Intraoperative image registration

• US 8,010,177 B2
• Filed: 04/24/2007
• Issued: 08/30/2011
• Est. Priority Date: 04/24/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Csavoy, Andrew N., Solar, Matthew S., Waynik, Jeffrey M., Freas, Mark S., Miller, Thomas I., Sootsman, Keith
• Primary Examiner(s): Casler, Brian
• Assistant Examiner(s): LAMPRECHT, JOEL
• Application Number:
  US11/739,513
• Publication Number:
  US 20080269588A1
• Time in Patent Office: 1,589 Days
• Field of Search: 600/407, 600/410, 600/424, 600/429, 600/433, 606/61, 606/130, 606/86, 606/99, 606/104
• US Class Current: 600/407
• CPC Class Codes: A61B 2017/00699 correcting for movement caused by respiration, e.g. by triggering
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• 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 2090/363 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 2090/365 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 2090/376 using X-rays, e.g. fluoroscopy
• 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 5/704 Tables
• CPC Class Codes: A61B 6/4441 the rigid structure being a C-arm or U-arm
• CPC Class Codes: A61B 6/5247 combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
• 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

Abstract

A system to allow registration of a patient to image space is disclosed. The registration can be performed without touching a plurality of fiducial points on the patient or in the image data. The registration process can eliminate manual steps of image to patient registration and image to image registration.

Claims

1. A navigation system for registering an image space to a physical space relative to a patient for a surgical procedure, comprising:

a tracking system including a localizer and a tracking device;

a system operable to access intraoperative image data of the patient that was acquired at a determined position relative to the patient in the physical space;

a processor operable to at least one of determine a position of the tracking device in the physical space, determine an intraoperative image data fiducial point in the intraoperative image data, determine a preoperative image data fiducial point in a preoperative image data, correlate the intraoperative image data and the preoperative image data with the intraoperative image data fiducial point and the preoperative image data fiducial point, or combinations thereof;

wherein the preoperative image data is operable to be registered to the physical space to correlate points in the preoperative image data with corresponding points in the physical space based upon the intraoperative image data that was acquired at the determined position relative to the patient;

wherein the registered preoperative image data allow navigation of the tracking device in the physical space relative to the preoperative image data;

wherein the processor is operable to determine the position of an intraoperative imaging system to determine a position relative to the determined intraoperative fiducial image data point in the physical space.

2. The system of claim 1, further comprising:

a preoperative imaging system operable to acquire the preoperative image data of the patient; and

an intraoperative imaging system operable to acquire the intraoperative image data of the patient.

3. The system of claim 2, wherein the intraoperative imaging system and the preoperative imaging system are a single imaging system.

4. The system of claim 1, further comprising:

a display device operable to display at least one of the intraoperative image data, the preoperative image data, or combinations thereof.

5. The system of claim 4, further comprising:

an instrument, wherein the tracking device is operable to track an instrument position.

6. The system of claim 5, wherein the instrument is at least one of a deep brain stimulation electrode, a micro-electrode, a catheter, an ablation catheter, or combinations thereof.

7. The system of claim 4, wherein the display device is operable to display an icon representing an instrument superimposed on the registered preoperative image data for the navigation of the tracking device.

8. The system of claim 1, further comprising:

a fiducial marker operable to be imaged and form the intraoperative image data fiducial point and the preoperative image data fiducial point.

9. The system of claim 1, further comprising:

a second processor operable to at least one of determine a position of the tracking device in the physical space, determine an intraoperative image data fiducial point in the intraoperative image data, determine a preoperative image data fiducial point in a preoperative image data, correlate the intraoperative image data and the preoperative image data with the intraoperative image data fiducial point and the preoperative image data fiducial point, or combinations thereof.

10. The system of claim 1, wherein the processor is operable with the determination in the physical space to register the preoperative image data and the physical space.

11. The system of claim 10,

wherein the determined position of the intraoperative imaging system relative to the patient in the physical space is based on tracking the intraoperative imaging system;

wherein the intraoperative image data is acquired with the intraoperative imaging system and defines at least a portion of the physical space;

wherein the preoperative image data is correlated to the intraoperative image data to be registered to the physical space with the processor.

12. The system of claim 1, wherein the intraoperative imaging system is at least one of a computed tomography imaging system, a magnetic resonance imaging system, an ultrasound imaging system, an X-ray imaging system, or combinations thereof.

38. The system of claim 1, wherein the patient is moved from the preoperative imaging system to the intraoperative imaging system.

13. A method of registering an image space to a physical space relative to a patient, comprising:

accessing preoperative image data of the patient;

determining a preoperative image data fiducial point in the preoperative image data;

accessing intraoperative image data of the patient, wherein the intraoperative image data defines at least a portion of the physical space;

determining an intraoperative image data fiducial point in the intraoperative image data;

correlating the preoperative image data and the intraoperative image data using the determined preoperative image data fiducial point in the preoperative image data and the determined intraoperative image data fiducial point in the intraoperative image data;

accessing a determined position of an intraoperative imaging system that acquired the intraoperative image data to determine a position of the patient within the physical space; and

correlating the correlated preoperative image data to the physical space based at least on the accessed determined position of the intraoperative imaging system.

14. The method of claim 13, further comprising:

determining the position of the intraoperative imaging system relative to the patient such that acquiring intraoperative image data includes acquiring image data of the physical space including the patient.

20. The method of claim 13, wherein correlating the correlated preoperative image data includes:

tracking an imaging device;

acquiring the intraoperative image data with the imaging device;

defining the physical space with the intraoperative image data; and

registering the preoperative image data to the physical space.

21. The method of claim 13, wherein each of the determined preoperative image data fiducial point in the preoperative image data and the determined intraoperative image data fiducial point in the intraoperative image data include:

attaching a fiducial marker to the patient; and

imaging the fiducial marker and the patient;

wherein the preoperative image data of the fiducial marker defines the preoperative image data fiducial point and the intraoperative image data of the fiducial marker defines the intraoperative image data fiducial point.

22. The method of claim 13, further comprising:

moving the patient relative to the intraoperative imaging system;

wherein acquiring the intraoperative image data of the patient occurs subsequent to the acquisition of the preoperative image data.

23. The method of claim 13, further comprising:

planning a procedure for the patient with the preoperative image data.

24. The method of claim 13, further comprising:

navigating an instrument relative to the patient in the physical space;

wherein the correlated preoperative image data to the physical space includes registering the image space to the physical space;

wherein the image space is defined by at least one of the intraoperative image data, the preoperative image data, or combinations thereof.

15. The method of 14, further comprising:

fixing the patient relative to an intraoperative imaging system that acquires the intraoperative image data.

16. The method of claim 15, wherein correlating the preoperative image data and the intraoperative image data includes:

processing the intraoperative image data with an intraoperative image data processor to determine the intraoperative image data fiducial point; and

processing the preoperative image data with a preoperative image data processor to determine the preoperative image data fiducial point.

17. The method of claim 16, wherein the intraoperative image data processor and the preoperative image data processor are the same processor.

18. The method of claim 16, wherein the intraoperative image data fiducial point and the preoperative image data fiducial point are the same type of fiducial point.

19. The method of claim 16, wherein each of the intraoperative image data fiducial point and the preoperative image data fiducial point is a surface, a single point, a pixel, a voxel, a marker, or combinations thereof.

25. A method of registering an image space to a physical space relative to a patient, comprising:

accessing a first image data set of the patient;

determining a first image data set fiducial point;

preparing the patient for a surgical procedure in at least a portion of the physical space;

defining at least a portion of the physical space in a second image data set of the patient including at least determining a position of the patient in the second image data relative to a first imaging system;

determining a second image data set fiducial point;

correlating the first image data set and the second image data set at least in part by matching the first image data set fiducial point and the second image data set fiducial point; and

registering the first image data set with the physical space with the correlation of the first image data set and the second image data set, wherein the physical space includes a space in which the patient is positioned and the registration allows for navigation of a member within the physical space relative to the first image data.

26. The method of claim 25, further comprising:

navigating an instrument relative to the patient based upon the registration.

27. The method of claim 25, further comprising:

tracking a location of the first imaging system while the second image data set is acquired; and

determining a position of the first imaging system in the physical space at least in part with the tracking a location of the first imaging system.

28. The method of claim 27, further comprising:

tracking a position of the patient during the acquisition of the second image data set; and

determining a position of at least a portion of the physical space based upon the tracked position of the patient.

29. The method of claim 27, further comprising:

fixing the patient in physical space relative to the first imaging system.

30. The method of claim 25, further comprising:

attaching a fiducial marker to the patient; and

acquiring the second image data set with the attached fiducial marker;

wherein determining the second image data set fiducial point includes determining a portion of the second image data set formed by imaging the fiducial marker.

31. The method of claim 30, further comprising:

acquiring the first image data set with the fiducial marker attached to the patient;

wherein determining the first image data set fiducial point includes determining a portion of the second image data set formed by imaging the fiducial marker.

32. The method of claim 25, further comprising:

acquiring the first image data set prior to moving the patient into an operating theater.

33. The method of claim 25, further comprising:

acquiring the second set of image data after moving the patient into an operating theater.

34. The method of claim 25, wherein the first image data set defines a first image space of the patient;

wherein the second image data set defines a second image space of the patient and at least defines a portion of the physical space.

35. The method of claim 25, wherein navigating a procedure includes navigating a deep brain stimulation electrode, navigating a micro-electrode, navigating a catheter, navigating an ablation catheter, or combinations thereof.

36. The method of claim 25, further comprising:

determining a position of an imaging system in the physical space;

acquiring the second set of image data; and

defining at least a portion of the physical space with the second set of image data;

wherein the defining at least a portion of the physical space with the second set of image data includes determining the position of the patient relative to the imaging system while the second image data set is acquired.

37. The method of claim 25, wherein determining the first image data set fiducial point, determining the second image data set fiducial point, or combinations thereof include at least one of determining in each of the first image data set and the second image data set a pixel, a voxel, a surface, a region, or combinations thereof.