Method and apparatus for performing interventional medical procedures using MR imaging of interventional device superimposed with ghost patient image

• US 5,155,435 A
• Filed: 08/08/1991
• Issued: 10/13/1992
• Est. Priority Date: 08/08/1991
• Status: Expired due to Term

• Current Assignee: Regents of the University of California (University of California)
• Original Assignee: Regents of the University of California (University of California)
• Inventors: Kaufman, Leon, Kramer, David M., Hawryszko, Christine
• Primary Examiner(s): Tokar, Michael J.
• Application Number:
  US07/741,943
• Time in Patent Office: 432 Days
• Field of Search: 364/413, 324/300, 324/307, 324/308, 324/309, 324/310, 324/311, 324/312, 324/313, 324/314, 324/318, 324/322, 128/653 A, 128/653 SC
• US Class Current: 324/309
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: G01R 33/28 Details of apparatus provided for in groups G01R33/44 - G01R33/64

Abstract

Positioning of interventional devices within the patient image volume of an MRI system is performed while viewing real-time fluoroscopic MR images of such devices superimposed upon a saved prior image ("ghost") of patient anatomy that was earlier located within the same image volume. After such interventional medical procedure is thoroughly planned using the earlier acquired three-dimensional ghost image, the patient anatomy is relocated within the image volume and the final selected trajectory for the interventional device or medical procedure is then performed (preferably while real time MRI fluoroscopy is used to monitor the actual interventional procedure within the real patient anatomy).

Claims

1. An MRI method comprising:

positioning an interventional device within the patient image volume of an MRI system while viewing real-time fluoroscopic MR images of such device superimposed on a saved prior image of patient anatomy that was earlier located within the same image volume.

2. An MRI method as in claim 1 further comprising:

defining a repeatable trajectory to at least one predetermined position of the interventional device within the image volume;

locating patient anatomy within the image volume to correspond with that of the saved prior image; and

re-introducing said interventional device into the image volume and into the patient anatomy along said repeatable trajectory to said at least one predetermined position.

3. An MRI method as in claim 2 wherein during said re-introducing step, the movement of said interventional device within the patient anatomy is subjected to real-time fluoroscopic MRI.

4. An MRI method comprising:

superimposing a prior saved image of a first physical field with real-time fluoroscopic MR images of a second physical field.

5. An MRI method as in claim 4 wherein said first physical field comprises a patient anatomy and said second physical field comprises an interventional device.

6. An MRI method as in claim 4 wherein said first physical field comprises an interventional device and said second physical field comprises a patient anatomy.

7. An MRI method as in claim 4, 5 or 6 further comprising:

thereafter generating real-time fluoroscopic MR images of said first physical field as it physically merges with said second physical field.

8. An MRI method for facilitating the safe introduction of interventional devices into patient anatomy, said method comprising:

placing patient anatomy within the image volume of an MRI system;

creating and saving an MR image of said patient anatomy;

removing said patient anatomy from the image volume;

locating a desired trajectory for an interventional device within said image volume while superimposing the saved MR image of said patient anatomy with real-time fluoroscopic MR images of the interventional device;

removing said interventional device from the MR image of the patient anatomy while retaining an ability to retrace said desired trajectory;

returning said patient anatomy to the image volume in substantial registry with its earlier position at the time the saved MR image was created; and

introducing said interventional device into said patient anatomy along said desired trajectory.

9. An MRI method as in claim 8 wherein, during said introducing step, MRI fluoroscopy is utilized to provide substantially real time images of said patient anatomy and of said interventional device as it retraces said desired trajectory.

10. An MRI method as in claim 8 wherein, during said locating step, said interventional device is at least partly loaded with an MR-visible fluid.

11. An MRI method as in claim 8 wherein, during said locating step, said interventional device is at least partly surrounded by an MR-visible fluid.

12. An MRI method as in claim 8 wherein said interventional device is mounted for movement within an adjustable guiding jig which can be adjusted to at least partially define said desired trajectory and to thereafter facilitate retracing of that same trajectory.

13. An MRI method as in claim 8 wherein said interventional device is used in a stereotatic procedure coordinated with a stereotatic frame affixed to the patient anatomy.

14. An MRI method as in claim 8 wherein said interventional device is used to withdraw patient tissue for biopsy.

15. An MRI method as in claim 8 wherein said interventional device is used to impart treatment to tissues within said patient anatomy.

16. An MRI method as in claim 8 performed with an MRI system having a main magnet structure which is openly accessible from a lateral side of the patient anatomy.

17. An MRI method as in claim 8 wherein said returning step includes creating new MR images of the patient anatomy and superimposing same with the earlier saved image of the patient anatomy.

18. An MRI method as in claim 8 wherein said locating step includes plural trial attempts to locate trajectories for the interventional device reusing the same superimposed saved image of the patient anatomy for each trial and a selection of one such trajectory as the optimum and desired trajectory.

19. An MRI apparatus comprising:

an open structure background MRI magnet allowing lateral access to a patient imaging volume for performance, of interventional procedures; and

means for positioning an interventional device within the patient image volume of an MRI system while viewing real-time fluoroscopic MR images of such device superimposed on a saved prior image of patient anatomy that was earlier located within the same image volume.

20. An MRI apparatus as in claim 19 further comprising:

means for defining a repeatable trajectory to at least one predetermined position of the interventional device within the image volume;

means for locating patient anatomy within the image volume to correspond with that of the saved prior image; and

means for re-introducing said interventional device into the image volume and into the patient anatomy along said repeatable trajectory to said at least one predetermined position.

21. An MRI apparatus as in claim 20 including means for performing real-time fluoroscopic MRI within said patient anatomy of said interventional device during said operation of said means for re-introducing.

22. An MRI apparatus comprising:

an open structure background MRI magnet allowing lateral access to a patient imaging volume for performance of interventional procedures; and

means for superimposing a prior saved image of a first physical field with real-time fluoroscopic MR images of a second physical field.

23. An MRI apparatus as in claim 22 wherein said first physical field comprises a patient anatomy and said second physical field comprises an interventional device.

24. An MRI apparatus as in claim 22 wherein said first physical field comprises an interventional device and said second physical field comprises a patient anatomy.

25. An MRI apparatus as in claim 22, 23 or 24 further comprising:

means for generating real-time fluoroscopic MR images of said first physical field as it physically merges with said second physical field.

26. An MRI apparatus for facilitating the safe introduction of interventional devices into patient anatomy, said apparatus comprising:

means for placing patient anatomy within the image volume of an MRI system;

means for creating and saving an MR image of said patient anatomy;

means for removing said patient anatomy from the image volume;

means for locating a desired trajectory for an interventional device within said image volume while superimposing the saved MR image of said patient anatomy with real-time fluoroscopic MR images of the interventional device;

means for removing said interventional device from the MR image of the patient anatomy while retaining an ability to retrace said desired trajectory;

means for returning said patient anatomy to the image volume in substantial registry with its earlier position at the time the saved MR image was created; and

means for introducing said interventional device into said patient anatomy along said desired trajectory.

27. An MRI apparatus as in claim 26 including means for performing MRI fluoroscopy to provide substantially real time images of said patient anatomy and of said interventional device as it retraces said desired trajectory.

28. An MRI apparatus as in claim 26 wherein said interventional device is at least partly loaded with an MR-visible fluid when used to locate said trajectory.

29. An MRI apparatus as in claim 26 wherein said interventional device is at least partly surrounded by an MR-visible fluid when used to locate said trajectory.

30. An MRI apparatus as in claim 26 wherein said interventional device is mounted for movement within an adjustable guiding jig which can be adjusted to at least partially define said desired trajectory and to thereafter facilitate retracing of that same trajectory.

31. An MRI apparatus as in claim 26 wherein said interventional device is part of a stereotatic apparatus coordinated with a stereotatic frame affixed to the patient anatomy.

32. An MRI apparatus as in claim 26 wherein said interventional device is capable of withdrawing patient tissue for biopsy.

33. An MRI apparatus as in claim 26 wherein said interventional device capable of imparting treatment to tissues within said patient anatomy.

34. An MRI apparatus as in claim 26 including means for creating new MR images of the patient anatomy and superimposing same with the earlier saved image of the patient anatomy.