Medical interventional system and method
The present invention relates to a medical interventional system and a corresponding method. Further, the present invention relates to medical glove and a medical instrument for use in such a medical interventional system. Many medical interventions, e.g. cardio-vascular interventions, are guided by X-ray fluoroscopy. These interventions are characterized by an increased usage of different systems and devices, such as intra- vascular imaging, non-line-of-sight navigation, stereotaxis devices, as well as by increasingly more operating modes and software packages to support specific tasks during the intervention. A considerable amount of the available functionality can only be used in combination with distingued interventional devices, such as intra- vascular imaging probes, catheters, guidewires, more generally also called medical instruments, or refers to a specific step in the intervention. The increasing number of devices, operating modes and software packages complicates system handling and raises desires for easier user interfaces. In addition, this situation can lead to faulty usage of the system if functionality is used at the wrong time, forgotten to be used, or used with a wrong equipment. It is an object of the present invention to provide a medical interventional system and a corresponding medical interventional method which provide an easier user interface also in more complex interventional systems and by which the risk of faulty usage of the interventional system and its functionalities by the user is reduced. This object is achieved according to the present invention by a medical interventional system as claimed in claim 1 comprising: one or more medial instruments each carrying a detectable unique identifier uniquely identifying a medical instrument or a type of medical instrument, a detection unit for detecting said identifiers and for issuing a detection signal, - a transmitter for transmitting said detection signal to an evaluation unit and an evaluation unit for evaluating said detection signal. A corresponding medical interventional method is claimed in claim 11. Preferred embodiments are defined in the dependent claims.
The invention is based on the idea to provide the ability to watch which medical instrument is actually and currently being used by an operator or, on a higher level, which step the intervention is currently in. A corresponding information is provided and evaluated which evaluation result can be used for different purposes. For instance, the evaluation result can be used to set system parameters, select functionality or generate context sensitive menus that improve ease-of-use. Furthermore, this information can be used to record, check, and document the interventional steps. According to the invention, means are provided which allow the identification of the used medical instruments for which purpose appropriate detectable unique identifiers are provided on the medical instruments. These identifiers are unique in the sense that they either identify each single instrument or that they at least identify the type of medical instrument. In this way it is, for instance, possible to recognize whether a guidewire is equipped with non-line-of-sight localisation technology or not, and functionality for roadmap-based guidance can be configured accordingly. If a stent is selected for usage, the detection signal carrying the information about the detected medical instrument or type of medical instrument can be used to verify agreement of the stent dimensions with the results of intervention planning and can thus signal possible deviations. If a stent combined with an IVUS probe is used, the interventional system can automatically offer or invoke the functionality for IVUS-based guidance during stent positioning. Another possibility is that dose control in X-ray imaging can be adapted based on material properties of the medical instrument with the aim of dose reduction. According to preferred embodiments of the invention the identifiers and the detection unit are operative for contactless and/or optical detection of the identifiers. Thus, no mechanical contact is required between the identifiers provided on the medical instruments and the detection unit, but detection is possible over a certain distance. Preferably, the detection unit is adapted and/or located such that not all medical instruments, for instance present in the room, are detected, but only medical instruments which are currently in use or going to be used by one or more defined users. For instance, the detection unit has a detection area of a predetermined size and/or direction to provide this functionality. In a preferred embodiment the identifiers include RF (Radio Frequency) tags and the detection unit includes an RF tag reading unit. Such RF tags are widely used, for instance attached to goods in warehouses to avoid thefts since such RF tags would invoke an alarm when passing a reading unit installed at all exits of the warehouse. For many other purposes such RF tags are used, for instance, in person identification at the entrance of areas
with restricted access. Such RF tags are cheap, easily attachable or integratable into medical instruments and can be programmed to uniquely identify medical instruments or different types of medical instruments. In a further embodiment of the invention the detection unit is embedded or attachable to a medical glove or is attachable to a user's hand. In this way medical instruments that are taken and used by the user can be easily detected. Preferably, the detection range of the detection unit in this embodiment needs only to be several centimetres which thus also avoids detection of other medical instruments currently not used by the user. In a different embodiment the identification is based on capacitive coupling between identifier and detection unit. This allows the detection unit to be placed anywhere on the user's body to detect capacitive identification signals transmitted by identifiers of touched (metal) instruments. In another embodiment the detection unit is attachable to a patient's body, in particular at spots where a medical intervention shall be carried out. This enables particularly the detection of medical instruments just before or when they are introduced into the patient's body, particularly when the detection range is only a few centimetres. In addition, this embodiment avoids the attachment of the detection unit to the user's hand which might hamper the user in this hand movements. Additionally, in order to enable gesture recognition the medical interventional system according to the present invention further comprises acceleration and/or movement sensors attachable to a user's body, in particular attachable to a user's hands and/or arms, and a recognition unit for detecting movements of said sensors. Such sensors can also be integrated into the clothing, i.e. the user's gloves. The information about the gestures and movements of the user's hands and/or arms can be additionally used to improve recognition of executed intervention steps to automatically adjust system functionality and increase ease of use. Preferably in another embodiment a pre-processing unit is provided for preprocessing the detection signal before providing it to the transmitter, said pre-processing unit being attachable to the user's body. For instance, wearable computers which are more and more used and which can be integrated into the user's clothes or can be easily carried by the user can be used for this purpose. In addition, also the transmitter may be attachable to the user's body, for instance as a wireless card integrated into the wearable pre-processing unit. Particularly in the case of using additional movement and/or acceleration sensors for providing the ability of gesture recognition it is desired to use such a pre-processing unit
before transmission of any detection signals in order to reduce the bandwidth for the transmission of all detection signals. As explained above the detection signal is evaluated, which evaluation result can be used for many different purposes. An advantageous embodiment of the evaluation unit is defined in claim 10. Besides the medical interventional system and the corresponding medical interventional method the invention also relates to a medical glove as claimed in claim 12 comprising a detection unit as described above. Further, the present invention also relates to a medical instrument as claimed in claim 13 carrying a detectable unique identifier as explained above.
The invention will now be explained in more detail with reference to the figure which schematically shows a medical interventional system according to the present invention.
In the figure a C-arm X-ray device is shown having a C-arm 1 provided with an X-ray source 2 and an X-ray detector 3 at opposing ends for acquiring X-ray image data of a patient (not shown) lying on the patient table 4. According to the invention medical or interventional instruments, such as a biopsy needle 5 or a scissor 6, or a catheter (not shown), are provided with detectable unique identifiers 7 which are preferably RF tags. By these identifiers a medical instrument or a type of medical instrument can be uniquely identified. For instance, the identifiers are different, provide a different read-out signal or are differently programmed, e.g. in case of RF tags. For detection of said identifiers a detector 8 is provided at or within the glove worn by the interventionalist 9. When the interventionalist 9 takes a medical instrument 5, 6 in his hand the detector 8 detects the identifiers provided at said instrument, and a detection signal is provided which carries the information which medical instrument 5, 6 the interventionalist 9 has in his hand (or at least which type of medical instrument). The detectors 8 are preferably connected, e.g. via cables or a body area network, to a transmitter 10 worn by the interventionalist 9. This transmitter 10 at least serves for transmitting the detection signal to a receiver 11 of a processing unit 12. In addition, the transmitter 10 might include computer functionality for pre-processing the detection signal
and for translating it to events which are then sent, for instance by wireless technology, to the processing unit 12. The receiver 11 receives the transmitted signal which is then evaluated by an evaluation unit 13. In particular, it is determined which medical instrument the interventionalist 9 actually uses. This information can be used for different purposes, for instance to set system parameters, select functionality or generate context sensitive menus. Other possibilities are that the system will use this information to discover, verify and document the steps chosen by the interventionalist during the intervention. It can be further advantageous that the interventionalist 9 wears sensors 14, for instance acceleration or movement sensors or nearfield RF sensors (e.g. RF tags), e.g. integrated into the clothing, e.g. the gloves 15. By use of sensor signals from these sensors 14 additional information about the actual interventional step can be obtained which may also be transmitted to be processed by the processing unit 12. This can include for example pulling or pushing movements, turning of objects and grasps into different directions as well as the magnitude of these movements. Such movement recognition can be employed to detect finer grained steps done with the same instrument. The information provided by the present invention about the status and actual step of the intervention enables a better support of the interventionalist and prevents faulty system usage. According to the invention, this information is obtained without the need for explicit actions by the interventionalist.