined as a marker area. That is, if the density g (i, j) of each pixel (i, j) of the MRI image satisfies the following expression, the pixel is registered as a marker area candidate. Note that g _min and g _max in the following equation are constants.

[0079]

(Equation 8)

After the above processing is performed on each slice image, the data of the marker area candidates is combined as three-dimensional volume data.

Then, the marker area registered as the volume data is three-dimensionally labeled.
A geometric feature value is calculated for each of the labeled volume areas, and it is next determined whether the volume area really corresponds to the marker area. Indices used for this determination include 1) the volume of the volume area, 2) the radius and the length of the main axis (rotation axis) when the volume area is approximated by a cylinder, and these are within a certain range. Is adopted as the marker volume area.

FIG. 10A shows an example of such registered data.
This is a model of a marker volume area. This
When modeling the marker, the marker is attached to the marker shell 46 and the marker.
For the solution area 47 inside the laser and the depression 48 for the probe
The main axis 49 of the marker internal solution area 47,
Is the end point A5 of the spindle which is an end point in the marker internal solution area 47.
0 and a spindle end point B51 are defined. At this time, the spindle end point A
50 and the coordinate value of the spindle end point B51 in the inspection image coordinate system 29
With (x_a, Y_a, Z_a), (X_b, Y _b, Z
_b). On the other hand, the mask defined by the inspection image coordinate system 29
The marker position 52 corresponds to the probe recess in FIG.
Within 48, the main shaft 49 and the marker shell 46 intersect outside
Point, and its coordinate value is in the inspection image coordinate system 29.
(X_m, Y_m, Z_m), The spindle end point A50
The distance from the power position 52 is an interval d53.

At this time, when the spindle end point A50 and the spindle end point B51 are calculated by the above-described method, the marker position 52 can be calculated by the following equation.

[0084]

(Equation 9)

As described above, as the method of step S12,
Although the method of calculating the marker position by an image processing method has been described, the operator may, of course, manually detect the marker position while checking the inspection image.

Thus, the position of the marker mounted on the positioning frame 1 in the inspection image coordinate system 29 is detected. The number of currently detected marker as n, their position _{(x p (i), y} p (i), z p (i))
(However, i = 1, 2,..., N).

On the other hand, in the case of a CT image, the following processing is performed. That is, since the marker image appearing in the CT examination image is the outer shell 46 of the marker, in each CT image,
The area of the marker outer shell 46 is extracted. Then MR
These are three-dimensionally reconstructed as in the case of the I image. Inside the outer shell 46, there is an empty packet that is extracted in the MRI image but not in the CT image.
These are approximated as cylindrical shapes by the filling process. By performing the same processing as in the case of the MRI image on the cylindrical shape approximated in this way, the marker position corresponding to the probe recess 48 can be measured.

The schematic shape of the marker is shown in FIG.
In the case of having a cone or its cut shape or a conical depression as shown by, the marker position is extracted as in the case of the cylindrical shape by defining the upper end portion or the bottom of the depression as the marker position It is clear that we can do it.

Next, step S13 will be described. This step S13 corresponds to a calibration process (coordinate encoding process) performed immediately before performing surgery on the subject 27. This step S13
Is performed as shown in FIG.

That is, first, the subject 27 mounts the positioning frame 1 used at the time of photographing the examination image again, and confirms that the positioning frame 1 is mounted at the same place as that at the time of photographing (step). S131). On this occasion,
The hardened materials 18 and 19 with time work effectively so as to determine the positioning.

Next, when it is necessary to create a clean environment in the operation, an iodine-containing drape or the like is applied from above the positioning frame 1 (step S132). When applying the drape, at least three “markers 5 arranged on the positioning frame 1”
-11 (tip 48)) so as not to be hidden in the drape. As a result, the body surface of the subject 27 and the positioning frame 1 that have been handled in a dirty environment before drape can be controlled in a clean environment.

Then, the position of the subject 27 in the real space is encoded using the three-dimensional position sensor 24 usable in a clean environment (step S13).
3). Examples of the three-dimensional sensor 24 described here include a sensor probe for a probe. In this sensor probe, in the reference coordinate system (real space coordinate system 30) defined in the real space, the top of the marker (probe) which is not hidden by the drape and which is not hidden by the drape (probe) By using the probe in the real recess 48), the position of the marker in the real space coordinate system 30 is measured.

As such a sensor probe, an optical sensor system capable of detecting infrared rays, a mechanical sensor system using a mechanical arm, and the like can be used.

Here, in the former optical sensor system capable of detecting infrared rays, a plurality of infrared light emitting diodes (LEDs) are mounted on a sensor probe, and a compound eye CCD camera (stereo camera) for detecting the light emission of the infrared light emitting diodes. (Located in the real space coordinate system 30)) and measures the position of the light emitting diode in the real space coordinate system 30 based on the principle of triangulation. When the positions of the individual light emitting diodes can be measured in this way, the position of the tip of the probe can be measured in the real space coordinate system 30.

On the other hand, in the latter mechanical sensor system using a mechanical arm, the rotation of the arm is detected by using an encoder or the like, and the position of the probe at the tip of the mechanical sensor is detected according to the rotation. As in the case of the optical sensor system capable of detecting infrared rays, the position of the probe at the tip in the real space coordinate system 30 can be measured.

Using such a sensor probe, the position of the marker detected in step S12 is determined by (x _W (i), y _W (i), z) in the real space coordinate system 30.
_W (i)) (where i = 1, 2,..., _M ).

Next, step S14 will be described. That is, not all of the markers detected in step S12 can be measured in step S13. Therefore, in step S14, these markers are associated with each other, and step S12 and step S12 are performed.
13 markers both sensed by the rearranged so as to correspond, their _{coordinates, (x P (k),} y P (k), z P (k)) (x W (k), y
_{W (k), z W (} k)) , however, k = 1,2, ..., and n.

In the present step S14, the inspection image coordinate system 29 and the real space coordinate system 30 are subjected to coordinate encoding. That is, from the inspection image coordinate system 29 to the real space coordinate system 30
Will be calculated. This can be mathematically described as _{W W P} expressed by the following equation.
Or it becomes a problem of estimating (R, t).

[0099]

(Equation 10)

Now, let the barycenter vectors of the marker group in both coordinate systems be (x _W ^mean , y _W ^mean , z _W ^mean ),
If (x _P ^mean , y _P ^mean , z _P ^mean ), the following equation is established, and the translation vector and the rotation matrix can be calculated by different equations.

[0101]

[Equation 11]

Here, as a method of solving the above equation for i = 1, 2, 3, there is a quaternion method (quaternion method). See BKPHorn, “Closed-fom s
o1ution of abso1ute orientation using unit quatern
ions, "Journal of OpticalSociety of America A, Vo
l.4, No.4. 1987, pp.629-642.
The details are omitted here.

[0103] In this way R, t is calculated, it is clear that it is also easily calculated homogeneous transformation matrix _W H _P. Specifically, the elements of R are r _ij , and the elements of t are (t _x , _ty ,
When t _z ) can be described as follows.

[0104]

(Equation 12)

Next, step S15 will be described. That is, in the above step S14, the inspection image coordinate system 29
And the coordinate encoding between the real space coordinate system 30 are obtained, the coordinate conversion parameters from the inspection image coordinate system 29 to the real space coordinate system 30 have been calculated. By measuring the position and orientation of the surgical instrument, navigation of the surgical tool 28 can be performed. Since the method is described above, it is omitted here.

As described above, by using the positioning frame 1 described in the first embodiment, the positioning (calibration) of the operation can be performed even in a practical operation scene which has been a problem in the past. The necessary processing can be easily achieved. More specifically, the following effects are obtained.

1) The positioning frame 1 is a structurally stable positioning frame that can be used during surgery.

2) It can be easily attached and detached even after taking an examination image, and it is possible to carry out surgery by attaching it with good reproducibility before surgery.

3) The marker position can be easily detected from the inspection image, and the marker position on the frame mounted on the subject 27 can be easily identified.

[Second Embodiment] (Method of Using Secondary Marker Plate) Next, a second embodiment of the present invention will be described.

In the first embodiment, the method of using the positioning frame 1 directly during the operation has been described.
In the embodiment of the present invention, even if the positioning frame 1 is not removed during the operation, the three-dimensional position sensor 24 can effectively use the marker measurement, and the subject 27 moves during the operation, While following the body movement, the inspection image coordinate system 2
9 and a method capable of performing coordinate coding on the real space coordinate system 30.

As described in the first embodiment, as the three-dimensional position sensor 24 for measuring the position of a marker, an optical sensor system capable of detecting infrared rays can be used. The features of this system can be used for other applications as well as probing marker positions. Specifically, a plate on which a plurality of infrared light emitting diodes LED are mounted is used, and a coordinate system defined by the plate is used as a temporary system reference coordinate system. That is, by fixedly mounting the plate on the subject 27, the body movement of the subject 27 is canceled out as the movement of the plate, and the movement of the surgical tool 28 is defined as the relative movement from the plate. Become.
With such a method, the relative positional relationship between the surgical tool coordinate system 31 defined by the surgical tool 28 and the inspection image coordinate system 29 defined by the subject 27 can be measured every moment.

The method will be described below. FIG. 11A shows a basic configuration of the second embodiment. In the figure, a positioning frame 1 is mounted on the subject 27, and a secondary marker plate 54 is mounted separately from the positioning frame 1. A secondary marker 55 is provided on the secondary marker plate 54. In this case, a plurality of secondary markers 55 that can be optically recognized by the three-dimensional position sensor 24 are provided. As the secondary marker 55, the infrared light emitting diode L described above is used.
ED etc. are good.

FIG. 12 is a diagram showing the relationship of the coordinate system when such a secondary marker plate 54 is used. FIG.
In the second embodiment, a secondary marker plate coordinate system 56, which is a coordinate system related to the secondary marker plate 54, is defined in addition to the coordinate system and the coordinate transformation described above. A coordinate transformation 57 to the real space coordinate system 30 is also defined. In the coordinate transformation 57, the parameters are defined by measuring the position of the secondary marker 55 on the secondary marker plate 54 by the three-dimensional position sensor 24. Also, a coordinate transformation 58 from the secondary marker plate coordinate system 56 to the inspection image coordinate system 29 is defined.

In the surgical calibration according to the second embodiment, steps S13 and S14 of the steps of the first embodiment shown in FIG. 9 are different.

That is, step S13 in the second embodiment is configured to include the above-described step S14. Hereinafter, step S13 will be described.

FIG. 13 is a flowchart showing details of the processing in step S13 in the surgical calibration processing shown in FIG.

That is, as shown in FIG.
7 is mounted with the positioning frame 1 (step S13).
A). Subsequently, the secondary marker plate 54 is mounted on the subject 27 (Step S13B). Thereafter, in order to generate a clean environment for the operation, a drape is mounted on the positioning frame 1 and the secondary marker plate 54 as necessary (step S13C). At this time, drape is applied while paying attention so that the positioning frame 1 does not move.

Then, the marker position on the positioning frame 1 is measured by the three-dimensional position sensor 24, and the real space coordinate system 30
Is obtained (step S13D). Thereafter, a coordinate conversion parameter from the real space coordinate system 30 to the inspection image coordinate system 29 is calculated (step S13).
E). Next, the position of the secondary marker 55 in the real space coordinate system 30 is measured by the three-dimensional position sensor 24 to calculate a coordinate conversion parameter from the secondary marker plate coordinate system 56 to the real space coordinate system 30. (Step S13F). Finally, a coordinate conversion parameter from the secondary marker plate coordinate system 56 to the inspection image coordinate system 29 is calculated (step S13G).

Here, the above steps S13A to S13
G will be described in more detail. First, the above step S13A
Will be described. In this step S13A,
The positioning frame 1 is mounted on the subject 27. The mounting can be performed in the same manner as described in the first embodiment.

Next, step S13B will be described. In this step S13B, the secondary marker plate 54 is mounted on the subject 27. The mounting position of the secondary marker plate 54 is, for example, the forehead portion of the subject 27 as shown in FIG.
It must be a place where is easily fixed and mounted, and a position whose position can be easily measured by the three-dimensional position sensor 24. When the secondary marker plate 54 is mounted, the fixing to the subject 27 is assisted by utilizing the temporally solidified materials 18 and 19 as described in the first embodiment. You may think about it.

Next, step S13C will be described. In this step S13C, if necessary, a drape is applied from above the positioning frame 1 and the secondary marker plate 54 to generate a clean environment necessary for the operation. At this time, drape is applied while taking care not to change the position of the positioning frame 1 with respect to the subject.
This processing is the same as that described in the first embodiment.

Next, step S13D will be described. In this step S13D, the marker position on the positioning frame 1 is measured using the three-dimensional position sensor 24. This measuring method is the same as that described in the first embodiment. Of course, the positions of the markers 5 to 11 on the positioning frame 1 are defined in the real space coordinate system 30.

Next, step S13E will be described. In this step S13E, a coordinate conversion parameter from the real space coordinate system 30 to the inspection image coordinate system 29 is calculated. This method is also the same as that described in the first embodiment, and a detailed description thereof will be omitted.

Next, step S13F will be described. Since the secondary marker plate 54 is formed of a fixed plate, the position of the secondary marker 55 in the secondary marker plate coordinate system 56 can be measured and defined in advance. Now, assuming that the number of the secondary markers 55 is m, the positions defined in the secondary marker plate coordinate system 56 are (x _L (i), y _L (i), z _L (i)) (where
i = 1, 2,..., m).

In this step S13F, the actual sky
The three-dimensional position sensor 24 arranged in the
To measure the position of the secondary marker 55. The method first
Same as described. Thus, the three-dimensional position sensor 2
4 is the position of the secondary marker 55 in the real space.
And its coordinate value is (x_W(I),
y_W(I), z_W(I)) (where i = 1, 2,...,
m). At this time, the secondary marker plate coordinate system 56
From the coordinate conversion parameter to the real space coordinate system 30 _WH_L
Then, the following equation is established.

[0127]

(Equation 13)

By calculating _W H _L that satisfies this equation,
A coordinate conversion parameter from the secondary marker plate coordinate system 56 to the real space coordinate system 30 can be determined. This method corresponds to step S14 in the first embodiment.
Since it can be calculated by a method (quaternion method) similar to that described above, the details will not be described here. By obtaining the coordinate conversion parameters, step S13
F ends.

Next, step S13G will be described. In this step S13G, a coordinate conversion parameter from the secondary marker plate coordinate system 56 to the inspection image coordinate system 29 is calculated. For this, the two coordinate transformations obtained in steps S13E and S13F are used. Specifically, the coordinate conversion parameter from the real space coordinate system 30 obtained in step S13E to the inspection image coordinate system 29 is _P H _W , and the secondary marker plate coordinate system 56 obtained in step S13F is The coordinate conversion parameter to the real space coordinate system 30 is _W
Assuming that H _L , the coordinate conversion parameter _P H _L from the secondary marker plate coordinate system 56 to the inspection image coordinate system 29 is calculated as a multiplication of a 4 × 4 matrix of _P H _L = _P H _{W W} H _L be able to.

The intraoperative navigation processing according to the second embodiment is performed as shown in the flowchart of FIG.

That is, first, it is checked whether or not this intraoperative navigation processing is to be terminated (step S2A). If not, the secondary marker plate coordinate system 56 obtained above is transferred to the real space coordinate system 30. obtaining a coordinate transformation parameters _W H _L in (step S2B).

Subsequently, the 3 defined by the real space coordinate system 30
Using the dimension position sensor 24, it calculates a coordinate transformation parameter _P H _L from the secondary marker plate coordinate system 56 to the inspection image coordinate system 29 (step S2C). Actually, 2
When the next marker 55 is composed of an infrared LED, the position of the infrared LED is measured by the three-dimensional position sensor 24, and the information from the secondary marker plate coordinate system 56 is used for inspection by using information on the arrangement definition of the LED. A coordinate conversion parameter _P H _L to the image coordinate system 29 is calculated.

[0133] Subsequently, to calculate the coordinate transformation _E H _W to the surgical instrument coordinate system 31 from the real space coordinate system 30 (step S2
D). For this purpose, the coordinate transformation is calculated by measuring the three-dimensional position and orientation of the surgical tool 28 using the three-dimensional position sensor 24 arranged in the real space.

[0134] Next, to calculate the coordinate transformation _E H _P from the inspection image coordinate system 29 to the surgical instrument coordinate system 31 (step S2
E). This is performed by using the results calculated in steps S2B to S2D. _{Specifically, E H P = E H W} W H L L H P = E H W W H L (P H
_L ) ^-1 is realized by multiplication of a 4 × 4 matrix.

Finally, using the coordinate transformation 34 from the examination image coordinate system 29 to the surgical tool coordinate system 31, (1)
Where the surgical tool 28 is in the inspection image coordinate system 29,
(2) By calculating where the affected part defined in the examination image coordinate system 29 exists in the surgical instrument coordinate system 31, navigation information necessary for the operation is calculated and displayed on the monitor 26. Will do. The method is the same as the method described in the first embodiment.

By adopting the second embodiment as described above, since the positional relationship between the inspection image coordinate system 29 and the secondary marker plate coordinate system 56 is fixed, the movement of the subject 27 Even if the inspection image coordinate system 29 moves with respect to the real space coordinate system 30, the movement component can be canceled out by measuring the movement in the secondary marker plate coordinate system 56. Therefore, the inspection image coordinate system 29 is also affected by the body movement of the subject 27.
The coordinate transformation 34 from to the surgical tool coordinate system 31 can be measured, and surgical navigation can be performed.

[Third Embodiment] (Removable Marker) Next, a third embodiment of the present invention will be described.

In the first embodiment, MRI and C
The marker whose position can be detected in both of the T images has been described. In the second embodiment, the infrared light LE
The surgical navigation method using the marker plate 54 in which D is the secondary marker 55 has been described. According to the method as in the second embodiment, it is necessary to prepare a marker plate 54 different from the positioning frame 1. This is because it is difficult to mount a metal component such as an infrared LED and take an inspection image such as an MRI.

Therefore, in the third embodiment, the positioning frame 1 has a structure in which a metal marker such as an infrared LED marker or a marker plate can be attached and detached as necessary.

FIG. 11B is a diagram showing the configuration of the positioning frame 1 according to the third embodiment to which such a removable secondary marker plate 59 is applied.
FIG. 2 shows a case where a secondary marker plate 59 on which a secondary marker 60 is mounted is mounted on the positioning frame 1. In this case, the secondary marker plate 59
It has a detachable structure, and when it is mounted as shown in the figure, it has a structure that can be mounted on the positioning frame 1 with high accuracy and high reproducibility.

Now, as shown in FIG. 11B, the secondary marker
With the plate 59 attached, the secondary marker
Position in the secondary marker plate coordinate system specified by the label 59
To (x_L(I), y_L(I), z_L(I)) similar seat
In the coordinate system, the position of the marker on the positioning frame 1 is represented by (x
_M(J), y_M(J), z_M(J)),
The position of the secondary marker 60 on the
Measurement by the three-dimensional position sensor 24 specified by the coordinate system
From the secondary marker plate coordinate system to the real space coordinate system
Transformation parameters to_WH_LCan be calculated
You. By utilizing this coordinate transformation, positioning
Position of the marker on the room 1 in the real space coordinate system (x
_W(J), y_W(J), z_W(J)) is calculated by the following equation.
Can be calculated.

[0142]

[Equation 14]

That is, the position of the marker on the positioning frame 1 can be calculated in the real space coordinate system without performing a probe.

That is, by adopting the removable secondary marker plate 59, the secondary marker plate 59 can be used.
The position of the upper marker 60 is directly determined by the three-dimensional position sensor 24.
And the position of the marker on the positioning frame 1 in the real space coordinate system can be calculated.

The subsequent operation calibration processing is as follows.
Since this is the same as that described in the second embodiment, it is omitted here.

In the third embodiment, the secondary marker plate 59 is used. However, the secondary marker 60 does not need to be set on the secondary marker plate 59. For example, the secondary marker itself may be of a form that can be screwed directly onto the positioning frame 1. Even in such a case, similarly, the position of the secondary marker can be defined on the positioning frame 1 with high reproducibility, so that the marker on the positioning frame is not probed in the real space coordinate system as in the above method. Surgery calibration can be simplified in that the position of the marker in the positioning frame can be calculated.

As described above, by using the removable secondary marker 60 or the secondary marker plate 59, the inspection image coordinate system and the real space coordinate system can be used without probing the marker on the positioning frame 1. This makes it possible to encode coordinates with the system, and has the following effects: 1) simplification of surgical calibration, and 2) simplification of maintaining a clean environment by not using a probe.

Although the present invention has been described based on the embodiments, the present invention is not limited to the above-described embodiments, and various modifications and applications are possible within the scope of the present invention. . Here, the summary of the present invention is as follows.

(1) A marker which is placed in a predetermined positional relationship with the subject and serves as a mark for measuring the position or orientation of the subject. The marker includes a hollow outer shell formed using a ceramic material and the hollow shell. A copper sulfate-based solution put in the part,
A marker comprising:

That is, by using a marker having such a configuration, it is possible to capture an X-ray (CT) image and an MRI image, which are often used in medical treatment.

(2) The marker according to (1), wherein the outer shape of the marker is conical.

That is, by using a marker having such a configuration, the marker can be easily distinguished from the upper and lower portions, and can be stably mounted on the positioning frame.

(3) The positioning frame according to claim 1 or 2, wherein the markers are arranged asymmetrically.

That is, by arranging the markers asymmetrically on the positioning frame, the direction of the slice image can be easily determined.

(4) At least X-ray images or MRI
From an image of a subject mounted with a positioning frame having three or more markers arranged at predetermined positions that are not linear and can be imaged with any one of the images, the image is fixed to this image. The image coordinate calculating means for obtaining the coordinates of the marker in the inspected image coordinate system, the output of the image coordinate calculating means, and the measurement result of the coordinates of the marker in the actual space coordinate system, the inspection image coordinate system and the space First correspondence calculating means for finding a correspondence between coordinate systems;
Second correspondence calculating means for determining a correspondence between the spatial coordinate system and a surgical tool coordinate system fixed to the surgical tool from a measurement result of coordinates of the surgical tool in the spatial coordinate system; And a third correspondence calculating means for obtaining a correspondence between the examination image coordinate system and the surgical tool coordinate system from an output of the correspondence calculating means.

The image coordinate calculating means, the first correspondence calculating means, the second correspondence calculating means, and the third correspondence calculating means correspond to the PC in the embodiment. Here, the image coordinate calculating means and the first and second correspondence calculating means are functional means corresponding to the surgical calibration processing, and the third correspondence calculating means is a functional means corresponding to the intraoperative navigation processing. . Note that the measurement of the coordinates of the marker in the actual spatial coordinate system is performed by a three-dimensional position sensor in the embodiment.

According to the surgical navigation apparatus having such a configuration, the target position can be grasped by the position on the captured image, so that the positional relationship between the target, the surgical tool, and the subject can be quantitatively grasped as numerical data. , You can get the data needed for surgical navigation.

(5) A display means capable of displaying the positional relationship between the subject, the target, and the surgical tool in a plurality of images having different observation directions using the outputs of the first to third correspondence relation calculation means. The surgical navigation device according to (4), further comprising:

(6) The apparatus further comprises a display means capable of displaying an image having a line of sight in the direction in which the surgical tool is facing, using the output of the first to third correspondence relation calculation means. The navigation device according to (1).

(7) At least X-ray images or MRI
From an image obtained by imaging a subject mounted with a first positioning member having three or more markers arranged at predetermined positions that can be imaged in any one of the images and are not on a straight line, The image coordinate calculation means for obtaining the coordinates of the marker in the inspection image coordinate system fixed to the image, the image coordinate calculation means, and the measurement result of the coordinates of the marker in the actual space coordinate system, the inspection image coordinate system and the From the result of measuring the coordinates of the second positioning member attached to the subject in the spatial coordinate system during the operation, the results of the correspondence calculating means are obtained from the correspondence calculating means for obtaining the correspondence of the spatial coordinate system. A surgical navigation device comprising: a correction unit that corrects the operation.

The image coordinate calculating means, correspondence calculating means, and correcting means correspond to the PC in the embodiment. Note that the measurement of the coordinates of the marker in the actual spatial coordinate system is performed by a three-dimensional position sensor in the embodiment. Further, the first positioning member corresponds to the positioning frame in the embodiment, and the second positioning member corresponds to the secondary marker plate in the embodiment.

According to the surgical navigation apparatus having such a configuration, even if the inspection image coordinate system moves with respect to the spatial coordinate system due to the body movement of the subject, the moving component can be corrected by the correction means. Becomes possible.

(8) The surgical navigation device according to (7), wherein a plurality of markers made of infrared light emitting diodes are attached to the second positioning member.

(9) The surgical navigation device according to (7) or (8), wherein the second positioning member is detachably attached to the first positioning member.

That is, by adopting the detachable second positioning member, the second positioning member is measured and the first positioning member is measured.
Of the positioning member in the spatial coordinate system can be calculated.

(10) In a positioning frame that is fixed by using at least three physical irregularities of the subject, at least three markers that are not on a straight line are mounted on the frame, and the markers are at least X Line or /
And a member including a material capable of detecting a position in an MRI examination image.

Here, in the embodiment, the above-mentioned physical irregularities correspond to the upper end of the right ear, the upper end of the left ear, and the nose projection, but also include the upper teeth and the inside of the ear.

According to the positioning frame having such a configuration, the frame can be fixed with good reproducibility by fixing the frame at at least three physical irregularities of the subject. The position of the marker in the inspection image can be easily detected by using, as the marker, a member having a shape or a material whose position can be easily detected by an image inspection method often used in (1). In addition, by stably fixing the marker, the frame is less likely to be displaced with respect to the subject even when drape is applied, and can be used during surgery.

(11) In a surgical calibration apparatus using a positioning frame fixed by using at least three physical irregularities of a subject, at least three markers that are not on a straight line are mounted on the frame. ,
The marker is composed of a member including a material capable of detecting a position in at least an X-ray or / and an MRI examination image. By detecting the marker position, and measuring the marker position on the frame that the subject wears in the real space, and encoding both marker position coordinates,
A surgical navigation apparatus for encoding an examination image and coordinates of a subject.

According to the surgical navigation device having such a configuration, the positioning between the subject and the examination image can be easily and accurately performed by using the positioning frame described in the above (10). In addition, surgical navigation can be performed with less burden and invasion of the subject.

(12) The positioning frame according to (10), wherein at least the upper end of the right ear, the upper end of the left ear, and the nose projection are used as the physical irregularities of the subject.

(13) The surgical navigation apparatus according to (11), wherein at least the upper end of the right ear, the upper end of the left ear, and the nose projection are used as the physical unevenness of the subject.

(14) The surgical navigation apparatus according to (11), wherein the positioning is adjusted using a material that solidifies over time when the frame is fixed to the body unevenness of the subject.

According to the surgical navigation apparatus having such a configuration, by using a material which solidifies with time, it is possible to cope with a variety of shapes of the head of the subject and to stabilize the grounding place. This allows for more accurate positioning for surgical navigation.

(15) When measuring the marker position of the frame in the real space, the coordinate between the inspection image and the subject is encoded by probing the corresponding marker position using the three-dimensional position sensor. The surgical navigation device according to (11), which is characterized in that:

(16) The surgical navigation device according to (15), wherein the three-dimensional position sensor is an optical sensor system capable of detecting infrared rays.

(17) Attach the frame to the subject,
The surgical navigation device according to (15), wherein after applying an iodine-containing drape, a transparent drape, or a translucent drape, a marker group on the frame is probed from above the drape.

According to the surgical navigation apparatus having such a configuration, a marker can be probed from above the drape, thereby realizing a clean environment during the operation.
Operation efficiency and safety can be improved.

(18) The subject is located on the positioning frame
After attaching the next marker plate and performing coordinate coding of the positioning frame and the secondary marker plate, the position of the secondary marker in the inspection image is defined, and the relative position between the secondary marker frame and the surgical tool is three-dimensionally determined. The surgical navigation device according to (15), wherein the relative position between the subject and the surgical tool is measured by measuring with the position sensor.

That is, according to the surgical navigation apparatus having such a configuration, the three-dimensional position sensor can directly measure the marker position by using the secondary marker frame. Therefore, even if the positioning frame is shifted during the operation, there is an advantage that the navigation does not shift unless the secondary marker is shifted.

(19) The marker or the secondary marker plate is detachable.
The positioning frame according to 0).

That is, since the marker or the secondary marker can be attached and detached, there is an advantage that injuries do not occur due to the characteristics of the marker member during photographing of the examination image, and that the calibration between the examination images and the surgical calibration become easy. is there.

(20) The positioning frame according to (10), wherein the marker has a substantially cylindrical shape, and the upper end thereof is defined as a marker position.

That is, by using a cylindrical marker,
After the cylindrical marker is extracted from the image, the position coordinates defined as the marker position can be easily detected.

(21) The positioning according to (10), wherein the marker has a conical or truncated or conical depression, and the upper end or the bottom of the depression is defined as the marker position. The surgical navigation device according to (11), further comprising a frame.

That is, by using the cone marker, when the ridge line of the cone marker in the image is extracted, the tip position can be easily measured, and the position defined as the marker can be easily calculated.

(22) The surgical navigation apparatus according to (11), wherein the shape of the marker image in the examination image space is recognized, and the marker position is measured from the marker shape image.

According to the surgical navigation apparatus having such a configuration, the marker position can be automatically extracted without the operator manually determining the position, so that efficient surgical positioning can be performed.

(23) A positioning frame characterized in that a marker is formed by combining a member which is easily detected by the first image inspection method and a member which is easily detected by the second image inspection method.

For example, a marker is prepared by injecting a solution expressed by MRI into a ceramic container expressed by CT, and by using a member which is easy to detect in a heterogeneous inspection image, a marker is manufactured by combining the members. Then, the position of the marker can be easily detected in each inspection image, and positioning between different types of inspection images can be easily performed.

(24) The positioning frame according to (23), wherein the first and second image inspection methods are X-ray and MRI.

(25) The positioning frame according to (10), wherein at least one of the markers mounted on the positioning frame is located at an asymmetrical position in the left-right direction.

That is, since at least one marker position is photographed asymmetrically, it is possible to easily recognize the positional relationship such as up, down, left, and right in the inspection image coordinate system, and to identify the marker. Also becomes easier.

[0194]

As described in detail above, according to the present invention,
1) It is structurally stable that can be used even during surgery, 2) It can be easily attached and detached even after taking an examination image, and it is possible to perform surgery that can be mounted with good reproducibility before surgery. 3) It is possible to provide a positioning frame that can easily detect the position of the marker from within the inspection image and that can easily identify the position of the marker on the frame attached to the subject.

Further, the present invention can provide a surgical navigation apparatus that effectively utilizes such a positioning frame.

[Brief description of the drawings]

FIG. 1A is a diagram showing a positioning frame according to a first embodiment of the present invention, and FIG. 1B is a block configuration diagram of a surgical navigation device according to the first embodiment of the present invention. .

2A is a perspective view, an elevation view, and a side view of a columnar marker fixedly mounted on the positioning frame of FIG. 1A, and FIG. 1 shows a perspective view, an elevation view, and a side view of a conical marker as an example of FIG.

FIG. 3A is a diagram for explaining fixation of a positioning frame by a temporally solidified material, and FIG. 3B is a flowchart of a surgical navigation process.

FIG. 4 is a diagram showing a relationship between coordinate systems necessary for assuming intraoperative navigation.

FIG. 5 is a basic flowchart of an intraoperative navigation process in FIG. 3 (B).

6A is a diagram illustrating a surgical tool coordinate system that defines an endoscope, and FIG. 6B is a diagram illustrating a surgical tool coordinate system related to the endoscope.

FIG. 7 is a diagram showing a display example when an inspection image is displayed in a three-view drawing.

8A is a diagram illustrating an example in which a wire frame model is displayed in an endoscope visual field coordinate system, and FIG. 8B is an MRI when the cylindrical marker of FIG. 2A is used; It is a figure showing a slice image.

FIG. 9 is a flowchart showing a basic flow of a surgical calibration process in FIG. 3 (B).

10A is a diagram modeling a marker volume area, and FIG. 10B is a flowchart for explaining details of a marker position measurement process in a real space where a subject actually exists in FIG. 9; It is.

11A is a diagram showing a basic configuration of a second embodiment of the present invention, and FIG. 11B is a diagram showing a third embodiment of the present invention to which a removable secondary marker plate is applied. It is a figure showing composition of such a positioning frame.

FIG. 12 is a diagram showing a relationship of a coordinate system when a secondary marker plate is used.

FIG. 13 is a flowchart illustrating details of a marker position measurement process in a real space where a subject actually exists in FIG. 9 according to a second embodiment.

FIG. 14 is a flowchart for explaining details of a second embodiment of the intraoperative navigation processing in FIG. 3 (B).

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Positioning frame 2 Glasses-shaped main body part 5, 6, 7, 8, 9, 10, 11 Marker 15 Outer shell part 16 Internal solution 17 Probe dent part 18, 19 Solidified material over time 21 Surgical navigation device 22 Inspection image photographing device Reference Signs List 23 surgical tool or observation tool 24 three-dimensional position sensor 25 PC 26 monitor 27 subject 28 surgical tool 54 secondary marker plate 55 secondary marker 56 secondary marker plate coordinate system 59 secondary marker plate 60 secondary marker

 ──────────────────────────────────────────────────続 き Continued on the front page (72) Inventor Akito Saito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Takeo Asano 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Inside Olympus Optical Co., Ltd. (72) Hiroshi Matsuzaki, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Yukito Furuhashi 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. F term (reference) 4C093 AA30 CA15 CA17 CA50 EE30 FD01 FD20 FF22 FF44 FG13 4C096 AB36 AC01 DD13 FC20

Claims (3)

[Claims] 1. A positioning frame mounted on a subject and provided with markers serving as markers for measuring the position or posture of the subject, engaging at least three places with the undulations of the outer shape of the subject. An engaging portion, and at least three markers that can be captured with at least one of an X-ray image and an MRI image and are arranged at predetermined positions that are not on a straight line. Positioning frame. 2. The positioning frame according to claim 1, wherein the positioning frame is shaped like a pair of glasses and is configured to be detachable from a subject. 3. An object mounted with a positioning frame having at least three markers which can be picked up at least in one of an X-ray image and an MRI image and which is arranged at a predetermined position which is not on a straight line. Image coordinate calculating means for obtaining the coordinates of the marker in the test image coordinate system fixed to the image from the image obtained by capturing the specimen; and the coordinates of the marker in the test image coordinate system obtained by the image coordinate calculating means; A surgical operation navigation apparatus comprising: a correspondence calculating means for obtaining a correspondence between the examination image coordinate system and the space coordinate system based on a measurement result of the coordinates of the marker in the space coordinate system.