WO2000057767A2 - Dispositif et methodes de diagnostic medical, d"interventions et de traitement medical guides - Google Patents

Dispositif et methodes de diagnostic medical, d"interventions et de traitement medical guides Download PDF

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Publication number
WO2000057767A2
WO2000057767A2 PCT/IL2000/000202 IL0000202W WO0057767A2 WO 2000057767 A2 WO2000057767 A2 WO 2000057767A2 IL 0000202 W IL0000202 W IL 0000202W WO 0057767 A2 WO0057767 A2 WO 0057767A2
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WO
WIPO (PCT)
Prior art keywords
imaging device
medical imaging
medical
volume
target
Prior art date
Application number
PCT/IL2000/000202
Other languages
English (en)
Other versions
WO2000057767A3 (fr
Inventor
Victor Segalescu
Yoav Paltieli
Original Assignee
Ultraguide Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ultraguide Ltd. filed Critical Ultraguide Ltd.
Priority to JP2000607528A priority Critical patent/JP2003527880A/ja
Priority to AU35739/00A priority patent/AU3573900A/en
Priority to EP00914346A priority patent/EP1196089A2/fr
Publication of WO2000057767A2 publication Critical patent/WO2000057767A2/fr
Publication of WO2000057767A3 publication Critical patent/WO2000057767A3/fr

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Classifications

    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01S—RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES
    • G01S7/00—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00
    • G01S7/52—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00 of systems according to group G01S15/00
    • G01S7/52017—Details of systems according to groups G01S13/00, G01S15/00, G01S17/00 of systems according to group G01S15/00 particularly adapted to short-range imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01S—RADIO DIRECTION-FINDING; RADIO NAVIGATION; DETERMINING DISTANCE OR VELOCITY BY USE OF RADIO WAVES; LOCATING OR PRESENCE-DETECTING BY USE OF THE REFLECTION OR RERADIATION OF RADIO WAVES; ANALOGOUS ARRANGEMENTS USING OTHER WAVES
    • G01S15/00—Systems using the reflection or reradiation of acoustic waves, e.g. sonar systems
    • G01S15/88—Sonar systems specially adapted for specific applications
    • G01S15/89—Sonar systems specially adapted for specific applications for mapping or imaging
    • G01S15/8906—Short-range imaging systems; Acoustic microscope systems using pulse-echo techniques
    • G01S15/899—Combination of imaging systems with ancillary equipment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A61B2090/365—Correlation of different images or relation of image positions in respect to the body augmented reality, i.e. correlating a live optical image with another image
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/25—User interfaces for surgical systems

Definitions

  • the present invention relates to apparatus for performing medical diagnosis
  • the present invention is related to apparatus for performing
  • energy field towards a target in a body are assisted by images of said body and target produced by medical imaging devices like CT, MR, ultrasound, etc.
  • the same target can be viewed by ultrasound and by some other means.
  • CT computed tomography
  • X-Ray X-Ray
  • endoscope imaging device other medical imaging device such as a CT, X-Ray, or endoscope imaging device.
  • the present invention comprises methods and apparatus for combining two or
  • medical imaging systems such as an ultrasound and a CT
  • the present invention is particularly useful in guided medical interventions into a body or body volume, where a target is sought to be evaluated.
  • the apparatus disclosed in the present invention comprises at least two medical
  • imaging devices for example, an ultrasound, CT, X-Ray, endoscope, at least a display,
  • a data processor and a position measuring system comprising position controlling and
  • the position measuring system enables the establishment of the relative positions between
  • the data processor receiving the information
  • the position measuring system is also able to establish the position between the image planes/volumes produced by the at least two imaging devices and using it for at
  • position measuring components defines any of the following group:
  • position measuring system may be magnetic, acoustic, optic, inertial or a combination of the above.
  • the resultant apparatus enables free-hand manipulation of all or part of the
  • the apparatus and methods described in the present invention facilitate the combination of a number of medical imaging devices to perform various medical
  • the apparatus of the present invention is configured to perform diagnostic, therapy procedures and intervention tasks more safely and efficiently than those of the conventional systems.
  • the apparatus of the present invention is configured to perform diagnostic, therapy procedures and intervention tasks more safely and efficiently than those of the conventional systems.
  • the apparatus of the present invention is configured to perform diagnostic, therapy procedures and intervention tasks more safely and efficiently than those of the conventional systems.
  • intervention tool or a medical therapeutic tool or alternatively inserting a medical device when using a second medical imaging device. This can be particularly useful
  • PCT/IL98/00631 entitled: Calibration Method And Apparatus For Calibrating
  • the apparatus described in the present invention may also reduce the amount of
  • the present invention also comprises methods and apparatus for guiding a directional
  • the apparatus therefore, enables free-hand manipulation of part or
  • directional therapy procedure will define any procedure
  • This energy field can be ultrasonic or Shockwaves (lithotripsy) , or
  • electromagnetic radiotherapy, laser, etc
  • particle beam proto beam for example
  • the data processor receives the information from the position measuring system and
  • the method and apparatus are beneficial in that they have add-on capabilities
  • FIG. la pictorially illustrates one form of a system constructed according in
  • CT computerized topography
  • FIG. lb pictorially illustrates the relative position between the scanning beams
  • FIG. 2a is a vector diagram which pictorially illustrates the vectors used in
  • FIG. 2b is a block diagram illustrating the steps involved in calculating the
  • FIG. 3 pictorially illustrates display functions enabled according to the present
  • FIG. 4 is a simplified flowchart illustrating the steps of using in a cooperative
  • FIG. 5a pictorially illustrates one possible position measuring system to be used
  • FIG. 5b pictorially illustrates another possible position measuring system to be
  • FIG. 6 pictorially illustrates one form of a system constructed according in
  • FIG. la illustrates a first embodiment, exemplary of the present invention.
  • the medical imaging devices include an ultrasound apparatus 2,
  • CT computerized tomography
  • the medical imaging devices could be the same or different
  • these devices may be devices that are compatible.
  • these devices may be devices that are compatible.
  • these devices may be devices that are compatible.
  • body 6 or body volume of a target 8 in the body 6 (body volume) may be utilized to position ultrasound transducer 18 at known position with respect with respect to target
  • the system can be fitted to existing and deployed
  • Ultrasound 2 and/or CT 4 are connected to a display 10 via an image processor
  • Ultrasound 2 and/or CT 4 can also be
  • processor 12 can be part of the data processor 14 or can be connected to it.
  • Ultrasound 2 comprises a main unit 17 connected to a scanning head 18 further
  • CT 4 comprises a main
  • CT computer computer 20 connected to a scanning head 22, further referred as a CT
  • CT scanning head 22 includes X-ray emitter and detector(s) (not
  • scanning head will be used to define the
  • detector and/or emitter component of the medical imaging or scanning device such as
  • the transducer of an ultrasound or the X-ray emitter and detector(s) of a CT or an
  • a position measuring system comprising at least a position sensing controller
  • position measuring components will define any of the following group:
  • Patent No. 4,649,504 or inertial for example, IS900 manufactured by InterSense
  • Position sensing controller 26 can be part of the data processor 14.
  • the attachment can be either directly to the transducer 18 or by means of an extension
  • Position measuring component 28 is calibrated to ultrasound transducer 18 such
  • measuring component 28 Such calibration can be achieved by operating according to PCT application PCT/IL98/00631.
  • Position measuring component 30 is attached at a known and fixed position
  • CT scanning head (gantry) 22 from CT scanning head (gantry) 22.
  • the attachment can be either directly to the CT
  • Position sensing controller 26 measures the relative position between position
  • measuring component 28 and position measuring component 30, enabling to calculate
  • Position measuring component 30 is calibrated to scanning head 22 such that the CT
  • scanning beam 34 is at a known and fixed position with respect to position measuring component 30.
  • Such calibration can be achieved by operating according to the
  • FIG. lb shows a detailed view of ultrasound
  • position measuring component 32 may be attached to
  • the attachment can be either directly to the CT bed 15 or by means of an
  • position measuring component 34 is attached at a fixed position.
  • An additional position measuring component 34 may be attached at a fixed
  • position measuring component 34 is attached at a fixed position with
  • a reference position of the CT for example the default position
  • Position measuring components 32 and 34 are calibrated to CT scanning head
  • position measuring component 28 is calibrated to transducer 18 and at
  • block 40 shows the result of the calibrating
  • Block 42 shows the
  • Blocks 40 and 42 are generally performed off-line.
  • Block 44 shows the measurement
  • FIG. 2a diagram of FIG. 2a and flowchart of FIG. 2b. It is therefore possible to calculate the relative position of transducer 18 and ultrasound beam ⁇ image 36 with respect to a CT
  • stretcher 16 can be measured with an accuracy of less than 1
  • the movement of the bed stretcher 16 can be at a predetermined
  • CT stretcher 16 can be moved at any time
  • Necessary correction due to tilt of the scanning head of the CT 22 may be
  • processor 14 or transferred through communication links from CT main unit 20 or data
  • processor 14 can identify them automatically for example according to information
  • CT image video or DICOM form
  • the indications are in 2-D and/or 3-D fashion for example in the form of
  • scanning image 38 can be displayed to the operator, for example in the from of angles and distances, as in box 60, and in the form of side-view illustration box 62, and
  • box 64 This enables the operator to first scan body 6 by CT,
  • target 8 can be marked in a CT image and it is possible to
  • maneuver ultrasound transducer 18 such as to view the target 8.
  • the indications can be
  • box 66 comprising arrows indicating how to maneuver transducer 18
  • Boxes 68 and 70 provide information regarding the position transducer beam 36
  • Box 68 shows the CT slice (reconstruction)
  • Box 70 illustrates the relative
  • transducer 18 With respect to the scanned volume in a sagital view.
  • FIG. 3 illustrated specific display modalities for enabling the user to
  • FIG. 4 is a flow-chart illustration of the steps
  • step 90 it is
  • position measuring component 30 instead or in addition to position measuring component 30 (as explained above).
  • step 92 it is calculated the relative position between ultrasound scanning
  • the calculation at step 92 is based on the calibration of position measuring component 28 and 30 (32, 34)
  • step 94 may also be used in other medical procedures (step 96) that is optional, but
  • step 92 may also be used in order to instruct the maneuvering ultrasound transducer 18 in a required position.
  • CT system 4 and ultrasound system 2 may be correlated and or fused in optional,
  • step 98 This can be performed according to conventional image processing algorithms and techniques. By correlating or fusing these images (from the
  • the displayed ultrasound image may be
  • step 98 may be enhanced.
  • the superimposed image/information resulting of step 98 may be optionally used to improve calculation at step 92 in an iterative mode.
  • step 98 may also be used in other medical
  • step 96 procedures (step 96) or in order to instruct maneuvering of ultrasound transducer 18
  • the imaging options 100 are non-exhaustively, listed as follows.
  • the image from CT system 4 and ultrasound system 2 may be displayed individually (steps 102 ).
  • the relative position between CT and ultrasound scanning beams may be
  • step 98 displayed (step 106, illustrated in Fig. 3) and the result of image fusing, at step 98 may
  • Target and image correlation information can also be available to the operator indicating for example internal anatomic movements as
  • ancillary functions such as optionally marking a target 8 (step 112) on the image
  • the position of target 8 may be calculated within the scanning beam of the medical imaging device,
  • a reference plane/volume may be marked or
  • step 118 The data in steps 114 and/or 118 may be optionally used in order to instruct the positioning of CT
  • Body volume 6 is scanned by the CT system 4 producing high
  • the operator defines at least one target on CT image as
  • the position of the ultrasound scanning beam ⁇ image 36 is determined (as detailed
  • FIG. 5a illustrates a magnetic position
  • position measuring component 28 is a receiver
  • Transmitter 30' being attached to CT scanning head 22 by an arm 80' .
  • receiver 30' is transmitting AC or DC magnetic/electromagnetic signals to receiver 28' .
  • the output of receiver 28' is transmitted by wire or wireless connections to position
  • sensing controller 26 enabling to calculate the relative position of receiver 28' with
  • position measuring component 28 could be a
  • transmitter and position measuring component 30 could be a receiver.
  • FIG. 5b wherein an optical position measuring
  • a stereo vision charge coupled device (CCD) camera 84' is
  • arm 88' and position measuring component 30 includes a cluster of LED's 30" being
  • beam 34 can be optical, acoustic, magnetic or inertial or a combination of the above.
  • the relative position between position measuring components 28 and 30 can be
  • a third position measuring component When making these indirect calculations, a third position measuring component
  • this CCD 84 is operative communication with position measuring components 28 and 30, this CCD 84
  • the first reference location may be fixed and
  • the first reference position can be movable and unknown.
  • the first reference position can be attached to the bed 24.
  • Position measuring components 28, 30 and 84 may be
  • Position measuring components 28, 30 and 84 may be part of a magnetic or acoustic or optic or inertial
  • Position sensing controller 26 may communicate with at least one or all of
  • FIG. 6, illustrates an additional embodiment
  • the second embodiment illustrates an
  • the X-Ray imaging device comprises X-Ray main unit 140 and X-Ray scanning head 142 including emitter 142' and detector 142' .
  • X-Ray scanning head 142 is mounted on a movable and adjustable arm 144.
  • Bed 24 may or may not be
  • Position measuring component 30 is attached at known and fixed positions from
  • position measuring component 30 is calibrated
  • An additional position measuring component 84 can be placed at a reference
  • This position measuring component 84 (if used) is in
  • FIG. 5b Body 6 can be fixed so as to avoid movement during the procedure.
  • scanning head 142 is positioned in order to view target 8 in the body 6 or body volume
  • the position of X-Ray scanning head 142 is measured with
  • the operator may indicate target 8
  • transducer 18 is then applied to body volume 6 and its position is measured with
  • the body volume 6 is first imaged by ultrasound in order to
  • Data processor 14 stores the
  • Ultrasound transducer 18 is then removed and the position of X-Ray scanning head
  • X-Ray 138 are similar to those described for the system illustrated in Figs. la ( 4 and
  • FIG. 7a and 7b illustrate an additional embodiment of the present invention. Similar items to those shown in previous figures have similar numbers and will not further be described.
  • FIG. 1 illustrates an ultrasound 2, and an optical endoscope 150 to be used in cooperative
  • Said endoscope 150 comprising an
  • endoscope head 152 with a CCD 154 (not shown in the drawing) and optical apparatus
  • Endoscope head 152 can be rigid, or can be flexible. It is still possible to use a rigid endoscope head 152 with a mobile tip enabling to
  • Position measuring component 30 is attached at a known position with respect
  • measuring component 28 is attached at a known position with respect to transducer 18
  • endoscope head 152 is calibrated to transducer beam/image 36 as described above. If endoscope head 152
  • is rigid position measuring component may be attached internally or externally at any combination
  • endoscope head 152 is flexible or
  • position measuring component 30 is positioned at the tip of head 150.
  • position measuring component is the magnetic sensor
  • position component 30 can be a
  • measuring component 30 being attached to the flexible part of endoscope head 152
  • target 8 is viewed by
  • ultrasound transducer 18, and endoscope head 152 is maneuvered to view target 8 based on guiding information received from data processor 14 (not shown in Fig. 7)
  • target 8 is viewed by
  • transducer 18 and also by endoscope head 152. It is then possible to mark target 8 in
  • the ultrasound image and calculate its position with respect to position measuring
  • a target is viewed by endoscope 150 while moving the endoscope head 150 at several positions on a strait line around the focussed position, at least one position providing a focussed image of
  • the target According to the focussing and de-focussing of the target and according to
  • the measured position of position measuring component 30 it is possible to receive the
  • endoscope head 152 is viewing a volume of
  • body 6 comprising target 8 from at least two different positions enabling to implement

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  • Engineering & Computer Science (AREA)
  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • Radar, Positioning & Navigation (AREA)
  • Remote Sensing (AREA)
  • Acoustics & Sound (AREA)
  • Molecular Biology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Physics & Mathematics (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Robotics (AREA)
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  • Apparatus For Radiation Diagnosis (AREA)

Abstract

Cette invention concerne des systèmes et des méthodes de diagnostic et d"interventions médicales guidées aux moyens de systèmes d"imagerie multiples. Ces systèmes et méthodes prennent en compte la nécessité de disposer d"un moyen relativement simple et modulaire permettant de combiner les informations fournies par au moins deux dispositifs d"imagerie médicale pour le diagnostic ainsi que pour les interventions et les traitements médicaux guidés. Plus particulièrement, ces méthodes permettent de limiter les contraintes mécaniques inhérentes à l"utilisation conjointe de plusieurs dispositifs d"imagerie médicale. Grâce au dispositif et aux méthodes selon l"invention, il est possible de mesurer la position relative entre différents dispositifs d"imagerie médicale et entre les plans image et/ou les plans volume produits par ces dispositifs, ceci au moyen d"un système de détermination de position sur lequel peuvent venir se raccorder divers organes de mesure. Ce dispositif facilite la fusion d"images lorsque des images appartenant au même plan/volume proviennent de différents systèmes d"imagerie médicale. De plus/en variante, il permet de positionner un second dispositif d"imagerie médicale sur une surface/volume déterminé conformément à des informations générées par le premier dispositif d"imagerie médicale.
PCT/IL2000/000202 1999-03-31 2000-03-30 Dispositif et methodes de diagnostic medical, d"interventions et de traitement medical guides WO2000057767A2 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
JP2000607528A JP2003527880A (ja) 1999-03-31 2000-03-30 医療診断ならびに医療誘導インターベンションおよび治療のための装置および方法
AU35739/00A AU3573900A (en) 1999-03-31 2000-03-30 Apparatus and methods for medical diagnostic and for medical guided interventions and therapy
EP00914346A EP1196089A2 (fr) 1999-03-31 2000-03-30 Dispositif et methodes de diagnostic medical, d'interventions et de traitement medical guides

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US12726799P 1999-03-31 1999-03-31
US60/127,267 1999-03-31

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Publication Number Publication Date
WO2000057767A2 true WO2000057767A2 (fr) 2000-10-05
WO2000057767A3 WO2000057767A3 (fr) 2001-01-11

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EP (1) EP1196089A2 (fr)
JP (1) JP2003527880A (fr)
AU (1) AU3573900A (fr)
WO (1) WO2000057767A2 (fr)

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WO2002062250A1 (fr) * 2001-02-07 2002-08-15 Synthes Ag Chur Procede et dispositif de navigation peroperatoire
JP2003339725A (ja) * 2002-05-22 2003-12-02 Mitsubishi Heavy Ind Ltd 骨折整復誘導装置及び方法
EP1365686A2 (fr) * 2000-09-23 2003-12-03 The Board Of Trustees Of The Leland Stanford Junior University Procede et systeme de ciblage endoscopique
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US10617324B2 (en) 2014-04-23 2020-04-14 Veran Medical Technologies, Inc Apparatuses and methods for endobronchial navigation to and confirmation of the location of a target tissue and percutaneous interception of the target tissue
US10624701B2 (en) 2014-04-23 2020-04-21 Veran Medical Technologies, Inc. Apparatuses and methods for registering a real-time image feed from an imaging device to a steerable catheter
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