Systems and Methods for Intraoperative Targeting

• US 20070225553A1
• Filed: 10/21/2004
• Published: 09/27/2007
• Est. Priority Date: 10/21/2003
• Status: Abandoned Application

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Shahidi, Ramin
• Application Number:
  US10/576,781
• Publication Number:
  US 20070225553A1
• Time in Patent Office: Days
• US Class Current: 600/103
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3995 Multi-modality markers
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 8/0816 using echo-encephalography
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4245 involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
• CPC Class Codes: A61B 8/4254 using sensors mounted on the probe
• CPC Class Codes: A61B 8/4416 related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
• CPC Class Codes: A61B 8/463 characterised by displaying multiple images or images and diagnostic data on one display composite display in devices for short-range imaging with acoustic waves G01S7/52074
• CPC Class Codes: A61B 8/483 involving the acquisition of a 3D volume of data
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

The method of some embodiments of the invention assists a user in guiding a medical instrument to a subsurface target site in a patient. This method generates one or more intraoperative images. The method indicates a target site on the image(s). The method determines 3-D coordinates of the target site in a reference coordinate system. The method (1) tracks the position of the instrument in the reference coordinate system, (2) projects onto a display device a view field as seen from the position with respect to the tool in the reference coordinate system, and (3) projects onto the displayed view field indicia of the target site corresponding to the position. In some embodiments, the field of view is a view not only from the position of the instrument but also from a known orientation of the instrument in the reference coordinate system. By observing the indicia, the user can guide the instrument toward the target site by moving the instrument so that the indicia are placed or held in a given state in the displayed field of view.

Claims

1. A method for guiding a medical instrument to a target site within a patient, comprising:

capturing at least one image during an operation of the patient;

from a user, receiving an indication of a target site on the captured image;

based on the indication, determining coordinates of the patient target site in a reference coordinate system;

determining a position of the instrument in the reference coordinate system;

projecting onto the display device a field of view from a perspective of the instrument in the reference coordinate system; and

projecting onto the field of view the indicia that specifies the position of the target site relative to the position of the instrument.

2. The method of claim 1, wherein the field of view comprises an image captured by the instrument.

3. The method of claim 1, wherein said medical instrument is an endoscope and the view field projected onto the display device is the image seen by the endoscope.

4. The method of claim 1, wherein the view field projected onto the display device is that seen from the tip-end position and orientation of the medical instrument having a defined field of view.

5. The method of claim 1, wherein the view field projected onto the display device seen from a position along the axis of instrument different from the target seen at a tip-end position of the medical instrument.

6. The method of claim 1, wherein the target site is specified as a point, and said indicia are arranged in a geometric pattern indicating a position of a point within the target site.

7. The method of claim 1, wherein the target site is a spatial region within the patient.

8. The method of claim 7, wherein the spatial region has an area, and said indicia are arranged in a geometric pattern defining a boundary of the indicated area.

9. The method of claim 7, wherein the spatial region has a volume, and said indicia are arranged in a geometric pattern defining a boundary of the indicated volume.

10. The method of claim 1, wherein determining the coordinates comprises determining three-dimensional coordinates of the target site in the reference coordinate system.

11. The method of claim 1, wherein the positions of the instrument and the target site are specified by at least two sets of indicia.

12. The method of claim 11, wherein the spacing between indicia is indicative of the distance of the instrument from the target site.

13. The method of claim 11, wherein the size of the individual indicia is indicative of the distance of the instrument from the target site.

14. The method of claim 11, wherein the shape of the individual indicia is indicative of the distance of the instrument from the target site.

15. The method of claim 11, wherein the size of the indicia is indicative of the orientation of said instrument.

16. The method of claim 11, wherein the shape of the indicia is indicative of the orientation of said instrument.

17. The method of claim 1, wherein said indicating includes indicating on each image, a second target site which, together with the first-indicated target site, defines a surgical trajectory on the displayed image.

18. The method of claim 1, which further includes using said instrument to indicate on a patient surface region, an entry point that defines, with said indicated target site, a surgical trajectory on the displayed image.

19. The method of claim 11 or 12, wherein the surgical trajectory on the displayed image is indicated by two sets of indicia, one set corresponding to the first-indicated target site and the second set by the second target site.

20. The method of claim 11 or 12, wherein the surgical trajectory on the displayed image is indicated by a geometric object defined, at its end regions, by the first-indicated target site and the second target site or entry point indicated.

21. The method of claim 1, further comprising moving the instrument toward the target site by moving the instrument so that said indicia are placed or held in a given state in the displayed field of view.

22. The method of claim 1, further comprising determining an orientation of the instrument.

23. A system designed to assist a user to guide a medical instrument to a target site in a patient, the system comprising

(a) an imaging device for generating, during an operation, an image of a patient;

(b) a tracking system for tracking the position of the medical instrument and imaging device in a reference coordinate system,

(c) an indicator for allowing a user to indicate a target site on the image,

(d) a display device,

(e) an electronic computer operably connected to said tracking system, display device, and indicator, and

(f) computer-readable code which is operable, when used to control the operation of the computer, to carry out the steps of

(i) recording target-site spatial information indicated by the user on said image(s), through the use of said indicator,

(ii) determining from the spatial information of the target site indicated on said image(s), 3-D coordinates of the target site in a reference coordinate system,

(iii) tracking the position of the instrument in the reference coordinate system,

(iv) projecting onto a display device, a view field as seen from a known position of the tool in the reference coordinate system, and

(v) projecting onto the displayed view field, indicia whose states indicate the spatial information of the target site with respect to said known position.

24. The system of claim 23, wherein the indicia'"'"'s states indicate the spatial information of the target site not only with respect to said known position but also with respect to the known orientation of the tool.

25. The system of claim 23, wherein the user, by observing the states of said indicia, can guide the instrument toward the target site by moving the instrument so that said indicia are placed or held in a given state in the displayed field of view.

26. A computer readable medium that stores a computer program that is designed to assist a user in guiding a medical instrument to a target site in a patient, said computer program comprising sets of instructions for:

capturing at least one image during an operation of the patient;

from a user, receiving an indication of a target site on the captured image;

based on the indication, determining coordinates of the patient target site in a reference coordinate system;

determining a position of the instrument in the reference coordinate system;

projecting onto the display device a field of view from a perspective of the instrument in the reference coordinate system; and

projecting onto the field of view the indicia that specifies the position of the target site relative to the position of the instrument.