Method and system for guiding a diagnostic or therapeutic instrument towards a target region inside the patient's body

• US 6,567,687 B2
• Filed: 07/09/2001
• Issued: 05/20/2003
• Est. Priority Date: 02/22/1999
• Status: Expired due to Term

• Current Assignee: Spectrum Dynamics Medical Ltd
• Original Assignee: Gal Ben-David, Yaron Front
• Inventors: Ben-David, Gal, Front, Yaron
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US09/900,042
• Publication Number:
  US 20010041835A1
• Time in Patent Office: 680 Days
• Field of Search: 607/130, 600/407, 600/411, 600/414, 600/417, 600/426, 600/427, 600/440, 600/429
• US Class Current: 600/426
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• 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 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• 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 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• 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
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

Method and system are presented for guiding a diagnostic or therapeutic instrument towards a correct target inside the patient'"'"'s body. A combined image obtained by registering structural and functional images of at least a portion of the patient'"'"'s body including the target is used together with a guiding device. The guiding device has an indicator associated with the instrument, and is operable for presenting data indicative of a position of a location on the instrument relative to any other point in the at least portion of the patient'"'"'s body. The guiding device is connectable to a computer device displaying the combined image and operable thereby for guiding the instrument towards the target.

Claims

1. A medical imaging system, comprising:

a rigid frame, which includes;

fittings for snugly securing said frame to a patient'"'"'s body; and

at least three fiducial marks, arranged at different locations, on said frame;

a three-dimensional, first structural imaging modality, adapted for imaging different densities within the patient'"'"'s body and adapted to detect said at least three fiducial marks, for defining a three-dimensional coordinate system;

a three-dimensional, first functional imaging modality, adapted for imaging radioactively tagged pharmaceuticals, injected to the patient and distributed in the patient'"'"'s body due to physiological activities, thus adapted to detect said target, wherein said first functional imaging modality is spatially registered to said three-dimensional coordinate system; and

a computer device, for receiving input from said first structural and functional imaging modalities and for simultaneously displaying both, superimposed.

2. The system of claim 1, wherein said first structural imaging modality is selected from the group consisting of CT, MRI, Ultrasound and planar X-Ray imaging.

3. The system of claim 1, wherein said first structural imaging modality is MRI.

4. The system of claim 3, wherein said fiducial marks are formed as hollow plastic containers filled with a solution of Gd-DTPA.

5. The system of claim 1, wherein said first structural imaging modality is CT.

6. The system of claim 5, wherein said fiducial marks are formed of lead.

7. The system of claim 1, wherein said first functional imaging modality is nuclear imaging, selected from the group consisting of gamma camera, PET and SPECT.

8. The system of claim 1, wherein said system comprises at least one additional, three-dimensional, functional imaging modality, spatially registered to said three-dimensional coordinate system.

9. The system of claim 8, wherein said computer device is adapted for simultaneously displaying an image of said at least one additional functional imaging modality, superimposed on said first structural imaging modality.

10. The system of claim 8, wherein said at least one additional functional imaging modality is adapted for imaging at least one body organ which should not be penetrated.

11. The system of claim 8, wherein said at least one additional functional imaging modality is adapted for imaging at least one organ selected from the group consisting of blood vessels, the kidneys, the gut, the pancreas, the heart, a breast, the prostate, the thyroid, the lungs, the brain, a lymph Node, bones, ovaries, the colon, the rectum.

12. The system of claim 1, and further including at least one additional, structural imaging modality of a lower resolution than said first structural imaging modality, spatially registered to said three-dimensional coordinate system.

13. The system of claim 1, wherein said at least three fiducial marks are arranged on different planes, with respect to said three-dimensional coordinate system.

14. A system for guiding an instrument towards a target inside a patient'"'"'s body, said system comprising:

a rigid frame, which includes;

fittings for snugly securing said frame to the patient'"'"'s body; and

at least three fiducial marks, arranged at different locations, on said frame;

a three-dimensional, first structural imaging modality, adapted for imaging different densities within the patient'"'"'s body and adapted to detect said at least three fiducial marks, for defining a three-dimensional coordinate system;

a three-dimensional, first functional imaging modality, adapted for imaging radioactively tagged pharmaceuticals, injected to the patient and distributed in the patient'"'"'s body due to physiological activities, thus adapted to detect said target, wherein said first functional imaging modality is spatially registered to said three-dimensional coordinate system;

a computer device, for receiving input from said first structural and functional imaging modalities and for simultaneously displaying both, superimposed; and

a stereotactic guide, selectively attached to said rigid frame, so as to be spatially registered to said three-dimensional coordinate system, said stereotactic guide having an instrument mounted thereon, for guiding said instrument to said target, under the control of said computer device.

15. The system of claim 14, wherein said first structural imaging modality is selected from the group consisting of CT, MRI, Ultrasound and planar X-Ray imaging.

16. The system of claim 14, wherein said first structural imaging modality is MRI.

17. The system of claim 14, wherein said fiducial marks are formed as hollow plastic containers filled with a solution of Gd-DTPA.

18. The system of claim 14, wherein said first structural imaging modality is CT.

19. The system of claim 18, wherein said fiducial marks are formed of lead.

20. The system of claim 14, wherein said first functional imaging modality is nuclear imaging, selected from the group consisting of gamma camera, PET and SPECT.

21. The system of claim 14, wherein said system comprises at least one additional, three-dimensional, functional imaging modality, spatially registered to said three-dimensional coordinate system.

22. The system of claim 21, wherein said computer device is adapted for simultaneously displaying an image of said at least one additional functional imaging modality, superimposed on said first structural imaging modality.

23. The system of claim 21, wherein said at least one additional functional imaging modality is adapted for imaging at least one body organ which should not be penetrated.

24. The system of claim 21, wherein said at least one additional functional imaging modality is adapted for imaging at least one organ selected from the group consisting of blood vessels, the kidneys, the gut, the pancreas, the heart, a breast, the prostate, the thyroid, the lungs, the brain, a lymph Node, bones, ovaries, the colon, the rectum.

25. The system of claim 14, said system comprising at least one additional three-dimensional, structural imaging modality, of a lower resolution than said first structural imaging modality, spatially registered to said three-dimensional coordinate system.

26. The system of claim 14, wherein said at least three fiducial marks are arranged on at least two different planes, with respect to said three-dimensional coordinate system.

27. The system of claim 14, wherein said stereotactic guide includes an optical guiding system.

28. The system of claim 14, wherein said a stereotactic guide includes a magnetic guiding system.

29. The system of claim 14, wherein said instrument includes an indicator, in communication with said computer device, for generating and transmitting data, indicative of said instrument'"'"'s position, in a six-dimensional space.

30. The system of claim 14, wherein said instrument includes an identification chip, in communication with said computer device, for providing exact information on the physical dimensions of said instrument.

31. The system of claim 14, wherein said instrument includes a highlight mark.

32. The system of claim 31, wherein said highlight mark includes a lead capsule, which is visible on a CT image.

33. The system of claim 31, wherein said highlight mark includes iodine, which is visible on a CT image.

34. The system of claim 33, wherein said iodine is mixed and injected with a therapeutic solution, at said target.

35. The system of claim 31, wherein said highlight mark includes a radioactive material, which is visible on a nuclear image.

36. The system of claim 35, wherein said radioactive material is mixed and injected with a therapeutic solution.

37. A system for guiding an instrument towards a target inside a patient'"'"'s body, said system comprising:

a rigid frame, which includes;

fittings for snugly securing said frame to the patient'"'"'s body; and

at least two fiducial marks, arranged at different locations, on a plane of said frame;

a two-dimensional, first structural imaging modality, adapted for imaging different densities within the patient'"'"'s body and adapted to detect said at least two fiducial marks, for defining a two-dimensional coordinate system;

a two-dimensional, first functional imaging modality, adapted for imaging radioactively tagged pharmaceuticals, injected to the patient and distributed in the patient'"'"'s body due to physiological activities, thus adapted to detect said target, wherein said first functional imaging modality is spatially registered to said two-dimensional coordinate system;

a computer device, for receiving input from said first structural and functional imaging modalities and for simultaneously displaying both, superimposed; and

a guide, selectively attached to said rigid frame, so as to be spatially registered to said coordinate system, said guide having an instrument mounted thereon, for guiding said instrument to said target, under the control of said computer device.

38. The system of claim 37, wherein said first structural imaging modality is MRI.

39. The system of claim 38, wherein said fiducial marks are formed as hollow plastic containers filled with a solution of Gd-DTPA.

40. The system of claim 37, wherein said first structural imaging modality is CT slices.

41. The system of claim 40, wherein said fiducial marks are formed of lead.

42. The system of claim 37, wherein said first functional imaging modality is nuclear imaging.

43. The system of claim 37, wherein said system comprises at least one additional, two-dimensional, functional imaging modality, spatially registered to said coordinate system.

44. The system of claim 43, wherein said computer device is adapted for simultaneously displaying an image of said at least one additional functional imaging modality, superimposed on said first structural imaging modality.

45. The system of claim 43, wherein said at least one additional functional imaging modality is adapted for imaging at least one body organ which should not be penetrated.

46. The system of claim 43, wherein said at least one additional functional imaging modality is adapted for imaging at least one organ selected from the group consisting of blood vessels, the kidneys, the gut, the pancreas, the heart, a breast, the prostate, the thyroid, the lungs, the brain, a lymph Node, bones, ovaries, the colon, the rectum.

47. The system of claim 37, said system comprising at least one additional two-dimensional, structural imaging modality, of a lower resolution than said first structural imaging modality, spatially registered to said coordinate system.

48. The system of claim 37, wherein said guide includes an optical guiding system.

49. The system of claim 37, wherein said guide includes a magnetic guiding system.

50. The system of claim 37, wherein said instrument includes an indicator, in communication with said computer device, for generating and transmitting data, indicative of said instrument'"'"'s position, in a six-dimensional space.

51. The system of claim 37, wherein said instrument includes an identification chip, in communication with said computer device, for providing exact information on the physical dimensions of said instrument.

52. The system of claim 37, wherein said instrument includes a highlight mark.

53. The system of claim 52, wherein said highlight mark includes a lead capsule, which is visible on a CT image slice.

54. The system of claim 52, wherein said highlight mark includes iodine, which is visible on a CT image slice.

55. The system of claim 54, wherein said iodine is mixed and injected with a therapeutic solution, at said target.

56. The system of claim 52, wherein said highlight mark includes a radioactive material, which is visible on a nuclear image.

57. The system of claim 56, wherein said radioactive material is mixed and injected with a therapeutic solution.