MRI-Guided Medical Interventional Systems and Methods

• US 20130102883A1
• Filed: 12/17/2012
• Published: 04/25/2013
• Est. Priority Date: 06/07/2007
• Status: Active Grant

• Current Assignee: Clearpoint Neuro, Inc.
• Original Assignee: MRI Interventions, Inc. (Clearpoint Neuro, Inc.)
• Inventors: Piferi, Peter, Jenkins, Kimble L., Sayler, David John
• Granted Patent: US 9,055,884 B2
• Time in Patent Office: Days
• US Class Current: 600/417
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 2017/00212 using remote controls
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00911 for fields applied by a magnetic resonance imaging system
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2017/3409 including needle or instrument drives
• CPC Class Codes: A61B 2034/101 Computer-aided simulation of surgical operations
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• 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 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/3933 Liquid markers
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/25 : User interfaces for surgical systems
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 5/0036 : including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/004 : adapted for image acquisition of a particular organ or body part A61B5/0082 takes precedence; arrangements for optical scanning A61B5/0062
• CPC Class Codes: A61B 5/0042 : for the brain
• CPC Class Codes: A61B 5/0044 : for the heart
• CPC Class Codes: A61B 5/055 : involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/062 : using magnetic field
• CPC Class Codes: A61B 5/4839 : combined with drug delivery
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/14 : Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61N 1/0529 : Electrodes for brain stimulation
• CPC Class Codes: A61N 1/0534 : Electrodes for deep brain stimulation
• CPC Class Codes: A61N 1/372 : Arrangements in connection with the implantation of stimulators
• CPC Class Codes: G01R 33/286 : involving passive visualization of interventional instruments, i.e. making the instrument visible as part of the normal MR process
• CPC Class Codes: G01R 33/287 : involving active visualization of interventional instruments, e.g. using active tracking RF coils or coils for intentionally creating magnetic field inhomogeneities
• CPC Class Codes: G01R 33/3415 : comprising arrays of sub-coils , i.e. phased-array coils with flexible receiver channels

Abstract

An MRI-guided interventional system includes a trajectory guide frame for guiding an interventional device with respect to a patient in an MRI-guided procedure and including a base, a platform, a targeting cannula, and a stabilizer mechanism. The platform is mounted on the base and includes a support table and a moving plate that is translatable relative to the support table and the base along a translational axis. The targeting cannula is mounted on the moving plate for movement therewith and includes an elongate guide bore defining a trajectory axis. The stabilizer mechanism is operable to selectively control movement between the support table and the moving plate to stabilize a position of the targeting cannula with respect to the base. The frame is operable to translate the moving plate along the translational axis relative to the base to position the trajectory axis. The translational axis is transverse to the trajectory axis.

Claims

1. An MRI-guided interventional system for use with a body of patient and an interventional device, the system including:

a trajectory guide frame for guiding the interventional device with respect to a body of a patient in an MRI-guided procedure, the trajectory guide frame including;

a base having a patient access aperture therein, wherein the base is configured to be secured to the body of the patient;

a platform mounted on the base and including a support table and a moving plate that is translatable relative to the support table and the base along a translational axis;

a targeting cannula mounted on the moving plate for movement therewith relative to the support table and the base, the targeting cannula including an elongate guide bore therethrough, the guide bore defining a trajectory axis and being configured to guide placement of the interventional device in vivo; and

a stabilizer mechanism operable to selectively control movement between the support table and the moving plate to stabilize a position of the targeting cannula with respect to the base;

wherein the trajectory guide frame is operable to translate the moving plate and thereby the targeting cannula along the translational axis relative to the base to position the trajectory axis to a desired intrabody trajectory to guide placement of the interventional device in vivo; and

wherein the translational axis is transverse to the trajectory axis.

2. The system of claim 1 including an elongate interventional device configured to be serially inserted along the trajectory axis through the guide bore and into the body of the patient in vivo.

3. The system of claim 1 wherein:

the translational axis is an X-translational axis;

the moving plate is translatable relative to the support table and the base along a Y-translational axis transverse to the X-translational axis; and

the Y-translational axis is transverse to the trajectory axis.

4. The system of claim 1 further including a yoke movably mounted on the base and rotatable relative to the base about a pivot axis, wherein the platform is mounted on the yoke for rotation therewith and the platform is configured to permit translational movement of the moving plate with respect to the yoke.

5. The system of claim 1 wherein:

the stabilizer mechanism includes an adjustment device and a rub bar; and

the rub bar and the support table cooperatively define a slot through which the moving plate slides in contact with the rub bar.

6. The system of claim 5 wherein the adjustment device includes a loading device operable to apply a load to the rub bar to compressively load the moving plate in the slot between the support table and the rub bar.

7. The system of claim 5 wherein the loading device includes at least one screw.

8. A trajectory guide frame for guiding an interventional device with respect to a body of a patient in an MRI-guided procedure, the trajectory guide frame comprising:

a base having a patient access aperture therein, wherein the base is configured to be secured to the body of the patient;

a platform mounted on the base and including a support table and a moving plate that is movable relative to the support table and the base;

a targeting cannula mounted on the moving plate for movement therewith relative to the support table and the base, the targeting cannula including a guide bore therethrough that is configured to guide placement of the interventional device in vivo; and

a stabilizer mechanism operable to selectively control movement between the support table and the moving plate to stabilize a position of the targeting cannula with respect to the base;

wherein;

the stabilizer mechanism includes an adjustment device and a rub bar; and

the rub bar and the support table cooperatively define a slot through which the moving plate slides in contact with the rub bar.

9. The trajectory guide frame of claim 8 wherein the adjustment device is operable to apply a load to the rub bar to compressively load the moving plate in the slot between the support table and the rub bar.

10. The trajectory guide frame of claim 8 wherein the loading device includes at least one screw.

11. A method of adjusting a trajectory of an in vivo interventional device, comprising:

affixing a trajectory guide frame to a body of a patient in an MRI-guided procedure, the trajectory guide frame including;

a base having a patient access aperture therein, wherein the base is configured to be secured to the body of the patient;

a platform mounted on the base and including a support table and a moving plate that is translatable relative to the support table and the base along a translational axis;

a targeting cannula mounted on the moving plate for movement therewith relative to the support table and the base, the targeting cannula including an elongate guide bore therethrough, the guide bore defining a trajectory axis and being configured to guide placement of the interventional device in vivo; and

a stabilizer mechanism operable to selectively control movement between the support table and the moving plate to stabilize a position of the targeting cannula with respect to the base;

wherein the trajectory guide frame is operable to translate the moving plate and thereby the targeting cannula along the translational axis relative to the base; and

wherein the translational axis is transverse to the trajectory axis; and

while the patient remains in position in a magnetic field associated with an MRI scanner, adjusting the trajectory guide frame to translate the moving plate and thereby the targeting cannula along the translational axis relative to the base to position the trajectory axis to a desired intrabody trajectory to guide placement of the interventional device in vivo.

12. The method of claim 11 wherein:

the stabilizer mechanism includes an adjustment device and a rub bar;

the rub bar and the support table cooperatively define a slot through which the moving plate slides in contact with the rub bar;

the adjustment device includes a loading device operable to apply a load to the rub bar to compressively load the moving plate in the slot between the support table and the rub bar; and

the method includes selectively operating the loading device to change the compressive load on the moving plate.

13. An MRI-guided interventional system, comprising:

a trajectory guide frame with a cooperating targeting cannula, wherein the trajectory guide frame is configured to translate and rotate such that the targeting cannula can be positioned to a desired intrabody trajectory, and wherein the targeting cannula includes a guide bore therethrough that is configured to guide placement of an interventional device in vivo, wherein the trajectory guide frame comprises;

a base having a patient access aperture formed therein, wherein the base is configured to be secured to the body of a patient;

a yoke movably mounted to the base and rotatable about a roll axis;

a platform movably mounted to the yoke and rotatable about a pitch axis, wherein the platform comprises an X-Y support table and a moving plate, wherein the moving plate is movably mounted to the support table to move in an X-direction and Y-direction relative to the base; and

a stabilizer mechanism operable to selectively control movement between the X-Y support table and the moving plate to stabilize a position of the targeting cannula with respect to the base.

14. The system of claim 13 including at least one user-activatable actuator operably connected to the trajectory guide frame and configured to translate and rotate the trajectory guide frame relative to the body of the patient so as to position the targeting cannula to a desired intrabody trajectory.