JP2019531809A - 画像誘導手術のための連続的な位置合せのシステム及び方法 - Google Patents
画像誘導手術のための連続的な位置合せのシステム及び方法 Download PDFInfo
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Abstract
Description
本特許出願は、2016年11月2日に出願された、“Systems and Methods of Continuous Registration For Image-Guided
Surgery”という表題の米国仮特許出願第62/416,393号の優先権及びその出願日の利益を主張するものであり、この文献は、その全体が本明細書に参照により組み込まれる。
前述した一般的な説明と以下の詳細な説明との両方は、本質的に例示的且つ説明的なものであり、本開示の範囲を限定することなく本開示の理解を与えることを意図していることを理解されたい。その点に関して、本開示の更なる態様、特徴、及び利点は、以下の詳細な説明から当業者に明らかとなるであろう。
Anatomic Structure for Image-Guided Surgery”を開示する)がそのような1つのシステムを開示しており、この文献は、その全体が参照により本明細書に組み込まれる。遠隔操作医療システム100は、照明システム、操縦制御システム、洗浄システム、及び/又は吸引システム等のオプションの操作及びサポートシステム(図示せず)をさらに含み得る。いくつかの実施形態では、遠隔操作医療システム100は、2つ以上の遠隔操作マニピュレータアセンブリ及び/又は2つ以上のマスターアセンブリを含み得る。遠隔操作マニピュレータアセンブリの正確な数は、他の要因の中でも、手術処置及び手術室内の空間的制約に左右されるであろう。マスターアセンブリ106は、並置されてもよく、又はそれらアセンブリは別々の位置に位置付けしてもよい。複数のマスターアセンブリによって、2人以上のオペレータが1つ又は複数の遠隔操作マニピュレータアセンブリを様々な組合せで制御するのを可能にする。
thereto”を開示する);(2004年7月16日に出願された)米国特許出願第12/047,056号(“Fiber-optic
shape and relative position sensing”を開示する);(1998年6月17日に出願された)米国特許第6,389,187号(“Optical Fibre Bend Sensor”を開示する)に記載されており、これら全ての文献は、その全体が参照により本明細書に組み込まれる。
on the Object Being Tracked”を開示する)に提供されており、この文献は、その全体が参照により本明細書に組み込まれる。いくつかの実施形態では、形状センサ222は、(患者の固定座標系(「患者空間」と呼ばれる)において)形状センサ222のベースの位置に関する情報と一緒のセンサ222の形状によって、先端チップを含む形状センサに沿った様々な点の位置を計算することができるので、位置センサとしても機能し得る。
Surgery with Enhanced Dexterity and Sensitivity”を開示する)及び(2008年9月30日に出願された)米国特許出願第12/286,644号(“Passive Preload and Capstan Drive for Surgical Instrument”を開示する)に詳細に記載されており、これらの文献は、その全体が参照により本明細書に組み込まれる。
Anatomic Structure for Image-Guided Surgery”を開示する)に提供されており、この文献は、その全体が参照により本明細書に組み込まれる。
Claims (20)
- 患者の1つ又は複数の解剖学的通路のモデルを患者空間に位置合わせする方法であって、当該方法は、
前記患者の1つ又は複数の解剖学的通路の前記モデルのモデル点のセットにアクセスするステップであって、前記モデル点はモデル空間に関連付けられる、アクセスするステップと、
前記患者の前記1つ又は複数の解剖学的通路内に挿入されたカテーテルの長さに沿って測定点の第1セットを収集するステップであって、前記測定点は前記患者空間内の前記カテーテルの形状によって決定される、収集するステップと、
前記測定点の第1セットの点を測定点の複数の第1サブセットに割り当てるステップと、
前記測定点の第1サブセットを前記モデル点のセットと位置合わせして、第1の複数の位置合せ候補を生成するステップと、
該位置合せ候補同士を比較して、前記第1の複数の位置合せ候補のうちの最適な位置合せに関連する最適なサブセットを特定するステップと、
前記最適な位置合せの視覚的表現をディスプレイによって提供されるユーザインターフェイス内に表示するステップであって、前記最適な位置合せは、前記モデル点のセット及び前記測定点の第1セットの少なくとも1つのサブセットを共通の空間に変換する、表示するステップと、を含む、
方法。 - 前記測定点の第1セットを収集するステップは、前記カテーテルの形状センサに問い合わせるステップを含む、請求項1に記載の方法。
- 前記点を前記測定点の複数の第1サブセットに割り当てるステップは、
周期的な生理学的運動を決定するステップと、
前記収集された測定点を前記第1サブセットに割り当てるステップであって、その割当てはそれぞれ前記周期的な生理学的運動の規定された部分に関連付けられる、割り当てるステップと、を含む、請求項1に記載の方法。 - 前記規定された部分は、前記周期的な生理学的運動の周期に関連している、請求項3に記載の方法。
- 前記規定された部分は、前記周期的な生理学的運動の振幅に関連している、請求項3に記載の方法。
- 前記測定点の複数の第1サブセットは、それぞれ周期的な生理学的運動の一部に関連付けられる、請求項1又は2に記載の方法。
- 前記点を前記測定点の複数の第1サブセットに割り当てるステップは、
前記カテーテルの挿入深さを決定するステップと、
前記点に関連する前記カテーテルの一部の前記挿入深さに基づいて、各点を前記複数の第1サブセットのうちの1つに割り当てるステップと、を含む、請求項1又は2に記載の方法。 - 前記カテーテルの前記長さに沿って追加の測定点を収集するステップと、
該追加の測定点を前記測定点の複数の第1サブセットに割り当てて、測定点の複数の第2サブセットを生成するステップと、
該測定点の複数の第2サブセットを前記モデル点と位置合わせして、第2の複数の位置合せ候補を生成するステップと、
該第2の複数の位置合せ候補のそれぞれを比較して、前記第2の複数の位置合せ候補から第2の最適な位置合せに関連する最適な第2サブセットを特定するステップと、をさらに含む、請求項1乃至5のいずれか一項に記載の方法。 - 前記カテーテルの前記長さに沿って追加の測定点を収集するステップと、
該追加の測定点を測定点の複数の第2サブセットに割り当てるステップと、
該測定点の複数の第2サブセットを前記モデル点と位置合わせして、第2の複数の位置合せ候補を生成するステップと、
該第2の複数の位置合せ候補のそれぞれを比較して、前記第2の複数の位置合せ候補から第2の最適な位置合せに関連する最適な第2サブセットを特定するステップと、をさらに含む、請求項1乃至5のいずれか一項に記載の方法。 - 患者の1つ又は複数の解剖学的通路のモデルを患者空間に位置合わせする方法であって、当該方法は、
前記患者の1つ又は複数の解剖学的通路の前記モデルのモデル点のセットにアクセスするステップであって、前記モデル点はモデル空間に関連付けられる、アクセスするステップと、
前記患者の前記1つ又は複数の解剖学的通路内に挿入されたカテーテルの長さに沿って測定点のセットを収集するステップであって、前記測定点は前記患者空間内の前記カテーテルの形状によって決定される、収集するステップと、
前記測定点のセットのサブセットを前記モデル点のセットと位置合わせして、複数の位置合せ候補を生成するステップと、
医療処置を行う際に使用するために、前記複数の位置合せ候補から位置合せ候補を選択するステップと、
該選択された位置合せ候補を前記モデルの前記モデル点のセットに適用して、前記モデルを前記患者空間に位置合わせするステップと、を含む、
方法。 - 前記位置合わせされたモデルの視覚的表現をディスプレイによって提供されるユーザインターフェイスに表示するステップをさらに含む、請求項10に記載の方法。
- 前記位置合わせされたモデルの前記視覚的表現及び前記ユーザインターフェイスは、前記カテーテルの視覚的表現をさらに含む、請求項11に記載の方法。
- 前記カテーテルの長さに沿って前記測定点のセットを収集するステップは、周期的な生理学的機能に従って前記測定点をフィルタリングするステップをさらに含む、請求項10又は11に記載の方法。
- 前記位置合せ候補を選択するステップは、
前記測定点のサブセットに1つ又は複数のフィルタを適用するステップと、
各サブセット内の測定点に異なる重みを割り当てるステップと、
前記複数の位置合せ候補のそれぞれに関連するエラー値同士を比較するステップと、を含む、請求項13に記載の方法。 - 前記医療処置を行う際に使用するために、他の位置合せ候補を選択するステップと、
該他の選択された位置合せ候補を前記モデルの前記モデル点のセットに適用して、前記モデルを前記患者空間に位置合わせするステップと、をさらに含む、請求項10又は11に記載の方法。 - 前記他の位置合せ候補を選択するステップは、前記複数の位置合せ候補のそれぞれに関連するメトリックの変化を検出し、その後に前記測定点のセットの少なくともサブセットを破棄する際に、実行される、請求項15に記載の方法。
- 医療撮像システムであって、当該システムは、
動き検出器と、
挿入ステージに沿って移動可能な器具キャリッジに結合された基端部を有する可撓性カテーテルと、
該可撓性カテーテルの長さに沿って延びる点収集器具と、
該点収集器具によって収集された測定点のセットを1つ又は複数の解剖学的通路のモデルに位置合わせするように構成される追跡システムと、を有しており、
該追跡システムは、
前記モデルのモデル空間に関連付けられるモデル点のセットにアクセスすることと、
患者の前記1つ又は複数の解剖学的通路内に挿入された前記可撓性カテーテルの前記長さに沿って前記測定点のセットを収集することであって、前記測定点は患者空間内の前記カテーテルの形状によって決定される、収集することと、
前記動き検出器によって監視される周期的な生理学的機能に従って、前記測定点のセットをサブセットに割り当てることと、
前記測定点の前記サブセットに基づいて、複数の位置合せ候補から第1の位置合せ候補を選択することと、
該選択された第1の位置合せ候補を前記モデルの前記モデル点のセットに適用して、前記モデルを前記患者空間に位置合わせすること、を含む動作を行う、
システム。 - 前記動き検出器は医療処置中に使用される人工呼吸器に結合され、前記周期的な生理学的機能は呼吸である、請求項17に記載のシステム。
- 前記点収集器具は、前記可撓性カテーテル内でその先端部まで延びる光ファイバー形状センサである、請求項17に記載のシステム。
- 前記動作には、
前記複数の位置合せ候補を比較するために使用される比較メトリックの変化を検出することと、
該比較メトリックの前記変化に基づいて、前記複数の位置合せ候補から第2の位置合せ候補を選択することと、
前記選択された第2の位置合せ候補を適用して、前記モデルを前記患者空間に位置合わせすることと、
前記第1の位置合せ候補に関連する前記測定点の前記サブセットを変更することと、がさらに含まれる、請求項17乃至19のいずれか一項に記載のシステム。
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EP3534818B1 (en) | 2023-09-20 |
KR20190067917A (ko) | 2019-06-17 |
JP7229155B2 (ja) | 2023-02-27 |
CN109788992B (zh) | 2022-11-11 |
CN115631843A (zh) | 2023-01-20 |
US20240090963A1 (en) | 2024-03-21 |
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