KR101441089B1 - Registration method of surgical space and image space - Google Patents

Abstract

The present disclosure relates to a method for obtaining an image of a patient before operation, A second step of virtually installing a micro marker on the image data of the patient before the operation; A third step of physically placing the micro marker at a position of the same patient as the virtual position; And a fourth step of matching the image space and the operation space by using the virtual micro marker and the actual micro marker as index points, and a matching method of the image space and the operation space.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method of matching a surgical space and an image space,

Disclosure relates to a method of matching an image space with a surgical space, and more particularly, to a method for matching a surgical space with an image space by virtually installing a micro marker in an image space, To a matching method using a guide capable of precisely positioning a micro marker.

With the rapid development of science and technology, medical equipment has been advanced and various treatments and diagnoses that have not been possible in the past have become possible. Among these medical devices, there are medical image capturing devices which can observe the internal state of the human body in more detail.

Examples of the medical image photographing apparatus include a computer tomography apparatus (hereinafter referred to as a CT apparatus) and a magnetic resonance imaging apparatus (hereinafter referred to as an 'MRI apparatus'), which diagnose various symptoms, It plays an important role. CT apparatuses and MRI apparatuses have different advantages and disadvantages. Therefore, it is necessary to selectively use imaging apparatuses with good images according to the purpose of diagnosis, or to perform more accurate diagnosis and treatment with various types of imaging apparatuses And analyzing the images obtained through shooting.

On the other hand, when an actual operation is performed using an image captured by a CT apparatus or an MRI apparatus, a medical navigation system or a surgical robot is used. The surgical navigation device stores the medical image taken by the CT apparatus or the MRI apparatus before surgery and displays the image corresponding to the lesion of the patient to be examined by the doctor during the operation through the monitor provided in the surgical navigation apparatus, So that it can proceed. For this operation, a registration operation for precisely matching an image (hereinafter referred to as " image space ") stored in a surgical navigation device and a corresponding body part (hereinafter referred to as & . Matching can be performed by various methods, and a method of using landmarks is generally known. For example, surgical image matching methods and surgical navigation methods are known in Korean Patent Nos. 10-0529119 and 10-0957727.

According to the method of registration of the surgical space and the image space according to the Korean Patent Registration No. 10-0957727, the operator is required to input a lot of input, and the marker used as the landmark point must be maintained from the operation to the operation site. If the patient moves during surgery, it is troublesome for the user to designate the index point from the beginning with the surgical tool and to perform registration.

[Reference literature]: Korean Patent No. 10-0529119, Korean Patent No. 10-0957727

This will be described later in the Specification for Enforcement of the Invention.

SUMMARY OF THE INVENTION Herein, a general summary of the present disclosure is provided, which should not be construed as limiting the scope of the present disclosure. of its features).

According to one aspect of the present disclosure, there is provided a method comprising: a first step of obtaining image data of a patient before surgery; A second step of virtually installing a micro marker on the image data of the patient before the operation; A third step of physically placing the micro marker at a position of the same patient as the virtual position; And a fourth step of matching the image space and the operation space using the virtual micro marker and the actual micro marker as the landmarks, and a matching method of the image space and the operation space is provided.

This will be described later on in the 'form for carrying out the invention'.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a flowchart showing a micro marker installation process according to an embodiment of the present disclosure;
FIG. 2 is a flowchart showing a micro marker setting process according to another embodiment of the present disclosure;
FIG. 3 is a view showing a combined state of the formwork according to the embodiment of the present disclosure;
4 shows a guide according to an embodiment of the present disclosure,
5 is a view showing a coupled state of the guide according to the embodiment of the present disclosure,
6 is a view showing a micro marker placement state according to the embodiment of the present disclosure;
FIG. 7 is a flow chart illustrating a matching process through an image matching technique of an image space and a surgical space according to an embodiment of the present disclosure;
FIG. 8 is a conceptual view illustrating a matching process through an image matching technique of an image space and a surgical space according to an embodiment of the present disclosure;
FIG. 9 is a conceptual view illustrating a matching process through a sensing means technique of an image space and a surgical space according to an embodiment of the present disclosure.

The technical objects achieved by the present disclosure and the implementation of the present disclosure will be clarified by the following preferred embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Reference will now be made in detail to the preferred embodiments of the present invention, examples of which are illustrated in the accompanying drawings.

FIGS. 1 and 2 are flowcharts showing a micro marker placement process according to an embodiment of the present disclosure. FIG. 3 and FIG. 5 are views showing a combined state of a form and a guide according to an embodiment of the present disclosure, FIG. 6 is a view showing a guide according to an embodiment of the present disclosure, and FIG. 6 is a view showing a micro marker placement state according to the embodiment of the present disclosure.

First, referring to FIG. 1, a micro marker mounting process according to an embodiment of the present invention will be described. As a pre-positioning micro marker (see 14 in FIG. 6) (S11), and establishes a surgical plan based on the photographed image data. Particularly, in the operation planning process, a virtual position for placing the micro marker 14 in the image space is determined (S12). For imaging, a conventional CT device or MRI device can be used. By using all of them, an optimal image for a surgical site including a hard tissue is obtained. It is preferable to determine a specific position at which the micro marker 14 is to be placed on the hard tissue surface using the obtained image data, and determine a plurality of positions.

Also, as shown in FIG. 4, a guide 13 having a shape corresponding to the hard tissue of the surgical site is prepared using the photographed image data (S13). The guide 13 is configured to guide the micro marker 14 to be placed at a correct position when the micro marker 14 is placed on the hard tissue. One side surface of the guide 13 for this purpose is formed in a negative shape closely corresponding to the surface of the hard tissue. A hole through which the micro marker is passed is formed at a position where the micro marker 14 is placed. A plurality of holes may be formed according to the number of the micro markers 14, and a plurality of the guides 13 may be formed.

The position where the micro marker 14 is to be placed and the hole formation in the guide 13 corresponding to the position where the micro marker 14 is to be placed can be formed by a predetermined program. In the template, a hole is formed to accurately guide the micro marker to the planned position in the program. At this time, it is preferable that the hole portion where the micro marker 14 is placed is made of a metal material or a reinforcement material which can prevent abrasion.

The guide 13 can be manufactured through a rapid prototyping machine. SLS machines manufactured by 3D System can be made by using a transparent photo-curable polymer resin of liquid resin, and the SLS machine of DTM is made by fusing powder using a laser, and Stratasys The FDM machine can be made using a thin, thermoplastic material. After the guide is manufactured, a transparent or colored guide can be produced after a slight polishing.

On the other hand, after the guide 13 is manufactured, the guide 13 is bonded to the hard tissue surface while entering the actual operation step (S14). At this time, since the guide 13 has a negative shape corresponding to the surface of the hard tissue, accurate coupling can be achieved as shown in FIG. After the guide 13 is coupled to the hard tissue, the micro marker 14 is placed (S15). Since the guide 13 has holes for the micro-markers 14 to penetrate therethrough, the micro-markers 14 are guided by the holes and can be placed on the hard tissue surface at the correct positions. After the plurality of micro markers 14 are placed, the guide is removed (S16).

After the guide is removed, the micro marker 14 remaining in the hard tissue is used as an index point for matching the surgical space and the image space. As shown in FIG. 6, the micro markers 14 are arranged in a plurality, and at least three or four or more micro marks 14 are preferably placed.

In the method of placing a micro marker according to an embodiment of the present disclosure, a preliminary marker is placed outside the soft tissue before surgery, and a surgery plan can be established based on the preliminary marker. That is, as shown in FIG. 2, in the micro marker placement process according to another embodiment of the present disclosure, a process of bonding a mold to a surface of a soft tissue in a pre-operation step is performed first (S21). A series of steps of photographing the surgical site in the state where the form is coupled and placing the guide and micro marker in accordance with the surgical plan are performed in the same manner (S22 to S27).

Here, the mold 11 is bonded to the surface of the soft tissue at the surgical site, and the mold 11 can be made of a variety of hardenable materials such as gypsum or through a rapid prototyping method such as a guide. In particular, in the present disclosure, a plurality of spare markers 12 are placed on the manufactured die 11. As shown in FIG. 3, the molds 11 are joined at both sides of the soft tissue, and two preliminary markers 12 are usually placed on the respective molds, and four spare markers 12 as a whole are displayed at the time of imaging. The spare marker 12 may be placed on the mold in a state where the mold 11 is coupled to the soft tissue and the mold 11 on which the spare marker 12 is placed may be coupled to the soft tissue.

The preliminary marker 12 can be used as an index point in establishing the operation plan by using CT or MRI images pre-operatively. That is, by establishing the surgical plan using a plurality of spare markers 12 and hard tissue information appearing on the CT or MRI image data, the virtual position at which the micro marker is to be placed can be determined more precisely. Therefore, more precise surgery can be performed by using the mold in which the pre-surgery marker is placed. After the imaginary position at which the micro marker is to be placed is determined using the spare marker 12, a guide is prepared and a process of placing the micro marker is performed.

Meanwhile, according to the embodiment of the present disclosure, after the micro-markers are placed, the matching of the image space and the operation space can be performed by using the micro-markers as landmarks. The matching of the video space and the surgical space can be performed in two ways. The first method is based on the image matching technique and the second method is based on the sensing means technique.

FIG. 7 is a flowchart illustrating a matching process using an image matching technique of an image space and a surgical space according to an embodiment of the present disclosure. FIG. 8 is a flowchart illustrating a matching process using an image matching technique between an image space and a surgical space according to an embodiment of the present disclosure FIG.

As shown in FIG. 7, in a state in which a plurality of micro-markers are placed (S31), the micro marker 14 is automatically detected in the operation procedure (S32), and the image with the detected micro marker and the virtual micro marker The image matching method is applied to the image having the image space to match the operation space (S33). Here, the detection image of the micro marker can be detected by using the C-arm or CT Fluoroscopy. As shown in FIG. 8, using the two-dimensional C-Arm or CT Fluoroscopy image, . In this case, the image matching technique can be generally performed by a transform matrix calculation method, and the calculation method of a transform matrix is exemplified in Korean Patent No. 10-0529119. As an image matching method, it is also possible to manually match landmarks in addition to an automatic method using a transform matrix calculation method.

When matching the image space and the surgical space, if the patient moves during the operation, the micro marker is detected again and the image matching technique is applied again to the image with the virtual micro marker. When the hard tissue moves according to the patient's movement in the surgical field, the position of the changed micro marker is detected by acquiring the image from the C-Arm or CT Fluoroscopy under real-time monitoring, and according to the transform matrix calculation, Lt; / RTI >

FIG. 9 is a conceptual view illustrating a matching process through a sensing means technique of an image space and a surgical space according to an embodiment of the present disclosure.

A surgical navigation device 15, an infrared camera 16, a reference frame 17, and a monitor 18 are provided in the surgical field. On the other hand, as part of the patient, the bone (BN), the tumor (TM) transferred into the bone (BN), the inner tissue (TS) relatively movable with respect to the bone (BN) Are shown. The reference frame 17 can be fixed to the bone BN after incising the internal tissue TS in the surgical field. At least three micro-markers (19, 20, 21) are embedded in the bone (BN), and these are used as index points in the registration of the surgical space and the image space. Namely, when each of the micro markers 19, 20, and 21 is designated by using a surgical tool or probe 23 having an infrared ray reflector 22, a micro marker and a virtual micro marker are associated with each other, The matching of the image spaces is performed. A method of matching an operation space and an image space in this manner is described in Korean Patent Registration No. 10-0957727. In this embodiment, the infrared ray reflector and the infrared ray camera are described as the sensing means, but the present invention is not limited thereto. For example, a magnetic sensor using an electromagnetic wave can be used as the sensing means, and in this case, the infrared ray reflector can be replaced with a coil.

Since the micro-marker placed on the hard tissue surface according to the embodiment of the present disclosure accurately recognizes the movement of the patient regardless of how the patient moves, the alignment of the image space with the operation space causes the vision- It is possible to check whether the surgical instruments are positioned correctly according to the preoperative plan and to control the surgical robot to move accurately according to the preliminary plan.

Also, in the case of the matching of the image space and the surgical space according to the embodiment of the present invention, even when the patient is moving, the image for detecting the new position of the micro marker is obtained by using the C-arm or CT Fluoroscopy It is possible to easily match the operation space and the image space by applying the image matching technique to the image having the virtual micro marker.

Also, in the case of the matching of the surgical space and the image space according to the sensing means technique embodiment of the present disclosure, unlike the prior art, it is sufficient to attach the marker to the patient without attaching the marker to the patient, So that the convenience of the surgery can be improved.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed exemplary embodiments.

11: mold 12: spare marker 13: guide 14: micromarker

Claims (10)

A first step of obtaining image data of a patient before surgery;
A second step of virtually installing a micro marker on the image data of the patient before the operation;
A third step of fabricating a guide for allowing the actual micro markers to be physically placed at the same position as the position where the virtual micro markers are installed; And,
And a fourth step of matching the image space with the operation space using the virtual micro marker and the actual micro marker as the landmarks. The method according to claim 1,
Wherein the image data of the patient is obtained before the operation so that a spare marker attached to the soft tissue of the patient appears in the first step. The method of claim 2,
Wherein the shape marker is used to attach the spare marker to the soft tissue of the patient. The method of claim 2,
Wherein the spare marker is composed of at least four or more. The method according to claim 1,
Wherein the hole portion in which the micro marker of the guide is inserted is made of a metal material capable of preventing abrasion. The method according to claim 1,
The method comprising: acquiring image data of a patient including a practiced micro marker in a fourth step, and matching the image and patient image data with an image of a pre-operation patient showing a virtual micro marker. The method of claim 6,
Wherein when the motion of the patient is detected, the image data of the patient including the actually placed micro-marker is newly acquired. The method of claim 6,
Wherein the image data of the patient is obtained before the operation so that a spare marker attached to the soft tissue of the patient appears in the first step. The method according to claim 1,
And a fourth step of associating the actually placed micro markers with the virtual micro markers using the sensing means. The method of claim 9,
Wherein the image data of the patient is obtained before the operation so that a spare marker attached to the soft tissue of the patient appears in the first step.

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