WO2016070113A1 - Procédé et système pour ajuster une zone de traitement tridimensionnelle (3d) interactive pour un traitement percutané - Google Patents

Procédé et système pour ajuster une zone de traitement tridimensionnelle (3d) interactive pour un traitement percutané Download PDF

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Publication number
WO2016070113A1
WO2016070113A1 PCT/US2015/058441 US2015058441W WO2016070113A1 WO 2016070113 A1 WO2016070113 A1 WO 2016070113A1 US 2015058441 W US2015058441 W US 2015058441W WO 2016070113 A1 WO2016070113 A1 WO 2016070113A1
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WIPO (PCT)
Prior art keywords
treatment zone
surgical instrument
user
probe
controls
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Application number
PCT/US2015/058441
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English (en)
Inventor
Cheng-Chung Liang
Guo-Qing Wei
Li Fan
Jianzhong Qian
Xiaolan Zeng
Original Assignee
Edda Technology, Inc.
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
Priority claimed from US14/926,559 external-priority patent/US11264139B2/en
Application filed by Edda Technology, Inc. filed Critical Edda Technology, Inc.
Priority to CN201580060066.2A priority Critical patent/CN107077757A/zh
Publication of WO2016070113A1 publication Critical patent/WO2016070113A1/fr

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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T19/00—Manipulating 3D models or images for computer graphics
    • G06T19/20—Editing of 3D images, e.g. changing shapes or colours, aligning objects or positioning parts
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T15/00—3D [Three Dimensional] image rendering
    • G06T15/08—Volume rendering
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2210/00—Indexing scheme for image generation or computer graphics
    • G06T2210/21—Collision detection, intersection
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2210/00—Indexing scheme for image generation or computer graphics
    • G06T2210/41—Medical
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2219/00—Indexing scheme for manipulating 3D models or images for computer graphics
    • G06T2219/20—Indexing scheme for editing of 3D models
    • G06T2219/2004—Aligning objects, relative positioning of parts

Definitions

  • the present teaching relates to surgical procedure planning. More specifically, the present teaching is pertaining to interactive medical image processing for surgical procedure planning.
  • the present teaching relates to surgical procedure planning. More specifically, the present teaching is pertaining to interactive medical image processing for surgical procedure planning.
  • a method, implemented on a computing device having at least one processor, storage, and a communication platform capable of connecting to a network for surgical procedure planning is disclosed.
  • At least one three dimensional (3D) object contained in a 3D volume is rendered on a display screen.
  • the at least one 3D object includes a 3D object corresponding to an organ.
  • First information related to a 3D pose of a surgical instrument positioned with respect to the at least one 3D object is received from a user.
  • a 3D representation of the surgical instrument is rendered in the 3D volume based on the first information.
  • Second information related to a setting of the surgical instrument is received from the user.
  • a 3D treatment zone in the 3D volume with respect to the at least one 3D object is estimated based on the first and second information.
  • the 3D treatment zone in the 3D volume is visualized on the display screen.
  • the 3D representation of the surgical instrument and the 3D treatment zone are to be used for surgical procedure planning.
  • One or more controls associated with the 3D representation of the surgical instrument and/or the 3D treatment zone are provided to facilitate the user to dynamically adjust the 3D treatment zone via the one or more controls.
  • a system for surgical procedure planning includes a three dimensional (3D) scene rendering mechanism, a probe handling module, a control handling module, a treatment zone calculation module, and a treatment zone rendering mechanism.
  • the 3D scene rendering mechanism is configured for rendering at least one 3D object contained in a 3D volume on a display screen.
  • the at least one 3D object includes a 3D object corresponding to an organ.
  • the probe handling module is configured for receiving, from a user, first information related to a 3D pose of a surgical instrument positioned with respect to the at least one 3D object.
  • the probe rendering mechanism is configured for rendering a 3D representation of the surgical instrument in the 3D volume based on the first information.
  • the control handling module is configured for receiving, from the user, second information related to a setting of the surgical instrument.
  • the treatment zone calculation module is configured for estimating a 3D treatment zone in the 3D volume with respect to the at least one 3D object based on the first and second information.
  • the treatment zone rendering mechanism is configured for visualizing the 3D treatment zone in the 3D volume on the display screen.
  • the 3D representation of the surgical instrument and the 3D treatment zone are to be used for surgical procedure planning.
  • the control handling module is further configured for providing one or more controls associated with the 3D representation of the surgical instrument and/or the 3D treatment zone to facilitate the user to dynamically adjust the 3D treatment zone via the one or more controls.
  • a software product in accord with this concept, includes at least one non-transitory machine-readable medium and information carried by the medium.
  • the information carried by the medium may be executable program code data, parameters in association with the executable program code, and/or information related to a user, a request, content, or information related to a social group, etc.
  • FIG. 1(a) depicts a three dimensional (3D) volume having 3D objects contained therein;
  • FIG. 1(b) shows a 3D volume containing 3D objects displayed in a 3D coordinate system
  • FIG. 1(c) shows a 3D volume displayed in a 3D coordinate system in an opaque mode
  • FIG. 2(a) depicts a 3D scene having 3D objects displayed therein and 3D point specified in the 3D scene for placing a virtual probe, according to an embodiment of the present teaching
  • FIG. 2(b) depicts a 3D scene with a plurality of 3D objects displayed therein and a movable and adjustable probe being placed at a specified 3D point near an object, according to an embodiment of the present teaching
  • FIGS. 4(a)-4(c) show different variations associated with movable and adjustable features of a virtual probe, according to an embodiments of the present teaching
  • FIG. 8(a) illustrates the concept of detecting an obstacle encountered by a probe, according to an embodiment of the present teaching
  • FIG. 8(b) depicts an exemplary means to generate a warning of a detected obstacle, according to an embodiment of the present teaching
  • FIG. 9 presents an exemplary way to visualizing different zones for placing a probe, according to an embodiment of the present teaching
  • FIG. 10 is a flowchart of an exemplary process, in which a virtual probe is placed, manipulated, and rendered based on optional conditions specified by a user, according to an embodiment of the present teaching
  • FIG. 1 1 illustrates exemplary types of operational control in percutaneous pre- surgical planning, according to an embodiment of the present teaching
  • FIG. 12 depicts an exemplary construct of a system that facilitates 3D placement and manipulation of a virtual probe in a 3D environment, according to an embodiment of the present teaching
  • FIG. 13 depicts another exemplary construct of a system that facilitates 3D placement and manipulation of a virtual probe in a 3D environment, according to an embodiment of the present teaching
  • FIG. 14 is a flowchart of an exemplary process, in which a 3D treatment zone is estimated, adjusted, and rendered based on information specified by a user, according to an embodiment of the present teaching
  • FIGS. 15(a)- 15(b) depict 3D representations of a surgical instrument, an organ, anatomical structures, and a treatment zone in a 3D volume, according to an embodiment of the present teaching
  • FIG. 16 depicts a plurality of controls associated with 3D representations of a surgical instrument and a treatment zone, according to an embodiment of the present teaching.
  • FIG. 17 depicts the architecture of a computer which can be used to implement a specialized system incorporating the present teaching.
  • This present teaching is pertaining to interactive adjustment of a three dimensional (3D) treatment zone for percutaneous thermal ablation probe. It may be used in pre- surgical planning for percutaneous procedures such as radiofrequency ablation, microwave ablation, or cryoablation to help doctors better observe and decide the effective treatment area. It can provide unique interaction schemes such as on-probe controls or on-zone controls for treatment zone adjustment in 3D. It may also provide a more intuitive and real-time feedback of the impact to the zone by surrounding thermal dissipation structures.
  • FIG. 1(a) depicts a three dimensional scene with a 3D volume 100 having three dimensional objects rendered therein.
  • the 3D volume 100 has been segmented into several objects 101-a, 101-b, . . . , 101-c, and 102. These objects may correspond liver, lesions, bones, arteries, vital organs, or skin (e.g., 102).
  • Each 3D object may correspond to a sub 3D volume within the 3D volume 100.
  • the 3D volume 100 may be visualized on a 2D display screen such as a computer display screen. Such visualization may be performed in a well- defined 3D coordinate system. This is shown in FIG.
  • the 3D volume 100 in which the 3D volume 100 is displayed in a 3D space defined by a coordinate system 120 with three axes, X, Y, and Z.
  • the 3D volume 100 may be rendered on a 2D display screen with respect to the 3D coordinate system 120 with a particular 3D pose, including its geometric position and orientation.
  • the 3D volume 100 may be sliced into a plurality of 2D slices along some 3D orientation so that each of the slices provides 2D imagery of the 3D volume 100 along a certain direction.
  • these 2D slices can be placed inside this 3D scene to enable a viewer to observe the composition of different objects, if any, on a planar surface. Through this means, one may be able to observe the spatial relationship among different segmented 3D objects.
  • the concept is described in U.S. Pat. No. 7,315,304, entitled “Multiple Volume Exploration System and Method”.
  • a user may manipulate the visualization of the 3D volume 100 in different ways.
  • the entire 3D volume may be rotated and translated with respect to the 3D coordinate system 120. This may facilitate the user to observe the spatial relationships among different objects from different angles.
  • the visualization of each segmented object can be independently manipulated, e.g., a 3D object may be made visible or invisible so that a user can see the areas of the 3D volume 100 where it is occluded by the selected 3D object. This may be done by adjusting the transparency of such selected 3D object. When the selected 3D object is made completely transparent or highly translucent, an object occluded by the selected 3D object can be made more visible.
  • a 3D object of interest can be made opaque and when additional 2D slices for that object are also rendered, one can be more clearly observe the internal structure of the 3D object.
  • a 3D object corresponds to skin of a human body
  • all the objects inside of the skin structure can be made visible.
  • the user elects to visualize the skin in an opaque mode none of the 3D objects wrapped inside of the skin will be visible. This is shown in FIG. 1(c), where the skin object 102 is visualized in an opaque mode 103 and none of the objects inside of the skin is visible.
  • the level of transparency may be adjusted gradually and interactively to meet a user's needs.
  • a screen point determined via, e.g., a mouse click may correspond to a 2D coordinate with respect to a 2D coordinate system defined based on the underlying display screen.
  • a 2D coordinate needs to be transformed into a 3D coordinate point in the 3D scene 300, which can be done by translating the 2D coordinate into a 3D coordinate via a transformation.
  • Such a 2D coordinate may be selected with respect to a 3D object (e.g., skin 102) in the 3D scene and the 3D location transformed may correspond to a 3D location on the 3D object at which a virtual probe or needle is to be virtually placed in order to simulate the effect of percutaneous surgery in a percutaneous pre-operational surgical planning procedure.
  • FIG. 2(b) shows that once the 3D coordinate corresponding to a 2D point selected on a display screen is determined, a virtual probe or needle 204 may be virtually placed at the
  • the virtual probe or needle 204 may have a straight shape or any other shape as needed, as shown in FIG. 3.
  • a virtual probe may be constructed to have a tip 301, a body 302, and a handle 303.
  • the tip 301 is where the virtual probe 204 is placed on a 3D object (e.g., object 102 in FIG. 2(b)).
  • a user may manipulate the movement of the virtual probe 204 via certain part of the probe, e.g., the body 302 or handle 303.
  • a lesion may be selected as a 3D object to which a virtual probe is to be placed (e.g., object 101 -a) and the point at which the virtual probe and the human skin intersect is where a needle in real operation may need to be placed.
  • the virtual probe once inserted, may be adjusted. This may be done by allowing a user to use a tool (e.g., in a GUI, use a drag and pull motion) to move different parts of the virtual probe based on needs. For example, a user may be allowed to drag the tip 301 of the probe and pull to a desired 3D location. A user may also be allowed to grab the body 302 of the probe and drag it so that the tip of the probe remains the same. Similarly, a user may be allowed to drag the handle 303 of the tip and move around. In other embodiments, a user may be allowed to move the tip by dragging the body 302 or the handle 303.
  • a tool e.g., in a GUI, use a drag and pull motion
  • a virtual probe When a virtual probe is created, it may have a certain length and such a length may be displayed along with the probe (see FIG. 4(a)).
  • the probe length can be dynamic or fixed.
  • a fixed-length probe may be used to mimic the commercial needle electrode systems which commonly have length of 10 cm, 15 cm, and 20 cm. Different lengths may be made available and a user may select any one of the available lengths.
  • a configuration using a probe of a fixed length may be helpful in terms of having a more realistic simulation in pre-surgical planning.
  • the movement of the probe may be accordingly determined. For instance, e.g., the movement of the probe may be confined to skin 102, or to a half sphere with respect to the tip of the probe when the length of the probe is fixed. This is shown in FIG. 4(c).
  • the scope of allowed movement of a probe may be accordingly or automatically adjusted.
  • the length of a probe may be made dynamic.
  • a user can use a probe with a dynamic length as shown in FIG. 4(b).
  • the scope of movement of a probe with a dynamic length may be defined with respect to the tip of the probe.
  • the movement of the probe may be constrained on, e.g., a skin surface.
  • the probe's angles with respect to a coordinate system, such as patient coordinate system, may be displayed on the screen in real-time while the probe is being manipulated.
  • FIG. 5 illustrates two probes 510 and 520 being placed on the same 3D location of a selected object. This may be helpful to provide a user the ability to experiment with more than one probe simultaneously and make it possible to assess the possibility of utilizing multiple probes in the same treatment and effect thereof.
  • FIG. 8 illustrates the concept of detecting an obstacle encountered by a probe, according to an embodiment of the present teaching.
  • an actual or physical probe cannot go through some parts of the body such as bones, vital organs, or major arteries.
  • Such parts of the body may be categorically defined as obstacles or prohibited parts.
  • mechanisms and method are provided to automatically detect collision when a probe intersects with such parts of the body.
  • a system in accordance with the present teaching may define default obstacles or prohibited parts.
  • it can also provide flexible means for a user to dynamically define such obstacles according to the needs of specific applications. For instance, in some applications, bones may be an obstacle. However, in other applications, bones may be a target area for which a probe needs to be placed.
  • the system may provide automatic collision detection capabilities while a probe is placed into a 3D scene.
  • FIG. 8(a) it is shown that whenever a probe is placed, collision detection may be applied automatically.
  • the system may alert the user.
  • Example ways to alert a user is to create an alarming visual effect such as using a visually stimulating color or generate an audio sound. This is illustrated in FIG. 8(b).
  • Such a feedback is to generate a warning effect to catch the user's attention.
  • different colors or sounds may be used so that the user can recognize the type of obstacle associated with each different warning. Audio feedback may also be design to indicate orally the type of obstacle encountered.
  • obstacles may be individually turned on or off so that a user can experiment and explore different scenarios when moving and inserting the probe.
  • bones may be considered as obstacles.
  • major arteries may likely be considered as areas that are constrained or prohibited regions.
  • means may be provided to automatically identify these constrained regions and mark as such on the skin surface corresponding to such prohibited areas. This is illustrated in FIG. 9, in which the skin surface is marked as two zones.
  • Zone 901 is a valid insertion zone which is the area that the probe 903 can reach a target position of the target object without encountering any obstacles or constraints.
  • the other zone 902 is an area that the probe is obstructed by some obstacles or constraints. Different zones may be displayed using a different visual effect such as using different colors or with different appearance such as transparency.
  • FIG. 10 is a high level flow of an exemplary process, in which a percutaneous pre-surgical planning process is carried out, according to an embodiment of the present teaching.
  • Volumetric data may be first loaded into a system at 1010.
  • such loaded volumetric data may be further processed, at 1010, to extract different segmented 3D objects.
  • the loaded data may have been previously segmented and one or more 3D objects may already exist.
  • the 3D volume and the 3D objects contained therein are rendered in a 3D scene at 1015.
  • a user may enter an instruction to interact with the system during a percutaneous pre-surgical planning process.
  • a user input may be issued via different means. For instance, an input may be related to an action such as a mouse click on some control buttons or a selection of a plurality of available choices.
  • Such a user input may be dispatched to relative action modules according to the nature of the input or some preset system configurations.
  • the input is interpreted at 1020.
  • One exemplary type of input relates to definitions such as definitions of a target object, an obstacle, or a prohibited region in a 3D volume.
  • Another exemplary type of input is an instruction related to insertion, manipulation, and visualization of different 3D objects in the process of a percutaneous pre-surgical planning.
  • a different target object may be defined. For instance, for a procedure to treat liver tumor, a lesion in a liver may identified as a target object.
  • different types of obstacle may also be defined.
  • An obstacle may be defined to be an object that a probe cannot penetrate.
  • One example of such an obstacle may be bones.
  • bones may be defined as target rather than obstacle.
  • Another exemplary type of object is a prohibited region, which may be defined as a region that if a probe's entry may cause harm. For instance, a user may select one or more major arteries around a liver as prohibited regions to enter a probe. In this example, to allow a probe to enter into a lesion inside a liver, the probe has to take a route that avoids the bones and major arteries.
  • Selections of target object, obstacles, or prohibited regions may be made based on a plurality of choices, which may correspond to all the segmented 3D objects.
  • the segmented objects in a 3D volume representing a human body may include skin, liver, pancreas, kidney, lesions inside or nearby certain organs, surrounding tissue, bones, blood vessels, etc.
  • a lesion associated with, e.g., the liver may be selected as a target object.
  • different obstacles or prohibited regions may be selected. For instance, for percutaneous treatment, bones may be selected as obstacles and major blood vessels may be selected as prohibited regions.
  • another type of input corresponds to instructions related to insertion, manipulation, and visualization of different 3D objects. Different types of instructions may be further recognized. If the input instruction relates to insertion of a virtual probe, determined at 1025, the system further receives, at 1030, a 2D coordinate corresponding to a screen location specified by a user as where a probe is to reach. To translate the 2D screen location to a 3D coordinate at which a probe is to reach, a transformation between the 2D coordinate and a 3D coordinate is performed at 1035. Since a received 2D coordinate may correspond to either a user's desire to insert a new probe or to make an adjustment to an already inserted probe, it is further determined, at 1040, whether the operation requested corresponds to creation of new probe or adjusting an existing probe.
  • the system renders, at 1045, a new probe at the transformed 3D coordinate. The process then proceeds to detecting, at 1055, a potential collision between the probe and any other object that has been defined as either an obstacle or a prohibited region. If the user's request is to make an adjustment to an existing probe, the system adjusts, at 1050, the existing probe to the transformed 3D coordinate and then proceeds to collision detection at 1055. When a collision is detected, the system may generate a warning message, at 1060, to caution the user that the probe may have encountered some obstacle or entered into a prohibited region. The manner the warning message is generated and presented may depend on the system setting. For example, the system may be defaulted to flash on the location where the collision is detected (see FIG. 8(b)).
  • an additional step may be performed, in which the user and the system may interactively determine which probe is to be adjusted.
  • the 2D coordinate received from the user may correspond to a manipulation with respect to the tip, the body, or the handle of a probe, depending on, e.g., what is the closest part and which mode of operation the system is placed under (not shown). For example, if the system is set in a mode in which a probe is to be manipulated using the handle of the probe, then the 3D coordinate transformed from the 2D coordinate received from the user is where the handle of the probe is to be re-located.
  • the 3D coordinate needs also to be determined based on the fact that the handle of the probe has to be on a sphere centered around the tip of the probe.
  • a user can also switch between different modes of operation. For instance, a user may elect first to adjust the probe's tip to a best location by manipulating with respect to the tip of the probe. Once the tip location satisfies the needs of a procedure, the user may then switch to a mode in which the manipulation of the probe is through the handle of the probe. Through such manipulation via the handle of the probe, the user may adjust the entry point of the probe on the skin, without affecting the tip position, to avoid any obstacle or prohibited regions.
  • 3D scene manipulation may include object oriented scene rotation, zooming, visualization mode, etc.
  • a probe that has been inserted into the 3D scene may be moved around accordingly. In this way, a user may be able to observe the spatial relationship between the probe and surrounding objects from different angles.
  • a user may manipulate the visibility of individual object by, e.g., making them transparent, opaque, or translucent.
  • a user may also control to view a 2D cross sectional view of an object along the probe and may arbitrarily change the location at which a 2D cross sectional view is generated and displayed.
  • a user may also be able to manipulate the 3D scene via the probe by, e.g., dragging the handle of the probe to rotate the entire 3D scene.
  • it can also set that manipulation to a 3D scene does not affect the 3D pose of the probe. This may be useful at times because the user can adjust the 3D volume, e.g., so that or until a collision is avoided.
  • the system automatically proceeds to 1055 to detect collisions and subsequently report a collision at 1060 if it is detected.
  • FIG. 11 illustrates some exemplary types. For instance, a user may control to turn on or off of the view of the virtual probe (1 120). A user may also control to turn on or off the view in which different zones associated with certain constraint may be visually distinct (1 130). A user may also control how a collision situation may be presented, e.g., visually or acoustically. In addition, as discussed earlier, a user may also control how to display a 3D object, e.g., opaque or transparent. This includes to control the display of each individual object or the entire 3D scene.
  • a 3D object e.g., opaque or transparent. This includes to control the display of each individual object or the entire 3D scene.
  • FIG. 12 depicts a construct of an exemplary system 1200 that facilitates the placement and manipulation of a virtual probe in a 3D environment for percutaneous preoperational surgical planning, according to an embodiment of the current invention.
  • the system 1200 comprises a display device 1210, a graphical user interface 1215, a 2D/3D transformation mechanism 1220, a control panel facilitator 1225, a probe handling module 1230, a collision detection module 1235, a plurality of rendering mechanisms, including a probe view rendering mechanism 1240, a constraint zone rendering mechanism 1245, a probe rendering mechanism 1250, and a 3D scene rendering mechanism 1255, a 3D object management module 1260, a probe view manipulation module 1265, a constraint zone calculation module 1270, and a 3D scene manipulating mechanism 1275.
  • a user 1205 may interact with the system 1200 via a user interface displayed on the display device 1210.
  • the GUI controller 1215 may control interaction between the system 1200 and user 1205. If the user 1205 desires to use a tool associated with a virtual probe once a 3D scene is set up, the user may request the system to retrieve 3D object information from the 3D object management 1260 and render such objects via the 3D scene rendering mechanism 1255. When such user request is entered via the user interface, the GUI controller 1215 may then interpret the request and accordingly activates appropriate functional modules to perform the requested operations.
  • the system may activate the 3D scene manipulator module 1275 to modify the orientation of the 3D scene based on the specification from the user.
  • the user and the GUI controller may continuously interact, e.g., user may click a point in the 3D scene and drag along a certain direction so that the entire 3D scene may move along in the same direction.
  • the user may exercise the same control with respect to a particular 3D object such as a virtual probe.
  • a user may also interact with the system to exercise various controls over a probe.
  • the 2D/3D transformation mechanism 1220 dynamically transforms a 2D screen point to a 3D point in the 3D scene, and then pass the 3D point to the probe handling module 1230 which determines whether it is a new probe creation operation or an adjustment operation to be made to an existing probe.
  • the desired probe is then rendered in the 3D scene by the probe rendering mechanism 1250.
  • the collision detection module 1235 is operative to detect intersection between the applicable probe and any 3D objects that have been defined as either an obstacle or prohibited regions.
  • the collision detection module 1235 may also generate warning information when a collision is detected.
  • the system also provides the means for a user to exercise various control regarding the operation of the system.
  • a user may activate or deactivate a probe view controlled by the probe view manipulation module 1265.
  • a user may also control other visualization parameters such as transparency through the probe view rendering mechanism 1240.
  • a user may also set desired mode of display which may also be personalized and such a setting may be applied automatically when the user signs up with the system. For example, a user may desire to always have the skin (a 3D object) displayed in a transparent mode. Another user may desire to have a particular sound as a warning whenever a collision is detected.
  • a user may also control the activation or deactivation of computation of a constraint zone by interacting with the constraint zone calculation module 1270 or control the display of a detected constraint zone by interacting with the constraint zone rendering mechanism 1245.
  • Minimally invasive techniques for the ablation are becoming popular with advances in medical imaging.
  • percutaneous thermal ablation has been studied in different forms such as radiofrequency ablation, microwave ablation, or cryoablation.
  • This operation is a minimally invasive procedure that includes inserting a needle in targeted tissues and then destroys it using different levels of thermal energy.
  • the success of such an operation mainly depends on the accuracy of the needle insertion, making it possible to destroy the whole targeted tumor, while avoiding damages on other organs and minimizing risks of a local recurrence. Therefore, the effective treatment zone planning is one of the crucial factors in determining the success or failure of the procedure.
  • a system and method according to one embodiment of the present teaching enhance a 3D virtual probe with several on-probe controls.
  • the end handle of the virtual probe may be used as pose manipulator to change the orientation and location of the probe.
  • the body of the probe may have several control-handlers for adjusting settings of the probe, such as the model, the length, and the level of thermal energy o the probe.
  • On-zone controls may be provided on the thermal treatment zone itself (e.g., placed on the border or edge of the 3D treatment zone) for adjusting the length, radius-width, and pre- gap size of the treatment zone.
  • a thermal dissipation model can be used to calculate the corresponding impact or changes to the shape of the zone. The affected zone may then be updated and visualized accordingly in real time.
  • FIG. 13 depicts another construct of an exemplary system 1300 that facilitates the placement and manipulation of a virtual surgical instrument and a treatment zone in a 3D environment for percutaneous pre-operational surgical planning, according to an embodiment of the present teaching. It is noted that the same mechanisms and modules that have been described above with respect to FIG. 12 will not be repeated in this embodiment.
  • the system 1300 further includes a treatment zone calculation module 1305, a treatment zone rendering mechanism 1310, and a control handling module 1315.
  • the visualization of the 3D treatment zone may be achieved in the same manner as described above for rendering the 3D objects and 3D virtual probe by the 3D scene rendering mechanism 1255 and the probe rendering mechanism 1250.
  • the 3D treatment zone may be rendered together with the 3D objects and the 3D virtual probe in the 3D volume on the display screen 120 so that users can easily see the spatial relationships between them.
  • FIG. 15(b) shows the impact on the size and shape treatment zone caused by the thermal dissipation effect of the anatomical structures.
  • the vascular structures 1507 dissipates heat from the probe 1509 through the vascular tree and thus, changes the size and shape of the treatment zone. So the original treatment zone 1511 is adjusted to an adjusted treatment zone 1515, which may not cover the target area 1507 completely and thus, make the treatment ineffective.
  • a user may adjust the 3D pose and/or setting of the virtual probe 1509 accordingly in real-time to obtain an adjusted surgical plan for better treatment.
  • the control handling module 1315 may provide one or more on-probe controls associated with the 3D virtual probe and/or one or more on-zone controls associated with the 3D treatment zone.
  • the on-probe controls may be any graphic user interface elements such as a button, knob, scroll, etc.
  • the setting of the probe that can be adjusted by the on-probe controls include, for example, the model of the probe, the length of the probe, and the level of thermal energy o the probe.
  • the setting of the probe may be dynamically adjusted by a user via the on-probe control in-real time by manipulating the on-probe control in 3D.
  • the 3D treatment zone may be dynamically adjusted accordingly based on the adjustment of the probe setting, and the adjusted 3D treatment zone is visualized in real-time in 3D.
  • the on-zone controls may be any graphic user interface elements provided on the display
  • FIG. 16 shows a zoomed section 1601 of the probe 1509. It contains a scale 1603 and on-probe controls 1605.
  • the scale 1603 enables a user to determine the required length of the probe 1509 visually and directly in 3D scene.
  • the on-probe controls 1605 enable a user to adjust the treatment zone 151 1. These controls 1605 may be used by a user to adjust the setting of the probe 1509 in parametric space and reflect the change of the treatment zone 151 1 and/or probe 1509 spatially and visually in 3D scene in real-time.
  • on-zone controls 1607 are provided on the border of the treatment zone 1611 to enable a user to adjust the size and/or shape of the treatment zone 1511 directly in spatial space.
  • second information related to a setting o the surgical instrument is received from the user.
  • the setting includes, for example, a model, length, and level of thermal energy of the surgical instrument.
  • a 3D treatment zone in the 3D volume with respect to the 3D objects is estimated based on the first and second information. In one embodiment, the 3D treatment zone may be estimated further based on a thermal dissipation effect on the second 3D object corresponding to the anatomical structure.
  • the 3D treatment zone is visualized in the 3D volume on the display screen. The 3D representation of the surgical instrument and the 3D treatment zone are to be used for surgical procedure planning.
  • one or more controls associated with the 3D representation of the surgical instrument and/or the 3D treatment zone are provided to facilitate the user to dynamically adjust the 3D treatment zone.
  • a first set of controls associated with the 3D representation of the surgical instrument may be provided.
  • the setting of the surgical instrument can be dynamically updated by the user via the first set of controls.
  • a second set of controls associated with the 3D treatment zone may be provided.
  • the 3D treatment zone can be dynamically adjusted by the user via the second set of controls.
  • an update of the second information related to the setting of the surgical instrument may be determined based on the adjusted 3D treatment zone and provided to the user.
  • computer hardware platforms may be used as the hardware platform(s) for one or more of the elements described herein (e.g., the system 1300 described with respect to FIGS. 1-16).
  • the hardware elements, operating systems and programming languages of such computers are conventional in nature, and it is presumed that those skilled in the art are adequately familiar therewith to adapt those technologies to surgical procedure planning as described herein.
  • a computer with user interface elements may be used to implement a personal computer (PC) or other type of work station or terminal device, although a computer may also act as a server if appropriately programmed. It is believed that those skilled in the art are familiar with the structure, programming and general operation of such computer equipment and as a result the drawings should be self-explanatory.
  • FIG. 17 depicts the architecture of a computing device which can be used to realize a specialized system implementing the present teaching.
  • a specialized system incorporating the present teaching has a functional block diagram illustration of a hardware platform which includes user interface elements.
  • the computer may be a general purpose computer or a special purpose computer. Both can be used to implement a specialized system for the present teaching.
  • This computer 1700 may be used to implement any component of surgical procedure planning techniques, as described herein.
  • the system 1300 may be implemented on a computer such as computer 1700, via its hardware, software program, firmware, or a combination thereof.
  • the computer 1700 includes COM ports 1702 connected to and from a network connected thereto to facilitate data communications.
  • the computer 1700 also includes a central processing unit (CPU) 1704, in the form of one or more processors, for executing program instructions.
  • CPU central processing unit
  • a machine-readable medium may take many forms, including but not limited to, a tangible storage medium, a carrier wave medium or physical transmission medium.
  • Non- volatile storage media include, for example, optical or magnetic disks, such as any of the storage devices in any computer(s) or the like, which may be used to implement the system or any of its components as shown in the drawings.
  • Volatile storage media include dynamic memory, such as a main memory of such a computer platform.
  • Tangible transmission media include coaxial cables; copper wire and fiber optics, including the wires that form a bus within a computer system.
  • Carrier-wave transmission media may take the form of electric or electromagnetic signals, or acoustic or light waves such as those generated during radio frequency (RF) and infrared (IR) data communications.
  • Computer-readable media therefore include for example: a floppy disk, a flexible disk, hard disk, magnetic tape, any other magnetic medium, a CD-ROM, DVD or DVD-ROM, any other optical medium, punch cards paper tape, any other physical storage medium with patterns of holes, a RAM, a PROM and EPROM, a FLASH-EPROM, any other memory chip or cartridge, a carrier wave transporting data or instructions, cables or links transporting such a carrier wave, or any other medium from which a computer may read programming code and/or data. Many of these forms of computer readable media may be involved in carrying one or more sequences of one or more instructions to a physical processor for execution.

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Abstract

La présente invention concerne une planification d'intervention chirurgicale. Selon un exemple, au moins un objet tridimensionnel (3D) contenu dans un volume en 3D est restitué sur un écran d'affichage. Le ou les objets en 3D comprennent un objet en 3D correspondant à un organe. Les premières informations associées à une pose en 3D d'un instrument chirurgical, positionné par rapport au ou aux objets en 3D, sont reçues d'un utilisateur. Une représentation 3D de l'instrument chirurgical est restituée dans le volume en 3D sur la base des premières informations. Des secondes informations associées à un réglage de l'instrument chirurgical sont reçues de l'utilisateur. Une zone de traitement en 3D dans le volume en 3D par rapport au ou aux objets en 3D est estimée sur la base des premières et secondes informations. La zone de traitement en 3D dans le volume en 3D est visualisée sur l'écran d'affichage. Des commandes associées à la représentation 3D de l'instrument chirurgical et/ou à la zone de traitement en 3D sont fournies pour faciliter l'ajustement dynamique, par l'utilisateur, de la zone de traitement en 3D par l'intermédiaire des commandes.
PCT/US2015/058441 2014-10-31 2015-10-30 Procédé et système pour ajuster une zone de traitement tridimensionnelle (3d) interactive pour un traitement percutané WO2016070113A1 (fr)

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US201462073420P 2014-10-31 2014-10-31
US62/073,420 2014-10-31
US14/926,559 US11264139B2 (en) 2007-11-21 2015-10-29 Method and system for adjusting interactive 3D treatment zone for percutaneous treatment
US14/926,559 2015-10-29

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