SYSTEM AND METHOD FOR IMAGE GUIDED MEDICAL PROCEDURES

• US 20140073907A1
• Filed: 03/15/2013
• Published: 03/13/2014
• Est. Priority Date: 09/12/2012
• Status: Abandoned Application

• Current Assignee: Convergent Life Sciences, Inc.
• Original Assignee: Convergent Life Sciences, Inc.
• Inventors: Kumar, Dinesh, Vohra, Amit, Sperling, Daniel S.
• Application Number:
  US13/835,479
• Publication Number:
  US 20140073907A1
• Time in Patent Office: Days
• US Class Current: 600/414
• CPC Class Codes: A61B 10/00 Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis vaccination prophylaxis, vaccination therapy A61B17/20; Sex determination; Ovulation-period determination menstruation tables G06C3/00; Throat striking implements
• CPC Class Codes: A61B 10/02 Instruments for taking cell samples or for biopsy A61B10/0038 and A61B10/0045 take precedence; needle locating or guiding means A61B17/3403; samplers for enzymology or microbiology C12M1/26; sampling or preparing biological specimens G01N33/48
• CPC Class Codes: A61B 10/0241 for prostate
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2018/2005 with beam delivery through an interstitially insertable device, e.g. needle
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 2005/0612 using probes penetrating tissue; interstitial probes
• CPC Class Codes: A61N 2005/063 comprising light transmitting means, e.g. optical fibres
• CPC Class Codes: A61N 2005/1012 Templates or grids for guiding the introduction of sources
• CPC Class Codes: A61N 5/0601 Apparatus for use inside the body
• CPC Class Codes: A61N 5/0625 Warming the body, e.g. hyperthermia treatment

Abstract

A system and method combines information from a plurality of medical imaging modalities, such as PET, CT, MRI, MRSI, Ultrasound, Echo Cardiograms, Photoacoustic Imaging and Elastography for a medical image guided procedure, such that a pre-procedure image using one of these imaging modalities, is fused with an intra-procedure imaging modality used for real time image guidance for a medical procedure for any soft tissue organ or gland such as prostate, skin, heart, lung, kidney, liver, bladder, ovaries, and thyroid, wherein the soft tissue deformation and changes between the two imaging instances are modeled and accounted for automatically.

Claims

1. A method for combining information from plurality of medical imaging modalities, comprising:

acquiring a first volumetric image using a first volumetric imaging modality of an anatomical region;

defining an elastic soft tissue model for at least a portion of the anatomical region encompassed by the first volumetric image;

labeling features of the anatomical region based on at least the first volumetric image and the soft tissue model, comprising at least features of the anatomical region which are visualized by both the first imaging modality and a second imaging modality, and features of the anatomical region which are poorly visualized in the second imaging modality;

acquiring a second volumetric image of the anatomical region using the second imaging modality comprising a real time image;

registering the features of the anatomical region which are visualized by both the first imaging modality and a second imaging modality, and the features of the anatomical region which are poorly visualized in the second imaging modality, with respect to the soft tissue model, such that the features of the anatomical region which are visualized by both the first imaging modality and a second imaging modality are linked, compensating for at least one distortion of the portion of the anatomical region between a first time of the first volumetric image and a second time of the second volumetric image; and

presenting an output based on at least the features of the anatomical region which are poorly visualized in the second imaging modality in the real time image, compensated based on at least the registered features and the soft tissue model.

2. The method according to claim 1, wherein the first imaging modality comprises at least one selected from the group consisting of positron emission tomography, computed tomography, magnetic resonance imaging, magnetic resonance spectrography imaging, photoacoustic imaging, high frequency ultrasound, and elastography.

3. The method according to claim 1, wherein the anatomical region comprises at least one organ selected from the group consisting of prostate, skin, heart, lung, kidney, liver, bladder, ovaries, and thyroid.

4. The method according to claim 1, wherein further comprising acquiring a tissue sample from a location determined based on at least the first imaging modality and the second imaging modality.

5. The method according to claim 1, wherein further comprising delivering a therapeutic intervention at a location determined based on at least the first imaging modality and the second imaging modality.

6. The method according to claim 5, wherein the therapeutic intervention includes one or more selected from the group consisting of laser ablation, radiofrequency ablation, high intensity focused ultrasound, brachytherapy, stem cell injection for ischemia of the heart, cryotherapy, direct injection of a photothermal or photodynamic agent, and radiotherapy.

7. The method according to claim 1, further comprising performing at least one image-guided at least partially automated procedure selected from the group consisting of high intensity focused ultrasound, IMRT, and robotic surgery.

8. The method according to claim 1, wherein the differentially visualized anatomical region comprises at least one selected from the group consisting of a suspicious lesion for targeted biopsy, a suspicious lesion for targeted therapy, and a lesion for targeted dose delivery.

9. The method according to claim 1, wherein the differentially visualized anatomical region is at least one anatomical structure to be spared in an invasive procedure, selected from the group consisting of a nerve bundle, a urethra, a rectum and a bladder.

10. The method according to claim 1, wherein the registered features comprise at least one anatomical landmark selected from the group consisting of a urethra, a urethra at a prostate base, a urethra at an apex, a verumontanum, a calcification and a cyst, a seminal vesicle, an ejaculatory duct, a bladder and a rectum.

11. The method according to claim 1, further comprising automatically defining a plan comprising a target and an invasive path to reach the target.

12. The method according to claim 11, wherein the plan is defined based on the first imaging modality, and is adapted in real time based on at least the second imaging modality.

13. The method according to claim 11, wherein the plan comprises a plurality of targets.

14. The method according to claim 1, wherein a plurality of anatomical features are consistently labeled in the first volumetric image and the second volumetric image.

15. The method according to claim 1, wherein the soft tissue model comprises an elastic triangular mesh approximating a surface of an organ.

16. The method according to claim 1, wherein the anatomical landmark registration is performed rigidly using a simultaneous landmark and surface registration algorithm.

17. The method according to claim 16, further comprising performing an affine registration.

18. The method according to claim 1, wherein the registering comprises an elastic registration based on at least one parameter selected from the group consisting of an intensity, a binary mask, and surfaces and landmarks.

19. The method according to claim 1, wherein the model is derived from a plurality of training datasets representing different states of deformation of an organ of a respective human using the first imaging modality and the second imaging modality.

20. The method according to claim 1, further comprising identifying a mismatch of corresponding anatomical features of the first volumetric image and the second volumetric image, and updating the registration to converge the corresponding anatomical features to reduce the mismatch based on corrections of an elastic deformation model constrained by object boundaries.

21. A method for combining information from plurality of medical imaging modalities, comprising:

acquiring volumetric images using a first volumetric imaging modality of an anatomical region of a person under a plurality of states of deformation;

acquiring volumetric images using a second volumetric imaging modality of the anatomical region of the person under a plurality of states of deformation;

defining an elastic soft tissue model for the anatomical region comprising model parameters representing tissue compliance and surface properties;

labeling features of the anatomical region based on at least the volumetric images of the first imaging modality, the volumetric images of the second imaging modality, and the soft tissue model, wherein the labeling aligns corresponding features and compensates for rigid, elastic and affine transform of the anatomical region between times for acquiring the volumetric images of the first imaging modality and the volumetric images of the second imaging modality; and

presenting an output based on at least the labeled features of the anatomical region.

22. A system for combining information from plurality of medical imaging modalities, comprising:

an input port configured to receive at least two first volumetric images using a first volumetric imaging modality of an anatomical region representing respectively different states of elastic deformation, and at least two second volumetric images using a second volumetric imaging modality, of the anatomical region representing respectively different states of elastic deformation;

at least one processor configured to define an elastic soft tissue model for at least a portion of the anatomical region encompassed by the first volumetric image, and to label features of the anatomical region based on at least the first volumetric image and the soft tissue model; and

a memory configured to store the defined elastic soft tissue model.