JP2019213904A - 医用イメージングインフォマティクスのためのシステム及び方法 - Google Patents
医用イメージングインフォマティクスのためのシステム及び方法 Download PDFInfo
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Abstract
Description
本出願は、2014年3月14日に出願された「外科データのイントラモーダル同期化」と題する、国際特許出願第PCT/CA2014/050269号の優先権を主張し、その全内容が本明細書に参照として援用される。
本開示は、低侵襲治療に使用される撮像方法、マルチモダリティ画像誘導医療処置、および治療計画情報を提供する方法およびシステムに関する。
本開示のいくつかの実施形態では、低侵襲性医療処置と関連する。手術、画像診断、治療、または他の医療処置(例えば、低侵襲性医療処置)は内部組織へのアクセスを提供するため、アクセスポートを介して行われている。
例示的な処理モジュールは、ユーザ・インターフェース・エンジン372、追跡モジュール374、モータコントローラ376、画像処理エンジン378、画像登録エンジン380、プロシージャ計画エンジン382、ナビゲーションエンジン384、及びコンテキスト解析モジュール386に限定されません。例示的な処理モジュールが図3に別々に示されても、一例では、処理モジュール370は、メモリ304に格納されてもよいし、まとめて処理モジュール370と呼んでもよい。
医用ナビゲーションシステム205は、典型的には、使用中のツールの場所と3次元(3D)空間における患者の参照を取得し、維持しなければならない。換言すれば、ナビゲーション手術中、典型的には患者の頭蓋骨に固定される追跡参照フレームが必要である。ナビゲーション手術の登録段階中に(例えば、図4Aお呼び図4Bに示すようなステップ406)、変換は、患者の頭部のような手術の物理的な領域への術前画像(例えば、MRIまたはCT画像)の基準フレームをマッピングするように計算される。これは、患者静的基準フレームに対する、患者の頭部に固定された基準マーカのナビゲーションシステム205の追跡位置によって達成することができる。患者の基準フレームは、典型的に、MayfieldTMクランプのような頭部固定装置に取り付けられている。典型的に登録は、無菌領域が確立される前に、行われる(例えば、図4Aに示すステップ410)。
例えば、データ処理エンジン720による処理後の結果(また、「分析」と呼ばれる)を提示する。このような情報は、例えば、ひとつの使いやすいウェブページに提示されてもよい。
このようなデータ分析は:治療計画を支援するためにリアルタイムの前例的な目標情報を外科医に提供すること;使用したエントリポイントを示す同時に術後に重要な神経線維束の組織保存を評価し可視化すること;そしておそらく、患者のトラクトの変化と予後との相関の決意を有効にする。そのようなデータ分析は、低侵襲性ICH管理及び腫瘍切除などの手術に関連し得る。
図5Bは、過去の組織の分析に関連した局所組織診断データをユーザに提示することができる、別の例示的オーバーレイ590を示す。
の一例を示すフローチャートである。例示的な方法は、例えば、データ処理エンジン720の病理相関器726によって実行されてもよい。例示的な方法は、手術中にリアルタイムで行うことができる。
Claims (15)
- 脳神経外科手術のために計画情報を表すコンピュータ実装方法であって、該方法は:
拡散テンソルイメージングを用いて収集された脳神経外科手術のデータを受信し、
データを用いてトラクトグラフィデータを生成し、
脳神経外科手術を特徴付ける第1のデータセットを受け取り、
過去の脳神経外科手術に関する過去のデータを含む一つまたは複数の過去のデータベースにアクセスし、
一つまたは複数の過去のデータから、脳神経外科手術に関連する一つまたは複数の手術パラメータの一つまたは複数の過去のインスタンスを識別し、そして
脳神経外科手術のための関心領域の画像上に重ね合わされた、一つまたは複数の手術パラメータの一つまたは複数の過去のインスタンスの指標を出力装置上に表示することを含む方法であって、
第1のデータセット、一つまたは複数の過去のデータ、および1つまたは複数の過去のデータベースは、脳神経外科手術のためのトラクトグラフィデータを含み、該方法はさらに、第1のデータセットとの類似性の判定に基づいて、脳神経外科手術に関連する一つまたは複数の過去のデータを識別するステップの前に、繊維束の繊維量を計算することによってトラクトグラフィデータを定量化する、
ことを含む方法。 - 少なくとも一つの他の局部または遠隔データベースにアクセスし、
最初のデータセットに含まれる識別情報に基づいて神経外科手術に関連する神経外科手術を特徴付ける追加データを識別し、そして
第1のデータセットに追加データを加える機能を含む、請求項1に記載の方法。 - 前記一つまたは複数の手術パラメータは、脳神経外科手術のための侵入部位を含み、そして表示することは、脳神経外科手術の関心領域の画像に重ねた一つまたは複数の過去の侵入部位の場所の指標を表示する機能を含む、請求項1又は2に記載の方法。
- 前記脳神経外科手術に関連する一つまたは複数の過去のデータを識別することは神経外科手術に関連する画像データと同様の画像データに関連する一つまたは複数の過去のデータを識別することを含む、請求項1に記載の方法。
- 1つ以上の過去のデータに関連する一つまたは複数の手術結果を出力装置上に表示することをさらに含む、請求項1に記載の方法。
- 脳神経外科手術のためにフィードバックを提供するコンピュータ実装方法であって、該方法は:
拡散テンソルイメージングを用いて収集された脳神経外科手術のデータを受け取り、
データを用いてトラクトグラフィデータを生成し、
術前および術後のトラクトグラフィデータを含む一つまたは複数の遠隔データベースにアクセスし、
識別情報を使用して、患者に対する所与の脳神経外科手術に関連する一連の術前トラクトグラフィデータおよび一連の術後トラクトグラフィデータを識別し、
繊維束の繊維量を計算することによってトラクトグラフィデータを定量化し、
術前トラクトグラフィデータと術後トラクトグラフィデータとの定量的な比較を行い、そして
術前トラクトグラフィデータと術後トラクトグラフィデータとを組み合わせて定量的な比較を出力装置に表示し、定量的な比較は術前トラクトグラフィデータと術後トラクトグラフィデータとの間の神経路面積の比較である、ことを含む方法。 - 前記患者に対する前記所与の脳神経外科手術に関連する定量的な比較を保存することをさらに含む、請求項6に記載の方法。
- 脳神経外科手術の術中に提供される、脳神経外科手術に関する情報を提供するシステムであって、該システムは:
二つまたは複数のデータベースを含む中央システムであって、それぞれの二つまたは複数のデータベースは、異なる脳神経外科手術に関連する情報を記憶する二つまたは複数のデータベースと通信する一つまたは複数のプロセッサと、
中央システムによって実行可能な、拡散テンソル画像によって収集されたデータを使用して神経管の3Dモデルを生成するためのトラクトジェネレータを一つまたは複数のデータ処理モジュールと、
一つまたは複数の計画モジュールであって、計画モジュールは実行時に、
システムに:
脳神経外科手術を特徴付ける第1のデータセットを受け取り、
過去の脳神経外科手術に関する過去のデータを含む一つまたは複数の過去のデータベースにアクセスし、
一つまたは複数の過去のデータから、脳神経外科手術に関連する一つまたは複数の手術パラメータの一つまたは複数の過去のインスタンスを識別するステップを引き起こし、そして、
出力装置に:
脳神経外科手術のための関心領域の画像上に重ね合わされた、一つまたは複数の手術パラメータの一つまたは複数の過去のインスタンスの指標を表示するステップを引き起こし、
第1のデータセット、一つまたは複数の過去のデータ、および一つまたは複数の過去のデータベースは、脳神経外科手術のためのトラクトグラフィデータを含み、システムと出力装置によって実行されるステップはさらに、第1のデータセットとの類似性の判定に基づいて、脳神経外科手術に関連する一つまたは複数の過去のデータを識別するステップの前に、繊維束の繊維量を計算することによってトラクトグラフィデータを定量化する、ことを含む方法である事を含む、
計画モジュールと、
を含むシステム。 - 前記計画モジュールがさらに前記システムに:
少なくとも1つの他の局部または遠隔データベースにアクセスし、
第1のデータセットに含まれる識別情報に基づいて、脳神経外科手術を特徴付ける追加のデータを識別し、そして
追加データを最初のデータセットに含める事を行わせる、
請求項8に記載のシステム。 - 一つまたは複数の手術パラメータは、脳神経外科手術のための侵入部位を含み、計画モジュールはさらに、システムによって、出力装置に脳神経外科手術のための関心領域の画像上に重ね合わされた一つまたは複数の過去の侵入部位の位置の指標を表示させる、請求項8または9に記載のシステム。
- 計画モジュールはさらに、前期システムに前記脳神経外科手術に関連する組織分析データと同様の組織分析データに関連する一つまたは複数の過去のデータを識別することによって、前記脳神経外科手術に関連する一つまたは複数の過去のデータを識別させ、そして、一つまたは複数の過去のデータに関連付けられた少なくとも一つの組織診断を決定することによって、一つまたは複数の手順パラメータの一つまたは複数の過去のインスタンスを識別させる、請求項8に記載のシステム。
- 前記第1のデータセットが前記脳神経外科手術に関連する画像データを含み、前記計画モジュールがさらに前記システムに前記画像データ内の場所を選択する入力を受信させ、選択された位置に関連する組織分析データに基づいて脳神経外科手術に関連する一つまたは複数のデータを識別させる、請求項11に記載のシステム。
- 前記計画モジュールは、前記システムに前記脳神経外科手術に関連する画像データと同様の画像データに関連する一つまたは複数の過去のデータを識別させることによって前記神経外科的処置に関連する前記一つまたは複数の過去のデータを識別させる、請求項8に記載のシステム。
- 前記計画モジュールは、前記システムによって、前記出力装置に前記一つまたは複数の過去のデータに関連付けられた一つまたは複数の手術結果を表示させる、請求項8に記載のシステム。
- 脳神経外科手術の結果についてのフィードバックを提供するためのシステムあって、該システムは:
術前および術後のトラクトグラフィデータを含む一つまたは複数の遠隔データベースと通信する一つまたは複数のプロセッサを含む中央システムと、
中央システムによって実行可能な、拡散テンソル画像によって収集されたデータを使用して神経管の3Dモデルを生成するためのトラクトジェネレータを一つまたは複数のデータ処理モジュールと、
一つまたは複数のフィードバックモジュールであって、フィードバックモジュールは実行時に、
システムに:
術前および術後のトラクトグラフィデータを含む少なくとも1つの遠隔データベースにアクセスし、
識別情報を使用して、患者に対する所与の脳神経外科手術に関連する一連の術前トラクトグラフィデータおよび一連の術後トラクトグラフィデータを識別し、
繊維束の繊維体積を計算することによってトラクトグラフィデータを定量化し、
術前トラクトグラフィデータと術後トラクトグラフィデータの定量的な比較を行うステップを引き起こし、そして、
出力装置に:
術前トラクトグラフィデータと術後トラクトグラフィデータとを組み合わせて、術前トラクトグラフィデータと術後トラクトグラフィデータとの間の神経路面積の比較である定量的な比較を出力装置に表示しするステップを引き起こす、
フィードバックモジュールと、
を含むシステム。
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