Method and apparatus for transforming view orientations in image-guided surgery

• US 6,442,417 B1
• Filed: 11/28/2000
• Issued: 08/27/2002
• Est. Priority Date: 11/29/1999
• Status: Expired due to Term

• Current Assignee: Ramin Shahidi, Stryker European Operations Holdings, LLC (Stryker Corporation)
• Original Assignee: CBYON, Inc., Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Datnow, Steven L., Randall, Rory S., Shahidi, Ramin
• Primary Examiner(s): NERBUN, PETER P
• Application Number:
  US09/723,819
• Time in Patent Office: 637 Days
• Field of Search: 600/427, 600/429, 600/426, 600/411, 600/417, 600/424, 600/407, 600/117, 606/130
• US Class Current: 600/429
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2068 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 2090/365 augmented reality, i.e. correlating a live optical image with another image
• 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 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

Systems and methods for performing transformations between a view orientation in a virtual space and a view orientation with respect to a target site in a patient'"'"'s body where surgery is being performed. The view in virtual space enables the surgeon to see the internal structures in the target site in a variety of ways and orientations including from behind the site.

Claims

1. Apparatus for use in an image-guided surgical or a diagnostic procedure at an internal target site of a patient, said apparatus comprising:

(a) a data-storage medium for storing scan data representing internal scans of the patient target site;

(b) an instrument defining a view axis, the instrument being adapted to be moved to a selected orientation with respect to the patient target site;

(c) means for tracking the orientation of the instrument with respect to the patient target site as the instrument is moved;

(d) a display device; and

(e) a processor in communication with the data storage medium, the tracking means, and the display device, for carrying out steps (i)-(iii) in a first mode, and steps (iv)-(viii) in a second mode;

(i) determining the orientation of the instrument view axis with respect to the patient target site, as the instrument is moved to a selected orientation with respect to the patient target site;

(ii) using at least some of the scan data to construct an image of the patient target site, as viewed with respect to the orientation of the instrument;

(iii) displaying the image on the display device;

(iv) receiving input that indicates a selected orientation at which a virtual target point, external to the patient, is being viewed;

(v) determining, from the input, the selected view orientation with respect to the virtual target point;

(vi) transforming the view orientation determined in step (v) to a view orientation with respect to the selected patient target point;

(vii) using the scan data to construct an image of the patient target site, as viewed along the transformed view orientation generated in step (vi); and

(viii) displaying the image generated in step (vii) on the display device.

2. The apparatus of claim 1, wherein the tracking means is further operable to track the position of the instrument with respect to the patient target site and virtual target site, and the processor is further operable, in carrying out step (iv) to receive user input that indicates the selected orientation and position at which the virtual target point is being viewed, in carrying out step (v) to determine from the user input a view orientation and position with respect to the virtual target point, in-carrying out step (vi) to transform the view orientation and position with respect to the virtual target point to a view orientation and position, respectively, with respect to the selected patient target point, and in carrying out step (vii) to use the scan data to construct an image of the patient target site, as viewed along the transformed view orientation and position generated in step (vi).

3. The apparatus of claim 1, which further includes a user control for setting a reference condition for the first mode of processor operation, and the processor is operable to establish, as a reference orientation, the orientation of the medical instrument view axis determined in step (i) at the time the user sets the reference condition.

4. The apparatus of claim 3, wherein the processor is further operable to maintain the image displayed in step (iii) at the time the user sets the reference condition, and optionally, to display the image displayed in step (iii) and the image displayed in step (viii) simultaneously on the display device.

5. The apparatus of claim 1, which further includes a user input function by which the user can specify the coordinates of the virtual target point with respect to the medical instrument, and the processor is operable to maintain the specified virtual target-site coordinates with respect to the medical instrument, as the orientation of the instrument with respect to the virtual target point is selectively changed by the user.

6. The apparatus of claim 5, wherein the user input function is operable to specify target-site coordinates which are on the instrument view axis, a specified distance from a known point of the instrument.

7. The apparatus of claim 5, wherein the means for tracking the orientation of said instrument with respect to the patient includes (i) tracking elements carried on said instrument, (ii) positional elements adapted to be placed at fixed positions on the patient, and (iii) a sensing device for sensing the positions of the tracking and positional elements, and said sensing device is operably connected to said processor.

8. The apparatus of claim 1, which further includes a user input function by which the user can trigger the position of the virtual target point with respect to the medical instrument, at a selected position of the medical instrument, and the processor is operable to maintain the specified virtual target-site at a fixed position in space, as the orientation of the instrument with respect to the virtual target point is selectively changed by the user.

9. The apparatus of claim 8, wherein the user input function is further operable to trigger the positioning of the virtual target point on the instrument view axis, a specified distance from a known point of the instrument.

10. The apparatus of claim 8, wherein the means for tracking the orientation of said instrument with respect to the patient includes (i) tracking elements carried on said instrument, (ii) positional elements adapted to be placed at fixed positions on the patient, and (iii) a sensing device for sensing the positions of the tracking and positional elements, and the sensing device is operably connected to said processor.

11. The apparatus of claim 8, wherein the tracking means is further operable to track the position of said instrument with respect to the patient target site and the virtual target site, and the processor is further operable, in carrying out step (iv) to receive user input that indicates the a selected orientation and position at which the virtual target point is being viewed, in carrying out step (v) to determine from the user input, a view orientation and position with respect to the virtual target point, in carrying out step (vi) to transform the view orientation and position with respect to the virtual target point to a view orientation and position, respectively, with respect to the selected patient target point, and in carrying out step (vii) to use the scan data to construct an image of the patient'"'"'s target site, as viewed along the transformed view orientation and position generated in step (vi).

12. The apparatus of claim 1, which further includes a positioning device having a pointer adapted to be moved about a fixed, virtual target point, and one or more position sensors operably connected to said processor for providing such user-determined input for step (v) of the processor operation.

13. The apparatus of claim 12, wherein the positioning device, includes a universal swivel adapted to be mounted adjacent and external to the patient, and having a swivel point corresponding to the virtual target point, an elongated pointer carried on the swivel for movement by the user to a selected orientation with respect to the virtual target point, and one or more position sensors for sensing the orientation and position of the pointer with respect to the virtual target point.

14. The apparatus of claim 12, which further includes a user control for setting a reference condition for the first mode of processor operation, and the processor is operable to establish, as a reference orientation, the orientation of the medical instrument view axis determined in step (i) at the time the user sets the reference condition.

15. The apparatus of claim 12, wherein the processor is operable, in carrying out steps (v) and (vi) to maintain the same orientation coordinates for the pointer, with respect to the virtual target point, as the medical instrument has with respect to the selected target point, such that the image displayed in step (viii) is from the same view orientation as that displayed in step (iii) when the medical instrument and the pointer have the same orientation in space.

16. The apparatus of claim 1, wherein the virtual target point is a fixed site defined by a physical structure adapted to be placed adjacent and external to the patient, and the user-determined input is supplied by a user-held pointer that can be moved to a selected position and orientation in space with respect to the virtual target point.

17. The apparatus of claim 16, wherein the user-held pointer is the medical instrument.

18. The apparatus of claim 17, wherein the means for tracking the position and orientation of the instrument with respect to the patient includes tracking elements carried on the instrument, positional elements adapted to be placed at fixed positions on the patient, and a sensing device for sensing the positions of the tracking and positional elements, and the sensing device is operably connected to the processor.

19. The apparatus of claim 18, wherein the physical structure defining the virtual target point also contains positional elements adapted to be sensed by the sensing device, and the processor is operable to determine the relative position and orientation of the medical instrument with respect to the virtual target point by input received from the sensing device.

20. The apparatus of claim 17, wherein the processor is operable to use input data about the position of the medical instrument with respect to the virtual target point, when the medical instrument is placed at a selected calibration position with respect to the virtual target point.

21. The apparatus of claim 16, wherein the processor is operable, in carrying out steps (iv) and (v) to shift the actual coordinates of the virtual target point so that they correspond to a point of the view axis of the medical instrument.

22. The apparatus of claim 16, wherein the pointer includes a three-dimensional position tracker adapted to be held by the user, and moved freely by the user to selected positions and orientation with respect to the virtual target point.

23. The apparatus of claim 22, wherein the pointer has a defined pointer axis, the processor is operable, in carrying out steps (iv) and (v) to shift the actual coordinates of the virtual target point so that they correspond to a point on the view axis of the pointer.

31. The apparatus of claim 1, wherein the second mode of operation further includes transforming the coordinates of a selected point in the target site to the virtual target point.

32. The apparatus of claim 1, which further includes a positioning device in communication with the processor and adapted to moved about a fixed, virtual target point to select the orientation at which the virtual target point is being viewed.

33. The apparatus of claim 32, wherein the positioning device comprises a joystick or track ball.

24. A device-readable medium embodying a program of instructions executable by the device for performing a method for use in an image-guided surgical or diagnostic procedure of transforming a view orientation, the program of instructions comprising instructions for:

(a) storing scan data representing internal scans of a patient target site;

(b) tracking the orientation of a medical instrument defining a view axis with respect to the patient target site, as the instrument is moved to a selected orientation with respect to the patient target site; and

(c) carrying out the following steps (i)-(iii) in a first mode, and steps (iv)-(viii) in a second mode;

(i) determining the orientation of the instrument view axis with respect to the patient target site, as the instrument is moved to a selected orientation with respect to the site;

(ii) using at least some of the scan data to construct an image of the patient target site, as viewed with respect to the instrument;

(iii) displaying the image on the display device;

(iv) determining a view orientation with respect to a virtual target point external to the patient;

(v) transforming the view orientation determined in step (iv) to a view orientation with respect to a selected patient target point;

(vi) using the scan data to construct an image of the patient'"'"'s target site, as viewed along the transformed view orientation generated in step (v); and

(vii) displaying the image generated in step (vi) on the display device.

25. The device-readable medium of claim 24, wherein the tracking includes (i) placing tracking elements on the instrument and positional elements on the patient, and (ii) using a sensing device operably connected to the processor for sensing the positions of the tracking and positional elements.

26. The device-readable medium of claim 24, which further includes specifying the coordinates of the virtual target point with respect to the medical instrument, and the processor operates to maintain the specified virtual target-site coordinates with respect to the medical instrument, as the orientation of the instrument with respect to the virtual target point is selectively changed by the user.

27. The device-readable medium of claim 24, which further includes specifying the position of the virtual target point with respect to the medical instrument, at a selected position of the medical instrument, and the processor operates to maintain the specified virtual target-site at a fixed position in space, as the position orientation of the instrument with respect to the virtual target point is selectively changed by the user.

28. The device-readable medium of claim 24, wherein step (iv) is carried out by moving a pointer pivotally mounted on a universal swivel for movement to a selected orientation about a fixed, virtual target point, where the orientation of the pointer is detected by one or more position sensors operably connected to the processor.

29. The device-readable medium of claim 24, wherein step (iv) is carried out by moving a pointer about a fixed virtual target point defined by a physical structure positioned adjacent the patient.

30. The device-readable medium of claim 29, wherein the processor is operable to shift the actual coordinates of the virtual target point so that they correspond to a point of the view axis of the medical instrument.