System using computed tomography as for selective body treatment

• US 4,608,977 A
• Filed: 12/20/1982
• Issued: 09/02/1986
• Est. Priority Date: 08/29/1979
• Status: Expired due to Term

• Current Assignee: Sherwood Services AG
• Original Assignee: Russell A. Brown
• Inventors: Brown, Russell A.
• Primary Examiner(s): NOT, DEFINED
• Assistant Examiner(s): Kartchner, Gene B.
• Application Number:
  US06/450,955
• Time in Patent Office: 1,352 Days
• Field of Search: 128/303 B, 128/660, 128/630, 378/208, 378/20, 378/162-164
• US Class Current: 606/130
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A system utilizing computed tomography (CT) as for surgery. A CT scanner provides data representative of or slices taken through a body member. Display apparatus reveals the slices. A reference apparatus (frame) affixed to the body, operates in conjunction with the scanner and the display apparatus. The frame includes: structure for affixation to the body, holder means for guiding the therapeutic instrument, and structure for providing reference indications. The system further includes a data processing structure and control means for transforming data between frame coordinates and slice coordinates.

Claims

1. A method of treating the interior of a body at a specific target location, comprising:

rigidly affixing a support means to the body;

fastening a graphic reference means to said support means to provide varying data to a computed tomography (CT) scanner to index scan in relation to said support means;

scanning said body and said support means with a computed tomography (CT) scanner to provide data representative of scan slices through said body and said reference means; and

computing a course to said target location using said data representative of scan slices.

2. A method according to claim 1 further including the step of fastening a probe means to said support means and aligning said probe means in accordance with the computed course to attain said target location.

3. In association with a computed tomography (CT) scanner and a probe means for attaining a target location in a body, the improvement which comprises an apparatus for developing data to compute a course to said target location comprising:

support means adapted to be rigidly connected to said body for providing a frame coordinate reference;

graphic reference means supported by said support means and including diagonal members with respect to said frame coordinate reference whereby upon scanning of said body and said graphic reference means by said scanner, slice data is obtained which includes data for referencing such data to said support means.

4. Stereotactic frame apparatus adapted for use in performing stereotactic surgery with an X-ray CT scanner, said stereotactic frame apparatus comprising:

a stereotactic frame defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient,

said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said three-dimensional coordinate system, and

X-ray detectable fiducial marker means associated with said stereotactic frame defining at least three noncollinear points within each planar cross-section therethrough, said marker means including means for determining the three-dimensional coordinates of said three points in each said cross-section whereby a scan in any single plane provides the three-dimensional coordinates of said three noncollinear points.

5. Apparatus as in claim 4 wherein said X-ray detectable fiducial markers comprise:

a member having an X-ray detectable feature which intersects any said cross-section at a location which varies depending upon the relative disposition of the cross-section.

6. An improved stereotactic surgery frame of the type defining a three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said three-dimensional coordinate system, said improvement comprising:

X-ray detectable fiducial markers physically associated with said frame and defining at least three measurable noncollinear fiducial points, each having predetermined visually determinable three-dimensional coordinates within a single cross-section depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers.

7. An improvement as in claim 6 wherein said fiducial markers comprise:

a member having a detectable feature which intersects any desired cross-sectional depiction at a location which varies depending upon the relative disposition of the cross-section.

8. A method to facilitate stereotactic surgery, said method comprising the steps of:

fixing a stereotactic surgical frame, having a first predetermined three-dimensional coordinate system, with respect to living tissue,

scanning the combination of said frame and living tissue with penetrating radiation to provide a cross-sectional depiction thereof in a single plane which includes a desired anatomical target within said living tissue,

determining the three-dimensional coordinates of said target with respect to a second predetermined three-dimensional coordinate system,

determining the three-dimensional coordinates of each of at least three non-collinear points located within said cross-sectional depiction in a single plane, both with respect to the three-dimensional coordinate system of said frame and with respect to said second three-dimensional coordinate system, and

using said determined coordinates to calculate the coordinates of said target with respect to the three-dimensional coordinate system of said frame.

9. A method as in claim 8 wherein said scanning step is performed with an X-ray CT scanner.

10. A method as in claim 8 wherein said fixing step includes the attachment of X-ray detectable fiducial markers to said frame.

11. A method as in claim 8 wherein said second-mentioned determining step includes measurement of relative distances between detectable features associated with said frame at predetermined relative locations and present in said cross-sectional depiction.

12. Apparatus for performing three-dimensional stereotactic surgery within the anatomy of a living patient, said apparatus comprising:

a tomographic scanner having a programmable data processing computer, a CRT display for depicting the relative densities of elemental volumes with a desired planar cross-sectional slice of matter appropriately placed within the CT scanner, and an operator console for entering data and/or instructions into said computer and for identifying the location and relative positional coordinates of any desired element or portion of said slice;

a rigid frame fixably securable with respect to said anatomy and defining a multi-dimensional coordinate system in which surgical devices can be precisely positioned;

said frame including plural detectable features which if included as a portion of a single said slice of matter in a single plane, will be represented in said depiction of said cross-sectional slice as a respectively corresponding set of at least three functional points in the plane having predetermined known or readily determinable three-dimensional frame coordinates; and

said computer being programmed to compute the three-dimensional frame coordinates of any desired anatomical target depicted within said slice as a function of the frame coordinates of said fiducial points and of the relative positional coordinates of said target and said fiducial points within said CRT display.

13. Apparatus as in claim 12 wherein said rigid frame includes at least one detectable feature disposed along a path connecting dissimilar portions of similar spaced-apart frame structures.

14. Apparatus as in claim 12 or 28 wherein said rigid frame includes an inclined rod connected between dissimilar portions of two spaced-apart parallel posts.

15. A method to facilitate stereotactic surgery, said method comprising the steps of:

fixing a stereotactic surgical frame, having a first predetermined multi-dimensional coordinate system, with respect to living tissue,

scanning the combination of said frame and living tissue with penetrating radiation to provide a cross-sectional depiction thereof in a single plane which includes a desired anatomical target within said living tissue,

determining the three-dimensional coordinates of said target with respect to a second predetermined multi-dimensional coordinate system,

determining the three-dimensional coordinates of each of plural points located within said cross-sectional depiction, both with respect to the first multi-dimensional coordinate system of said frame and with respect to said second multi-dimensional coordinate system, and

using said determined three-dimensional coordinates to calculate the three-dimensional coordinates of said target with respect to the multi-dimensional coordinate system of said frame.

16. A method as in claim 15 wherein said scanning step is performed with an x-ray CT scanner.

17. A method as in claim 15 wherein said fixing step includes the attachment of x-ray detectable fiducial markers to said frame.

18. A method as in claim 15 wherein said determining step includes measurement of relative distances between detectable features associated with said frame at predetermined relative location and present in said cross-sectional depiction.

19. An improved stereotactic surgery frame of the type defining a multi-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient and which can thereafter position a desired surgical device within such anatomy at any desired location defined in terms of said multi-dimensional coordinate system, said improvement comprising:

fiducial markers physically associated with said frame and defining at least three unique non-collinear measurable fiducial points having determinable three-dimensional coordinates with respect to said frame with a single planar cross-sectional depiction taken through the combination of said anatomy and of said frame and its associated fiducial markers.

20. Apparatus for use in performing stereotactic surgery, said apparatus comprising:

an X-ray CT scanner capable of measuring relative X-ray absorption within elemental volumes of a desired planar cross-section of the anatomy of a living patient and which CT scanner also defines a first multi-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions with said planar cross-section relative to said first coordinate system,

a stereotactic frame defining a second multi-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient,

said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second multi-dimensional coordinate system, and

X-ray detectable fiducial markers associated with said stereotactic frame defining plural points within each of said planar cross-sections, each point having determinable coordinates in both said first and said second coordinate systems

said CT scanner including means for transforming the measured CT scan coordinates in three dimensions of a desired portion of the anatomy to corresponding three-dimensional coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery.

21. Stereotactic frame apparatus adapted for use in performing stereotactic surgery, said apparatus comprising:

an X-ray CT scanner means capable of measuring relative X-ray absorption within elemental volumes of a desired cross-section of the anatomy of a living patient and which CT scanner means defines a first three-dimensional CT scanner coordinate system relative to its own geometrical structure for locating specific anatomical positions within said cross-section relative to said first coordinate system,

a stereotactic frame defining a second three-dimensional coordinate system which can be fixed with respect to the anatomy of a living patient,

said stereotactic frame including mechanism for positioning a desired surgical device within said anatomy at any desired location defined in terms of said second three-dimensional coordinate system,

X-ray detectable fiducial markers associated with said stereotactic frame defining at least three non-collinear points within each of said cross-sections, each point having determinable coordinates in both said first and said second coordinate systems such that the measured CT scan coordinates of a desired portion of the anatomy can be transformed to corresponding coordinates in said second coordinate system thereby facilitating the use of said stereotactic frame during stereotactic surgery,

said frame including spaced-apart posts; and

said markers including a rod extending between dissimilar portions of pairs of said spaced-apart posts.

22. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

a computed tomography (CT) scanner means for scanning through the body in the proximity of said support means to product graphic data representative of cross-sectional scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means; and

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location.

23. A system according to claim 22 further including means for displaying said graphic data and said reference data.

24. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means including rods to extend diagonally with respect to said support means and supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means; and

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location.

25. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means;

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location; and

a data processing means for computing settings for said path on the basis of said graphic data and reference data and further including means to transform data defining said path to a coordinate system referenced to said scan slices.

26. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means;

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location; and

data processing means to transform data from a coordinate system referenced to said support means to a coordinate system, or coordinate systems, referenced to said graphic data representative of said body.

27. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means;

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location; and

data processing means to transform data from a coordinate system referenced to said support means to coordinate systems referenced to said scan slices.

28. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means;

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location; and

data processing means to transform data from a coordinate system, or coordinate systems, referenced to said graphic data representative of a part of said body to a coordinate system referenced to said support means.

29. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means;

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location; and

data processing means to transform data from coordinate systems referenced to said scan slices to a coordinate system referenced to said support means.

30. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means;

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location; and

data processing means to transform said graphic data representative of a part of said body from a coordinate system referenced to said graphic data representative of a part of said body to a coordinate system referenced to said support means.

31. A system for specifying a path into a body as to direct a surgical probe, comprising:

support means adapted to be rigidly connected to said body;

scanner means for scanning through the body in the proximity of said support means to produce graphic data representative of scan slices through said body defining a target location;

graphic reference means supported by said support means to be within said scan slices and for providing reference data for said individual scan slices with respect to said support means;

probe means supported by said support means and setable to penetrate said body along a path in accordance with said graphic data and said reference data to attain said target location; and

data processing means further including means to transform data defining said path from a coordinate system referenced to said support means to coordinate systems referenced to each of said scan slices.