WO2015015385A1 - Système et procédé permettant de guider le positionnement d'un capteur - Google Patents

Système et procédé permettant de guider le positionnement d'un capteur Download PDF

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Publication number
WO2015015385A1
WO2015015385A1 PCT/IB2014/063402 IB2014063402W WO2015015385A1 WO 2015015385 A1 WO2015015385 A1 WO 2015015385A1 IB 2014063402 W IB2014063402 W IB 2014063402W WO 2015015385 A1 WO2015015385 A1 WO 2015015385A1
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WIPO (PCT)
Prior art keywords
location
subject
marker
unit
image
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PCT/IB2014/063402
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English (en)
Inventor
Shiyun SHAO
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Koninklijke Philips N.V.
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Publication of WO2015015385A1 publication Critical patent/WO2015015385A1/fr

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/684Indicating the position of the sensor on the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/103Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1113Local tracking of patients, e.g. in a hospital or private home
    • A61B5/1114Tracking parts of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/103Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
    • A61B5/1126Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb using a particular sensing technique
    • A61B5/1127Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb using a particular sensing technique using markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/24Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316Modalities, i.e. specific diagnostic methods
    • A61B5/389Electromyography [EMG]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6813Specially adapted to be attached to a specific body part
    • A61B5/6824Arm or wrist
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2055Optical tracking systems
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3937Visible markers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3937Visible markers
    • A61B2090/395Visible markers with marking agent for marking skin or other tissue

Definitions

  • the present invention generally relates to the placement of a sensor, especially to the placement of a medical sensor on a region of interest of a subject.
  • sensors may be placed on a subject to detect physiological parameters of the subject.
  • the sensors include, but are not limited to, electrocardiography (ECG) sensors, electromyography (EMG) sensors, electroencephalogram (EEG) sensors and ultrasonic sensors.
  • ECG electrocardiography
  • EMG electromyography
  • EEG electroencephalogram
  • ultrasonic sensors A major factor affecting the quality of the detected physiological parameters for such sensors is sensor placement on the subject.
  • a sensor in order to obtain a high-quality physiological signal from a region of interest of the subject, it is important to place a sensor in a desired location on the region of interest so that a physiological signal of optimal quality may be obtained from said desired location.
  • a physiological signal of optimal quality may be obtained from said desired location.
  • different methods have been proposed to detect a desired location for the EMG sensor.
  • a straight way to detect the desired location of the EMG sensor is manual measurement using a ruler with reference to certain anatomical landmarks in the region of interest of the subject according to some well-accepted guidelines for sensor placement such as the SENIAM (surface EMG for non-invasive assessment of muscles) recommendations.
  • SENIAM surface EMG for non-invasive assessment of muscles
  • Another method detects the desired location of the EMG sensor on the region of interest of the subject in dependence on the motion of the subject.
  • the method detects as the desired location of the EMG sensor a location on the region of interest of a subject where the obtained EMG signal has the largest signal-to-noise ratio during motion of the subject.
  • the method has to be performed during motion of the subject and requires multiple measurements for a plurality of locations on the region of interest of the subject, it is time-consuming and cannot be used for applications where the subject is immobile or not supposed to perform active movement.
  • US 2009/0118610 Al proposes a MRI localization and/or guidance system for facilitating placement of an interventional therapy and/or device in vivo.
  • the MRI system is an expensive healthcare device, the guidance for the placement of an interventional device using a MRI system may be feasible in a complicated surgery. However, it is not possible to request MRI guidance for the placement of a sensor in a normal quick physical exam.
  • the desired location where the sensor is to be placed on a subject is automatically determined relative to the anatomical location(s) of the subject according to pre-defined criteria which define the spatial relationship between the desired location of the subject and the anatomical location(s) of the subject.
  • Said automatic determination instead of manual measurement for the placement of the sensor is fast and convenient. Moreover, it reduces measurement errors and thus enables repeatable placement of the sensor on the same location the subject across sessions or by different practitioners.
  • the desired location where the sensor is to be placed may be determined while the subject keeps still. Therefore, it is applicable even when the examinee is immobile or not supposed to perform active movement.
  • the present invention provides a system for guiding the placement of a sensor.
  • the system comprises: an image acquisition unit, such as an infrared camera, configured to acquire an image of the subject; a first unit configured to identify at least one marker in the acquired image, wherein the at least one marker is retro-reflective marker and each of the at least one marker is attached to an anatomical location of the subject.
  • the system further comprises a second unit configured to generate a control signal according to the location(s) of the identified at least one retro-reflective marker in the image and predefined criteria, wherein the predefined criteria define the spacial relationship between the anatomical location(s) of the subject and a first location of the subject where the sensor is to be placed.
  • the system further comprise a third unit configured to provide an indication signal indicative of the first location of the subject, wherein the second unit is further configured to control, based on the control signal, the third unit to provide the indication signal indicative of the first location of the subject for guiding the placement of the sensor.
  • the present invention provides a method of guiding the placement of a sensor.
  • an image of an subject is acquired by an infrared camera, and at least one marker is identified in the image, wherein the at least one marker (A, B) is retro-reflective marker and each of the at least one marker is attached to an anatomical location of the subject;
  • a control signal is generated according to the location(s) of the identified at least one retro-reflective marker in the image and predefined criteria, wherein the predefined criteria define the spacial relationship between the anatomical location(s) of the subject and a first location of the subject where the sensor is to be placed; and an indication signal indicative of the first location of the subject is provided based on the control signal.
  • the present invention provides a computer program comprising computer program code means for causing a computer to perform the steps of the method as described above according to the present invention.
  • Fig. 1 is a schematic block diagram of a system for guiding the placement of an EMG sensor on a subject according to one embodiment of the present invention
  • Fig. 2 shows a configuration of one or more markers on the subject, i.e., a patient
  • Fig. 3 is a schematic block diagram of a system for guiding the placement of an EMG sensor on a subject according to another embodiment of the present invention
  • Fig. 4 is a schematic block diagram of a system for guiding the placement of an EMG sensor on a subject according to a further embodiment of the present invention
  • Fig. 5 is a flowchart for guiding the placement of an EMG sensor on a subject according to the method of the invention
  • Embodiments of the invention will be described with reference to an EMG sensor in the following part of the document. However, for those skilled in the art, it may be easy to apply the embodiments to other types of sensors which need to be located on a certain position of a subject, including but not limited to ECG sensors, EEG sensors, ultrasonic sensors, etc.
  • Fig. 1 shows, according to one embodiment of the present invention, a schematic block diagram of a system 10 for guiding the placement of an EMG sensor on a subject, e.g., an upper arm of a patient, to obtain EMG signals from a muscle of interest.
  • a subject e.g., an upper arm of a patient
  • Fig.2 shows a configuration of the marker(s) on the subject, i.e., an upper arm of a patient.
  • a desired location to place an EMG sensor for the assessment of the biceps brachii of a patient is indicated according to the present invention.
  • System 10 comprises an image acquisition unit, such as an infrared camera, for acquiring images of the subject.
  • the image acquisition unit could also be other type of the camera, such as a digital camera.
  • the system 10 further comprises a first unit 11 which receives images of the subject and identifies at least one marker (i.e. marker A and marker B as shown in Fig.2) in the acquired image.
  • the at least one marker is attached to an anatomical location of the subject. For example, in Fig.2, the marker A and the marker B have been attached on the medial acromion and the cubital fossa, respectively.
  • the first unit 11 determines one or more locations of the at least one marker in the image, for example, the first unit 11 determines the coordinates of the one marker A and marker B in the image.
  • the at least one marker is an entity marker (i.e. a physical marker) which may be attached directly to one or more anatomical locations of the subject or to one or more corresponding parts of a training garment to be worn by the subject before imaging the subject.
  • the marker may also be part of a garment.
  • the marker and the garment is designed such that when the subject wears the garment, each of the at least one marker is attached to (i.e. cover) a desired anatomical location.
  • the at least one marker may be displayed and identified in the image of the subject.
  • the at least one marker is of the retro-reflective type reflecting the light with a specific wavelength and the image acquisition unit may receive the reflected light with the specific wavelength and obtain the image of the markers which reflect light with the specific wavelength.
  • the one or more retro-reflective markers are markers which reflect infrared light only and the image acquisition unit is an infrared camera to obtain an infrared image.
  • the anatomical locations to be selected for different muscles of the subject to be detected by EMG may be different from one another.
  • the anatomical location(s) to be indicated by the at least one marker may be selected for different muscles from certain guidelines for desired placement of the EMG sensor.
  • the guidelines comprise currently well-accepted recommendations - SENIAM (surface electromyography for non-invasive assessment of muscles recommendations).
  • SENIAM surface electromyography for non-invasive assessment of muscles recommendations.
  • the anatomical location(s) to be indicated by the at least one marker may be selected to be the medial acromion and the cubital fossa. Therefore, the markers may be positioned on the medial acromion and the cubital fossa, respectively.
  • the number of anatomical locations to be indicated by the markers is different for different muscles to be detected by EMG and not limited to two locations as described above.
  • only one anatomical location may be selected as superior rim of the patella
  • for scapula three anatomical locations are to be selected: one on the inferior tip of the scapula, one on the spine and another along the lateral edge of the torso.
  • the system 10 also comprises a second unit 12.
  • the second unit 12 receives, from the first unit 11, the determined one or more locations, e.g., the coordinates, of the identified at least one marker in the image and generates a control signal according to the received location(s) of the identified at least one marker in the image and predefined criteria.
  • the predefined criteria define the spacial relationship between the anatomical location(s) of the subject and a desired location of the subject (hereinafter referred to as "first location") where the sensor is to be placed.
  • the system further comprises a third unit 13 which is capable of providing an indication signal.
  • the indication signal is for indicating the desired first location where the EMG sensor is to be placed on the subject.
  • the second unit 12 provides the generated control signal to control the third unit 13 to provide the indication signal based on the control signal. .
  • a user may conveniently and repeatably position the EMG sensor on the desired location of the subject.
  • the predefined criteria may also be selected from the guidelines for optimal placement of the EMG sensor, as described above, and be pre-stored in a memory comprised in the system or in a remote memory.
  • the predefined criteria define the relationship between the first location of the subject and the anatomical location(s) of a subject indicated by the at least one marker attached on the anatomical location(s).
  • the EMG sensor is to be placed on the line between the medial acromion (marker A) and the cubital fossa (marker B) at 1/3 of the distance from the cubital fossa to the medial acromion, as marked with a cross in Fig.2.
  • Fig.3 is schematic block diagram of a system 10A for guiding the placement of an EMG sensor on a subject according to another embodiment of the present invention.
  • the second unit 12 in Fig.3 comprises a fourth unit 14 which receives the determined one or more locations of the at least one marker in the image of the subject from the first unit 11 as shown in Fig. l and the fourth unit 14 then determines one or more location parameters in accordance with the location of the at least one marker in the image and the criteria define the spacial relationship between the first locaiton and the at least one marker.
  • the one or more location parameters determine a location in the image.
  • the determined location satisfies the relation defined by the predefined criteria and therefore it reflects the first location of the subject.
  • the location parameters may not be limited to distance between the marker(s) and the first location. Angles, orientations, azimuth relative to the marker(s) and so on may be used also.
  • the one or more location parameters in the image may be further converted to the location parameters which represents the first location of the subject, and then the second unit 12 generates a control signal to control the third unit 13 to provide the indication signal according to the actual first location of the subject.
  • the second unit 12 may also need the information such as the disctance between the user and the camera, the physical distance between the at least two markers, etc. These information may be used to map the determined location parameters of the image to the first location on the body of the subject.
  • the conversion of the location parameter(s)in the image into the actual location parameters on the subject may be based on coordination transformation between different reference systems according to the principle of perspective projection.
  • Fig.4 shows a system 10B according to a further embodiment of the present invention.
  • the third unit 13 comprises a fifth unit 15.
  • the second unit 12 receives the determined one or more locations of the identified at least one marker in the image from the first unit 11 and generates a control signal based on the received locations and the predefined criteria.
  • the predefined criteria as described above, may be received from a local or remote memory in which the predefined criteria are pre-stored.
  • the control signal generated by the second unit 12 is transmitted to the fifth unit 15.
  • the fifth unit 15 receives the control signal from the second unit 12.
  • the fifth unit 15, being controlled by the control signal, enables the third unit 13 to provide the indication signal indicative of the first location of the subject to the subject.
  • the fifth unit 15 may be implemented as an actuating device, such as a servomotor.
  • the third unit 13 may also comprise a light source 16, such as a laser pointer.
  • the servomotor is connected to the laser pointer such that the laser pointer can be actuated to project a visible light (the indication signal) to the first location of the subject.
  • the indication signal provided by the third unit 13 is a visible light signal.
  • the servomotor may be controlled to adjust the pitch and yaw of the laser pointer to provide the visible light to the first location of the subject.
  • the light source 16 could also be any other types, such as LED, which may also provide the visible light signal to the first location of the subject.
  • the fifth unit 15 and the light source 16 are described with respect to the system 10B, it is clear that the fifth unit 15 and the light source 16 may also be used for the system 10 or 1 OA as shown in Figs. 1 or 3.
  • the location where the EMG sensor is to be placed may be automatically indicated to the subject using a very cheap infrared camera and lights source. Therefore, a user may immediately and conveniently locate the EMG sensor on the indicated location with low cost.
  • an object may be configured to be directly close to the subject and to be moved from an original location (hereinafter referred to as "second location") to the first location.
  • the object may be comprised in the system of the invention or disposed independently of the system.
  • the object may be moved by a user who aids the subject to place the sensor, such as a nurse, or a physician.
  • the object can be imaged while the subject is being imaged.
  • the object may be a marking device, preferably a marking pen.
  • the object may be covered with a marker at one end.
  • the object may be covered with retro-reflective material at one end, similar to the above described retro-reflective marker, and in this case the object may be shown in the image and the other part of the subject may not be shown in the image.
  • the first unit 11 of system 10 and 10A identifies not only the at least one marker of the region of interest in the image but also the moving object.
  • the second unit 12 of the system 10 and 10A guides the user to move the object from the second location to the first location.
  • the first location of the subject may be computed from the location(s) of the identified at least one marker in the image, based on the predefined criteria, by using perspective projection.
  • the second unit 12 may provide a control signal to control the third unit 13 to generate an indication signal, which indication signal may be an audio signal.
  • the third unit 13 may comprise a speaker.
  • the audio signal reflects the deviation between the first location and the current location of the identified object; such an audio signal may be used by the user for guiding the user in moving the object from the current location to the first location.
  • the user further moves the object according to the guidance from the audio signal and marks the location as the first location when the audio signal indicates that the current location of the object matches the first location.
  • the user may mark the location directly in response to a corresponding audio signal.
  • marking may be done by means of the object directly. Otherwise, marking may be done by means of a marking device, such as a pen.
  • the object may comprise adhesive material at one end, and when the indication signal indicates that the object has been moved to the first location of the subject, the object may be attached to the first location of the subject by sticking it to the first location directly.
  • the object may be the EMG sensor itself, and when the audio signal (indication signal) indicates that the EMG sensor has been moved to the first location, the user attaches the EMG sensor to the first location.
  • the third unit 13 may also be a display and the indication signal may be a real-time image of the subject displayed on the third unit 13; in the image, the location of the identified object and the desired location, i.e., the first location, where the EMG sensor is to be placed are shown. The user may move the object according to the displayed image until the location of the identified object coincides with the first location.
  • system of the invention is described with respect to a first unit, a second unit, a third unit, a fourth unit, and a fifth unit, respectively, it may be determined that the system of the invention is not limited to the configurations described above. One or more units of the above units may be omitted or integrated into one unit to perform the same function. Furthermore, it may be determined that the individual units of the system of the invention may be achieved by any one of software, hardware, firmware or a combination thereof.
  • the units of the application may be achieved not only by means of computer programs for performing corresponding functions but also by means of various entity devices, such as application-specific integrated circuits (ASIC), digital signal processors (DLP), programmable logic devices (PLD), field-programmable gate arrays (FPGA), CPUs and controllers.
  • ASIC application-specific integrated circuits
  • DLP digital signal processors
  • PLD programmable logic devices
  • FPGA field-programmable gate arrays
  • the system of the invention is illustrated such that the third unit 13 and the object are not included therein, it may be clear that at least one of them may be also comprised in the system of the invention.
  • system of the invention may be commercially available as an individual device.
  • system of the invention may also be implemented as a rehabilitation system.
  • the system further comprises a training garment configured to be worn by a subject, e.g., a patient, and an image acquisition unit configured to acquire an image of the subject.
  • one or more markers may be attached to the training garment at one or more locations which is attached to to one or more anatomical locations of the subject.
  • the image acquisition unit e.g., a video camera, acquires an image of the subject, e.g., the patient, when the subject wears the training garment, and the one or more markers are located at the corresponding anatomical locations of the subject.
  • the first unit 11 of the system receives the images from the image acquisition unit and the second unit 12 of the system controls the third unit to provide an indication signal to the first location of the subject.
  • the markers are retro-reflective markers which optionally reflect the infrared light only and in this case the image acquisition unit may be an infrared camera that acquires the infrared image, wherein only the markers are visible in the acquired image.
  • Fig. 5 shows a flowchart for guiding the placement of a sensor according to the method of the invention.
  • step SI an image of a region of interest of a subject, e.g., an upper arm of a patient, is acquired by an infrared camera. Before the image acquisition, the subject may be asked to assume a proper position and keep still, such that the region of interest of the subject may be imaged.
  • Proper positioning of the subject to allow a specific region of interest to be detected may also be found in the guideline as described above. Since, according to the method, the placement of the EMG sensor may be guided when the subject keeps still, it may also be used in applications where the subject is either not able or not supposed to move. Furthermore the one or more markers may be attached to the corresponding anatomical locations of the region of interest of the subject prior to the image acquisition process.
  • step S2 at least one marker is identified in the image of the subject.
  • the coordinates of the location of the identified one or more markers in the image may be determined.
  • an object to be moved from an initial location to the first location of the subject may also be identified in the image.
  • a control signal is generated, based on the location(s) of the identified at least one marker in the image and the predefined criteria, and transmitted to a fifth unit, i.e., an actuating device, being controlled by the control signal, to enable the third unit, i.e., an indication unit, to provide the indication signal for indicating the first location of the subject.
  • the first location is computed from the location(s) of the identified at least one marker in the image, based on predefined criteria, by using perspective projection.
  • predefined criteria define the relationship between the first location of the subject and the anatomical location(s) indicated by the at least one marker, the anatomical location may be selected according to certain guidelines for optimal placement of the EMG sensor.
  • an indication signal may be an audio signal, wherein such an audio signal, for example, reflecting the deviation between the first location of the subject and the location of the object, may be used for guiding the object to be moved from the second location to the first location of the subject.
  • the user moves the object according to the indication signal.
  • the invention further comprises a step of marking the first location with a marking device when the indication signal indicates that the object is moved to the first location.
  • step S4 an indication signal is provided by the third unit based on the generated control signal to indicate a desired location (first location) to place the sensor on such desired location.

Abstract

La présente invention concerne un système et une méthode permettant de guider le positionnement d'un capteur. Un système permettant de guider le positionnement du capteur comprend une caméra infrarouge configurée pour acquérir une image du sujet ; une première unité (11) servant à identifier au moins un marqueur dans l'image acquise ; ledit marqueur (A, B) est le marqueur rétroréfléchissant et chaque marqueur dudit marqueur est fixé à un emplacement anatomique du sujet ; et une deuxième unité (12) pour générer un signal de commande en fonction de(s) l'emplacement(s) d'au moins un marqueur identifié dans l'image et d'un critère prédéfini, le critère prédéfini délimitant la relation spatiale entre le(s) emplacement(s) anatomique(s) sur le sujet et un premier emplacement sur le sujet où le capteur doit être placé ; la deuxième unité est configurée de manière à commander une troisième unité (13) pour fournir un signal d'indication indiquant un premier emplacement où le capteur doit être placé sur la base du signal de commande. Conformément au système, la mise en place du capteur est obtenue de façon reproductible, rapide et pratique.
PCT/IB2014/063402 2013-07-31 2014-07-25 Système et procédé permettant de guider le positionnement d'un capteur WO2015015385A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CNPCT/CN2013/080519 2013-07-31
CN2013080519 2013-07-31
EP13191329.5 2013-11-04
EP13191329 2013-11-04

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