Method for carrying out a medical procedure using a three-dimensional tracking and imaging system

• US 5,797,849 A
• Filed: 03/07/1997
• Issued: 08/25/1998
• Est. Priority Date: 03/28/1995
• Status: Expired due to Term

• Current Assignee: Sonometrics Corporation
• Original Assignee: Sonometrics Corporation
• Inventors: Vesely, Ivan, Smith, Wayne
• Primary Examiner(s): MANUEL, GEORGE C
• Application Number:
  US08/812,518
• Time in Patent Office: 536 Days
• Field of Search: 600/437, 600/456, 600/459, 600/461, 600/471, 600/417, 607/115, 607/116, 128/898, 128/899, 128/916
• US Class Current: 600/461
• 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 18/14 Probes or electrodes therefor
• 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 2034/2063 Acoustic tracking systems, e.g. using ultrasound
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3908 Soft tissue, e.g. breast tissue
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2560/045 with a separable interface unit, e.g. for communication
• CPC Class Codes: A61B 2562/043 in a linear array
• 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 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/287 Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61B 5/4519 Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 8/0833 : involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4245 : involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
• CPC Class Codes: A61B 8/4254 : using sensors mounted on the probe
• CPC Class Codes: A61B 8/4411 : Device being modular
• CPC Class Codes: A61B 8/483 : involving the acquisition of a 3D volume of data
• 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 90/17 : for soft tissue, e.g. breast-holding devices
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61M 2025/0166 : Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61M 25/0105 : Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: G01H 3/00 : Measuring characteristics of vibrations by using a detector in a fluid G01H7/00, G01H9/00, G01H11/00 take precedence
• CPC Class Codes: G01H 5/00 : Measuring propagation velocity of ultrasonic, sonic or infrasonic waves , e.g. of pressure waves
• CPC Class Codes: G01S 11/14 : using ultrasonic, sonic, or infrasonic waves
• CPC Class Codes: G01S 15/101 : Particularities of the measurement of distance G01S15/12, G01S15/14, and G01S15/18 take precedence
• CPC Class Codes: G01S 15/66 : Sonar tracking systems
• CPC Class Codes: G01S 15/86 : Combinations of sonar systems with lidar systems; Combinations of sonar systems with systems not using wave reflection
• CPC Class Codes: G01S 15/87 : Combinations of sonar systems
• CPC Class Codes: G01S 15/876 : Combination of several spaced transmitters or receivers of known location for determining the position of a transponder or a reflector G01S15/872 takes precedence
• CPC Class Codes: G01S 15/88 : Sonar systems specially adapted for specific applications seismic or acoustic prospecting or detecting G01V1/00
• CPC Class Codes: G01S 15/8922 : the array being concentric or annular
• CPC Class Codes: G01S 15/899 : Combination of imaging systems with ancillary equipment
• CPC Class Codes: G01S 15/8993 : Three dimensional imaging systems
• CPC Class Codes: G01S 5/18 : using ultrasonic, sonic, or infrasonic waves
• CPC Class Codes: G01S 7/52003 : Techniques for enhancing spatial resolution of targets G01S7/52046 takes precedence
• CPC Class Codes: G01S 7/5206 : Two-dimensional coordinated display of distance and direction; B-scan display
• CPC Class Codes: G01S 7/52074 : Composite displays, e.g. split-screen displays; Combination of multiple images or of images and alphanumeric tabular information
• CPC Class Codes: G01S 7/52079 : Constructional features constructional features of transducers B06B; mounting transducers G10K11/00; constructional features of ultrasonic medical diagnostic devices A61B8/44
• CPC Class Codes: G01S 7/6245 : Stereoscopic displays; Three-dimensional displays; Pseudo-three dimensional displays

Abstract

A method for carrying out a medical procedure using a 3-D tracking and imaging system (1600). A surgical instrument, such as a catheter, probe, sensor, needle or the like is inserted into a living being, and the position of the surgical instrument is tracked as it moves through a medium in a bodily structure. The location of the surgical instrument relative to its immediate surroundings is displayed to improve a physician'"'"'s ability to precisely position the surgical instrument. The medical procedures including removal of an obstruction from the circulatory system, a biopsy, amniocentesis, brain surgery, measurement of cervical dilation, evaluation of knee stability, assessment of myocardial contractibility, eye surgery, prostate surgery and transmyocardial myocardial revascularization (TMR). In addition, the method of the present invention also finds use in connection with the generation of 2-D echo planes.

Claims

1. A method of performing an in vivo medical procedure on an associated body using a 3-D tracking and imaging system, said method comprising:

mounting a plurality of mobile transducer means to an instrument means;

mounting one or more reference transducers means to locations on the body, the reference transducer means having a position fixed relative to the body;

generating three-dimensional coordinates of the mobile transducer means relative to a reference frame established by the reference transducer means;

generating image data of the environment surrounding the instrument means to provide an image template;

registering the three-dimensional coordinates with the image data to form a 3-D image scene showing the position of the mobile transducer means relative to the image template.

2. The method as defined in claim 1, wherein the body is a human body.

3. The method as defined in claim 2, wherein the medical procedure is the removal of an obstruction from the circulatory system, and said instrument is one of the following:

a standard catheter, an intravascular ultrasound imaging catheter, a balloon catheter and a stent deployment catheter.

4. The method as defined in claim 2, wherein the medical procedure is a biopsy, and said instrument is at least one of a biopsy catheter and a biopsy needle.

5. The method as defined in claim 2, wherein the medical procedure is amniocentesis, and said instrument is an amniocentesis needle.

6. The method as defined in claim 2, wherein said medical procedure is stereotactic brain surgery, and said instrument is a surgical probe.

7. The method as defined in claim 6, wherein said method further comprises:

warping said image data in response to the changes in the position of said reference transducer means.

8. The method as defined in claim 7, wherein said method further comprises:

guiding a robotic arm in accordance with a path established in the 3-D image scene.

9. The method as defined in claim 2, wherein said medical procedure is brain surgery to seal leaking cerebral arteries, and said instrument is a catheter.

10. The method as defined in claim 2, wherein said medical procedure is measurement of cervical dilation.

11. The method as defined in claim 2, wherein said medical procedure is evaluation of knee stability.

12. The method as defined in claim 2, wherein said medical procedure is assessment of myocardial contractibility, said mobile transducer means mounted to the myocardium.

13. The method as defined in claim 2, wherein said medical procedure is eye surgery.

14. The method as defined in claim 2, wherein said medical procedure is prostate surgery, and said instrument is a medical probe moved through the prostate.

15. The method as defined in claim 2, wherein said medical procedure is transmyocardial revascularization (TMR), and said instrument is a TMR catheter moved through the heart.

16. A method according to claim 1, wherein the locations on the body for mounting the reference transducer means are internal to the body.

17. A method according to claim 1, wherein said method further comprises the step of:

ablating a portion of the bodily structure when the instrument means has been positioned at a location in a bodily structure where ablation is desired.

18. A method as defined in claim 17, wherein the instrument means is a catheter.

19. A method for carrying out a medical procedure by displaying a 3-D image scene having 2-D echo planes presented therein, the method comprising:

mounting a plurality of mobile transducer means to an instrument having an ultrasound image transducer means for generating a 2-dimensional echo image plane;

mounting a first reference transducer means to a first fixed location;

mounting a second reference transducer means to a second fixed location;

generating three-dimensional coordinates of the mobile transducer means relative to a reference frame established by the first and second reference transducer means;

registering the 2-dimensional echo image plane with the three-dimensional coordinates; and

,

displaying the 2-dimensional echo image plane at the three-dimensional coordinates, in relation to the reference frame established by the first and second reference transducer means.

20. The method as defined in claim 19, wherein said first fixed location is a patient'"'"'s back, and said second fixed location is a patient'"'"'s abdomen.