WO2021162355A1 - Procédé et appareil pour fournir des données de guidage pour un dispositif d'insertion d'instrument médical intravasculaire - Google Patents

Procédé et appareil pour fournir des données de guidage pour un dispositif d'insertion d'instrument médical intravasculaire Download PDF

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Publication number
WO2021162355A1
WO2021162355A1 PCT/KR2021/001537 KR2021001537W WO2021162355A1 WO 2021162355 A1 WO2021162355 A1 WO 2021162355A1 KR 2021001537 W KR2021001537 W KR 2021001537W WO 2021162355 A1 WO2021162355 A1 WO 2021162355A1
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WIPO (PCT)
Prior art keywords
blood vessel
target area
intermediate target
medical tool
processor
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PCT/KR2021/001537
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English (en)
Korean (ko)
Inventor
권지훈
김영학
김경환
이채혁
송교석
Original Assignee
재단법인 아산사회복지재단
울산대학교 산학협력단
주식회사 메디픽셀
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Publication of WO2021162355A1 publication Critical patent/WO2021162355A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0113—Mechanical advancing means, e.g. catheter dispensers
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06N—COMPUTING ARRANGEMENTS BASED ON SPECIFIC COMPUTATIONAL MODELS
    • G06N20/00—Machine learning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/102—Modelling of surgical devices, implants or prosthesis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/107—Visualisation of planned trajectories or target regions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2065—Tracking using image or pattern recognition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B2034/303—Surgical robots specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M2025/0166—Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided

Definitions

  • a guide wire is a tool for setting a route for transporting a stent, etc. into a blood vessel through a catheter.
  • visual information based on medical images such as angiography and fine hand Tactile information based on the senses of
  • a method of providing guide data for a medical tool insertion device performed by a processor, the method comprising: setting an initial position of a distal end of a medical tool inserted into a blood vessel in a blood vessel image as a starting point; , determining a middle target point in a path from the starting point to a destination point based on a blood vessel branch point, and in at least a partial area of the blood vessel image. and providing guide data including at least a portion of the intermediate target area.
  • the guide data providing method includes generating blood vessel structure data by obtaining connection information between branch points of blood vessels from the blood vessel image, and searching for a path to the target region based on the blood vessel structure data.
  • the determining of the intermediate target area includes generating a basic intermediate target area at a position corresponding to a branching point in the blood vessel image, and selecting an additional intermediate target area based on a distance between the basic intermediate target areas. determining whether to create or not.
  • the determining of the intermediate target areas may include determining the number of the additional intermediate target areas to be generated between the basic intermediate target areas according to a distance between the basic intermediate target areas.
  • the method of providing guide data includes outputting an intermediate target area graphic object to a position where the intermediate target area is generated in the blood vessel image, and when it is determined that the tip of the medical tool reaches the target area selected from the intermediate target area , deleting the graphic object of the target region from the blood vessel image.
  • the method for guiding a medical tool inserted into a blood vessel includes setting an initial position of the tip of the medical tool in a blood vessel image as a starting point, within a path from the starting point to a destination point. determining a middle target point based on a blood vessel branch point, corresponding to at least a portion of the blood vessel image, and providing guide data including at least a portion of the intermediate target area generating, and moving the distal end of the medical tool to the intermediate target area by driving the medical tool insertion device based on the guide data.
  • a point different from the target area in the intermediate target area is set as the next target area may include steps.
  • the next target area may be an intermediate target area closest to the target area along a traveling direction of the distal end of the medical tool.
  • the guide data providing method may search for a path for moving a medical tool (eg, a medical tool) of the medical tool insertion apparatus to a target region within a blood vessel. After searching for the optimal path, the medical tool insertion apparatus for controlling the medical tool may provide a recognizable intermediate destination by generating an intermediate target area on the path.
  • a medical tool eg, a medical tool
  • the method for guiding a device for inserting a medical tool may generate a basic intermediate target area based on a blood vessel branch point and then generate an additional intermediate target area according to a distance between the basic intermediate target areas, the mobile device may Even in the partial blood vessel image divided from the blood vessel image, the tip of the medical tool can be moved to the intermediate destination. Accordingly, the processor performing the method for guiding the apparatus for inserting a medical tool can precisely move the medical tool to the target area without remote control by an operator.
  • FIG. 1 is a diagram illustrating an operation of an apparatus for inserting a medical tool and a medical tool according to an exemplary embodiment.
  • FIG. 2 is a flowchart illustrating a method of providing guide data according to an exemplary embodiment.
  • FIG. 3 is a diagram illustrating generation of a blood vessel structure image in which an intermediate target region is generated from a blood vessel image according to an exemplary embodiment.
  • FIG. 4 is a diagram illustrating generation of blood vessel structure data from a blood vessel image according to an exemplary embodiment.
  • FIG. 5 is a diagram illustrating generating a path from blood vessel structure data to a target region and generating a location corresponding to a branch point of a blood vessel as a basic intermediate target region according to an exemplary embodiment.
  • FIG. 6 is a flowchart illustrating the creation of an additional intermediate target area according to an embodiment.
  • FIG. 7 is a diagram illustrating generation of an additional intermediate target region from an image of a blood vessel structure in which a basic intermediate target region is generated, according to an exemplary embodiment.
  • FIG. 8 is a diagram illustrating movement of a medical tool insertion device from a starting point to a destination area according to an exemplary embodiment
  • FIG. 9 is a block diagram schematically illustrating a configuration of a system for moving a medical tool insertion device according to an embodiment.
  • first or second may be used to describe various components, these terms should be interpreted only for the purpose of distinguishing one component from another.
  • a first component may be termed a second component, and similarly, a second component may also be termed a first component.
  • FIG. 1 is a diagram illustrating operations of a medical tool insertion apparatus 110 and a medical tool 120 according to an exemplary embodiment.
  • the medical tool insertion apparatus 110 may move the medical tool 120 to the blood vessel target area according to a driving command from the processor.
  • the medical tool insertion device 110 may move the distal end of the medical tool 120 to the blood vessel target region.
  • the medical tool insertion device 110 may be implemented as a robot for performing surgery, for example, a robot for controlling a medical tool for cardiovascular intervention.
  • the medical tool 120 is a member inserted into a blood vessel, and may include a medical tool disposed at the tip of the medical tool 120 and a medical wire connecting the medical tool to the driving unit.
  • the medical wire may include, for example, a catheter or a guidewire.
  • the guide wire may refer to a medical wire used for inserting and guiding the above-described medical tool to a target site of a blood vessel.
  • the medical tool may be a surgical tool operated under the control of a doctor, for example, an introducer kit.
  • the medical tool insertion device 110 may determine the above-described driving command by using the guide data. For example, the medical tool insertion apparatus 110 may output a driving command from the guide data by performing an operation according to the machine learning model.
  • the machine learning model is a model designed and trained to receive guide data and output guide data, and may be implemented as, for example, a neural network model.
  • the driving command may represent a command for operating a driving unit connected to the medical tool 120 to move and rotate the medical tool 120 .
  • the driving command may be, for example, a forward command, a reverse command, a clockwise rotation command, and a counterclockwise rotation command, but is not limited thereto.
  • the guide data may represent data in which guide information is mapped to a blood vessel image or a blood vessel structure image.
  • the blood vessel structure image is an image in which a specific blood vessel is extracted from the blood vessel image, and may be an image obtained by preprocessing the blood vessel image.
  • the blood vessel structure image will be described with reference to FIG. 3 below.
  • the blood vessel image may be an image generated using corona angiography (CAG) or magnetic resonance imaging (MRI). In the blood vessel image, not only blood vessels but also the medical tool 120 may be photographed.
  • CAG corona angiography
  • MRI magnetic resonance imaging
  • the guide information is information for guiding the movement and rotation of the medical tool 120, and may include, for example, information about a point where the medical tool 120 should start, a point through which the medical tool 120 should start, and information about a target area in a blood vessel. have.
  • the information about each point may include, but is not limited to, image coordinates in the blood vessel structure image of the corresponding point.
  • guide information may be visually mapped to the blood vessel structure image. For example, a graphic object corresponding to each target region may be visualized in the blood vessel structure image, and the blood vessel structure image in which the target region is visualized may be represented as a guide image.
  • the medical tool insertion device 110 may receive guide data from an external device (eg, a guide data providing device).
  • the guide data providing apparatus may receive and analyze a blood vessel image from the blood vessel imaging device 130 , and generate guide data from the blood vessel image.
  • the medical tool insertion device 110 may be implemented integrally with the guide data providing device described above. In this case, the medical tool insertion apparatus 110 may receive a blood vessel image from the blood vessel imaging device 130 , and may generate guide data by analyzing the received blood vessel image.
  • the processor of the medical tool insertion apparatus 110 may determine to drive the medical tool 120 based on a result of analyzing the blood vessel image.
  • the medical tool insertion apparatus 110 may generate guide data by analyzing the received blood vessel image, and may determine a driving command from the generated guide data. For example, the medical tool insertion apparatus 110 may select one of a forward command, a backward command, a clockwise rotation command, and a counterclockwise rotation command from the guide data as an operation command.
  • the driving unit of the medical tool insertion device 110 may be driven according to a selected operation command. For example, the driving unit may advance the medical tool 120 in response to the forward command. The driving unit may retract the medical tool 120 in response to the reverse command.
  • the driving unit may rotate the guide wire clockwise with respect to the longitudinal axis of the guide wire in response to the clockwise rotation command. In response to the counterclockwise rotation command, the driving unit may rotate the guide wire counterclockwise with respect to the longitudinal axis of the guide wire.
  • the medical tool insertion apparatus 110 may move the distal end of the medical tool 120 to a point guided by the guide data by determining a series of operation commands using the guide data generated by analyzing the blood vessel image. .
  • the medical tool insertion apparatus 110 may move the distal end of the medical tool 120 to the final target area by repeating the operation determination using the guide data. After the distal end of the medical tool 120, for example, the medical tool reaches the target area, the medical tool may perform a surgical operation under the control of the doctor.
  • FIG. 2 is a flowchart illustrating a method of providing guide data according to an exemplary embodiment.
  • the processor may set the initial position of the tip of the medical tool inserted into the blood vessel in the blood vessel image as the starting point.
  • the initial position may be a position corresponding to a point in the blood vessel at a time point at which the tip of the medical tool is first identified in the blood vessel region.
  • a starting point may be set in the vascular structure image in which a specific blood vessel is extracted from the blood vessel image.
  • the processor may determine an intermediate target area within a path from the starting point to the target area based on the blood vessel branch point.
  • the target region may be a location in the blood vessel image designated by an operator or a processor.
  • the processor may identify the branching point of the blood vessel as a location corresponding to the branching point of the blood vessel.
  • the processor may determine a path from the starting point to the target region as the shortest distance in the blood vessel image.
  • the processor may determine the route based on the blood vessel structure data generated by obtaining connection information between branch points of the blood vessel. Determining a path by the processor from the starting point to the destination area will be described in detail with reference to FIGS. 4 and 5 .
  • the processor may determine an intermediate target area within the path. For example, the processor may set basic intermediate target regions based on the branching point of a blood vessel, and may set additional intermediate target regions according to a distance between the basic intermediate target regions. Setting the basic intermediate target area and the additional intermediate target area will be described in detail with reference to FIGS. 6 and 7 .
  • the guide data providing device provides the guide data in which the intermediate target area including the basic intermediate target area and the additional intermediate target area is set to the medical tool insertion device.
  • the medical tool insertion apparatus may move the distal end of the medical tool to the intermediate target area set in a series of images corresponding to each partial area.
  • the medical tool insertion device can move the medical tool tip to the final target area.
  • the processor may provide guide data corresponding to at least a partial region of the blood vessel image and including at least a part of the intermediate target region.
  • the guide data may be data in which guide information (eg, a position of a starting point, a target region, and an intermediate target region) is set in a blood vessel image or a blood vessel structure image.
  • the guide data may include a guide image visualized by overlapping graphic objects corresponding to a start point, a target region, and an intermediate target region on a blood vessel image or a blood vessel structure image.
  • the processor may determine whether the distal end of the medical tool has reached the target area or the intermediate target area based on whether the distal end of the medical tool overlaps the target area or the intermediate target area by a predetermined area in the blood vessel image. .
  • the processor may calculate a ratio of the medical tool tip portion among the target region or the intermediate target region in the blood vessel image, and when the calculated ratio is greater than or equal to the threshold ratio, it may be determined that the medical tool tip has reached the target region or the intermediate target region.
  • Steps 210 to 230 of FIG. 2 described above may be performed by the processor of the guide data providing apparatus, but are not limited thereto, and may be performed by the processor of the medical tool insertion apparatus.
  • FIG. 3 is a diagram illustrating generation of a blood vessel structure image 320 in which an intermediate target region 322 is generated from a blood vessel image 310 according to an exemplary embodiment.
  • the processor may receive the blood vessel structure image 320 generated from the blood vessel image 310 , but the present invention is not limited thereto and the processor may directly generate the blood vessel structure image 320 .
  • the blood vessel structure image 320 may be an image in which a blood vessel identified from the blood vessel image 310 and the structure and connection relationship of the blood vessel are displayed.
  • the processor may generate the blood vessel structure image 320 by dividing the blood vessel region and the background region from the blood vessel image 310 by using an edge detecting method.
  • the boundary detection method may be a boundary detection of a region in which the grayscale level of an arbitrary pixel and neighboring pixels rapidly changes, but is not limited thereto, and may be another method of detecting a boundary between a blood vessel region and a background region. may be
  • the processor may extract a target blood vessel from an image in which the blood vessel region and the background region are separated, based on a thickness of a blood vessel in the blood vessel region and a grayscale level in the image.
  • the blood vessel image 310 may include a blood vessel other than the cardiovascular system.
  • the blood vessel in which the molding agent is injected may have a lower grayscale level than the blood vessel in which the molding agent is not injected, and the blood vessel in which the medical tool 321 is movable may have a thicker vessel than the blood vessel in which the molding agent is not injected.
  • the processor may determine a blood vessel having a thickness greater than a threshold thickness and a grayscale level lower than the threshold grayscale level among the blood vessel regions as cardiovascular.
  • the present invention is not limited thereto, and the processor may distinguish a blood vessel region to be extracted using a trained machine learning model.
  • the processor may search for a path from a starting point to a target region using the blood vessel structure image 320 , and includes a starting point, a target region, and an intermediate target region 322 based on the searched path.
  • a blood vessel structure image 320 including guide data may be provided.
  • FIG. 4 is a diagram illustrating generation of blood vessel structure data from a blood vessel image according to an exemplary embodiment.
  • the processor may extract a blood vessel region from the blood vessel image 410 , and may recognize a location where a blood vessel branch starts in the blood vessel region as a blood vessel branch point.
  • the recognized blood vessel is shown as a solid line, and the position identified as a branch point of the vessel and the distal point of the vessel are shown as nodes.
  • the processor may identify a branching point and a branching blood vessel from the blood vessel image 410 .
  • the processor may identify a branch point while scanning along the blood vessel from the starting point to the end of the blood vessel, and may identify a blood vessel branching from the identified branch point.
  • the branching point may include a blood vessel extending from the inlet to the end of the blood vessel and one or more remaining blood vessels branching from the branching point.
  • the branching point may indicate a point within a blood vessel at which a blood vessel branches into at least two or more blood vessel branches.
  • the processor may identify a point where two or more blood vessel branches are formed as a branch point while scanning the blood vessel, and identify a blood vessel connecting the branch point to another branch point.
  • the processor may generate the blood vessel structure data 430 based on the branch point identified from the blood vessel image 420 and connection information of the branched blood vessel.
  • the processor may generate node data indicating a branching point and edge data indicating a branched blood vessel. Since a branched blood vessel is connected to two different branching points, the processor can connect two node data to one edge data, and the node data can map edge data corresponding to the number of branched blood vessels. .
  • the connection information between the branching point and the branched blood vessel may be information indicating a connection relationship between the branching point and the branched blood vessel.
  • the connection information may be generated using edge data mapped to node data and node data that is a connection target of the edge data.
  • the processor may structure the blood vessel data based on the connection information. For example, the processor may create a tree structure in which the node and the edge are connected by using a branch point closest to the blood vessel introduction part as a root node.
  • the root node is a node corresponding to the highest branching point, and may be, for example, a node corresponding to a starting point.
  • FIG. 5 is a diagram illustrating generation of a path from blood vessel structure data to a target region 522 and generating a location corresponding to a branch point of a blood vessel as a basic intermediate target region according to an exemplary embodiment.
  • the processor may search for a path from a root node corresponding to the starting point 521 to a node or an edge corresponding to the target region 522 from the blood vessel structure data formed in a tree-type graph.
  • the processor may search for a path based on the number of nodes that must pass from the root node to the node or edge corresponding to the destination region 522 , and searches for a path from the root node to a specific node through the minimum node. can do.
  • the blood vessel structure data is formed in a tree-type graph, and the processor may acquire the level of each node while forming the blood vessel structure data.
  • the level of a node may mean how many nodes must pass from the root node to reach a specific node.
  • the specific node corresponding to the target region 522 may be a leaf node that does not have a child node at the bottom of the tree graph, and the processor is configured to operate at the level of the leaf node and the root node.
  • the shortest path can be calculated based on the difference.
  • the processor may determine, as the shortest path, a path in which the number of nodes passed from the root node to the specific node corresponds to a level difference between the leaf node and the root node.
  • the part corresponding to the target area 522 may be an edge rather than a node. In this case, the processor may search for a shortest path to reach one of the two nodes to which the edge is connected.
  • a method for searching for a path from the starting point 521 to the destination region 522 may be using a tree traversal method as well as using a level difference from a root node to a specific node.
  • the processor may determine a location in the image 530 corresponding to nodes on the path as the intermediate target region 531 .
  • the processor visualizes the starting point 521 , the target area 522 , and the intermediate target area 531 as graphic objects at positions corresponding to the starting point 521 , the target area 522 , and the intermediate target area 531 . can do.
  • the processor may overlap and display the start point 521 , the target area 522 , and the intermediate target area 531 at positions corresponding to the respective points in the image 530 .
  • FIG. 6 is a flowchart illustrating the creation of an additional intermediate target area according to an embodiment.
  • the processor may set an intermediate target area at a position corresponding to a branch point in the blood vessel image as a basic intermediate target area, and calculate a distance between adjacent basic intermediate target areas in units of image pixels.
  • the processor may determine whether to additionally set the intermediate target area according to the distance between the undulation target areas calculated in units of image pixels. When the processor determines that the distance between the basic intermediate target areas is greater than the threshold distance, the processor may proceed to step 630 , and when it is determined that the distance between the basic intermediate target areas is smaller than the threshold distance, it may determine that it is not necessary to set an additional intermediate target area.
  • the additional intermediate target area may be generated.
  • the guide data providing apparatus or the medical tool insertion apparatus may generate the guide patch image by dividing and enlarging the blood vessel image or the blood vessel structure image in units of patches.
  • the guide patch image may be used to accurately determine the operation of the medical tool insertion device.
  • the guide data device may generate an additional intermediate target area on the movement path found in the blood vessel image of the divided patch area. Since the additional intermediate target area is created on the path that the medical tool tip must pass, the medical tool insertion device can accurately move the medical tool tip to the final target area simply by moving the medical tool tip to the additional intermediate target area within the segmented patch area. have.
  • the additional intermediate target region may provide information on the exact position to which the medical tool tip should be moved on some paths shown in the divided patch regions among the entire paths.
  • the processor may determine the threshold distance according to the patch size. For example, when a blood vessel image is enlarged with a square patch, the length of one side of the square may be set as a threshold distance.
  • the medical tool insertion apparatus uses the patch image, for example, Using the machine learning model, it is possible to calculate a series of motion commands for moving the tip of the medical tool to the next target area.
  • the processor may change the threshold distance according to the size of the patch for enlarging the blood vessel image.
  • the size of the patch may be changed in real time according to the complexity of the vascular structure.
  • the size of the rectangular patch has a default value of 84 x 84 pixels, and may increase or decrease according to the complexity of the vascular structure.
  • the processor may determine the threshold distance to be 84 pixels, which is the length of one side of the square patch, but may also be determined to be 50 pixels according to the operator's choice.
  • FIG. 7 is a diagram illustrating generation of an additional intermediate target region from an image of a blood vessel structure in which a basic intermediate target region is generated, according to an exemplary embodiment.
  • the processor may generate an image 720 in which additional intermediate target areas 721 are set from the image 710 in which basic intermediate target areas 711 and 712 are set.
  • the additional intermediate target areas 721 may be set according to a distance between the basic intermediate target areas 711 and 712 .
  • the medical tool insertion apparatus may determine the operation command using a patch image including a partial path instead of using the image of the entire blood vessel region.
  • the patch image is a patch divided from the blood vessel image or the blood vessel structure image, and may include some paths between the basic intermediate target regions 711 and 712 .
  • the medical tool insertion apparatus may segment the patch image corresponding to the current position of the distal end of the medical tool based on the path searched for in the entire blood vessel region.
  • the segmented patch image may include at least one additional intermediate target region 721 together with the distal end of the medical tool. This is because the additional intermediate target area 721 is set according to the distance between the basic intermediate target areas as described above with reference to FIG. 6 . Accordingly, the medical tool insertion device may calculate an operation command from the machine learning model by using the current position of the tip of the medical tool and the additional intermediate target region 721 .
  • the distance between the basic intermediate target regions 711 and 712 may vary depending on the blood vessel structure of the recipient.
  • the processor may determine the number of additional intermediate target areas 721 according to a distance between the basic intermediate target areas 711 and 712 .
  • the processor may determine the distance between the additional intermediate target areas 721 by comparing the distance between the basic intermediate target areas 711 , 712 with a distance that is a multiple of the threshold distance. That is, the processor may calculate n (n is a natural number) satisfying Equation 1, and determine n as the number of additional intermediate target areas 721 generated between the basic intermediate target areas 711 and 712 .
  • the processor divides the additional intermediate target areas 721 between the basic intermediate target areas 711 and 712 at equal intervals. It may be created and visualized as an intermediate target area by overlapping the intermediate target area graphic object on the blood vessel image or the blood vessel structure image.
  • the processor may generate the additional intermediate target area 721 at equal intervals between the basic intermediate target areas 711 and 712 , but is not limited thereto, and at least one intermediate target area 721 may be used in an image enlarged in units of patches. Other embodiments that allow the identification of target areas may also emerge. Since the additional intermediate target area 721 is visualized, each patch image divided into patch units may include the intermediate target area. Accordingly, the medical tool insertion apparatus may calculate an operation command for moving the distal end of the medical tool to the newly created intermediate target area using the patch image.
  • FIG. 8 is a diagram illustrating movement of a medical tool insertion device from a starting point to a destination area according to an exemplary embodiment
  • the processor providing guide data outputs the intermediate target area graphic objects 811 and 812 at the location where the intermediate target area is generated in the blood vessel image, and the distal end of the medical tool reaches the target area selected from the intermediate target area. If it is determined that , the graphic object 811 of the target region may be deleted from the blood vessel image.
  • the processor may determine an intermediate target area closest to the distal end of the medical tool as the target area along the progress direction of the medical tool from the blood vessel image. By deleting the graphic object of the target area when the tip of the medical tool reaches the target area, the processor can visualize in real time a situation in which the tip of the medical tool is moved to the target area 821 .
  • the processor When the processor according to an embodiment recognizes that the graphic object of the target area is deleted, the processor provides an index for evaluating the operation of the medical tool insertion apparatus, so that the medical tool insertion apparatus can learn the operation by itself. That is, it is possible to provide data used for training a machine learning model through an artificial neural network.
  • FIG. 9 is a block diagram schematically showing the configuration of a medical tool guide device according to an embodiment.
  • a medical tool guide system 900 for moving a medical tool 941 inserted into a blood vessel may include a medical tool insertion device 940 and a guide data providing device 910 .
  • the guide data providing device 910 may receive a blood vessel image or a blood vessel structure image from the blood vessel imaging device 950 through the input/output interface 913 , and transmit guide data including the guide image to the medical tool insertion device 940 . can be created and provided.
  • the memory 912 of the guide data providing apparatus 910 may at least temporarily store data and guide images generated by the processor 911 .
  • the processor 911 of the guide data providing device 910 sets the initial position of the distal end 941 of the medical tool as the starting point in the blood vessel image, and sets the intermediate target area within the path from the starting point to the target area as the blood vessel branching point.
  • Guide data determined as a reference, corresponding to at least a partial region of the blood vessel image, and including at least a part of an intermediate target region may be provided. Since the operation of the processor 911 of the guide data providing apparatus 910 has been described above, a detailed description thereof will be omitted.
  • the medical tool insertion device 940 may move the medical tool 941 based on the guide data received from the guide data providing device 910 .
  • the processor 911 of the guide data providing device 910 or the processor of the medical tool insertion device 940 is an operation command for moving the medical tool 941 based on guide data including a guide image.
  • the guide data providing apparatus 910 and the medical tool insertion apparatus 940 may be divided according to functions.
  • the guide data providing device 910 and the medical tool insertion device 940 may be devices that perform different functions within a single device housing. That is, the processors of the guide data providing apparatus 910 and the medical tool insertion apparatus 940 may perform different functions as one processor.
  • the present invention is not limited thereto, and the guide data providing device 910 and the medical tool insertion device 940 may be implemented as separate devices independent of each other.
  • the processor may drive the medical tool insertion device 940 based on the generated guide data.
  • the processor may set a point different from the target area among the intermediate target areas as the next target area.
  • the next target area may be an intermediate target area closest to the target area along the moving direction of the distal end 941 of the medical tool.
  • the processor reaches the target area, the medical tool tip 941 can be moved to a series of intermediate target areas by continuously setting the next target area, and finally the medical tool tip 941 can be positioned as the target area. have.
  • the embodiments described above may be implemented by a hardware component, a software component, and/or a combination of a hardware component and a software component.
  • the apparatus, methods and components described in the embodiments may include, for example, a processor, a controller, an arithmetic logic unit (ALU), a digital signal processor, a microcomputer, a field programmable gate (FPGA) array), a programmable logic unit (PLU), a microprocessor, or any other device capable of executing and responding to instructions.
  • the processing device may execute an operating system (OS) and one or more software applications running on the operating system.
  • the processing device may also access, store, manipulate, process, and generate data in response to execution of the software.
  • OS operating system
  • the processing device may also access, store, manipulate, process, and generate data in response to execution of the software.
  • the processing device includes a plurality of processing elements and/or a plurality of types of processing elements. It can be seen that can include For example, the processing device may include a plurality of processors or one processor and one controller. Other processing configurations are also possible, such as parallel processors.
  • the software may comprise a computer program, code, instructions, or a combination of one or more thereof, which configures a processing device to operate as desired or is independently or collectively processed You can command the device.
  • the software and/or data may be any kind of machine, component, physical device, virtual equipment, computer storage medium or device, to be interpreted by or to provide instructions or data to the processing device. , or may be permanently or temporarily embody in a transmitted signal wave.
  • the software may be distributed over networked computer systems, and stored or executed in a distributed manner. Software and data may be stored in one or more computer-readable recording media.
  • the method according to the embodiment may be implemented in the form of program instructions that can be executed through various computer means and recorded in a computer-readable medium.
  • the computer-readable medium may include program instructions, data files, data structures, etc. alone or in combination.
  • the program instructions recorded on the medium may be specially designed and configured for the embodiment, or may be known and available to those skilled in the art of computer software.
  • Examples of the computer-readable recording medium include magnetic media such as hard disks, floppy disks and magnetic tapes, optical media such as CD-ROMs and DVDs, and magnetic such as floppy disks.
  • - includes magneto-optical media, and hardware devices specially configured to store and execute program instructions, such as ROM, RAM, flash memory, and the like.
  • Examples of program instructions include not only machine language codes such as those generated by a compiler, but also high-level language codes that can be executed by a computer using an interpreter or the like.
  • the hardware devices described above may be configured to operate as one or more software modules to perform the operations of the embodiments, and vice versa.

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Abstract

Un procédé par lequel un processeur fournit des données de guidage pour un dispositif d'insertion d'instrument médical comprend les étapes consistant à: définir, en tant que point de départ, la position initiale d'une partie d'extrémité avant d'un instrument médical inséré dans un vaisseau sanguin, dans une image de vaisseau sanguin; à déterminer, à l'intérieur du trajet allant du point de départ au point de destination, un point cible intermédiaire sur la base d'un point de ramification de vaisseau sanguin; et fournir des données de guidage qui correspondent à au moins une zone partielle de l'image de vaisseau sanguin, et comprenant au moins une partie du point cible intermédiaire.
PCT/KR2021/001537 2020-02-10 2021-02-05 Procédé et appareil pour fournir des données de guidage pour un dispositif d'insertion d'instrument médical intravasculaire WO2021162355A1 (fr)

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