Frameless stereotactic CT scanner with virtual needle display for planning image guided interventional procedures

• US 6,064,904 A
• Filed: 11/28/1997
• Issued: 05/16/2000
• Est. Priority Date: 11/28/1997
• Status: Expired due to Term

• Current Assignee: Picker International, Inc. (Marconi Holdings Company Limited)
• Original Assignee: Picker International, Inc. (Marconi Holdings Company Limited)
• Inventors: Klahr, Paul H., O'Donnell, Lauren, Yanof, Jeffrey H.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/980,337
• Time in Patent Office: 900 Days
• Field of Search: 600/427, 600/429, 600/426, 600/411, 600/414, 600/417, 606/130
• US Class Current: 600/414
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• 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 2017/00482 with a code
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• 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 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

A frameless stereotactic CT scanner includes a virtual needle display for planning image-guided interventional procedures. The virtual needle is useful for planning the introduction of an object such as a biopsy probe into a patient at an entry point along a trajectory to a target point within the patient. Using an imaging device, the patient is scanned to generate an image volume data set of an area of the patient. Using a stereotactic mechanical arm assembly mounted on one end to the imaging device, a surgical planning device is positioned adjacent the patient on the imaging device. A display includes a first transverse axial view of the patient taking through an image slice corresponding to the virtual needle entry point on the patient and, a second transverse axial view of the patient taken on an image slice of the image volume data set corresponding to a target point within the patient. A first oblique axial/coronal view is also displayed together with the first and second transverse axial views, the oblique coronal view being co-planar with the virtual needle trajectory and closest to the coronal axis. An oblique sagittal view is displayed together with the above images, the oblique sagittal view being co-planar with the virtual needle. A manually adjustable virtual needle depth control member is used to adjust the "length" of a virtual needle displayed within the image volume data set. Each of the views displayed are simultaneously updated to reflect the then current position and orientation of a surgical planning device on a stereotactic mechanical arm assembly.

Claims

1. A method of planning a minimally invasive surgical procedure for introducing an object along a trajectory from a patient entry point to a target point within the patient, the method comprising the steps of:

using an imaging device, scanning the patient to generate an image volume data set of an area of the patient, the image volume data set being formed of a plurality of two-dimensional image slices of the patient spaced apart along an axial axis substantially aligned with the toe-to-head axis of the patient;

using a stereotactic mechanical arm assembly mounted on one end in a fixed relationship to the imaging device and having a surgical planning device defining a linear trajectory on the other end of the arm, positioning the surgical planning device in a first position adjacent the patient on the imaging device;

displaying a first transverse axial view of the patient on a first portion of a display device, the first transverse axial view of the patient being a display of a first two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory intersects the patient'"'"'s body defining a first patient entry point;

displaying a second transverse axial view of the patient on a second portion of the display device, the second transverse axial view of the patient being a display of a second two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory intersects the patient'"'"'s body at a first target point within the patient; and

,

displaying a first oblique view of the patient on the display device, the first oblique view of the patient being a display of a first plane within said image volume data set co-planar with a line defined by said trajectory.

2. The method of planning a minimally invasive surgical procedure according to claim 1, further comprising the step of:

while moving said surgical planning device from said first position adjacent the patient to a second position adjacent the patient, simultaneously updating at least a one of said first and second transverse axial views so that i) the first transverse axial view corresponds to a first two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory with the surgical planning device at said second position intersects the patient'"'"'s body defining a second patient entry point, and ii) the second transverse axial view corresponds to a second two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory with the surgical planning device at said second position intersects the patient'"'"'s body at a second target point within the patient.

3. The method of planning a minimally invasive surgical procedure according to claim 2 wherein the step of simultaneously updating at least a one of said first and second transverse axial views includes simultaneously updating both of said first and second transverse axial views.

4. The method of planning a minimally invasive surgical procedure according to claim 1 further comprising the step of:

without moving said surgical planning device, manually operating a virtual needle depth control member to change said second transverse axial view of the patient on said second portion of the display device to correspond to a third two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory intersects the patient'"'"'s body at a second target point within the patient.

5. The method of planning a minimally invasive surgical procedure according to claim 4 wherein the step of manually operating said virtual needle depth control member includes:

manually operating the virtual needle depth control member in a first direction to reduce a distance between the patient entry point and the target point within the patient; and

,

manually operating the virtual needle depth control member in a second direction to increase a distance between the patient entry point and the target point within the patient.

6. The method of planning a minimally invasive surgical procedure according to claim 1 further comprising the step of:

while moving said surgical planning device from a first position adjacent the patient to a second position adjacent the patient, updating only said first transverse axial view of the patient on said first portion of the display device so that i) the first transverse axial view corresponds to a first two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory intersects the patient'"'"'s body with the surgical planning device at said second position, defining a second patient entry point, and ii) the second transverse axial view remains fixed corresponding to said first two-dimensional image slice from said plurality of said two-dimensional image slices of the patient.

7. The method of planning a minimally invasive surgical procedure according to claim 1 wherein the step of scanning the patient includes scanning the patient at a first position on the imaging machine.

8. The method of planning a minimally invasive surgical procedure according to claim 1 further comprising the steps of:

using said stereotactic mechanical arm assembly, positioning the surgical planning device in a second position adjacent the patient on the imaging device;

displaying a third transverse axial view of the patient on said first portion of a display device, the third transverse axial view of the patient being a display of a third two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory defined by the planning device in said second position intersects the patient at a second patient entry point; and

,

displaying a fourth transverse axial view of the patient on said second portion of the display device, the fourth transverse axial view of the patient being a display of a fourth two-dimensional image slice from said plurality of two-dimensional image slices of the patient where the linear trajectory defined by the planning device in said second position intersects the patient at a second target point within the patient.

9. The method of planning a minimally invasive surgical procedure according to claim 1, further comprising the step of:

displaying a second oblique view of the patient on the display device, the second oblique view of the patient being a display of a second plane through said image volume data set that is co-planar with said line defined by the trajectory.

10. The method of planning a minimally invasive surgical procedure according to claim 9 wherein:

the step of displaying said first oblique view of the patient includes displaying a oblique axial/coronal view of the patient on a third portion of the display device; and

,

the step of displaying said second oblique view of the patient includes displaying a oblique coronal/sagittal view of the patient on a fourth portion of the display device.

11. A method of planning a minimally invasive surgical procedure for introducing an object along a trajectory from a patient entry point to a target point within the patient, the method comprising the steps of:

using an imaging device, scanning the patient to generate an image volume data set of an area of the patient;

using a stereotactic assembly mounted on one end in a fixed relationship to the imaging device and having a surgical planning device defining a linear trajectory on the other end of the assembly, positioning the surgical planning device adjacent the patient;

displaying a first transverse axial view of the patient on a first portion of a display device, the first transverse axial view of the patient being a display of a first two-dimensional image slice from said image volume data set taken where the linear trajectory intersects the patient defining a patient entry point;

displaying a second transverse axial view of the patient on a second portion of the display device the second transverse axial view of the patient being a display of a second two-dimensional image slice from said image volume data set taken where the linear trajectory intersects the patient at a first target point within the patient;

displaying a first oblique axial/coronal view of the patient on a third portion of the display device, the first oblique axial/coronal view of the patient being a display of a first plane within said image volume data set co-planar with said trajectory from said patient entry point to said target point within the patient; and

,

displaying a first oblique coronal/sagittal view of the patient on a fourth portion of the display device, the first oblique coronal/sagittal view of the patient being a display of a second plane through said image volume data set that is co-planar with the trajectory between said patient entry point and the first target point within the patient and is substantially sagittal in orientation.

12. The method of planning a minimally invasive surgical procedure according to claim 11 further comprising the step of:

while moving said surgical planning device from a first position adjacent the patient to a second position adjacent the patient, simultaneously updating each of said first and second transverse axial views of the patient, said first oblique axial/coronal view of the patient, and said first oblique coronal/sagittal view of the patient.

13. The method of planning a minimally invasive surgical procedure according to claim 11, further comprising the step of:

while moving said surgical planning device from a first position adjacent the patient to a second position adjacent the patient, simultaneously updating at least a one of said first and second transverse axial views so that i) the first transverse axial view corresponds to a first two-dimensional image from said image volume data set of the patient where the linear trajectory, with the surgical planning device at said second position, intersects the patient defining a second patient entry point, and ii) the second transverse axial view corresponds to a second two-dimensional image from said image volume data set of the patient where the linear trajectory, with the surgical planning device at said second position, intersects the patient at a second target point within the patient.

14. The method of planning a minimally invasive surgical procedure according to claim 13 wherein the step of simultaneously updating at least a one of said first and second transverse axial views includes simultaneously updating both of said first and second transverse axial views.

15. The method of planning a minimally invasive surgical procedure according to claim 11 further comprising the step of:

without moving said surgical planning device, manually operating a virtual needle depth control member to change said second transverse axial view of the patient on said second portion of the display device to correspond to a third two-dimensional image from said image volume data set of the patient where the linear trajectory intersects the patient at a second target point within the patient.

16. The method of planning a minimally invasive surgical procedure according to claim 15 wherein the step of manually operating said virtual needle depth control member includes:

manually operating the virtual needle depth control member in a first direction to reduce a distance between the patient entry point and the target point within the patient; and

,

manually operating the virtual needle depth control member in a second direction to increase a distance between the patient entry point and the target point within the patient.

17. The method of planning a minimally invasive surgical procedure according to claim 11 further comprising the step of:

while moving said surgical planning device from a first position adjacent the patient to a second position adjacent the patient, updating only said first transverse axial view of the patient on said first portion of the display device so that i) the first transverse axial view corresponds to a first two-dimensional image from said image volume data set of the patient where the linear trajectory intersects the patient'"'"'s body with the surgical planning device at said second position, defining a second patient entry point, and ii) the second transverse axial view remains fixed corresponding to said first two-dimensional image from said image volume data set of the patient.

18. The method of planning a minimally invasive surgical procedure according to claim 11, further comprising the step of:

while moving said surgical planning device from a first position adjacent the patient to a second position adjacent the patient, simultaneously updating at least a one of said first oblique axial/coronal view and said first oblique coronal/sagittal view so that the at least one updated view remains co-planar with said line defined by the trajectory.

19. A method of planning a surgical procedure for inserting an object into a patient along a surgical planning trajectory from an entry point on the patient to a target point within the patient, the method comprising the steps of:

using an imaging device, scanning the patient to generate an image volume data set of an area of the patient;

using an associated surgical planning device disposed in a first position relative to the patient, defining a linear planning trajectory extending from the planning device and through the patient;

displaying a first oblique sectional image of the patient co-planar with the linear planning trajectory, the first sectional image being derived from said image volume data set based on said first position of the surgical planning device relative to the patient; and

,

displaying a second oblique sectional image of the patient co-planar with the linear planning trajectory, the second sectional image being derived from said image volume data set based on said first position of the surgical planning device relative to the patient.

20. The method of planning a surgical procedure according to claim 19 wherein:

the step of displaying said first oblique sectional image of the patient includes displaying a first oblique axial/coronal view of the patient co-planar with the linear planning trajectory; and

,

the step of displaying said second oblique sectional image of the patient includes displaying a first oblique coronal/sagittal view of the patient co-planar with the linear planning trajectory.

21. The method of planning a surgical procedure according to claim 20 further including the step of:

while moving the associated surgical planning device from said first position relative to the patient towards a second position relative to the patient, simultaneously updating at least a one of said first and second sectional images of the patient so that the first and second sectional images of the patient remain co-planar with the linear planning trajectory defined by the associated surgical planning device.

22. The method of planning a surgical procedure according to claim 20 further including the steps of:

displaying a first transverse axial view of the patient, the first transverse axial view being a display of a two-dimensional image of the patient where said planning trajectory intersects the patient at said entry point; and

,

displaying a second transverse axial view of the patient, the second transverse axial view being a two-dimensional image of the patient where said planning trajectory intersects the patient at said target point.

23. A method of planning an interventional procedure for inserting a surgical tool into a patient along an interventional planning trajectory from a patient entry point towards a target point within the patient, the method comprising the steps of:

providing an image volume data set representative of a multi-dimensional view of the patient;

defining a linear interventional planning trajectory extending from a first patient entry point to a first target point;

deriving first and second sectional images of the patient from said image volume data set, the first and second sectional images intersecting at a line defined by said linear interventional planning trajectory; and

,

displaying at least one of the first and second sectional images.

24. The method of planning an interventional procedure according to claim 23 wherein:

the step of deriving said first and second sectional images of the patient include deriving a first oblique axial/coronal view of the patient as said first sectional image and deriving a first oblique coronal/sagittal view of the patient as said second sectional image; and

,

the step of displaying at least one of said the first and second sectional images includes displaying at least one of said first oblique axial/coronal view and said first oblique coronal/sagittal view.

25. A surgical procedure planning apparatus for use in inserting an object into a patient along a surgical planning trajectory from an entry point on the patient to a target point within the patient, the planning apparatus comprising:

an imaging device for scanning the patient to generate an image volume data set of an area of the patient;

a surgical planning device, disposed in a first position relative to the patient, for defining a linear planning trajectory extending from the planning device and through the patient;

means for displaying a first oblique sectional image of the patient co-planar with the linear planning trajectory, the first sectional image being derived from said image volume data set based on said first position of the surgical planning device relative to the patient; and

,

means for displaying a second oblique sectional image of the patient co-planar with the linear planning trajectory, the second sectional image being derived from said image volume data set based on said first position of the surgical planning device relative to the patient.

26. The surgical procedure planning apparatus according to claim 25 further comprising:

means for displaying said first oblique sectional image of the patient as a first oblique axial/coronal view of the patient co-planar with the linear planning trajectory; and

,

means for displaying said second oblique sectional image of the patient as a first oblique coronal/sagittal view of the patient co-planar with the linear planning trajectory.

27. The surgical procedure planning apparatus according to claim 26 further comprising:

means for simultaneously updating at least a one of said first and second sectional images of the patient so that the first and second sectional images of the patient remain co-planar with the linear planning trajectory defined by the associated surgical planning device while moving the associated surgical planning device from said first position relative to the patient towards a second position relative to the patient.

28. The surgical procedure planning apparatus according to claim 26 further comprising:

means for displaying a first transverse axial view of the patient, the first transverse axial view being a display of a two-dimensional image of the patient where said planning trajectory intersects the patient at said entry point; and

,

means for displaying a second transverse axial view of the patient, the second transverse axial view being a two-dimensional image of the patient where said planning trajectory intersects the patient at said target point.

29. A method of surgical procedure planning for planning insertion of an object into a patient along a surgical planning trajectory from an entry point on the patient to a target point within the patient, the method comprising the steps of:

scanning the patient to generate an image volume data set of an area of the patient;

defining a linear planning trajectory extending in a first position through said image volume data set of the area of the patient;

displaying a first oblique sectional image of the patient co-planar with the linear planning trajectory, the first sectional image being derived from said image volume data set based on said first position of the linear planning trajectory relative to said area of the patient; and

,

displaying a second oblique sectional image of the patient co-planar with the linear planning trajectory, the second sectional image being derived from said image volume data set based on said first position of the linear planning trajectory relative to said area of the patient.

30. The method according to claim 29 wherein:

the step of displaying said first oblique sectional image of the patient includes the step of displaying a first oblique axial/coronal view of the patient co-planar with the linear planning trajectory in said first position; and

,

the step of displaying said second oblique sectional image of the patient includes displaying a coronal/sagittal view of the patient co-planar with the linear planning trajectory in said first position.

31. The method according to claim 29 further including the step of, while moving the linear planning trajectory from said first position towards a second position relative to the area of the patient in said image volume data set, simultaneously updating at least a one of said first and second sectional images of the patient so that the first and second sectional images of the patient remain co-planar with the linear planning trajectory.

32. The method according to claim 29 further including the steps of:

displaying a first transverse axial view of the patient, the first transverse axial view being a display of a two-dimensional image of the patient where said planning trajectory in said first position intersects the patient at said entry point; and

,

displaying a second transverse axial view of the patient, the second transverse axial view being a two-dimensional image of the patient where the planning trajectory in said first position intersects the patient at said target point.

33. The method according to claim 32 further including the steps of:

selecting on a display screen, a second target point within said patient; and

,

displaying a third transverse axial view of the patient, the third transverse axial view being a two-dimensional image of the patient where said planning trajectory intersects the patient at said second target point.

34. The method according to claim 29 further including the steps of:

selecting on a display screen, a second target point within said patient;

updating said first oblique sectional image of the patient based on said, linear planning trajectory extending from said entry point on the patient to said second target point within said patient; and

,

updating said second oblique sectional image of the patient based on said linear planning trajectory extending from said entry point on the patient to said second target point within said patient.

35. The method according to claim 34 further including the step of, while moving said second target point on said display screen, simultaneously updating at least one of said first oblique sectional image of the patient and said second oblique sectional image of the patient to show said second target point moved on said display screen.

36. The method according to claim 35 wherein the step of scanning the patient includes the step of magnetic resonance image scanning the patient to generate said image volume data set of said area of the patient.