WO2015058816A1 - Marqueur médical hybride - Google Patents
Marqueur médical hybride Download PDFInfo
- Publication number
- WO2015058816A1 WO2015058816A1 PCT/EP2013/072434 EP2013072434W WO2015058816A1 WO 2015058816 A1 WO2015058816 A1 WO 2015058816A1 EP 2013072434 W EP2013072434 W EP 2013072434W WO 2015058816 A1 WO2015058816 A1 WO 2015058816A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- marker
- medical
- hybrid
- core
- contrast medium
- Prior art date
Links
Classifications
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3933—Liquid markers
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3954—Markers, e.g. radio-opaque or breast lesions markers magnetic, e.g. 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3966—Radiopaque markers visible in an X-ray image
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3995—Multi-modality markers
Definitions
- the present invention relates to a hybrid medical marker for use in a medical navigation system and to a method for producing the same.
- CT computed tomography
- MR magnetic resonance
- fiducial markers are installed on the patient.
- Fiducial markers are markers which are easily recognisable in the 3D image data. Bone fiducials are screwed directly into a bone. They offer very precise localisation, but are invasive. Non-invasive markers use an adhesive to hold the markers on the patient.
- a first conventional approach localises the fiducial markers in the 3D image data set. The position of the fiducial markers of the reference of the medical navigation system is then determined by sampling the markers using an instrument such as a pointer. The locations of the fiducial markers in the 3D image data set and the sampled locations can then be co-registered.
- a device comprising different types of markers.
- This device comprises an array of fiducial markers in a known arrangement, i.e. having known locations relative to each other.
- the device also comprises an array of markers which can be detected by the medical navigation system.
- markers are in particular optical markers, in particular infrared-reflective (IR-reflective) markers.
- IR-reflective infrared-reflective
- the relative position between the two arrays is known, such that the 3D image data and the reference of the medical navigation system can be co-registered once the locations of the fiducial markers in the 3D image data set and the positions of the navigation system markers in the reference of the navigation system have been determined.
- bone fiducials require an invasive procedure in order to be installed. Noninvasive markers introduce the problem of skin shift.
- the marker can move while it is being sampled.
- the pointer has to be placed in the centre of the fiducial marker in order to accurately record its location. This can mean applying a downward or lateral pressure to the marker. If the marker is located in an area of loose skin, this can cause the marker to move, thus creating an error in its sampled location.
- a device comprising two different types of markers requires the relative position between the two different arrays of markers to be known and precisely maintained. This necessitates a very rigid and therefore complex and/or heavy structure to bear the markers.
- a hybrid medical marker can facilitate co -registration.
- Such a hybrid medical marker can be detected both in the 3D image data and by the medical navigation system.
- a hybrid medical marker and a method for manufacturing the same are specified in the independent claims. Advantageous embodiments are described in the dependent claims.
- a hybrid medical marker for use in medical navigation systems comprises a marker core which comprises a contrast medium, and an outer surface which is at least partly light-reflective.
- the contrast medium is a material which can be detected in the 3D image data. Since the outer surface of the marker is light-reflective, the marker can be detected by a camera of the medical navigation system.
- a medical navigation system typically comprises a stereoscopic camera which captures two images from positions which are spaced apart. Since the distance between the lenses of the stereoscopic camera is known, the position of a marker in the reference of the medical navigation system can be determined from the stereoscopic image.
- the stereoscopic camera operates in the infrared spectrum.
- An infrared light source on or close to the stereoscopic camera emits light which is then reflected by the marker and captured by the stereoscopic camera.
- the outer surface of the marker is at least partly light-reflective in the infrared (IR) spectrum.
- the light-reflective property of the marker's surface is preferably achieved by using one or more retro -reflectors.
- the contrast medium is preferably a material which is visible in at least one of the following imaging modalities: x-ray, CT and MR. This ensures that the marker core can be reliably identified in the 3D medical image.
- the marker core consists of a solid contrast medium.
- the contrast medium is a liquid, such as a multi-modal hydrogel.
- the marker core is preferably a housing which is filled with the liquid contrast medium. The housing is or can be sealed such that the liquid contrast medium cannot leak out of the housing.
- the contrast medium preferably has a Hounsfield unit measurement which is distinct from the Hounsfield unit measurements of the substances which are part of the body, such as fat, water, grey matter or white matter.
- the housing comprises a sealable opening for re-filling the housing with the contrast medium. If the contrast property of the hybrid marker degrades over time, the marker core can be re-filled with the contrast medium in order to re-establish the desired properties of the marker.
- the outer surface of the hybrid marker is light- reflective.
- the outer surface of the marker is at least partly provided with a light-reflective coating.
- This light-reflective coating is for example a light-reflective paint which is deposited on the outer surface.
- the outer surface of the marker is at least partly provided with a light-reflective foil.
- Such light-reflective foil can comprise a plurality of retro-reflectors, in particular micro-retro-reflectors, which reflect incident light in a parallel manner.
- the hybrid marker comprises a mounting means for receiving a marker holder.
- the mounting means can be a simple opening into which a marker holder can be snapped.
- the mounting means can also comprise a female thread, such that the hybrid marker can be screwed onto a male thread of a holder.
- the marker core has a spherical shape. If a liquid contrast medium is used, then the spherical core is preferably made of two hemispherical shells which are assembled to form a hollow sphere which is filled with the contrast medium.
- the whole outer surface of the spherical marker core is light-reflective, with the optional exception of a portion in which mounting means is provided. Such a spherical hybrid marker can be easily detected by the stereoscopic camera of the medical navigation system, irrespective of its orientation.
- the marker core has a cylindrical shape, in which case the marker core is in particular shaped as a flat cylinder or disc, i.e. the height of the cylinder or disc is smaller than its radius.
- the cylindrical hybrid marker preferably comprises an adhesive base attached to one of the front faces of the cylindrical core.
- a front face of the cylindrical core is one of the two flat surfaces of the cylinder.
- the adhesive base can for example comprise an adhesive tape or Velcro fastening.
- the hybrid marker can easily be attached to an object via its adhesive base.
- only one of the front faces of the cylindrical core of the hybrid marker is light-reflective, i.e. the hybrid marker has one circular light-reflective portion. It is then simple for the medical navigation system to determine the centre of this circular area from the reflected light captured.
- the present invention also relates to an array of hybrid medical markers as described above. It is an advantage of the present invention that the hybrid markers in the array need not have known and/or constant relative spatial locations, since they can be "seen” both by a stereoscopic camera and in a 3D medical image.
- the array of hybrid markers preferably comprises a base support to which the hybrid markers are attached.
- the base support preferably comprises a connector via which the array can be attached to an MR coil. Using this connector, it is possible to ensure that the array of hybrid markers is within the field of view of the MR coil.
- the present invention also relates to a method for providing a hybrid medical marker for use in a medical navigation system.
- This method comprises the steps of providing a marker core comprising a contrast medium and making at least a part of the outer surface of the marker light-reflective.
- imaging methods are used to generate image data (for example, two-dimensional or three-dimensional image data) of anatomical structures (such as soft tissues, bones, organs, etc.) of the human body.
- image data for example, two-dimensional or three-dimensional image data
- medical imaging methods is understood to mean (advantageously apparatus-based) imaging methods (so-called medical imaging modalities and/or radiological imaging methods) such as for instance computed tomography (CT) and cone beam computed tomography (CBCT, in particular volumetric CBCT), x-ray tomography, magnetic resonance tomography (MRT or MRI), conventional x-ray, sonography and/or ultrasound examinations, and positron emission tomography.
- CT computed tomography
- CBCT cone beam computed tomography
- MRT or MRI magnetic resonance tomography
- sonography and/or ultrasound examinations
- positron emission tomography positron emission tomography
- Analytical devices in particular are used to generate the image data in apparatus-based imaging methods.
- the imaging methods are in particular used for medical diagnostics, to analyse the anatomical body in order to generate images which are described by the image data.
- the imaging methods are also in particular used to detect pathological changes in the human body.
- Figure la an external view of a spherical hybrid marker
- Figure lb a sectional view of the hybrid marker of Figure la;
- Figure 2a a perspective view of a flat hybrid marker
- Figure 2b an exploded view of the hybrid marker of Figure 2a
- Figure 3 an array of hybrid markers within the field of view of a medical navigation system and also the field of view of an MR imaging apparatus.
- Figure la shows a spherical hybrid medical marker 1, the outer spherical surface of which is covered with a retro-reflective foil 4.
- the retro -reflective foil 4 reflects light back along its direction of incidence.
- the marker 1 is attached to a pole 6, via which the marker 1 can be attached to an object.
- Figure lb shows a sectional view of the marker 1 of Figure la.
- the hybrid marker 1 comprises a core consisting of a spherical housing 2 which is made of plastic and filled with a contrast medium 3.
- the contrast medium 3 is a material which is visible in a CT or MR image, and for example has a known x-ray attenuation per unit volume, such that it generates a predetermined grey value in a CT image. If the hybrid marker 1 is to be used with an MR imaging apparatus, then the contrast medium 3 is a material which exhibits known MR properties.
- the housing 2 has an opening 5 comprising a female thread for receiving the mounting pole 6.
- a liquid contrast medium 3 can be introduced into or removed from the housing 2.
- the opening 5 is sealed by the inserted mounting pole 6 in order to prevent the contrast medium 3 from leaking out of the marker 1.
- the contrast medium 3 can also be a solid contrast medium.
- the marker 1 can be detected by a stereoscopic camera of a medical navigation system, irrespective of the orientation of the marker 1.
- Figure 2a shows a perspective view of a flat hybrid medical marker 11.
- Figure 2b shows an exploded view of the flat hybrid medical marker 11.
- the core of the marker 11 is formed by a plastic housing 12 filled with a contrast medium 13.
- the contrast medium 13 of the marker 11 can be a solid contrast medium or a liquid contrast medium.
- the housing 12 of the marker 11 has a cylindrical shape, wherein the height of the housing 12 is smaller than its radius.
- the radius of the housing 12 is in particular at least two, three, five or ten times as large as the height of the housing 12.
- the cylindrical housing 12 has two circular front faces, one of which is provided with a reflective foil 14.
- the reflective foil 14 is in particular a retro -reflective foil comprising a plurality of retro -reflectors.
- the opposite front face of the housing 12 is attached to an adhesive base 15 via which the marker 11 can be attached to an object.
- Figure 3 schematically shows a system which utilises a hybrid medical marker.
- Figure 3 shows three spherical hybrid medical markers la, lb and lc by way of example.
- the system comprises a medical navigation system consisting of a navigation computer 20 connected to a stereoscopic camera 21 and an MR imaging apparatus consisting of an MR computer 22 connected to an MR coil 23.
- the stereoscopic camera 21 comprises an IR light emitter which emits infrared light.
- the infrared light is reflected by the hybrid markers 1 and captured via the two lenses of the stereoscopic camera 21.
- the stereoscopic image of the stereoscopic camera 21 is provided to the navigation computer 20 which determines the position of the hybrid markers 1.
- the MR coil 23 is used to produce a varying electromagnetic field in order to influence the alignment of protons in an object to be examined.
- the MR coil detects a radio frequency signal produced as the protons return to their previous alignment.
- the MR computer 22 calculates a 3D medical image in which both the object to be examined and the hybrid medical markers 1 are shown.
- the position of the hybrid markers 1 in the 3D medical image can be used to co-register the 3D medical image and the spatial reference of the medical navigation system.
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Pathology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Apparatus For Radiation Diagnosis (AREA)
- Magnetic Resonance Imaging Apparatus (AREA)
Abstract
La présente invention concerne un marqueur médical hybride (1;11) conçu pour être utilisé dans un système de navigation médical (20, 21), lequel marqueur (1;11) comprend un noyau de marqueur qui comporte un milieu de contraste (3;13) et une surface extérieure (4;14) au moins partiellement réfléchissante.
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/EP2013/072434 WO2015058816A1 (fr) | 2013-10-25 | 2013-10-25 | Marqueur médical hybride |
EP13802643.0A EP3062729A1 (fr) | 2013-10-25 | 2013-12-11 | Procédé et dispositif pour l'enregistrement simultané d'une image 3d médicale et d'une référence spatiale |
PCT/EP2013/076149 WO2015058819A1 (fr) | 2013-10-25 | 2013-12-11 | Procédé et dispositif pour l'enregistrement simultané d'une image 3d médicale et d'une référence spatiale |
US15/031,390 US20160267659A1 (en) | 2013-10-25 | 2013-12-11 | Method and device for co-registering a medical 3d image and a spatial reference |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/EP2013/072434 WO2015058816A1 (fr) | 2013-10-25 | 2013-10-25 | Marqueur médical hybride |
Publications (1)
Publication Number | Publication Date |
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WO2015058816A1 true WO2015058816A1 (fr) | 2015-04-30 |
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PCT/EP2013/072434 WO2015058816A1 (fr) | 2013-10-25 | 2013-10-25 | Marqueur médical hybride |
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Cited By (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP3498212A1 (fr) * | 2017-12-12 | 2019-06-19 | Holo Surgical Inc. | Procédé d'enregistrement d'un patient, d'étalonnage et d'affichage d'image de réalité augmentée en temps réel pendant une intervention chirurgicale |
US10382748B2 (en) | 2015-03-24 | 2019-08-13 | Augmedics Ltd. | Combining video-based and optic-based augmented reality in a near eye display |
WO2020109904A1 (fr) | 2018-11-26 | 2020-06-04 | Augmedics Ltd. | Marqueur de positionnement |
US11090019B2 (en) | 2017-10-10 | 2021-08-17 | Holo Surgical Inc. | Automated segmentation of three dimensional bony structure images |
US11263772B2 (en) | 2018-08-10 | 2022-03-01 | Holo Surgical Inc. | Computer assisted identification of appropriate anatomical structure for medical device placement during a surgical procedure |
US11278359B2 (en) | 2017-08-15 | 2022-03-22 | Holo Surgical, Inc. | Graphical user interface for use in a surgical navigation system with a robot arm |
US11389252B2 (en) | 2020-06-15 | 2022-07-19 | Augmedics Ltd. | Rotating marker for image guided surgery |
US11766296B2 (en) | 2018-11-26 | 2023-09-26 | Augmedics Ltd. | Tracking system for image-guided surgery |
US11801115B2 (en) | 2019-12-22 | 2023-10-31 | Augmedics Ltd. | Mirroring in image guided surgery |
US11896445B2 (en) | 2021-07-07 | 2024-02-13 | Augmedics Ltd. | Iliac pin and adapter |
US11974887B2 (en) | 2018-05-02 | 2024-05-07 | Augmedics Ltd. | Registration marker for an augmented reality system |
US11980506B2 (en) | 2019-07-29 | 2024-05-14 | Augmedics Ltd. | Fiducial marker |
US12044856B2 (en) | 2022-09-13 | 2024-07-23 | Augmedics Ltd. | Configurable augmented reality eyewear for image-guided medical intervention |
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EP0591712A1 (fr) * | 1992-10-08 | 1994-04-13 | Leibinger GmbH | Dispositif de marquage de points de référence sur le corps pour examen médical |
WO2004075768A2 (fr) * | 2003-02-25 | 2004-09-10 | Image-Guided Neurologics, Inc. | Systemes de reperes fiduciels et outils et procedes associes |
WO2011038759A1 (fr) * | 2009-09-30 | 2011-04-07 | Brainlab Ag | Marqueur de poursuite médicale en deux parties |
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WO2013114247A2 (fr) * | 2012-02-01 | 2013-08-08 | Koninklijke Philips N.V. | Marqueur fiduciaire à modes multiples et système de marqueur |
-
2013
- 2013-10-25 WO PCT/EP2013/072434 patent/WO2015058816A1/fr active Application Filing
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
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EP0591712A1 (fr) * | 1992-10-08 | 1994-04-13 | Leibinger GmbH | Dispositif de marquage de points de référence sur le corps pour examen médical |
WO2004075768A2 (fr) * | 2003-02-25 | 2004-09-10 | Image-Guided Neurologics, Inc. | Systemes de reperes fiduciels et outils et procedes associes |
WO2011038759A1 (fr) * | 2009-09-30 | 2011-04-07 | Brainlab Ag | Marqueur de poursuite médicale en deux parties |
US20130134059A1 (en) * | 2011-11-30 | 2013-05-30 | Izi Medical Products | Packaging for retro-reflective markers |
WO2013114247A2 (fr) * | 2012-02-01 | 2013-08-08 | Koninklijke Philips N.V. | Marqueur fiduciaire à modes multiples et système de marqueur |
Cited By (26)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10382748B2 (en) | 2015-03-24 | 2019-08-13 | Augmedics Ltd. | Combining video-based and optic-based augmented reality in a near eye display |
US12069233B2 (en) | 2015-03-24 | 2024-08-20 | Augmedics Ltd. | Head-mounted augmented reality near eye display device |
US12063345B2 (en) | 2015-03-24 | 2024-08-13 | Augmedics Ltd. | Systems for facilitating augmented reality-assisted medical procedures |
US11750794B2 (en) | 2015-03-24 | 2023-09-05 | Augmedics Ltd. | Combining video-based and optic-based augmented reality in a near eye display |
US11622818B2 (en) | 2017-08-15 | 2023-04-11 | Holo Surgical Inc. | Graphical user interface for displaying automatically segmented individual parts of anatomy in a surgical navigation system |
US11278359B2 (en) | 2017-08-15 | 2022-03-22 | Holo Surgical, Inc. | Graphical user interface for use in a surgical navigation system with a robot arm |
US11090019B2 (en) | 2017-10-10 | 2021-08-17 | Holo Surgical Inc. | Automated segmentation of three dimensional bony structure images |
EP3498212A1 (fr) * | 2017-12-12 | 2019-06-19 | Holo Surgical Inc. | Procédé d'enregistrement d'un patient, d'étalonnage et d'affichage d'image de réalité augmentée en temps réel pendant une intervention chirurgicale |
US11980508B2 (en) | 2018-05-02 | 2024-05-14 | Augmedics Ltd. | Registration of a fiducial marker for an augmented reality system |
US11974887B2 (en) | 2018-05-02 | 2024-05-07 | Augmedics Ltd. | Registration marker for an augmented reality system |
US11980507B2 (en) | 2018-05-02 | 2024-05-14 | Augmedics Ltd. | Registration of a fiducial marker for an augmented reality system |
US11263772B2 (en) | 2018-08-10 | 2022-03-01 | Holo Surgical Inc. | Computer assisted identification of appropriate anatomical structure for medical device placement during a surgical procedure |
EP4296729A2 (fr) | 2018-11-26 | 2023-12-27 | Augmedics Ltd. | Marqueur de positionnement |
US11980429B2 (en) | 2018-11-26 | 2024-05-14 | Augmedics Ltd. | Tracking methods for image-guided surgery |
WO2020109904A1 (fr) | 2018-11-26 | 2020-06-04 | Augmedics Ltd. | Marqueur de positionnement |
EP4296729A3 (fr) * | 2018-11-26 | 2024-02-28 | Augmedics Ltd. | Marqueur de positionnement |
EP3888058A4 (fr) * | 2018-11-26 | 2022-08-24 | Augmedics Ltd. | Marqueur de positionnement |
US11766296B2 (en) | 2018-11-26 | 2023-09-26 | Augmedics Ltd. | Tracking system for image-guided surgery |
US10939977B2 (en) | 2018-11-26 | 2021-03-09 | Augmedics Ltd. | Positioning marker |
US11980506B2 (en) | 2019-07-29 | 2024-05-14 | Augmedics Ltd. | Fiducial marker |
US11801115B2 (en) | 2019-12-22 | 2023-10-31 | Augmedics Ltd. | Mirroring in image guided surgery |
US12076196B2 (en) | 2019-12-22 | 2024-09-03 | Augmedics Ltd. | Mirroring in image guided surgery |
US11389252B2 (en) | 2020-06-15 | 2022-07-19 | Augmedics Ltd. | Rotating marker for image guided surgery |
US11896445B2 (en) | 2021-07-07 | 2024-02-13 | Augmedics Ltd. | Iliac pin and adapter |
US12044856B2 (en) | 2022-09-13 | 2024-07-23 | Augmedics Ltd. | Configurable augmented reality eyewear for image-guided medical intervention |
US12044858B2 (en) | 2022-09-13 | 2024-07-23 | Augmedics Ltd. | Adjustable augmented reality eyewear for image-guided medical intervention |
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