Apparatus and method for determining a location of an anatomical target with reference to a medical apparatus

• US 6,405,072 B1
• Filed: 12/01/1997
• Issued: 06/11/2002
• Est. Priority Date: 01/28/1991
• Status: Expired due to Fees

• Current Assignee: Integra Burlington MA, Inc. (Integra LifeSciences Holdings Corporation)
• Original Assignee: Sherwood Services AG
• Inventors: Cosman, Eric R.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/980,572
• Time in Patent Office: 1,653 Days
• Field of Search: 606/130, 600/425-427, 600/429, 600/414, 600/417
• US Class Current: 600/426
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• 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 2090/371 with simultaneous use of two cameras
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/502 Headgear, e.g. helmet, spectacles
• 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 5/1127 using markers
• CPC Class Codes: A61B 6/0421 with immobilising means
• CPC Class Codes: A61B 6/0492 using markers or indicia for aiding patient positioning
• CPC Class Codes: A61B 6/08 Auxiliary means for directing the radiation beam to a particular spot, e.g. using light beams
• 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 90/10 : 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 90/16 : Bite blocks
• CPC Class Codes: A61B 90/20 : Surgical microscopes characterised by non-optical aspects
• CPC Class Codes: A61N 2005/105 : using a laser alignment system
• CPC Class Codes: A61N 2005/1051 : using an active marker
• CPC Class Codes: A61N 2005/1052 : using positron emission tomography [PET] single photon emission computer tomography [SPECT] imaging
• CPC Class Codes: A61N 2005/1059 : using cameras imaging the patient
• CPC Class Codes: A61N 2005/1061 : using an x-ray imaging system having a separate imaging source
• CPC Class Codes: A61N 5/1049 : for verifying the position of the patient with respect to the radiation beam
• CPC Class Codes: A61N 5/1064 : for adjusting radiation treatment in response to monitoring
• CPC Class Codes: A61N 5/107 : in real time, i.e. during treatment
• CPC Class Codes: G06T 2207/10081 : Computed x-ray tomography [CT]
• CPC Class Codes: G06T 2207/30204 : Marker
• CPC Class Codes: G06T 7/73 : using feature-based methods

Abstract

A system for positioning and repositioning of a portion of a patient'"'"'s body with respect to a treatment or imaging machine includes multiple cameras to view the body and the machine. Index markers, either light-emitting, passive, geometric shapes, or natural landmarks, are identified and located by the cameras in 3D space. In one embodiment, such reference or index markers are in a determinable relationship to analogous markers used during previous image scanning of the patient. Anatomical targets determined from image scanning can be located relative to reference positions associated with the treatment or diagnostic machine. Several forms of camera, index markers, methods and systems accommodate different clinical uses. X-ray imaging of the patient further refines anatomical target positioning relative to the treatment or diagnostic imaging reference point. Movements of the patient based on comparative analysis of imaging determined anatomical targets relative to reference points on treatment or diagnostic apparatus are controlled by the system and process of the invention.

Claims

1. A process for determining a location of an anatomical target with reference to a medical apparatus, comprising the steps of:

scanning a patient'"'"'s anatomy, including an anatomical target to obtain image scan data thereof referenced in image scanner coordinates;

indexing a position of the patient'"'"'s anatomy and a position of a medical apparatus with a camera system to obtain camera data thereof referenced in camera coordinates;

correlating the image scan data and the camera data by identifying at least one marker having a known location with respect to the image scan data and the camera data; and

transforming the image scanner coordinates to the camera data coordinates such that the position of the anatomical target is determined with respect to a reference point of the medical apparatus.

2. The process according to claim 1 wherein the step of indexing includes optically sensing optical index markers disposed on the patient'"'"'s anatomy and the medical apparatus and referencing the optical index markers in camera coordinates.

3. The process according to claim 2 wherein the step of scanning includes detecting scanner index markers positioned with respect to the patient'"'"'s anatomy and referencing the scanner index markers in image scanner coordinates.

4. The process according to claim 3, including the step of graphically displaying an image representative of the medical apparatus related to the patient'"'"'s anatomy.

5. The process according to claim 3 wherein the medical apparatus is a LINAC and wherein the step of transforming includes determining the position of the anatomical target with respect to a radiation isocenter of the LINAC.

6. The process according to claim 3 wherein the medical apparatus is a diagnostic image scanning apparatus and wherein the step of transforming includes determining the position of the anatomical target with respect to an image acquisition range of the diagnostic image scanning apparatus.

7. The process according to claim 1 including the step of automatically adjusting a position of the patient'"'"'s anatomy using computer control means to align the position of the anatomical target with respect to the reference point of the medical apparatus.

8. A system for indicating a positional relationship of a treatment apparatus having a treatment center location with respect to a patient'"'"'s anatomy represented by image scan data, which comprises:

a computer for storing and processing image scan data representing the patient'"'"'s anatomy including an anatomical target location, and referenced in image scan coordinates;

index means mountable to the patient'"'"'s anatomy and the treatment apparatus for indexing positional data of the patient'"'"'s anatomy and the treatment apparatus at fiducial points;

a camera system comprising two or more cameras, each camera having a field of view encompassing at least a portion of the patient'"'"'s anatomy and the treatment apparatus, the camera system adapted for providing camera data of spatial points within respective field of views of the patient'"'"'s anatomy and a treatment center location of the surgical treatment apparatus, the camera data indexed at the fiducial points and referenced in camera coordinates; and

means associated with the computer for establishing a correlation between the image scan data and the camera data and for transforming the image scan coordinates to the camera coordinates such that the position of the treatment center location of the treatment apparatus is known with respect to the patient'"'"'s anatomy.

9. The system according to claim 8 wherein the index means includes a plurality of optical detectable elements mountable to the patient'"'"'s anatomy and the surgical treatment apparatus.

10. The system according to claim 9 wherein the optical detectable elements are devices with geometric patterns.

11. The system according to claim 8 including graphic display means for displaying an image representative of the treatment center location and the anatomical target location.

12. The system according to claim 8 including means associated with the computer for automatically adjusting a position of the patient'"'"'s anatomy to align the anatomical target location and the treatment center location of the treatment apparatus.