System for guiding a medical instrument in a patient body

• US 20070276243A1
• Filed: 12/17/2004
• Published: 11/29/2007
• Est. Priority Date: 12/22/2003
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Gerard, Olivier, Gijsbers, Geert, Florent, Raoul
• Granted Patent: US 9,237,929 B2
• Time in Patent Office: Days
• US Class Current: 600/440
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• 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 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/463 characterised by displaying multiple images or images and diagnostic data on one display
• CPC Class Codes: A61B 6/469 for selecting a region of interest [ROI]
• 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 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 8/42 Details of probe positioning or probe attachment to the patient
• CPC Class Codes: A61B 8/4227 characterised by straps, belts, cuffs or braces
• 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 8/44 Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
• CPC Class Codes: A61B 8/483 involving the acquisition of a 3D volume of data
• CPC Class Codes: A61B 8/5238 for combining image data of patient, e.g. merging several images from different acquisition modes into one image for image registration algorithms G06T7/30
• CPC Class Codes: A61B 8/5276 due to motion
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers

Abstract

The present invention relates to a system for guiding a medical instrument in a patient body. Such a system comprises means for acquiring a 2D X-ray image of said medical instrument, means for acquiring a 3D ultrasound data set of said medical instrument using an ultrasound probe, means for localizing said ultrasound probe in a referential of said X-ray acquisition means, means for selecting a region of interest around said medical instrument within the 3D ultrasound data set and means for generating a bimodal representation of said medical instrument detection by combining said 2D X-ray image and said 3D ultrasound data set. A bimodal representation is generated on the basis of the 2D X-ray image by replacing the X-ray intensity value of points belonging to said region of interest by the ultrasound intensity value of the corresponding point in the 3D ultrasound data set.

Claims

1. A medical system comprising:

a medical instrument to be guided in a patient body,

X-Ray acquisition means for acquiring a two-dimensional X-ray image of said medical instrument,

ultrasound acquisition means for acquiring a three-dimensional ultrasound data set of said medical instrument using an ultrasound probe,

means for providing a localization of said ultrasound probe within a referential of said X-ray acquisition means,

means for selecting a region of interest around said medical instrument in the three-dimensional ultrasound data set, that define a first localization of said region of interest within a referential of said ultrasound acquisition means,

means for converting said first localization of said region of interest within said referential of the ultrasound acquisition means into a second localization of said region of interest within said referential of the X-ray acquisition means, using said localization of the ultrasound probe,

means for generating and displaying a bi-modal representation of said medical instrument in which said two-dimensional X-ray image and the three-dimensional ultrasound data included in said region of interest are combined using said second localization.

2. A system as claimed in claim 1, wherein said means for selecting a region of interest are intended to define a reference plane in which a part of said medical instrument is included.

3. A system as claimed in claim 2, wherein said region of interest is a 2D ultrasound image obtained by sampling said 3D ultrasound data set over said reference plane.

4. A system as claimed in claim 2, wherein said region of interest is obtained by cropping a 3D ultrasound data subset, which lies behind said reference plane or by cropping a slab which is formed around said reference plane.

5. A system as claimed in claim 4, wherein said generating means are intended to generate a volume rendered view of said region of interest within said 3D ultrasound data set.

6. A system as claimed in claim 1, wherein said probe localization means are intended to localize an active localizer, which has been arranged on said ultrasound probe.

7. A system as claimed in claim 1, wherein said ultrasound probe is equipped with at least three non aligned and interdependent radio-opaque markers and said localization means are intended to localize said markers in at least a first 2D X-ray image having a first orientation angle in said referential.

8. A system as claimed in claim 7, wherein said localization means are intended to further localize said markers in a second 2D X-ray image having a second orientation angle in said referential.

9. A system as claimed in claim 1, wherein said selection means comprise means for detecting said medical instrument within said region of interest of the 3D ultrasound data set and said generating means are intended to give to the points of the detected medical instrument in said bimodal representation the X-ray intensity values of the corresponding points in the 2D X-Ray image.

10. A system as claimed in claim 1, comprising means for segmenting a wall tissue region in the 3D ultrasound data set and said generating means are intended to give to the points belonging to said wall tissue region the ultrasound intensity values of the corresponding points of said region of interest.

11. A system as claimed in claim 1, wherein the X-Ray acquisition means are intended to provide live two-dimensional X-Ray images and the ultrasound acquisition means live three-dimensional ultrasound data sets.

12. A system as claimed in claim 11, comprising controlling means for periodically triggering the probe localization means.

13. A system as claimed in claim 11, comprising means for compensating a motion between a current three-dimensional ultrasound data set acquired at a current time and a previous three-dimensional ultrasound data set acquired at a previous time.

14. A method of guiding a medical instrument in a patient body, comprising the steps of:

acquiring a two-dimensional X-ray image of said medical instrument using an X-ray acquisition system,

acquiring a three-dimensional ultrasound data set of said medical instrument using said ultrasound probe and an ultrasound acquisition system,

localizing said ultrasound probe in a referential of said X-ray acquisition system,

selecting a region of interest of said medical instrument within said 3D ultrasound data set, that define a first localization of said region of interest within a referential of said ultrasound acquisition system,

converting said first localization within said referential of said ultrasound acquisition system into a second X-Ray localization within said referential of the X-ray acquisition system,

generating and displaying a bimodal representation of said medical instrument in which said two-dimensional X-ray image and the three-dimensional ultrasound data included in said region of interest are combined using said second localization.