Surgical navigation systems including reference and localization frames

• US 7,139,601 B2
• Filed: 04/12/2001
• Issued: 11/21/2006
• Est. Priority Date: 04/26/1993
• Status: Expired due to Term

• Current Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc), St. Louis University
• Original Assignee: Surgical Navigation Technologies, Inc. (Medtronic Plc), St. Louis University
• Inventors: Bass, Daniel, Wiedenmaier, Udo, Wiedenmaier, Thomas, Pope, Todd, Foley, Kevin T., Bucholz, Richard D., Smith, Kurt R.
• Primary Examiner(s): MANTIS MERCADER, ELENI M
• Application Number:
  US09/832,848
• Publication Number:
  US 20020035321A1
• Time in Patent Office: 2,049 Days
• Field of Search: 600/407, 600/425, 600/426, 600/427, 600/429, 378/54, 378/63, 378/205, 606/130, 382/128, 382/131, 382/132, 128/920, 128/922, 128/923, 128/924
• US Class Current: 600/407
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/207 Divots for calibration
• 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 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/0064 Body surface scanning
• CPC Class Codes: A61B 5/0073 by tomography, i.e. reconstruction of 3D images from 2D projections A61B5/0066 takes precedence
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/06 : Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/1077 : Measuring of profiles
• CPC Class Codes: A61B 6/12 : Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/501 : for diagnosis of the head, e.g. neuroimaging or craniography
• 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 8/00 : Diagnosis using ultrasonic, sonic or infrasonic waves imaging of objects using sonar G01S15/00
• CPC Class Codes: A61B 8/0833 : involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/4227 : characterised by straps, belts, cuffs or braces
• 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: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• 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

Abstract

A system for use during a medical or surgical procedure on a body. The system generates an image representing the position of one or more body elements during the procedure using scans generated by a scanner prior or during the procedure. The image data set has reference points for each of the body elements, the reference points of a particular body element having a fixed spatial relation to the particular body element. The system includes an apparatus for identifying, during the procedure, the relative position of each of the reference points of each of the body elements to be displayed. The system also includes a processor for modifying the image data set according to the identified relative position of each of the reference points during the procedure, as identified by the identifying apparatus, said processor generating a displaced image data set representing the position of the body elements during the procedure. The system also includes a display utilizing the displaced image data set generated by the processor, illustrating the relative position of the body elements during the procedure. Methods relating to the system are also disclosed. Also disclosed are devices for use with a surgical navigation system having a sensor array which is in communication with the device to identify its position. The device may be a reference frame for attachment of a body part of the patient, such as a cranial reference arc frame for attachment to the head or a spine reference arc frame for attachment to the spine. The device may also be a localization frame for positioning an instrument relative to a body part, such as a localization biopsy guide frame for positioning a biopsy needle, a localization drill guide assembly for positioning a drill bit, a localization drill yoke assembly for positioning a drill, or a ventriculostomy probe for positioning a catheter.

Claims

1. A method for determining the geometry of a semi-rigid body element during a procedure, the method using an image data set having reference points for the body element, a relative position between said reference points of the semi-rigid body element being variable, the method comprising:

identifying, during the procedure, the relative position of each of the reference points for the semi-rigid body element;

deriving a transform relating the relative position of the reference points during the procedure to the relative position of the reference points in the image data set in order to determine the geometry of the body element during the procedure, said transform indicative of a difference between the relative position of each of the reference points for the semi-rigid body element during the procedure and the relative position of the reference points in the image data set;

modifying the image data set based on the transform in order to generate a displaced image data set representing the geometry of the body element during the procedure; and

generating a display based on the displaced image data set illustrating the geometry of the body element during the procedure.

2. The method of claim 1 wherein the semi-rigid body element is soft tissue.

3. The method of claim 1 wherein deriving comprises deriving a transformation which allows the determination of the procedural position, orientation, and shape in surgical space of the semi-rigid body element, and wherein modifying comprises modifying the image data set according to said transfonnation to produce a displaced image data set reflecting changes in the geometry of the semi-rigid body elements during the procedure.

4. A method for determining the geometry and position of a semi-rigid body element during a procedure, the method using a system including an array, and instrument in communication with the array, and a processor in communication with the array and storing an image data set having reference points for the body element, a relative position between said reference points of the semi-rigid body element being variable, the method comprising:

touching the reference points for the semi-rigid body element with the instrument during the procedure and communicating the position of the reference points to the array;

communicating the position of the reference points of the body element during the procedure to the processor;

determining the relative position of the reference points;

deriving a transform of the relative position of the reference points during the procedure to the relative position of the reference points in the image data set in order to determine the geometry and position of the body element during the procedure, said transform indicative of a difference between the relative position of each of the reference points for the semi-rigid body element during the procedure and the relative position of the reference points in the image data set;

modifying the image data set based on the transform in order to generate a displaced image data set representing the geometry and position of the body element during the procedure; and

displaying the geometry and position of the body element during the procedure based on the displaced image data set.

5. The method of claim 4 wherein the semi-rigid body element is soft tissue.

6. The method of claim 4 wherein deriving comprises deriving a transformation which allows the determination of the procedural position, orientation, and shape in surgical space of the semi-rigid body element, and wherein modifying comprises modifying the image data set according to said transformation to produce a displaced image data set reflecting changes in the geometry of the semi-rigid body elements during the procedure.

7. A system for determining the geometry and position of a semi-rigid body element during a procedure, the system comprising:

an image data set of the body element, the image data set having reference points for the body element, a relative position between said reference points of the semi-rigid body element being variable;

an array of receivers;

an instrument in communication with the array, the instrument identifying the position of the reference points of the body element during the procedure;

a processor in communication with the array and storing the image data set, the processor programmed to modify the image data set based on the identified position of the reference points of the body element during the procedure and to generate a displaced image data set representing the geometry and position of the body element during the procedure, said processor transforming the image data set indicative of a difference between the relative position of each of the reference points for the semi-rigid body element during the procedure and the relative position of the reference points in the image data set; and

a display for displaying the geometry and position of the body element during the procedure based on the displaced image data set generated by the processor.

8. The system of claim 7 wherein the processor derives a transformation which allows the determination of the procedural position, orientation, and shape in surgical space of the semi-rigid body element, and wherein the processor modifies the image data set according to said transformation to produce a displaced image data set reflecting changes in the geometry of the semi-rigid body elements during the procedure.

10. The system of claim 8, wherein the processor derives a transformation which allows the determination of the procedural position, orientation, and shape in surgical space of the semi-rigid body element, and wherein the processor modifies the image data set according to said transformation to produce a displaced image data set reflecting changes in the geometry of the semi-rigid body elements during the procedure.

9. A system for determining the geometry and position of a semi-rigid body element during a procedure, the system comprising:

an image data set of the body element, the image data set data points identifying a contour, said contour having a position and having contour reference points for the body element, a relative position between said reference points of the semi-rigid body element being variable;

an array of receivers;

a scanning probe in communication with the array, the scanning probe determining the contour of the body element during the procedure;

a processor in communication with the array and storing the image data set, the processor programmed to determine the position of the contour of the body element during the procedure and to compare the position of the contour of the body element to the position of the contour of the body element as represented by the image data set, the processor further programmed to modify the image data set based on the identified position of the contour of the body element during the procedure and to generate a displaced image data set representing the geometry and position of the body element during the procedure, said processor transforming the image data set indicative of a difference between the relative position of each of the reference points for the semi-rigid body element during the procedure and the relative position of the reference points in the image data set; and

a display for displaying the geometry and position of the body element during the procedure based on the displaced image data set generated by the processor.

11. A method for determining the geometry of a deformable body element during a procedure, the body element having reference points, the method comprising:

obtaining an image data set of the deformable body element, the data set including the reference points for the body element, a relative position between said reference points of the deformable body element being variable;

identifying the relative position of each of the reference points for the body element during the procedure;

deriving a transform relating the relative position of the reference points during the procedure to the relative position of the reference points in the image data set in order to determine the geometry of the body element during the procedure, said transform indicative of a difference between the relative position of each of the reference points for the semi-rigid body element during the procedure and the relative position of the reference points in the image data set;

modifying the image data set based on the transform in order to generate a displaced image data set representing the geometry of the body element during the procedure; and

generating a display based on the displaced image data set illustrating the geometry of the body element during the procedure.

12. The method of claim 11 wherein the deformable body element is soft tissue.

13. The method of claim 11 wherein deriving comprises deriving a transformation which allows the determination of the procedural position, orientation, and shape in surgical space of the semi-rigid body element, and wherein modifying comprises modifying the image data set according to said transformation to produce a displaced image data set reflecting changes in the geometry of the semi-rigid body elements during the procedure.

14. A system for use during a medical or surgical procedure on a body, said system generating a display representing the position and geometry of a body element during the procedure based on scans taken of the body by a scanner prior to the procedure, the scan having reference points for the body element, a relative position between said reference points of the body element being variable, and based on a position of a projection of the body element prior to the procedure, said system comprising:

means for identifying, during the procedure the position of the reference points of the body element wherein said identifying means comprises a reference array having a location outside the body for providing a reference, means for determining the position of the reference points of the body element relative to the reference array, and a fluoroscopic device for determining a position of a projection of the body element during the procedure;

a processor comparing the position of the projection of the body element during the procedure to the position of the projection of the body element prior to the procedure, said processor modifying the image data set according to the comparison of the projection during the procedure and the projection prior to the procedure and according to the identified position of the reference points during the procedure, as identified by the identifying means, said processor generating a displaced image data set representing the position and geometry of the body element during the procedure, said processor transforming the image data set indicative of a difference between the relative position of each of the reference points for the semi-rigid body element during the procedure and the relative position of the reference points in the image data set; and

a display utilizing the displaced image data set generated by the processor, illustrating the position and geometry of the body element during the procedure.

15. The system of claim 14 wherein the fluoroscopic device comprises a fluoroscopic tube in fixed relation to a fluoroscopic plate adapted so that the body element may be positioned therebetween for determining a position of a projection of the body element during the procedure and wherein the processor compares the position of the projection of the body element during the procedure to the position of the projection of the body element prior to the procedure.

16. The system of claim 15 wherein said fluoroscopic tube or said fluoroscopic plate each have emitters thereon in communication with the reference array and wherein the determining means is adapted to determine the position of the tube and plate relative to the reference array whereby the position of the projection of the body element can be determined.

17. The system of claim 15 wherein said reference array has emitters thereon in communication with the fluoroscopic tube or the fluoroscopic plate and wherein the determining means is adapted to determine the position of the tube or plate relative to the reference array whereby the position of the projection of the body element can be determined.

18. The system of claim 14 wherein the processor derives a transformation which allows the determination of the procedural position, orientation, and shape in surgical space of the semi-rigid body element, and wherein the processor modifies the image data set according to said transformation to produce a displaced image data set reflecting changes in the geometry of the semi-rigid body elements during the procedure.