WO2010140075A2 - System and method for integrated biopsy and therapy - Google Patents

System and method for integrated biopsy and therapy Download PDF

Info

Publication number
WO2010140075A2
WO2010140075A2 PCT/IB2010/052152 IB2010052152W WO2010140075A2 WO 2010140075 A2 WO2010140075 A2 WO 2010140075A2 IB 2010052152 W IB2010052152 W IB 2010052152W WO 2010140075 A2 WO2010140075 A2 WO 2010140075A2
Authority
WO
WIPO (PCT)
Prior art keywords
biopsy
images
recited
therapy
mri
Prior art date
Application number
PCT/IB2010/052152
Other languages
French (fr)
Other versions
WO2010140075A3 (en
Inventor
Sheng Xu
Jochen Kruecker
Bradford Johns Wood
Original Assignee
Koninklijke Philips Electronics, N.V.
The United States Of America, As Represented By The Secretary, Department Of Health And Human Services
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 Koninklijke Philips Electronics, N.V., The United States Of America, As Represented By The Secretary, Department Of Health And Human Services filed Critical Koninklijke Philips Electronics, N.V.
Priority to RU2011154203/14A priority Critical patent/RU2558521C2/en
Priority to JP2012513693A priority patent/JP5587993B2/en
Priority to BRPI1009004A priority patent/BRPI1009004A2/en
Priority to CN201080030085.8A priority patent/CN102481115B/en
Priority to EP10727139.7A priority patent/EP2437661B1/en
Priority to US13/321,836 priority patent/US10980508B2/en
Publication of WO2010140075A2 publication Critical patent/WO2010140075A2/en
Publication of WO2010140075A3 publication Critical patent/WO2010140075A3/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5247—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/0841—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5238—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • 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
    • A61B2090/374—NMR or MRI
    • 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
    • A61B34/20—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
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/12—Arrangements for detecting or locating foreign bodies

Definitions

  • This disclosure relates to imaging technology, and more particularly to systems and methods that integrate biopsy imaging with therapeutic procedures.
  • Prostate cancer affects one in every six men in the western world at some point in their lives. Because of the lack of imaging and image guidance, conventional (blind) sextant biopsy used for diagnosis is painful and unreliable. As a result, prostate cancer is over-diagnosed and over-treated. In therapy, almost all prostate cancers are currently treated by surgery or whole -prostate radiation therapy, leading to significant side effects.
  • a biopsy is ultrasound guided because ultrasound is real-time and cost-effective and can be employed to visualize the prostate.
  • ultrasound does not show a cancer. So, instead of going for the cancer in a targeted, image-guided way, the biopsy is blindly sampled with a sextant biopsy, which results in an up to a 30% false negative rate.
  • image guidance also extends to prostate cancer therapy. Without adequate guidance, therapy approaches remain limited to whole-gland therapy, which shows significant side effects such as urinary incontinence and impotence in a large number of patients. Therefore, a move away from blind and whole-gland approaches needs to be made.
  • Magnetic resonance imaging is currently the most promising imaging modality for depicting prostate cancer and other abnormalities and cancers on internal organs.
  • Magnetic resonance imaging (MRI) guidance is not compatible with current workflows, however. Since MRI is expensive and typically not used for procedure guidance, it is desirable to fuse pre-operative MRI with real-time transrectal ultrasound (TRUS) during an intervention related to the prostate. As a result, the MRI information can be used during the intervention outside the MRI suite.
  • TRUS transrectal ultrasound
  • the present inventors developed an image fusion system for MRI/TRUS guided targeted biopsy.
  • the fusion system utilized electromagnetic (EM) tracking for spatial localization of an ultrasound probe.
  • a sextant biopsy employs a targeted biopsy to increase the yield of the sextant biopsy and detect lesions that are not recognizable by MRI.
  • prostate biopsy and therapy are two separate procedures. Therefore, even if lesions are found in the sextant biopsy procedure, it is difficult to go back exactly to the same location during the therapy to treat the lesion.
  • the position information of sextant biopsy is under-utilized. With the tracked biopsy and image fusion, the gap between prostate biopsy and focal therapy can be bridged by using the same diagnosis MRI image to document biopsy, plan for therapy and provide image guidance.
  • An integrated prostate cancer suite in accordance with the present principles enables physicians to seamlessly plan, navigate, execute and monitor a biopsy or focal therapy procedure. It is based on the fusion of pre-acquired MRI with live transrectal ultrasound (TRUS): target information from MRI augments TRUS guidance, which improves the accuracy of biopsy and focal treatment.
  • TRUS live transrectal ultrasound
  • a system and method combine biopsy and therapy by using a same diagnostic MRI image to document biopsy, plan for therapy and provide image guidance.
  • the system/method includes the following: (1) performing tracked sextant with MRI-targeted biopsies for prostate cancer detection, (2) identifying all the biopsy sites on MRI using MRI/TRUS fusion, (3) planning focal therapy on the MRI image using the pathology results of the biopsy specimens, and (4) fusing the MRI -based treatment plan with real-time TRUS for focal therapy guidance.
  • Combining sextant biopsy with targeted biopsy increases the yield of sextant biopsy and detects lesions that are not recognizable by MRI.
  • Prostate biopsy and therapy can be carried out at different times, but the biopsy findings are used to guide the therapy.
  • the system and method are adaptable and not limited to treatment of prostate cancer.
  • a system and method for integrating diagnosis and treatment for internal tissues includes imaging at least a portion of an internal organ of a subject using a first technology capable of differentiating tissue types, and targeting and accessing biopsy sites using images of the first technology fused with images of a second technology capable of real-time image updates.
  • Treatment of a biopsy site is planned using the images of the first technology.
  • Target information that may be used for treatment planning includes positive biopsy locations and/or suspicious regions of diagnostic images (e.g. MRI or MRI+PET fusion). Instruments for treating the biopsy site are guided by fusing the images of the first technology with the images of the second technology.
  • FIG. 1 is a block diagram showing a system and method for integrating diagnosis and treatment for internal tissues in accordance with the present principles
  • FIG. 2 is a block/flow diagram showing a system/method for integrating diagnosis and treatment for internal tissues in accordance with the present principles
  • FIGS. 3A-3C are MRI images showing three views of a specimen employed in accordance with an illustrative procedure.
  • FIG. 3D is a fused image combining an MRI with and ultrasound image in accordance with an illustrative embodiment.
  • the present disclosure describes systems and methods for fusing imaging technologies and employing biopsy information in therapy or subsequent procedures.
  • the present embodiments will be illustratively described in terms of prostate cancer diagnosis and therapy. It should be understood that the present principles may be employed for other cancers or procedures and should not be construed as limited by the illustrative examples.
  • MRI imaging and MRI/ultrasound fusion technologies are employed to enable lesion targeted biopsy and focal therapy which may reduce side effects. (E.g., conventional prostate cancer biopsy and therapy are blind, whole-gland procedures with significant side effects).
  • a method in accordance with one embodiment includes performing a tracked sextant with MRI-targeted biopsies for prostate cancer detection; identifying all the biopsy sites on the MRI using MRI/TRUS fusion; planning focal therapy on the MRI image using the pathology results of the biopsy specimens and fusing the MRI -based treatment plan with real-time TRUS for focal therapy guidance.
  • This method bridges the gap between prostate biopsy and therapy, increases the yield of biopsy and reduces the side effects of therapy. It should be understood that the present disclosure is applicable for any cancer or disease in any organism.
  • FIGS may be implemented in various combinations of hardware and/or software and provide functions which may be combined in a single element or multiple elements.
  • the present principles can take the form of a computer program product accessible from a computer-usable or computer-readable medium providing program code for use by or in connection with a computer or any instruction execution system.
  • a computer-usable or computer readable medium can be any apparatus that may include, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device.
  • the medium can be an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system (or apparatus or device).
  • Examples of a computer-readable medium include a semiconductor or solid state memory, magnetic tape, a removable computer diskette, a random access memory (RAM), a read-only memory (ROM), a rigid magnetic disk and an optical disk.
  • Current examples of optical disks include compact disk - read only memory (CD-ROM), compact disk - read/write (CD-R/W) and DVD.
  • a data processing system suitable for storing and/or executing program code may include at least one processor coupled directly or indirectly to memory elements through a system bus.
  • the processor or processing system may be provided with the scope system or provided independently of the scope system.
  • the memory elements can include local memory employed during actual execution of the program code, bulk storage, and cache memories which provide temporary storage of at least some program code to reduce the number of times code is retrieved from bulk storage during execution.
  • I/O devices including but not limited to keyboards, displays, pointing devices, etc.
  • Network adapters may also be coupled to the system to enable the data processing system to become coupled to other data processing systems or remote printers or storage devices through intervening private or public networks.
  • System 100 includes a tracking system 102 employed during an ultrasound-guided medical procedure.
  • the tracking system 102 may include, e.g., an electromagnetic tracking system with a field generator placed near a patient or subject 107 to provide positional coordinates of a tracking sensor(s) 106 during a procedure.
  • the tracking sensor 106 is attached to an ultrasound probe 108.
  • a needle guide 110 may be provided with tracking sensors 106 which can be attached to the ultrasound probe 108.
  • the tracking sensor 106 may be attached to a biopsy needle 112.
  • the equipment and methodology may be varied in accordance with the procedure and anatomy being analyzed and treated.
  • a processing unit 116 is connected to the tracking system 102 and an ultrasound scanner 118 (or other real-time scanning technology).
  • the processing unit 116 simultaneously obtains ultrasound images from the scanner 118, and corresponding position information from the sensor 106.
  • the processing unit 116 can be a workstation, or may be part of the ultrasound scanner 118.
  • the processing unit 116 includes memory 121 which includes a software program 120 for execution on the processing unit 116 that guides an MRI-targeted biopsy, acquires and stores real-time ultrasound images, together with the volume's tracking system coordinates provided by the sensor 106, identifies the needle 110 or other interventional device in real-time or recorded ultrasound, and transforms the biopsy sample's position to a corresponding spot in an MRI image 119.
  • Processing unit 116 includes software 123 for focal therapy planning based on the MRI image 119, the biopsy positions in the MRI image 119 and pathology results of the biopsies.
  • An image guidance system 122 executes on processing unit 116 for focal therapy that permits fusing a treatment plan with real-time ultrasonic imaging, and guiding targeted focal therapy based on the plan.
  • the image guidance system 122 of the biopsy can be adapted for focal therapy, or the image guidance system 122 for focal therapy can be based on mechanical devices 124 with position encoders and template grids. Such mechanical devices can therefore be accurately tracked with reference to image positions obtained in real-time and fused with other images (e.g., MRI).
  • the MRI images and the scanner images e.g., ultrasonic images
  • device tracking e.g., the ultrasound probe, a registration pointer etc.
  • real-time images may benefit from the detailed MRI images (or other type images) since the fused images provide a complete set of information.
  • the information is advantageously employed for both diagnosis and for treatment, and the fused image can be updated in realtime to track diagnosis, analysis and treatment. Scanned and fused images may be viewed using one or more display devices 130, which provide visual feedback for users to interface with the system 100.
  • a block/flow diagram illustratively depicts a system/method for diagnosis (e.g., biopsy) and treatment (e.g., focal therapy) for a surgical procedure.
  • the system/method combines a tracked sextant and MRI-targeted biopsies for prostate cancer detection.
  • images are collected for a subject. The images preferably employ a technology capable of differentiating between tissues (e.g., MRI technology).
  • static (e.g., MRI or other technology) images are fused with real-time updated images (e.g., ultrasonic images) by performing a registration method or by employing tracked coordinate systems.
  • real-time updated images e.g., ultrasonic images
  • all the biopsy sites are identified on the MRI using MRI/TRUS fusion.
  • the biopsy site(s) is targeted and samples are obtained using guided interventional instruments in block
  • Positional information for the biopsy site(s) is recorded and stored for use later in therapy/treatment.
  • the MRI image is then used to plan for focal therapy based on a pathology examination of the biopsy specimens in block 207.
  • the plan (static image) is fused with real-time images (e.g., TRUS) to guide focal therapy in block 208.
  • the plan is carried out or executed using the MRI and TRUS information in the fused image in block 210.
  • MRI -targeted biopsy The prostate MR image is acquired first and transferred to a workstation (e.g., 116, FIG. 1). The patient is then positioned on an examination table and a 2D TRUS probe with tracking sensors is inserted into the rectum.
  • the operator performs a 2D axial sweep (prostate base to apex) such that the series of 2D ultrasound images covers the entire volume of the prostate.
  • a 3D ultrasound probe can be used to obtain the prostate volume.
  • the images and corresponding tracking data from the tracking sensors are transferred to the workstation in real-time. Based on these images and tracking data, a volumetric ultrasound image is immediately reconstructed on the workstation. The MR image and ultrasound volume are then spatially aligned.
  • the operator manually holds the 2D probe to scan the prostate. Spatial tracking of the ultrasound probe, and registering MRI coordinate system with the tracking coordinate system, enables real-time fusion of the live ultrasound image with the spatially corresponding multi-planar reconstruction (MPR) from the MRI scan.
  • MPR multi-planar reconstruction
  • a tissue sample may be obtained when the needle is aligned with the target.
  • Tracked sextant biopsy can be carried out with a targeted biopsy under the same clinical setup. The order between them is not important. The physician can ignore the MRI image and perform sextant biopsy under TRUS guidance only. The TRUS images and the corresponding tracking information of the probe can be recorded. The locations of sextant biopsy can be (retrospectively) identified on the MRI using MRI/TRUS fusion as shown in FIGS. 3A-3D.
  • FIGS. 3A-3D images of a prostate region in a subject are illustratively depicted.
  • FIGS. 3A-3D show the development of an MRI/TRUS fusion for a biopsy needle firing.
  • FIG. 3D shows an alpha-blending of MRI and TRUS images. This fusion provides the accuracy needed for identifying particular tissues along with the dynamic and real-time images provided by ultrasound.
  • FIGS. 3A-3C show axial, sagittal and coronal views, respectively, of an MRI focused on a mid-point of a specimen to be analyzed and treated in a patient.
  • Markers 302, 304 and 306 show two end points (302 and 306) and a mid-point (304) of the biopsy specimen.
  • the markers 302, 304 and 306 indicate a biopsy needle trajectory.
  • MRI images are described, instead of using an MRI volume for diagnosis, procedure guidance and treatment planning, other 3D (or 4D) image volumes may be employed (e.g., computed tomography (CT), positron emission tomography (PET), single photon emission computer tomography (SPECT), 3D ultrasound, and cancer probability mapping, and image fusion of multiple diagnostic images such as MRI, PET and contrast ultrasound, etc.).
  • CT computed tomography
  • PET positron emission tomography
  • SPECT single photon emission computer tomography
  • Both positive and negative biopsy cores can be used to plan focal therapy.
  • the sites of the sextant biopsy can be optimized based on the MRI target locations to maximize the probability for finding cancer.
  • the processes described may be applied to ultrasound/MR images of the breast, liver, kidney or other soft-tissue targets.
  • the workflow of focal therapy is similar to that of the MRI-targeted biopsy.
  • the treatment plan can be highlighted on real-time TRUS for procedure guidance.
  • the therapy modality can be any modality suitable for focal therapy, such as cryo-ablation, radiofrequency ablation or other ablative therapies, brachytherapy or other radiation-based therapy, or photodynamic therapy.
  • results from several biopsies - even obtained on different times/dates - can be combined by registering a reconstructed ultrasound volume obtained for each biopsy with the same baseline MRI scan, or by registering the ultrasound sweeps with different MRI scans which in turn are spatially co-registered.
  • the treatment delivery locations can be tracked and recorded as well with the same tracking system used to track biopsy locations.
  • the system can then also be used for optimizing multiple, sequential treatments over time, by considering prior treated regions in the treatment plan for subsequent/repeat treatments (e.g., avoiding unnecessary duplication of treatment in the same area).
  • electronic images may be colorized or otherwise marked to identify treated regions or regions yet to be treated or both. Other manipulations of images data are also contemplated.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • General Health & Medical Sciences (AREA)
  • Pathology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physics & Mathematics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Optics & Photonics (AREA)
  • Magnetic Resonance Imaging Apparatus (AREA)
  • Surgical Instruments (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)
  • Radiation-Therapy Devices (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

A system and method for integrating diagnosis and treatment for internal tissues includes imaging (202) at least a portion of an internal organ of a subject using a first technology capable of differentiating tissue types, and targeting (205) and accessing biopsy sites using images of the first technology fused with images of a second technology capable of real-time image updates. Treatment of a biopsy site is planned (207) using the images of the first technology. Instruments for treating the biopsy site are guided (210) by fusing (208) the images of the first technology with the images of the second technology.

Description

PATENT SYSTEMAND METHOD FOR INTEGRATED BIOPSYAND THERAPY
This invention was made in the performance of a Cooperative Research and Development Agreement with the United States Public Health Service (CRADA No. NCI- NIHCC-01864). The Government of the United States has certain rights in the invention.
This disclosure relates to imaging technology, and more particularly to systems and methods that integrate biopsy imaging with therapeutic procedures.
Prostate cancer affects one in every six men in the western world at some point in their lives. Because of the lack of imaging and image guidance, conventional (blind) sextant biopsy used for diagnosis is painful and unreliable. As a result, prostate cancer is over-diagnosed and over-treated. In therapy, almost all prostate cancers are currently treated by surgery or whole -prostate radiation therapy, leading to significant side effects.
Today, prostate cancer care is performed without ample visual feedback. A biopsy is ultrasound guided because ultrasound is real-time and cost-effective and can be employed to visualize the prostate. Unfortunately, ultrasound does not show a cancer. So, instead of going for the cancer in a targeted, image-guided way, the biopsy is blindly sampled with a sextant biopsy, which results in an up to a 30% false negative rate. One problem with image guidance also extends to prostate cancer therapy. Without adequate guidance, therapy approaches remain limited to whole-gland therapy, which shows significant side effects such as urinary incontinence and impotence in a large number of patients. Therefore, a move away from blind and whole-gland approaches needs to be made.
In accordance with the present principles, a move toward targeted, localized procedures is made. Magnetic resonance imaging (MRI) is currently the most promising imaging modality for depicting prostate cancer and other abnormalities and cancers on internal organs. Magnetic resonance imaging (MRI) guidance is not compatible with current workflows, however. Since MRI is expensive and typically not used for procedure guidance, it is desirable to fuse pre-operative MRI with real-time transrectal ultrasound (TRUS) during an intervention related to the prostate. As a result, the MRI information can be used during the intervention outside the MRI suite. In a previous work, the present inventors developed an image fusion system for MRI/TRUS guided targeted biopsy. The fusion system utilized electromagnetic (EM) tracking for spatial localization of an ultrasound probe. Spatial tracking of the probe is enabled by attaching a biopsy guide to the probe that is customized with electromagnetic tracking sensors. Although MRI has good sensitivity and specificity in prostate cancer diagnosis, it may not be sufficiently definitive. MRI may miss identifying prostate lesions, suggesting that MRI -targeted prostate biopsy alone may be insufficient. In accordance with the present embodiments, a sextant biopsy employs a targeted biopsy to increase the yield of the sextant biopsy and detect lesions that are not recognizable by MRI. In the current standard care of prostate cancer, prostate biopsy and therapy are two separate procedures. Therefore, even if lesions are found in the sextant biopsy procedure, it is difficult to go back exactly to the same location during the therapy to treat the lesion. The position information of sextant biopsy is under-utilized. With the tracked biopsy and image fusion, the gap between prostate biopsy and focal therapy can be bridged by using the same diagnosis MRI image to document biopsy, plan for therapy and provide image guidance.
An integrated prostate cancer suite in accordance with the present principles enables physicians to seamlessly plan, navigate, execute and monitor a biopsy or focal therapy procedure. It is based on the fusion of pre-acquired MRI with live transrectal ultrasound (TRUS): target information from MRI augments TRUS guidance, which improves the accuracy of biopsy and focal treatment.
A system and method combine biopsy and therapy by using a same diagnostic MRI image to document biopsy, plan for therapy and provide image guidance. In one embodiment, the system/method includes the following: (1) performing tracked sextant with MRI-targeted biopsies for prostate cancer detection, (2) identifying all the biopsy sites on MRI using MRI/TRUS fusion, (3) planning focal therapy on the MRI image using the pathology results of the biopsy specimens, and (4) fusing the MRI -based treatment plan with real-time TRUS for focal therapy guidance. Combining sextant biopsy with targeted biopsy increases the yield of sextant biopsy and detects lesions that are not recognizable by MRI. Prostate biopsy and therapy can be carried out at different times, but the biopsy findings are used to guide the therapy. The system and method are adaptable and not limited to treatment of prostate cancer.
A system and method for integrating diagnosis and treatment for internal tissues includes imaging at least a portion of an internal organ of a subject using a first technology capable of differentiating tissue types, and targeting and accessing biopsy sites using images of the first technology fused with images of a second technology capable of real-time image updates. Treatment of a biopsy site is planned using the images of the first technology. Target information that may be used for treatment planning includes positive biopsy locations and/or suspicious regions of diagnostic images (e.g. MRI or MRI+PET fusion). Instruments for treating the biopsy site are guided by fusing the images of the first technology with the images of the second technology.
These and other objects, features and advantages of the present disclosure will become apparent from the following detailed description of illustrative embodiments thereof, which is to be read in connection with the accompanying drawings. This disclosure will present in detail the following description of preferred embodiments with reference to the following figures wherein:
FIG. 1 is a block diagram showing a system and method for integrating diagnosis and treatment for internal tissues in accordance with the present principles;
FIG. 2 is a block/flow diagram showing a system/method for integrating diagnosis and treatment for internal tissues in accordance with the present principles;
FIGS. 3A-3C are MRI images showing three views of a specimen employed in accordance with an illustrative procedure; and
FIG. 3D is a fused image combining an MRI with and ultrasound image in accordance with an illustrative embodiment. The present disclosure describes systems and methods for fusing imaging technologies and employing biopsy information in therapy or subsequent procedures. The present embodiments will be illustratively described in terms of prostate cancer diagnosis and therapy. It should be understood that the present principles may be employed for other cancers or procedures and should not be construed as limited by the illustrative examples. In one particularly useful application, MRI imaging and MRI/ultrasound fusion technologies are employed to enable lesion targeted biopsy and focal therapy which may reduce side effects. (E.g., conventional prostate cancer biopsy and therapy are blind, whole-gland procedures with significant side effects).
MRI is insufficient to detect all prostate cancer. To improve the outcome of the procedures, a method in accordance with one embodiment includes performing a tracked sextant with MRI-targeted biopsies for prostate cancer detection; identifying all the biopsy sites on the MRI using MRI/TRUS fusion; planning focal therapy on the MRI image using the pathology results of the biopsy specimens and fusing the MRI -based treatment plan with real-time TRUS for focal therapy guidance. This method bridges the gap between prostate biopsy and therapy, increases the yield of biopsy and reduces the side effects of therapy. It should be understood that the present disclosure is applicable for any cancer or disease in any organism. The elements depicted in the FIGS, may be implemented in various combinations of hardware and/or software and provide functions which may be combined in a single element or multiple elements. Furthermore, the present principles can take the form of a computer program product accessible from a computer-usable or computer-readable medium providing program code for use by or in connection with a computer or any instruction execution system. A computer-usable or computer readable medium can be any apparatus that may include, store, communicate, propagate, or transport the program for use by or in connection with the instruction execution system, apparatus, or device. The medium can be an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system (or apparatus or device). Examples of a computer-readable medium include a semiconductor or solid state memory, magnetic tape, a removable computer diskette, a random access memory (RAM), a read-only memory (ROM), a rigid magnetic disk and an optical disk. Current examples of optical disks include compact disk - read only memory (CD-ROM), compact disk - read/write (CD-R/W) and DVD.
A data processing system suitable for storing and/or executing program code may include at least one processor coupled directly or indirectly to memory elements through a system bus. The processor or processing system may be provided with the scope system or provided independently of the scope system. The memory elements can include local memory employed during actual execution of the program code, bulk storage, and cache memories which provide temporary storage of at least some program code to reduce the number of times code is retrieved from bulk storage during execution. Input/output or I/O devices (including but not limited to keyboards, displays, pointing devices, etc.) may be coupled to the system either directly or through intervening I/O controllers. Network adapters may also be coupled to the system to enable the data processing system to become coupled to other data processing systems or remote printers or storage devices through intervening private or public networks. Modems, cable modem and Ethernet cards are just a few of the currently available types of network adapters. Referring now to the drawings in which like numerals represent the same or similar elements and initially to FIG. 1, a system 100 is depicted for combining biopsy information with therapy. System 100 includes a tracking system 102 employed during an ultrasound-guided medical procedure. The tracking system 102 may include, e.g., an electromagnetic tracking system with a field generator placed near a patient or subject 107 to provide positional coordinates of a tracking sensor(s) 106 during a procedure. In one embodiment, the tracking sensor 106 is attached to an ultrasound probe 108. Alternatively, a needle guide 110 may be provided with tracking sensors 106 which can be attached to the ultrasound probe 108. Optionally, the tracking sensor 106 may be attached to a biopsy needle 112. The equipment and methodology may be varied in accordance with the procedure and anatomy being analyzed and treated.
A processing unit 116 is connected to the tracking system 102 and an ultrasound scanner 118 (or other real-time scanning technology). The processing unit 116 simultaneously obtains ultrasound images from the scanner 118, and corresponding position information from the sensor 106. The processing unit 116 can be a workstation, or may be part of the ultrasound scanner 118. The processing unit 116 includes memory 121 which includes a software program 120 for execution on the processing unit 116 that guides an MRI-targeted biopsy, acquires and stores real-time ultrasound images, together with the volume's tracking system coordinates provided by the sensor 106, identifies the needle 110 or other interventional device in real-time or recorded ultrasound, and transforms the biopsy sample's position to a corresponding spot in an MRI image 119. Processing unit 116 includes software 123 for focal therapy planning based on the MRI image 119, the biopsy positions in the MRI image 119 and pathology results of the biopsies.
An image guidance system 122 executes on processing unit 116 for focal therapy that permits fusing a treatment plan with real-time ultrasonic imaging, and guiding targeted focal therapy based on the plan. Optionally, the image guidance system 122 of the biopsy can be adapted for focal therapy, or the image guidance system 122 for focal therapy can be based on mechanical devices 124 with position encoders and template grids. Such mechanical devices can therefore be accurately tracked with reference to image positions obtained in real-time and fused with other images (e.g., MRI). Advantageously, the MRI images and the scanner images (e.g., ultrasonic images) are combined or fused using device tracking (e.g., the ultrasound probe, a registration pointer etc.) and/or image registration. Once registered, real-time images (e.g., ultrasound images) may benefit from the detailed MRI images (or other type images) since the fused images provide a complete set of information. The information is advantageously employed for both diagnosis and for treatment, and the fused image can be updated in realtime to track diagnosis, analysis and treatment. Scanned and fused images may be viewed using one or more display devices 130, which provide visual feedback for users to interface with the system 100.
Referring to FIG. 2, a block/flow diagram illustratively depicts a system/method for diagnosis (e.g., biopsy) and treatment (e.g., focal therapy) for a surgical procedure. In the present example for prostate cancer, the system/method combines a tracked sextant and MRI-targeted biopsies for prostate cancer detection. In block 202, images are collected for a subject. The images preferably employ a technology capable of differentiating between tissues (e.g., MRI technology). In block 204, static (e.g., MRI or other technology) images are fused with real-time updated images (e.g., ultrasonic images) by performing a registration method or by employing tracked coordinate systems. In block
205, all the biopsy sites are identified on the MRI using MRI/TRUS fusion. The biopsy site(s) is targeted and samples are obtained using guided interventional instruments in block
206. Positional information for the biopsy site(s) is recorded and stored for use later in therapy/treatment.
The MRI image is then used to plan for focal therapy based on a pathology examination of the biopsy specimens in block 207. The plan (static image) is fused with real-time images (e.g., TRUS) to guide focal therapy in block 208. The plan is carried out or executed using the MRI and TRUS information in the fused image in block 210. MRI -targeted biopsy: The prostate MR image is acquired first and transferred to a workstation (e.g., 116, FIG. 1). The patient is then positioned on an examination table and a 2D TRUS probe with tracking sensors is inserted into the rectum. At the beginning of the TRUS procedure, the operator performs a 2D axial sweep (prostate base to apex) such that the series of 2D ultrasound images covers the entire volume of the prostate. (In an alternative, a 3D ultrasound probe can be used to obtain the prostate volume.) The images and corresponding tracking data from the tracking sensors are transferred to the workstation in real-time. Based on these images and tracking data, a volumetric ultrasound image is immediately reconstructed on the workstation. The MR image and ultrasound volume are then spatially aligned. During the procedure, the operator manually holds the 2D probe to scan the prostate. Spatial tracking of the ultrasound probe, and registering MRI coordinate system with the tracking coordinate system, enables real-time fusion of the live ultrasound image with the spatially corresponding multi-planar reconstruction (MPR) from the MRI scan.
When prostate motion results in misalignment between the ultrasound and MR images, image-based registration between the real-time 2D ultrasound images and the static ultrasound volume will be carried out to recover the correct MRI/TRUS fusion. A tissue sample may be obtained when the needle is aligned with the target.
Tracked sextant biopsy: Tracked sextant biopsy can be carried out with a targeted biopsy under the same clinical setup. The order between them is not important. The physician can ignore the MRI image and perform sextant biopsy under TRUS guidance only. The TRUS images and the corresponding tracking information of the probe can be recorded. The locations of sextant biopsy can be (retrospectively) identified on the MRI using MRI/TRUS fusion as shown in FIGS. 3A-3D.
Referring to FIGS. 3A-3D, images of a prostate region in a subject are illustratively depicted. FIGS. 3A-3D show the development of an MRI/TRUS fusion for a biopsy needle firing. FIG. 3D shows an alpha-blending of MRI and TRUS images. This fusion provides the accuracy needed for identifying particular tissues along with the dynamic and real-time images provided by ultrasound. FIGS. 3A-3C show axial, sagittal and coronal views, respectively, of an MRI focused on a mid-point of a specimen to be analyzed and treated in a patient. Markers 302, 304 and 306 show two end points (302 and 306) and a mid-point (304) of the biopsy specimen. The markers 302, 304 and 306 indicate a biopsy needle trajectory.
While MRI images are described, instead of using an MRI volume for diagnosis, procedure guidance and treatment planning, other 3D (or 4D) image volumes may be employed (e.g., computed tomography (CT), positron emission tomography (PET), single photon emission computer tomography (SPECT), 3D ultrasound, and cancer probability mapping, and image fusion of multiple diagnostic images such as MRI, PET and contrast ultrasound, etc.). Further, instead of using electromagnetic tracking, optical, mechanical or other tracking systems may be employed. After the locations of sextant and targeted biopsies are identified on the MRI images, the locations can be correlated with the pathology examination of the specimens collected during the biopsy. A treatment plan can be made on the MRI image to cover all the cancer locations and spare the healthy tissue. Both positive and negative biopsy cores can be used to plan focal therapy. In other embodiments, instead of performing separate sextant and MRI-targeted biopsies, the sites of the sextant biopsy can be optimized based on the MRI target locations to maximize the probability for finding cancer. The processes described may be applied to ultrasound/MR images of the breast, liver, kidney or other soft-tissue targets. The workflow of focal therapy is similar to that of the MRI-targeted biopsy. Instead of using the MRI targets, the treatment plan can be highlighted on real-time TRUS for procedure guidance. The therapy modality can be any modality suitable for focal therapy, such as cryo-ablation, radiofrequency ablation or other ablative therapies, brachytherapy or other radiation-based therapy, or photodynamic therapy.
Advantageously, results from several biopsies - even obtained on different times/dates - can be combined by registering a reconstructed ultrasound volume obtained for each biopsy with the same baseline MRI scan, or by registering the ultrasound sweeps with different MRI scans which in turn are spatially co-registered. The treatment delivery locations can be tracked and recorded as well with the same tracking system used to track biopsy locations. The system can then also be used for optimizing multiple, sequential treatments over time, by considering prior treated regions in the treatment plan for subsequent/repeat treatments (e.g., avoiding unnecessary duplication of treatment in the same area). In one embodiment, electronic images may be colorized or otherwise marked to identify treated regions or regions yet to be treated or both. Other manipulations of images data are also contemplated.
In interpreting the appended claims, it should be understood that: a) the word "comprising" does not exclude the presence of other elements or acts than those listed in a given claim; b) the word "a" or "an" preceding an element does not exclude the presence of a plurality of such elements; c) any reference signs in the claims do not limit their scope; d) several "means" may be represented by the same item or hardware or software implemented structure or function; and e) no specific sequence of acts is intended to be required unless specifically indicated. Having described preferred embodiments for systems and methods (which are intended to be illustrative and not limiting), it is noted that modifications and variations can be made by persons skilled in the art in light of the above teachings. It is therefore to be understood that changes may be made in the particular embodiments of the disclosure disclosed which are within the scope and spirit of the embodiments disclosed herein as outlined by the appended claims. Having thus described the details and particularity required by the patent laws, what is claimed and desired protected by Letters Patent is set forth in the appended claims.

Claims

CLAIMS:
1. A method for integrating diagnosis and treatment for internal tissues, comprising: imaging (202) at least a portion of an internal organ of a subject using a first technology capable of differentiating tissue types; targeting (205) and accessing biopsy sites using images of the first technology fused with images of a second technology capable of real-time image updates; planning (207) treatment of at least one of the biopsy sites using the images of the first technology; and guiding (210) instruments for treating the at least one biopsy site by fusing (208) the images of the first technology with the images of the second technology.
2. The method as recited in claim 1, wherein the first technology includes magnetic resonance imaging and the second technology includes ultrasonic imaging.
3. The method as recited in claim 2, wherein the internal organ includes a prostate and the step of targeting (205) and accessing biopsy sites using images of the first technology fused with images of a second technology capable of real-time image updates includes performing (206) a sextant and magnetic resonance tracked biopsy.
4. The method as recited in claim 1, wherein the internal organ includes any soft- tissue organ.
5. The method as recited in claim 1, wherein the guiding (210) step employs the images taken using the first technology during the imaging (202) step.
6. The method as recited in claim 1, wherein targeting (205) and accessing biopsy sites includes tracking an instrument in the fused image using a tracking system.
7. The method as recited in claim 1, wherein guiding (210) instruments for treating the at least one biopsy site includes guiding focal therapy using the fused images.
8. The method as recited in claim 7, wherein the focal therapy includes at least one of an ablative therapy, a radiation-based therapy, and a photodynamic therapy.
9. The method as recited in claim 7, wherein guiding (210) instruments for treating the at least one biopsy site includes adapting an image guidance system employed for biopsy to perform the focal therapy.
10. The method as recited in claim 7, wherein guiding (210) instruments for treating the at least one biopsy site includes employing a mechanical device for the focal therapy by using one of a position encoder and a template grid.
11. A method for integrating diagnosis and treatment for internal tissues, comprising: imaging (202) at least a portion of an internal organ of a subject using magnetic resonance imaging (MRI); locating (206) the biopsy sites in the MRI image using a tracking system; targeting (205) and accessing biopsy sites using MRI images fused with ultrasound images having real-time image updates; planning (207) treatment of at least one of the biopsy sites using the MRI images; and guiding (210) instruments for treating the at least one biopsy site by fusing (208) the MRI images with the ultrasound images.
12. The method as recited in claim 11, wherein the internal organ includes a prostate and the step of targeting (205) and accessing biopsy sites includes performing at least one of a sextant, a blind, systematic and a magnetic resonance tracked biopsy.
13. The method as recited in claim 11, wherein the guiding (210) step employs the MRI images taken during the imaging (202) step.
14. The method as recited in claim 11, wherein targeting (205) and accessing biopsy sites includes tracking an instrument in the fused image using the tracking system.
15. The method as recited in claim 11, wherein guiding (210) instruments for treating the at least one biopsy site includes guiding focal therapy using the fused images.
16. The method as recited in claim 15, wherein the focal therapy includes at least one of an ablative therapy, a radiation-based therapy, and a photodynamic therapy.
17. The method as recited in claim 15, wherein guiding (210) instruments for treating the at least one biopsy site includes adapting an image guidance system employed for biopsy to perform the focal therapy.
18. The method as recited in claim 15, wherein guiding (210) instruments for treating the at least one biopsy site includes employing a mechanical device (124) for the focal therapy by using one of a position encoder and a template grid.
19. A system for integrating diagnosis and treatment for internal tissues, comprising: a scanner (118) configured to image at least a portion of an internal organ of a subject; a tracking system (102) configured to track an interventional instrument for targeting and accessing biopsy sites in accordance with images from the scanner and to locate focal therapy sites corresponding therewith; a processing unit (116) having associated memory storage (121) for storing a program, the program configured to fuse images taken in real-time by the scanner with images taken with a technology capable of differentiating tissue types, the program configured to guide the interventional instrument using the scanned images and to track positions on the images taken with the technology capable of differentiating tissue types, the program further configured to employ information obtained at the tracked positions to plan and perform focal therapy on or near the internal organ.
20. The system as recited in claim 19, wherein the scanner (118) includes an ultrasonic imaging scanner and the technology capable of differentiating tissue types includes magnetic resonance imaging.
21. The system as recited in claim 20, wherein the internal organ includes a prostate and the interventional instrument includes at least one of a sextant and a tracked biopsy device.
22. The system as recited in claim 19, wherein the internal organ includes any soft-tissue organ.
23. The system as recited in claim 19, wherein positions of the biopsy sites are employed for guiding focal therapy based on pathology results of biopsied tissue.
24. The system as recited in claim 19, wherein the focal therapy includes at least one of an ablative therapy, a radiation-based therapy, and a photodynamic therapy.
25. The system as recited in claim 19, wherein the focal therapy employs mechanical instruments (124) guided by using one of a position encoder and a template grid.
26. The system as recited in claim 19, wherein the information obtained at the tracked positions includes at least one of positive biopsy locations or suspicious regions of diagnostic images.
27. The system as recited in claim 26, wherein the at least one positive biopsy location or suspicious region is found in a MRI image or fused MRI and PET image.
PCT/IB2010/052152 2009-06-05 2010-05-14 System and method for integrated biopsy and therapy WO2010140075A2 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
RU2011154203/14A RU2558521C2 (en) 2009-06-05 2010-05-14 System and method of integrated biopsy and treatment
JP2012513693A JP5587993B2 (en) 2009-06-05 2010-05-14 System and method for integrated biopsy and treatment
BRPI1009004A BRPI1009004A2 (en) 2009-06-05 2010-05-14 method for integrating diagnosis and treatment for internal tissues, and system for integrating diagnosis and treatment for internal tissues
CN201080030085.8A CN102481115B (en) 2009-06-05 2010-05-14 System and method for integrated biopsy and therapy
EP10727139.7A EP2437661B1 (en) 2009-06-05 2010-05-14 System and method for integrated biopsy and therapy
US13/321,836 US10980508B2 (en) 2009-06-05 2010-05-14 System and method for integrated biopsy and therapy

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US18432209P 2009-06-05 2009-06-05
US61/184,322 2009-06-05

Publications (2)

Publication Number Publication Date
WO2010140075A2 true WO2010140075A2 (en) 2010-12-09
WO2010140075A3 WO2010140075A3 (en) 2011-01-27

Family

ID=42990318

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2010/052152 WO2010140075A2 (en) 2009-06-05 2010-05-14 System and method for integrated biopsy and therapy

Country Status (7)

Country Link
US (2) US10980508B2 (en)
EP (1) EP2437661B1 (en)
JP (1) JP5587993B2 (en)
CN (1) CN102481115B (en)
BR (1) BRPI1009004A2 (en)
RU (1) RU2558521C2 (en)
WO (1) WO2010140075A2 (en)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120083653A1 (en) * 2010-10-04 2012-04-05 Sperling Daniel P Guided procedural treatment device and method
WO2016207048A1 (en) 2015-06-26 2016-12-29 Koninklijke Philips N.V. Image guidance system
RU2610916C1 (en) * 2016-01-29 2017-02-17 Руслан Марсович Абдеев Method for transrectal ultrasonic scanning in carrying out transurethral laser enucleation of prostate
WO2017042650A3 (en) * 2015-09-09 2017-06-08 Koninklijke Philips N.V. System and method for planning and performing a repeat interventional procedure
WO2018170592A1 (en) * 2017-03-20 2018-09-27 Exact Imaging Inc. Method and system for visually assisting an operator of an ultrasound system
CN108814643A (en) * 2018-04-04 2018-11-16 飞依诺科技(苏州)有限公司 A kind of ultrasonic scanning method and apparatus
US11504154B2 (en) 2016-07-28 2022-11-22 The United States Of America, As Represented By The Secretary, Department Of Health And Human Services Transperineal imaging-guided prostate needle placement

Families Citing this family (34)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006119166A2 (en) 2005-04-29 2006-11-09 The Regents Of The University Of Colorado Multi-excitation diagnostic systems and methods for classification of tissue
JP5822554B2 (en) * 2011-06-17 2015-11-24 キヤノン株式会社 Image processing apparatus, image processing method, photographing system, and program
US9119550B2 (en) * 2012-03-30 2015-09-01 Siemens Medical Solutions Usa, Inc. Magnetic resonance and ultrasound parametric image fusion
US20130310680A1 (en) 2012-05-21 2013-11-21 The Regents Of The University Of Colorado, A Body Corporate Three-dimensional optical imaging and therapy of prostate cancer
US9814448B2 (en) 2012-05-21 2017-11-14 Precision Biopsy, Inc. Three-dimensional optical imaging and therapy of prostate cancer
US20130316318A1 (en) * 2012-05-22 2013-11-28 Vivant Medical, Inc. Treatment Planning System
US10588597B2 (en) 2012-12-31 2020-03-17 Intuitive Surgical Operations, Inc. Systems and methods for interventional procedure planning
WO2014111853A2 (en) * 2013-01-17 2014-07-24 Koninklijke Philips N.V. Method of adjusting focal zone in ultrasound-guided medical procedure and system employing the method
EP2967424B1 (en) * 2013-03-15 2021-09-01 UC-Care Ltd. System and methods for processing a biopsy sample
RU2665187C2 (en) 2013-04-05 2018-08-28 Профаунд Медикал Инк. Energy deposition zone determination for catheter with ultrasound array
KR101563498B1 (en) * 2013-05-02 2015-10-27 삼성메디슨 주식회사 Ultrasound system and method for providing change information of target object
CN105392428B (en) * 2013-06-26 2019-06-04 皇家飞利浦有限公司 System and method for mapping the measurement of ultrasonic shear wave elastogram
US10098566B2 (en) * 2013-09-06 2018-10-16 Covidien Lp System and method for lung visualization using ultrasound
EP3074947B1 (en) 2013-11-27 2020-07-01 BK Medical Holding Company, Inc. Multi-imaging modality navigation system
AU2014360318B2 (en) 2013-12-05 2019-10-31 Rfemb Holdings, Llc Cancer immunotherapy by radiofrequency electrical membrane breakdown (RF-EMB)
PL3110336T3 (en) 2014-02-28 2019-07-31 3Dbiopsy, Inc. Biopsy needle assembly
JP6548730B2 (en) * 2014-08-23 2019-07-24 インテュイティブ サージカル オペレーションズ， インコーポレイテッド System and method for display of pathological data in image guided procedures
US10043272B2 (en) * 2014-09-16 2018-08-07 Esaote S.P.A. Method and apparatus for acquiring and fusing ultrasound images with pre-acquired images
JP6723249B2 (en) 2015-01-30 2020-07-15 アールエフイーエムビー ホールディングス リミテッド ライアビリティ カンパニー System and method for ablating soft tissue
WO2016126778A1 (en) * 2015-02-04 2016-08-11 Rfemb Holdings, Llc Radio-frequency electrical membrane breakdown for the treatment of benign prostatic hyperplasia
CN104835169A (en) * 2015-05-15 2015-08-12 三爱医疗科技（深圳）有限公司 Prostate image integration method
RU2746895C2 (en) * 2015-12-24 2021-04-21 Конинклейке Филипс Н.В. Device for three-dimensional staining of biopsy tissue
CN109069624A (en) 2016-01-15 2018-12-21 瑞美控股有限责任公司 The immunization therapy of cancer
RU2611405C1 (en) * 2016-02-15 2017-02-21 Федеральное государственное бюджетное военное образовательное учреждение высшего образования Военно-медицинская академия им. С.М. Кирова Министерства обороны Российской Федерации (ВМедА) Selection method of parts of prostatic gland for puncture in case of diagnosis of prostate cancer
JP6692445B2 (en) 2016-03-16 2020-05-13 コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ． A system that supports the implementation of intervention procedures
US11464570B2 (en) 2016-09-29 2022-10-11 Koninkluke Philips N.V. System and method for planning and performing an interventional procedure based on the spatial relationships between identified points
KR101931747B1 (en) 2016-10-28 2019-03-13 삼성메디슨 주식회사 Biopsy apparatus and method for operating the same
JP6849462B2 (en) 2017-02-06 2021-03-24 キヤノンメディカルシステムズ株式会社 Medical information processing system and medical image processing device
US11107213B2 (en) * 2018-12-28 2021-08-31 Biosense Webster (Israel) Ltd. Correcting medical scans
US20200281561A1 (en) * 2019-03-05 2020-09-10 Ethos Medical, Inc. Systems, Methods, and Devices for Instrument Guidance
US11304683B2 (en) * 2019-09-13 2022-04-19 General Electric Company Biopsy workflow using multimodal imaging
JP7499135B2 (en) 2020-09-28 2024-06-13 オリンパス株式会社 Ultrasound observation device, endoscope auxiliary device, operation method of ultrasound observation device, and operation program of ultrasound observation device
US20220409167A1 (en) * 2021-06-24 2022-12-29 Biosense Webster (Israel) Ltd. Visualization of 4d ultrasound maps
CN114569146A (en) * 2022-03-01 2022-06-03 西安大医集团股份有限公司 Medical image processing method, medical image processing device, computer equipment and storage medium

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008065600A2 (en) 2006-11-27 2008-06-05 Koninklijke Philips Electronics, N.V. System and method for fusing real-time ultrasound images with pre-acquired medical images

Family Cites Families (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002516586A (en) 1997-06-23 2002-06-04 ティーエイチエス インターナショナル，インコーポレイテッド Method and apparatus for providing acoustic hemostasis
US6675037B1 (en) 1999-09-29 2004-01-06 Regents Of The University Of Minnesota MRI-guided interventional mammary procedures
WO2001043640A2 (en) 1999-12-15 2001-06-21 Koninklijke Philips Electronics N.V. Diagnostic imaging system with ultrasound probe
WO2005067392A2 (en) 2004-01-20 2005-07-28 Topspin Medical (Israel) Ltd. Mri probe for prostate imaging
US20080132782A1 (en) 2004-02-02 2008-06-05 Rueckmann Bogdan Von Combined MR-ultrasound (US) coil for prostate-, cevix- and rectum cancer imaging diagnostics
US8932233B2 (en) 2004-05-21 2015-01-13 Devicor Medical Products, Inc. MRI biopsy device
US20060116576A1 (en) 2004-12-01 2006-06-01 Scimed Life Systems, Inc. System and use thereof to provide indication of proximity between catheter and location of interest in 3-D space
EP1858418B1 (en) * 2005-02-28 2017-08-16 Robarts Research Institute System for performing a biopsy of a target volume and a computing device for planning the same
US8548562B2 (en) * 2006-04-04 2013-10-01 John Trachtenberg System and method of guided treatment within malignant prostate tissue
KR100971417B1 (en) 2006-10-17 2010-07-21 주식회사 메디슨 Ultrasound system for displaying neddle for medical treatment on compound image of ultrasound image and external medical image
US20080119725A1 (en) * 2006-11-20 2008-05-22 General Electric Company Systems and Methods for Visual Verification of CT Registration and Feedback
US20080161687A1 (en) * 2006-12-29 2008-07-03 Suri Jasjit S Repeat biopsy system
CN101836236B (en) 2007-10-26 2013-08-21 皇家飞利浦电子股份有限公司 Closed loop registration control for multi-modality soft tissue imaging
JP2011511652A (en) * 2007-11-14 2011-04-14 コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ System and method for automatic calibration of tracked ultrasound
CN102215770B (en) * 2008-06-20 2013-11-13 皇家飞利浦电子股份有限公司 Method and system for performing biopsies
CN100586379C (en) 2008-07-04 2010-02-03 浙江大学 Computer simulation scaling biopsy method and apparatus

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008065600A2 (en) 2006-11-27 2008-06-05 Koninklijke Philips Electronics, N.V. System and method for fusing real-time ultrasound images with pre-acquired medical images

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120083653A1 (en) * 2010-10-04 2012-04-05 Sperling Daniel P Guided procedural treatment device and method
WO2016207048A1 (en) 2015-06-26 2016-12-29 Koninklijke Philips N.V. Image guidance system
RU2703688C2 (en) * 2015-06-26 2019-10-21 Конинклейке Филипс Н.В. Image control system
CN109073725A (en) * 2015-09-09 2018-12-21 皇家飞利浦有限公司 System and method for planning and executing repetition intervention process
WO2017042650A3 (en) * 2015-09-09 2017-06-08 Koninklijke Philips N.V. System and method for planning and performing a repeat interventional procedure
US11051902B2 (en) 2015-09-09 2021-07-06 Koninklijke Philips N.V. System and method for planning and performing a repeat interventional procedure
US11950967B2 (en) 2015-09-09 2024-04-09 Koninklijke Philips N.V. System and method for planning and performing a repeat interventional procedure
RU2610916C1 (en) * 2016-01-29 2017-02-17 Руслан Марсович Абдеев Method for transrectal ultrasonic scanning in carrying out transurethral laser enucleation of prostate
US11504154B2 (en) 2016-07-28 2022-11-22 The United States Of America, As Represented By The Secretary, Department Of Health And Human Services Transperineal imaging-guided prostate needle placement
WO2018170592A1 (en) * 2017-03-20 2018-09-27 Exact Imaging Inc. Method and system for visually assisting an operator of an ultrasound system
CN111093548A (en) * 2017-03-20 2020-05-01 精密成像有限公司 Method and system for visually assisting an operator of an ultrasound system
US11857370B2 (en) 2017-03-20 2024-01-02 National Bank Of Canada Method and system for visually assisting an operator of an ultrasound system
CN111093548B (en) * 2017-03-20 2024-04-16 精密成像有限公司 Method and system for visually assisting an operator of an ultrasound system
CN108814643A (en) * 2018-04-04 2018-11-16 飞依诺科技(苏州)有限公司 A kind of ultrasonic scanning method and apparatus

Also Published As

Publication number Publication date
EP2437661A2 (en) 2012-04-11
CN102481115B (en) 2014-11-26
US10980508B2 (en) 2021-04-20
JP5587993B2 (en) 2014-09-10
BRPI1009004A2 (en) 2016-03-08
WO2010140075A3 (en) 2011-01-27
RU2558521C2 (en) 2015-08-10
US20120071749A1 (en) 2012-03-22
US20210161507A1 (en) 2021-06-03
RU2011154203A (en) 2013-07-20
EP2437661B1 (en) 2021-04-07
JP2012528649A (en) 2012-11-15
CN102481115A (en) 2012-05-30

Similar Documents

Publication Publication Date Title
US20210161507A1 (en) System and method for integrated biopsy and therapy
US11950967B2 (en) System and method for planning and performing a repeat interventional procedure
US20200085412A1 (en) System and method for using medical image fusion
US20140073907A1 (en) System and method for image guided medical procedures
US10166078B2 (en) System and method for mapping navigation space to patient space in a medical procedure
RU2510699C2 (en) Method and system for biopsy
US9782147B2 (en) Apparatus and methods for localization and relative positioning of a surgical instrument
US20070230757A1 (en) System and method of guided treatment within malignant prostate tissue
EP1542591A2 (en) Methods and systems for localizing a medical imaging probe and for spatial registration and mapping of a biopsy needle during a tissue biopsy
Sridhar et al. Image-guided robotic interventions for prostate cancer
WO2014031531A1 (en) System and method for image guided medical procedures
US12114933B2 (en) System and method for interventional procedure using medical images
JP6438601B2 (en) Image guidance system
Warlick et al. Beyond transrectal ultrasound-guided prostate biopsies: available techniques and approaches
Rapetti et al. Virtual reality navigation system for prostate biopsy
Kettenbach et al. Computer-based imaging and interventional MRI: applications for neurosurgery
US20130085383A1 (en) Systems, methods and computer readable storage media storing instructions for image-guided therapies
De Silva et al. Evaluating the utility of intraprocedural 3D TRUS image information in guiding registration for displacement compensation during prostate biopsy
Alameddine et al. Image Fusion Principles: Theory
Coleman et al. Advances in imaging for urologic procedures

Legal Events

Date Code Title Description
WWE Wipo information: entry into national phase

Ref document number: 201080030085.8

Country of ref document: CN

121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10727139

Country of ref document: EP

Kind code of ref document: A2

WWE Wipo information: entry into national phase

Ref document number: 13321836

Country of ref document: US

Ref document number: 2010727139

Country of ref document: EP

WWE Wipo information: entry into national phase

Ref document number: 2012513693

Country of ref document: JP

NENP Non-entry into the national phase

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 9715/CHENP/2011

Country of ref document: IN

WWE Wipo information: entry into national phase

Ref document number: 2011154203

Country of ref document: RU

REG Reference to national code

Ref country code: BR

Ref legal event code: B01A

Ref document number: PI1009004

Country of ref document: BR

ENP Entry into the national phase

Ref document number: PI1009004

Country of ref document: BR

Kind code of ref document: A2

Effective date: 20111201