Methods and apparatus for planning and executing minimally invasive procedures for in-vivo placement of objects

• US 6,505,065 B1
• Filed: 10/27/2000
• Issued: 01/07/2003
• Est. Priority Date: 10/29/1999
• Status: Expired due to Term

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Yanof, Jeffrey H., Ivan, Andy, Klahr, Paul, Hoffmeyer, Dave
• Primary Examiner(s): Vo, Hieu T.
• Application Number:
  US09/697,805
• Time in Patent Office: 802 Days
• Field of Search: 600/427, 600/440, 600/443, 600/439, 600/444, 600/449, 600/424, 600/103, 600/117
• US Class Current: 600/427
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 6/584 determining position of components of the apparatus or device using images of the phantom
• CPC Class Codes: A61B 90/10 for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61N 5/1027 Interstitial radiation therapy
• CPC Class Codes: A61N 5/103 Treatment planning systems

Abstract

A method (310) and apparatus (1) are provided for planning an executing minimally invasive procedures for in-vivo placement of objects within the body of a patient. The method and apparatus enable non-invasive pre-operation virtual seed placement and dose distribution planning using visualization information showing a patient'"'"'s anatomy together with a set of single point targets (182) within the patient'"'"'s body and a corresponding set of trajectories (184) through the skin and body of the patient leading to the selected target points. For enhanced visualization, multiplanar reformatted images (166, 168) are derived from CT image data sets and are angled to always contain the plane of the virtual needle (300) in the pseudo-axial image and its 90 degree slice counterpart. In an implementation stage, a stereotactic arm (40) spatially referenced to the patient'"'"'s data set acts a needle guide (52) and is used to locate preplanned image planes containing virtual seed deposition points. A physical needle (50) is aligned with preplanned virtual needle trajectories (282, 284, 286) so that one or more seeds or other objects can be precisely placed within the patient'"'"'s body.

Claims

1. An apparatus (1) for planning placement of objects within the body of the patient by a minimally invasive procedure, the apparatus comprising:

an image device (20) scanning the patient to generate a volumetric image data set of the patient;

a human readable device (32, 36, 128) for displaying an image (162) of the patient derived from said volumetric image data set;

means (132-154) for selecting a virtual target point (182) in said image of the patient by identifying a first set of virtual coordinates in said image of the patient;

means (132-154) for selecting a virtual trajectory (184) for inserting an object into said patient by identifying a virtual path extending from said selected virtual target point (182) and out from the body of the patient; and

,

display means (164, 166, 168) for displaying said virtual trajectory (184) from said selected virtual target point and out from the body of the patient on said human readable display (32, 36, 128) together with said image (162) of the patient.

2. The apparatus according to claim 1 wherein the display means for displaying the virtual trajectory (184) includes:

means for developing a multi-planar reformatted image (166, 168) of the patient; and

,

means for displaying a planar image of the patient coincident with said virtual trajectory (184).

3. The apparatus according to claim 1 further including means (210) for displaying a virtual prescription dose profile (192) surrounding the selected virtual target point (182) in said image of the patient.

4. The apparatus according to claim 1 further including a memory for storing, said first set of virtual coordinates corresponding to said selected virtual target point in said image of the patient and, information corresponding to said selected virtual trajectory.

5. The apparatus according to claim 4 further including:

means for selecting a plurality of virtual target points in said image of the patient by identifying a plurality of sets of virtual coordinates in said image of the patient; and

,

means for selecting a plurality of virtual trajectories for inserting objects into said patient by identifying a corresponding plurality of virtual paths extending from said plurality of virtual target points and out from the body of the patient.

6. The apparatus according to claim 5 further including means for displaying a plurality of virtual prescription dose profiles surrounding said plurality of selected virtual target points in said image of the patient.

14. The method according to claim 1 wherein the step of providing said visualization information includes:

providing at least one axial planar image slice of the patient showing said object placement target point within the patient; and

,

providing at least one multi-planar reformatted image view of the patient oblique to said axial planar image slice, the at least one multi-planar reformatted image view containing said at least one planning therapy trajectory.

15. The method according to claim 14 wherein the step of displaying said interventional therapy tool on said human readable display as a virtual tool image includes overlaying the virtual tool image on said visualization information of the patient on said human readable display.

16. The method according to claim 15 wherein:

the step of displaying said virtual tool image includes displaying said virtual tool image on said human readable display in a manner to visually distinguish the virtual tool image from said visualization information of the patient.

7. A method of planning placement of objects within the body of the patient by a minimally invasive procedure, the method comprising the steps of:

scanning the patient in an imaging device (20) to generate a volumetric image data set of the patient;

displaying on a human readable device (32, 36, 128) an image (162, 164, 166, 168) of the patient derived from said volumetric image data set;

selecting a virtual target point (182) in said image of the patient by identifying a first set of virtual coordinates in said image of the patient;

selecting a virtual trajectory (184) for inserting an object into said patient by identifying a virtual path extending from said selected virtual target point (182) and out from the body of the patient; and

,

displaying said virtual trajectory (184) from said selected virtual target point and out from the body of the patient on said human readable display (32, 36, 128) together with said image of the patient.

8. The method according to claim 7 wherein the step displaying the virtual trajectory (184) includes:

developing a multi-planar reformatted image of the patient; and

,

displaying a planar image of the patient coincident with said virtual trajectory (184).

9. The method according to claim 7 further including the step of displaying a virtual prescription dose profile (192) surrounding the selected virtual target point (182) in said image of the patient.

10. The method according to claim 7 further including the steps of:

storing, in a memory of said imaging device, said first set of virtual coordinates corresponding to said selected virtual target point in said image of the patient; and

,

storing, in said memory, information corresponding to said selected virtual trajectory.

11. The method according to claim 10 further including the steps of:

selecting a plurality of virtual target points in said image of the patient by identifying a plurality of sets of virtual coordinates in said image of the patient; and

,

selecting a plurality of virtual trajectories for inserting objects into said patient by identifying a corresponding plurality of virtual paths extending from said plurality of virtual target points and out from the body of the patient.

12. The method according to claim 11 further including the step of displaying a plurality of virtual prescription dose profiles surrounding said plurality of selected virtual target points in said image of the patient.

13. A method for use with an imaging apparatus for minimally invasive placement of objects within a patient, the method comprising the steps of:

providing visualization information of the patient on a human readable display associated with said imaging apparatus, the visualization information showing at least one interventional therapy object placement target point within said patient, and at least one planning therapy trajectory extending through the patient from the object placement target point;

providing an interventional therapy tool carried on a localizing device of the imaging apparatus;

displaying the interventional therapy tool on said human readable display as a virtual tool image together with said visualization information of said patient;

manually moving the localizing device relative to the patient to align the virtual tool image with said planning therapy trajectory; and

,

after the virtual tool image is aligned with said planning therapy trajectory, locking the localizing device in place so that an interventional therapy object can be translated along said planning therapy trajectory to a desired depth for precise placement of said interventional therapy object at said object placement target point within said patient.

17. The method according to claim 13 further including the steps of:

providing a minimally invasive surgical tool adapted for movement relative to the localizing device and carrying at least one of said objects;

advancing the tool along said planning therapy trajectory; and

,

depositing said at least one object within said patient at said target point.

18. The method according to claim 17 further including the steps of:

imaging the patient using said imaging apparatus to generate second visualization information of the patient and said at least one object;

displaying the second visualization information on said human readable display; and

,

identifying a dose distribution on said human readable display.

19. The method according to claim 13 further including the steps of:

generating a dose distribution profile surrounding the target point; and

,

displaying said dose distribution profile on said human readable display.