PRECISE ENDOSCOPIC PLANNING AND VISUALIZATION

• US 20090156895A1
• Filed: 12/24/2008
• Published: 06/18/2009
• Est. Priority Date: 01/31/2007
• Status: Abandoned Application

• Current Assignee: Penn State Research Foundation
• Original Assignee: Penn State Research Foundation
• Inventors: Higgins, William E., Gibbs, Jason D.
• Application Number:
  US12/344,040
• Publication Number:
  US 20090156895A1
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: G06T 19/003 Navigation within 3D models or images
• CPC Class Codes: G06T 2207/30061 Lung
• CPC Class Codes: G06T 2210/41 Medical

Abstract

Endoscopic poses are used to indicate the exact location and direction in which a physician must orient the endoscope to sample a region of interest (ROI) in an airway tree or other luminal structure. Using a patient-specific model of the anatomy derived from a 3D MDCT image, poses are chosen to be realizable given the physical characteristics of the endoscope and the relative geometry of the patient'"'"'s airways and the ROI. To help ensure the safety of the patient, the calculations also account for obstacles such as the aorta and pulmonary arteries, precluding the puncture of these sensitive blood vessels. A real-time visualization system conveys the calculated pose orientation and the quality of any arbitrary bronchoscopic pose orientation. A suggested pose orientation is represented as an icon within a virtual rendering of the patient'"'"'s airway tree or other structure. The location and orientation of the icon indicates the suggested pose orientation to which the physician should align during the procedure.

Claims

1. A method of planning a route for an endoscope through an anatomical luminal structure to a target, the endoscope including a working lumen with a working end, the method comprising the steps of:

generating a 3D model of a luminal structure including a target;

calculating a plurality of candidate poses along the luminal structure, each candidate pose indicating the location and direction of the working end of the endoscope in relation to the target; and

planning the route as a function of which candidate pose or poses would optimize the sampling of the target.

2. The method of claim 1, wherein the sampling optimization is based upon a physical characteristic of the target.

3. The method of claim 2, wherein:

the physical characteristic is the volume of the target; and

the optimization corresponds to the candidate pose representing the largest volume of target sample.

4. The method of claim 1, further comprising the steps of:

deriving one or more obstacles or constraints from endoscope information or anatomical information; and

eliminating one or more of the candidate poses as a function of the obstacles or constraints.

5. The method of claim 4, wherein the endoscope information includes endoscope diameter.

6. The method of claim 4, wherein the anatomical information includes the diameter of the luminal structure.

7. The method of claim 4, wherein the anatomical information includes the location of a blood vessel.

8. The method of claim 1, including the steps of:

obtaining endoscope flexibility information; and

eliminating one or more of candidate poses in accordance with the flexibility information.

9. The method of claim 1, further comprising the step of generating a report including at least one candidate pose.

10. The method of claim 1, wherein;

the luminal structure is an airway tree; and

the endoscope is a bronchoscope.

11. The method of claim 1, further comprising the step of indicating at least one of the poses.

12. The method of claim 11, wherein the step of indicating is carried out by displaying an icon comprising a direction and location.

13. The method of claim 12, wherein the icon has an arrow shape.

14. The method of claim 12, wherein:

the target is displayed in combination with the icon; and

the target includes a pose-dependant visual effect.

15. The method of claim 1, further including the step of ensuring that the working end of the endoscope fits within the luminal structure at a final location.

16. The method of claim 1, further including the step of obtaining information about an appliance to be used in combination with the endoscope.

17. The method of claim 16, wherein the appliance information is received in the form of an appliance model number.

18. The method of claim 16, wherein the optimization of target sampling takes into account the appliance information.

19. The method of claim 16, wherein the appliance is appliance is a needle, coring needle, brush, forceps, RF ablator, cryo-ablator, oxygen sensor, electrical sensor, implant delivery catheter, aspiration device, fluid delivery device, or temperature sensor.

20. The method of claim 16, wherein the appliance information comprises a conic volume originating from the working end of the endoscope.

21. The method of claim 16, wherein the appliance is configured to deliver an implant.

22. The method of claim 21, wherein the implant is a conduit, valve, balloon, or plug.

23. The method of claim 4, further including the step of receiving endoscope information in the form of an endoscope model number.

24. A method of guiding a surgical appliance towards a region of interest (ROI) prior to or during an endoscopic procedure, comprising the steps of:

displaying a region of interest (ROI) to be sampled and a rendered lumen in a vicinity of the ROI on a display;

generating an instant pose corresponding to a position and direction of a working end of an endoscope including a surgical appliance;

indicating, on the display, a visual effect derived from a physical dimension of the ROI as a function of the instant pose and the surgical appliance; and

adjusting the position or direction of the working end and observing a change in the visual effect on the display.

25. The method of claim 24, wherein:

the pose corresponds to an endoscope in use during a live procedure; and

the instant pose is generated as the working end of the manipulated toward the ROI.

26. The method of claim 24, further comprising the step of selecting the instant pose corresponding to a maximum change in visual effect.

27. The method of claim 24, wherein a pose icon representative of the instant pose is displayed on the display.

28. The method of claim 26, wherein the visual effect is a change in the color intensity of the ROI on the display.

29. The method of claim 28, wherein the color intensity increases if the physical dimension of the ROI to be sampled increases.

30. The method of claim 29, wherein the physical dimension is the depth of a tissue sample.

31. The method of claim 24, further including the step of registering a pre-computed virtual image of the ROI and lumen at the instant pose with a real image arising from an endoscopic device in a position corresponding to the instant pose.

32. The method of claim 24, wherein the ROI is a lymph node, tumor, or lesion located within a lung.

33. The method of claim 24, wherein the endoscope is a virtual endoscope controlled with an input device.

34. A system for planning or visualizing a route through a branched lumen to a target region of interest (ROI), comprising:

a memory storing a reconstructed 3D model of the branched lumen and the ROI;

a processor including a route module operative to compute a route to the ROI and a pose module operative to compute a pose based on a physical dimension of a tissue sample obtained from the ROI using an appliance to obtain the sample.

35. The system of claim 34, wherein the pose is computed in real time based on a position and direction of the working end of an endoscope.

36. The system of claim 34, further including a display for displaying a visual effect corresponding to the pose.

37. The system of claim 36, wherein:

the physical dimension is the depth of sample; and

the visual effect is color intensity of an ROI image, the color intensity increasing as the depth of sample increases.

38. The system of claim 34, wherein the pose is a candidate pose based on a simulated endoscope position and direction.

39. The system of claim 34, wherein the pose is derived from a plurality of candidate poses.

40. The system of claim 34 wherein the processor is further operative to derive information and to eliminate one or more poses based on said information, wherein said information is at least one of obstacle information, appliance information, and anatomical information.

41. The system of claim 40 wherein said processor is further operative to indicate one of the following 1) a first route and first pose corresponding to a route and pose that provides the sample with a maximum physical dimension, and 2) the absence of a first route or first pose based on said information.