WO1999027837A2 - System and method for guiding the movements of a device to a target particularly for medical applications - Google Patents

System and method for guiding the movements of a device to a target particularly for medical applications Download PDF

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Publication number
WO1999027837A2
WO1999027837A2 PCT/IL1998/000578 IL9800578W WO9927837A2 WO 1999027837 A2 WO1999027837 A2 WO 1999027837A2 IL 9800578 W IL9800578 W IL 9800578W WO 9927837 A2 WO9927837 A2 WO 9927837A2
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WIPO (PCT)
Prior art keywords
system
transmitter
device
position
position sensor
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Application number
PCT/IL1998/000578
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French (fr)
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WO1999027837A3 (en
Inventor
Yoav Paltieli
Victor A. Segalescu
Ron Nagar
Michael Hareven
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Ultraguide Ltd.
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Publication date
Priority to IL12233697A priority Critical patent/IL122336D0/en
Priority to IL122336 priority
Application filed by Ultraguide Ltd. filed Critical Ultraguide Ltd.
Publication of WO1999027837A2 publication Critical patent/WO1999027837A2/en
Publication of WO1999027837A3 publication Critical patent/WO1999027837A3/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3403Needle locating or guiding means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/0841Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107Visualisation of planned trajectories or target regions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • A61B2090/378Surgical systems with images on a monitor during operation using ultrasound
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3925Markers, e.g. radio-opaque or breast lesions markers ultrasonic
    • A61B2090/3929Active markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3937Visible markers
    • A61B2090/3945Active visible markers, e.g. light emitting diodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • A61B8/4472Wireless probes

Abstract

A system and method for guiding the movements of a device (2) to a target (4) particularly for medical applications is provided. In one aspect of the invention, the system guides the movements of a device (2) toward a target (4), which is viewable from an image. The system includes at least one scanning apparatus (5) for creating the image including the target (4), at least one transmitter 10 at a first reference location for transmitting radiant energy from the reference location, several position sensors (8, 9) and a data processor (6). The position sensors (8, 9) include at least one position sensor (8) on the device (2) for receiving the radiant energy, at least one position sensor (9) on the scanning apparatus (5) for receiving the radiant energy and at least one position sensor (8, 9) for receiving the radiant energy on either the device (2) or the scanning apparatus (5). The data processor (6) is in operative communication with the transmitter (10) and each of the position sensors (8, 9), for monitoring the accuracy of the calculated position of the device (2) with respect to the scanning apparatus (5).

Description

SYSTEM AND METHOD FOR GUIDING THE MOVEMENTS OF A DEVICE TO _ A TARGET PARTICULARLY FOR MEDICAL APPLICATIONS

FIELD OF THE INVENTION

The present invention relates to guidance systems and safety systems ^ associated therewith, and also to methods for their use for guiding the movements of a device towards a target The invention is particularly useful in medical applications for guiding the movements of a medical device, such as an aspiration, biopsy needle, or an endoscope, through biological tissue in a body to a target therein, in conjunction with an imaging system, such as ultrasound, CT or

10 MRI

BACKGROUND OF THE INVENTION Guiding systems are used in medical applications for the purpose of guiding various types of medical devices, such as aspiration and biopsy needles, endoscopes, etc , towards specific targets within the body For example, where i guiding a biopsy needle, a position sensor is usually rigidly affixed to the top of the needle, and its absolute position in space is determined The part of the body in which the target tissue is located is usually imaged by an imaging system, such as ultrasound, CT, MRI The absolute position of the plane displayed by the imaging system can likewise be determined with the aid of a similar position sensor, so 0 that the relative location and orientation of the needle with respect to the target tissue can be calculated Once these values are determined, it is possible to compute the expected path of the needle towards the target and to display it on the image in order to enable the physician to navigate the biopsy needle (or other medical devices) to the target Such a composite device using ultrasound imaging for guidance has been described in our Patent Application No PCT/IL96/00050, published February 6, 1997, the description of which is hereby incorporated by reference In that case, the location and orientation of the ultrasound scan plane is measured by a sensor mounted on the ultrasound transducer

The most prevalent method for effecting the required measurements is by transmitting a set of signals from a transmitter located at a fixed location in space, which signals are received by a set of sensors mounted on the biopsy needle (or other device being navigated) Both the transmitter and the receiver are linked, in this case, to a separate set of Cartesian coordinates The relative position and orientation of the receiver Cartesian coordinates with respect to the transmitter ones is given by a translation vector pointing from the transmitter's to the receiver's origin of coordinates and by a three-dimensional rotation matrix

The transmitter signals received by the receivers are sufficient to determine the components of the said vector and matrix Thus, the location and orientation of the device can be calculated with respect to the transmitter's coordinates The

signals utilized for this purpose may be light, radio frequency (RF) or low-frequency (LF) electromagnetic waves, etc The above method is sensitive to measurement errors caused by interfering objects and/or interfering electromagnetic fields present in the vicinity of the receiving sensors In the case of medical intervention procedures, such measurement errors may cause irreversible damages to the patient's body, and

as such must be avoided OBJECTS AND BRIEF SUMMARY OF THE PRESENT INVENTION

An object of the present invention is to provide systems, and also methods having advantages in the above respects for guiding the movements of 4 a device towards a target More particularly, an object of the present invention is to provide systems and methods that may be used for guiding medical devices towards a target in a body, which method and system will produce an indication, more particularly will actuate an alarm, if interfering objects and/or interfering electromagnetic fields are present which might produce measurement errors that

10 could cause serious injury to the patient's body

According to one aspect of the present invention, there is provided a system for guiding the movements of a device towards a target, comprising transmitter apparatus at a reference location in space for transmitting radiant energy from said reference location, position sensor(s) on said device to be

ID guided to the target, said position sensor(s) receiving radiant energy from the transmitter apparatus and producing an output corresponding to the position of said device with respect to said reference location in space, and a data processor receiving the output of said position sensor and calculating the position of said device with respect to said reference location, position sensor(s) on said scanning

20 device, which is scanning the target, as said position sensor(s) receiving radiant energy from the transmitter apparatus and producing an output corresponding to the position of said scanning device with respect to said reference location in space, and a data processor receiving the output of said position sensor(s) and calculating the position of said device with respect to said reference location and also calculating the position of said guided device with respect to said scanning device/imaging plane Such a system was described in our Patent Application No PCT/IL96/00050, incorporated by reference in its entirety herein, and further referred as first guidance system According to a further aspect of the invention the guiding system is employed with a safety system characterized in that transmitter apparatus includes a first transmitter (T^ and a second transmitter (T2) in a known spatial

relationship to each other defined by a known vector ( fn ), and further

characterized in that said data processor (a) produces a measurement of the location and orientation of the position sensor with respect to said first transmitter (Tj) and defines same by a first vector,

(b) produces a measurement of the location and orientation of the position sensor with respect to said second transmitter (T2) and defines same by a

second vector,

(c) calculates from said first vector and the said second vector a

measured vector ( fn )m between the two transmitters,

(d) compares the measured vector ( JP )m with the known vector ( 12 ),

and

(e) produces an output corresponding to the absolute value of the

difference between the measured vector ( fl2 )m and the known vector ( fn )

According to further features in the described preferred embodiment, the

data processor includes an alarm, compares the output produced in step (e) with a predetermined threshold value, and actuates said alarm if the output produced in step (e) exceeds said predetermined threshold value

According to still further features in the described preferred embodiment, the device is a medical device, more particularly an interventional device such as a biopsy needle, to be guided through the body to a target therein An imaging system is provided which scans the body by a scanning device along a plurality of scan lines The scanning device also includes a second position sensor receiving radiant energy from the first and second transmitters The data processor produces an output corresponding to the position of the second position sensor, and thereby of the scanning device with respect to said known location in space The data processor performs said step (a) - (e) also with respect to said second position sensor to produce an output error with respect to the measured vector

( 7j ,„for the scanner, and utilizes the larger of said two output errors for

comparison with the predetermined threshold and for activating the alarm According to further features in the described preferred embodiment, the scanning device is an ultrasound scanner (transducer) and the first and second transmitters are mounted at the opposite ends of an arm having a known length

and orientation in space defining the known vector ( 7j2)

The invention also provides methods for guiding the movements of a device towards a target

The invention also provides apparatus and methods for ensuring the safety of the system by providing redundant transmitters, redundant receivers and/or alternating signaling mechanisms The invention also discloses additional guidance systems and apparatus and methods for ensuring the safety of these systems by providing redundant transmitters, redundant receivers and/or alternating signaling mechanisms

More particularly, an object of the present invention is to provide systems and methods that may be used for guiding medical devices towards a target in a body, which method and system will produce an indication, more particularly will actuate an alarm, if interfering objects and/or interfering electromagnetic fields are present which might produce measurement errors that could cause serious injury to the patient's body

Further features and advantages of the invention will be apparent from a

description below

BRIEF DESCRIPTION OF THE DRAWINGS

The invention is herein described, by way of example only, with reference to the accompanying drawings, wherein like reference numerals or characters indicate corresponding or like components In the drawings Fig 1 pictoπally illustrates one form of a system constructed in accordance with the present invention for guiding the movements of a device by ultrasound, in this case a medical biopsy needle, towards a target, employing a safety system based on redundant transmitters, where the relative positional relationship between the transmitters is known, Fig 2 diagrammatically illustrates the various vectors involved in using the system of Fig 1 for guiding the movements of the biopsy needle towards the target,

Fig 3a is a flowchart illustrating Safety Algorithm 11 for the operation of the systems of the present invention, Fig 3b is a flowchart illustrating Safety Algorithm 12 for the operation of the systems of the present invention

Fig 3c is a flowchart illustrating Safety Algorithm 13 for the operation of the systems of the present invention,

Fig 3d is a flowchart illustrating Safety Algorithm 14 for the operation of the systems of the present invention

Fig 3e is a flowchart illustrating the sequential analysis that can be performed on the output of Safety Algorithms 11 , 12, 13 or 14,

Fig 4 pictonally illustrates one form of a system constructed in accordance with a present invention for guiding the movements of a device by ultrasound, in this case a medical needle, towards a target employing a safety system based on redundant transmitters, where the relative positional relationship between the transmitters is unknown,

Fig 5a shows the guidance system and safety system of Fig 1 , where the locations of the transmitters and receivers have been switched,

Fig 5b shows the guidance system and safety system of Fig 1 , where the transmitters are replaced by transcievers and the receivers are replaced by reflectors,

Fig 6 pictoπally illustrates one form of a system constructed in accordance with the present invention for guiding the movements of a device by ultrasound, in this case a medical needle, towards a target, employing a safety system based on redundant receivers,

Fig 7 diagrammatically illustrates the various vectors involved in using the system of Fig 6 for guiding the movements of the needle towards the target, Fig 8a is a flowchart illustrating Safety Algorithm 21 for the operation of the systems of the present invention,

Fig 8b is a flowchart illustrating Safety Algorithm 22 for the operation of the systems of the present invention,

Fig 8c is a flowchart illustrating Safety Algorithm 23 for the operation of the systems of the present invention,

Figs 9a-9c illustrate various waveforms associated with a safety system based on signal alternating (hopping), Fig 10 pictoπally illustrates a second guidance system constructed in accordance with the present invention for guiding the movements of a device by ultrasound, in this case a medical needle, towards a target,

Fig 11 a pictoπally illustrates a third guidance system constructed in > accordance with the present invention for guiding the movements of a device by ultrasound, in this case a medical needle, towards a target,

Fig 11 b shows the guidance system of Fig 11a, where the positions of the transmitters and receivers are switched,

Fig 11c shows the guidance system of Fig 11a, where the lo transmιtter(s) is/are replaced by a transceiver and the receιver(s) is/are replaced by reflectors,

Fig 12 diagrammatically illustrates the various vectors involved in using the system of Figs 11a-11 c,

Fig 13 pictoπally illustrates the third guidance system of the present ID invention, employing a safety system based on redundant transmitters,

Fig 14 diagrammatically illustrates the various vectors involved in using the system of Fig 13 for guiding the movements of the needle towards the target,

Fig 15 pictoπally illustrates the third guidance system of the present invention, employing an alternate safety system based on redundant receivers, 0 Fig 16 diagrammatically illustrates the various vectors involved in using the system of Fig 15 for guiding the movements of the needle towards the target, and, Fig 17 pictoπally illustrates the third guidance system of the present invention, employing a safety system based on redundant transmitters and redundant receivers

DETAILED DESCRIPTION OF THE DRAWINGS

The system illustrated in Fig 1 shows the invention of the present application embodied in an ultrasound imaging system based on the guidance system described in the above-cited Patent Application PCT/IL96/00050, hereby incorporated by reference (also referred to herein as a first guidance system), in an operating area 1 , for guiding a biopsy needle 2 through a body 3 to a target 4 within the body The body 3, the needle 2, and the target 4, are all imaged by an ultrasound transducer (scanner) 5, or other similar scanning device, connected to a data processor 6 which produces an image of the target 4 on a display screen 7

A safety system, based on two or more transmitters, at least one of these transmitters being "redundant" or additional, is incorporated with this first guidance system The needle 2 includes a position sensor 8, typically a receiver (Rn), at a predetermined location on the needle 2 The ultrasound transducer 5, also includes a position sensor 9, typically a receiver (Ru), at a predetermined

location on it

Transmitter apparatus, generally designated 10, transmits radiant energy, preferably in signals, such as light, magnetic or electromagnetic radiation at frequencies ranging from approximately DC to approximately high frequency, to the two position sensors 8 and 9 The two position sensors 8 and 9 receive this radiant energy from transmitter apparatus 10, preferably including two transmitters 10a, 10b (Ti T2), also known as transmitter units, and produce outputs corresponding to the positions of the needle 2 and the transducer 5, respectively, with respect to a reference location in space occupied by the transmitter apparatus 10 Data processor 6 receives the information from the transmitter apparatus 10, the needle position sensor 8, and the transducer position sensor 9 It processes this data and displays on the display screen 7 the expected position and trajectory of the needle 2 with respect to the target 4, thereby aiding the physician to guide the movement of the needle 2 towards the target 4

Further details of the construction and operation of the system illustrated in Fig 1 , as well as other similar systems that could be used, are set forth in the above-cited Patent Application PCT/IL96/00050, incorporated herein by reference In the system described in PCT/IL96/00050 the transmitter apparatus

10 includes a single transmitter, such as described in U S Patent 4,945,305 (Blood), for transmitting the signals to position sensor 8 on the needle 2, and to position sensor 9 on the transducer 5 The position of the transmitter, serves as a reference in space for the two position sensors As briefly described above interfering objects and/or interfering fields, such as electromagnetic fields, within the region, particularly in the vicinity of either of the position sensors 8, 9 may produce measurement errors which if relied upon by the physician in guiding the needle 2, may cause serious injury to the patient The system illustrated in Fig 1 , therefore, includes an arrangement which is effective to alert the physician, e g by the actuation of an alarm 18, in the event that there are interfering objects or interfering fields in the immediate vicinity which could produce measurement errors of a magnitude that could cause injury to the patient, so that the physician will not rely on the displayed measurements until the interfering objects are removed For this purpose, the transmitter apparatus 10 preferably includes two transmitters 10a, 10b (Ti and T2), also known as transmitter units, one being "redundant" or additional, mounted at the opposite ends of an arm 11 having a

known spatial relationship, defined by the vector fn . Arm 11 is supported on a

stand 12 mounted on a base 13.

In the example illustrated in the drawings, the two transmitters 10a, 10b (Tι,T2) are both oriented in arbitrary directions; that is, the two sets of Cartesian coordinates to which the two transmitters are linked may be parallel or non-parallel to each other. As seen in Fig. 2, the separation of the origins of the

coordinates is described by a known and fixed vector fl2 , determined by the

construction of the device and therefore known or measurable beforehand. The safety system detailed in Figs. 1 and 2 is based on transmitter redundancy and the position of each receiver is measured relative to the position of each transmitter unit, the positions of the transmitter units being reference positions.

The magnitude of the arm 11 , and thereby of fixed vector fn , should be

long enough to amplify the effects of the errors, when and if they occur by the presence of an interfering object or interfering fields, but should be short enough to make the device relatively compact. In applications such as described herein, the length of arm 11 is preferably from 0.1 to 1.0 meters, most preferably about 35 cm.

Fig. 2 illustrates the location and orientation of transmitter 10b (T2) from

transmitter 10a (Ti) as represented by the known vector 12. The location and

orientation of position sensor 8 on the needle 2 is represented by a first vector dn with respect to transmitter Ti, and by a second vector „ ,2 with respect to

transmitter T2. Similarly, the distance and orientation of position sensor 9 on the

ultrasound transducer 5 is represented by a third vector u ,,with respect to

transmitter Ti, and by a fourth vector du t2 , with respect to transmitter T2.

The location of the needle tip 2' relative to the needle position sensor 8

is represented by Ln, the location of the needle tip relative to the ultrasound position sensor 9 is represented by dn.,u,τi, i =1 ,2, where the index Tj indicates that the measurement was made according to transmitter Ti, or T2.

Since the arm 11 carrying the two transmitters 10a, 10b (T-,, T2) at its

opposite ends is fixed in space, the vector fn representing the location and

orientation of transmitter T2 with respect to transmitter T-i, (which as described above is known beforehand) remains fixed during the operation of the system. However, as needle 2 is manipulated during the operation of the system, the first

and second vectors dn and du representing the location and orientation of the

needle sensor 8 with respect to the two transmitters Ti and T2, respectively, continuously change with the movement of the needle. Similarly, the third and fourth vectors "ϋ^ and J^l2 , representing the location and orientation of the

ultrasound transducer position sensor 9 with respect to transmitters 10a and 10b (Ti and T2) respectively, also continuously change with the movement of the

ultrasound transducer 5.

The output of the position sensors 8, 9 and data for the transmitter apparatus 10 are communicated in any suitable manner, e.g. by wired or wireless links 14, 15, 16, 17 respectively, to the data processor 6. Based on the data received therefrom, the data processor 6 measures the position of the sensors 8, 9 with respect to the transmitters 10a, 10b (T-, and T2).

The data processor 6 processes the inputted data to calculate, and display the expected trajectory of the needle 2 towards the target 4 on the display screen 7, in the manner described in the above-cited Application PCT/IL96/00050. However, data processor continuously performs additional operations, preferably in the form of Algorithms 11 , 12, 13 and 14, detailed immediately below, and illustrated in Figs. 3a-3c, constituting an error-analysis procedure. As described below, the purpose of the error-analysis procedure (as well as that of the safety system) is to alert the physician, as by actuating an alarm 18 (Fig. 1), should there be in the immediate vicinity interfering objects which might produce measurement errors which could lead to injury to the patient should the physician rely on these calculations and on the display on screen 7 for guiding the needle to the target.

Algorithm 11

The vector fn can be determined by a mechanical measurement. It can

also be determined by measurement in an interference-free environment. For example, a needle containing a position sensor attached to its tip may be placed in an environment free of interference, and the position of the sensor may then be measured with respect to the coordinates linked to transmitters 10a and 10b (Ti and T2). The actual measurement may be by optical means, e.g. lasers, or any other known method for measuring position. For this algorithm, block 120 illustrated in Fig. 3a (generally measured off-line) is the starting state of the error-analysis procedure performed by data

processor 6 to define the vector f . The data processor first measures the

location vector distance dn ύ ; and orientation matrix Mn „ defining the location

and orientation of the position sensor 8 on needle 2 with respect to transmitter

10a (Ti) (block 121). It then measures the location vector dn l2 and the matrix

Mn,t2, defining the location and orientation of the needle position sensor 8 with respect to transmitter 10b (T2) (block 122). From these measurements, the data processor then computes the measured value of the vector (T12)m defining the location of transmitter T2 with respect to transmitter Ti by making the following computation (block 123):

{fn Ym = dn ] -[Mn ^[Mn l2 ]dn 2 Eq. (1)

The value of the known vector Tι2 between the two transmitters Ti and T2 is subtracted from the value of the measured vector between the two

transmitters to compute the error (Δn) as follows (block 124):

Figure imgf000018_0001

The steps represented by blocks 121 , 122, 123 and 124, are then repeated with respect to position sensor 9 on the ultrasound transducer 5, in blocks 125, 126, 127 and 128, respectively, wherein block 128 computes the error between the known vector Tn and the transducer-based measured vector (TnY

by making the following computation:

Figure imgf000019_0001
In block 129, a computation is made as to the larger of the two errors, determined in blocks 124 and 128, respectively. The larger of the two errors, defined by En, is then subject to a one step analysis or a sequential analysis in block 130 (detailed in Fig. 3e). The one step analysis consists of comparing En with a threshold Thn, (a maximum permissible error) (block 131), which, if exceeded, actuates alarm 18 (block 132). This alerts the physician that the calculations and display on screen 7 are not to be relied upon because of the errors produced by the intervening objects.

Algorithm 12

Implementation of Algorithm 12, as described below and illustrated in Fig. 3b does not require previous knowledge of the position relationship between the two transmitters 10a, 10b (Ti and T2).

After measuring the position of the needle sensor 8 and ultrasound transducer sensor 9 with respect to Ti, blocks 141 and 142 (similar to blocks 121 and 125 respectively), the data processors calculates the location of the needle position sensor 8 relative to ultrasound transducer position sensor 9, in block 143 is as follows:

cC,n = [Mu,τι] • { djrι - d-Tπ } (Eq. 4) Similarly the data processor calculates in block 146 the location of the needle position sensor 8 relative to ultrasound transducer position sensor 9 defined as dn u T2 based on measurements made relative to T2, as in blocks 144 and 145 (similar to blocks 122 and 126 respectively). The difference between the computed vectors in block 147, defined as

^12 is then calculated as follows:

E12 = ||~c ,u,τι - dn,u,T2 || (Eq. 5)

The value E12 can then be processed in the same manner as En in Fig.

3a.

Algorithm 13

The implementation of Algorithm 13, as described below and illustrated in Fig. 3c, does not require knowing the relative spatial relationship between the transmitters 10a, 10b.

Algorithm 13 is similar to Algorithm. 12, except it is based on calculating the position of the needle tip 2' (referred by subscript "nt") relative to the

ultrasound transducer position sensor 9, this vector expressed as dnt,u-

Initially, steps, shown as blocks 161 , 162, corresponding to those detailed as blocks 141 and 142 (Fig. 3b above) are performed. The data processor 6 then calculates the position of the needle tip 2' with respect to the ultrasound transducer position sensor, based on Ti transmissions, block 163, as follows:

d"nTu,τι = [Mu.τι] * { cCτι - < τι + [Mn,T1]T *~U } (Eq. 6) Similarly, the data processor calculates in block 166, the position of the needle tip 2' with respect to the ultrasound transducer position sensor 9, defined as dnt|U,T2, based on T2 transmissions, according to the measurements made relative to T2 in blocks 164 and 165. The difference between the two vectors, defined as E13 is then calculated in block 167 as follows:

Ei3 = II dnt,u,T1 - dnt,u,T2 || (Eq. 7)

The value E13 can then be processed in the same manner as En or E12 in Figs. 3a and 3b above. A variation to Algorithm 13 can be made by employing in Eq. 6 a vector other than Ln.

Algorithm 14

Algorithm 14, shown by a flowchart in Fig. 3d, is a variation to Algorithm 11. It begins with the steps detailed as blocks 120-122 as detailed for Algorithm 11 above. The data processor 6 then calculates, based on the measurements made in blocks 121 and 122, the orientation matrix of the transmitter 10b (T2) with respect to the other transmitter 10a (Ti) in block 173, and defines this orientation

matrix as: [MT2J m

This value for the orientation matrix is then compared with the known

orientation matrix, [MT2,τι], in block 174, resulting in output E1 ι, as follows:

^| I Kr2.n l - [ r2.r. ]j • L ref \\ (Eq.S) where Lref is a predefined vector.

Measurements in accordance with blocks 125 and 126 (detailed above) are then performed, whereby these measurements are used to calculate the orientation matrix, [MT2 Tl ]"m, in block 177. This value for the orientation matrix is then compared with the known orientation matrix, [Mτ2,τι], in block 178, resulting in output E142 (similar to the calculation made in block 174 above). The maximum for the values E14ι and Eι42 is calculated in block 179, and defined as E .

The value E can then be processed in the same manner as En or E12 in Figs. 3a and 3b above. It must be emphasized that in most cases Algorithm 13 and its proposed variations are preferred, since they are based on the same parameters as the guiding calculation (the needle tip 2' relative to the ultrasound imaging target 4).

A variation to the transmitter redundancy Algorithms 12 and 13 can be based on making the same measurement by N transmitter units, where N>2 and

preferably an odd integer. In this case, the data processor 6 checks that more than P (an integer greater than N/2) of the measurements made relative to different transmitter units are in accord in order to clear the measurement.

While Algorithms 11-14 and variations thereof have been disclosed, additional Algorithms for systems having redundant transmitters are also

permissible.

If the transmitter units are not transmitting simultaneously, rather one at the time, additional care should be taken in order to avoid effects of movement when applying this method. More specifically, motion should be noticed and/or be compensated for Such algorithms involving Kalman filters or other linear or non-linear estimators may be employed here

Fig 3e is a flowchart illustrating sequential analysis (see block 130 of Figs 3a-3d) The input to the sequential analysis can be the output of any of Algorithms 11 , 12, 13 or 14, and/or other Algorithms detailed herein (together all separately) The values monitoring measurement errors, such as En (block 181a), E12 (block 181b) etc , can be subject to a sequential analysis together or separately as desired by enabling the register switches Sn, Sι2, Sι3, etc , with the requisite switch Sn, Sι2, enabled The enabled values are stored in a buffer 183 and then they are subjected to one of the following analysis

(a) m out of k = checking for m "bad" values out of k measurements (block 184),

(b) Counter = incrementing by Va when receiving a "bad" measurement, and decrementing by Val2 when receiving a "good" measurement (block 185),

(c) Other Analysis This involves, for example, sequential analysis in which each safety measurement receives a coefficient (weight) according to its difference from a threshold value (block 186)

The preferred analysis to be employed is chosen by enabling the switch desired, these switches being SWn, SWι2 and SWn The output of the Analysis block is then continuously inputted to a decision-maker block 188, which if necessary signals an alarm (block 189) As long as the guidance system is functioning, the safety system monitors the accuracy of the measurements by continuing to take safety measurements (block 190) Fig. 4 is similar to the guidance and safety system shown and described in Fig. 1 , except the transmitters 10a (Ti) and 10b (T2) are not necessarily in a known spatial relationship. The vector diagram for the safety system would be in accordance with that shown and described for Fig. 2. Algorithms 12, 13, or variations thereof can be employed with the safety system and method for its use.

Fig. 5a is similar to the guidance and safety system shown and described in Fig. 1 , except the positions of the transmitters Ti and T2 and receivers 8 (Rn), 9 (Ru) have been switched. The receivers 8', 9' (Ri, R2) (in accordance with receivers 8, 9 detailed in Fig. 1 above) are located on reference positions, and the transmitters 10a', 10b' (Tu and Tn) (in accordance with transmitters 10a and 10b detailed in Fig. 1 above) are affixed to the ultrasound transducer 5 and on the needle 2, respectively. A system comprising only the receiver 9' (Ri) and transmitters 10a', 10b' (T-i, T2) as illustrated in Fig. 5b, would result in a similar system to that of the first guidance system, as described in PCT/IL96/00050. Measuring the position of the ultrasound transducer 5 and of the needle 2 with respect to the reference location is performed as above. The vector diagram for the guidance and safety system (receivers Ri, R2 and transmitters Tn, Tu) would be in accordance with that shown and described for Fig. 2 (except for replacing the appropriate indexes from T to Ri, i =1 ,2). Algorithms 11 , 12, 13, 14 or variations thereof can be employed with the safety system and method, for its use.

Fig. 5b is similar to the guidance and safety system shown and described in Fig. 1 , except, the transmitter apparatus is replaced by transceivers 20a, 20b (TR.,, TR2), typically formed of a transmitter unit coupled with a receiver, and the receivers are replaced by reflectors 21 (RLJ mounted on the needle 2,

and reflectors 22 (RL2), mounted on the ultrasound transducer 5 The vector

diagram for this safety system would be in accordance with that shown and described for Fig 2 Algorithms 11 , 12, 13, 14 or variations thereof can be employed with the safety system and method

Fig 6 illustrates a second safety system based on receiver redundancy, to be employed with the first guidance system as disclosed in our PCT IL/96/00050 The apparatus of the invention would be modified slightly as follows The transmitter apparatus 10 would include only a single transmitter unit 10a (T,),

although additional transmitter units are also permissible therein Either the needle 2, the ultrasound transducer 5 or both would have an additional sensor receiver (redundant) It is preferred that the sensors (one sensor being redundant) be spaced as far apart as possible and at different orientations on the device to maximize the probability that any interference will affect each individual sensor 8, 9 (on the needle 2 and ultrasound transducer 5) differently

Alternatively control position sensor(s) 23a, 23b, typically receivers RCa,

RCfc (in accordance with those detailed above) could be placed in the operating

area 1 These control position sensors 23a, 23b would function only to monitor any interference, described above and are placed as a group of sensors with known or fixed positional relationship to each other Additionally, a reference control position sensor 24 typically a receiver Rref (in accordance with those

detailed above) could be placed on a member 1 1 at a known and fixed position with respect to the transmitter 10a (T It is to be noted that the safety system based on receiver redundancy to be employed together with said first guiding system can be based on one or more of the above receiver arrangements, and it is not necessary to implement all of the above together The sensor(s) 8 (receivers) on the needle 2 and the sensor(s) 9

(receivers) on the ultrasound transducer 5, the transmitter unit 10a (T., ) and the

control sensors 23a, 23b (receivers) (if employed) and the reference sensor 24 (receiver) (if employed) are connected by wireless or wired connections 14, 16, 17, 25, 26 (detailed above) to the data processor 6 The data processor 6 then processes the received data, from the sensors 8, 9, 23a, 23b, 24 and transmitter unit 10a (TJ, in accordance with any one of Algorithms 21 , 22 or 23 (below), such

as to monitor interference and alert the physician in case the measurements are degraded over a predetermined margin

Alternately, safety systems with both redundant transmitters and redundant receivers are permissible to form the safety system for use with the above detailed first guidance system Similarly, the above detailed redundant transmitters and redundant receivers could be employed in a safety system with the second and third guidance systems, and alternates thereto, as detailed below Fig 7 diagrammatically illustrates the various vectors involved in using the guidance system and safety system detailed in Fig 6

Algorithms 21 , 22 and 23 as employed with the safety system detailed in Fig 6 are as follows Algorithm 21

Algorithm 21 is based on the assumption that the relative position between two receivers is known It can be applied to any pair of receivers placed at a known and fixed spatial relationship, such as a pair of sensors 8 (Rna, Rnb ) (receivers) affixed on the needle 2, and/or a pair of sensors 9 (Rua, Rub ) (receivers) affixed on the ultrasound transducer 5, and/or a pair of control sensors 23a, 23b (RCa, RCb) (receivers), all of these receiver pairs generally referenced below (in the Algorithm) as Ra and Rb

The vector between a pair of position sensors can be determined (apπoπ) by a mechanical measurement It can also be determined by measurement in an interference-free environment The actual measurement may be by optical means, e g lasers, or any other known method for measuring position

Algorithm 21 is as follows For this algorithm, block 220 illustrated in Fig 8a (generally measured off-line) to define the vector between the two position sensors is the starting state of the error-analysis procedure

The data processor measures the position of receiver Ra with respect to transmitter unit Ti (block 221), and defines same as the location vector dRaτι and orientation matrix MRaτι I then measures the position of receiver Rb with respect to transmitter unit Ti, and defines same (block 222) as location vector dRb Tι and orientation matrix MRb

The data processor calculates in block 224 from dRaτι and MRaπ and dR Tι and MRb Tι a measured vector (dRb a)m between the two receivers Ra and Rb It compares the measured vector (dRb Ra)m with the known vector (dRb Ra) between the two receivers and produces an output, E2ι, in block 226, relative to the difference between them

The value E2ι can then be processed in the same manner as En in Fig 3a

Algorithm 22

Algorithm 22 can be applied whenever a reference control position sensor 24 (Rref) is placed a known and a fixed position with respect with respect to transmitter 10a (T-i) The actual position of the control position sensor Rref with respect to the transmitter T^ defined as the location vector dRref τι , and orientation matrix MRrβf τι, can be determined in block 240 similarly to that for the value T12 for Algorithm 11 or the value dRb Ra for Algorithm 21

The data processor measures the position of receiver Rref with respect to transmitter unit Ti in block 241 , and defines the same as location vector (dRefτι)m and orientation matrix [MRefτι]m The measured value (vector) (dRefτι)m is compared with the known vector dRefτι, m block 244, to produce an output relative to the difference between them defined as E221 The measured orientation matrix [MRefτι]m is then compared to the known orientation matrix MRefτι in block 246 to produce an output relative to the difference between them, defined as E222

The values E221 and E222 can then be processed in the same manner as En in Fig 3a Algorithm 23

This algorithm can be implemented whenever there are at least two

receivers 8 (Rna and Rnb )(one of them redundant) affixed to the needle and/or two

receivers 9 (Rua and Rub)(one of them redundant) affixed to the ultrasound

transducer 5

The data processor measures the position of receiver Rna with respect

to transmitter T-j , in block 261 , and defines same as location vector dRna T1 and

orientation matrix MRna j1

The data processor measures the position of receiver Rua with respect

in to transmitter T-, , in block 262, and defines same as dRua T and MRua T

It then calculates, in block 264, the position of the needle tip 2', with

respect to the ultrasound position sensor 9, based on the measurements of Rna

and Rua, and defines same as dnt u paιr(Rna Rua)

It then measures in block 265 the position of receiver Rub with respect to

I transmitter 10a (T-,), and defines same as dRnt, T1 and M nt> τι

It then calculates, in block 266 , the position of the needle tip 2', with respect to the ultrasound position sensor 9, based on the measurements of Rnb

and R ua and defines same as dnt u paιr(Rnb Rua)

The data processor compares in block 268 the calculated vectors 0 dnt u,Paιr(Rna Rua) and dntιUιPaιr(Rnb Rua), and produces an output E23 as follows

E23 = l | d nt u paιr(Rna RM) - dnt U palr( Rnb Rlιl)| | (Eq 9) The value E23 can then be processed in the same manner as the En in Fig 3a

If an additional redundant receiver (Rub) is fixed on the ultrasound

transducer 5, two additional measurements can be added to this Algorithm These two additional measurements are based on the fact that there are now four pairs of receivers, according to which the needle tip position relative to the ultrasound transducer 5, can be calculated

A variation to Algorithm 23 is based on making the same measurement relative to N position sensors placed on the said (guided) device, N > 2, ιo (preferably odd number) In this case the algorithm checks that more than P (an integer greater than N/2) of the measurements made relative to different position sensors are in accord (in accord defined as within a certain predefined margin) in order to clear the measurement

While Algorithms 21-23 and variations thereof have been disclosed, I D additional Algorithms for systems having redundant receivers are also permissible

The redundant receivers for the safety system above can be employed with the guidance system detailed in Fig 5a Here, the receιver(s) serves as the reference position Further implementation of the system includes the addition of 0 redundant transmitters on the needle 2 and/or the ultrasound transducer 5 This safety system can employ Algorithm 23 as detailed above

Alternately, redundant transceivers for the safety system above can be employed with the guidance system detailed in Fig 5b Here, the transceιver(s) serve as the reference position Further implementation of the system includes the addition of redundant reflectors on the needle 2 and/or the ultrasound transducer 5 This safety system can employ Algorithm 23 as detailed above

Another safety system, to be employed together with the first guidance system (disclosed in PCT/IL96/00050) (and the guidance systems detailed below), could be transmission/signal/frequency alternating (hopping) For example, in the first guidance system, employing positioning systems as described in U S Patent No 4,945,305 (Blood) and U S Patent No 4,054,881 (Raab), both patents incorporated by reference herein, the transmission of

transmitter T-i can be altered, as illustrated in Fig 9a, and described as follows

lo In one cycle of measurements, Cycle K, the transmitter T^ emits first

from antenna X, then from antenna Y, and finally from antenna Z The following

cycle of measurements, Cycle K + 1 the transmitter Ti, emits from antennae X

and Y (together), then from antennae X and Z (together), and finally from antennae Y and Z (together) The measurements made in the two cycles should

I D be differently affected by interfering objects and/or interfering electromagnetic fields The data processor 6 measures the needle tip 2' with respect to the ultrasound position sensor 9 according to measurements made in Cycle K and defines the same as dnt u cycle K The data processor then measures the needle tip 2' with respect to the ultrasound position sensor 9 according to measurements 0 made in Cycle K + 1 and defines the same as dntu cycie κ+ι It then compares dπtu cycle K and dntu cycle κ+ι and then produces an output equal to the difference between the two measurements, defined as Es1, whose value can then be processed in the same manner as the value En m Fig 3a U S Patent No 4,945,305 (Blood) describes both types of measurement cycles, however as separate implementations of the positioning system and not in a possible combined system in order to monitor measurement errors caused by interference Another safety system, based on signal alternation to be employed together with said first guidance system, when employing a positioning system as described in U S Patent No 4,945,305 (Blood), is illustrated in Fig 9b and described below

The transmitter, as detailed in the '305 (Blood) patent, emits different pulse shapes and/or pulse lengths in consequent measurement cycles, e g ,

Cycle K and Cycle K+1 Data processor 6 calculates dnt u cycie K and dntu cycie κ+1 (both defined above) The measurements made in the two cycles should be differently affected by interfering objects and/or interfering electromagnetic fields The data processor 6 then compares the above measurements and produces an output equal to them, defined as Es2, whose value can then be processed in the same manner as the En in Fig 3a

When employing a system as described in US Patent Nos 4,054,881 and 4,314,251 (both to Raab), this '251 patent is also incorporated by reference herein, a safety system based on frequency hoping can be employed, as illustrated in Fig 9c and described below

The transmitter emits on different frequency carriers on consequent measurement cycles (frequency hoping) The measurements made in the two cycles should be differently affected by interfering objects and/or interfering electromagnetic fields Therefore, the data processor can compare between the measurements and produce an output equal to the difference between the two measurements, defined as Es3, whose value can then be processed in the same manner as the value En in Fig 3a

An additional safety system to be employed with said first guidance system, when using positioning systems as described in the '305 (Blood) patent, and the '881 (Raab) and '521 (Raab) patents, can be made by checking the unitaπty of matrix A, this matrix A being the receiver attitude matrix in the '305 patent Accordingly, the data processor calculates

Eunι = matπx_norm(Aτ*A - I) (Eq 10)

Euπ2 = { λmax (Aτ*A) /λmιn(Aτ*A) } (Eq 11)

where, matπx_norm stands for matrix norm, and λmax (AT*A), λmιn(Aτ*A)

stand for maximal eigenvalue and minimal eigenvalue of matrix AT*A

The values of Eunι or Eun2 can then be processed in the same manner

Figure imgf000033_0001
Fig 10 is directed to a second guidance system More particularly, it is directed to provide a second guidance system and method that may be used for guiding medical devices towards a target in a body

In this guidance system, all components remain the same and function similarly to those of the first guidance system detailed in the above cited PCT/IL96/00050, except the needle 2 is mounted on an articulated arm 30, mounted on a stand 32 The articulated arm 30 and stand 32 are disclosed in U S Patent No 5,647,373, assigned to the assignee of the present invention, the disclosure of which is incorporated by reference in its entirety herein A transmitter 10a (T-, ) is positioned at a reference position on the stand 32 A sensor 9, preferably a receiver Ru, is placed on the ultrasound transducer 5 Both the sensor 9, and the transmitter 10a communicate with the data processor 6 by wired or wireless links 14, 17, detailed above, enabling the data processor 6 to measure the position of the ultrasound transducer 5 with respect to the reference position as described above

This second guidance system and alternates, detailed above, can have its receivers and transmitters arranged such that a positioning and tracking system is defined These receivers and transmitters could be modified such that the desire positioning and tracking system are magnetic, acoustic, or electro-optical or combination thereof (in addition to that detailed above), in accordance with PCT/IL96/00050

The arm 30 is mechanically calibrated to the reference position, such that its movements, including those of the needle 2, are sent to the data processor 6, by wired or wireless connections as detailed above This enables the data processor 6 to measure the position of the needle with respect to the reference position The data processor 6 calculates from these measurements, the position of the needle 2 with respect to the ultrasound imaging plane The expected trajectory of the needle 2 with respect to the target 4 is now viewable on the display screen 7, thereby aiding the physician to guide the movement of the needle 2 toward the target 4

This second guidance system and alternates may also be employed together with other scanning apparatus such as computerized tomography, X - ray, as detailed in the above cited PCT/IL96/00050 All the above safety systems, as described in connection with the first guidance system, can be employed with this second guidance system For example, a safety system based on redundant transmitters is formed when a second transmitter (T2) is placed on the stand 32 These "transmitter redundant"

safety systems would have vector diagrams in accordance with that detailed in Fig 2 above, and could employ any of the safety algorithms, detailed as Algorithms 11 , 12, 13 and 14 above

Alternately, two or more, position sensors, receivers, (at least one being redundant) could be placed on the ultrasound transducer 5, or control position sensors (23a, 23b and 24 as shown in Fig 6) could be placed in the operating area 1 , as described above for Fig 6, resulting in receiver redundant safety systems, in accordance with those described above These "receiver redundant" safety systems would have vector diagrams in accordance with that detailed in Fig 7 above, and could employ any of the safety Algorithms, detailed as Algorithms 21 , 22 and 23 above

Safety systems based on signal alternating as described above can also be employed together with these second types of guidance systems

Additional variations to said second type of guidance systems could be made by exchanging the position of the transmitter T-\ and receiver Ru, and placing the receiver at the reference position, or replacing the transmitter by a transceiver and the receivers by reflectors, as described above

An alternate guidance system based on that shown in Fig 10, is formed when the needle 2 is free and the ultrasound transducer 5 is mounted on the articulated arm 30 and stand 32, as detailed above The needle 2 includes a sensor 8, preferably a receiver (RJ , attached thereto, and the stand 32 includes a transmitter (TJ, attached thereto, as detailed above, both the sensor 8 and Transmitter (TJ communicating with the data processor 6 by wired or wireless links, detailed above All above variations to the second guidance system apply to D this type of system also

Fig 11a is directed to a third guidance system More particularly, it is directed to provide a third guidance system and method that may be used for guiding medical devices towards a target in a body

This third guidance system differs from the first and second guidance o systems detailed above, in that it directly measures the position of the needle 2 with respect to the ultrasound transducer 5 without employing an additional reference location in space (In the first and second guidance systems, the position of the needle 2 and the position of the ultrasound transducer 5 are first measured, relative to a reference position in space From these two s measurements, the relative position of the needle 2 with respect to the ultrasound transducer 5 is calculated, as detailed above and in PCT/IL96/00050 )

This third guidance system includes a position sensor 8, typically a receiver (R) attached to the needle 2, as detailed above and a transmitter 10b' (T) (in accordance with transmitter 10b detailed in Fig 1 above), affixed to the o ultrasound transducer 5 The position sensor 8 and the transmitter 10b' (T) communicate with the data processor 6 by wired or wireless links 16, 35, as detailed above The position of the needle tip 2' with respect to the transmitter 10b' (and therefore to the scanning device and scanning plane) is then measured directly, without the need of an additional reference position (as for said first guidance system), according to the following equation dnt u = dn u + [Mn u]τ - Ln (Eq. 12)

The expected trajectory of the needle 2 with respect to the target 4 is now viewable on the display screen 7, thereby aiding the physician to guide the movement of the needle 2 toward the target 4 as described in PCT/IL96/00050

This third guidance system and alternates may also be employed together with other scanning apparatus such as computerized tomography, X -

ray, as detailed in the above cited PCT/IL96/00050 This third guidance system and alternates, detailed above, can have its receivers and transmitters arranged such that a positioning and tracking system is defined These receivers and transmitters could be modified such that the desire positioning and tracking system are magnetic, acoustic, or electro-optical or combination thereof (in addition to that detailed above) in accordance with PCT/IL96/00050

Fig 11 b shows an alternate system to that shown in Fig 11a In this system, the positions of the receiver R and transmitter T have been switched on the needle 2 and ultrasound transducer 5 respectively

Fig 11c shows an alternate system to that shown in Fig 11a In this system, the transmitter 12 has been replaced by a transceiver 20' (detailed above), and the receiver has been replaced by reflectors 21 Alternately, the transceiver is positioned on the needle 2 and the reflectors 21 are positioned on the ultrasound transducer 5 Fig 12 shows a vector diagram guidance calculation performed for the system of Fig 11a, that could be modified in accordance with the principles therewith, so as to be applicable to Figs 11b and 11c and alternates thereto

All of the above detailed safety systems can be employed with this third guidance system and alternates shown and detailed above For example, Fig 13 shows a safety system based on redundant transmitters This safety system is used in conjunction with the third guidance system as a sensor 8, typically a receiver R, is on the needle 2 and at least two, preferably two, transmitters 10b' Cn, T2) are on the ultrasound transducer 5, such that one of the transmitters is "redundant" (as detailed above) All transmitters and receivers would communicate with the data processor 6 by wired or wireless communications, as detailed above Alternately the transmitters (T1 τ T2) could be on the needle 2 and the sensor (receiver) 8 on the ultrasound transducer 5 These transmitter redundant safety systems could employ any of the safety algorithms detailed as Algorithms 11 , 12, 13 or 14 above, with the necessary adjustments to account for the changes in vectors

Fig 14 shows a vector diagram for the system of Fig 13 This diagram could be modified in accordance with the principles therewith, so as to be also applicable to the alternates thereto Fig 15 details a safety system employing redundant receivers It is

possible to attach two position sensors 8 (receivers) (Rna, Rnb) (at least one of these receivers being redundant), on the needle 2 A transmitter 10b' (T) is attached to the ultrasound transducer 5 Alternately, control receivers 23a, 23b (in accordance with those above) (RCa, RC ) at a known spatial relationship can be placed in the operating area 1 Additionally, a reference position sensor (control receiver) 24 (Rref) (in accordance with that detailed in Fig 6 above) is preferably placed at a fixed and known position, from the transmitter (as described in relation to first guidance system) Alternately, the two receivers 8 could be on the ultrasound transducer 5, while the transmitter 10b' could be on the needle 2 All transmitters and receivers would communicate with the data processor 6 by wired or wireless communications, as detailed above These receiver redundant safety systems could employ any of the safety algorithms detailed as Algorithms 21 , 22 or 23 above, with the necessary modifications that account for the changes in vectors

Fig 16 shows a vector diagram for the receiver redundant system detailed in Fig 15 above

Fig 17 details a safety system employed with the third guidance system that is both transmitter and receiver redundant A position sensor 8, typically a receiver (Rn) as detailed above, and a transmitter 10a' (Tn) (in accordance with transmitter 10a detailed in Fig 1 above) are on the needle 2, and a position sensor 9, typically a receiver (Ru), as detailed above, and a transmitter 10b' (Tu) are on the ultrasound transducer 5 All transmitters and receivers would communicate with the data processor 6 by wired or wireless communications, as detailed above

Alternately, safety systems with both redundant transmitters and redundant receivers are permissible to form the safety system for use with the above detailed second and third guidance systems Safety systems based on signal alternating as described above can also be employed together with these third types of guidance systems.

While the invention has been described with respect to several embodiments, it will be appreciated that this is set forth merely for purposes of example, and that many variations, modifications and other applications of the invention may be made. Rather, the scope of the invention is defined by the claims that follow.

Claims

A system for guiding the movements of a device towards a target, comprising transmitter apparatus at a reference location in space for transmitting radiant energy from said reference location, a position sensor on said device to be guided to the target, said position sensor receiving radiant energy from the transmitter apparatus and producing an output corresponding to the position of said device with respect to said reference location in space, and a data processor receiving the output of said position sensor and calculating the position of said device with respect to said reference location characterized in that said transmitter apparatus includes a first transmitter (T1), and a second transmitter (T2) in a known spatial
relationship to each other defined by a known vector ^ ^ ' and further characterized in that said data processor
(a) produces a measurement of the location and orientation of the position sensor with respect to said first transmitter (T1) and defines same by a first vector,
(b) produces a measurement of the location and orientation of the position sensor with respect to said second transmitter (T2) and defines same by a second vector, (c) calculates from the said first vector and said second vector
a measured vector ' '2 ^m between the two transmitters;
(d) compares the measured vector (^m with the known
vector ( '2 J and (e) produces an output corresponding to the difference
between the measured vector ( ^m and the known vector (τπ
2. The system according to claim 1 , wherein said data processor includes an alarm, compares said output produced in step (e) with a predetermined threshold value, and actuates said alarm if the output produced in step (e) exceeds said predetermined threshold value.
3. The system according to either of claims 1 or 2, wherein said data
processor compares the absolute values of said measured vector ( 12 )
and of the known vector (fn ).
4. The system according to either of claims 2 or 3, wherein said device is a medical device to be guided through biological tissue in a body to a target therein.
5. The system according to claim 4, wherein said medical device is an interventional device , and said position sensor is located at a predetermined location with respect to said interventional device.
6. The system according to claim 5, wherein said body is imaged by an
imaging system which scans the body by a scanning device along a plurality of scan planes.
7. The system according to claim 6: wherein said scanning device also includes a second position sensor receiving radiant energy from said first and second transmitters and producing an output corresponding to the position of said second position sensor, and thereby of said scanning device, with respect to said reference location in space; and wherein said data processor performs said steps (a) - (e) also with respect to said second position sensor to produce an output error
with respect to said measured vector (R12 )^for the scanner, and utilizes,
the larger of said two output errors, for comparison with said predetermined threshold and for actuating said alarm.
8. The system according to claim 7, wherein said scanning device is an ultrasound scanner.
9. The system according to any one of claims 1-8, wherein said first and second transmitters are mounted at the opposite ends of an arm having a known length and orientation in space with respect to said known location
in space defining said known vector (- 2 ) .
10. The system according to claim 9, wherein said arm has a length of 0J to
1.0 meters.
11. The system according to claim 10, wherein said arm has a length of 35 cm.
12. A method for guiding the movements of a device towards a target,
comprising: transmitting radiant energy from transmitter apparatus at a reference location in space; providing a position sensor on said device to be guided to the target, said position sensor receiving radiant energy from the transmitter apparatus and producing an output corresponding to the position of said device with respect to said reference location in space; processing in a data processor the output of said position sensor and calculating the position of said device with respect to said reference location: characterized in that said transmitter apparatus includes a first transmitter (TJ, and a second transmitter (T2), in a known spatial
relationship to each other defined by a known vector ( 12 ) ;
and further characterized in that said data processor:
(a) produces a measurement of the location and orientation of the position sensor with respect to said first transmitter (TJ and defines same by a first vector;
(b) produces a measurement of the location and orientation of
the position sensor with respect to said second transmitter (T2) and
defines same by a second vector;
(c) calculates from said first vector and from said second vector
a measured vector (Tι2)m between the two transmitters;
(d) compares the measured vector (Tι2)m with the known (T<|2)
vector; and (e) produces an output corresponding to the difference
— ► — ► between the measured vector (Tι2)m and the known vector (Tι2)
13 The method according to claim 12, wherein said data processor compares said output produced in step (e) with a predetermined threshold value, and actuates an alarm if the output produced in step (e) exceeds said predetermined threshold
14 The method according to either of claims 12 or 13, wherein said data processor compares the absolute values of said measured vector (T12)m
— ► and of the known vector (T12)
15 The method according to any one of claim 12-14, wherein said known
vector ( fp ) is mechanically measured
16. The method according to any one of claim 12-14, wherein said known
vector ( p ) is determined by attaching a position sensor to the tip of a
needle, placing the needle in an environment free of interference, and measuring the position of said latter position sensor with respect to said first and second transmitters
17 The methods according to any one of claims 12 -16, wherein said device is a medical device to be guided through biological tissue in a body to a target therein
18 The method according to claim 17, wherein said medical device is a biopsy needle, and said position sensor is located at a predetermined location with respect to said biopsy needle The method according to claim 18, wherein said body is imaged by an imaging system that scans the body by a scanning device along a plurality of scan planes
The method according to claim 19, wherein said scanning device also includes a second position sensor receiving radiant energy from said first and second transmitters and producing an output corresponding to the position of said second position sensor, and thereby of said scanning device, with respect to said reference location in space, and wherein said data processor performs said steps (a) - (e) also with respect to said second position sensor to produce an output error
with respect to said measured vector ( 7p ) ", for the scanner, and
utilizes, the larger of said two output errors for comparison with said predetermined threshold and for activating said alarm
The method according to claim 20, wherein said scanning device is an ultra-sound scanner
The method according to any one of claims 12-14, wherein said first and second transmitters are mounted at the opposite ends of an arm having a known length and orientation in space with respect to said reference
location in space defining said known vector ( f )
The method according to claim 22, wherein said arm has a length of 0 1 to 1 0 meters
The method according to claim 23, wherein said arm has a length of 35 cm A system for guiding the movements of a device toward a target viewable from an image, comprising at least one scanning apparatus for creating said image including said target, at least one transmitter at a first reference location for transmitting radiant energy from said reference location, at least one first position sensor on said device for receiving said radiant energy, at least one second position sensor on said at least one scanning apparatus for receiving said radiant energy, at least one third position sensor for receiving said radiant energy on either said device or said at least one scanning apparatus, and a data processor in operative communication with said at least one transmitter and each of said at least one first, second and third said position sensors, for monitoring the accuracy of the calculated position of said device with respect to said at least one scanning apparatus
The system of claim 25, wherein said each of said at least one first, second and third position sensors includes a receiver
The system of claim 25, wherein said each of said at least one position sensors is one position sensor
The system of claim 25, wherein said first reference location is a known and fixed location in space
The system of claim 25, wherein said reference location is unknown 30 The system of claim 25, wherein said at least one scanning apparatus includes one scanning apparatus
31 The system of claim 30, wherein said at least one third position sensor is on said device and said relative position between said at least one first
5 position sensor and said at least one third position sensor is known
32 The system of claim 30, wherein said at least one third position sensor is on said scanning apparatus and said relative position between said at least one second position sensor and said at least one third position sensor is known
ιo 33 The system of claim 25, additionally comprising at least one fourth position sensor at a second reference location, said at least one fourth position sensor for receiving said radiant energy and in operative communication with said data processor
34 The system of claim 33, wherein said at least one fourth position sensor I D includes two receivers at a relative position from each other
35 The system of claim 34, wherein said second reference location is a known and fixed location
36 The system of claim 34, wherein said second reference location is unknown
20 37 The system of claim 25, additionally comprising at least one fifth position sensor at a known and fixed position from said first reference location, said at least one fifth position sensor for receiving said radiant energy and in operative communication with said data processor
The system of claim 25, wherein said at least one transmitter includes one transmitter
The system of claim 25, wherein said at least one transmitter includes two transmitters, one of said transmitters being redundant
A system for guiding the movements of a device toward a target viewable from an image, comprising
at least one scanning apparatus for creating said image including said target, at least one transmitter at a reference location for transmitting radiant energy from said reference location, said radiant energy being in the form of signals emitted so as to alternate at different measurement cycles, at least one position sensor on said device for receiving said radiant energy and producing an output corresponding to the position of said device with respect to said reference location in space, at least one position sensor on said at least one scanning apparatus for receiving said radiant energy and producing an output corresponding to the position of said device with respect to said reference location in space, and a data processor in operative communication with said at least one transmitter and each of said at least one position sensors, for monitoring the accuracy of the calculated position of said device with respect to said at least one scanning apparatus
41 The system of claim 40, wherein said position sensors are receivers
42 The system of claim 41 , wherein said receivers are magnetic and said at D least one transmitter emits electromagnetic energy
43 The system of claim 40, wherein said signals emitted so as alternate at different measurement cycles include DC or AC signals
44 The system of claim 43, additionally comprising three independent antennae
lo 45 The system of claim 44, wherein said transmitter emits from each antenna at least partially sequentially during a first measurement cycle and at least partially sequentially from paired antennae during a second
measurement cycle
46 The system of claim 40, wherein said first reference location is a known I D and fixed location in space
47 The system of claim 40, wherein said reference location is unknown
48 The system of claim 40, wherein said at least one transmitter includes one transmitter
20 49 The system of claim 40, wherein said at least one transmitter includes two transmitters, one of said transmitters being redundant
50 A system for guiding a device towards a target, said target viewable from an image comprising imaging apparatus for creating said image, at least one transmitter at a reference location for transmitting radiant energy from said reference location, imaging apparatus for creating said image, said imaging apparatus including at least one position sensor for receiving said radiant energy and producing an output proportional to the position of said imaging apparatus with respect to said reference location, an articulated arm for retaining said device to be guided, said articulated arm being calibrated to said reference location, a data processor in operative communication with said at least one transmitter, said at least one position sensor, and said articulated arm for calculating the position of the device with respect to the imaging apparatus for displaying the position of the device with respect to the target on said image
The system of claim 50, wherein, said device includes a needle
The system of claim 50, wherein, said apparatus is selected from the group comprising ultrasound apparatus, CT apparatus, MRI apparatus and X-ray apparatus
The system of claim 50, additionally comprising at least one additional position sensor on said imaging apparatus for receiving said radiant energy, said at least one additional position sensor in operative communication with said data processor said data processor for monitoring the accuracy of the calculated position of said device with respect to said imaging apparatus
54 The system of claim 50 wherein, said at least one transmitter is such that said transmitted radiant D energy is in the form of signals, emitted so as to alternate at different measurement cycles, and said data processor in operative communication with said at least one transmitter and said at least one position sensor, and said articulated arm, for monitoring the accuracy of the calculated position of lo said device with respect to said imaging apparatus
55 The system of claim 50, wherein said at least one transmitter includes one transmitter
56 The system of claim 50, wherein said at least one transmitter includes is two transmitters, one of said transmitters being redundant, said data processor in operative communication with said two transmitters, said at least one position sensor, and said articulated arm, for monitoring the accuracy of the calculated position of said device with respect to said imaging apparatus
20 57 A system for guiding a device towards a target, said target viewable from an image comprising imaging apparatus for creating said image, at least one transmitter at a reference location for transmitting radiant energy from said reference location, an articulated arm for retaining imaging apparatus, said articulated arm being calibrated to said reference location, a device to be guided, said device including at least one position sensor for receiving said radiant energy and producing an output proportional to the position of said device with respect to said reference location, said data processor in operative communication with said at least one transmitter, said at least one position sensor, and said articulated arm for calculating the position of the device with respect to the imaging apparatus for displaying the position of the device with respect to the target on said image
The system of claim 57 wherein said device includes a needle
The system of claim 57, additionally comprising at least one additional position sensor on said device for receiving said radiant energy and producing an output proportional to the position of said device with respect to said reference location, and said at least one additional position sensor in operative communication with said data processor, said data processor for monitoring the accuracy of the calculated position of said device with respect to said imaging apparatus
The system of claim 57 wherein, said at least one transmitter is such that said transmitted radiant energy is in the form of signals, emitted so as to alternate at different measurement cycles, and said data processor in operative communication with said at least one transmitter and said at least one position sensor, and said articulated arm, for monitoring the accuracy of the calculated position of said device with respect to said imaging apparatus
The system of claim 57, wherein said at least one transmitter includes one transmitter
The system of claim 57, wherein said at least one transmitter includes two transmitters, one of said transmitters being redundant, said data processor in operative communication with said two transmitters, said at least one position sensor, and said articulated arm, for monitoring the accuracy of the calculated position of said device with respect to said imaging apparatus
A system for free hand directing of a guided device towards a target imaged by a scanning device comprising at least one transmitter for transmitting radiant energy affixed to said scanning device at a predetermined position on it, at least one position sensor affixed to said guided device for receiving said radiant energy from said at least one transmitter and producing an output proportional to the relative position of said guided device with respect to said scanning device, and a data processor in operative communication with said at least one transmitter and said at least one position sensor, for calculating the position of the guided device with respect to the scanning device for displaying the position of the guided device with respect to the target on said image.
64. The system of claim 63, wherein said data processor is in operative communication with said at least one transmitter and said at least one position sensor by wired or wireless links therebetween.
65. The system of claim 63, wherein said at least one transmitter and said at least one position sensor define a positioning and tracking system.
66. The system of claim 65, wherein said positioning and tracking system is magnetic.
67. The system of claim 65, wherein said positioning and tracking system is acoustic.
68. The system of claim 65, wherein said positioning and tracking system is
electro-optical.
69. The system of claim 63, wherein said at least one transmitter includes one transmitter.
70. The system of claim 63, wherein said at least one transmitter includes two transmitters, one of said transmitters being redundant, said data processor in operative communication with said two transmitters and said at least one position sensor, for monitoring the accuracy of the calculated position of said guided device with respect to said scanning device.
71. The system of claim 63, wherein said at least one position sensor includes one position sensor. 72 The system of claim 63, wherein said at least one position sensor includes two position sensors, one of said position sesnors being redundant, said data processor in operative communication with said at least one transmitter and said two position sensors, for monitoring the accuracy of the calculated position of said guided device with respect to said scanning device
73 The system of claim 63 wherein, said at least one transmitter is such that said transmitted radiant energy is in the form of signals, emitted so as to alternate at different measurement cycles and said data processor in operative communication with said at least one transmitter and said at least one position sensor, for monitoring the accuracy of the calculated position of said guided device with respect to said scanning device
74 A system for free hand directing of a guided device towards a target imaged by a scanning device comprising at least one transmitter for transmitting radiant energy affixed to said guided device at a predetermined position on it, at least one position sensor affixed to said scanning device for receiving said radiant energy from said at least one transmitter and producing an output proportional to the relative position of said scanning device with respect to said guided device, and a data processor in operative communication with said at least one transmitter and said at least one position sensor, for calculating the position of the guided device with respect to the scanning device for displaying the position of the guided device with respect to the target on
5 said image
75 The system of claim 74, wherein said data processor is in operative communication with said at least one transmitter and said at least one position sensor by wired or wireless links therebetween
76 The system of claim 74, wherein said at least one transmitter and said at lo least one position sensor define a positioning and tracking system
77 The system of claim 76, wherein said positioning and tracking system is magnetic
78 The system of claim 76, wherein said positioning and tracking system is
acoustic
I D 79 The system of claim 76, wherein said positioning and tracking system is
electro-optical
80 The system of claim 74, wherein said at least one transmitter includes
one transmitter
20 81 The system of claim 74, wherein said at least one transmitter includes two transmitters, one of said transmitters being redundant, said data processor in operative communication with said two transmitters and said at least one position sensor, for monitoring the accuracy of the calculated position of said guided device with respect to said scanning device
82 The system of claim 74, wherein said at least one position sensor includes one position sensor
83 The system of claim 74, wherein said at least one position sensor includes two position sensors, one of said position sensors being redundant, said data processor in operative communication with said at least one transmitter and said two position sensors, for monitoring the accuracy of the calculated position of said guided device with respect to said scanning device
84 The system of claim 74 wherein said at least one transmitter is such that said transmitted radiant energy is in the form of signals, emitted so as to alternate at different measurement cycles and said data processor in operative communication with said at least one transmitter and said at least one position sensor, for monitoring the accuracy of the calculated position of said guided device with respect to said scanning device
PCT/IL1998/000578 1997-11-27 1998-11-26 System and method for guiding the movements of a device to a target particularly for medical applications WO1999027837A2 (en)

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US10349890B2 (en) 2015-06-26 2019-07-16 C. R. Bard, Inc. Connector interface for ECG-based catheter positioning system
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JP2001524339A (en) 2001-12-04
EP1034461A4 (en) 2002-01-23
WO1999027837A3 (en) 1999-07-22

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