JP5632286B2 - Mri画像データ及び外科用具の既定のデータを使用してリアルタイムで視覚化するmri外科システム - Google Patents
Mri画像データ及び外科用具の既定のデータを使用してリアルタイムで視覚化するmri外科システム Download PDFInfo
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Description
(雑音閾値)=(雑音ピーク)+4*(雑音標準偏差) (1)
2.格子について「最適観察画方向」を推定する。この方向は格子中心からAC−PC線の中点へのベクトルとして規定される。
a.最適観察画方向の粗い推定値から始めて、図12Bで示されるような初期距離画像を構築する。
i.推定された観察画方向に垂直で頭部ボリュームの外側にある画像平面を作り出す。
ii.画像平面内の各画素について、雑音閾値の上にある画像ボリューム内の最初のボクセルへの距離を記録する。
b.距離画像内の格子セルを発見する。
i.格子セルは頭部表面上の「隆起」であり、従って距離画像内の極小として現れる。この特性は、ガウスのラプラス演算子を距離画像へ適用することによって向上される。
ii.画像内の各場所について、仮想格子(この次元は物理格子の次元と一致する)を幾つかの配向で配置する。最小画像の1つの上に載る各仮想格子セルについて1ポイントを与えることによって得点を計算する。最高得点は、距離画像内の格子の場所及び配向に対応する。
c.そのようにして取得された格子の中心は、最適観察画方向の新しい推定を与える。この推定は、推定を精緻化するためステップ2a及び2bの新しい反復の開始点として使用される。
3.最適観察画方向を使用して格子を発見する。
a.ステップ2aで説明されたような距離画像を構築する。しかし、ステップ2で取得された最適観察画方向を使用する。
b.2bで説明されたように、新しい距離画像内の格子を発見する。
c.2bの探索手順を反復することによって格子の位置及び配向を精緻化する。しかし、非常に微小なステップサイズを用いて、既知の近似場所の周囲の小さい領域内でのみ探索する(図12Dを参照)。
4.格子を頭部の形状へ変形する。
a.この時点までは、格子は平面として取られている。
b.ロバストな回帰アルゴリズムを使用して距離画像内の格子セル場所を立方体表面へ当てはめ、ステップ3からの各格子セルをこの表面へはめ込む。(これは、距離画像内の雑音及び低解像度に起因する非常に不規則な格子表面の生成を回避するためである。)
一般的に、格子セルが任意の曲面へはめ込まれるとき、格子セル間で等距離を維持するのは不可能であることに留意されたい。従って、変形中の伸長及び屈曲量を最小化するため、物理的格子パッチの挙動をシミュレートするアルゴリズムが使用される。
5.格子セルの間を補間して、格子の頂点を計算する。図12Eは変形結果を示す。
2.領域成長アルゴリズムを使用して、雑音閾値を超えるピクセルの全ての「集団」を発見する。
3.既知のフレームマーカボリュームから遠いボリュームを有する全ての集団を廃棄する。
4.フレームマーカの既知の境界ボックス次元から遠い境界ボックス次元を有する全ての集団を廃棄する。
5.残りの集団の中で、軌道基部50bのフレームマーカの既知の空間配列とマッチする空間配列を有する三つ組を探す(即ち、集団の図心は既知の次元の三角形(例えば、二等辺三角形)を形成すべきである)。
6.マーカの各三つ組について、マーカ場所を精緻化する。
a.3つのマーカ図心によって規定された平面へスタックを再フォーマットすることによって、各マーカの2D画像を抽出する。
b.各2Dマーカ画像のキャニー・エッジマスクを計算する。
c.キャニー・エッジマスクへ円を当てはめる。円の直径は、物理フレームマーカの直径と等しく設定される。当てはめは、円を動かしてエッジマスクと円との重なりが最大になるときに実行される。当てはめ円の中心が、フレームマーカの中心の場所とされる。
注意:患者は動かされているので、前の画像座標系で規定された点は、もはや有効ではない。更に、この時点で脳シフトが起こる。
測定線の描画
観察画のパン
拡大縮小、全ての拡大縮小、領域への拡大縮小、点への拡大縮小
拡大鏡
注釈の表示/隠蔽
十字線の表示/隠蔽
パネル間での観察画のドラッグ
観察画パネルのサイズ変更
1x1表示への観察画の最大化
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Claims (18)
- MRIスキャナと、
前記MRIスキャナと通信する、回路及びディスプレイを有する医師用ワークステーションと、
患者の頭蓋骨へ取り外し可能に取り付けられるように構成され、表面に格子を有する柔軟性パッチと、
患者の頭蓋骨へ取り付け可能な軌道案内であって、間隔を空けられた複数の基準マーカを有すると共に、患者の頭蓋骨中に形成された掘削孔の上に存在するように構成された開口を備える基部を有し、前記基部開口が、当該軌道案内に関連づけられたピボット軸のために回転の機械的中心を提供する、軌道案内と
を備える、MRI案内付き介入脳深部システムであって、
前記回路は、前記パッチに関する物理データを備えると共に、前記MRIスキャナによって提供された患者撮像データについて問い合わせて前記画像データを区分化し、前記パッチの格子が所望の脳内軌道と交差する位置で掘削孔場所を規定するように構成され、
前記回路は、前記軌道案内の用具特定データを備えると共に、前記MRIスキャナによって提供された患者撮像データについて問い合わせて、前記患者の脳及び前記軌道案内の視覚化像を前記ディスプレイへ対話的に生成するように構成され、
前記回路は一連の選択可能ワークフローグループを含むユーザインタフェースと通信し、前記一連の選択可能ワークフローグループは、「スタート」、「入口計画」、「ターゲット計画」、「ナビゲート」、及び「精緻化」を含み、これらのワークフローグループは、MRI案内付き外科手順を案内して、前記「精緻化」ワークフローグループの後で療法の送達を生じるように使用可能であり、
前記ユーザインタフェースは、患者機能情報を前記視覚化像内で表示するかどうかをユーザが選択することを可能とするように構成することができ、及び/又は、前記ユーザインタフェースは、「管理」ワークフローグループを更に含み、これにより前記回路が、
(a)MR空間内のAC、PC、及びMSP点(ユーザが修正した場合には、検出され及びユーザによって指定されたものの双方)、
(b)MR及びACPC空間の双方における計画及び補正されたターゲット、
(c)前記外科手順の経過時間、
(d)医師の症例記録、及び
(e)前記外科手順の間に撮られたスクリーンショット
の少なくとも複数を含む前記患者及びある一定の外科情報に関する臨床情報を自動的に要約する医用報告書を電子的に生成する、ように構成することができる、MRI案内付き介入脳深部システム。 - 前記回路は、患者機能データを取得して、患者機能を示す前記視覚化像を実質的にリアルタイムで生成するように構成される請求項1に記載のシステム。
- 前記回路は、前記格子パッチの中心場所を通って延在するデフォルト軌道を前記軌道案内のために前記ディスプレイ上で提供するように構成される請求項1に記載のシステム。
- 両側手順のための2つの前記格子パッチと2つの前記軌道案内、及び2つの光ファイバビデオストリーム撮像デバイスを備え、前記軌道案内へそれぞれ1つの前記撮像デバイスが搭載され、
前記撮像デバイスの各々が、前記MRIスキャナの口径の近くに搭載された異なるMRI適合性カメラと通信し、
前記ワークステーションは、前記視覚化像を表示している間でも前記カメラの1つ又は双方からのビデオストリームを表示する請求項1に記載のシステム。 - 体内プローブ又はリードの体内への挿入前に、ユーザが、前記体内プローブ又はリードに関連づけられた深度ストップを設定して、深度値を決定及び表示するように構成された請求項1に記載のシステム。
- 前記回路はディスプレイのためにユーザインタフェースと通信し、それによってユーザは、(a)脳内ターゲットを選択し、(b)リード先端を表すMR座標内の位置を選択又は指定し、(c)前記リード先端からの電極オフセットを示すオフセット集合を選択する識別子を選択又は指定することができ、
前記回路は、各オフセット値について、前記先端位置から前記リードの軌道に沿って後方へオフセットされた点に対応するAC−PC座標を提供し、それによって前記AC−PC座標がAC−PC空間内の電極位置に対応するように構成される請求項1に記載のシステム。 - 前記回路は、ユーザが前記格子パッチと交差しない軌道を選択又は描画するとき警告を生成するように構成される請求項1に記載のシステム。
- 前記回路は、ハードウェア識別子データを要求するように構成され、前記識別子データが認識されないか、前記回路との不適合性を規定される場合には、システムでの使用を阻止するように構成される請求項1に記載のシステム。
- ターゲット用カニューレの中を伸長して狭視野高解像度画像データを収集するように構成される体内アンテナを有する撮像プローブを更に備え、
前記回路は、前記撮像プローブから収集された画像データに関連づけられた強度歪みを低減する補正を電子的に適用するように構成される請求項1に記載のシステム。 - 片側又は両側手順を含む異なった体内手順及び所望の体内ターゲットをユーザが選択することを可能にするユーザインタフェースを更に備え、
両側手順が選択される場合、前記ユーザインタフェースは、左及び右のワークフローステップを有するツールバーを提供する請求項1に記載のシステム。 - 両側手順のための前記ユーザインタフェースは、可視コントロールのワークフローステップを備え、
前記可視コントロールは、脳シフトに起因する「ターゲット計画」ステップへ進む前に、及び患者を導いてマグネット内の撮像場所へ戻す前に、双方の側に対する格子入口の位置決め、双方の側に対する掘削孔の形成、及び双方の側に対する軌道フレームの取り付けを完了するようにユーザを案内する請求項10に記載のシステム。 - ワークフローステップを有するユーザインタフェースを備え、
前記ユーザインタフェースは、「入口計画」、「ターゲット計画」、「ナビゲート」、「精緻化」、又は「療法送達」ステップの少なくとも1つの間に、患者機能情報を前記視覚化像の中に実質的にリアルタイムで表示する選択をユーザに許容するコントロールを備える請求項1に記載のシステム。 - 前記軌道案内は、中央通路及び少なくとも1つの基準マーカを有するターゲット用カニューレを備え、
前記回路は、前記ターゲット用カニューレの既定の物理特性に基づいて前記少なくとも1つの基準マーカを含むスラブの高解像度画像データを前記MRIスキャナに要求するか又は要求して取得し、前記ターゲット用カニューレの実際の軌道を決定するように構成され、
前記少なくとも1つのマーカは、近位マーカ及び遠位マーカを備えることができ、この場合の前記回路は、前記近位又は遠位マーカの単一の1つのスラブを単一の時点で選択的に要求するように構成することができる請求項1に記載のシステム。 - 前記軌道案内は、中央通路及び間隔を空けられた近位及び遠位基準マーカを有するターゲット用カニューレを備え、前記近位マーカは前記遠位マーカとは異なる形状を有し、
前記回路は、前記ターゲット用カニューレの既定の物理特性に基づいて前記近位又は遠位マーカの1つのみを含むスラブの高解像度画像データを前記MRIスキャナに要求し又は要求して取得するように構成される請求項1に記載のシステム。 - 少なくとも1つのMRI適合性外科用具と、
MRIスキャナと通信するように適合された回路であって、前記少なくとも1つの用具の既定の物理特性を電子的に認識して、前記MRIスキャナによって提供されたMR画像データを自動的に区分化する、回路と、
前記回路と通信する少なくとも1つのディスプレイと
を備える、MRI案内付き外科システムであって、
前記回路は、MRI案内付き外科手順についてワークフローの進行を規定してユーザが前記ワークフロー内のステップを選択することを可能にするユーザインタフェースを提供するように構成されると共に、前記回路は、前記少なくとも1つの用具の既定のデータ及び前記患者のMRI画像からのデータを使用し、前記外科手順の間に実質的にリアルタイムで多次元視覚化像を生成するように構成され、
前記少なくとも1つの用具が格子を有する柔軟性パッチを備えると共に前記回路が区分化モジュールを有するように構成され、前記区分化モジュールは、前記パッチをMRボリューム内で位置決めし、前記ディスプレイ上に提示される視覚化像を生成することができ、
前記視覚化像は、外科処置入口部位の規定された格子座標と共に前記パッチを患者の上のオーバーレイとして表示する、MRI案内付き外科システム。 - 少なくとも1つのMRI適合性外科用具と、
MRIスキャナと通信するように適合された回路であって、
前記少なくとも1つの用具の既定の物理特性を電子的に認識して、前記MRIスキャナによって提供されたMR画像データを自動的に区分化する、回路と、
患者の頭蓋骨へ取り外し可能に取り付けられるように構成され、表面に格子を有する柔軟性パッチと、
前記回路と通信する少なくとも1つのディスプレイと
を備える、MRI案内付き外科システムであって、
前記回路は、MRI案内付き外科手順についてワークフローの進行を規定してユーザが前記ワークフロー内のステップを選択することを可能にするユーザインタフェースを提供するように構成されると共に、前記回路は、前記少なくとも1つの用具の既定のデータ及び前記患者のMRI画像からのデータを使用し、前記外科手順の間に実質的にリアルタイムで多次元視覚化像を生成するように構成され、
当システムが脳外科システムであり、前記柔軟性パッチは、患者の頭蓋骨の上に存在するように構成された脳外科パッチであり、前記回路は、前記パッチの既定の物理特性に基づいて前記患者の上で前記パッチの位置及び配向を同定し、前記パッチを電子的に変形して患者の頭蓋骨の屈曲に当てはめ、前記患者の前記頭蓋骨の上で前記パッチの可視オーバーレイを生成及び表示するように構成される、MRI案内付き外科システム。 - 少なくとも1つのMRI適合性外科用具と、
MRIスキャナと通信するように適合された回路であって、前記少なくとも1つの用具の既定の物理特性を電子的に認識して、前記MRIスキャナによって提供されたMR画像データを自動的に区分化する、回路と、
前記回路と通信する少なくとも1つのディスプレイと
を備える、MRI案内付き外科システムであって、
前記回路は、MRI案内付き外科手順についてワークフローの進行を規定してユーザが前記ワークフロー内のステップを選択することを可能にするユーザインタフェースを提供するように構成されると共に、
前記回路は、前記少なくとも1つの用具の既定のデータ及び前記患者のMRI画像からのデータを使用し、前記外科手順の間に実質的にリアルタイムで多次元視覚化像を生成するように構成され、
当システムが脳外科システムであり、
前記少なくとも1つの用具は、患者頭部の上に存在するように構成された脳外科柔軟性格子パッチであり、
前記回路は、脳の深い場所へのユーザ選択可能軌道線を前記ディスプレイ上で可視的に表示するように構成され、
前記軌道線は、前記格子と交差して前記所望の軌道線に基づいて掘削入口孔をマークする場所を前記格子上で規定し、
前記ユーザインタフェースは、前記ユーザが前記格子と交差しない軌道線を選択するとき、可聴及び可視のいずれか又は両方の警告を表示する、MRI案内付き外科システム。 - 前記回路は、前記格子に関連づけられた場所及び座標のいずれか又は両方を表示するように構成され、前記場所及び座標のいずれか又は両方は、患者の頭蓋骨を通る軌道入口経路について所望の掘削孔場所を提供する請求項17に記載の外科システム。
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WO2009042136A1 (en) | 2009-04-02 |
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JP2010540021A (ja) | 2010-12-24 |
CN101918855A (zh) | 2010-12-15 |
EP2195676A2 (en) | 2010-06-16 |
CA2700577A1 (en) | 2009-04-02 |
US20090079431A1 (en) | 2009-03-26 |
EP2192870A1 (en) | 2010-06-09 |
US7602190B2 (en) | 2009-10-13 |
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