WO2015034906A1 - System and method for lung visualization using ultrasound - Google Patents

System and method for lung visualization using ultrasound Download PDF

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Publication number
WO2015034906A1
WO2015034906A1 PCT/US2014/053878 US2014053878W WO2015034906A1 WO 2015034906 A1 WO2015034906 A1 WO 2015034906A1 US 2014053878 W US2014053878 W US 2014053878W WO 2015034906 A1 WO2015034906 A1 WO 2015034906A1
Authority
WO
WIPO (PCT)
Prior art keywords
target
sensor
model
location
ewc
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/US2014/053878
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English (en)
French (fr)
Inventor
Joseph D. Brannan
William J. Dickhans
Casey M. Ladtkow
Darion R. Peterson
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien LP
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Covidien LP
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 Covidien LP filed Critical Covidien LP
Priority to CA2923457A priority Critical patent/CA2923457A1/en
Priority to AU2014315356A priority patent/AU2014315356B2/en
Priority to CN201480056086.8A priority patent/CN105611881A/zh
Priority to EP14842294.2A priority patent/EP3041415A4/en
Priority to JP2016540341A priority patent/JP6335310B2/ja
Publication of WO2015034906A1 publication Critical patent/WO2015034906A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; Determining position of diagnostic devices within or on the body of the patient
    • A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
    • A61B5/062—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A61B5/113—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb occurring during breathing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A61B5/7207—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts
    • 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
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4254—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors mounted on the probe
    • 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
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Clinical applications
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A61B8/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/467—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means
    • 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
    • A61B8/5261—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 combining images from different diagnostic modalities, e.g. ultrasound and X-ray

Definitions

  • the one or more processors 124 execute computer-executable instructions.
  • the EM board 140 may be configured to be operatively coupled with the reference sensors 170 which are located on the chest of the patient 170.
  • the reference sensors 170 move up and down following the chest while the patient 150 is inhaling and move down following the chest while the patient 150 is exhaling.
  • the movement of the reference sensors 170 in the EM field is captured by the reference sensors 170 and transmitted to the tracking device 160 so that the breathing pattern of the patient 150 may be recognized.
  • the tracking device 160 also receives outputs of the EM sensor 265, combines both outputs, and compensates the breathing pattern for the location of the EM sensor 265.
  • the distance is measured in accordance with the coordinate system of the EM field. Since the coordinate system of the EM field is different from the coordinate system of the 3D model, there is a scaling factor to match the coordinate system of the EM field to the coordinate system of the 3D model. Thus, by multiplying a scale factor to the distance the EM sensor 265 travels, the coordinate system of the EM field is synchronized with the coordinate system of the 3D model. In this way, the EM field may be synchronized with the 3D model and 2D images of the navigation and procedure software. Or other suitable method may be employed to synchronize the coordinate system of the EM field with the coordinate system of the 3D model.
  • the memory 126 also stores another program that can process and convert image data captured by an imaging modality associated with the catheter guide assembly 110, as will be described in detail below.
  • This image data may be converted into visual images having sufficient resolutions to identify such targets and terminal bronchial branches or be incorporated into and used to update the data from the CT scans in an effort to provide a greater resolution and fill-in data that was missing in the CT scan.
  • the US transducer 255 and the EM sensor 265 are separated by a distance, D OFF - This distance, D 0F F, may be sensed, coded into the navigation and procedure software, measured and sent by the clinician, or sensed by the US transducer 255 and the EM sensor 265.
  • the computing device 120 uses the distance, D OFF , to adjust the incorporation of the US images into the 3D model or 2D images derived therefrom.
  • the EM sensor 265 confirms its location at the target and a clinician may visually confirm the location at the target by looking at visual images generated from the US images.
  • the LG catheter 220 may be removed from the catheter guide assembly 110 and a biopsy tool may be inserted into the EWC 230 to the target to retrieve sample of the target for confirmation of the disease.
  • An anchoring tool may be employed to anchor the EWC 230 at the target.
  • treatment tools such as an ablation catheter may be inserted through the EWC 230 and into the target.
  • the US transducer 255 may be a sacrificial US transducer 255 which may be positioned in a forward looking manner to identify the target.
  • the US transducer 255 is sacrificial because it may be rendered ineffective following treatments of the target by the application of microwave energy of the treatment device.
  • one or more markers can be placed through the EWC 230 to identify the location of the target.
  • the marker may assist in navigating to a desired location and confirming placement of the EWC 230, particularly after removal of the LG 220 and the EM sensor 265 when the EM navigation features of the present disclosure may not be effective.
  • the marker may give a clinician an ability to re-visit the target after the target has been treated and to collect further samples.
  • the marker may be a fiducial marker, fluorescent dye, or FLUOROGOLD ® . In the case of fluorescent dye markers, the US imaging capabilities may further increase the determination of sufficiency of treatment, or provide greater clarity as to the exact location of the target.
  • Other markers for marking the location of a target may be employed by those of ordinary skill in the art without departing from the scope of the present disclosure.
  • FIG. 3 illustrates a 3D model 300 for a patent's bronchial trees and the trachea together with the lung.
  • the 3D model 300 may include information of most of the organs so that a clinician may selectively see particular organs or portions of organs of interest as shown in FIG. 3. In this case, these selected organs are the lungs including right lobe 310, the left lobe 320, the trachea 330 and bronchial trees 340.
  • the right lobe 310 has three sub-lobes, i.e., superior lobe 312, middle lobe 314, and inferior lobe 316
  • the left lobe 320 has two sub-lobes, i.e., superior lobe 322 and inferior lobe 324.
  • FIG. 4A shows a planar view of bronchial trees of the 3D model or of the slices of images of the lung such as the bronchial trees of FIG. 3 and a pathway plan to a target.
  • a pathway plan shows how to get to the target via the luminal network of the lung.
  • an EM field is generated by an EM board, such as the EM field generating device 145 of the EM board 140 as shown in FIG. 1.
  • an EM sensor 265 and a US transducer 255 are inserted into the lung via a natural orifice or an incision.
  • the EM sensor 265 and the US transducer 255 may be located on the EWC 230 with a distance apart or may be located at different places.
  • the EM sensor 265 may be located at or around the distal tip 260 of the LG 220 and the US transducer 255 may be located at or around the distal end 250 of the EWC 230, or vice versa.
  • the location of the EM sensor 265 is synchronized to the 3D model and the 2D images derived therefrom.
  • This location may be the starting location of the 3D model, or the entrance of the trachea of the 3D model. Even though the location is synchronized, the actual movement of the EM sensor 265 is not synchronized to the 3D model yet, here.
  • the EM sensor 265 travels a certain distance (e.g., from the entrance of the trachea to the branching point at the bottom of the trachea). This distance may be measured in the coordinate system of the EM field after the EM sensor 265 starts to sense the EM field.
  • step 535 the EM sensor 265, the LG 220, and the EWC 230 navigate the luminal network of the lung to the target following the pathway plan.
  • step 540 it is determined whether the sensor 265 has reached the target. If it is determined that the EM sensor 265 has not reach the target, step 535, i.e., the navigation step, is continued until the target is reached following the pathway plan.
  • step 1 when it is determined that the target is reached in step 1
  • step 565 it is determined whether there is a new target along the pathway plan to the target.
  • step 570 the new target is identified and registered to the 3D model for later treatment.
  • step 575 the route to the new target, which is a part of the pathway plan to the target, is also saved as a pathway plan to the new target. Then, the method 535 goes back to step 565 to continue checking whether there are any further new targets.
  • the computing device may generate images based on the processed reflected US waves. Since the US waves are reflected from an interface between tissues where density changes, the generated images show details both inside and outside of the bronchial tree. The generated images may depict a diseased or cancerous cells residing on the outside of the bronchial tree. In an aspect, when a treatment device penetrates the target for treatment purposes, the generated images can also be used to show whether the treatment device is in the center of the target.
  • steps 605-615 of FIG. 5C may be applied for biopsy.
  • the US transducer 255 is used to check whether the biopsy tool is at the correct location of the target. When it is determined that the biopsy tool is at the right place, then the biopsy tool takes samples. Or when it is determined that the biopsy tools is not at the target, the biopsy tool may be adjusted to reach correctly at the target.
  • the treatment device treats the target.
  • the US transducer 255 may be employed to image the target, determine the attributes of the target in step 625 (e.g., the size), and compares the attributes of the target with threshold values in step 630.
  • the threshold size may be predetermined based on a type of disease and may indicate that the disease is treated completely.
  • the input device 129 is used for inputting data or control information, such as setting values, or text information.
  • the input device 129 includes a keyboard, mouse, scanning devices, or other data input devices.
  • the input device 129 may be further used to manipulate displayed images or the 3D model to zoom in and out, and rotate in any direction.
  • the monitoring device 130 is operatively connected with the bronchoscope 115 and the computing device 120.
  • the monitoring device 130 includes buttons and switches for setting settable items of the monitoring device 130.
  • the monitoring device 130 may be touch-sensitive and/or voice-activated, enabling the monitoring device 130 to serve as both an input and output device.
  • settable items of the monitoring device 130 may be set, changed, or adjusted by using the buttons, touches to the screen of the monitoring device 130, or voices.

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  • Health & Medical Sciences (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Psychiatry (AREA)
  • Pulmonology (AREA)
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  • Oral & Maxillofacial Surgery (AREA)
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PCT/US2014/053878 2013-09-06 2014-09-03 System and method for lung visualization using ultrasound Ceased WO2015034906A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
CA2923457A CA2923457A1 (en) 2013-09-06 2014-09-03 System and method for lung visualization using ultrasound
AU2014315356A AU2014315356B2 (en) 2013-09-06 2014-09-03 System and method for lung visualization using ultrasound
CN201480056086.8A CN105611881A (zh) 2013-09-06 2014-09-03 用于利用超声进行肺部可视化的系统和方法
EP14842294.2A EP3041415A4 (en) 2013-09-06 2014-09-03 System and method for lung visualization using ultrasound
JP2016540341A JP6335310B2 (ja) 2013-09-06 2014-09-03 超音波を用いて肺を可視化するためのシステム

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US201361874881P 2013-09-06 2013-09-06
US61/874,881 2013-09-06
US201462041850P 2014-08-26 2014-08-26
US201462041842P 2014-08-26 2014-08-26
US62/041,842 2014-08-26
US62/041,850 2014-08-26
US14/469,718 2014-08-27
US14/469,718 US10098565B2 (en) 2013-09-06 2014-08-27 System and method for lung visualization using ultrasound

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WO2015034906A1 true WO2015034906A1 (en) 2015-03-12

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PCT/US2014/053882 Ceased WO2015034909A1 (en) 2013-09-06 2014-09-03 System and method for lung visualization using ultrasound

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US (5) US10098566B2 (enExample)
EP (2) EP3041415A4 (enExample)
JP (3) JP6387101B2 (enExample)
CN (2) CN105611881A (enExample)
AU (2) AU2014315356B2 (enExample)
CA (2) CA2923457A1 (enExample)
WO (2) WO2015034906A1 (enExample)

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