Classifications

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• • A—HUMAN NECESSITIES
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• • A—HUMAN NECESSITIES
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  • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
  • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
  • A61B6/5235—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
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  • G06T7/33—Determination of transform parameters for the alignment of images, i.e. image registration using feature-based methods
  • G06T7/344—Determination of transform parameters for the alignment of images, i.e. image registration using feature-based methods involving models
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  • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
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  • G06T2207/30172—Centreline of tubular or elongated structure

Definitions

• the embodiments of the present invention relate to interventional devices and methods of use thereof.
• the present invention provides a method, comprising: obtaining a first image from a first imaging modality,
• the at least one element comprises an airway, a blood vessel, a body cavity, or any combination thereof; obtaining, from a second imaging modality, at least (i) a first image of a radiopaque instrument in a first pose and (ii) a second image of the radiopaque instrument in a second pose,
• radiopaque instrument is in a body cavity of a patient; generating at least two augmented bronchograms,
• a first augmented bronchogram corresponds to the first image of the radiopaque instrument in the first pose
• a second augmented bronchogram corresponds to the second image of the radiopaque instrument in the second pose
• estimating the first pose of the radiopaque instrument and the second pose of the radiopaque instrument by comparing the first pose of the radiopaque instrument and the second pose of the radiopaque instrument to the first image of the first imaging modality , wherein the comparing is performed using:
• the estimated first pose of the radiopaque instrument and the estimated second pose of the radiopaque instrument meets the determined mutual geometric constraints, generating a third image; wherein the third image is an augmented image derived from the second imaging modality which highlights an area of interest, wherein the area of interest is determined from data from the first imaging modality.
• the at least one element from the first image from the first imaging modality further comprises a rib, a vertebra, a diaphragm, or any combination thereof.
• the mutual geometric constraints are generated by:
• the estimating is performed using a device comprising a protractor, an accelerometer, a gyroscope, or any combination thereof, and wherein the device is attached to the second imaging modality;
• the plurality of image features comprise anatomical elements, non- anatomical elements, or any combination thereof
• image features comprise: patches attached to a patient, radiopaque markers positioned in a field of view of the second imaging modality, or any combination thereof,
• image features are visible on the first image of the radiopaque instrument and the second image of the radiopaque instrument;
• the camera comprises: a video camera, an infrared camera, a depth camera, or any combination thereof,
• the camera is at a fixed location, wherein the camera is configured to track at least one feature
• the at least one feature comprises: a marker attached the patient, a marker attached to the second imaging modality, or any combination thereof, and
• the method further comprises: tracking the radiopaque instrument for: identifying a trajectory, and using the trajectory as a further geometric constraint, wherein the radiopaque instrument comprises an endoscope, an endo-bronchial tool, or a robotic arm.
• the present invention is a method, comprising:
• the map is generated using a first image from a first imaging modality, obtaining, from a second imaging modality, an image of a radiopaque instrument comprising at least two attached markers,
• the at least two attached markers are separated by a known distance, identifying a pose of the radiopaque instrument from the second imaging modality relative to a map of at least one body cavity of a patient,
• the radiopaque instrument comprises an endoscope, an endobronchial tool, or a robotic arm.
• the method further comprises: identifying a depth of the radiopaque instrument by use of a trajectory of the radiopaque instrument.
• the first image from the first imaging modality is a preoperative image.
• the at least one image of the radiopaque instrument from the second imaging modality is an intra-operative image.
• the present invention is a method, comprising:
• the at least one element comprises an airway, a blood vessel, a body cavity or any combination thereof;
• the second image of the radiopaque instrument is captured at a second pose of second imaging modality, and wherein the radiopaque instrument is in a body cavity of a patient; generating at least two augmented bronchograms correspondent to each of two poses of the imaging device, wherein a first augmented bronchogram derived from the first image of the radiopaque instrument and the second augmented bronchogram derived from the second image of the radiopaque instrument,
• the third image is an augmented image derived from the second imaging modality highlighting the area of interest, based on data sourced from the first imaging modality.
• anatomical elements such as: a rib, a vertebra, a diaphragm, or any combination thereof, are extracted from the first imaging modality and from the second imaging modality.
• the mutual geometric constraints are generated by:
• the estimating is performed using a device comprising a protractor, an accelerometer, a gyroscope, or any combination thereof, and wherein the device is attached to the second imaging modality; b. extracting a plurality of image features to estimate a relative pose change,
• the plurality of image features comprise anatomical elements, non-anatomical elements, or any combination thereof
• image features comprise: patches attached to a patient, radiopaque markers positioned in a field of view of the second imaging modality, or any combination thereof,
• the image features are visible on the first image of the radiopaque instrument and the second image of the radiopaque instrument; c. estimate a difference between (i) the first pose and (ii) the second pose by using a at least one camera, wherein the camera comprises: a video camera, an infrared camera, a depth camera, or any combination thereof, wherein the camera is at a fixed location, wherein the camera is configured to track at least one feature, wherein the at least one feature comprises: a marker attached the patient, a marker attached to the second imaging modality, or any combination thereof, and tracking the at least one feature; d. or any combination thereof.
• the camera comprises: a video camera, an infrared camera, a depth camera, or any combination thereof, wherein the camera is at a fixed location, wherein the camera is configured to track at least one feature, wherein the at least one feature comprises: a marker attached the patient, a marker attached to the second imaging modality, or any combination thereof, and tracking the at least one feature; d.
• the method further comprises tracking the radiopaque instrument to identify a trajectory and using such trajectory as additional geometric constrains, wherein the radiopaque instrument comprises an endoscope, an endo-bronchial tool, or a robotic arm.
• the present invention is a method to identify the true instrument location inside the patient, comprising:
• a map of at least one body cavity of a patient generated from a first image of a first imaging modality obtaining, from a second imaging modality, an image of the radiopaque instrument with at least two markers attached to it and having the defined distance between them , that may be perceived from the image as located in at least two different body cavities inside the patient,
• the radiopaque instrument comprises an endoscope, an endo-bronchial tool, or a robotic arm.
• the method further comprises: identifying a depth of the radiopaque instrument by use of a trajectory of the radiopaque instrument.
• the first image from the first imaging modality is a preoperative image.
• the at least one image of the radiopaque instrument from the second imaging modality is an intra-operative image.
• Figure 1 shows a block diagram of a multi-view pose estimation method used in some embodiments of the method of the present invention.
• Figures 2, 3, and 4 show an exemplary embodiments of intraoperative images used in the method of the present invention.
• Figures 2 and 3 illustrate a fluoroscopic image obtained from one specific pose.
• Figure 4 illustrates a fluoroscopic image obtained in a different pose, as compared to Figures 2 and 3, as a result of C-arm rotation.
• the Bronchoscope - 240, 340, 440, the instrument - 210, 310, 410, ribs - 220, 320, 420 and body boundary - 230, 330, 430 are visible.
• the multi view pose estimation method uses the visible elements in Figures 2, 3, 4 as an input.
• FIG. 5 shows a schematic drawing of the structure of bronchial airways as utilized in the method of the present invention.
• the airways centerlines are represented by 530.
• a catheter is inserted into the airways structure and imaged by a fluoroscopic device with an image plane 540.
• the catheter projection on the image is illustrated by the curve 550 and the radio opaque markers attached to it are projected into points G and F.
• Figure 6 is an image of a bronchoscopic device tip attached to a bronchoscope, in which the bronchoscope can be used in an embodiment of the method of the present invention.
• Figure 7 is an illustration according to an embodiment of the method of the present invention, where the illustration is of a fluoroscopic image of a tracked scope (701) used in a bronchoscopic procedure with an operational tool (702) that extends from it.
• the operational tool may contain radio opaque markers or unique pattern attached to it.
• a "plurality” refers to more than one in number, e.g., but not limited to, 2, 3, 4, 5, 6, 7, 8, 9, 10, etc.
• a plurality of images can be 2 images, 3 images, 4 images, 5 images, 6 images, 7 images, 8 images, 9 images, 10 images, etc.
• an “anatomical element” refers to a landmark, which can be, e.g.: an area of interest, an incision point, a bifurcation, a blood vessel, a bronchial airway, a rib or an organ.
• “geometrical constraints” or “geometric constraints” or “mutual constraints” or “mutual geometric constraints” refer to a geometrical relationship between physical organs (e.g., at least two physical organs) in a subject's body which construct a similar geometric relationship within the subject between ribs, the boundary of the body, etc. Such geometrical relationships, as being observed through different imaging modalities, either remain unchanged or their relative movement can be neglected or quantified.
• a "pose” refers to a set of six parameters that determine a relative position and orientation of the intraoperative imaging device source as a substitute to the optical camera device.
• a pose can be obtained as a combination of relative movements between the device, patient bed, and the patient.
• Another non-limiting example of such movement is the rotation of the intraoperative imaging device combined with its movement around the static patient bed with static patient on the bed.
• a "position” refers to the location (that can be measured in any coordinate system such as x, y, and z Cartesian coordinates) of any object, including an imaging device itself within a 3D space.
• an "orientation" refers the angles of the intraoperative imaging device.
• the intraoperative imaging device can be oriented facing upwards, downwards, or laterally.
• a "pose estimation method” refers to a method to estimate the parameters of a camera associated with a second imaging modality within the 3D space of the first imaging modality.
• a non-limiting example of such a method is to obtain the parameters of the intraoperative fluoroscopic camera within the 3D space of a preoperative CT.
• a mathematical model uses such estimated pose to project at least one 3D point inside of a preoperative computed tomography (CT) image to a corresponding 2D point inside the intraoperative X-ray image.
• CT computed tomography
• a "multi view pose estimation method” refers a method to estimate to poses of at least two different poses of the intraoperative imaging device. Where the imaging device acquires image from the same scene/subject.
• relative angular difference refers to the angular difference of the between two poses of the imaging device caused by their relative angular movement.
• relative pose difference refers to both location and relative angular difference between two poses of the imaging device caused by the relative spatial movement between the subject and the imaging device.
• epipolar distance refers to a measurement of the distance between a point and the epipolar line of the same point in another view.
• an “epipolar line” refers to a calculation from an x, y vector or two-column matrix of a point or points in a view.
• a “similarity measure” refers to a real-valued function that quantifies the similarity between two objects.
• the present invention provides a method, comprising: obtaining a first image from a first imaging modality,
• the at least one element comprises an airway, a blood vessel, a body cavity, or any combination thereof;
• radiopaque instrument is in a body cavity of a patient; generating at least two augmented bronchograms,
• a first augmented bronchogram corresponds to the first image of the radiopaque instrument in the first pose
• a second augmented bronchogram corresponds to the second image of the radiopaque instrument in the second pose
• estimating the first pose of the radiopaque instrument and the second pose of the radiopaque instrument by comparing the first pose of the radiopaque instrument and the second pose of the radiopaque instrument to the first image of the first imaging modality , wherein the comparing is performed using:
• the estimated first pose of the radiopaque instrument and the estimated second pose of the radiopaque instrument meets the determined mutual geometric constraints, generating a third image; wherein the third image is an augmented image derived from the second imaging modality which highlights an area of interest,
• the at least one element from the first image from the first imaging modality further comprises a rib, a vertebra, a diaphragm, or any combination thereof.
• the mutual geometric constraints are generated by:
• the estimating is performed using a device comprising a protractor, an accelerometer, a gyroscope, or any combination thereof, and wherein the device is attached to the second imaging modality;
• the plurality of image features comprise anatomical elements, non- anatomical elements, or any combination thereof
• image features comprise: patches attached to a patient, radiopaque markers positioned in a field of view of the second imaging modality, or any combination thereof,
• image features are visible on the first image of the radiopaque instrument and the second image of the radiopaque instrument;
• the camera comprises: a video camera, an infrared camera, a depth camera, or any combination thereof,
• the camera is configured to track at least one feature, wherein the at least one feature comprises: a marker attached the patient, a marker attached to the second imaging modality, or any combination thereof, and
• the method further comprises: tracking the radiopaque instrument for: identifying a trajectory, and using the trajectory as a further geometric constraint, wherein the radiopaque instrument comprises an endoscope, an endo-bronchial tool, or a robotic arm.
• the present invention is a method, comprising:
• the map is generated using a first image from a first imaging modality, obtaining, from a second imaging modality, an image of a radiopaque instrument comprising at least two attached markers,
• the at least two attached markers are separated by a known distance, identifying a pose of the radiopaque instrument from the second imaging modality relative to a map of at least one body cavity of a patient,
• the radiopaque instrument comprises an endoscope, an endo-bronchial tool, or a robotic arm.
• the method further comprises: identifying a depth of the radiopaque instrument by use of a trajectory of the radiopaque instrument.
• the first image from the first imaging modality is a preoperative image.
• the at least one image of the radiopaque instrument from the second imaging modality is an intra-operative image.
• the present invention is a method, comprising:
• the at least one element comprises an airway, a blood vessel, a body cavity or any combination thereof;
• the second image of the radiopaque instrument is captured at a second pose of second imaging modality, and wherein the radiopaque instrument is in a body cavity of a patient; generating at least two augmented bronchograms correspondent to each of two poses of the imaging device, wherein a first augmented bronchogram derived from the first image of the radiopaque instrument and the second augmented bronchogram derived from the second image of the radiopaque instrument,
• the third image is an augmented image derived from the second imaging modality highlighting the area of interest, based on data sourced from the first imaging modality.
• anatomical elements such as: a rib, a vertebra, a diaphragm, or any combination thereof, are extracted from the first imaging modality and from the second imaging modality.
• the mutual geometric constraints are generated by:
• the estimating is performed using a device comprising a protractor, an accelerometer, a gyroscope, or any combination thereof, and wherein the device is attached to the second imaging modality; b. extracting a plurality of image features to estimate a relative pose change,
• the plurality of image features comprise anatomical elements, non-anatomical elements, or any combination thereof
• image features comprise: patches attached to a patient, radiopaque markers positioned in a field of view of the second imaging modality, or any combination thereof,
• the image features are visible on the first image of the radiopaque instrument and the second image of the radiopaque instrument; c. estimate a difference between (i) the first pose and (ii) the second pose by using a at least one camera, wherein the camera comprises: a video camera, an infrared camera, a depth camera, or any combination thereof, wherein the camera is at a fixed location, wherein the camera is configured to track at least one feature, wherein the at least one feature comprises: a marker attached the patient, a marker attached to the second imaging modality, or any combination thereof, and tracking the at least one feature; d. or any combination thereof.
• the camera comprises: a video camera, an infrared camera, a depth camera, or any combination thereof, wherein the camera is at a fixed location, wherein the camera is configured to track at least one feature, wherein the at least one feature comprises: a marker attached the patient, a marker attached to the second imaging modality, or any combination thereof, and tracking the at least one feature; d.
• the method further comprises tracking the radiopaque instrument to identify a trajectory and using such trajectory as additional geometric constrains, wherein the radiopaque instrument comprises an endoscope, an endo-bronchial tool, or a robotic arm.
• the present invention is a method to identify the true instrument location inside the patient, comprising:
• a map of at least one body cavity of a patient generated from a first image of a first imaging modality obtaining, from a second imaging modality, an image of the radiopaque instrument with at least two markers attached to it and having the defined distance between them , that may be perceived from the image as located in at least two different body cavities inside the patient,
• the radiopaque instrument comprises an endoscope, an endo-bronchial tool, or a robotic arm.
• the method further comprises: identifying a depth of the radiopaque instrument by use of a trajectory of the radiopaque instrument.
• the first image from the first imaging modality is a preoperative image.
• the at least one image of the radiopaque instrument from the second imaging modality is an intra-operative image.
• the application PCT/IB2015/000438 includes a description of a method to estimate the pose information (e.g., position, orientation) of a fluoroscope device relative to a patient during an endoscopic procedure, and is herein incorporated by reference in its entirety.
• PCT/IB 15/002148 filed October 20, 2015 is also herein incorporated by reference in its entirety.
• the present invention is a method which includes data extracted from a set of intra-operative images, where each of the images is acquired in at least one (e.g., 1, 2, 3, 4, etc.) unknown pose obtained from an imaging device. These images are used as input for the pose estimation method.
• Figures 3, 4, 5, are examples of a set of 3 Fluoroscopic images. The images in Figures 4 and 5 were acquired in the same unknown pose while the image in Figure 3 was acquired in a different unknown pose. This set, for example, may or may not contain additional known positional data related to the imaging device.
• a set may contain positional data, such as C-arm location and orientation, which can be provided by a Fluoroscope or acquired through a measurement device attached to the Fluoroscope, such as protractor, accelerometer, gyroscope, etc.
• positional data such as C-arm location and orientation
• a Fluoroscope or acquired through a measurement device attached to the Fluoroscope, such as protractor, accelerometer, gyroscope, etc.
• anatomical elements are extracted from additional intraoperative images and these anatomical elements imply geometrical constraints which can be introduced into the pose estimation method. As a result, the number of elements extracted from a single intraoperative image can be reduced prior to using the pose estimation method.
• the multi view pose estimation method further includes overlaying information sourced from a pre-operative modality over any image from the set of intraoperative images.
• the plurality of second imaging modalities allow for changing a Fluoroscope pose relatively to the patient (e.g., but not limited to, a rotation or linear movement of the Fluoroscope arm, patient bed rotation and movement, patient relative movement on the bed, or any combination of the above) to obtain the plurality of images, where the plurality of images are obtained from abovementioned relative poses of the fluoroscopic source as any combination of rotational and linear movement between the patient and Fluoroscopic device.
• a Fluoroscope pose relatively to the patient e.g., but not limited to, a rotation or linear movement of the Fluoroscope arm, patient bed rotation and movement, patient relative movement on the bed, or any combination of the above
• a non-limiting exemplary embodiment of the present invention can be applied to a minimally invasive pulmonary procedure, where endo-bronchial tools are inserted into bronchial airways of a patient through a working channel of the Bronchoscope (see Figure 6).
• the physician Prior to commencing a diagnostic procedure, the physician performs a Setup process, where the physician places a catheter into several (e.g., 2, 3, 4, etc.) bronchial airways around an area of interest.
• the Fluoroscopic images are acquired for every location of the endo-bronchial catheter, as shown in Figures 2, 3, and 4.
• pathways for inserting the bronchoscope can be identified on a pre-procedure imaging modality, and can be marked by highlighting or overlaying information from a pre-operative image over the intraoperative Fluoroscopic image.
• the physician can rotate, change the zoom level, or shift the Fluoroscopic device for, e.g., verifying that the catheter is located in the area of interest.
• pose changes of the Fluoroscopic device would invalidate the previously estimated pose and require that the physician repeats the Setup process.
• repeating the Setup process need not be performed.
• Figure 4 shows an exemplary embodiment of the present invention, showing the pose of the Fluoroscope angle being estimated using anatomical elements, which were extracted from Figures 2 and 3 (in which, e.g., Figures 2 and 3 show images obtained from the initial Setup process and the additional anatomical elements extracted from image, such as catheter location, ribs anatomy and body boundary).
• the pose can be changed by, for example, (1) moving the Fluoroscope (e.g., rotating the head around the c-arm), (2) moving the Fluoroscope forward are backwards, or alternatively through the subject position change or either through the combination of both etc.
• the mutual geometric constraints between Figure 2 and Figure 4 such as positional data related to the imaging device, can be used in the estimation process.
• Figure 1 is an exemplary embodiment of the present invention, and shows the following:
• the component 120 extracts 3D anatomical elements, such as Bronchial airways, ribs, diaphragm, from the preoperative image, such as, but not limited to, CT, magnetic resonance imaging (MRI), Positron emission tomography-computed tomography (PET-CT), using an automatic or semi-automatic segmentation process, or any combination thereof.
• 3D anatomical elements such as Bronchial airways, ribs, diaphragm
• CT magnetic resonance imaging
• PET-CT Positron emission tomography-computed tomography
• Examples of automatic or semi-automatic segmentation processes are described in "Three- dimensional Human Airway Segmentation Methods for Clinical Virtual Bronchoscopy", Atilla P. Kiraly, William E. Higgins, Geoffrey McLennan, Eric A. Hoffman, Joseph M. Reinhardt, which is hereby incorporated by reference in its entirety.
• the component 130 extracts 2D anatomical elements (which are further shown in Figure 4, such as Bronchial airways 410, ribs 420, body boundary 430 and diaphragm) from a set of intraoperative images, such as, but not limited to, Fluoroscopic images, ultrasound images, etc.
• 2D anatomical elements which are further shown in Figure 4, such as Bronchial airways 410, ribs 420, body boundary 430 and diaphragm
• intraoperative images such as, but not limited to, Fluoroscopic images, ultrasound images, etc.
• the component 140 calculates the mutual constraints between each subset of the images in the set of intraoperative images, such as relative angular difference, relative pose difference, epipolar distance, etc.
• the method includes estimating the mutual constraints between each subset of the images in the set of intraoperative images.
• Non-limiting examples of such methods are: (1) the use of a measurement device attached to the intraoperative imaging device to estimate a relative pose change between at least two poses of a pair of fluoroscopic images.
• patches e.g., ECG patches
• the component 150 matches the 3D element generated from preoperative image to their corresponding 2D elements generated from intraoperative image. For example, matching a given 2D Bronchial airway extracted from Fluoroscopic image to the set of 3D airways extracted from the CT image.
• the component 170 estimates the poses for the each of the images in the set of intra-operative images in the desired coordinate system, such as preoperative image coordinate system, operation environment related, coordinated system formed by other imaging or navigation device, etc.
• the images in the set can be sourced from the same or different imaging device poses.
• the component 170 evaluates the pose for each image from the set of intraoperative images such that:
• a similarity measure such as a distance metric
• a distance metric provides a measure to assess the distances between the projected 3D elements and their correspondent 2D elements. For example, a Euclidian distance between 2 polylines (e.g., connected sequence of line segments created as a single object) can be used as a similarity measure between 3D projected Bronchial airway sourcing pre-operative image to 2D airway extracted from the intra-operative image.
• the method includes estimating a set of poses that correspond to a set of intraoperative images by identifying such poses which optimize a similarity measure, provided that the mutual constraints between the subset of images from intraoperative image set are satisfied.
• the optimization of the similarity measure can be referred to as a Least Squares problem and can be solved in several methods, e.g., (1) using the well-known bundle adjustment algorithm which implements an iterative minimization method for pose estimation, and which is herein incorporated by reference in its entirety: B. Triggs; P. McLauchlan; R. Hartley; A. Fitzgibbon (1999) "Bundle Adjustment — A Modern Synthesis". !CCV '99: Proceedings of the international Workshop on Vision Algorithms. Springer- Verlag. pp. 298-372, and (2) using a grid search method to scan the parameter space in search for optimal poses that optimize the similarity measure.
• Radio-opaque markers can be placed in predefined locations on the medical instrument in order to recover 3D information about the instrument position.
• Several pathways of 3D structures of intra-body cavities, such as bronchial airways or blood vessels, can be projected into similar 2D curves on the intraoperative image.
• the 3D information obtained with the markers may be used to differentiate between such pathways, as shown, e.g., in Application PCT/IB2015/000438.
• an instrument is imaged by an intraoperative device and projected to the imaging plane 505. It is unknown whether the instrument is placed inside pathway 520 or 525 since both pathways are projected into the same curve on the image plane 505.
• the markers observed on the preoperative image are named "G" and "F”.
• the differentiation process between 520 and 525 can be performed as follows:
• Fluoroscopic device uses anatomical elements detected both in the Fluoroscopic image and in the CT scan as an input to a pose estimation algorithm that produces a Fluoroscopic device Pose (e.g., orientation and position) with respect to the CT scan.
• Pose e.g., orientation and position
• the following extends this method by adding 3D space trajectories, corresponding to an endobronchial device position, to the inputs of the registration method.
• These trajectories can be acquired by several means, such as: attaching positional sensors along a scope or by using a robotic endoscopic arm.
• Such an endo-bronchial device will be referred from now on as Tracked Scope.
• the Tracked scope is used to guide operational tools that extends from it to the target area (see Figure 7).
• the diagnostic tools may be a catheter, forceps, needle, etc.
• the following describes how to use positional measurements acquired by the Tracked scope to improve the accuracy and robustness of the registration method shown herein.
• the registration between Tracked Scope trajectories and coordinate system of Fluoroscopic device is achieved through positioning of the Tracked Scope in various locations in space and applying a standard pose estimation algorithm. See the following paper for a reference to a pose estimation algorithm: F. Moreno-Noguer, V. Lepetit and P. Fua in the paper "EPnP: Efficient Perspective-n-Point Camera Pose Estimation", which is hereby incorporated by reference in its entirety.
• the pose estimation method disclosed herein is performed through estimating a
• adding the Tracked Scope trajectories as an input to the pose estimation method extends this method.
• These trajectories can be transformed into the Fluoroscopic device coordinate system using the methods herein. Once transformed to the Fluoroscopic device coordinate system, the trajectories serve as additional constraints to the pose estimation method, since the estimated pose is constrained by the condition that the trajectories must fit the bronchial airways segmented from the registered CT scan.
• the Fluoroscopic device estimated Pose may be used to project anatomical elements from the pre-operative CT to the Fluoroscopic live video in order to guide an operational tool to a specified target inside the lung.
• Such anatomical elements may be, but are not limited to,: a target lesion, a pathway to the lesion, etc.
• the projected pathway to the target lesion provides the physician with only two-dimensional information, resulting in a depth ambiguity, that is to say several airways segmented on CT may correspond to the same projection on the 2D Fluoroscopic image. It is important to correctly identify the bronchial airway on CT in which the operational tool is placed.
• One method used to reduce such ambiguity, described herein, is performed by using radiopaque markers placed on the tool providing depth information.
• the Tracked scope may be used to reduce such ambiguity since it provides the 3D position inside the bronchial airways. Having such approach applied to the brunching bronchial tree, it allows eliminating the potential ambiguity options until the Tracked Scope tip 701 on Figure 7. Assuming the operational tool 702 on Figure 7 does not have the 3D trajectory, although the abovementioned ambiguity may still happen for this portion 702 of the tool, such event is much less probable to occur. Therefore this embodiment of current invention improves the ability of the method described herein to correctly identify the current tool's position.
• the present invention provides among other things novel methods and compositions for treating mild to moderate acute pain and/or inflammation. While specific embodiments of the subject invention have been discussed, the above specification is illustrative and not restrictive. Many variations of the invention will become apparent to those skilled in the art upon review of this specification. The full scope of the invention should be determined by reference to the claims, along with their full scope of equivalents, and the specification, along with such variations.

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• 2017
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