APPARATUS AND METHOD FOR FOUR DIMENSIONAL SOFT TISSUE NAVIGATION

• US 20130303887A1
• Filed: 08/22/2011
• Published: 11/14/2013
• Est. Priority Date: 08/20/2010
• Status: Abandoned Application

• Current Assignee: Veran Medical Technologies, Inc. (Olympus Corporation)
• Original Assignee: Veran Medical Technologies, Inc. (Olympus Corporation)
• Inventors: Hunter, Mark, Lee, Christopher, Wennogle, Marc, Holsing, Troy L.
• Application Number:
  US13/817,730
• Publication Number:
  US 20130303887A1
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 1/00009 of image signals during a use of endoscope
• CPC Class Codes: A61B 1/0005 combining images e.g. side-by-side, superimposed or tiled
• CPC Class Codes: A61B 1/00094 Suction openings
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2061 using shape-sensors, e.g. fiber shape sensors with Bragg gratings
• CPC Class Codes: A61B 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• 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 5/0066 Optical coherence imaging
• 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 5/062 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 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 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 : lymph vessels, ducts or nodes
• 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 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61M 2025/09183 : having tools at the distal tip
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: G06T 2207/30061 : Lung

Abstract

A surgical instrument navigation system is provided that visually simulates a virtual volumetric scene of a body cavity of a patient from a point of view of a surgical instrument residing in the cavity of the patient. The surgical instrument navigation system includes: a surgical instrument; an imaging device which is operable to capture scan data representative of an internal region of interest within a given patient; a tracking subsystem that employs electro-magnetic sensing to capture in real-time position data indicative of the position of the surgical instrument; a data processor which is operable to render a volumetric, perspective image of the internal region of interest from a point of view of the surgical instrument; and a display which is operable to display the volumetric perspective image of the patient.

Claims

1. An image-guided method comprising directing an endoscope including a tip sensor to an anatomical position in a patient;

orienting an endoscopic view to a visual orientation of a user;

activating a steering mechanism of the endoscope to agitate the tip sensor in a plane; and

determining the orientation and location of the tip sensor in the patient and correlating the tip sensor location and orientation with one or more patient images.

2. The image-guided method of claim 1 wherein the anatomical position is a branching point of a bronchial tree.

3. The image-guided method of claim 1, wherein the tip sensor is an angled coil sensor, the coil being disposed at a 45°

angle relative to a core portion of the tip sensor.

4. The image-guided method of claim 1, wherein orientation and location determination comprise applying a deformation vector field.

5. The image-guided method of claim 1, wherein the one or more patient images are derived from an imaging device in conjunction with a patient tracking device disposed at an external region of the patient.

6. A method of using a guidewire or other navigated instrument with one to one rotation to continuously align a virtual display view to be consistent with an actual bronchoscopic video view.

7. A method of using a video input of the bronchoscope to adjust the virtual fly-through view to be consistent with a user'"'"'s normal perspective.

8. The method of claim 7 wherein video processing and matching techniques can be used between the real-time video and the virtual image to align.

11. A system or apparatus comprising one or more components for carrying out one or more elements of the method of claim 7.

12. A non-transitory processor-readable medium storing code representing instructions to cause a processor to perform a process, the code comprising code to carry out one or more elements of the method of claim 7.

9. A method of using bronchoscopic video to provide angular information at a current location to provide targeting or directional cues to the user.

10. The method of claim 9 wherein the angular information is derived from the location of patient anatomy in the image and the relative size of each within the image.

13. An imaging method comprising tracking the traveled path of an instrument in a patient and correlating the tracked path with one or more sets of image data derived from an imaging device in conjunction with a patient tracking device.

14. The method of claim 13 wherein a respiratory signal or a heartbeat signal derived from the patient tracking device is used to gate localization data of the instrument in an anatomical position of the patient to determine on or more patient airway models and correlate the instrument position to the image data to provide a registration of the one or more patient airway models during a respiratory cycle of the patient.

15. The method of claim 13 wherein the patient airway model determination comprises the addition of patient airway data to the image data.

16. The method of claim 15 wherein the patient airway data comprises branching points or segments of branching points in a bronchial tree.

17. The method of claim 13, wherein the correlation of the tracked path comprises applying a deformation vector field.

18. A system or apparatus comprising one or more components for carrying out one or more elements of the method of claim 13.

19. A non-transitory processor-readable medium storing code representing instructions to cause a processor to perform a process, the code comprising code to carry out one or more elements of the method of claim 13.

20. A endoscope or attachment thereof including one or more offset devices proximate a port of the endoscope or attachment, the offset devices capable of securing a navigated guidewire in a predetermined location.

21. The endoscope or attachment of claim 20 wherein a guidewire of the endoscope comprises one or more detachable sensors on a fiducial structure.

22. The endoscope or attachment of claim 20 wherein the endoscope comprises an sensor affixed proximate to an aspiration needle disposed at an end of the endoscope or attachment, wherein the needle tip and the sensor move in conjunction with one another upon actuation of the endoscope by a user.

23. The endoscope or attachment of claim 20 wherein the endoscope comprises an sensor affixed proximate to a brush disposed at an end of the endoscope or attachment, wherein the brush and the sensor move in conjunction with one another upon actuation of the endoscope by a user.

24. The endoscope or attachment of claim 20 wherein the endoscope comprises an sensor affixed proximate to a forceps disposed at an end of the endoscope or attachment, wherein the forceps and the sensor move in conjunction with one another upon actuation of the endoscope by a user.

25. The endoscope or attachment of claim 20, wherein the endoscope or attachment comprises three or more offset devices.

26. The endoscope or attachment of claim 20 wherein the endoscope or attachment includes two or more offsets in a series, each offset being positioned 1 cm from each other.

27. A system or method comprising the use of an endoscope or attachment of claim 20 in a medical procedure.

28. A method of constructing a three-dimensional model of an airway or vessel of a patient comprising correlating a three-dimensional location of instrument at an internal position of the patient with image data collected in conjunction with a patient tracking device disposed on an external position of the patient.

29. The method of claim 28 wherein the construction comprises recording three-dimensional location of an instrument and corresponding EBUS video or images to construct a three-dimensional model of the patient'"'"'s airway or a lesion therein.

30. The method of claim 28 wherein the construction comprises recording three-dimensional location and corresponding IVUS video or images to construct a three-dimensional model of the patient'"'"'s vessel or a plaque therein.

31. The method of claim 28 wherein the construction comprises recording three-dimensional location and corresponding OCT images to construct a three-dimensional model of the patient'"'"'s vessel or a plaque therein.

32. The method of claim 28 wherein the construction comprises the use of a fiber optic localization (FDL) device disposed on an instrument positioned within an airway or vessel of the patient and further comprises generating localization information and shape sensing information and applying an algorithm to said localization and shape sensing information to determine the location and orientation of the instrument within the patient.

33. A system or apparatus comprising one or more components for carrying out one or more elements of the method of claim 28.

34. A non-transitory processor-readable medium storing code representing instructions to cause a processor to perform a process, the code comprising code to carry out one or more elements of the method of claim 28.