Frameless stereotaxy system

• US 5,309,913 A
• Filed: 11/30/1992
• Issued: 05/10/1994
• Est. Priority Date: 11/30/1992
• Status: Expired due to Term

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Steiner, Charles P., Kormos, Donald W., Barnett, Gene H.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US07/983,390
• Time in Patent Office: 526 Days
• Field of Search: 128/653.1, 128/653.2, 128/660.03, 606/130, 378/4, 378/20, 378/205
• US Class Current: 600/429
• 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 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• 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 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

A patient'"'"'s head is anchored (16) at one end of a patient support (10). An array of receivers (50) are mounted on a frame (12) which is fixed to the patient support. The frame carries at least one reference transmitter (52). A wand (42) has at least two emitters (44, 46) mounted thereto. By measuring relative travel time of the signals from the wand emitters to the receiver array and comparing the travel time with travel time over a known distance from the reference transmitter to one or more of the receivers, the position of the wand in a coordinate system of the patient support is determined (80). A three-dimensional array of diagnostic image data was taken through the anchored portion of the patient and at least three markers (114) affixed to the patient. By positioning the wand on the markers after the patient is secured to the patient support, a transform (110) between the patient support coordinate system and the image data coordinate system is derived. Once the relationship between the coordinate systems is known, the surgeon can use the wand to select locations and orientations on a surface of the patient and retrieve corresponding portions of the image data for display on video monitors (30).

Claims

1. A stereotaxy system comprising:

a subject support;

a means for securing a preselected portion of a subject to the subject support;

a frame assembly which mounts at least three receivers in a fixed relationship to the subject support closely adjacent the means for securing a portion of the subject to the subject support;

at least one reference emitter mounted a fixed, known distance from the receivers, the reference emitter emitting a reference signal which travels from the reference emitter the fixed distance to the receivers;

a calibration means for measuring a reference travel time of the reference signal over the preselected distance and generating a corresponding calibration factor;

a wand having a pointer and at least two emitters mounted thereto, the two wand emitters selectively emitting wand signals which are received by the at least three receivers;

a wand position determining means for determining a position of the wand pointer by measuring wand signal travel times of the wand signals between the two wand emitters and the at least three receivers, the wand position determining means being connected with the calibration means for calibrating the wand signal travel times with the reference travel time.

2. The system as set forth in claim 1 further including:

a three-dimensional image memory means for storing image data indicative of a three-dimensional region of the portion of the subject which is secured to the subject support;

a plane selecting means for selecting planar slices of data from the three-dimensional image memory means;

a display means for converting the selected slices of data from the plane selecting means into human-readable displays;

a transform means for transforming with a wand pointer coordinate system to image data coordinate system transform a position of the wand pointer into a coordinate system of the image data stored in the three-dimensional image memory means, the transform means being connected with the plane selecting means such that the displayed images have a preselected relationship to the position of the wand pointer.

3. The system as set forth in claim 2 wherein the frame assembly is mounted directly to the subject support to be movable therewith such that movement of the subject support does not alter the subject coordinate system.

4. The system as set forth in claim 2 wherein the frame assembly is mounted to the subject support angled from a perpendicular relationship to focus on the secured subject region, even when mounted away from the secured region of the subject.

5. The system as set forth in claim 1 wherein a plurality of reference emitters are mounted to the frame in fixed relationship to the receivers.

6. The system as set forth in claim 1 wherein the wand includes a physical tip portion, a portion extending along a pointing axis of the wand, and an offset portion which is offset from the pointing axis of the wand, the wand emitters being mounted in a spaced relationship to the offset section in alignment with the pointing axis of the wand such that the wand tip and the two actuators are co-linear.

7. A stereotaxy system comprising:

a subject support;

a means for securing a preselected portion of a subject to the subject support;

at least three markers adapted to be disposed on the preselected subject portion;

a frame assembly which mounts at least three receivers in a fixed relationship to the subject support;

at least one reference emitter mounted a fixed, known distance from the receivers, the reference emitter emitting a reference signal which travels from the reference emitter the fixed distance to the receivers;

a calibration means for measuring a reference travel time of the reference signal over the preselected distance and generating a corresponding calibration factor;

a wand having a pointer and at least two emitters mounted thereto, the two wand emitters selectively emitting wand signals which are received by the at least three receivers;

a wand position determining means for determining a position of the wand pointer by measuring wand signal travel times of the wand signals between the two wand emitters and the at least three receivers, the wand position determining means being connected with the calibration means for calibrating the wand signal travel times with the reference travel time;

a three-dimensional image memory means for storing image data indicative of a three-dimensional region of the preselected subject portion and the markers in an image data coordinate system;

a plane selecting means for selecting planar slices of data from the three-dimensional image memory means;

a display means for converting the selected slices of data from the plane selecting means into human-readable displays;

a transform means for transforming a position of the wand pointer into a coordinate system of the image data stored in the three-dimensional image memory means with a wand pointer position to image data coordinate system transform, the transform means being connected with the plane selecting means such that the displayed images have a preselected relationship to the position of the wand pointer; and

a transform calculating means for calculating the wand pointer to image data coordinate system transform from positions of the markers in the image data coordinate system determined by selectively placing the wand pointer on each of the markers.

8. The system as set forth in claim 7 wherein the markers contain materials which are visible in both magnetic resonance and CT imaging techniques such that the same markers can be used for both CT and magnetic resonance examinations.

9. A stereotaxy apparatus comprising:

a patient support;

a means for securing a preselected portion of a patient to the patient support;

a frame assembly which mounts at least three receivers in a fixed relationship to the patient support closely adjacent the means for securing a portion of the patient to the patient support;

a wand having a tip end and at least two emitters mounted thereto, the two wand emitters selectively emitting signals which are received by the at least three receivers;

a wand position determining means for determining a position of the wand tip in accordance with travel times of the signals between the two wand emitters and the at least three receivers;

at least one reference emitter mounted a fixed, known distance from the receivers, the reference emitter emitting a reference signal which travels from the emitter the fixed distance to the receivers, a calibration means for measuring a travel time of the reference signal over the preselected distance, the wand position determining means being connected with the calibration means for correcting the wand tip position in accordance with the travel time of the reference signal over the fixed distance;

a three-dimensional memory means for storing image data indicative of a three-dimensional region of the portion of the patient which is secured to the patient support;

a slice selecting means for selecting slices of data from the three-dimensional memory means;

a display means for converting the selected slices of data into a human-readable display;

a transform means for transforming a position of the wand tip into a coordinate system of the image data stored in the three-dimensional image memory, the transform means being connected with the slice selecting means such that the displayed images have a preselected relationship to the position of the wand tip.

10. A stereotaxy method comprising:

a) securing a portion of a subject to a subject supporting surface in close proximity to at least three signal receivers that are mounted in a fixed relationship to the patient supporting surface;

b) positioning a wand to designate selected locations on the subject portion, the wand having at least two wand emitters mounted thereon for selectively emitting signals which are received by the receivers;

c) actuating the wand emitters to emit wand signals;

d) from the wand emitter signals, calculating a calculated wand emitter distance between the wand emitters in a coordinate system of the subject support;

e) comparing the calculated wand emitter distance with a physical distance between the wand emitters;

f) in response to the comparison of step e) exceeding a preselected standard, providing an error signal.

11. A stereotaxy method comprising:

a) securing a portion of a subject to a subject supporting surface in close proximity to at least three signal receivers that are mounted in a fixed relationship to the patient supporting surface, a reference signal emitter fixedly mounted at a fixed, known distance from the plurality of receivers;

b) positioning a wand to designate selected locations on the subject portion, the wand having at least two wand emitters mounted thereon for selectively emitting signals which are received by the receivers;

c) actuating the wand emitters individually and the reference emitter in close temporal proximity to emit wand and reference signals;

d) measuring travel durations for the wand and reference signals to travel from each of the wand emitters to the receivers and from the reference emitter to the receivers;

e) from the travel times, calculating coordinates of the locations designated by the wand in a coordinate system of the subject support.

12. The method as set forth in claim 11 further including:

calculating a distance between the wand emitters;

comparing the calculated distance between the wand emitters with a premeasured physical distance between the emitters to verify an acceptable accuracy of the measurement.

13. The method as set forth in claim 12 further including sterilizing the wand.

14. The method as set forth in claim 12 further including repeating steps (b)-(e) with the wand in a second location to calculate coordinates of the second location and further including from the coordinates of the first and second locations, determining a distance therebetween.

15. The method as set forth in claim 12 wherein the subject support coordinate system coordinates calculating step includes:

determining travel times between the wand emitters and the plurality of receivers, the relative travel times between each emitter and the receivers being indicative of a location of each emitter;

correcting at least one of (i) the relative travel times between the wand emitters and the receivers and (ii) the determined positions of the emitters in accordance with the travel time between the reference emitter and at least one of the receivers, whereby the position of the wand is corrected for variations in signal transmission speed attributable to changes in temperature, humidity, and other conditions adjacent the subject.

16. The method as set forth in claim 15 wherein:

the two wand emitters are actuated alternately a plurality of times;

the reference emitter is actuated at least once;

the travel times are adjusted for delays between (i) actuation of the emitter and emission of the signal and between (ii) the signal reaching the receiver and being converted into an electronic timing signal;

the correcting step includes correcting the travel times between the wand emitters and the receivers in accordance with the travel time between the reference emitter and the receivers; and

further including;

averaging the corrected travel times and determining coordinates for each wand emitter;

from the wand emitter coordinates calculating a coordinate of a tip portion of the wand.

17. The method as set forth in claim 12 further including:

conducting a first non-invasive diagnostic examination of the subject portion and generating three-dimensional electronic image data thereof;

storing the three-dimensional image data;

determining a transform between the a first image data coordinate system and the subject support coordinate system.

18. The method as set forth in claim 17 further including:

conducting a second non-invasive diagnostic examination of the subject portion and generating three-dimensional electronic image data thereof;

storing the second examination three-dimensional image data;

determining a transform between the second image data coordinate system and the subject support coordinate system;

determining a relationship between the first and second image data coordinate systems.

19. The method as set forth in claim 17 wherein the transform determining step includes:

mounting at least three non-invasive examination visible markers to the subject portion such that the three-dimensional diagnostic image data includes indications of the at least three markers;

with the wand designating a position of each of the three markers and determining a coordinate of each marker in the subject support coordinate system;

comparing the coordinates of the markers in the subject support coordinate system and a position of the marker indications in the image data coordinate system to determine at least a translation offset between the image data and subject support coordinate systems and a rotational offset between the subject support and image data coordinate systems.