System and method for use in displaying images of a body part

• US 6,347,240 B1
• Filed: 09/16/1997
• Issued: 02/12/2002
• Est. Priority Date: 10/19/1990
• Status: Expired due to Term

• Current Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc), St. Louis University
• Original Assignee: St. Louis University
• Inventors: Foley, Kevin T., Bucholz, Richard D., Smith, Kurt R.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/931,654
• Time in Patent Office: 1,610 Days
• Field of Search: 606/130, 600/407, 600/425-427, 600/429, 600/410, 600/411, 600/414, 600/417, 600/437, 600/439
• US Class Current: 600/426
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• 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 2090/364 Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/0064 Body surface scanning
• CPC Class Codes: A61B 5/0073 by tomography, i.e. reconstruction of 3D images from 2D projections A61B5/0066 takes precedence
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• 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 5/1077 Measuring of profiles
• CPC Class Codes: A61B 6/12 : Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/501 : for diagnosis of the head, e.g. neuroimaging or craniography
• 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 8/00 : Diagnosis using ultrasonic, sonic or infrasonic waves imaging of objects using sonar G01S15/00
• CPC Class Codes: A61B 8/5238 : for combining image data of patient, e.g. merging several images from different acquisition modes into one image for image registration algorithms G06T7/30
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/14 : Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• 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

Abstract

A system for use during a medical or surgical procedure on a body. The system generates a display representing the position of two or more body elements during the procedure based on an image data set generated by a scanner prior to the procedure. The image data set has reference points for each of the body elements, the reference points of a particular body element having a fixed spatial relation to the particular body element. The system includes an apparatus for identifying, during the procedure, the relative position of each of the reference points of each of the body elements to be displayed. The system also includes a processor for modifying the image data set according to the identified relative position of each of the reference points during the procedure, as identified by the identifying apparatus, said processor generating a displaced image data set representing the position of the body elements during the procedure. The system also includes a display utilizing the displaced image data set generated by the processor, illustrating the relative position of the body elements during the procedure. Methods relating to the system are also disclosed.

Claims

1. A system for use during a procedure on a body, said system generating a display representing a position of two or more body elements during the procedure, said system comprising:

a memory storing an image data set representing the position of the two or more body elements based on scans taken of the body prior to the procedure, the image data set having a plurality of data points and corresponding to a plurality of reference points for each of the body elements, the reference points of a particular body element having a known spatial relation to the data points of the particular body element;

means for identifying, during the procedure, the position of the reference points of each of the body elements relative to the reference points of the other body elements;

a processor modifying the spatial relation of the data points of one body element relative to the data points of another body element according to the identified relative position of the reference points during the procedure as identified by the identifying means, said processor generating a displaced image data set representing the position of the body elements during the procedure; and

a display utilizing the displaced image data set generated by the processor, illustrating the relative position of the body elements during the procedure.

2. The system of claim 1 wherein the reference points are in relation to the body elements and further comprising:

a medical or surgical instrument;

means for identifying, during the procedure, the position of medical or surgical instrument relative to one or more of the body elements; and

wherein the display is responsive to the medical or surgical instrument position identifying means to illustrate during the procedure the relative position of the body elements relative to the medical or surgical instrument.

3. The system of claim 2 wherein the medical or surgical instrument position identifying means determines an orientation of the medical or surgical instrument relative to the body elements and wherein the display illustrates the orientation of the medical or surgical instrument relative to the body elements.

4. The system of claim 1 wherein the identifying means comprises:

a reference array having a location outside the body for providing a reference; and

means for determining the position of the reference points of the body elements to be displayed relative to the reference array.

5. The system of claim 4 further comprising a registration probe in communication with the reference array and wherein the determining means determines the position of a tip of the registration probe relative to the reference array whereby the position of the reference points of the body elements can be determined by positioning the tip of the registration probe at each of the reference points.

6. The system of claim 5 wherein the reference array includes sensors and wherein the registration probe includes emitters communicating with the sensors of the reference array to indicate the position of the registration probe relative to the reference array.

7. The system of claim 5 wherein the registration probe includes sensors and wherein the reference array includes emitters communicating with the sensors of the registration probe to indicate the position of the registration probe relative to the reference array.

8. The system of claim 4 further comprising a reference frame having a position in known relation to one of the body elements, said reference frame in communication with the reference array, and further comprising means for determining the position of the reference frame relative to the reference array whereby the body may be moved during the procedure while the body elements remain in fixed relation to each other and in known relation to the reference frame so that the system can determine the position of each of the body elements after movement without again identifying the relative position of each of the reference points of each of the body elements.

9. The system of claim 8 wherein the reference array includes sensors and wherein the reference frame is adapted to be attached to one of the body elements and includes emitters communicating with the sensors of the reference array to indicate the position of the reference frame relative to the reference array.

10. The system of claim 8 wherein the reference frame includes sensors and wherein the reference array is adapted to be attached to one of the body elements and includes emitters communicating with the sensors of the reference frame to indicate the position of the reference frame relative to the reference array.

11. The system of claim 4 further comprising a fluoroscopic device for determining a position of a projection of each of the body elements during the procedure and wherein the processor compares the position of the projection of the each of the body elements during the procedure to the position of the projection of each of the body elements prior to the procedure.

12. The system of claim 11 wherein the fluoroscopic device comprises a fluoroscopic tube in fixed relation to a fluoroscopic plate between which the body elements are located for determining a position of a projection of each of the body elements during the procedure and wherein the processor compares the position of the projection of each of the body elements during the procedure to the position of the projection of each of the body elements prior to the procedure.

13. The system of claim 12 further comprising a reference array and wherein said fluoroscopic tube or said fluoroscopic plate have emitters thereon in communication with the reference array and wherein the determining means determines the position of the tube or plate relative to the reference array whereby the position of the projection of each body element can be determined.

14. The system of claim 12 comprising a reference array having emitters thereon in communication with the fluoroscopic tube or the fluoroscopic plate and wherein the determining means determines the position of the tube or plate relative to the reference array whereby the position of the projection of each body element can be determined.

15. The system of claim 11 wherein the fluoroscopic device determines a position of a projection of each of the body elements during the procedure, and the processor compares the position of the projection of the each of the body elements during the procedure as determined by the fluoroscopic device to the position of the projection of each of the body elements prior to the procedure as represented by the image data set whereby the projection of the body elements may be determined without the need for exposing the body elements.

16. The system of claim 15 wherein the reference array has emitters thereon in communication with the fluoroscopic device and wherein the determining means determines the position of the fluoroscopic device relative to the reference array whereby the position of the projection of each body element can be determined.

17. The system of claim 1 further comprising means for discriminating the body elements of the image data set by creating an image data subset defining each of the body elements.

18. The system of claim 17 wherein the processor translates each of the image data subsets from the position of the body elements prior to the procedure to the position of the body elements during the procedure whereby the displaced data set consists of the translated image data subsets.

19. The system of claim 17 wherein the identifying means comprises a device for determining a position of a contour of each of the body elements during the procedure and wherein the processor compares the position of the contour of each of the body elements during the procedure as determined by the device to the position of the contour of each of the body elements prior to the procedure as represented by the image data subset.

20. The system of claim 19 wherein the device comprises an ultrasound probe for determining a position of a contour of each of the body elements during the procedure and wherein the processor compares the position of the contour of the each of the body elements during the procedure as determined by the device to the position of the contour of each of the body elements prior to the procedure as represented by the image data subset whereby the contour of the body elements may be determined without the need for exposing the body elements.

21. The system of claim 20 further comprising a reference array and wherein said ultrasound probe has emitters thereon in communication with the reference array and wherein the determining means determines the position of the ultrasound probe relative to the reference array whereby the position of the contour of each body element can be determined.

22. The system of claim 20 comprising a reference array having emitters thereon in communication with the ultrasound probe and wherein the determining means determines the position of the ultrasound probe relative to the reference array whereby the position of the contour of each body element can be determined.

23. The system of claim 19 wherein the device comprises a scanner for determining a position of a contour of each of the body elements during the procedure and wherein the processor compares the position of the contour of the each of the body elements during the procedure as determined by the device to the position of the contour of each of the body elements prior to the procedure as represented by the image data subset.

24. The system of claim 23 further comprising a reference array and wherein said scanner has emitters thereon in communication with the reference array and wherein the determining means determines the position of the scanner relative to the reference array whereby the position of the contour of each body element can be determined.

25. The system of claim 23 comprising a reference array having emitters thereon in communication with the scanner and wherein the determining means determines the position of the scanner relative to the reference array whereby the position of the contour of each body element can be determined.

26. A system for use during a procedure on a body, said system generating a display representing a geometrical relationship of two or more body elements during the procedure, said system comprising:

a memory for storing an image data set representing the position of the two or more body elements based on scans taken of the body prior to the procedure, the image data set having a pre-procedural geometrical spatial relationship of the body elements and having a plurality of reference points on each of the body elements, the reference points of a particular body element having a known spatial relation on the particular body element;

means for identifying, during the procedure, a position of each of the reference points of the body elements to be displayed;

a processor modifying the pre-procedural geometrical relationship of the body elements as necessary according to the identified position of each of the reference points as identified by the identifying means, said processor generating a displaced image data set from the modified pre-procedural geometrical relationship of the body elements, said displaced image data set representing the geometrical relationship of the body elements during the procedure; and

a display system utilizing the displaced image data set to generate the display.

27. A method for use during a procedure, said method generating a display representing a position of two or more body elements during the procedure, said method comprising the steps of:

storing an image data set in a memory, the image data set representing the position of the two or more body elements based on scans taken of the body prior to the procedure;

reading the image data set stored in the memory, said image data set having a plurality of data points and a plurality of reference points for each of the body elements, the data points of each body element having a spatial relation to the data points of another body element, the reference points of a particular body element having a known spatial relation to the data points of the particular body element;

identifying, during the procedure, the position of each of the reference points of each of the body elements relative to the reference points of the other body elements;

modifying the spatial relation of the data points of one body element relative to the data points of another body element according to the identified relative position of the reference points during the procedure in order to generate a displaced image data set representing the relative position of the body elements during the procedure; and

generating a display based on the displaced image data set illustrating the relative position of the body elements during the procedure.

28. The method of claim 27 further comprising the step of repositioning the body elements so that the display based on the displaced data set representing the position of the body elements during the procedure is substantially the same as the display based on the image data set generated prior to the procedure whereby the position of the body elements after repositioning is substantially the same as the position of the body elements prior to the procedure when the image data set was generated.

29. The method of claim 27 wherein the reference points are part of the body elements and further comprising the steps of:

providing a medical or surgical instrument;

identifying, during the procedure, the position of medical or surgical instrument relative to one or more of the body elements; and

generating a display based on the position of the medical or surgical instrument illustrating the relative position of the body elements and the medical or surgical instrument during the procedure.

30. The method of claim 29 further comprising the steps of determining an orientation of the medical or surgical instrument relative to the body elements and generating a display illustrating the orientation of the medical or surgical instrument relative to the body elements.

31. The method of claim 30 further comprising the steps of:

providing a reference array having a location outside the body for providing a reference; and

determining the position of the reference points of the body elements to be displayed relative to the reference array.

32. The method of claim 31 further comprising the steps of providing a registration probe in communication with the reference array and determining the position of the reference points of the body elements by positioning the tip of the registration probe at each of the reference points.

33. The method of claim 31 further comprising the steps of providing a reference frame having a position in fixed relation to one of the body elements, said reference frame in communication with the reference array, and determining the position of the reference frame relative to the reference array whereby the body may be moved during the procedure while the body elements remain in fixed relation to each other and the reference frame so that the method can determine the position of each of the body elements after movement without again identifying the relative position of each of the reference points of each of the body elements.

34. The method of claim 27 further comprising the step of discriminating the body elements of the image data set by creating an image data subset defining each of the body elements.

35. The method of claim 34 further comprising the step of translating each of the image data subsets from the position of the body elements prior to the procedure to the position of the body elements during the procedure whereby the displaced data set comprises the translated image data subsets.

36. The method of claim 34 comprising the steps of determining a position of a contour of each of the body elements during the procedure and comparing the position of the contour of the each of the body elements during the procedure to the position of the contour of each of the body elements prior to the procedure as represented by the image data set.

37. The method of claim 27 comprising the steps of positioning the body elements between a fluoroscopic tube and a fluoroscope plate in fixed relation to the tube, energizing the tube to generate a projection of each of the elements on the plate, determining the relative position of the fluoroscopic projection of each of the body elements during the procedure and comparing the position represented by the fluoroscopic projection of each of the body elements during the procedure to the relative position of the body elements prior to the procedure.

38. A system for use during a procedure on a body, said system generating a display representing a position of two or more body elements during the procedure, said system comprising:

a memory configured to store an image data set representing the position of the two or more body elements based on scans taken of the body prior to the procedure, the image data set having a plurality of data points and corresponding to a plurality of reference points for each of the body elements, the reference points of a particular body element having a known spatial relation to the data points of the particular body element;

at least three light emitters positioned with respect to the reference points on the particular body element;

light sensors positioned to detect light emitted by the at least three light emitters;

a digitizer positioned to receive a signal output by the light sensors, said digitizer being configured to determine a three dimensional position of the light emitters for the particular body element relative to the light emitters for the other body elements;

a processor modifying the spatial relation of the data points of one body element relative to the data points of another body element according to the identified relative position of the reference points during the procedure as determined by the light emitters and the digitizer, said processor generating a displaced image data set representing the position of the body elements during the procedure; and

a display utilizing the displaced image data set generated by the processor, illustrating the relative position of the body elements during the procedure.

39. The system of claim 38 wherein the reference points are in relation to the body elements and further comprising:

a medical or surgical instrument;

means for identifying, during the procedure, the position of the medical or surgical instrument relative to one or more of the body elements; and

wherein the display is responsive to the medical or surgical instrument position identifying means and includes means for illustrating, during the procedure, the relative position of the body elements relative to the medical or surgical instrument.

40. The system of claim 39 wherein the medical or surgical instrument position identifying means determines an orientation of the medical or surgical instrument relative to the body elements and wherein the display illustrates the orientation of the medical or surgical instrument relative to the body elements.

41. The system of claim 38 further comprising means for discriminating the body elements of the image data set by creating an image data subset defining each of the body elements.

42. The system of claim 41 wherein the processor translates each of the image data subsets from the position of the body elements prior to the procedure to the position of the body elements during the procedure whereby the displaced data set consists of the translated image data subsets.

43. The system of claim 41 further comprising a contour position determining means for determining a position of a contour of each of the body elements during the procedure and wherein the processor compares the position of the contour of each of the body elements during the procedure as determined by the contour position determining means to the position of the contour of each of the body elements prior to the procedure as represented by the image data subset.

44. The system of claim 43 wherein the contour position determining means comprises an ultrasound probe for determining a position of a contour of each of the body elements during the procedure and wherein the processor compares the position of the contour of the each of the body elements during the procedure as determined by the contour position determining means to the position of the contour of each of the body elements prior to the procedure as represented by the image data subset whereby the contour of the body elements may be determined without the need for exposing the body elements.

45. The system of claim 44 further comprising a reference array and wherein said ultrasound probe has emitters thereon in communication with the reference array and wherein the contour position determining means determines the position of the ultrasound probe relative to the reference array whereby the position of the contour of each body element can be determined.

46. The system of claim 44 comprising a reference array having emitters thereon in communication with the ultrasound probe and wherein the contour position determining means determines the position of the ultrasound probe relative to the reference array whereby the position of the contour of each body element can be determined.

47. The system of claim 43 wherein the contour position determining means comprises a scanner for determining a position of a contour of each of the body elements during the procedure and wherein the processor compares the position of the contour of the each of the body elements during the procedure as determined by the contour position determining means to the position of the contour of each of the body elements prior to the procedure as represented by the image data subset.

48. The system of claim 47 further comprising a reference array and wherein said scanner has emitters thereon in communication with the reference array and wherein the contour position determining means determines the position of the scanner relative to the reference array whereby the position of the contour of each body element can be determined.

49. The system of claim 47 further comprising a reference array having emitters thereon in communication with the scanner and wherein the contour position determining means determines the position of the scanner relative to the reference array whereby the position of the contour of each body element can be determined.

50. The system of claim 38 further comprising a fluoroscopic device for determining a position of a projection of each of the body elements during the procedure and wherein the processor compares the position of the projection of the each of the body elements during the procedure to the position of the projection of each of the body elements prior to the procedure.

51. The system of claim 50 wherein the fluoroscopic device comprises a fluoroscopic tube in fixed relation to a fluoroscopic plate between which the body elements are located for determining a position of a projection of each of the body elements during the procedure and wherein the processor compares the position of the projection of each of the body elements during the procedure to the position of the projection of each of the body elements prior to the procedure.

52. The system of claim 51 further comprising a reference array and wherein said fluoroscopic tube or said fluoroscopic plate have emitters thereon in communication with the reference array and wherein fluoroscopic device includes means for determining the position of the tube and plate relative to the reference array whereby the position of the projection of each body element can be determined.

53. The system of claim 51 further comprising a reference array having emitters thereon in communication with the fluoroscopic tube or the fluoroscopic plate and wherein the fluoroscopic device includes means for determining the position of the tube or plate relative to the reference array whereby the position of the projection of each body element can be determined.

54. The system of claim 50 wherein the fluoroscopic device determines a position of a projection of each of the body elements during the procedure, and the processor compares the position of the projection of the each of the body elements during the procedure as determined by the fluoroscopic device to the position of the projection of each of the body elements prior to the procedure as represented by the image data set whereby the projection of the body elements may be determined without the need for exposing the body elements.

55. The system of claim 54 comprising a reference array having emitters thereon in communication with the fluoroscope and wherein the determining means determines the position of the fluoroscope relative to the reference array whereby the position of the projection of each body element can be determined.