JP6635952B2 - 生検場所をマーキングするためのシステム - Google Patents
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Description
(技術分野)
本開示は、生検場所のマーキング、および、気管支樹モデル上で生検の場所をマーキングするためのデバイス、システムおよび、方法に関する。
患者の気道を検査する一般的なデバイスは気管支鏡である。一般的には、気管支鏡は、患者の鼻または口を通って患者の気道に挿入され、そして患者の肺中に延在し得る。一般の気管支鏡は、気管支鏡の先端より遠位の領域を照明するための照明アセンブリ、気管支鏡の先端からビデオ画像を提供するための画像化アセンブリ、および、機器、例えば、生検用具、治療機器のような診断機器が、通って挿入され得るワーキングチャネルを有する細長い可撓性のチューブを含む。
本開示に従って提供されるのは、生検の場所をマーキングするための方法である。
本願明細書は、例えば、以下の項目も提供する。
(項目1)
患者の気道において、生検場所をマーキングする方法であって、該方法は、
ナビゲーション計画をナビゲーションシステム内にロードすることであって、該ナビゲーション計画は、複数のCT画像から生成されるCT体積を含むことと、
プローブを患者の気道内に挿入することであって、該プローブは、該ナビゲーションシステムと動作可能に通信する場所センサを含むことと、
該ナビゲーション計画の該CT体積と共に、該プローブの感知された場所を位置合わせすることと、
該ナビゲーション計画における目標を選択することと、
該プローブおよび場所センサを該目標にナビゲートすることと、
該ナビゲーションシステムにおける該場所センサの位置を、生検場所として格納することと、
格納された生検場所において生検を行うことと、
を含む、方法。
(項目2)
前記CT体積から生成される前記患者の気道の3Dモデルまたは該CT体積のスライスから生成される該患者の気道の局所表示の内の少なくとも一つに、前記生検場所に対応する仮想マーカを配置することを、さらに含む、
項目1に記載の方法。
(項目3)
前記プローブを延長されたワーキングチャネルを通って挿入することをさらに含む、
項目1に記載の方法。
(項目4)
前記プローブを前記延長されたワーキングチャネルに対して固定することをさらに含む、
項目3に記載の方法。
(項目5)
前記延長されたワーキングチャネルおよび前記プローブを気管支鏡の中に挿入することと、それらを共に前記目標にナビゲートすることとを、さらに含む、
項目4に記載の方法。
(項目6)
前記場所センサが前記目標にナビゲートされるとき、前記延長されたワーキングチャネルを該目標における正しい位置に係止することをさらに含む、
項目5に記載の方法。
(項目7)
前記プローブを前記延長されたワーキングチャネルから取り除くことと、該延長されたワーキングチャネルを通って、生検用具を前記目標へ挿入して前記生検を行うこととを、さらに含む、
項目5に記載の方法。
(項目8)
前記目標に対する前記プローブの位置を調節することと、
前記場所センサの第二の位置を、第二の生検場所として前記ナビゲーションシステムに格納することと、
該第二の生検場所において第二の生検を行うことと、をさらに含む、
項目1に記載の方法。
(項目9)
前記ナビゲーション計画における第二の目標を選択することと、
前記プローブおよび前記場所センサを該第二の目標にナビゲートすることと、
該場所センサの第二の位置を、第二の生検場所として該ナビゲーションシステムに格納することと、
該格納された第二の生検場所において生検を行うことと、をさらに含む、
項目1に記載の方法。
(項目10)
前記生検場所、または速やかな現場での評価のための前記第二の生検場所の内の少なくとも一つからの組織を提供することを、さらに含む、
項目9に記載の方法。
(項目11)
前記生検場所または前記第二の生検場所の内の少なくとも一つに戻る必要性を臨床医が示す前記速やかな現場での評価からの結果を受け取ることと、
前記速やかな現場での評価に基づいて、前記ナビゲーション計画における帰還目標として、生検場所または第二の生検場所の内の少なくとも一つへの経路を提示することと、
前記場所センサを該帰還目標へナビゲートすることと、
該場所センサの帰還位置を、帰還生検場所として前記ナビゲーションシステムに格納することと、
該格納された帰還生検場所におけるさらなる生検または処置の内の少なくとも一つを行うこととを、さらに含む
項目10に記載の方法。
(項目12)
前記生検場所を伴って、前記目標の中心への距離および生検位置番号を格納することを、さらに含む、
項目1に記載の方法。
三次元(3D)モデル上の生検の場所をマーキングするためのデバイス、システムおよび方法が本開示に従って提供され、以下に詳細が記述される。3Dモデルを生成するための様々な方法が想像され、そのうちのいくらかは、同時係属中の米国特許出願第13/838,805号、第13/838,997号、および、第13/839,224号により詳細に説明され、それらば、すべて、PATHWAY PLANNING SYSTEM AND METHODと題され、2013年3月15日にBakerによって出願されており、それらの全体の内容が参照として本明細書に援用されている。場所センサは、異なるタイプの用具およびカテーテルに組み込まれ得、場所を追跡し、用具のナビゲーションを支援する。場所センサまたは用具のナビゲーションは、SYSTEM AND METHOD FOR NAVIGATING WITHIN THE LUNGと題される、2014年、7月2日にBrown他によって出願された、同時係属中の米国仮特許出願第62/020,240号により詳細に記述されており、それらの全体の内容が参照として本明細書に援用されている。場所センサの追跡された場所は、また、患者の気道の三次元モデル上で生検または処置が行われる患者の気道内の場所を仮想的にマーキングするために使用され得る。
Claims (12)
- 患者の気道において、生検場所をマーキングするためのシステムであって、該システムは、
その中にロードされたナビゲーション計画を有するナビゲーションシステムであって、該ナビゲーション計画は、複数のCT画像から生成されるCT体積を含む、ナビゲーションシステムと、
患者の気道内に挿入されるように構成されたプローブであって、該プローブは、該ナビゲーションシステムと動作可能に通信する場所センサを含む、プローブと
を備え、
該プローブの感知された場所は、該ナビゲーション計画の該CT体積と共に位置合わせられるように構成され、
該ナビゲーション計画における目標は、選択されるように構成され、
該プローブおよび該場所センサは、該目標にナビゲートされるように構成され、
該プローブが該目標にナビゲートされるにつれて、基準の座標フレーム内の該場所センサの座標が追跡され、
該場所センサの追跡された座標は、生検場所として、該ナビゲーションシステムに格納されるように構成され、
該生検場所は、該ナビゲーションシステムに格納された該場所センサの該追跡された座標に対応する場所において該CT体積上に表示され、
該格納された生検場所における生検は、行われるように構成されている、システム。 - 前記CT体積から生成される前記患者の気道の3Dモデルまたは該CT体積のスライスから生成される該患者の気道の局所表示のうちの少なくとも一つに、前記生検場所に対応する仮想マーカを配置するための手段をさらに備える、請求項1に記載のシステム。
- 前記プローブは、延長されたワーキングチャネルを通って挿入されるように構成されている、請求項1に記載のシステム。
- 前記プローブを前記延長されたワーキングチャネルに対して係止するための手段をさらに備える、請求項3に記載のシステム。
- 前記延長されたワーキングチャネルおよび前記プローブは、気管支鏡の中に挿入されるように構成され、共に前記目標にナビゲートされるように構成されている、請求項4に記載のシステム。
- 前記場所センサが前記目標にナビゲートされるとき、前記延長されたワーキングチャネルを該目標における正しい位置に係止するための手段をさらに備える、請求項5に記載のシステム。
- 前記プローブは、前記延長されたワーキングチャネルから取り除かれるように構成され、生検用具は、前記生検を行うために、該延長されたワーキングチャネルを通って前記目標へ挿入されるように構成されている、請求項5に記載のシステム。
- 前記プローブの位置は、前記目標に対して調節されるように構成され、
前記場所センサの第二の追跡された座標は、第二の生検場所として、前記ナビゲーションシステムに格納されるように構成され、
第二の生検は、該格納された第二の生検場所において行われるように構成されている、請求項1に記載のシステム。 - 第二の目標は、前記ナビゲーション計画に格納されるように構成され、
前記プローブおよび前記場所センサは、該第二の目標にナビゲートされるように構成され、
該場所センサの第二の追跡された座標は、第二の生検場所として、前記ナビゲーションシステムに格納されるように構成され、
第二の生検は、該格納された第二の生検場所において行われるように構成されている、請求項1に記載のシステム。 - 前記生検場所または前記第二の生検場所のうちの少なくとも一つからの組織は、速やかな現場での評価のために提供されるように構成されている、請求項9に記載のシステム。
- 前記生検場所または前記第二の生検場所のうちの少なくとも一つに戻る必要性を臨床医が示す前記速やかな現場での評価からの結果は、受け取られるように構成され、
前記システムは、該速やかな現場での評価に基づいて、前記ナビゲーション計画における帰還目標として、該生検場所または該第二の生検場所のうちの少なくとも一つへの経路を提示するための手段をさらに備え、
前記場所センサは、該帰還目標へナビゲートされるように構成され、
該場所センサの帰還座標は、帰還生検場所として、前記ナビゲーションシステムに格納されるように構成され、
さらなる生検または処置のうちの少なくとも一つは、該格納された帰還生検場所において行われるように構成されている、請求項10に記載のシステム。 - 前記生検場所を伴って、前記目標の中心への距離および生検位置番号を格納するための手段をさらに備える、請求項1に記載のシステム。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201462020177P | 2014-07-02 | 2014-07-02 | |
US62/020,177 | 2014-07-02 | ||
US14/753,229 | 2015-06-29 | ||
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WO2016003990A2 (en) | 2016-01-07 |
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CN106793938A (zh) | 2017-05-31 |
EP3164052B1 (en) | 2020-09-02 |
USD916749S1 (en) | 2021-04-20 |
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