Surgical positioning system

• US 20020188194A1
• Filed: 07/29/2002
• Published: 12/12/2002
• Est. Priority Date: 01/28/1991
• Status: Active Grant

• Current Assignee: Integra Burlington MA, Inc. (Integra LifeSciences Holdings Corporation)
• Original Assignee: Sherwood Services AG
• Inventors: Cosman, Eric R.
• Granted Patent: US 6,662,036 B2
• Time in Patent Office: Days
• US Class Current: 600/426
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/371 with simultaneous use of two cameras
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/502 Headgear, e.g. helmet, spectacles
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/1127 using markers
• CPC Class Codes: A61B 6/0421 with immobilising means
• CPC Class Codes: A61B 6/0492 using markers or indicia for aiding patient positioning
• CPC Class Codes: A61B 6/08 Auxiliary means for directing the radiation beam to a particular spot, e.g. using light beams
• CPC Class Codes: A61B 6/5247 combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/14 : Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61B 90/16 : Bite blocks
• CPC Class Codes: A61B 90/20 : Surgical microscopes characterised by non-optical aspects
• CPC Class Codes: A61N 2005/105 : using a laser alignment system
• CPC Class Codes: A61N 2005/1051 : using an active marker
• CPC Class Codes: A61N 2005/1052 : using positron emission tomography [PET] single photon emission computer tomography [SPECT] imaging
• CPC Class Codes: A61N 2005/1059 : using cameras imaging the patient
• CPC Class Codes: A61N 2005/1061 : using an x-ray imaging system having a separate imaging source
• CPC Class Codes: A61N 5/1049 : for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1064 : for adjusting radiation treatment in response to monitoring
• CPC Class Codes: A61N 5/107 : in real time, i.e. during treatment
• CPC Class Codes: G06T 2207/10081 : Computed x-ray tomography [CT]
• CPC Class Codes: G06T 2207/30204 : Marker
• CPC Class Codes: G06T 7/73 : using feature-based methods

Abstract

A system for positioning and repositioning of a portion of a patient'"'"'s body with respect to a treatment or imaging machine includes multiple cameras to view the body and the machine. Index markers, either light-emitting, passive, geometric shapes, or natural landmarks, are identified and located by the cameras in 3D space. In one embodiment, such reference or index markers are in a determinable relationship to analogous markers used during previous image scanning of the patient. Anatomical targets determined from image scanning can be located relative to reference positions associated with the treatment or diagnostic machine. Several forms of camera, index markers, methods and systems accommodate different clinical uses. X-ray imaging of the patient further refines anatomical target positioning relative to the treatment or diagnostic imaging reference point. Movements of the patient based on comparative analysis of imaging determined anatomical targets relative to reference points on treatment or diagnostic apparatus are controlled by the system and process of the invention.

Claims

1. A system for location of a patient'"'"'s body with spatial points on a treatment or diagnostic apparatus in registration with image data from an image scanner, the image scanner having a scanner coordinate frame and providing the image data of at least a portion of said patient'"'"'s body scanned by said image scanner to said computer system to develop scanner marker coordinates in the scanner coordinate frame of scanner index markers located on said at least a portion of said patient'"'"'s body, and to develop scanner target coordinates in said scanner coordinate frame of at least one target in said at least a portion of said patient'"'"'s body, said system comprising:

a computer system to process camera data and the image data from the image scanner;

a camera system comprising two or more cameras, each having a field of view that comprises at least a portion of the patient'"'"'s body on the treatment or diagnostic apparatus, said camera system indexing positions of the spatial points within the field of view, having at least one reference point in a known position with respect to said treatment or diagnostic apparatus with reference coordinates that are known in said camera system, the camera system providing camera data to the computer system to develop optical marker coordinates in the camera coordinate frame of optical index markers detectable by said camera system in the field-of-view and located in the same position on said patient'"'"'s body as said scanner index markers, and whereby said positions of said optical index markers are known with respect to said at least one reference point;

transformation means associated with said computer system to transform said scanner marker coordinates to said optical marker coordinates, and whereby said scanner target coordinates are transformed to camera target coordinates so that the position of said at least one target position is determined with respect to said at least one reference point of said treatment or diagnostic apparatus.

2. The system of claim 1 wherein said image scanner is a CT scanner and said scanner index markers are radiopaque markers that are adapted to be attached to said at least a portion of said patient'"'"'s body and that have positions that are detectable in said image data.

3. The system of claim 1 wherein said optical index markers are light-emitting objects that are adapted to be attached to said at least a portion of said patient'"'"'s body, and emit light detectable by said camera system to produce 5 detectable camera data representative of said camera marker coordinates.

4. The system of claim 1 wherein said optical index markers are objects with geometric patterns that are detectable by said camera system to provide camera marker coordinates.

5. The system of claim 1 wherein said optical index markers are light reflecting objects that are adapted to be attached to said at least a portion of said patient'"'"'s body and reflect light from light sources located near said camera system to produce detectable camera data representative of said camera marker coordinates.

6. The system of claim 1 wherein said treatment or diagnostic apparatus is a LINAC and said reference point is a radiation isocenter of radiation beams from said LINAC.

7. The system of claim 1 wherein said treatment or diagnostic apparatus is a diagnostic image scanning apparatus and wherein said reference point is a determinable point within the image acquisition range of the diagnostic image scanning apparatus.