EM TRACKING SYSTEMS FOR USE WITH ULTRASOUND AND OTHER IMAGING MODALITIES

• US 20100081920A1
• Filed: 12/15/2008
• Published: 04/01/2010
• Est. Priority Date: 09/29/2008
• Status: Active Grant

• Current Assignee: CIVCO Medical Instruments Company Incorporated (Roper Technologies, Inc.)
• Original Assignee: CIVCO Medical Instruments Company Incorporated (Roper Technologies, Inc.)
• Inventors: Whitmore, Willet F. III, Cermak, Craig J.
• Granted Patent: US 8,086,298 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 2017/00725 Calibration or performance testing
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2017/3413 guided by ultrasound
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/3975 active
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 46/10 specially adapted for instruments, e.g. microscopes
• 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 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• 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 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 8/4254 : using sensors mounted on the probe
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: G06T 7/0012 : Biomedical image inspection

Abstract

An EMT system for use in ultrasound and other imaging modality guided medical procedures. The system includes a tool set of various components to which EM sensors can be releasably secured. Thus, the sensors can be reused, notwithstanding the disposal of other components of the tool set. Various components of the tool set include keying elements to facilitate their registration to the anatomy of the patient undergoing the procedure via the EM sensors.

Claims

1. An instrument arranged for insertion into the body of a patient for use in an image-guided procedure on the patient, the position of the instrument to be tracked with respect to the patient by an EMT system, said instrument comprising an EM sensor, and a first member, said first member comprising a first handle and an elongated linear stylet secured to and projecting from said first handle, said linear stylet having a distal tip portion and a hollow interior cavity terminating adjacent said distal tip portion, said EM sensor having an electrical cable connected to said sensor, said sensor being located in said cavity adjacent said distal tip portion of said stylet, said electrical cable extending along the length of and out of said cavity, said sensor and said associated cable being arranged to be removed from said cavity of said stylet for reuse.

2. The instrument of claim 1 wherein the instrument is arranged for insertion into the body of the patient via a sheath, the sheath being a linear tubular member having a distal end and a proximal end, the distal end of the tubular sheath being open, the sheath also including a connector at the proximal end of the sheath, and wherein said first member is releasably securable to the connector of the sheath.

3. The instrument of claim 1 additionally comprising a second member including a second handle, said cable extending through said second handle.

4. The instrument of claim 3 wherein said first member includes a body portion having a recess and wherein said second handle includes a projection through which said cable passes.

5. The instrument of claim 4 wherein said projecting portion of said second handle is arranged to be releasably located within said recess of said body portion of said first member.

6. The instrument of claim 3 additionally comprising a cover in the form of a flexible sheath having an opening, said cover being arranged to be disposed over said second handle, with said cable extending though the opening in said cover.

7. The instrument of claim 6 wherein said second handle is movable to seal said cover about said cable.

8. The instrument of claim 5 additionally comprising a cover in the form of a flexible sheath having an opening, said cover being arranged to be disposed over said second handle, with said cable extending though the opening in said cover wherein a portion of said cover is located at the interface of said projecting portion of said second handle and said recess in said body portion of said first member.

9. The instrument of claim 8 wherein said first handle is pivotable and includes a member adapted to apply a force to a portion of said second handle when said first handle is pivoted to a closed position with respect to said second handle to seal said cover about said cable.

10. A device for releasable mounting on an elongated, linear medical instrument, used in an ultrasound-guided procedure on a patient, the procedure being carried out by an ultrasound transducer to enable the position of the instrument to be tracked with respect to a patient by an EMT system, said device comprising a housing and an EM sensor, said housing mounting said sensor and being releasably securable to the instrument at various positions along the length of the instrument, said housing comprising a first keying member arranged to be releasably coupled to the ultrasound transducer to enable the EMT system to register said sensor with respect to the ultrasound transducer.

11. The device of claim 10 wherein said housing is arranged to releasably frictionally engage the instrument at various positions along the length of the instrument.

12. The device of claim 10 wherein a bracket is provided on the ultrasound transducer and wherein the bracket includes a first keying member, said first keying member of said device being arranged to be coupled to the first keying member of the bracket to enable the EMT system to register said sensor with respect to the ultrasound transducer.

13. The device of claim 10 wherein a needle guide is provided on the ultrasound transducer and wherein the needle guide includes a first keying member, said first keying member of said device being arranged to be coupled to the first keying member of the needle guide to enable the EMT system to register said sensor with respect to the ultrasound transducer.

14. The device of claim 12 wherein the elongated linear instrument includes a distal end portion and wherein the bracket includes a second keying member, the second keying member being arranged to receive the distal end portion of the instrument to enable the EMT system to register the distal end of the instrument with respect to said sensor.

15. The device of claim 13 wherein the elongated linear instrument includes a distal end portion and wherein the needle guide includes a second keying member, the second keying member being arranged to receive the distal end portion of the instrument to enable the EMT system to register the distal end of the instrument with respect to said sensor.

16. The device of claim 10 wherein the EMT system includes a passive marker adapted to be releasably secured to the skin of the patient, said passive marker including a keying component, said keying component of said device being arranged to mate with the keying component of the marker.

17. The device of claim 10 wherein said EM sensor is adapted to be releasably mounted in said housing, wherein said EM sensor can be removed from said housing to enable said housing to be disposed of and said EM sensor reused.

18. A instrument guide for use on an ultrasound transducer in an ultrasound-guided procedure on a patient by an elongated linear instrument, said instrument guide forming a portion an EMT system and being arranged to receive the instrument, the EMT system comprising a sensor including a housing having a first keying member, said instrument guide including a first keying member adapted to be releasably coupled to the first keying member of the sensor to enable the EMT system to register the sensor with respect to the ultrasound transducer.

19. The instrument guide of claim 18, wherein said instrument guide is a needle guide.

20. The instrument guide of claim 18 wherein the instrument includes a distal end portion and wherein said instrument guide includes a second keying member, said second keying member being arranged to receive the distal end portion of the instrument to enable the EMT system to register the distal end of the instrument with respect to the sensor.

21. The instrument guide of claim 20 wherein said second keying member comprising an elongated slot including a stop surface.

22. An EMT system for use in an ultrasound-guided procedure on a patient by an elongated linear instrument comprising a first component adapted for mounting on an ultrasound transducer and a second component including an EM sensor, said first component being arranged to receive the instrument, said second component comprising a sensor including a housing, said housing comprising a first keying member, said first component comprising a first keying member adapted to be releasably coupled to said first keying member of said second component to enable the EMT system to register said sensor with respect to the ultrasound transducer.

23. The EMT system of claim 22 wherein said second component is adapted for releasable securement to the instrument at various positions along the length of the instrument.

24. The EMT system of claim 23 wherein said second component is arranged to releasably frictionally engage the instrument at various positions along the length of the instrument.

25. The EMT system of claim 23 wherein the instrument includes a distal end portion and wherein said first component additionally comprises a second keying member, said second keying member being arranged to receive the distal end portion of the instrument to enable the EMT system to register the distal end of the instrument with respect to said sensor.

26. The EMT system of claim 25 wherein said second keying member comprises an elongated slot including a stop surface.

27. The EMT system of claim 22 wherein said first component comprises a needle guide.

28. The EMT system of claim 22 wherein said first component comprises a bracket for the ultrasound transducer.

29. The EMT system of claim 25 wherein said first component comprises a needle guide.

30. The EMT system of claim 25 wherein said first component comprises a bracket for the ultrasound transducer.

31. The EMT system of claim 22 wherein said second component comprises the elongated linear instrument, said instrument having a distal tip portion including a cavity therein, said EM sensor being disposed within said cavity.

32. The EMT system of claim 31 wherein said distal tip portion of said instrument forms said first keying member.

33. The EMT system of claim 32 wherein said first keying member of said first component comprises an elongated slot including a stop surface.

34. An EMT system for use in an image guided procedure on a patient comprising a first component and a second component, said first component comprising a marker adapted for securement to the patient, said second component comprising a sensor including a housing, said housing comprising a first keying member, said marker comprising a first keying member adapted to cooperate with said first keying member of said second component to enable the registration of the marker with respect to the body of the patient.

35. The EMT system of claim 34 wherein the image guided procedure on the patient is accomplished by use of an elongated linear instrument and wherein said second component comprises a device for releasable securement to the instrument at various positions along the length of the instrument.

36. The EMT system of claim 35 wherein said second component is arranged to releasably frictionally engage the instrument at various positions along the length of the instrument.

37. The EMT system of claim 35 wherein the image guided procedure on the patient is accomplished by use said second component, said second component comprising an elongated instrument having a linear distal end portion terminating at a tip, said distal end portion forming said housing of said second component, said sensor being located within said distal end portion, said tip forming said first keying member of said second component.

38. A bracket for use on an ultrasound transducer to releasably mount a needle guide thereon, the needle guide comprising a body having an inner surface, a pivot member located adjacent the inner surface and a pair of spaced-apart arms projecting outward from the front surface, each of the arms including a flanged tip at the free end thereof, said bracket being arranged to be releasably mounted on the transducer and comprising a body having a guide-receiving surface, a pair of undercut surfaces located on opposite sides of said guide-receiving surface, and a pivot member located adjacent said guide-receiving surface, said pivot member of said bracket establishing a pivot axis and being arranged to cooperate with the pivot member of the needle guide to enable the needle guide to be pivoted about said pivot axis, whereupon the flanged tips of the spaced apart arms of the needle guide snap fit into releasable securement with respective ones of said undercut surfaces of said bracket to releasably secure the needle guide on said bracket.

39. The bracket of claim 38 wherein said pivot member of said bracket comprises a pair of axially aligned convex pivot surfaces and the pivot member of the needle guide comprises a pair of axially aligned recesses, and wherein respective ones of said convex pivot surfaces are arranged to be received within respective ones of the axially aligned recesses to enable the needle guide to be pivoted about said pivot axis to releasably secure the needle guide on said bracket.

40. The bracket of claim 39 wherein said body of said bracket includes an upper portion and a lower portion and wherein said undercut surfaces are located adjacent said upper portion and said pair of axially aligned convex pivot surfaces are located at said lower portion.

41. The bracket of claim 38 wherein said bracket is also arranged to releasably mount a sensor of a location sensing system and wherein said body portion of said bracket comprises a socket arranged for releasable receipt of the sensor therein.

42. The bracket of claim 41 wherein the sensor comprises a pair of pivot pins and wherein said socket comprises a pair of spaced-apart wall portions, each of said wall portions of said socket including a slot, said slots of said at least one socket being arranged for receipt of respective ones of the pins of the sensor.

43. The bracket of claim 41 wherein a portion of said socket is located above said undercut surfaces.

44. The bracket of claim 41 additionally comprising a pair of projecting arms located adjacent said socket for engaging respective portion of the sensor when the sensor is releasably received within said socket.

45. A needle guide for use with an ultrasound transducer on which a bracket is mounted, the bracket being arranged to be releasably mounted on the transducer and comprising a body having a guide-receiving surface, a pair of undercut surfaces located on opposite sides of the guide-receiving surface, and a pivot member located adjacent the guide-receiving surface, said needle guide being arranged to be releasably mounted on the bracket and comprising a body having an inner surface, a pivot member located adjacent the inner surface and a pair of spaced-apart arms projecting outward from the front surface, each of said spaced-apart arms including a flanged tip at the free end thereof, said pivot member of said needle guide establishing a pivot axis and being arranged to cooperate with the pivot member of said bracket to enable said needle guide to be pivoted about said pivot axis, whereupon said flanged tips of said spaced-apart arms of said needle guide snap fit into releasable securement with respective ones of the undercut surfaces of the bracket to releasably secure said needle guide on the bracket.

46. The needle guide of claim 45 wherein said body of said needle guide includes a pair of tabs, each of said tabs being associated with a respective one of said spaced-apart arms, said tabs being arranged to be squeezed together to cause said flanged tips of said arms to be moved apart.

47. The needle guide of claim 45 wherein each of said flanged tips includes a cam surface and an undercut surface, said undercut surface of each of said arms being arranged to engage a respective one of the undercut surfaces of the bracket.

48. The needle guide of claim 45 wherein said needle guide includes a slot for receipt of an elongated needle therein.

49. An EMT system for use in an image-guided procedure on a patient comprising a marker adapted for securement to the patient and a sensor-equipped adaptor arranged to be coupled to said marker, said sensor-equipped adaptor comprising a housing and a sensor, said housing comprising a first keying member in the form of a projection, said marker comprising a first keying member in the form of an opening, said opening of said marker being arranged to receive said projection of said housing to couple said marker to said adaptor to enable the registration of said marker with respect to the body of the patient.

50. The EMT system of claim 49 wherein said marker is arranged to be adhesively secured to the body of the patient.

51. The EMT system of claim 50 wherein said marker comprises a disk-like body having an adhesive undersurface and a central hub, said central hub including said opening.

52. A marker for use with an EMT system in an image-guided procedure on a patient, the EMT system comprising a sensor-equipped adaptor including a housing and a sensor, the housing comprising a first keying member in the form of a projection, said marker being adapted for securement to the patient and comprising a first keying member in the form of an opening, said opening of said marker being arranged to receive the projection of the housing to couple said marker to the adaptor to enable the registration of said marker with respect to the body of the patient.

53. The EMT system of claim 52 wherein said marker is arranged to be adhesively secured to the body of the patient.

54. The EMT system of claim 53 wherein said marker comprises a disk-like body having an adhesive undersurface and a central hub, said central hub including said opening.