Stereotactic diagnosis and treatment with reference to a combined image

• US 6,173,201 B1
• Filed: 02/22/1999
• Issued: 01/09/2001
• Est. Priority Date: 02/22/1999
• Status: Expired due to Term

• Current Assignee: Spectrum Dynamics Medical Ltd
• Original Assignee: V-Target Ltd.
• Inventors: Front, Yaron
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US09/253,779
• Time in Patent Office: 687 Days
• Field of Search: 600/407, 600/411, 600/414, 600/417, 600/426, 600/427, 600/429, 600/431, 600/436, 606/130
• US Class Current: 600/429
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• 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 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/5235 combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
• CPC Class Codes: A61B 6/5247 combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
• 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
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

A method of stereotactic therapy. A frame including at least three markers that are imaged by a structural imaging modality such as CT or MRI, is rigidly secured to a patient and a structural image, of a target inside the patient including diseased tissue, and of a part of the frame including the markers, is acquired. A functional image, such as a SPECT image or a PET image, of the diseased tissue is acquired and registered with the structural image to produce a combined image. A stereotactic guide is rigidly attached to the frame and is used to guide an instrument such as a biopsy needle or a brachytherapy needle to the diseased tissue, with reference to the combined image.

Claims

1. A method for diagnosing and accessing a target in a patient, comprising the steps of:

(a) rigidly securing a frame to the patient, said frame including at least three markers;

(b) imaging at least a portion of the patient including the target, using a structural imaging modality, to produce a structural image of said at least portion of the patient and of said markers;

(c) imaging said at least portion of the patient using a functional imaging modality to produce a functional image of said at least portion of the patient; and

(d) if a presence of a diseased portion of the target is indicated in said functional image;

(i) registering said functional image with said structural image to produce a first combined image,

(ii) rigidly attaching a stereotactic guide to said frame, and

(iii) directing a therapeutic instrument to said diseased portion of the target, using said stereotactic guide, with reference to said diseased portion and to said markers as imaged on said first combined image.

2. The method of claim 1, wherein said structural imaging modality is selected from the group consisting of CT and MRI.

3. The method of claim 1, wherein said functional imaging modality is a nuclear imaging modality.

4. The method of claim 3, wherein said nuclear imaging modality is selected from the group consisting of SPECT and PET.

5. The method of claim 3, wherein said nuclear imaging modality images radiation emitted by a radiopharmaceutical inside the target.

6. The method of claim 5, wherein said radiopharmaceutical is selected from the group consisting of Ga-67, Tc-99m MIBI Tl-201, F-18 fluorodeoxyglucose and In-111 octreotide.

7. The method of claim 1, further comprising the steps of:

(e) imaging at least one vascular structure in said at least portion of the patient to produce a vascular structure image; and

(f) registering said vascular structure image with said structural image to produce a second combined image;

and wherein said directing of said therapeutic instrument to said diseased portion of the target is effected with reference to said at least on one vascular structure as imaged in said second combined image.

8. The method of claim 7, wherein said imaging of said at least one vascular structure is effected by SPECT imaging of red blood cells labeled by Tc-99m.

9. The method of claim 1, further comprising the step of:

(e) imaging at least one organ in said at least portion of the patient to produce an organ image; and

(f) registering said organ image with said structural image to produce a second combined image;

and wherein said directing of said therapeutic instrument to said diseased portion of the target is effected with reference to said at least one organ as imaged in said second combined image.

10. The method of claim 9, wherein said imaging of said at least one organ includes SPECT imaging using Tc-99m DMSA.