Virtual reality 3D visualization for surgical procedures

• US 7,171,255 B2
• Filed: 07/02/2001
• Issued: 01/30/2007
• Est. Priority Date: 07/26/1995
• Status: Expired due to Fees

• Current Assignee: IMPAC Medical Systems, Inc. (Elekta AB)
• Original Assignee: Computerized Medical Systems, Inc. (Elekta AB)
• Inventors: Burdette, Everette C., Kaplan, Irving D., Holupka, Edward J.
• Primary Examiner(s): Smith; Ruth S.
• Application Number:
  US09/897,326
• Publication Number:
  US 20010041838A1
• Time in Patent Office: 2,038 Days
• Field of Search: 600/439, 600/437, 600/431, 600/427, 600/407, 600/411, 600 1- 3, 600/7, 600/424, 600/443, 600/8, 606/130
• US Class Current: 600/427
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2017/00274 Prostate operation, e.g. prostatectomy, turp, bhp treatment
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2018/00547 Prostate
• CPC Class Codes: A61B 2034/256 having a database of accessory information, e.g. including context sensitive help or scientific articles
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/367 creating a 3D dataset from 2D images using position information
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• 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 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 8/08 Detecting organic movements or changes, e.g. tumours, cysts, swellings A61B8/02 - A61B8/06 take precedence
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/42 Details of probe positioning or probe attachment to the patient
• CPC Class Codes: A61B 8/4209 by using holders, e.g. positioning frames
• CPC Class Codes: A61B 8/4218 characterised by articulated arms
• 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 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61M 37/0069 : Devices for implanting pellets, e.g. markers or solid medicaments for introducing of radioactive sources for interstitial radiation therapy, i.e. brachytherapy A61N5/1027
• CPC Class Codes: A61N 2005/1011 : Apparatus for permanent insertion of sources
• CPC Class Codes: A61N 2005/1012 : Templates or grids for guiding the introduction of sources
• CPC Class Codes: A61N 5/1001 : using radiation sources introduced into or applied onto the body; brachytherapy
• CPC Class Codes: A61N 5/1007 : Arrangements or means for the introduction of sources into the body
• CPC Class Codes: A61N 5/1027 : Interstitial radiation therapy
• CPC Class Codes: A61N 5/103 : Treatment planning systems
• CPC Class Codes: A61N 5/1048 : Monitoring, verifying, controlling systems and methods
• CPC Class Codes: A61N 5/1049 : for verifying the position of the patient with respect to the radiation beam

Abstract

A method and apparatus for three-dimensional imaging and treatment of a patient'"'"'s body. The method and apparatus utilize a system for developing a therapy plan for treatment of an organ of the patient, a device for generating ultrasound image data from a treatment region and a device for providing a translucent volume image of a portion of a patient'"'"'s body and a separate translucent image of the patient organ and a three dimensional viewing device to superimpose a translucent article image to enable viewing of the article image simultaneously with the patient organ and a portion of the patient'"'"'s body.

Claims

1. A computer-readable medium for facilitating performance of medical therapy treatment on a patient, the computer-readable medium comprising:

one or more instructions executable by a processor for processing real-time image data to generate in substantially real time an image of a treatment region of a patient'"'"'s body along with an image of a therapeutic device inserted inside the patient'"'"'s body relative to the treatment region, the therapeutic device including a radiation source;

one or more instructions executable by a processor for retrieving a planned dose spatial distribution for the patient'"'"'s body, the planned dose spatial distribution corresponding to a planned position for the radiation source; and

one or more instructions executable by a processor for displaying, in substantially real time and in spatial registration with each other, the real time treatment region image, the therapeutic device, the radiation source and the planned dose spatial distribution, wherein at least one of the real time treatment region image and the planned dose spatial distribution is displayed as a translucent image.

2. The computer-readable medium of claim 1, further comprising:

one or more instructions executable by a processor for retrieving a plan image of the treatment region; and

one or more instructions executable by a processor for displaying the plan image concurrently and in spatial registration with the real time treatment region image, the therapeutic device, the radiation source and the planned dose spatial distribution.

3. The computer-readable medium of claim 2, further comprising:

one or more instructions executable by a processor for determining an actual position of the radiation source that has been inserted within the treatment region;

one or more instructions executable by a processor for calculating an actual dose spatial distribution for the patient'"'"'s body, the actual dose spatial distribution corresponding to the determined actual position of the radiation source within the treatment region; and

one or more instructions executable by a processor for displaying the actual dose spatial distribution concurrently and in spatial registration with the plan image, the real time treatment region image, the therapeutic device, the radiation source and the planned dose spatial distribution.

4. The computer-readable medium of claim 3, further comprising:

one or more instructions executable by a processor for retrieving a planned position for the therapeutic device; and

one or more instructions executable by a processor for displaying the planned position for the therapeutic device concurrently and in spatial registration with the plan image, the real time treatment region image, the therapeutic device, the radiation source, the planned dose spatial distribution and the actual dose spatial distribution, wherein the planned position for the therapeutic device is displayed as a translucent image.

5. The computer-readable medium of claim 1, further comprising:

one or more instructions executable by a processor for displaying, in substantially real time and in spatial registration with each other, the real time treatment region image, the therapeutic device, the radiation source and the planned dose spatial distribution, wherein both the real time treatment region image and the planned dose spatial distribution is displayed as a translucent image.

6. The computer-readable medium of claim 1, further comprising:

one or more instructions executable by a processor for three-dimensionally displaying, in substantially real time and in spatial registration with each other, the real time treatment region image, the therapeutic device, the radiation source and the planned dose spatial distribution, wherein at least one of the real time treatment region image and the planned dose spatial distribution is displayed as a translucent image.

7. A method of performing medical imaging, comprising the steps of:

obtaining real time image data relating to a treatment region of a patient, a radiation source and a therapeutic device, wherein the treatment region includes at least an organ of the patient;

obtaining plan image data of the treatment region, the plan image data comprising an image of the treatment region and the patient organ, a planned position for a radiation source, and a planned dose spatial distribution for the planned radiation source position;

generating in substantially real time a three dimensional image of the treatment region and the radiation source based on the real time image data relating to the treatment region and the radiation source;

generating a three dimensional image of the therapeutic device based on the real time image data relating to the therapeutic device; and

displaying simultaneously the three dimensional real time image of the treatment region, the radiation source and the image of the therapeutic device, wherein the three dimensional real time images of the treatment region, the radiation source and the therapeutic device have a coordinated spatial reference frame; and

wherein the three dimensional real time image of the treatment region is displayed as a translucent three-dimensional image; and

wherein the displaying step further comprises simultaneously displaying the plan image data in spatial registration with the three dimensional real time image of the treatment region and the radiation source and the image of the therapeutic device.

8. A method for simultaneously displaying data corresponding to a treatment plan and medical images, the method comprising the steps of:

providing an image of a pre-treatment dose plan, the pre-treatment dose plan comprising a planned position for a radiation source within a treatment region of a patient'"'"'s body and a planned dose distribution corresponding to the planned radiation source position;

determining a position for a therapeutic device including a radiation source that has been inserted into the treatment region;

registering the determined position with the planned radiation source position;

determining a dose distribution from the inserted radiation source;

registering the determined dose distribution with the planned dose distribution;

obtaining real time image data of the therapeutic device relative to the treatment region;

registering in substantially real time the spatial position of the inserted radiation source relative to the treatment region based on the determined position of the therapeutic device; and

concurrently displaying in substantially real time the determined therapeutic device position, the planned radiation source position, the planned dose distribution, and the determined dose distribution, all in spatial registration with each other.

9. A system for assisting in a performance of medical therapy treatment on a patient, the system comprising:

an imaging component configured to generate in substantially real time an image, the real time image comprising a treatment region of a patient'"'"'s body, a therapeutic device that has been inserted into the treatment region, and a radiation source inserted into the treatment region via the therapeutic device;

a processing component in communication with the imaging component, the processing component being configured to (1) determine from the real time image a position for the inserted radiation source, (2) calculate a radiation dose distribution in the patient'"'"'s body based at least in part upon the determined position for the inserted radiation source, and (3) spatially register the calculated radiation dose distribution with a planned radiation dose distribution for the patient; and

a displaying component in communication with the processing component, the displaying component being configured to simultaneously display the real time image, the calculated radiation dose distribution and the planned radiation dose distribution, all in spatial registration with each other.

10. The system of claim 9, wherein the processing component is further configured to spatially register a plan image of the treatment region and a planned position for a radiation source with the real time image and the calculated radiation dose distribution, and wherein the displaying component is further configured to simultaneously display the real time image, the plan image, the inserted radiation source, the planned radiation source position, the calculated radiation dose distribution and the planned radiation dose distribution, all in spatial registration with each other, and wherein at least one of the real time image, the planned radiation source position, and the planned radiation dose distribution is displayed as a translucent image.

11. The system of claim 10, wherein at least two of the real time image, the planned radiation source position, and the planned radiation dose distribution are displayed as translucent images, and wherein each translucent image exhibits a user-controlled degree of translucency.

12. The system of claim 10, wherein the medical therapy treatment comprises prostate brachytherapy and wherein the displaying component is further configured to simultaneously display the real time image, the plan image, the inserted radiation source, the planned radiation source position, the calculated radiation dose distribution and the planned radiation dose distribution as three-dimensional images.

13. A computer-readable medium for facilitating a performance of medical therapy treatment on a patient, the computer-readable medium comprising:

one or more instructions executable by a processor for processing real time image data to generate in substantially real time an image of a treatment region of a patient'"'"'s body, the treatment region comprising a region of interest, portions of the patient'"'"'s body near the region of interest, a therapeutic device that has been inserted into the treatment region, and a radiation source that has been inserted into the treatment region via the inserted therapeutic device;

one or more instructions executable by a processor for calculating an actual dose spatial distribution for the patient'"'"'s body based at least in part upon the inserted radiation source;

one or more instructions executable by a processor for separately contouring from the real time image at least a portion thereof, thereby generating at least one contoured image;

one or more instructions executable by a processor for simultaneously displaying the real time image, the at least one contoured image, a plan image of the treatment region, the actual dose spatial distribution, a planned dose distribution, a planned position for the therapeutic device, and a planned position for a radiation source, all in spatial registration with one another; and

one or more instructions executable by a processor for rendering and displaying at least one selected from the group consisting of the real time image, the at least one contoured image, the planned dose distribution, the planned position for the therapeutic device, and the planned radiation source position as a translucent image.

14. The computer-readable medium of claim 13, wherein the translucent rendering and displaying instructions comprise one or more instructions executable by a processor for rendering and displaying at least two selected from the group consisting of the real time image, the at least one contoured image, the planned dose distribution, the planned position for the therapeutic device, and the planned radiation source position as translucent images.

15. The computer-readable medium of claim 14, wherein the translucent rendering and displaying instructions comprise one or more instructions executable by a processor for rendering and displaying the at least two translucent images with different translucent appearances.

16. The computer-readable medium of claim 13, wherein the translucent rendering and displaying instructions comprise one or more instructions executable by a processor for rendering and displaying at least the real time image and the planned dose distribution as translucent images.

17. The computer-readable medium of claim 13, wherein the translucent rendering and displaying instructions comprise one or more instructions executable by a processor for rendering and displaying at least the real time image and the planned position for the therapeutic device as translucent images.

18. The computer-readable medium of claim 13, wherein the real time image data comprises ultrasound image data, and wherein real time image, the at least one contoured image, a plan image of the treatment region, the actual dose spatial distribution, the planned dose distribution, the planned position for the therapeutic device, and the planned position for a radiation source are displayed as three-dimensional images.

19. A method for performing medical therapy treatment on a patient, comprising the steps of:

inserting a therapeutic device including a radiation source into a treatment region of a patient'"'"'s body;

obtaining image data of the therapeutic device relative to the treatment regions

registering in substantially real time the spatial position of the radiation source relative to the treatment region based on the position of the therapeutic device;

calculating in substantially real time a dose spatial distribution for the radiation source relative to the treatment region;

displaying in substantially real time an image of the treatment region, the therapeutic device, the radiation source and the dose spatial distribution; and

leaving the radiation source in the patient as part of a long term treatment procedure.

20. A system for performing medical therapy treatment on a patient, comprising:

an imaging component for generating in substantially real time an image of a treatment region of a patient'"'"'s body along with an image of a therapeutic device relative to the treatment region, the therapeutic device including a radiation source and having been inserted into the patient'"'"'s body;

a calculating component for calculating dose distribution in the patient'"'"'s body of the radiation source after the radiation source has been inserted into the patient'"'"'s body via the therapeutic device; and

a displaying component for simultaneously displaying an image of the treatment region, the therapeutic device, the radiation source, a planned dose distribution for a planned position of a radiation source, and the calculated dose distribution, all in spatial registration with one another; and

wherein the component for generating includes a component for obtaining two dimensional image slices of the treatment region to form a three dimensional image of the treatment region of the patient'"'"'s body; and

wherein the two dimensional images slices are obtained using an ultrasound probe mounted on a movable holder for positioning the ultrasound probe; and

wherein the movable holder includes a stepper device which includes a digital encoder to determine the spatial position of the probe.

21. The system of claim 20, wherein the image of the treatment region, the therapeutic device, the radiation source, and the planned dose distribution for the planned position of the radiation source are displayed in substantially real-time, and wherein the holder contains a template having openings for passage of the therapeutic device through said template into the treatment region.

22. The system of claim 21, wherein the template is comprised of a disposable material for a single use treatment.

23. An imaging system for use in connection with a performance of medical treatment on a patient'"'"'s body, the system comprising:

an imaging device for obtaining image data in substantially real time, the image data comprising a treatment region of the patient'"'"'s body, at least one radiation source that has been inserted inside the treatment region, and at least one therapeutic device that has been inserted inside the treatment region, the treatment region comprising a region of interest and portions of the treatment region near the region of interest;

a processor in communication with the imaging device, the processor configured to (1) retrieve a treatment plan for the patient'"'"'s medical treatment, the treatment plan comprising plan image data for the region of interest, at least one planned position for placement of a radiation source, and a planned spatial radiation dose distribution for each planned position, (2) generate a plan image from the treatment plan image data, (3) generate in substantially real time an image of the treatment region, the at least one inserted radiation source, and at least one inserted therapeutic device, (4) calculate a spatial radiation dose distribution for the at least one inserted radiation source, and (5) spatially register the plan image, the at least one planned radiation source placement position, and the planned spatial radiation dose distribution with the calculated spatial radiation dose distribution and the image of the treatment region, the at least one inserted radiation source, and the at least one inserted therapeutic device; and

a display device in communication with the processor, the display device being configured to simultaneously display, in spatial registration with each other, the plan image, an indicator for the at least one planned radiation source placement position, the planned spatial radiation dose distribution, the calculated spatial radiation dose distribution, and the image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device.

24. The system of claim 23 wherein the image of the treatment region, the at least one inserted radiation source, and the at least one inserted therapeutic device comprises a three-dimensional (3D) image.

25. The system of claim 24 wherein the planned and calculated spatial radiation dose distributions comprise 3D spatial radiation dose distributions.

26. The system of claim 25 wherein the plan image comprises a 3D image.

27. The system of claim 26 wherein the plan image further comprises an image of the region of interest and the treatment region.

28. The system of claim 26 wherein the imaging device comprises an ultrasound probe.

29. The system of claim 28 wherein the region of interest is a patient'"'"'s prostate.

30. The system of claim 29 wherein the therapeutic device comprises a needle and catheter.

31. The system of claim 26 wherein the display device is further configured to simultaneously display, in spatial registration with each other and in substantially real time, the plan image, an indicator for the at least one planned radiation source placement position, the planned spatial radiation dose distribution, the calculated spatial radiation dose distribution, and the image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device.

32. The system of claim 23 wherein the processor is further configured to generate a translucent image of the treatment region, the at least one inserted radiation source, and the at least one inserted therapeutic device and a translucent indicator for the planned radiation source placement position, and wherein the display device is further configured to simultaneously display, in spatial registration with each other, the plan image, the translucent indicator for the at least one planned radiation source placement position, the planned spatial radiation dose distribution, the calculated spatial radiation dose distribution, and the translucent image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device.

33. The system of claim 32 wherein the translucency of the translucent indicator and the translucent image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device are user-controlled.

34. The system of claim 32 wherein the processor is further configured to generate a translucent planned spatial radiation dose distribution, and wherein the display device is further configured to simultaneously display, in spatial registration with each other, the plan image, the translucent indicator for the at least one planned radiation source placement position, the translucent planned spatial radiation dose distribution, the calculated spatial radiation dose distribution, and the translucent image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device.

35. The system of claim 34 wherein the translucency of the translucent indicator, the translucent planned spatial radiation dose distribution, and the translucent image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device are user-controlled.

36. The system of claim 34 wherein the processor is further configured to generate a translucent plan image, and wherein the display device is further configured to simultaneously display, in spatial registration with each other, the translucent plan image, the translucent indicator for the at least one planned radiation source placement position, the translucent planned spatial radiation dose distribution, the calculated spatial radiation dose distribution, and the translucent image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device.

37. The system of claim 36 wherein the translucency of the translucent plan image, the translucent indicator, the translucent planned spatial radiation dose distribution, and the translucent image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device are user-controlled.

38. The system of claim 23 wherein the processor is further configured to generate a translucent image of the treatment region, the at least one inserted radiation source, and the at least one inserted therapeutic device and a translucent planned spatial radiation dose distribution, and wherein the display device is further configured to simultaneously display, in spatial registration with each other, the plan image, the indicator for the at least one planned radiation source placement position, the translucent planned spatial radiation dose distribution, the calculated spatial radiation dose distribution, and the translucent image of the treatment region, the at least one inserted radiation source, the at least one inserted therapeutic device.

39. A system for generating and displaying images for use in connection with a radiation treatment performed upon a patient, wherein the radiation treatment is based at least in part upon a treatment plan, the treatment plan comprising a planned position for at least one radiation source within the patient'"'"'s body and a planned radiation dose distribution for radiation source based on at least in part upon the planned position, the system comprising:

an imaging device configured to obtain image data of a patient'"'"'s treatment region in substantially real-time, the treatment region comprising a region of interest, portions of a patient'"'"'s body near the region of interest, and at least one radiation source that has been inserted in the patient'"'"'s body as part of the radiation treatment; and

a computer in communication with the imaging device, the computer being configured to (1) access data describing the treatment plan and (2) process the image data from the imaging device and the treatment plan data to calculate and display an actual radiation dose distribution for the at least one inserted radiation source, wherein the actual radiation dose distribution is displayed concurrently and in spatial registration with the planned radiation dose distribution from the treatment plan.

40. The system of claim 39 wherein the computer is further configured to display the planned radiation dose distribution translucently.

41. The system of claim 40 wherein the treatment plan further comprises a planned position for a delivery device, the delivery device for delivering the at least one radiation source to the planned position, wherein the treatment region further comprises the delivery device that has been inserted into the patient'"'"'s body to deliver the radiation source, and wherein the computer is further configured to process the image data from the imaging device and the treatment plan data to also display the actual delivery device concurrently with an in spatial registration with the planned position for the delivery device.

42. The system of claim 41 wherein the computer is further configured to display the planned position for the delivery device translucently.

43. The system of claim 42 wherein the computer is further configured to translucently display the planned radiation dose distribution and the planned position for the delivery device in accordance with a user-specified degree of translucency.

44. The system of claim 40 wherein the radiation treatment comprises prostate brachytherapy.

45. The system of claim 39 wherein the actual radiation dose distribution and the planned radiation dose distribution from the treatment plan are concurrently displayed as three-dimensional radiation dose distributions.