Medical instrument guidance using stereo radiolocation

• US 20020103431A1
• Filed: 01/30/2001
• Published: 08/01/2002
• Est. Priority Date: 01/30/2001
• Status: Active Grant

• Current Assignee: Siemens Healthcare GMBH (Siemens AG)
• Original Assignee: Fischer Imaging Corporation
• Inventors: Toker, Emre, Nields, Morgan W.
• Granted Patent: US 6,678,546 B2
• Time in Patent Office: Days
• US Class Current: 600/436
• CPC Class Codes: A61B 6/04 Positioning of patients; Tiltable beds or the like operating tables A61G13/00; operating chairs A61G15/00
• CPC Class Codes: A61B 6/4258 for detecting non x-ray radiation, e.g. gamma radiation A61B6/037 takes precedence
• CPC Class Codes: A61B 6/4417 related to combined acquisition of different diagnostic modalities
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 8/08 Detecting organic movements or changes, e.g. tumours, cysts, swellings A61B8/02 - A61B8/06 take precedence

Abstract

A stereo radiolocalization and targeting system (100) includes a table assembly (102) for supporting a patient (104), a stereo radiolocalization subsystem (117), a medical instrument support subsystem (119), and an ultrasound imaging subsystem (121). The stereo radiolocalization subsystem (117) provides three-dimensional localization information for an area of interest within the patient'"'"'s body such as a sentinel node. The medical instrument support subsystem (119) allows for targeting of a medical instrument (118) to the area of interest for treatment, extraction or other procedures. The imaging subsystem (121) provides real-time imaging for use in penetration path selection and monitoring medical instrument insertion. Flexible positioning support mechanisms (120, 122, and 124) provide substantial positioning flexibility for various elements of the system (100).

Claims

1. An apparatus for use in performing a medical procedure on an area of interest within a patient'"'"'s body, comprising:

a patient support for supporting said patient in a substantially fixed position relative to a predetermined frame of reference;

a photon detector system for receiving photon emissions from the area of interest within the patient'"'"'s body and providing location information based on the emissions; and

a processor for receiving the location information from said photo detector system and identifying a three-dimensional spatial location of the area of interest relative to said predetermined frame of reference based on the location information.

2. An apparatus as set forth in claim 1, wherein said patient support includes means for supporting said patient in a prone position.

3. An apparatus as set forth in claim 1, wherein said patient support includes a table having an opening, wherein said photon detector system includes at least one detector element positionable beneath said table for accessing said patient via said opening.

4. An apparatus as set forth in claim 1, wherein said photon detector system comprises a gamma camera and a multiple pin hole collimator, said camera and collimator being cooperatively operative for providing said location information.

5. An apparatus as set forth in claim 1, wherein said photon detector system includes:

a first photon detector, mounted in known spatial relation to and moveable with respect to said predetermined frame of reference, for providing first information regarding said location of the area of interest; and

a second photon detector, mounted in known spatial relation to and moveable with respect to said predetermined frame of reference for providing second information regarding said location of the area of interest.

6. An apparatus as set forth in claim 5, wherein said processor is operative for using said first information, said second information and known geometric relationships involving the positions of each of said first and second detectors to determine said three-dimensional spatial location of the area of interest.

7. An apparatus as set forth in claim 5, further comprising means for determining the position of each of said first and second photon detectors.

8. An apparatus as set forth in claim 7, wherein said means for determining comprises one of a position encoder and a radio frequency location unit associated with said first and second photon detectors.

9. An apparatus as set forth in claim 1, further comprising a medical instrument support assembly mounted in known spatial relation to and moveable relative to said predetermined frame of reference for targeting a medical instrument to said location of interest identified by said processor.

10. An apparatus as set forth in claim 9, wherein said medical instrument support assembly includes a penetration path selection subassembly for allowing for selection as between a plurality of different paths for targeting said medical instrument wherein, for each said path, said medical instrument is targeted at said area of interest.

11. An apparatus as set forth in claim 1, further comprising a substantially real-time imaging system including a monitor, positionable for viewing by a physician performing said medical procedure on said patient, for providing an image of a portion of said patient'"'"'s body including said location of interest.

12. An apparatus as set forth in claim 11, wherein said monitor is mounted on said patient support.

13. An apparatus as set forth in claim 11, wherein said processor and said imaging system are operatively interconnected so as to allow for display of a marker indicative of said spatial location of the area of interest.

15. An apparatus as set forth in claim 14, wherein said photon detector system comprises a gamma camera and a multiple pin hole collimator, said camera and collimator being cooperatively operative for providing said location information.

16. An apparatus as set forth in claim 14, wherein said photon detector system includes:

a first photon detector, mounted in known spatial relation to and moveable with respect to said predetermined frame of reference, for providing first information regarding said location of the area of interest; and

a second photon detector, mounted in known spatial relation to and moveable with respect to said predetermined frame of reference for providing second information regarding said location of the area of interest.

17. An apparatus as set forth in claim 14, wherein said medical instrument support assembly includes a penetration path selection subassembly for allowing for selection as between a plurality of different paths for targeting said medical instrument wherein, for each said path, said medical instrument is targeted at said area of interest.

18. An apparatus as set forth in claim 14, further comprising a substantially real-time imaging system including a monitor, positionable for viewing by a physician performing said medical procedure on said patient, for providing an image of a portion of said patient'"'"'s body including said location of interest.

19. An apparatus as set forth in claim 18, wherein said processor and said imaging system are operatively interconnected so as to allow for display of a marker indicative of said spatial location of the area of interest.

14. An apparatus for use in performing a medical procedure on a area of interest within a patient'"'"'s body, comprising:

a patient support for supporting a patient in a substantially fixed position relative to a predetermined frame of reference;

a photon detector system including at least one photon detector mounted in known spatial relation to and movable relative to said predetermined frame of reference, for providing position information regarding the area of interest based on photons emitted therefrom;

a medical instrument support assembly, located in predetermined spatial relation to and movable relative to said predetermined frame of reference, for use in targeting a medical instrument at said area of interest; and

a processor for receiving first information regarding the location of the area of interest, receiving second information regarding a position of the medical instrument and providing guidance information for use in targeting the medical instrument at the area of interest.

20. An apparatus for use in performing a medical procedure on an area of interest within a patient'"'"'s body, comprising:

a radiolocalization system for use in identifying a said area of interest within said patient'"'"'s body;

a medical instrument support system including a penetration path selection subsystem for allowing for selection as between a plurality of different paths for targeting a medical instrument wherein, for each said path, said medical instrument is targeted at said area of interest; and

a substantially real-time imaging system for allowing a physician to monitor in substantially real-time insertion of said medical instrument into said patient'"'"'s body to said area of interest.

21. An apparatus as set forth in claim 20, wherein said radiolocalization system is operative for use in determining the three-dimensional spatial coordinates of the area of interest.

22. An apparatus as set forth in claim 20, wherein said radiolocalization system comprises first and second photon detectors for stereo radiolocation of said area of interest.

23. An apparatus as set forth in claim 20, wherein said radiolocalization system and said imaging system are operatively interconnected so as to permit display of a marker indicative of a location of said area of interest on an image of a portion of said patient'"'"'s body.

25. An apparatus as set forth in claim 24, wherein said flexible positioning system is operative for allowing angular positioning of the medical instrument support so as to target said medical instrument in a desired direction.

26. An apparatus as set forth in claim 25, wherein said flexible positioning system allows for angular positioning of said medical instrument relative to two transverse reference planes.

24. An apparatus for use in performing a medical procedure on an area of interest within a patient'"'"'s body, comprising:

a patient support for supporting said patient in a substantially fixed position relative to a predetermined frame of reference;

one or more photon detectors, mounted in known spatial relation to and moveable relative to the predetermined frame of reference, for identifying a position of the area of interest based on radio emissions therefrom;

a medical instrument to support, mounted in known spatial relation to and moveable relative to the predetermined frame of reference, for supporting a medical instrument for use in penetrating to the area of interest; and

a flexible positioning system, mounted in known spatial relation to and moveable relative to the predetermined frame of reference, for allowing movement of a medical device in three spatial dimensions relative to the predetermined frame of reference, wherein said medical device comprises one of said photon detector and said medical instrument support.