Ultrasonic guidance of target structures for medical procedures

• US 6,390,982 B1
• Filed: 07/21/2000
• Issued: 05/21/2002
• Est. Priority Date: 07/23/1999
• Status: Expired due to Term

• Current Assignee: University of Florida Research Foundation, Incorporated (State University System of Florida)
• Original Assignee: University of Florida (State University System of Florida)
• Inventors: Friedman, William A., Meeks, Sanford L., Bova, Frank M., Buatti, John M.
• Primary Examiner(s): Jaworski, Francis J.
• Assistant Examiner(s): PATEL, MAULIN M
• Application Number:
  US09/621,868
• Time in Patent Office: 669 Days
• Field of Search: 600/443, 600/442, 600/440, 600/424, 600/428, 128/16
• US Class Current: 600/443
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• 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 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/08 Detecting organic movements or changes, e.g. tumours, cysts, swellings A61B8/02 - A61B8/06 take precedence
• 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 8/5238 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: A61N 2005/1058 using ultrasound imaging
• CPC Class Codes: A61N 2005/1059 using cameras imaging the patient
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: Y10S 128/916 Ultrasound 3-D imaging

Abstract

A system comprising a combination of an ultrasound probe and both passive and active infrared tracking systems. The combined system enables a real time image display of the entire region of interest without probe movement; real time tracking of the target region permitting physiological gating; and probe placement during image acquisition so that all external displacements introduced by the probe can be accounted for at the time of treatment planning. This system may be used in the surgical arena for image guidance during radiation therapy and surgery.

Claims

1. A method comprising the steps of:

imaging at least a portion of a patient with a first imaging technique to provide a first set of imaging data, the first set of imaging data having a fixed frame of reference;

imaging at least a part of the patient with a second imaging technique, the part of the patient including at least some of the portion of the patient, the second imaging technique using an ultrasound device to provide a second set of imaging data, the second set of imaging data being 3D data relative to the ultrasound device and not being fixed relative to the fixed frame of reference, the ultrasound device being operable to provide the 3D data without relative movement between the ultrasound device and the patient;

determining position data for the ultrasound device;

using the determined position data and the second set of imaging data to provide a converted set of imaging data corresponding to the second set of imaging data being referenced to the fixed frame of reference; and

combining the converted set of image data with at least some of the first set of imaging data to provide a composite set of imaging data.

2. The method of claim 1 wherein the first imaging technique as used to provide the first set of imaging data is selected from the group consisting of:

computerized tomography imaging, magnetic resonance imaging, and fluoroscopic imaging.

3. The method of claim 2 wherein the first imaging technique is performed and completed prior to the imaging with the ultrasound device.

4. The method of claim 2 wherein the step of imaging with the ultrasound device uses an ultrasound probe that produces 3D imaging data without relative movement between the ultrasonic probe and the patient.

5. The method of claim 4 wherein the step of determining position data for the ultrasound probe includes determining the position of a plurality of probe position markers on the ultrasound probe, the position of the probe position markers being determined by a technique not including the first and second imaging techniques.

6. The method of claim 5 wherein the position of the ultrasound probe is determined using infrared (IR) imaging.

7. The method of claim 5 further comprising the step of performing a medical procedure on the patient using both a medical device and the converted set of imaging data to determine positioning of the medical device relative to the patient.

8. The method of claim 7 wherein the medical device is a medical linear accelerator.

9. The method of claim 1 further comprising the steps of:

performing a medical procedure on the patient using both a medical device and the converted set of imaging data to determine positioning of the medical device relative to the patient;

and causing relative movement between the patient and the medical device to bring the second set of imaging data into registry with the first set of imaging data.

10. The method of claim 1 further comprising the step of, at least before completion of the first imaging technique, securing a plurality of patient position markers fixed relative to the patient.

11. A method comprising the steps of:

securing a plurality of patient position markers fixed relative to a patient, the patient position markers defining a fixed frame of reference;

imaging at least a part of the patient using an ultrasound device to provide an ultrasound set of imaging data, the ultrasound set of imaging data being 3D data relative to the ultrasound device and not being fixed relative to the fixed frame of reference, the ultrasound device being operable to provide the 3D data without relative movement between the ultrasound device and the patient;

determining position data for the ultrasound device;

using the determined position data and the ultrasound set of imaging data to provide a converted set of imaging data corresponding to the ultrasound set of imaging data being referenced to the fixed frame of reference.

12. The method of claim 11 wherein the patient position markers are secured directly to the patient.

13. The method of claim 11 wherein the step of imaging with the ultrasound device uses an ultrasound probe that produces 3D imaging data without relative movement between the ultrasound probe and the patient.

14. The method of claim 13 wherein the step of determining position data for the ultrasound probe includes determining the position of a plurality of probe position markers on the ultrasound probe, the position of the probe position markers being determined by a technique not including ultrasound.

15. The method of claim 14 wherein the position of the ultrasound probe is determined using infrared (IR) imaging.

16. The method of claim 15 further comprising the step of performing a medical procedure on the patient using both a medical device and the composite set of imaging data to determine positioning of the medical device relative to the patient.

17. The method of claim 16 wherein the medical device is a medical linear accelerator.

18. The method of claim 15 further comprising the steps of:

imaging at least a portion of a patient with a non-ultrasound imaging technique to provide a set of imaging data relative to the fixed frame of reference, and combining the converted set of image data with at least some of the set of imaging data from the non-ultrasound imaging technique to provide a composite set of imaging data.

19. The method of claim 18 wherein the non-ultrasound imaging technique is selected from the group consisting of:

computerized tomography imaging, magnetic resonance imaging, and fluoroscopic imaging.

20. A system for carrying out medical procedures comprising:

a plurality of patient position markers operable for fixing relative to a patient to define a fixed frame of reference;

an ultrasound device operable to provide an ultrasound set of imaging data, the ultrasound set of imaging data being 3D data relative to the ultrasound device and not being fixed relative to the fixed frame of reference, the ultrasound device being operable to produce 3D data without relative movement between the ultrasound device and the patient;

a position determiner to determine position data for the ultrasound device relative to the fixed frame of reference; and

a processor operable to use the determined position data and the ultrasound set of imaging data to provide a converted set of imaging data corresponding to the ultrasound set of imaging data being referenced to the fixed frame of reference.

21. The system of claim 20 wherein the ultrasound device is an ultrasound probe that produces 3D imaging data without relative movement between the ultrasound probe and the patient.

22. The system of claim 21 further comprising a plurality of probe position markers on the ultrasound probe.

23. The system of claim 22 wherein the position determiner includes a subsystem to determine the position of the probe position markers and the patient position markers.

24. The system of claim 23 wherein the subsystem includes an infrared (IR) camera.

25. The system of claim 22 further comprising a medical device for performing a medical procedure on a patient using both the medical device and the ultrasound set of imaging data to determine positioning of the medical device relative to the patient.

26. The system of claim 20 further comprising a medical device for performing a medical procedure on a patient using both the medical device and the ultrasound set of imaging data to determine positioning of the medical device relative to the patient.

27. The system of claim 20 further comprising a non-ultrasonic imaging subsystem operable to image at least a portion of a patient to provide a set of imaging data relative to the fixed frame of reference and wherein the processor is operable to combine the imaging data from the non-ultrasonic subsystem with the composite data to provide a composite set of imaging data.

28. The system of claim 27 wherein the non-ultrasonic imaging subsystem is selected from the group consisting of:

a computerized tomography system, a magnetic resonance system, and a fluoroscopy system.

29. The system of claim 28 further comprising a medical device for performing a medical procedure on a patient using both the medical device and the ultrasound set of imaging data to determine positioning of the medical device relative to the patient.

30. The system of claim 29 wherein the medical device a medical linear accelerator.