INTRA-OPERATIVE REGISTRATION FOR NAVIGATED SURGICAL PROCEDURES

• US 20110152676A1
• Filed: 12/21/2009
• Published: 06/23/2011
• Est. Priority Date: 12/21/2009
• Status: Active Grant

• Current Assignee: Stryker European Operations Holdings, LLC (Stryker Corporation)
• Original Assignee: General Electric Company
• Inventors: Jensen, Vernon Thomas, Battle, Vianney Pierre, Groszmann, Daniel Eduardo
• Granted Patent: US 8,694,075 B2
• Time in Patent Office: Days
• US Class Current: 600/426
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• 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 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61B 6/488 involving pre-scan acquisition
• 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 6/5247 combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound

Abstract

A navigation system for use during a surgical procedure is provided. The navigation system is configured to use electromagnetic tracking data produced by electromagnetic tracking devices and 2D image data produced by a fluoroscope to intra-operatively register 2D images of a patient to a pre-operative 3D image of the patient. In some implementations, a surgeon may be able to perform an interventional or surgical procedure guided by the navigation system.

Claims

1. A surgical navigation method comprising the acts of:

acquiring a three-dimensional representation of a region of interest of a patient;

establishing a coordinate frame based on the position and orientation of a first electromagnetic device with respect to the patient;

acquiring two or more two-dimensional fluoroscopic images of the patient;

providing the three-dimensional representation, the two or more two-dimensional fluoroscopic images, and the coordinate frame to a computerized navigation system;

mapping the two or more two-dimensional fluoroscopic images to the coordinate frame;

registering the two or more two-dimensional fluoroscopic images to the three dimensional representation of the region of interest to produce a navigable three-dimensional visualization of the patient.

2. The method of claim 1, comprising:

providing data from a second electromagnetic device and a calibration target to the computerized navigation system, wherein the calibration target and the second electromagnetic device are disposed on an imaging apparatus used to generate the two or more fluoroscopic images;

generating a projection model using the data from the second electromagnetic device and the calibration target, wherein the projection model relates the position and orientation of images acquired using the imaging apparatus to the coordinate frame.

3. The method of claim 2, wherein at least two of the two or more two-dimensional fluoroscopic images are at generally orthogonal angles to one another.

4. The method of claim 1, wherein the first electromagnetic device does not comprise an optical sensor or marker.

5. The method of claim 1, wherein the first electromagnetic device is disposed on or within the patient percutaneously.

6. The method of claim 1, wherein the first electromagnetic device is attached to a bone of the patient.

7. The method of claim 1, wherein the three-dimensional representation comprises a CT scan.

8. The method of claim 1, wherein the two or more two-dimensional fluorscopic images are acquired using a C-arm imager.

9. The method of claim 1, wherein the two or more two-dimensional fluorscopic images comprise two, three, or four two-dimensional fluorscopic images.

10. A method of surgical navigation comprising the acts of:

attaching a first electromagnetic device to a patient anatomy of interest, such that the first electromagnetic device establishes a coordinate frame;

performing an acquisition of two or more fluoroscopic images using a C-arm imaging system, wherein the C-arm imaging system comprises a second electromagnetic device and a calibration target;

performing a registration operation using a computerized navigation system configured to process the coordinate frame, the two or more fluoroscopic images, calibration data derived based upon the calibration target, spatial data derived for the C-arm using the second electromagnetic device, and a three-dimensional representation of the patient anatomy of interest generated prior to surgery, wherein the registration operation generates a three-dimensional visualization of the patient;

monitoring a representation of a surgical tool depicted with respect to the three-dimensional visualization, wherein the surgical tool is equipped with a third electromagnetic device.

11. The method of claim 10, comprising:

acquiring additional fluorscopic images after the three-dimensional visualization is generated; and

updating the registration and the three-dimensional visualization based on the additional fluoroscopic images.

12. The method of claim 10, wherein the two or more fluoroscopic images are generally orthogonal to one another.

13. The method of claim 10, wherein the first, second and third electromagnetic devices each generate a signal representative of the position and orientation of the patient, the fluoroscope, and the medical device, respectively.

14. The method of claim 10, comprising viewing the 3D visualization of the device and the patient from a coronal, sagittal, or axial plane perspective of the patient.

15. A computerized navigation system, comprising:

an interface unit configured to receive two-dimensional fluoroscopic images and electromagnetic tracking data produced by one or more electromagnetic tracking devices;

a memory configured to store the two-dimensional fluoroscopic images, the electromagnetic tracking data, and a three-dimensional image of the patient;

processing circuitry configured to execute one or more algorithms for registering the two-dimensional fluoroscopic images to the three-dimensional image through a digital radiographic reconstruction (DRR) and for generating a representation based on the registered two-dimensional fluoroscopic images and the three-dimensional image; and

a workstation in communication with the processing circuitry configured to communicate with a user interface and a display.

16. The system of claim 15 wherein the processing circuitry is configured to execute one or more algorithms for generating a projection model relating the two-dimensional fluoroscopic images and the electromagnetic tracking data.

17. The system of claim 15 wherein the representation comprises a three-dimensional visualization of a patient undergoing surgery.

18. The system of claim 15 wherein the electromagnetic tracking data comprises electromagnetic tracking data acquired for one or more of a patient, a C-arm fluoroscope, or a medical device configured for insertion into the patient.

19. The system of claim 18 wherein the representation comprises a three-dimensional visualization of the patient and the medical device during a surgical procedure.

20. The system of claim 15, wherein the memory comprises a computer-readable medium programmed with executable code corresponding to the one or more algorithms.