Method for planning a surgical procedure

• US 20080123922A1
• Filed: 10/20/2006
• Published: 05/29/2008
• Est. Priority Date: 09/08/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Appenrodt, Peter, Gielen, Frans L.H., Hertel, Frank, Gemmar, Peter
• Granted Patent: US 8,160,676 B2
• Time in Patent Office: Days
• US Class Current: 382/131
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/1127 using markers
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• 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 6/5241 combining overlapping images of the same imaging modality, e.g. by stitching
• 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: G06T 2207/10088 Magnetic resonance imaging [MRI]
• CPC Class Codes: G06T 2207/30016 Brain
• CPC Class Codes: G06T 7/32 using correlation-based methods
• CPC Class Codes: G06T 7/73 using feature-based methods

Abstract

A method for planning a procedure, which can include determining anatomical landmarks is disclosed. The anatomical landmarks can be used to determine anatomical targets of a patient. The plan can include a path or trajectory to reach a selected target.

Claims

1. A method to determine a surgical plan for reaching an anatomical target in a portion of an anatomy, the method comprising:

capturing image data of the anatomy;

processing the image data;

determining an anatomical target in the image data; and

determining a surgical plan, including;

determining an entry point into the anatomy illustrated in the image data;

weighting the image data;

inputting procedure specific data; and

determining a trajectory to reach a point relative to the anatomical target based on at least one of the weighted image data, the inputted procedure specific data, the determined anatomical target, or combinations thereof.

2. The method of claim 1, wherein weighting the image data includes determining high contrast areas of the image data, determining bright areas of the image data, determining a location of the anatomical target in the image data, determining dark areas of the image data, determining flow areas in the image data, or combinations thereof.

3. The method of claim 1, further comprising:

providing a display; and

displaying the determined surgical plan on the display.

4. The method of claim 3, further comprising:

displaying the image data on the display; and

displaying an icon superimposed over the image data illustrating the determined surgical plan.

5. The method of claim 1, wherein weighting the image data includes determining a sulcus of the brain in the image data, determining a fluid filled region in the brain, determining a vein relative to the brain, or combinations thereof.

6. The method of claim 1, further comprising:

determining an anatomical landmark;

wherein determining the anatomical target is based at least in part on the determining the anatomical landmark.

7. The method of claim 6, wherein determining the anatomical target includes processing the image data;

wherein processing the image data includes;

segmenting a third ventricle of a brain in the image data;

aligning the image data;

determining a location of the mid-sagittal plane in the aligned image data; and

determining the anatomical landmark relative to the mid-sagittal plane.

8. The method of claim 6, wherein determining the anatomical landmark includes determining at least one of an anterior commisure, a posterior commisure, or combinations thereof.

9. The method of claim 7, wherein segmenting the third ventricle includes providing a seed data.

10. The method of claim 9, wherein providing the seed data includes providing a seed voxel, determining a seed voxel, a user selecting a seed data, or combinations thereof.

11. The method of claim 8, wherein determining the anatomical target includes determining a location of the sub-thalamic nucleus based at least in part on the determined location of the anterior commissure, the posterior commissure, or combinations thereof.

12. The method of claim 1, wherein determining an entry point includes providing an acceptable entry point, providing all possible entry points to reach the anatomical target based upon a trajectory, selecting an entry point based upon the determined anatomical target, or combinations thereof.

13. The method of claim 12, wherein determining all possible entry points includes:

determining a possible trajectory of a device; and

determining all possible entry points to reach the determined anatomical target based upon the provided trajectory.

14. The method of claim 1, wherein determining a trajectory includes determining a straight trajectory, determining a curved trajectory, or combinations thereof.

15. The method of claim 1, further comprising:

providing instructions executable by a processor to at least one of process the image data, determine an entry point, weight the image data, determine a path, form the surgical plan, or combinations thereof.

16. The method of claim 15, further comprising:

selecting a deep brain stimulator;

wherein inputting the procedure specific data includes inputting the selected deep brain stimulator;

wherein the determined trajectory includes a determined trajectory to move the deep brain stimulator to the sub-thalamic nucleus.

17. The method of claim 1, further comprising:

providing a surgical frame operable to guide a device along the determined trajectory.

18. The method of claim 1, further comprising:

providing a tracking system;

providing a tracking device;

connecting the tracking device to a device;

tracking the tracking device; and

determining a position of the device based upon the tracked position of the tracking device.

19. The method of claim 18, further comprising:

displaying the image data; and

displaying an icon representing a position of the device superimposed on the image data.

20. The method of claim 19, further comprising:

providing feedback to a user based upon the tracked position of the device relative to the determined trajectory.

21. The method of claim 1, further comprising:

providing a treatment to the determined anatomical target.

22. The method of claim 1, further comprising:

sensing a region of a brain; and

refining the determined anatomical target based upon the sensed information of the region of the brain.

23. The method of claim 1, further comprising:

providing an imaging device to image the anatomy to provide the image data;

wherein the imaging device is at least one of a magnetic resonance imaging system, a computed tomography imaging system, an x-ray imaging system, an ultrasound imaging system, a positron emission tomography system, a single photo emission computed tomography system, a planar gamma tomography system, or combinations thereof.

24. A method to determine a surgical plan for reaching an anatomical target in a portion of an anatomy, the method comprising:

obtaining image data of a brain of a patient;

processing the image data;

displaying the image data;

displaying an anatomical target; and

determining a plan to reach the anatomical target, including;

determining an entry point into the brain imaged in the image data;

determining a path to reach the anatomical target in the brain; and

displaying the determined plan for the procedure.

25. The method of claim 24, further comprising:

providing procedure specific data;

wherein the procedure specific data includes at least one of a treatment to be provided, an anatomical target, a patient history, a treatment device, a treatment therapy, a time constraint, details of a deep brain stimulator, a recorder, or combinations thereof.

33. The method of claim 24, wherein determining an entry point into the brain includes identifying a region of a skull of a patient through which a device can be passed.

34. The method of claim 24, wherein determining a path includes determining all possible paths that would pass through the entry point to reach the anatomical target.

35. The method of claim 34, further comprising:

weighting a datum in the image data to obtain a weighted image data;

weighting the determined path based upon the weighted image data; and

providing a score of the determined path based upon the weighting of the image data.

36. The method of claim 35, further comprising:

determining a plurality of paths; and

providing a score for each of the plurality of the paths.

37. The method of claim 36 further comprising:

determining a selected path based at least in part upon the score of each of the plurality of paths;

wherein a selected path forms a part of the determined plan.

38. The method of claim 24, wherein displaying the determined plan includes displaying the image data and superimposing an icon representing the determined path on the image data.

39. The method of claim 24, wherein determining a path includes:

weighting the image data;

providing a plurality of paths based at least in part upon the anatomical target and the determined entry point;

automatically weighting each of the plurality of paths based upon the weight image data; and

determining a best path based upon the weighting for each of the plurality of paths.

27. The method of claim 26, further comprising:

determining an anatomical landmark; and

determining a location of the anatomical target in the image data;

wherein determining a location of the anatomical target includes determining the anatomical landmark in the image data of the brain;

wherein processing the image data includes removing unneeded data, smoothing the image data, segmenting the image data, aligning the image data, and combinations thereof.

28. The method of claim 27, wherein determining the anatomical landmark includes at least one of a user inputting an anatomical landmark, a processor determining an anatomical landmark, or combinations thereof.

29. The method of claim 28, wherein a processor determining an anatomical landmark includes a processor determining the position of an anterior commisure, a posterior commisure, a mid-sagittal plane, or combinations thereof.

30. The method of claim 29, wherein determining the anatomical target includes determining a position of a point relative to the anatomical landmark.

31. The method of claim 30, wherein determining the anatomical target includes determining the position of a sub-thalamic nucleus in the image data of the brain.

32. The method of claim 31, further comprising:

weighting the image data;

wherein weighting the image data includes at least one of determining high contrast areas of the image data, determining low contrast areas of the image data, determining bright areas of the image data, determining dark areas of the image data, determining sharp edges in the image data, or combinations thereof.

40. A method to determine a surgical plan for reaching an anatomical target in a portion of an anatomy, the method comprising:

providing procedure specific data;

determining an entry point in the portion of the anatomy;

weighting image data of the portion of the anatomy to determine a relative importance of a first region of the image data to a second region of the image data; and

determining a plan to reach the anatomical target of the portion of the anatomy based on the weighted image data and the provided procedure specific data; and

displaying the determined plan for the procedure.

41. The method of claim 40, wherein providing the procedure specific data includes entering the procedure specific data into a memory system accessible by a planning processor;

wherein the procedure specific data includes at least one of patient information;

user preference;

instruments available for the procedure;

therapy planned for the patient;

condition of the patient;

details of a deep brain stimulator;

details of a recorder;

or combinations thereof.

42. The method of claim 40, wherein determining an entry point is based at least in part on the provided procedure specific information.

43. The method of claim 40, further comprising:

obtaining the image data of a brain of a patient;

processing the image data to form processed image data;

displaying at least one of the image data, the processed image data, or combinations thereof; and

displaying the anatomical target.

44. The method of claim 40, wherein weighting the image data of the anatomy to determine a relative importance of a first region to a second region includes at least one of:

determining that a first region and a second region cannot be intersected with a device, determining that a first region and a second region can both be intersected with a device, determining that it is preferable to traverse a first region rather than a second region, determining that it is only possible to traverse a first region and not a second region, or combinations thereof.

45. The method of claim 40, wherein weighting the image data to determine a relative importance of a first region includes determining that the first region is a sulcus, a vein, a fluid transport duct, a nerve bundle, a muscle bundle, a muscle fiber, a damaged region, or combinations thereof.

46. The method of claim 40, wherein weighting the image data includes determining a high contrast region in the image data, determining a low contrast region in the image data, determining a bright region in the image data, determining a dark region in the image data, or combinations thereof.

47. The method of claim 40, wherein determining a plan includes determining a path to intersect a portion of the first region, the second region, or combinations thereof.

48. The method of claim 47, wherein the path includes a straight path, a curved path, or combinations thereof.

49. The method of claim 40, wherein determining a plan includes:

determining a therapy to be provided;

determining whether the therapy to be provided will have a selected affect on the first region, the second region, or combinations thereof; and

determining a plan to minimize the selected affect on the first region, the second region, or combinations thereof while providing the therapy to the anatomical target.

50. The method of claim 40, wherein determining a plan includes:

determining all possible plans to provide a determined therapy to the anatomical target;

determining an optimized plan of all possible plans to provide a determined therapy to the anatomical target based at least in part upon the weighted image data;

selecting the optimized plan; and

displaying the optimized plan.

51. The method of claim 50, wherein the determined therapy includes deep brain stimulation of a sub-thalamic nucleus.

52. The method of claim 40, wherein determining an entry point includes:

determining all possible entry points to reach a target based upon a selected path;

wherein the selected path is a straight path, a curved path, or combinations thereof.

53. The method of claim 40, wherein determining a plan includes:

determining a location of an anterior commissure, a posterior commissure;

a mid-sagittal plane, or combinations thereof in the image data;

determining a location of a sub-thalamic nucleus in the image data relative to at least one of the determined location of the anterior commissure, the posterior commissure;

the mid-sagittal plane, or combinations thereof in the image data;

determining a trajectory to reach the determined location of the sub-thalamic nucleus in the image data; and

determining an entry point into the anatomy to allow a deep brain stimulator to move along the determined trajectory into the anatomy to reach the sub-thalamic nucleus.