Systems and Methods for Intraoperative Targeting

• US 20070276234A1
• Filed: 10/21/2004
• Published: 11/29/2007
• Est. Priority Date: 10/21/2003
• Status: Abandoned Application

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Shahidi, Ramin
• Application Number:
  US10/576,632
• Publication Number:
  US 20070276234A1
• Time in Patent Office: Days
• US Class Current: 600/437
• 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 at least one intraoperative ultrasonic images. The method indicates a target site on the ultrasonic 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 intraoperative ultrasonic image from the patient;

identifying a spatial feature indication of a patient target site on the intraoperative ultrasonic image,

determining coordinates of the patient target site spatial feature in a reference coordinate system,

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

creating a view field from a predetermined position, and optionally orientation, relative to the instrument in the reference coordinate system, and

projecting onto the view field an indicia of the spatial feature of the target site corresponding to the predetermined position, and optionally orientation.

2. The method of claim 1, further comprising

using an ultrasonic source to generate the ultrasonic image of the patient, and

determining coordinates of a spatial feature indicated on said image from the coordinates of the spatial feature on the image and the position, and optionally orientation, of the ultrasonic source.

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

4. 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.

5. The computer readable medium of claim 4, wherein the computer program further comprises sets of instructions for:

using an ultrasonic source to generate the ultrasonic image of the patient, and

determining coordinates of a spatial feature indicated on said image from the coordinates of the spatial feature on the image and the position, and optionally orientation, of the ultrasonic source.

6. The computer readable medium of claim 4, wherein said medical instrument is a source of video and the view field projected onto the display device is the image seen by the video source.