Apparatus and method for planning a stereotactic surgical procedure using coordinated fluoroscopy

• US 6,198,794 B1
• Filed: 01/14/2000
• Issued: 03/06/2001
• Est. Priority Date: 05/15/1996
• Status: Expired

• Current Assignee: Northwestern University
• Original Assignee: Northwestern University
• Inventors: Santos-Munné, Julio J., Peshkin, Michael A.
• Primary Examiner(s): BRUCE, DAVID VERNON
• Application Number:
  US09/483,107
• Time in Patent Office: 417 Days
• Field of Search: 378/41, 378/42, 378/62, 606/130
• US Class Current: 378/42
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/371 with simultaneous use of two cameras
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/70 Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 6/464 involving a plurality of displays
• 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: G06T 2207/10121 Fluoroscopy
• CPC Class Codes: G06T 2207/30004 Biomedical image processing
• CPC Class Codes: G06T 3/08 Projecting images onto non-planar surfaces, e.g. geodetic screens
• CPC Class Codes: G06T 7/344 involving models

Abstract

An apparatus and method is provided for coordinating two fluoroscope images, which permits accurate computer-based planning of the insertion point and angle of approach of a needle, drill, screw, nail, wire or other surgical instrumentation into the body of a patient, and subsequently guides the surgeon in performing the insertion in accordance with the plan.

Claims

1. A computer-aided method for planning a surgical procedure comprising:

registering to a known coordinate frame a first two-dimensional, image of a body'"'"'s anatomy taken at a first observation angle;

displaying the first image; and

drawing in the displayed first image a representation of a surgical object to be placed in the body based on the registration of the first image with the known coordinate frame.

2. The method of claim 1 wherein drawing in the displayed first image the representation of the surgical object is in response to a user indicating at least one positioning parameter for the surgical object.

3. The method of claim 2 wherein the at least one positioning parameter for the surgical object is defined in reference to the known coordinate frame.

4. The method of claim 3 wherein the at least one parameter includes an approach angle of the surgical object.

5. The method of claim 2 wherein the at least one parameter is defined in reference to the first image.

6. The method of claim 5 wherein the at least one parameter includes a point in the body.

7. The method of claim 5 wherein the user indicates the at least one parameter by positioning a cursor displayed within the first image.

8. The method of claim 1 wherein a user indicates at least one parameter defining the surgical object.

9. The method of claim 8 wherein the at least one parameter includes a dimension of the surgical object.

10. The method of claim 1 further comprising:

registering to the known coordinate frame a second two-dimensional, image of the body'"'"'s anatomy taken at a second observation angle;

displaying the second image; and

drawing in the displayed second image the representation of the surgical object based on the registration of the second image with the known coordinate frame.

11. The method of claim 10 wherein drawing the representation of the surgical object in the second image is in response to a user indicating on the displayed first image indicating a change in position of the representation of the surgical object in the first image.

12. The method of claim 1, wherein the representation of the surgical object is a virtual guidewire defining, at least in part, a trajectory of insertion of the surgical object into the body.

13. The method of claim 1, wherein the representation of the surgical object is a virtual guidewire having a length corresponding to a dimension of the surgical object to be inserted into the body.

14. The method of claim 1 further comprising transmitting to a positioning mechanism coordinates for indicating the position of the surgical object represented in the first image.

15. The method of claim 14 further comprising manipulating the positioning mechanism such that a guide coupled to the positioning mechanism is substantially aligned with the representation of the surgical object in the image.

16. The method of claim 1 further comprising displaying information for indicating the position of the surgical object represented in the first image.

17. A computer readable storage medium encoded with instructions, which, when read by a computer, enable a computer to undertake a process comprising:

registering to a known coordinate frame a first two-dimensional, image of a body'"'"'s anatomy taken at a first observation angle;

displaying the first image; and

drawing in the displayed first image a representation of a surgical object to be placed in the body based on the registration of the first image with the known coordinate frame.

18. The computer readable storage medium of claim 17 wherein drawing in the displayed first image the representation of the surgical object is in response to a user indicating at least one positioning parameter for the surgical object.

19. The computer readable storage medium of claim 18 wherein the at least one positioning parameter for the surgical object is defined in reference to the known coordinate frame.

20. The computer readable storage medium of claim 19, wherein the indication of the at least one positioning parameter is a reference on the displayed first image controlled by a user.

21. The computer readable storage medium of claim 17 wherein the process further comprises:

registering to the known coordinate frame a second two-dimensional, image of the body'"'"'s anatomy taken at a second observation angle;

displaying the second image; and

drawing in the displayed second image the representation of the surgical object based on the registration of the second image with the known coordinate frame.

22. The computer readable storage medium of claim 21 wherein drawing the representation of the surgical object in the second image is in response to an input received from a user indicating a position of the surgical object.

23. The computer readable storage medium of claim 21 wherein drawing the representation of the surgical object in the second image is in response to an input received from a user indicating a position of the representation of the surgical object in the displayed first image.

24. The computer readable storage medium of claim 21 wherein drawing the representation of the surgical object in the second image is in response to an input indicating a change in position of the representation of the surgical object in the first image.

25. The computer readable storage medium of claim 21 wherein registering to the known coordinate frame the first image and the second image includes registering known coordinates of a plurality of fiducials within the reference frame with positions of the plurality of fiducials in the first and second images.

26. A computer-aided method for planning a surgical procedure comprising:

registering a first two-dimensional, image of a body'"'"'s anatomy taken at a first observation angle with a second two-dimensional image of the body'"'"'s anatomy taken at a second observation angle;

displaying the first image;

drawing within the displayed first image drawing within the displayed first image a representation of a surgical object to be placed in the body based on an input indicating a position of the surgical object;

displaying the second image; and

drawing in the displayed second image the representation of the surgical object.

27. The method of claim 26 wherein drawing the representation of the surgical object in the second image is based, at least in part, on positioning in the displayed first image of the representation of the surgical object in the first image.

28. The method of claim 26 wherein drawing in the first image and drawing second image the representation the surgical object is at least in part in response to a user indicating at least one positioning parameter for the surgical object.

29. The method of claim 28 wherein the at least one positioning parameter for the surgical object is defined in reference to a known coordinate frame to which the first and the second images are registered.

30. The method of claim 28 wherein the at least one parameter includes an approach angle of the surgical object.

31. The method of claim 28 wherein the at least one parameter includes a point in the body.

32. The method of claim 28 wherein the user indicates the at least one parameter by positioning a reference displayed within the first or second images.

33. The method of claim 26 wherein a user indicates at least one parameter defining the surgical object.

34. The method of claim 26 further comprising transmitting to a positioning mechanism coordinates for indicating the position of the surgical object represented in the first image.

35. The method of claim 34 further comprising manipulating the positioning mechanism such that a guide coupled to the positioning mechanism is substantially aligned with the representation of the surgical object in the image.

36. The method of claim 26 further comprising displaying information for indicating the position within a known coordinate frame of reference for the surgical object for use in manually positioning a guide.

37. The method of claim 26 wherein registering the first and second images includes registering a plurality of fiducials having known coordinates within a known coordinate frame of reference with images of the plurality of fiducials within in the respective first and second images.

38. A computer readable storage medium encoded with instructions, which, when read by a computer, enable a computer to undertake a process comprising:

receiving a first two-dimensional, image taken of a patient'"'"'s body and a plurality of radio-opaque fiducials placed adjacent the body at known positions; and

registering the image by optimizing parameters of a known geometric model such that projections of the plurality of fiducials into the first image best fit positions of the plurality of fiducials in the image.

39. The computer readable storage medium of claim 38, wherein the process further comprises:

receiving a second, two-dimensional image taken of the patient'"'"'s body and the plurality of fiducials from a position different from the first image; and

registering the second image by optimizing parameters of the known geometric model such that projections of the plurality of fiducials into the second image best fit positions of the plurality of fiducials in the second image.

40. The computer readable storage medium of claim 39, wherein the process further comprises:

receiving input indicating on one of the first and second images a position of a representation of an imaginary object with respect to the body; and

drawing on the other of the first and second images a corresponding representation of the imaginary object projected into said other of the first and second images.

41. The computer readable storage medium of claim 40 further comprising:

receiving input indicating a change to a second position of the representation of the imaginary object within said one of the first and second image; and

redrawing within said other of the first and the second images the corresponding representation of imaginary object in the second position.

42. The computer readable storage medium of claim 40 wherein the imaginary object is a representation of a surgical object and the corresponding representation is also of the same surgical object.

43. The computer readable storage medium of claim 39, wherein the process further comprises:

receiving an input indicating a position of an imaginary object within the body; and

drawing on the first and the second images a representation of the imaginary object in the indicated position.

44. The computer readable storage medium of claim 43, wherein the process further comprises:

receiving an input indicating a change in the position of the imaginary object to a second position; and

redrawing in the first and the second images the representation of imaginary object in the second position.

45. The computer readable storage medium of claim 38, wherein registering the image further comprises:

displaying the image; and

receiving an input from a user indicating on the image the position of each of the plurality of fiducials within the image.

46. The computer readable storage medium of claim 38, wherein the process further comprises linearizing the image before registering the image.

47. A method comprising:

receiving a first two-dimensional, image taken of a patient'"'"'s body and a plurality of radio-opaque fiducials placed adjacent the body at known positions; and

registering the image by optimizing parameters of a known geometric model such that projections of the plurality of fiducials into the first image best fit positions of the plurality of fiducials in the image.

48. The method of claim 47 further comprising:

receiving a second, two-dimensional image taken of the patient'"'"'s body and the plurality of fiducials from a position different from the first image; and

registering the second image by optimizing parameters of the known geometric model such that projections of the plurality of fiducials into the second image best fit positions of the plurality of fiducials in the second image.

49. The method of claim 48 further comprising:

receiving input indicating on one of the first and second images a position of a representation of an imaginary object with respect to the body; and

drawing on the other of the first and second images a corresponding representation of the imaginary object projected into said other of the first and second images.

50. The method of claim 49 further comprising:

receiving input indicating a change to a second position of the representation of the imaginary object within said one of the first and second image; and

redrawing within said other of the first and the second images the corresponding representation of imaginary object in the second position.

51. The method of claim 49 wherein the imaginary object is a representation of a surgical object and the corresponding representation is also of the same surgical object.

52. The method of claim 48 further comprising:

receiving an input indicating a position of an imaginary object within the body; and

drawing on the first and the second images a representation of the imaginary object in the indicated position.

53. The method of claim 52 further comprising:

receiving an input indicating a change in the position of the imaginary object to a second position; and

redrawing in the first and the second images the representation of imaginary object in the second position.

54. The method of claim 47 further comprising:

displaying the image; and

receiving an input from a user indicating on the image the position of each of the plurality of fiducials within the image.

55. The method of claim 47 further comprising linearizing the image before registering the image.