Frameless laser guided stereotactic localization system

• US 5,590,655 A
• Filed: 12/15/1994
• Issued: 01/07/1997
• Est. Priority Date: 09/20/1993
• Status: Expired due to Term

• Current Assignee: Karl L. Hussman
• Original Assignee: Karl L. Hussman
• Inventors: Hussman, Karl L.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/196,842
• Time in Patent Office: 754 Days
• Field of Search: 606/130, 128/653.1, 128/653.2, 128/654, 128/754
• US Class Current: 600/426
• 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 2017/00911 for fields applied by a magnetic resonance imaging system
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/13 guided by light, e.g. laser pointers
• CPC Class Codes: A61B 90/17 for soft tissue, e.g. breast-holding devices
• CPC Class Codes: G01R 33/285 Invasive instruments, e.g. catheters or biopsy needles, specially adapted for tracking, guiding or visualization by NMR
• CPC Class Codes: G01R 33/58 Calibration of imaging systems, e.g. using test probes , Phantoms; Calibration objects or fiducial markers such as active or passive RF coils surrounding an MR active material

Abstract

A lesion localization system is disclosed which employs imaging visible members (926, 928), and manifested sets of imaging space coordinates to define a retrograde point (1004) that is colinear with a lesion (940) and a selected entry point (946) thereto. Retrograde and antegrade lasers (1014, 1015) are employed to use the retrograde point in guidance of a medical instrument to the lesion. The localization system avoids mechanical calibration of stereotactic frames and is simpler to operate.

Claims

1. A method for guiding an instrument tip to a target point identified in a patient via an imaging modality, comprising the steps of:

establishing an imaging space coordinate system;

selecting an entry point;

placing an imaging visible marker at said entry point;

imaging said target point and said entry point to determine the imaging space coordinates thereof;

determining the coordinates of a retrograde point that lies on a line defined by said entry point coordinates and said target point coordinates wherein said entry point is between said retrograde point and said target point; and

,

providing a retrograde laser having a retrograde laser beam and a medical instrument having said tip;

causing said retrograde laser beam to be directed along said line to illuminate said retrograde point; and

,

guiding said instrument along said line by keeping said retrograde beam on said retrograde point to position said instrument tip proximate to said target point.

2. The method of claim 1 wherein said imaging step further includes the steps of:

disposing at least one imaging visible fiduciary member in a spaced relationship with said target point; and

,

employing the image of said fiduciary member to determine said coordinates.

3. The method of claim 1 wherein said determining step further includes the steps of:

manifesting a set of imaging space coordinates; and

,

finding the intersection of said line with said coordinate set.

4. The method of claim 1 further including the steps of:

providing an antegrade laser having an antegrade laser beam;

directing said antegrade laser beam along said line; and

,

illuminating said entry point with said antegrade laser beam.

5. The method of claim 4 wherein said directing said antegrade laser beam step includes originating said antegrade laser beam from said instrument.

6. The method of claim 4 wherein said medical instrument further includes an end spaced from said instrument tip and said guiding step includes the step of illuminating said end antegrade laser beam as said tip is positioned at said entry point and moved along said line to position said tip proximate to said target point by freehand technique.

7. The method of claim 1 further including the step of providing a thermoplastic mesh for immobilizing a body part containing said target point.

8. A method of guiding an instrument tip to a target point identified in a patient via an imaging modality, comprising the steps of:

establishing an imaging space coordinate system;

selecting an entry point;

placing an imaging visible marker at said entry point;

imaging said target point and said entry point to determine the imaging space coordinates thereof;

determining the coordinates of a retrograde point that lies on a line defined by said entry point coordinates and said target point coordinates wherein said entry point is between said retrograde point and said target point;

providing an antegrade laser having an antegrade laser beam and a medical instrument having a tip;

causing said antegrade laser beam to be directed from said retrograde point along said line to illuminate said entry point; and

,

guiding said instrument along said antegrade beam to position said instrument tip proximate to said target point.

9. The method of claim 8 wherein said imaging step further includes the steps of:

disposing at least one imaging visible fiduciary member in a spaced relationship with said target point; and

,

employing the image of said fiduciary member to determine said line.

10. The method of claim 8 wherein said medical instrument further includes an end spaced from said instrument tip and said guiding step includes the step of illuminating said end with said antegrade laser beam as said tip is positioned at said entry point and moved along said line to position said tip proximate to said target point by freehand technique.

11. The method of claim 8 further including the step of providing a thermoplastic mesh for immobilizing a body part containing said target point.

12. Apparatus for use with a medical imaging system for guiding an instrument tip to a target point in a patient via a selected entry point on a patient, the apparatus comprising:

indicia manifesting a selected coordinate set spaced from the patient;

means for determining the imaging space coordinates of the entry point and target point, defining a line therebetween, and locating a retrograde point on said line at the intersection of said line with said indicia wherein said entry point is between said retrograde point and said target point;

means for manifesting said retrograde point on said indicia;

a medical instrument having a tip; and

,

means for utilizing said retrograde point for guiding said instrument along said line for positioning said tip proximate to said target point including a retrograde laser for providing a retrograde laser beam along said line for illuminating said retrograde point.

13. Apparatus of claim 12 wherein said determining means includes at least one imaging visible fiduciary member for placement in a spaced relationship with the target point.

14. Apparatus of claim 12 and further including an antegrade laser for providing an antegrade laser beam directed along said line for illuminating said entry point.

15. Apparatus of claim 12 wherein said indicia for manifesting a selected coordinate set includes a room having a least one surface and a grid on said at least one surface.

16. Apparatus of claim 12 wherein said determining means includes a computer.

17. Apparatus for use with a medical imaging system for guiding an instrument tip to a target point in a patient via a selected entry point on a patient, the apparatus comprising:

indicia manifesting a selected coordinate set spaced from the patient;

means for determining the imaging space coordinates of the entry point and target point, defining a line therebetween, and locating a retrograde point on said line at the intersection of said line with said indicia wherein said entry point is between said retrograde point and said target point;

means for manifesting said retrograde point on said indicia;

a medical instrument having a tip; and

,

means for utilizing said retrograde point for guiding said instrument along said line for positioning said tip proximate to said target point including an antegrade laser for providing an antegrade laser beam along said line for illuminating said entry point.

18. Apparatus of claim 17 wherein said means for utilizing said retrograde point includes said antegrade laser coupled to said manifest retrograde point.

19. Apparatus of claim 17 wherein said means for utilizing said retrograde point includes:

said antegrade laser spaced from said manifest retrograde point; and

,

a mirror coupled to said manifest retrograde point for directing said antegrade laser beam along said line to said entry point.