Clinician programmer system and method for generating interface models and displays of volumes of activation

• US 20090287467A1
• Filed: 05/15/2009
• Published: 11/19/2009
• Est. Priority Date: 05/15/2008
• Status: Active Grant

• Current Assignee: Boston Scientific Neuromodulation Corporation (Boston Scientific Corporation)
• Original Assignee: IntElect Medical, Inc. (Boston Scientific Corporation)
• Inventors: Carlton, Keith, Hoffer, Brian James, Ionescu, Arna Diana, Barnhorst, Jordan, Lubensky, David Ari, Kokones, Scott, Sparks, Troy, Erdogan, Engin, Blum, David Arthur
• Granted Patent: US 8,849,632 B2
• Time in Patent Office: Days
• US Class Current: 703/21
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• 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 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61N 1/36082 Cognitive or psychiatric applications, e.g. dementia or Alzheimer's disease
• CPC Class Codes: A61N 1/36128 Control systems
• CPC Class Codes: A61N 1/36185 Selection of the electrode configuration
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G06V 40/10 Human or animal bodies, e.g. vehicle occupants or pedestrians; Body parts, e.g. hands
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A system and method for displaying a volume of activation (VOA) may include a processor that displays via a display device a model of a portion of a patient anatomy that includes anatomical structures, displays via the display device and overlying the display of the model a VOA associated by the processor with a set of anatomical stimulation parameter settings, the display of the VOA, and graphically identifies interactions between the displayed VOA and a first subset of the anatomical structures associated with one or more stimulation benefits and a second subset of the anatomical structures associated with one or more stimulation side effects, where the graphical identifications differ depending on whether the interaction is with the first subset or the second subset.

Claims

1. A method of a volume of activation (VOA) visualization machine, the method comprising:

displaying, by a processor of the machine and via a display device of the machine, a model of a portion of a patient anatomy, including a plurality of anatomical structures;

displaying, by the processor and via the display device, a VOA associated by the processor with a set of stimulation parameter settings, the display of the VOA overlaying the display of the model; and

graphically identifying interactions between the displayed VOA and a first subset of the anatomical structures associated with one or more stimulation benefits and a second subset of the anatomical structures associated with one or more stimulation side effects, the graphical identifications differing depending on whether the interaction is with the first subset or the second subset.

2. The method of claim 1, wherein the model is a two-dimensional model corresponding to a selectable cross section of a three-dimensional volume and the displayed VOA is a two-dimensional slice of a three-dimensional VOA, the two-dimensional VOA slice corresponding to the cross-section.

3. The method of claim 2, further comprising:

providing a scroll control operable to scroll through two-dimensional cross-sections of the three-dimensional volume; and

response to operation of the scroll control, changing the two-dimensional model and the two-dimensional VOA slice to correspond a newly selected cross-section.

4. The method of claim 1, wherein the identification is via use of differences in at least one of color, hatching, shading, intensity, transparency, and outlining.

5. The method of claim 4, further comprising textually identifying the anatomical structures of the first and second subsets.

6. The method of claim 5, further comprising textually identifying at least one of (a) the one or more stimulation benefits and (b) the one or more stimulation side effects.

7. The method of claim 4, wherein the model is a three dimensional model.

8. The method of claim 7, further comprising:

displaying a patient orientation model that is selectable and rotatable in response to user input; and

rotating the model of the portion of the patient anatomy in a manner that corresponds to a rotation of the patient orientation model.

9. The method of claim 8, wherein the patient orientation model is selectable by a clicking input and is rotatable by a dragging input.

10. The method of claim 4, further comprising:

generating the model based on one or more images of the portion of the patient anatomy.

11. The method of claim 10, wherein the images include at least one of a magnetic resonance imaging (MRI) image, a computer tomography (CT) image, a Diffusion Tensor Imaging (DTI) image, a Positron Emission Tomography (PET) image, and an X-Ray image.

12. The method of claim 11, further comprising:

displaying, overlaid on the model of the portion of the patient anatomy, a model of a stimulation leadwire implanted in the portion of the patient anatomy and used for a stimulation estimated to provide the displayed VOA when programmed with the set of stimulation parameter settings.

13. The method of claim 12, wherein the display of the model of the stimulation leadwire overlying the model of the portion of the patient anatomy is generated in a generation process that includes:

locating a position of the leadwire in one of the CT image and the MRI image of the portion of the patient anatomy; and

positioning the model of the leadwire at a location of the MRI image of the portion of the patient anatomy that corresponds to a position of the one of the CT image and the MRI image at which the leadwire was located.

14. The method of claim 13, wherein:

the MRI image is generated prior to or during an operation in which a burr hole is drilled in the patient to provide an entryway for insertion of the leadwire; and

the position of the of the leadwire is located in the CT image.

15. The method of claim 12, wherein:

the generation of the model of the portion of the patient anatomy includes creating a patient-specific brain atlas using the MRI image; and

the display of the model of the stimulation leadwire overlying the model of the portion of the patient anatomy is generated in a generation process that includes;

locating a position of the leadwire in the CT image of the portion of the patient anatomy; and

positioning the model of the leadwire at a location of the patient-specific brain atlas that corresponds to a position of the CT image at which the leadwire was located.

16. The method of claim 15, wherein the MRI image is generated prior to an operation in which a burr hole is drilled in the patient to provide an entryway for insertion of the leadwire.

17. The method of claim 1, further comprising:

determining a location, with respect to the model of the portion of the brain anatomy, of a stimulation leadwire implanted in the portion of the patient anatomy and used for a stimulation estimated to provide the displayed VOA when programmed with the set of stimulation parameter settings; and

displaying, overlaid on the model of the portion of the patient anatomy, a model of the stimulation leadwire;

wherein;

the stimulation leadwire includes a plurality of markers offset from each other with respect to a center longitudinal axis of the stimulation leadwire by a number of degrees; and

the determining of the location includes rotationally locating the leadwire by;

outputting to the user a set of images of a portion of the leadwire including the markers, the set of images including a respective image for each rotation of the leadwire by a certain number of degrees; and

receiving user input selecting one of the output images of the portion of the leadwire including the markers.

18. The method of claim 17, wherein the markers are offset from each other with respect to the center longitudinal axis of the stimulation leadwire by 90°

.

19. The method of claim 17, wherein the set of images includes a respective image for each rotation of the leadwire by 45°

, up to 315°

.

20. The method of claim 17, wherein each marker is a window extending 180°

about the longitudinal axis of the leadwire.

21. The method of claim 20, wherein one of the markers is positioned above the other of the markers.

22. The method of claim 17, wherein the plurality of markers include two markers of identical shape, an orientation of one of the markers being vertically offset from an orientation of the other of the markers by 180°

.

23. The method of claim 22, wherein, for each of the markers, an edge of the marker extends 180°

about the longitudinal axis of the leadwire.

24. The method of claim 23, wherein one of the markers is positioned above the other of the markers.

25. The method of claim 1, further comprising:

displaying a user-selectable component in a frame in which the VOA is displayed;

in response to selection of the component, providing a data entry form;

in response to completion of data entry via the data entry form, saving the entered data as a note in association with at least one of the displayed VOA and the stimulation parameter settings; and

displaying in the frame at least one note icon representative of a respective note associated with the displayed VOA, each of the at least one note icon being selectable for display of the respective note.

26. The method of claim 25, wherein the note icon is displayed at a boundary of the displayed VOA.

27. The method of claim 26, further comprising:

displaying in the frame a note icon associated with a non-displayed VOA at a location corresponding to a boundary of the non-displayed VOA.

28. The method of claim 1, further comprising:

within the displayed model, graphically distinguishing between portions of the model that are associated with a set of VOAs including the displayed VOA and portions of the model that are not associated with the set of VOAs.

29. The method of claim 28, wherein the portions associated with the set of VOAs and the portions not associated with the set of VOAs are distinguished by at least one of an outline and differences in at least one of shading, transparency, hatching, and color.

30. The method of claim 28, further comprising:

within a region including the portions of the model associated with the set of VOAs, graphically distinguishing between those portions associated with those of the set of VOAs that are not associated with significant side effects and those portion not associated with those of the set of VOAs that are not associated with significant side effects.

31. The method of claim 1, further comprising:

storing an atlas database including a plurality of three-dimensional brain atlases corresponding to brains of respective patients of a patient population;

one of;

comparing brain images of the patients of the patient population and of a patient with whom the displayed model corresponds; and

comparing microelectrode recording (MER) data of the patient with whom the displayed model corresponds to the plurality of stored atlases; and

based on the comparisons, selecting an atlas of the atlas database for use to generate the displayed model.

32. The method of claim 31, wherein the atlas database includes one or more composite atlases, each of the composite atlases generated based on features of a respective combination of at least two of the plurality of brain atlases.

33. The method of claim 31, the displayed model is generated by modifying the selected atlas.

34. A method of a volume of activation (VOA) visualization machine, the method comprising:

calculating, by a processor of the machine, a VOA associated with a stimulation;

displaying, by the processor and via a display device, the VOA overlaid on an anatomical model including at least one anatomical structure; and

differently highlighting an overlap between the VOA and a portion of the at least one anatomical structure associated with a negative side effect of the stimulation and an overlap between the VOA and a portion of the at least one anatomical structure not associated with any negative side effect of the stimulation.

35. A volume of activation (VOA) visualization system, comprising:

a display device; and

a processor, the processor configured to;

display via the display device a model of a portion of a patient anatomy, including a plurality of anatomical structures;

display via the display device a VOA associated by the processor with a set of stimulation parameter settings, the display of the VOA overlying the display of the model; and

provide for display via the display device, graphical indicia identifying interactions between the displayed VOA and a first subset of the anatomical structures associated with one or more stimulation benefits and a second subset of the anatomical structures associated with one or more stimulation side effects, the graphical indicia differing depending on whether the interaction is with the first subset or the second subset.

36. A method of a volume of activation (VOA) visualization machine, the method comprising:

displaying, by a processor of the machine and via a display device of the machine, a VOA associated by the processor with a set of stimulation parameter settings, the display of the VOA overlaying displayed structures in a model; and

graphically identifying interactions between the displayed VOA and a first subset of the structures associated with one or more stimulation benefits and a second subset of the structures associated with one or more stimulation side effects, the graphical identifications differing depending on whether the interaction is with the first subset or the second subset.

37. The method of claim 36, wherein:

the first subset includes a structure representing a previously explored region, all of which is associated with at least one VOA that is not associated with a side effect; and

the second subset includes a structure representing a previously explored region, all of which is associated with only VOAs that are associated with at least one side effect.

38. A method of an anatomical model generation machine, the method comprising:

determining a location, with respect to a model of a portion of an anatomy, of a stimulation leadwire implanted in the portion of the patient anatomy;

displaying the model of the portion of the anatomy; and

in accordance with the determined location, displaying, overlaid on the displayed model of the portion of the anatomy, a model of the stimulation leadwire;

wherein;

the stimulation leadwire includes a plurality of markers offset from each other with respect to a center longitudinal axis of the stimulation leadwire by a number of degrees; and

the determining of the location includes rotationally locating the leadwire by;

outputting a set of images of a portion of the leadwire including the markers, the set of images including a respective image for each rotation of the leadwire by a certain number of degrees; and

receiving user input selecting one of the output images of the portion of the leadwire including the markers.

39. A patient-implantable stimulation leadwire, comprising:

at least one electrode; and

a plurality of markers offset from each other with respect to a center longitudinal axis of the stimulation leadwire by a number of degrees.

40. A system comprising:

a patient-implantable stimulation leadwire including at least one electrode, and a plurality of markers offset from each other with respect to a center longitudinal axis of the stimulation leadwire by a number of degrees; and

a display device; and

a processor configured to rotationally locate the leadwire with respect to a surrounding environment by;

outputting a set of images of a portion of the leadwire including the markers, the set of images including a respective image for each rotation of the leadwire by a certain number of degrees; and

receiving user input selecting one of the output images of the portion of the leadwire including the markers.

41. A method of a volume of activation (VOA) visualization machine, the method comprising:

displaying, by a processor of the machine and via a display device of the machine, a VOA associated by the processor with a set of stimulation parameter settings, the display of the VOA overlaying a display of a stimulation leadwire; and

graphically identifying interactions between the displayed VOA and a first region about the displayed leadwire associated with one or more stimulation benefits and a second region about the displayed leadwire associated with one or more stimulation side effects, the graphical identifications differing depending on whether the interaction is with the first region or the second region.