JP2013530028A - 擬似特徴を使用する腹部表面マッチングのためのシステムおよび方法 - Google Patents
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Abstract
Description
本発明は、一般的に経皮的外科処置中の画像誘導のための腹部表面マッチングのためのシステムおよび関連方法に関する。
しばしば画像誘導インターベンション(IGI)とも呼ばれる画像誘導治療(IGT)は、腹部臓器腫瘍の位置特定のための使用において広範な注目および臨床的容認を得ている。IGTを利用する処置は、腫瘍の生検およびアブレーションを含んでいるが、それらに限定されない。
本発明は、種々の実施形態において、インターベンション誘導のために対比処置前画像を使用するシステムおよび方法を含んでいる。先行技術は処置中画像を使用するので、医師は、3D画像を生成するために十分な時間をもつことができず、また、詳細な処置計画を生成する時間もない。対照的に、本発明は、血管系、腫瘍、および臓器の3D画像を高度誘導情報のために使用する。さらに、本発明は、周到な処置前計画を容易とし、それにより処置時間を著しく低減する。本発明は、処置中画像の代わりに処置前画像を使用するので、それは患者の放射線被曝も最小化とする。それは、透視室への取り込みのために作業の流れの観点からも効率的である。
1つの例示的実施形態では、本発明は、経皮的外科処置中に画像誘導を提供するために、腹部の処置中表面画像を処置前画像データ(たとえば、磁気共鳴画像(MRI)またはコンピュータ断層撮影(CT)結果)から抽出した表面に登録するフレームワークを提供することを意図する。登録は、2つの座標空間間の数学的関係を決定する方法であり、かつ、画像誘導外科(IGS)装置の重要な構成要素である。IGSの目標は、医師が、追跡される外科機器のオーバーレイ・ディスプレイ経由のインターベンション中に、高解像度・高コントラストの処置前断層撮影画像データを相互作用的に使用できるようにすることである。
第1に、腹部表面を処置前画像データから抽出する。1つの実施形態では、腹部表面抽出方法は、腹部臓器の実質( paranchyma)内のシード点の入力を契機として開始される半自動プロセスである。このシード点から、組織領域と空気領域間の差異を決定することができ、そして腹部を抽出することができる。次に、先行技術において肝臓表面生成のために記述されている方法と同じ方法により、セグメント化された腹部画像で腹部表面を碁盤目状とする。別の実施形態では、自動的に腹部表面を生成する。
処置中プロトコルは、最初に、腹部表面を抽出できるLRS装置、光学的に追跡されるスタイラスペンまたはその他の画像モダリティを使用して患者の腹部の表面画像を獲得することを含む。図4に示す腹部表面画像を獲得した後、強調表示される特徴獲得プロトコルを行う。医師が光学的に追跡されるスタイラスペンまたは同様な装置を使用して患者の正中線に沿って上から下の方向に輪郭をデジタル化する。次に、正中線輪郭に直交し、患者の左から患者の右に向かい、へそで最初の輪郭と交差する輪郭をデジタル化する。これにより、図3に示すように、5つの別々の特徴が生成され、登録プロセスで使用される。輪郭獲得の順序に関する先験的情報が与えられた場合、これら5つの特徴は2つの掃引された輪郭( swabbed coutours)から自動的に生成される。
モデルの生成および上述した擬似特徴領域の描写の後、表面登録を行う。表面登録方法は、先行技術において記述されている方法でよい。
● 種々の撮像および機器を使用する腹部表面および擬似特徴のデータの獲得
○ 実施形態の例は、光学的または磁気的に追跡される手動スタイラスペン装置および腹部表面および表面擬似特徴の自動獲得のために使用できる非接触撮像装置(たとえば、レーザー・レンジ・スキャン)を使用する表面獲得を含む。
○ 次に、画像誘導装置における使用のために必要な数学的登録変換を計算するために腹部表面を擬似特徴とともに使用する。
● 腹部表面を擬似特徴および他の画像モダリティから抽出した内部臓器表面と組み合わせて使用する経皮的画像誘導のための表面マッチングの実行
○ 例示的実施形態は、超音波(US)画像から抽出した肝臓表面データおよび追跡されるスタイラスペンにより獲得した腹部表面データを経皮的画像誘導を目的とする登録のために使用することを含む。
● 他の画像モダリティから抽出した臓器表面獲得による腹部表面と擬似特徴のマッチングの精緻化
○ 1つの例示的実施形態は、処置前断層画像データと術中腹部表面の間の登録を擬似特徴により計算する誘導システムに関するものである。次にこの初期登録を最初の姿勢として使用して、手術室において獲得された内部腹部臓器表面と処置前画像データから抽出した臓器表面間の精緻化された登録を計算する。
● 処置画像データから処置前画像データへの画像対画像登録を経由して処置断層画像一式上において経皮的誘導情報を与えること
○ 経皮的画像誘導装置は処置前断層画像間の登録を行うため、「リアルタイム」処置画像データと処置前画像データ間の登録を行うことにより、処置全体を通じて「リアルタイム」で獲得される画像データに経皮的誘導情報を及ぼすことができる。
Claims (18)
- 経皮的外科処置のための登録を行う方法であって、
処置前画像データから患者の外部表面の一部分のコンピュータ・モデルを生成するステップと、
生成された前記表面上に一連の擬似特徴を記録するステップと、
前記患者の前記外部表面の対応する部分の処置中画像を獲得するステップと、
前記患者の前記外部表面の前記対応する部分上の1つまたは複数の輪郭をデジタル化することにより一連の処置中擬似特徴を生成するステップと、
前記処置前データから生成された前記モデルの前記処置中患者表面データへの位置合わせまたは登録を行うステップと
を含む方法。 - 患者の前記外部表面の前記部分が、前記患者の腹部を含む、請求項1に記載の方法。
- 前記患者表面の前記処置中画像が、レーザー・レンジ・スキャナーまたは光学的もしくは磁気的に追跡されるスタイラスペンもしくは装置により獲得される、請求項1に記載の方法。
- 前記擬似特徴が、前記患者の正中線沿いの上下方向の一連の点およびへそで交差する垂直線に鉛直な前記患者の腹部をよぎる一連の点の交差により形成される4個の象限を含む、請求項1に記載の方法。
- 前記擬似特徴が、前記4個の象限の交点を表す5番目の特徴をさらに含む、請求項4に記載の方法。
- 位置合わせまたは登録の前記ステップが、前記患者の1つまたは複数の内部臓器の処置前表面データの使用をさらに含む、請求項1に記載の方法。
- 前記位置合わせに基づく前記経皮的外科処置を容易にするためのデータを表示するステップをさらに含む、請求項1に記載の方法。
- 前記表示が、前記患者の一部分の三次元モデルをさらに含む、請求項7に記載の方法。
- 前記三次元モデルが、前記患者腹部の前記表面および前記腹部内の1つまたは複数の臓器を含む、請求項8に記載の方法。
- 画像誘導外科(IGS)処置の実行中に使用するために身体的空間データを収集・処理するシステムであって、
術前データに基づく患者の外部表面の一部分のコンピュータ・モデルを格納する記憶媒体と、
前記患者の前記外部表面に関する術間表面データを生成する少なくとも1つのセンサー装置と、
前記記憶媒体および前記センサー装置と通信的に結合され、前記コンピュータ・モデルおよび術間表面データの位置合わせを得るために構成される処理要素と
を含むシステム。 - 前記処理要素に結合され、前記位置合わせに基づく前記IGS処置を容易にするデータを表示するように構成される表示装置をさらに含む、請求項10に記載のシステム。
- 前記表示が、前記患者の一部分の三次元モデルをさらに含む、請求項11に記載の方法。
- 前記三次元モデルが、前記患者腹部の前記表面および前記腹部の内部の1つまたは複数の臓器を含む、請求項12に記載の方法。
- 前記IGS処置が経皮的処置である、請求項10に記載のシステム。
- 前記記憶媒体がさらに前記患者における対象の非剛体構造のコンピュータ・モデルを格納できる、請求項10に記載のシステム。
- 患者の前記外部表面の前記部分が、前記患者の腹部を含む、請求項10に記載のシステム。
- 前記センサー装置がレーザー・レンジ・スキャナーまたは光学的もしくは磁気的に追跡されるスタイラスペンもしくは装置を含む、請求項10に記載のシステム。
- 前記位置合わせが、前記コンピュータ・モデルおよび前記術中表面データのための対応する擬似特徴の生成により得られる、請求項10に記載のシステム。
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US8781186B2 (en) | 2014-07-15 |
EP2566392A2 (en) | 2013-03-13 |
WO2012169990A3 (en) | 2013-02-28 |
US20110274324A1 (en) | 2011-11-10 |
US20150133770A1 (en) | 2015-05-14 |
EP2566392A4 (en) | 2015-07-15 |
CN103118596A (zh) | 2013-05-22 |
CN103118596B (zh) | 2015-11-25 |
WO2012169990A2 (en) | 2012-12-13 |
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