Method and apparatus for invasive device tracking using organ timing signal generated from MPS sensors

• US 20090182224A1
• Filed: 11/10/2004
• Published: 07/16/2009
• Est. Priority Date: 05/18/1999
• Status: Active Grant

• Current Assignee: ST JUDE MEDICAL INTERNATIONAL HOLDING S. R.L.
• Original Assignee: MediGuide Ltd (Abbott Laboratories Incorporated)
• Inventors: Shmarak, Itzhak, Strommer, Gera, Eichler, Uzi
• Granted Patent: US 9,572,519 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 2017/00699 correcting for movement caused by respiration, e.g. by triggering
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• 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: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/06 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 5/061 : Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/066 : Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/0816 : Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/11 : Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/1102 : Ballistocardiography
• CPC Class Codes: A61B 5/1107 : Measuring contraction of parts of the body, e.g. organ, muscle apparatus for measuring work or force in general G01L
• CPC Class Codes: A61B 5/1128 : using image analysis A61B5/1127 takes precedence
• CPC Class Codes: A61B 5/113 : occurring during breathing
• CPC Class Codes: A61B 5/352 : Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/7207 : of noise induced by motion artifacts
• CPC Class Codes: A61B 5/721 : using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
• CPC Class Codes: A61B 5/7275 : Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61B 5/7289 : Retrospective gating, i.e. associating measured signals or images with a physiological event after the actual measurement or image acquisition, e.g. by simultaneously recording an additional physiological signal during the measurement or image acquisition
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 6/032 : Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/037 : Emission tomography
• CPC Class Codes: A61B 6/12 : Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/503 : for diagnosis of the heart
• CPC Class Codes: A61B 6/504 : for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/527 : using data from a motion artifact sensor
• CPC Class Codes: A61B 6/541 : involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 6/547 : involving tracking of position of the device or parts of the device
• CPC Class Codes: A61B 8/02 : Measuring pulse or heart rate
• 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 8/0883 : for diagnosis of the heart
• CPC Class Codes: A61B 8/0891 : for diagnosis of blood vessels
• 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 8/5276 : 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: A61N 5/1067 : in real time, i.e. during treatment

Abstract

Apparatus for generating an organ timing signal relating to an inspected organ within the body of a patient, including a medical positioning system, and a processor coupled with the medical positioning system, the medical positioning system including at least one reference electromagnetic transducer placed at a reference location, at least one inner electromagnetic transducer attached to a surgical tool inserted in a blood vessel in the vicinity of the inspected organ, and a medical positioning system processor coupled with the reference electromagnetic transducer and the inner electromagnetic transducer, the medical positioning system processor determining the three-dimensional position of the inner electromagnetic transducer, by processing transmitted electromagnetic signals transmitted from one of the reference electromagnetic transducer and the inner electromagnetic transducer with detected electromagnetic signals detected by the other of the reference electromagnetic transducer and the inner electromagnetic transducer, the medical positioning system processor further generating medical positioning system data sets, each of the medical positioning system data sets including a collection of three-dimensional position coordinate readings demonstrating the motion trajectory of the surgical tool over time, the processor generating the organ timing signal from the medical positioning system data sets by detecting and identifying periodic motion frequencies in the medical positioning system data sets, and filtering the periodic motion frequencies from the medical positioning system data sets.

Claims

1. An apparatus for generating an organ timing signal relating to at least one inspected organ within the body of a patient, said apparatus comprising:

a medical positioning system (MPS) including;

at least one reference electromagnetic transducer placed at a reference location;

at least one inner electromagnetic transducer attached to a surgical tool inserted in a blood vessel in the vicinity of said inspected organ; and

an MPS processor, coupled with said at least one reference electromagnetic transducer and with said at least one inner electromagnetic transducer, said MPS processor determining the three-dimensional position of said at least one inner electromagnetic transducer, by processing transmitted electromagnetic signals transmitted from at least one of said at least one reference electromagnetic transducer and said at least one inner electromagnetic transducer with detected electromagnetic signals detected by at least the other of said at least one reference electromagnetic transducer and said at least one inner electromagnetic transducer, said MPS processor further generating MPS data sets, each of said MPS data sets comprising a collection of three-dimensional position coordinate readings demonstrating the motion trajectory of said surgical tool over time; and

a processor coupled with said MPS, generating said organ timing signal from said MPS data sets by detecting and identifying periodic motion frequencies in said MPS data sets, and filtering said periodic motion frequencies from said MPS data sets.

3. The apparatus according to claim 1, wherein said reference electromagnetic transducer transmits electromagnetic signals and said inner electromagnetic transducer detects electromagnetic signals.

4. The apparatus according to claim 1, wherein said inner electromagnetic transducer transmits electromagnetic signals and said reference electromagnetic transducer detects electromagnetic signals.

5. The apparatus according to claim 1, wherein for at least one of said at least one reference electromagnetic transducer, said reference location is a portion of said body of a patient.

6. The apparatus according to claim 1, wherein for at least one of said at least one reference electromagnetic transducer, said reference location is stationary with respect to said body of a patient.

7. The apparatus according to claim 1, further comprising at least one additional electromagnetic transducer attached to an area of said body of a patient, said electromagnetic transducer obtaining three-dimensional position information of said area, for movement compensation.

8. The apparatus according to claim 1, further comprising at least one additional electromagnetic transducer attached to a known area on the surface on which said patient rests, said electromagnetic transducer obtaining three-dimensional position information of said area, for compensating for movement of said patient.

9. The apparatus according to claim 1, wherein said processor further reconstructs a cardiac trajectory from said MPS data sets and said filtered periodic motion frequencies, said cardiac trajectory representing the mechanical movement of said blood vessel originating from cardiac motion.

10. The apparatus according to claim 1, wherein said processor further reconstructs a respiratory trajectory from said MPS data sets and said filtered periodic motion frequencies, said respiratory trajectory representing the mechanical movement of said blood vessel originating from respiratory motion.

11. The apparatus according to claim 9, wherein said processor further detects phase information of said inspected organ by identifying a plurality of phases on said reconstructed cardiac trajectory.

12. The apparatus according to claim 10, wherein said processor further detects phase information of said inspected organ by identifying a plurality of phases on said reconstructed respiratory trajectory.

13. The apparatus according to claim 1, wherein said inspected organ is a heart.

14. The apparatus according to claim 1, wherein said inspected organ is a lung.

15. The apparatus according to claim 1, further comprising a database coupled with said MPS and with said processor, said database storing at least said MPS data sets.

16. The apparatus according to claim 15, further comprising a medical imaging device coupled with said database, said medical imaging device including an image detector, said medical imaging device acquiring a plurality of two-dimensional images of said inspected organ via said image detector, said database further storing at least said plurality of two-dimensional images.

17. The apparatus according to claim 16, wherein one of said at least one reference electromagnetic transducer is attached to said image detector, obtaining external optical parameters relating to said medical imaging device.

18. The apparatus according to claim 1, wherein one of said at least one inner electromagnetic transducer is coupled with an image sensor.

19. The apparatus according to claim 1, further comprising an additional electromagnetic transducer coupled with an image sensor.

20. The apparatus according to claim 1, wherein said reference location is associated with an image sensor.

21. The apparatus according to claim 11, further comprising:

a database coupled with said MPS and with said processor, said database storing at least said MPS data sets; and

a medical imaging device coupled with said database, said medical imaging device including an image detector, said medical imaging device acquiring a plurality of two-dimensional images of said inspected organ via said image detector, said database further storing at least said plurality of two-dimensional images,

wherein said processor further associates between said acquired two-dimensional images, said MPS data sets, and said phase information, and constructs trajectories of said surgical tool guided within said blood vessel, respective of different phases of said inspected organ.

22. The apparatus according to claim 16, wherein said medical imaging device includes an image acquisition system selected from the list consisting of:

ultrasound;

intra-vascular ultrasound;

X-ray;

C-arm machine;

fluoroscopy;

angiography;

computerized tomography;

nuclear magnetic resonance;

positron-emission tomography; and

single-photon-emission tomography.

23. The apparatus according to claim 16, further comprising a display coupled with said processor, said display presenting a motion picture of said inspected organ, said motion picture presenting the trajectory of said surgical tool guided within said blood vessel, respective of different phases of said inspected organ.

24. The apparatus according to claim 23, wherein said display presents a single image frame in said motion picture, respective of the real-time activity-state of said inspected organ.

25. The apparatus according to claim 23, wherein said display presents a playback of previous images in said motion picture, showing progress of said surgical tool during previous activity-states of said inspected organ.

26. The apparatus according to claim 23, wherein said display is selected from the list consisting of:

a two-dimensional display;

an auto-stereoscopic display viewed with a suitable pair of spectacles;

a stand alone stereoscopic display; and

a pair of goggles.

27. The apparatus according to claim 23, wherein said display includes multiple monitors.

28. The apparatus according to claim 27, wherein one of said monitors presents current real-time three-dimensional position data of said surgical tool superimposed on the current image frame of said inspected organ respective of the current activity-state, while another of said monitors presents the current real-time three-dimensional position data of said surgical tool superimposed on a previous image frame of said inspected organ respective of a previous activity-state.

29. The apparatus according to claim 23, wherein said display includes separate windows within a single monitor.

30. The apparatus according to claim 29, wherein one of said windows presents current real-time three-dimensional position data of said surgical tool superimposed on the current image frame of said inspected organ respective of the current activity-state, while another of said windows presents the current real-time three-dimensional position data of said surgical tool superimposed on a previous image frame of said inspected organ respective of a previous activity-state.

31. The apparatus according to claim 21, wherein said processor associates between said plurality of two-dimensional images and said MPS data sets, with respect to said phase information at the time of acquisition or measurement.

32. The apparatus according to claim 21, wherein said processor associates for a given two-dimensional image acquired during a given phase of said inspected organ, position coordinate readings detected during said given phase.

33. The apparatus according to claim 21, wherein said processor constructs trajectories of said surgical tool guided within said blood vessel, based on said position coordinate readings detected during a given phase of said inspected organ.

34. The apparatus according to claim 33, wherein said processor further associates each of said constructed trajectories with a two-dimensional image acquired during the corresponding phase of said inspected organ.

35. The apparatus according to claim 33, wherein said display presents a superimposition of said constructed trajectories on its respective two-dimensional image.

36. The apparatus according to claim 35, wherein said display presents said images as a series of individual image frames that are shown one at a time.

37. The apparatus according to claim 35, wherein said display presents said images as a sequence of image frames that are shown consecutively.

2. An apparatus for generating an organ timing signal relating to at least one inspected organ within the body of a patient, said apparatus being coupled with a medical positioning system (MPS), said medical positioning system transmitting and detecting electromagnetic signals between a reference location and a surgical tool inserted in the vicinity of said inspected organ, said medical positioning system determining a three-dimensional position of said surgical tool by processing said transmitted electromagnetic signals with said detected electromagnetic signals, said medical positioning system further generating MPS data sets, each of said MPS data sets comprising a collection of three-dimensional position coordinate readings demonstrating the motion trajectory of said surgical tool over time, said apparatus comprising:

a processor, generating said organ timing signal from said MPS data sets by detecting and identifying periodic motion frequencies in said MPS data sets, and by filtering said periodic motion frequencies from said MPS data sets.

38. Method for generating an organ timing signal relating to an inspected organ within the body of a patient, the method comprising the procedures of:

transmitting electromagnetic signals and detecting said electromagnetic signals;

processing said transmitted electromagnetic signals with said detected electromagnetic signals;

determining the three-dimensional position of a surgical tool inserted within the body of a patient based on said processing;

generating MPS data sets comprising a collection of three-dimensional position coordinate readings demonstrating the motion trajectory of said surgical tool over time;

detecting and identifying periodic motion frequencies in said MPS data sets; and

filtering said periodic motion frequencies from said MPS data sets.

39. The method according to claim 38, further comprising the procedures of:

reconstructing the cardiac trajectory from said MPS data sets and said filtered periodic motion frequencies, said cardiac trajectory representing the mechanical movement of said blood vessel originating from cardiac motion;

reconstructing the respiratory trajectory from said MPS data sets and said filtered periodic motion frequencies, said respiratory trajectory representing the mechanical movement of said blood vessel originating from respiratory motion;

detecting phases of said inspected organ by identifying a plurality of phases on either of said reconstructed cardiac trajectory or said reconstructed respiratory trajectory; and

associating said phases with said MPS data sets,

thereby obtaining phase information relating to said inspected organ.

40. The method according to claim 39, further comprising the procedure of:

acquiring a plurality of two-dimensional images of said inspected organ.

41. The method according to claim 40, further comprising the procedure of:

associating between said plurality of two-dimensional images, said MPS data sets, and said phase information.

42. The method according to claim 41, wherein said plurality of two-dimensional images are associated between said MPS data sets, with respect to said phase information at the time of acquisition or measurement.

43. The method according to claim 41, wherein a given one of said plurality of two-dimensional images acquired during a given phase is associated with position coordinate readings detected during said given phase at any cycle of said cardiac trajectory.

44. The method according to claim 40, further comprising the procedures of:

normalizing one of said MPS data sets;

performing magnetic-optical correlation on said normalized MPS data sets;

performing optical projection on said correlated MPS data set, said correlated MPS data set comprising three-dimensional coordinate readings in the optical domain; and

superimposing said projected MPS data set onto a two-dimensional image selected from said acquired plurality of two-dimensional images, said projected MPS data set comprising two-dimensional coordinate readings in the optical domain,

thereby superimposing MPS data onto two-dimensional image data for corresponding data sets.

45. The method according to claim 40, further comprising the procedures of:

obtaining phase information relating to said inspected organ from said MPS data sets for a first MPS data set selected from said MPS data sets, said first MPS data set being corresponding with a two-dimensional images data set;

obtaining phase information relating to said inspected organ from said MPS data sets for a second MPS data set selected from said MPS data sets, said second MPS data set being non-corresponding with said two-dimensional images data set; and

generating a third MPS data set from said second MPS data set using phase alignment between phases of said first MPS data set and said second MPS data set, said third MPS data set having the same time-tag as said first MPS data set.

46. The method according to claim 45, further comprising the procedures of:

performing magnetic-optical correlation on said third MPS data set, said third MPS data set comprising three-dimensional coordinate readings in the magnetic domain;

performing optical projection on said correlated third MPS data set, said correlated third MPS data set comprising three-dimensional coordinate readings in the optical domain; and

superimposing said projected third MPS data set onto a two-dimensional image selected from said acquired plurality of two-dimensional images, said projected third MPS data set comprising two-dimensional coordinate readings in the optical domain,

thereby superimposing MPS data onto two-dimensional image data for non-corresponding data sets.

47. The method according to claim 45, wherein said phase information is cardiac phase information.

48. The method according to claim 45, wherein said phase information is respiratory phase information.

49. The method according to claim 45, wherein said phase information is cardiac phase information and respiratory phase information.

50. The method according to claim 40, further comprising the procedures of:

obtaining phase information relating to said inspected organ from said MPS data sets for a selected one of said MPS data sets;

obtaining correlated phase information for a two-dimensional images data set selected from said acquired plurality of two-dimensional images; and

generating a separate MPS data set for each two-dimensional image in said two-dimensional images data set, in accordance with image phase and time-tags.

51. The method according to claim 50, further comprising the procedures of:

performing magnetic-optical correlation on each of said generated MPS data sets, each of said generated MPS data sets comprising three-dimensional coordinate readings in the magnetic domain;

performing optical projection on each of said correlated MPS data sets, each of said correlated MPS data sets comprising three-dimensional coordinate readings in the optical domain; and

superimposing each of said projected MPS data sets onto corresponding two-dimensional image selected from said two-dimensional images data set, said projected third MPS data set comprising two-dimensional coordinate readings in the optical domain,

thereby constructing trajectories of said surgical tool guided within a blood vessel in the vicinity of said inspected organ within the body of a patient, respective of different phases of said inspected organ.

52. The method according to claim 50, wherein said phase information is cardiac phase information.

53. The method according to claim 50, wherein said phase information is respiratory phase information.

54. The method according to claim 50, wherein said phase information is cardiac phase information and respiratory phase information.

55. The method according to claim 51, wherein said constructed trajectories are presented on a display.

56. The method according to claim 40, further comprising the procedures of:

obtaining phase information relating to said inspected organ from said MPS data sets for a selected one of said MPS data sets;

reconstructing the centerline trajectory from said MPS data sets and said filtered periodic motion frequencies, said centerline trajectory representing the central axis of the guiding motion of said surgical tool;

reconstructing separate centerline trajectories for each phase, in accordance with time-tags and detected phases of said reconstructed cardiac trajectory;

obtaining correlated phase information for a two-dimensional images data set selected from said acquired plurality of two-dimensional images; and

shifting each of said centerline trajectories by superimposing matching periodic motion components, for each phase of the two-dimensional images in said two-dimensional images data set.

57. The method according to claim 56, further comprising the procedures of:

performing magnetic-optical correlation on each of said shifted centerline trajectories, each of said shifted centerline trajectories comprising three-dimensional coordinate readings in the magnetic domain;

performing optical projection on each of said shifted centerline trajectories, each of said shifted centerline trajectories comprising three-dimensional coordinate readings in the optical domain; and

superimposing each of said shifted centerline trajectories onto corresponding two-dimensional image selected from said two-dimensional images data set, each of said shifted centerline trajectories comprising two-dimensional coordinate readings in the optical domain,

thereby constructing trajectories of said surgical tool guided within a blood vessel in the vicinity of said inspected organ within the body of a patient, respective of different phases of said inspected organ.

58. The method according to claim 56, wherein said phase information is cardiac phase information.

59. The method according to claim 56, wherein said phase information is respiratory phase information.

60. The method according to claim 56, wherein said phase information is cardiac phase information and respiratory phase information.

61. The method according to claim 57, wherein said constructed trajectories are presented on a display.

62. The method according to claim 38, wherein said inspected organ is a heart.

63. The method according to claim 38, wherein said inspected organ is a lung.