WO2022179877A1 - Détection d'un dispositif introduit dans un tissu biologique par imagerie médicale - Google Patents

Détection d'un dispositif introduit dans un tissu biologique par imagerie médicale Download PDF

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Publication number
WO2022179877A1
WO2022179877A1 PCT/EP2022/053520 EP2022053520W WO2022179877A1 WO 2022179877 A1 WO2022179877 A1 WO 2022179877A1 EP 2022053520 W EP2022053520 W EP 2022053520W WO 2022179877 A1 WO2022179877 A1 WO 2022179877A1
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WO
WIPO (PCT)
Prior art keywords
marking
markings
devices
image data
detected
Prior art date
Application number
PCT/EP2022/053520
Other languages
German (de)
English (en)
Inventor
Paulus Josephus Aloisius Borm
Rudolf Hubertus Johannes Schulze Vohren
Original Assignee
Nano4Imaging Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Nano4Imaging Gmbh filed Critical Nano4Imaging Gmbh
Publication of WO2022179877A1 publication Critical patent/WO2022179877A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3954—Markers, e.g. radio-opaque or breast lesions markers magnetic, e.g. NMR or MRI

Definitions

  • the invention relates to a method for detecting a first and at least one second device introduced into biological tissue using a medical imaging method, as well as a medical imaging device and an image processing unit for carrying out the method.
  • the devices introduced can be, for example, catheters or implants, which are typically made of non-biological material. Since medical imaging methods are designed to image biological tissue or biological structures, introduced devices are often not recognizable or at most only indirectly recognizable because they are not directly imaged.
  • the position and location of introduced devices in biological tissue can be shown with medical imaging, in which the introduced devices are provided with markings (markers) that are recognized and imaged directly by the imaging method.
  • the markers are made of a material that is detected by the imaging process, such as iron oxide nanoparticles in magnetic resonance imaging and magnetic particle imaging or materials with high absorptivity for X-rays in computed tomography or for ultrasound in sonography.
  • the positioning of the introduced device under observation in the medical imaging method can thus be facilitated.
  • US Pat. No. 6,574,497 B1 describes that markers from two different devices that have been introduced are detected on the screen of a medical imaging method. However, the recognition and evaluation of the markers in the displayed image is left to the viewer of the screen.
  • the aim of the invention is to improve the detection of at least two different devices introduced into biological tissue using a medical imaging method.
  • the two devices introduced each have markings (markers) that can be detected by the imaging method.
  • the at least two devices introduced may be a medical catheter and a guidewire.
  • the medical catheter can be a balloon catheter, for example for angioplasty, or a microcatheter for the local delivery of radioactive beads for the treatment of tumors or other drugs.
  • the devices introduced can be medical implants, for example in the form of a biopsy needle or a stent that is to be placed in biological tissue with the aid of a catheter and/or a guide wire.
  • an image data record with image data of the biological tissue and the markings is first generated with the device using the imaging method. At least one pixel of a first marking of the first introduced device is then detected in the image data record. Then at least one pixel of a second marking becomes one of the introduced ones Devices detected if the second mark is within a predetermined distance from the detected pixel of the first mark. For this purpose, a pixel of at least one further marking of the introduced devices is searched for in any spatial direction at a predetermined distance in the image data set. When such a pixel and the associated further markers have been detected, it is finally determined whether the detected second marker is a marker of the second device introduced.
  • steps b), c) and d) can be carried out automatically by a digital image processing algorithm.
  • the method according to the invention is not a therapeutic method because recognizing introduced devices in biological tissue does not constitute medical treatment of the human or animal body and also has no therapeutic effect. It is also not a diagnostic method, because no diagnosis of a patient's disease is carried out, but introduced devices in biological tissue are intended to be recognized. A surgical method is also not present because the method according to the invention has no invasive or surgical method step. The introduction of the devices to be detected is not part of the invention. There is no functional connection between the method according to the invention and the effect on the body. In particular, the method according to the invention should not be used therapeutically, diagnostically or surgically.
  • Markings of different devices introduced should be able to be distinguished as far as possible. A determination is to be made as to whether the detected second marker is a marker of the second inserted device or the first inserted device. In order to make this possible, it is advantageous if the markings of different devices that have been introduced each have different ones have features or properties that can be clearly assigned to the respective devices.
  • the markings of the first device introduced should therefore have a first feature, while the markings of the at least second device introduced have a second feature that is different from the first and clearly distinguishable by the imaging. The same applies to the markings of any other devices that may have been introduced.
  • the features or properties can be physical properties of the material of the markings, for example the magnetic spin in MRI, the relaxation time and/or the T1/T2 contrast in magnetic resonance imaging.
  • the markings of the devices introduced can have different shapes, with segmentation and/or pattern recognition of digital image processing being able to take place in order to determine the shapes of the two detected markings in the image data set.
  • the markings of the two devices introduced can have different materials, which are recognizable as different materials from the imaging, wherein in step d) an evaluation of properties of the image data (e.g. the amplitudes and/or the frequency) can be carried out in order to to determine the materials of the two detected markings in the image data set. It is advantageous if the different materials cause different amplitudes and/or different frequencies of the associated pixels of the two materials in the image data of the imaging.
  • the method according to the invention it is expedient to determine at least one further marking of the first device introduced and at least one further marking of the at least second device introduced.
  • the markings of different devices determined in this way can each be segmented and classified.
  • a first class contains the markings of the first introduced device and a second class contains the markings of the second introduced device.
  • the first class is associated with the first introduced device and the second class is associated with the second inserted device. Further classes may be provided for corresponding further introduced devices.
  • the various devices introduced can already be determined and observed in the image data set based on the number of markers identified in each case, without a human observer being required for this on a screen of the imaging method.
  • the second mark is a mark of the second device introduced
  • At least one further pixel of the same marking is detected by searching in the image data set for further pixels of the same marking within a predetermined distance from the detected pixel of the marking.
  • the shape, size, density or composition of the marker can be determined in the imaging system, thereby enabling the detection of the spatial position and/or orientation of the associated introduced device in the biological tissue.
  • the pixels can be segmented and then classified to identify the shape, size, density or composition of the marking.
  • each of different markings at least one pixel is determined in each case in the center of the markings in one exemplary embodiment.
  • the thus determined central image points of different markings of the same introduced device can then be connected to one another by a line.
  • the line generated in this way can be stored in the image data record in the form of image data. In this way, the shape, orientation, extent and/or position of the introduced device in the biological tissue can be determined and reconstructed in the image data set.
  • the detection of pixels of multiple markings of the at least two inserted devices it can be checked for each of the pixels of multiple markings of one of the two insertable devices whether there is a pixel of a marking of another inserted device within a predetermined distance from the pixel of the first marking.
  • the distance between the two pixels, between the two markers and/or between other pixels of the two markers can be determined and preferably observed over a period of time.
  • the method can be carried out several times at different points in time in order to observe changes in the position of the detected markers or changes in the relative position of markers of different inserted devices.
  • a medical imaging device is also provided with an image processing unit that is designed to carry out the method described above.
  • each of the two insertable devices is provided with a plurality of markings, for which the following applies to the distances between adjacent markings on the same insertable device: adjacent markings on one insertable device have the same spacing or an integer multiple of the spacing as adjacent markings the or other insertable device; adjacent markers of one insertable device are spaced from each other by a distance equal to the length or width of one of the markers of one or another insertable device and/or multiple markers of one insertable device are spaced apart by distances equal to the distances between corresponding markers of or correspond to another insertable device.
  • FIG. 1 shows a first view of the exemplary embodiment in a schematic representation
  • Fig. 2 is a second view of the embodiment in schematic
  • Fig. 3 is a third view of the embodiment in schematic
  • the three figures show a first device 12 in the form of a guide wire that can be inserted into biological tissue and a second device 14 that can be inserted into biological tissue in the form of a balloon catheter, which is placed in the biological tissue, more precisely in a blood vessel, of a patient with the help of the guide wire target.
  • Both are insertable devices rotationally symmetrical. Three or more insertable devices are also conceivable.
  • the first insertable device 12 is provided with three markings 16, 18, 20 in the form of annular circumferential strips of iron oxide.
  • the distance between the first marking 16 and the second marking 18 of the first device 12 is approximately 2 cm.
  • the distance between the second marking 18 and the third marking 20 of the first device 12 is also approximately 2 cm.
  • the second insertable device 14 is provided with a plurality of markers 22,24,26,28.
  • the distance between the first marking 22 and the second marking 24 of the second device 14 corresponds to the distance between the first two markings 16, 18 of the first device 12 and is therefore also approximately 2 cm.
  • the distance between the second marking 24 and the fourth marking 28 of the second device 14 corresponds to the distance between the second marking 18 and the third marking 20 of the first insertable device 12 and is therefore approximately 2 cm.
  • the distance between the third marker 26 and the fourth marker 28 of the second insertable device 14 is approximately equal to the axial width of the elongate first device 12.
  • FIG. 2 shows the two insertable devices 12, 14 one behind the other in the axial longitudinal direction.
  • the arrow in FIG. 2 indicates the direction in which the balloon catheter of the second insertable device 14 is to be advanced toward and over the guidewire of the first insertable device 12 .
  • the markings 16-28 of the two devices 12, 14 can be seen in the imaging of a magnetic resonance tomograph.
  • the imaging method of the magnetic resonance tomograph generates a digital image data set with the pixels of the imaged areas in a conventional manner. Due to their shape, size, density or composition, the markings 16-28 can be automatically recognized and differentiated from one another by imaging methods, with the principle of the imaging method being decisive for the structure of the algorithm.
  • the imaging method first searches for all pixels of the same marking for a detected pixel of one of the markings 16 , 18 , 20 .
  • the imaging process includes a digital image processing algorithm, the pixels by a
  • Pattern recognition method and assigned by a classification of the respective marking This procedure is repeated for each of the markers.
  • a pixel of a marking of the respective other insertable device is searched for at a predetermined distance.
  • the other markers of the other insertable device are also determined and the associated image points are identified, marked and stored in the image data set of the imaging method.
  • the image processing algorithm observes and tracks the positions of the markings on both devices 12, 14 .
  • the distances between markings of different devices 12, 14 that are close to one another are determined and tracked.
  • the distances between the pixels of the second marking 24 of the second device 14 and the second marking 18 of the first device 12 are observed while the two devices 12, 14 are displaced relative to one another. In Fig. 2 this distance is large. In Fig. 3 the distance is minimal. This can be recognized by the imaging method according to the invention.
  • the distances between the pixels of the first marking 16 of the first device 12 and the first marking 22 of the second device 14 are also observed and tracked.
  • the result of the distance measurement in relation to the two second markings 18, 24 can be confirmed as part of a redundancy measurement.
  • the same procedure is followed with regard to the distance between the pixels of the two third markings 20, 26 or the third marking 20 of the first device 12 and the fourth marking 28 of the second device 14.
  • the markers 26, 28 of the second device 14 and the third marker 18 of the first device 12 make it possible to determine whether the third marker 20 of the first device 12 is between the third marker 26 and fourth marker 28 of the second device 14.
  • the markings can be used in connection with the imaging method according to the invention as a “parking aid” in order to use the imaging method to determine whether the two devices 12, 14 introduced have a desired, predetermined distance and a preferred relative orientation to one another.
  • the invention also relates to a medical imaging device with an image processing unit, which is designed to carry out the method described above.
  • the invention relates in particular to an image processing unit with an electronic memory in which an image processing algorithm for executing the method described above is stored.
  • both the imaging device according to the invention and the image processing unit according to the invention are designed to generate an image data set with image data of the biological tissue and to detect at least one pixel of a first marking 16 of the first introduced device 12 in the image data set, and then at least one pixel of a second marking one of the inserted devices 12, 14 that is within a predetermined distance of the detected pixel of the first marker 16, finally determining whether the detected second marker is a marker of the second inserted device 14.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Image Processing (AREA)
  • Image Analysis (AREA)

Abstract

L'invention concerne un procédé de détection d'un premier et d'au moins un deuxième dispositif (12, 14), introduits dans un tissu biologique, à l'aide d'un procédé d'imagerie médicale, les deux dispositifs introduits présentant chacun des marqueurs en tant que marquages (16, 18, 20, 22, 24, 26, 28) qui peuvent être détectés par le procédé d'imagerie. Ce procédé est caractérisé par les étapes suivantes consistant : a) à produire un ensemble de données d'image contenant des données d'image du tissu biologique au moyen du procédé d'imagerie, b) à repérer dans l'ensemble de données d'image au moins un point d'image d'un premier marquage (16) du premier dispositif (12) introduit, c) à repérer dans l'ensemble de données d'image au moins un point d'image d'un deuxième marquage (22) d'un des dispositifs (12, 14) introduits, qui se trouve à une distance prédéfinie du point d'image repéré du premier marquage (16), d) à déterminer si le deuxième marquage (22) repéré est un marquage du deuxième dispositif (14) introduit.
PCT/EP2022/053520 2021-02-23 2022-02-14 Détection d'un dispositif introduit dans un tissu biologique par imagerie médicale WO2022179877A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102021104219.4 2021-02-23
DE102021104219.4A DE102021104219A1 (de) 2021-02-23 2021-02-23 Erkennung einer in biologisches Gewebe eingeführten Vorrichtung mit medizinischer Bildgebung

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WO2022179877A1 true WO2022179877A1 (fr) 2022-09-01

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5769789A (en) * 1993-02-12 1998-06-23 George S. Allen Automatic technique for localizing externally attached fiducial markers in volume images of the head
US6574497B1 (en) 2000-12-22 2003-06-03 Advanced Cardiovascular Systems, Inc. MRI medical device markers utilizing fluorine-19
WO2014144633A1 (fr) * 2013-03-15 2014-09-18 The Regents Of The University Of California Système et procédé pour la planification améliorée d'un traitement par radiothérapie à dose élevée
EP2959857A1 (fr) * 2013-02-21 2015-12-30 Koh Young Technology Inc. Système de poursuite et procédé de poursuite utilisant celui-ci
EP3031494A1 (fr) * 2014-12-10 2016-06-15 Nucletron Operations B.V. Système de vérification de position de curiethérapie et procédés d'utilisation
US20160310229A1 (en) * 2015-04-21 2016-10-27 The Board Of Trustees Of The Leland Stanford Junior University Devices and methods for trackable hearing protection in magnetic resonance imaging

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102010018291B4 (de) 2010-04-26 2018-12-20 Siemens Healthcare Gmbh Navigationssystem und Röntgensystem
DE102011078212B4 (de) 2011-06-28 2017-06-29 Scopis Gmbh Verfahren und Vorrichtung zum Darstellen eines Objektes
EP2861173B1 (fr) 2012-06-19 2016-04-06 Brainlab AG Procédé et appareil pour la détection d'une rotation indésirable de marqueurs médicaux

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5769789A (en) * 1993-02-12 1998-06-23 George S. Allen Automatic technique for localizing externally attached fiducial markers in volume images of the head
US6574497B1 (en) 2000-12-22 2003-06-03 Advanced Cardiovascular Systems, Inc. MRI medical device markers utilizing fluorine-19
EP2959857A1 (fr) * 2013-02-21 2015-12-30 Koh Young Technology Inc. Système de poursuite et procédé de poursuite utilisant celui-ci
WO2014144633A1 (fr) * 2013-03-15 2014-09-18 The Regents Of The University Of California Système et procédé pour la planification améliorée d'un traitement par radiothérapie à dose élevée
EP3031494A1 (fr) * 2014-12-10 2016-06-15 Nucletron Operations B.V. Système de vérification de position de curiethérapie et procédés d'utilisation
US20160310229A1 (en) * 2015-04-21 2016-10-27 The Board Of Trustees Of The Leland Stanford Junior University Devices and methods for trackable hearing protection in magnetic resonance imaging

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