Method and system for registering a medical situation associated with a first coordinate system, in second coordinate system using an MPS system

• US 20040138548A1
• Filed: 06/09/2003
• Published: 07/15/2004
• Est. Priority Date: 01/13/2003
• Status: Active Grant

• Current Assignee: ST JUDE MEDICAL INTERNATIONAL HOLDING S. R.L.
• Original Assignee: MediGuide Ltd (Abbott Laboratories Incorporated)
• Inventors: Strommer, Gera, Eichler, Uzi
• Granted Patent: US 7,505,809 B2
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• 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 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/702 Posture restraints
• CPC Class Codes: A61B 5/704 Tables
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: G06T 2207/10081 Computed x-ray tomography [CT]
• CPC Class Codes: G06T 2207/30021 Catheter; Guide wire
• CPC Class Codes: G06T 2207/30101 Blood vessel; Artery; Vein; Vascular
• CPC Class Codes: G06T 7/33 using feature-based methods

Abstract

System for registering a first image with a second image, the system including a first medical positioning system for detecting a first position and orientation of the body of a patient, a second medical positioning system for detecting a second position and orientation of the body, and a registering module coupled with a second imager and with the second medical positioning system, the first medical positioning system being associated with and coupled with a first imager, the first imager acquiring the first image from the body, the first imager producing the first image by associating the first image with the first position and orientation, the second medical positioning system being associated with and coupled with the second imager, the second imager acquiring the second image and associating the second image with the second position and orientation, the registering module registering the first image with the second image, according to the first position and orientation and the second position and orientation.

Claims

1. System for registering a first image with a second image, the system comprising:

a first medical positioning system for detecting a first position and orientation of the body of a patient, said first medical positioning system being associated with and coupled with a first imager, said first imager acquiring at least one image from said body, said first imager producing said first image by associating said at least one image with said first position and orientation;

a second medical positioning system for detecting a second position and orientation of said body, said second medical positioning system being associated with and coupled with a second imager, said second imager acquiring said second image and associating said second image with said second position and orientation; and

a registering module coupled with said second imager and with said second medical positioning system, said registering module registering said first image with said second image, according to said first position and orientation and said second position and orientation.

2. The system according to claim 1, further comprising an image database coupled with said first imager and with said registering module, wherein said first imager stores said first image in said image database, and

wherein said registering module retrieves said first image from said image database.

3. The system according to claim 1, wherein said first medical positioning system is associated with a first coordinate system, and

wherein said second medical positioning system is associated with a second coordinate system.

4. The system according to claim 1, further comprising a body position and orientation detector coupled with said body, wherein said first medical positioning system detects said first position and orientation, when said body position and orientation detector is coupled with said first medical positioning system, and

wherein said second medical positioning system detects said second position and orientation, when said body position and orientation detector is coupled with said second medical positioning system.

5. The system according to claim 1, further comprising a device position and orientation detector coupled with a medical intervention device and with said second medical positioning system, wherein said second medical positioning system detects a device position and orientation of said medical intervention device,

wherein said second medical positioning system provides a position and orientation signal respective of said device position and orientation to said registering module, and

wherein said registering module produces a representation of said medical intervention device, according to said position and orientation signal.

6. The system according to claim 5, wherein said medical intervention device is selected from the list consisting of:

catheter;

drug delivery unit; and

tissue severing unit.

7. The system according to claim 1, further comprising said first imager and said second imager.

8. The system according to claim 1, wherein each of said first imager and said second imager is selected from the list consisting of:

fluoroscopy;

ultrasound;

thermography;

nuclear magnetic resonance; and

optical imaging.

9. The system according to claim 1, wherein said registering module superimposes said first image on said second image.

10. The system according to claim 1, further comprising a display coupled with said registering module, for displaying at least one of said first image and said second image.

11. The system according to claim 1, further comprising:

a processor coupled with said first imager and with said registering module;

a first organ timing monitor coupled with said processor, said first organ timing monitor detecting a timing signal of an inspected organ, when a first pulse sensor is coupled with said inspected organ and with said first organ timing monitor; and

a second organ timing monitor coupled with said registering module, said second organ timing monitor detecting said timing signal, when a second pulse sensor is coupled with said inspected organ and with said second organ timing monitor,

wherein said processor reconstructs said first image by associating said at least one image with a respective one of said first position and orientation and with a respective time point of said timing signal, and

wherein said registering module registers said first image with said second image, according to said respective first position and orientation, a respective one of said second position and orientation and said respective time point.

12. The system according to claim 11, further comprising an image database coupled with said processor and with said registering module, wherein said processor stores said first image in said image database, and

wherein said registering module retrieves said first image from said image database.

13. The system according to claim 1, further comprising at least two body position and orientation detectors coupled with said body, wherein said first medical positioning system detects said first position and orientation, when said at least two body position and orientation detectors are coupled with said first medical positioning system,

wherein said second medical positioning system detects said second position and orientation, when said at least two body position and orientation detectors are coupled with said second medical positioning system, and

wherein said registering module adjusts the scale of said first image and said second image, according to the distance between said at least two body position and orientation detectors.

14. The system according to claim 1, wherein said first medical positioning system comprises:

a plurality of sensing units coupled with said body;

a first transceiver to be coupled with said sensing units; and

a first processor coupled with said first transceiver and with said first imager, said first processor determining said first position and orientation according to a first signal received from said first transceiver, when said sensing units are coupled with said first transceiver; and

wherein said second medical positioning system comprises;

said sensing units;

a second transceiver to be coupled with said sensing units; and

a second processor coupled with said second transceiver, said registering module and with said second imager, said second processor determining said second position and orientation according to a second signal received from said second transceiver, when said sensing units are coupled with said second transceiver.

15. The system according to claim 14, wherein each of said sensing units comprises a location detector and an orientation detector.

16. The system according to claim 15, wherein said location detector is selected from the list consisting of:

electromagnetic coil; and

sonar sensor.

17. The system according to claim 15, wherein said orientation detector is a gyroscope.

18. The system according to claim 14, further comprising:

a first sensing unit coupled with said first transceiver and with said first imager, said first processor determining a first imager position and orientation of said first imager according to a first signal received from said first transceiver; and

a second sensing unit coupled with said second transceiver and with said second imager, said second processor determining a second imager position and orientation of said second imager according to a second signal received from said second transceiver.

19. The system according to claim 14, further comprising a sensing unit coupled with a medical intervention device and with said second transceiver,

wherein said second processor determines a device position and orientation of said sensing unit,

wherein said second processor provides a position and orientation signal respective of said device position and orientation to said registering module, and

wherein said registering module produces a representation of said medical intervention device, according to said position and orientation signal.

20. The system according to claim 1, wherein said first medical positioning system comprises:

a plurality of transmitters coupled with said body;

a first processor coupled with said first imager;

a plurality of first receivers coupled with said first processor,

wherein said second medical positioning system comprises;

said transmitters;

a second processor coupled with said second imager and with said registering module; and

a plurality of second receivers coupled with said second processor,

wherein said first processor determines said first position and orientation, when said first receivers receive wireless signals from said transmitters, and

wherein said second processor determines said second position and orientation, when said second receivers receive wireless signals from said transmitters.

21. The system according to claim 20, wherein said first medical positioning system and said second medical positioning system determine said first position and orientation and said second position and orientation, respectively, by triangulation.

22. Method for registering a first image with a second image, the method comprising the procedures of:

detecting a first position and orientation of the body of a patient, in a first coordinate system, by a first medical positioning system;

determining a first set of coordinates of said first image in said first coordinate system;

detecting a second position and orientation of said body, in a second coordinate system, by a second medical positioning system;

determining a second set of coordinates of said second image in said second coordinate system; and

registering said first set of coordinates with said second set of coordinates.

23. The method according to claim 22, further comprising a procedure of acquiring said first image by a first imager, after performing said procedure of detecting said first position and orientation.

24. The method according to claim 23, further comprising a procedure of storing said first image in an image database, after performing said procedure of acquiring said first image.

25. The method according to claim 22, further comprising a procedure of acquiring said second image by a second imager, after performing said procedure of detecting said second position and orientation.

26. The method according to claim 22, wherein said first medical positioning system detects said first position and orientation, according to a position and orientation signal received from at least one body position and orientation detector, and

wherein said at least one body position and orientation detector is coupled with said body and with said first medical positioning system.

27. The method according to claim 22, wherein said second medical positioning system detects said second position and orientation, according to a position and orientation signal received from at least one body position and orientation detector, and

wherein said at least one body position and orientation detector is coupled with said body and with said second medical positioning system.

28. The method according to claim 22, wherein said procedure of registering is performed according to said first position and orientation and said second position and orientation.

29. The method according to claim 22, further comprising a procedure of modifying the scale of said first image to the scale of said second coordinate system, according to a scale factor between said first coordinate system and said second coordinate system.

30. The method according to claim 22, wherein said first medical positioning system detects said first position and orientation, by triangulation, according to a plurality of signals received from a plurality of sensing units, and

wherein said sensing units are coupled with said body and with said first medical positioning system.

31. The method according to claim 22, wherein said second medical positioning system detects said second position and orientation, by triangulation, according to a plurality of signals received from a plurality of sensing units, and

wherein said sensing units are coupled with said body and with said second medical positioning system.

32. The method according to claim 22, wherein said first medical positioning system detects said first position and orientation according to a plurality of signals received wirelessly from a plurality of transmitters,

wherein said second medical positioning system detects said second position and orientation according to said signals, and

wherein said transmitters are coupled with said body.

33. System for re-positioning a portion of the body of a patient at the same therapeutic position and orientation suitable for a therapeutic device to medically treat a selected tissue of the body automatically, during multiple therapeutic sessions, the system comprising:

a positioning user interface;

a position and orientation detector located at a selected location associated with said selected tissue; and

a medical positioning system coupled with a storage unit, said positioning user interface and with said position and orientation detector, said medical positioning system detecting an initial position and orientation of said position and orientation detector, while said selected tissue is placed in said therapeutic position and orientation, said medical positioning system indicates via said positioning user interface when said position and orientation detector is placed again in said initial position and orientation, thereby establishing that said selected tissue is placed again in said therapeutic position and orientation.

34. The system according to claim 33, further comprising said therapeutic device.

35. The system according to claim 33, further comprising said storage unit for recording said initial position and orientation;

36. The system according to claim 33, wherein said positioning user interface produces at least one indication to determine whether a currently detected position and orientation is substantially the same as said initial position and orientation detector.

37. The system according to claim 36, wherein said at least one indication includes a first indication respective of said currently detected position and orientation, and a second indication respective of said initial position and orientation.

38. The system according to claim 36, wherein said system further comprises a comparator coupled with said storage unit, said medical positioning system and with said positioning user interface,

wherein said comparator compares said currently detected position and orientation with said initial position and orientation,

wherein said comparator provides a signal to said positioning user interface, respective of the outcome of said comparison, and

wherein said positioning user interface produces said at least one indication according to said signal.

39. The system according to claim 36, wherein said at least one indication is selected from the list consisting of:

visual;

audio; and

tactile.

40. The system according to claim 33, wherein said system further comprises:

a moving mechanism coupled with said therapeutic device; and

a controller coupled with said moving mechanism, and

wherein said controller directs said moving mechanism to move said therapeutic device, such that said therapeutic device medically treats at least a portion of said selected tissue.

41. The system according to claim 40, wherein said system further comprises a therapeutic device user interface coupled with said controller,

wherein said therapeutic device user interface is employed to enter movement data in said controller, said movement data being respective of directions from which said therapeutic device medically treats said selected tissue, and

wherein said controller directs said moving mechanism to move said therapeutic device according to said movement data.

42. The system according to claim 40, wherein said system further comprises a therapeutic device user interface coupled with said controller,

wherein said therapeutic device user interface is employed to enter a set of coordinates in said controller, said set of coordinates being respective of the boundary of said selected tissue, and

wherein said controller directs said moving mechanism to move said therapeutic device according to said set of coordinates.

43. The system according to claim 33, wherein said set of coordinates is selected from the list consisting of:

discrete; and

volumetric.

44. The system according to claim 33, wherein said system further comprises:

a moving mechanism coupled with an operating table on which said patient lies; and

a controller coupled with said moving mechanism, and

wherein said controller directs said moving mechanism to move said operating table, such that said therapeutic device medically treats at least a portion of said selected tissue.

45. The system according to claim 33, wherein said system further comprises:

at least one moving mechanism coupled with an operating table on which said patient lies and with said therapeutic device; and

a controller coupled with said at least one moving mechanism, and

wherein said controller directs said at least one moving mechanism to move said therapeutic device and said operating table, such that said therapeutic device medically treats at least a portion of said selected tissue.

46. The system according to claim 33, wherein said therapeutic device is selected from the list consisting of:

linear accelerator;

local robotic surgical device; and

remote tele-surgical device.

47. The system according to claim 33, wherein said selected tissue is selected from the list consisting of:

tumoral; and

non-tumoral.

48. The system according to claim 33, further comprising a body intrusion device for placing said position and orientation detector at said selected location.

49. Method for re-positioning a portion of the body of a patient during a multi-session automatic therapeutic procedure, the method comprising the procedures of:

detecting an initial position and orientation of a position and orientation detector, wherein said initial position and orientation is associated with a therapeutic position and orientation, suitable for automatically treating a selected tissue of said body;

recording said initial position and orientation;

detecting the current position and orientation of said position and orientation detector, at the beginning of each recurring medical treatment; and

indicating whether said current position and orientation is substantially the same as said recorded position and orientation.

50. The method according to claim 49, further comprising a procedure of medically treating said selected tissue, while maintaining said position and orientation detector at said recorded initial position and orientation.

51. The method according to claim 49, further comprising a procedure of directing a therapeutic device to move to an orientation suitable for automatically treating said selected tissue, when said current position and orientation is substantially the same as said recorded initial position and orientation.

52. The method according to claim 49, further comprising a preliminary procedure of fixing said position and orientation detector at a selected location associated with said selected tissue.

53. The method according to claim 49, wherein said procedure of indicating comprises a sub-procedure of comparing said current position and orientation with said recorded initial position and orientation of.

54. The method according to claim 49, further comprising a procedure of controlling the movement of a therapeutic device relative to said selected tissue, such that said therapeutic device medically treats at least a portion of said selected tissue.

55. System for medically treating a selected tissue within the body of a patient, the system comprising:

a first medical positioning system for detecting a first position and orientation of a position and orientation detector in a first coordinate system, when said position and orientation detector is coupled with said first medical positioning system, said position and orientation detector being located at a selected location associated with said selected tissue;

a second medical positioning system for detecting a second position and orientation of said position and orientation detector in a second coordinate system, when said position and orientation detector is coupled with said second medical positioning system; and

a registering module coupled with said second medical positioning system and with a therapeutic device, said registering module registering a set of coordinates of said selected tissue in said first coordinate system, with said second coordinate system, said set of coordinates being associated with said first position and orientation, said therapeutic device medically treating said selected tissue according to said registered set of coordinates.

56. The system according to claim 55, further comprising:

an imager coupled with said first medical positioning system;

a storage unit coupled with said first medical positioning system and with said imager; and

a user interface coupled with said imager, said user interface being employed for storing said set of coordinates in said storage unit;

wherein said imager acquires at least one image from a section of said body, said at least one image including an image of said selected tissue, and

wherein said user interface displays said at least one image.

57. The system according to claim 55, further comprising said imager and said therapeutic device.

58. The system according to claim 55, wherein said imager is selected from the list consisting of:

fluoroscopy;

ultrasound;

thermography;

nuclear magnetic resonance; and

optical imaging.

59. The system according to claim 55, wherein said system further comprises:

a moving mechanism coupled with said therapeutic device; and

a controller coupled with said registering module, said therapeutic device and with said moving mechanism,

wherein said controller receives a signal from said registering module, respective of said registered set of coordinates, and

wherein said controller directs said moving mechanism to move said therapeutic device with respect to said selected tissue, such that said therapeutic device medically treats at least a portion of said selected tissue.

60. The system according to claim 55, wherein said therapeutic device is selected from the list consisting of:

linear accelerator;

local robotic surgical device; and

remote tele-surgical device.

61. Method for medically treating a selected tissue within the body of a patient, the method comprising the procedures of:

detecting a first position and orientation of a detector in a first coordinate system, by a first medical positioning system, said detector being located at a selected location associated with said selected tissue;

associating a set of coordinates of said selected tissue in said first coordinate system, with said first position and orientation;

detecting a second position and orientation of said detector in a second coordinate system, by a second medical positioning system; and

registering said associated set of coordinates with said second coordinate system, according to said second position and orientation.

62. The method according to claim 61, further comprising a procedure of medically treating said selected tissue according to said registered set of coordinates.

63. The method according to claim 61, further comprising a preliminary procedure of fixing said detector at said selected location.

64. The method according to claim 61, further comprising a procedure of acquiring at least one image of a section of said body after performing said procedure of fixing, said at least one image including an image of said selected tissue.

65. The method according to claim 64, further comprising a procedure of displaying said at least one image.

66. The method according to claim 61, further comprising a procedure of providing said registered set of coordinates to a therapeutic device, after performing said procedure of registering.

67. The method according to claim 61, further comprising a procedure of storing said associated set of coordinates in a storage unit, after performing said procedure of associating.

68. The method according to claim 61, wherein said procedure of registering includes transformation of said associated set of coordinates from said first coordinate system to said second coordinate system.

69. The method according to claim 68, wherein said transformation is selected from the list consisting of:

modifying said associated set of coordinates according to a scale factor associated with said first coordinate system and with said second coordinate system; and

modifying said associated set of coordinates according to a transformation matrix associated with said first coordinate system and with said second coordinate system.

70. The method according to claim 61, further comprising a procedure of controlling the movement of a therapeutic device relative to said selected tissue, before performing said procedure of medical treatment, to enable said therapeutic device to medically treat said selected tissue automatically.

71. System for adjusting an imager by means of a moving mechanism, to a desired orientation with respect to a section of the body of a patient, to acquire a visual representation of said section, the visual representation including an optimal representation of a portion of interest of a medical intervention device, the medical intervention device being inserted into said section, the system comprising:

a medical positioning system;

a processor coupled with said medical positioning system and with said moving mechanism; and

a device position and orientation detector coupled with said medical intervention device at said portion of interest and with said medical positioning system,

wherein said medical positioning system detects a device position and orientation of said device position and orientation detector, said medical positioning system providing said device position and orientation to said processor,

wherein said processor determines said desired orientation, according to said detector position and orientation, and

wherein said processor directs said moving mechanism to move said imager to said desired orientation.

72. The system according to claim 71, further comprising said moving mechanism.

73. The system according to claim 72, further comprising said imager.

74. The system according to claim 71, further comprising an imager position and orientation detector coupled with said imager and with said medical positioning system,

wherein said medical positioning system detects an imager position and orientation of said imager position and orientation detector, said medical positioning system providing said imager position and orientation to said processor, and

wherein said processor determines said desired orientation, according to said detector position and orientation and said imager position and orientation.

75. The system according to claim 71, wherein said imager comprises:

a radiation generator located at one side of said body; and

a radiation detector located at another side of said body, said radiation detector detecting the radiation generated by said radiation generator, said portion of interest being located between said radiation generator and said radiation detector,

wherein said system further comprises a display coupled with said imager,

wherein said radiation detector detects said visual representation, when said imager is located at said orientation, and

wherein said display displays said visual representation.

76. The system according to claim 71, wherein said moving mechanism has at least one degree of freedom.

77. The system according to claim 71, wherein said imager operates in a radiation domain selected from the list consisting of:

nuclear;

ultrasonic; and

electromagnetic.

78. The system according to claim 71, wherein said medical intervention device is selected from the list consisting of:

catheter;

drug delivery unit; and

tissue severing unit.

79. Method for adjusting an imager to a desired orientation to acquire a visual representation of a section of the body of a patient, the visual representation including an optimal representation of a portion of interest of a medical intervention device, the method comprising the procedures of:

detecting a device position and orientation of a position and orientation detector coupled with said medical intervention device, at said portion of interest;

determining said desired orientation according to said device position and orientation, such that said imager can acquire said visual representation; and

directing a moving mechanism to move said imager to said desired orientation.

80. The method according to claim 79, further comprising a preliminary procedure of inserting said medical intervention device into said body.

81. The method according to claim 79, further comprising the procedures of:

detecting an imager position and orientation of an imager position and orientation detector coupled with said imager; and

determining the position and orientation of said imager from said imager position and orientation.

82. The method according to claim 79, further comprising a procedure of retrieving an imager position and orientation from said imager.

83. The method according to claim 79, further comprising a procedure of acquiring said visual representation by said imager.

84. The method according to claim 83, further comprising a procedure of displaying said visual representation.

85. The method according to claim 79, wherein said moving mechanism has at least one degree of freedom.

86. The method according to claim 79, wherein imager acquires said visual representation by irradiating said section.