Respiratory gated image fusion of computed tomography 3D images and live fluoroscopy images

• US 20070270689A1
• Filed: 05/16/2006
• Published: 11/22/2007
• Est. Priority Date: 05/16/2006
• Status: Active Grant

• Current Assignee: Siemens Healthcare GMBH (Siemens AG)
• Original Assignee: Siemens Medical Solutions USA Incorporated (Siemens AG)
• Inventors: Lothert, Mark
• Granted Patent: US 7,467,007 B2
• Time in Patent Office: Days
• US Class Current: 600/428
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/5235 combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal

Abstract

A system and method is provided directed to improved real-time image guidance by uniquely combining the capabilities of two well-known imaging modalities, anatomical 3D data from computer tomography (CT) and real time data from live fluoroscopy images provided by an angiography/fluoroscopy system to ensure a more efficient and safer intervention in treating punctures, drainages and biopsies in the abdominal and thoracic areas of the human body.

Claims

1. A method for providing real-time image guidance in an image-guided medical procedure, the method comprising:

(a) constructing, in a pre-operative stage of said procedure, a fused image comprising a single image of a computer tomography (CT) generated anatomical 4D data set of a patient'"'"'s region of operative interest with a static fluoroscopic image of said patient'"'"'s region of operative interest;

(b) acquiring, in an operative stage of said procedure, a live fluoroscopic image of said patient'"'"'s region of operative interest;

(c) acquiring, in said operative stage, an operative respiratory gating signal of the patient, substantially coincident with said step (b); and

(d) triggering, in said operative stage, the fused image, obtained at said step (a), with the live fluoroscopic image, obtained at said step (b) by the real-time respiratory gating signal, obtained at said step (c) to generate a real-time fused and triggered image of said patient'"'"'s region of operative interest;

wherein the fused and triggered image provides real time image guidance during said image-guided medical procedure by displaying a medical device in real time to ensure a safer and more efficient intervention.

2. The method of claim 1, wherein the fused image comprises one of a landmark based fused image, surface based fused image, intensity based fused image, and point based fused image.

3. The method of claim 1, wherein the operative respiratory gating signal is acquired at substantially a point in time when the monitored respiratory signal reaches a preset phase of respiration.

4. The method of claim 1, wherein the constructing step (a) further comprises the steps of:

acquiring a pre-operative respiratory gating signal of the patient'"'"'s respiratory movement, at substantially a point in time when the monitored respiratory signal reaches a preset phase of respiration;

acquiring an anatomical 3D data set of a patient'"'"'s region of operative interest;

constructing an anatomical 4D data set from the acquired anatomical 3D data set;

acquiring a static fluoroscopic image of said patient'"'"'s region of operative interest;

selecting a single frame from the anatomical 4D data set as an optimal image; and

statically fusing the selected single frame from the anatomical 4D data set with the acquired static fluoroscopic image.

5. The method of claim 4, wherein the step of identifying a single frame from the anatomical 4D data set as an optimal image further comprises:

simultaneously displaying the anatomical 4D data set and the static fluoroscopic image on a display device; and

reviewing each frame of the 4D data set and the static fluoroscopic image to identify said single frame as a frame having the highest degree of correlation with the displayed static fluoroscopic image based on a set of common anatomical landmarks.

6. A system for providing real-time image guidance in an image-guided medical procedure, the system comprising:

a computer tomography (CT) apparatus for generating a 3D anatomical data set and a corresponding 4D anatomical data set derived from the 3D anatomical data set;

an angiography apparatus for generating a pre-operative static fluoroscopic image of a patient'"'"'s region of operative interest and for generating an operative live fluoroscopic image of said patient'"'"'s region of operative interest;

a respiratory sensor for sensing a respiration of said patient, a first processor for processing signals received from the respiratory sensor and for converting the received respiratory signals into a serial format for transmission to a personal computer for continuously monitoring the respiratory signals received from the first processor and for commanding the first processor to output a respiratory gating signal when the monitored respiratory signal reaches a preset phase of respiration;

a second processor for receiving and processing the 3D data set and the 4D data set, the processor performing the following steps;

(i) constructing, in a pre-operative phase, a static fused image comprised of a single frame of the 4D anatomical data set and the pre-operative static fluoroscopic image; and

(ii) triggering the fused image with the real-time respiratory gating signal of the patient to generate a real-time dynamically fused and triggered image for use in providing real time image guidance during said image-guided medical procedure.

7. The system of claim 6, wherein the static fused image comprises one of a landmark based fused image, surface based fused image, intensity based fused image, and point based fused image.

8. The system of claim 6, wherein the step of constructing in a pre-operative phase, a static fused image comprised of a single frame of the 4D anatomical data set and the pre-operative live fluoroscopic image, further comprises the steps of:

acquiring a pre-operative respiratory gating signal of the patient'"'"'s respiratory movement, at substantially a point in time when the monitored respiratory signal reaches a preset phase of respiration;

acquiring an anatomical 3D data set of a patient'"'"'s region of operative interest;

constructing an anatomical 4D data set from the acquired anatomical 3D data set;

acquiring a static fluoroscopic image of said patient'"'"'s region of operative interest;

selecting a single frame from the anatomical 4D data set as an optimal image; and

statically fusing the identified single frame from the anatomical 4D data set with the acquired static fluoroscopic image.

9. The system of claim 8, wherein the step of selecting a single frame from the anatomical 4D data set to be fused with the acquired fluoroscopic image, further comprises:

simultaneously displaying the anatomical 4D data set and the static fluoroscopic image on a display device; and

reviewing each frame of the 4D data set and the static fluoroscopic image to identify said single frame as a frame having the highest degree of correlation with the displayed static fluoroscopic image based on a set of common anatomical landmarks.

10. A computer readable medium having program instructions stored thereto for providing real-time image guidance in an image-guided medical procedure comprising:

.

a first set of instructions for constructing, in a pre-operative stage of the procedure, a fused image comprising a single image of a computer tomography (CT) generated anatomical 4D data set of a patient'"'"'s region of operative interest with a static fluoroscopic image of the patient'"'"'s region of operative interest;

a second set of instructions for acquiring, in an operative stage of the procedure, a live fluoroscopic image of the patient'"'"'s region of operative interest;

a third set of instructions for acquiring, in the operative stage, an operative respiratory gating signal of the patient, substantially coincident with the second set of instructions; and

a fourth set of instructions for triggering, in the operative stage, the fused image, obtained during the first set of instructions, with the live fluoroscopic image, obtained during the second set of instructions by the real-time respiratory gating signal, obtained during the third set of instructions to generate a real-time fused and triggered image of the patient'"'"'s region of operative interest,

wherein the fused and triggered image provides real time image guidance during the image-guided medical procedure by displaying a medical device in real time to ensure a safer and more efficient intervention.

11. The computer readable medium having program instructions of claim 10, wherein the fused image comprises one of a landmark based fused image, surface based fused image, intensity based fused image, and point based fused image.

12. The computer readable medium having program instructions of claim 10, wherein the operative respiratory gating signal is acquired at substantially a point in time when the monitored respiratory signal reaches a preset phase of respiration.

13. The computer readable medium having program instructions of claim 10, wherein the first set of instructions further comprises:

a fifth set of instructions for acquiring a pre-operative respiratory gating signal of the patient'"'"'s respiratory movement, at substantially a point in time when the monitored respiratory signal reaches a preset phase of respiration;

a sixth set of instructions for acquiring an anatomical 3D data set of a patient'"'"'s region of operative interest;

a seventh set of instructions for constructing an anatomical 4D data set from the acquired anatomical 3D data set;

an eight set of instructions for acquiring a static fluoroscopic image of the patient'"'"'s region of operative interest;

a ninth set of instructions for selecting a single frame from the anatomical 4D data set as an optimal image; and

a tenth set of instructions for statically fusing the selected single frame from the anatomical 4D data set with the acquired static fluoroscopic image.

14. The computer readable medium having program instructions of claim 13, wherein the ninth set of instructions further comprises:

an eleventh set of instructions for simultaneously displaying the anatomical 4D data set and the static fluoroscopic image on a display device; and

a twelfth set of instructions for reviewing each frame of the 4D data set and the static fluoroscopic image to identify the single frame as a frame having the highest degree of correlation with the displayed static fluoroscopic image based on a set of common anatomical landmarks.