System for identification of anatomical landmarks

• US 8,150,498 B2
• Filed: 10/20/2006
• Issued: 04/03/2012
• Est. Priority Date: 09/08/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Gielen, Frans L. H., Hertel, Frank, Gemmar, Peter, Appenrodt, Peter
• Primary Examiner(s): Casler, Brian
• Assistant Examiner(s): Santos, Joseph M
• Application Number:
  US11/584,423
• Publication Number:
  US 20080123921A1
• Time in Patent Office: 1,992 Days
• Field of Search: 600/103, 600/117, 600/407, 600/426, 600/427, 600/429, 382/128, 382/154, 606/130
• US Class Current: 600/427
• 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 2090/364 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 34/25 User interfaces for surgical systems
• 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 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/067 using accelerometers or gyroscopes
• CPC Class Codes: A61B 5/1127 using markers
• 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 6/5241 combining overlapping images of the same imaging modality, e.g. by stitching
• 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 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: G06T 2207/10088 : Magnetic resonance imaging [MRI]
• CPC Class Codes: G06T 2207/30016 : Brain
• CPC Class Codes: G06T 7/32 : using correlation-based methods
• CPC Class Codes: G06T 7/73 : using feature-based methods
• CPC Class Codes: G06V 10/245 : by locating a pattern; Special marks for positioning

Abstract

A system including a processor and/or processor system can be used to identify landmarks in image data. The landmarks can be used to further identify anatomical targets. The landmarks and/or targets can be used to create a plan for a procedure, such as a surgical procedure. The processor can be used to determine the anatomical landmarks that can be used to identify anatomical targets in image data of a subject, even if the anatomical targets are indistinguishable in the image data.

Claims

1. A system to determine an anatomical landmark in an anatomy, comprising:

a processor;

a first memory system to store instructions to be executed by the processor;

a second memory system to store an storing image data of the anatomy;

a display operable to display the determined anatomical landmark in the image data in the anatomy; and

a user input to select a seed datum in the image data;

wherein the processor is configured to access the first memory system and execute instructions stored in the first memory system to automatically determine the anatomical landmark in the anatomy based upon the selected seed datum in the image data stored in the second memory system, wherein the instructions include;

instructions to automatically segment at least a third ventricle in the image data based on the selected seed datum; and

subsequent to segmenting the third ventricle, determine at least one of an anterior commissure or a posterior commissure based on the location of the determined third ventricle in the image data;

subsequent to executing the instructions to segment at least the third ventricle, instructions to automatically determine a location of an anterior commissure in the image data relative to an anterior portion of the segmented third ventricle by at least identifying a bright point in the image data at an anterior boundary of the segmented third ventricle, where the bright point includes an intensity change at the edge of the third ventricle and the edge is also the edge of the anterior commissure,

subsequent to executing the instructions to segment at least the third ventricle, instructions to automatically determine a location of a posterior commissure in the image data at a posterior portion of the segmented third ventricle at least by identifying a bright point in the image data at a posterior boundary of the determined third ventricle, where the bright point can be an intensity change at an edge of the third ventricle that is also an edge of the posterior commissure; and

subsequent to executing the instructions to determine the location of the anterior commissure and determine the location of the posterior commissure, instructions to automatically locate an anatomical target that is relatively indistinguishable from the surrounding structures in the image data.

2. The system of claim 1, wherein the user input includes at least one of a mouse, a keyboard, a touch screen of the display, or a foot switch.

3. The system of claim 1, further comprising:

an imaging system operable to obtain the image data of the anatomy to be stored in the memory system and processed with the processor.

4. The system of claim 3, wherein the imaging system includes at least one of a magnetic resonance imaging system, an ultrasound system, a computer tomography system, an x-ray system, a positron emission tomography system, a planar gamma scintigraphy system, a single photon emission computed tomography system, a multi-slice computed tomography system, or combinations thereof.

5. The system of claim 3, further comprising:

a communications system operable to allow communication between the imaging system and at least one of the processor, the memory system, or combinations thereof;

wherein the image data created by the imaging system is transmitted to at least one of the memory system, the processor, or combinations thereof.

6. The system of claim 1, further comprising:

a navigation system operable to track a device relative to the anatomy;

wherein the display is operable to display a position of the device superimposed on the image data.

7. The system of claim 6, further comprising:

a device selected from a group including at least one of a stimulator, a sensor, a probe, a cannula, an ablation device, a deep brain stimulator, a drug delivery device, or a recorder.

8. The system of claim 7, further comprising a recorder;

wherein the recorder is operable to be moved relative to the anatomy;

wherein the recorder includes a recording portion operable to record an activity within the region of the anatomy;

wherein the navigation system is operable to determine a position of the recording portion relative to the anatomy.

9. The system of claim 6, further comprising:

a navigation system selected from at least one of an electromagnetic navigation system, an acoustic navigation system, an optical navigation system, a radiation navigation system, an accelerometer navigation system, a radar navigation system, or combinations thereof.

10. The system of claim 1, further comprising:

a navigation frame;

a guide portion interconnected with the navigation frame;

a tracking device coupled to the guide portion;

a navigation system operable to determine a position of the tracking device;

wherein an icon is operable to be displayed relative to the image data on the display showing a position of the guide portion.

11. The system of claim 1, wherein the seed datum includes at least one of a user selected portion of the image data, a user selected pixel in the image data, a bright pixel in the image data, and a pixel in a selected region of the image data.

12. The system of claim 1, wherein the instructions further include:

at least one of smoothing the image data, removing unneeded data in the image data, or combinations thereof.

13. The system of claim 1,

subsequent to segment at least the third ventricle in the image data that includes a plurality of slices and prior to determine the location of the anterior commissure or the posterior commissure at an edge of the segmented third ventricle:

skeletonize a line in each of the plurality of slices within the segmented third ventricle;

subsequent to skeletonizing the line, determine an axial slope angle and a coronal slope angle of the line;

subsequent to determining an axial slope angle and a coronal slope angle of the line, align the plurality of slices in the image data;

subsequent to aligning the plurality of slices in the image data, determine a mid-sagittal plane based on the skeletonized line in the aligned plurality of slices.

14. A system to determine an anatomical landmark in an anatomy, comprising:

a processor to access image data including at least a plurality of image slices including a third ventricle and execute instructions to process the image data;

a memory system to store the instructions to be executed by the processor;

a user input to identify a selected seed portion of the image data; and

a display to display the processed image data;

wherein the processor is operable to automatically execute the stored instructions configured to;

segment a third ventricle in each of the plurality of image slices in the image data by growing a region from a selected seed portion based on a homogeneity method defined in the stored instructions;

subsequent to segmenting the third ventricle in each of the plurality of slices, skeletonize a line in each of the plurality of slices within the segmented third ventricle;

subsequent to skeletonizing the line, determine an axial slope angle and a coronal slope angle of the line;

subsequent to determining an axial slope angle and a coronal slope angle of the line, align the plurality of slices in the image data;

subsequent to aligning the plurality of slices in the image data, determine a mid-sagittal plane based on the skeletonized line in the aligned plurality of slices; and

subsequent to aligning the plurality of slices in the image data, determine a location of at least one of an anterior commissure or a posterior commissure at an edge of the segmented third ventricle;

subsequent to determining the location of at least one of an anterior commissure or a posterior commissure at an edge of the segmented third ventricle, locate an anatomical target that is relatively indistinguishable from surrounding structures in the image data based upon a known location of the anatomical target relative to the determined at least one of an anterior commissure or a posterior commissure;

wherein the anatomical landmark is used to determine the anatomical target and the anatomical target is determined for performing a procedure on the anatomical target.

15. The system of claim 14, further comprising an imaging system operable to create the image data of the anatomy.

16. The system of claim 15, wherein the imaging system includes at least one of a magnetic resonance imaging system, a computer tomography imaging system, an x-ray imaging system, an ultrasound imaging system, a positron emission tomography system, planar gamma scintigraphy system, single photon emission computed tomography system, multi-slice computed tomography system, or combinations thereof.

17. The system of claim 15, wherein the imaging system is operable to obtain image data of a brain.

18. The system of claim 14, wherein the user inputs includes at least one of a computer mouse, a light pen, a touch screen, or a foot switch.

19. The system of claim 14, wherein the image data includes image data that has been at least one of smoothed, clarified, segmented, aligned, or combinations thereof.

20. The system of claim 14, further comprising:

a tracking system including a localizer, a tracking sensor, and a device;

wherein the tracking sensor is interconnected with the device to be tracked with the localizer.

21. The system of claim 20, wherein the display is operable to display an icon representing a position of the device relative to the anatomy superimposed on the image data.

22. The system of claim 21, further comprising:

an indication system to assist in defining the anatomical target;

wherein the determined anatomical landmark is determined in the image data and displayed on the display for use with the tracking system to allow for tracking of the device relative to the determined anatomical target.

23. The system of claim 14, wherein the instructions include at least one of smoothing the image data, segmenting the image data, identifying portions of the image data, or combinations thereof.

24. The system of claim 14, further comprising:

a deep brain stimulator to stimulate a sub-thalamic nucleus of a brain;

wherein the anatomical target includes a functional target in the brain that is relatively indistinguishable relative to surrounding structures including the sub-thalamic nucleus in the brain.

25. The system of claim 14, wherein the selected seed portion is identified manually based on several possible seed voxels determined and identified in the image data by the processor by executing the stored instructions.

26. The system of claim 14, wherein determine the location of at least one of an anterior commissure or a posterior commissure at an edge of the segmented third ventricle includes:

determine a location of an anterior commissure in the image data relative to an anterior portion of the segmented third ventricle by at least identifying a bright point in the image data at an anterior boundary of the segmented third ventricle, where the bright point includes an intensity change at the edge of third ventricle and the edge is also the edge of the anterior commissure,

determine a location of a posterior commissure in the image data at a posterior portion of the segmented third ventricle at least by identifying a bright point in the image data at a posterior boundary of the determined third ventricle, where the bright point can be an intensity change at an edge of the third ventricle that is also an edge of the posterior commissure.

27. A system to determine an anatomical landmark in an anatomy, comprising:

an imaging system operable to obtain a plurality of slices of image data of a brain of the anatomy at least including a third ventricle;

a processor operable to execute instructions configured to automatically;

generate refined image data by at least one of smooth the image data, remove unneeded data from the image data, define edges in the image data, or combinations thereof in each of the plurality of slices;

subsequent to the generate the refined image data, segment the third ventricle in each of at least a sub-plurality of the plurality of slices of the generated refined image data of the brain;

subsequent to segmenting the third ventricle, skeletonize a line within the segmented third ventricle in each of the sub-plurality of slices in the generated refined image data;

subsequent to the skeletonize the line, determine a slope of the skeletonized line in at least each of the sub-plurality of slices in the generated refined image data;

subsequent to the determine the slope, align at least each of the sub-plurality of slices of the generated refined image data based upon the determined slope of the skeletonized line in at least each of the sub-plurality of slices in the generated refined image data; and

subsequent to the align at least each of the sub-plurality of slices of the generated refined image data determine a second region in the aligned image data that defines a second region of the brain, wherein the second region includes the anatomical landmark that is operable to be used to determine an anatomical target that is relatively indistinguishable from other structures in the image data; and

a display operable to display at least one of the first region, the second region, or combinations thereof.

28. The system of claim 27, further comprising:

a sensing device including a portion operable to sense a response of the brain.

29. The system of claim 28, further comprising:

a communication system operable to interconnect the processor and the sensing device;

wherein the processor is operable to receive the sensed response of the brain to assist in determining at least one of the third ventricle of the brain, the second region of the brain, or combinations thereof.

30. The system of claim 29, wherein the display is operable to display the sensed response of the sensing device, the determined third ventricle in the brain, the determined second region in the brain, or combinations thereof.

31. The system of claim 28, wherein the imaging system includes at least one a T1 weighted magnetic resonance imaging system or a T2 weighted magnetic resonance imaging system.

32. The system of claim 31, further comprising:

a tracking system including at least one of a localizer or a tracking device;

wherein the tracking device is interconnected with the sensing device so that the tracking system is operable to determine a position of the sensing device relative to the region in the anatomy.

33. The system of claim 32, further comprising:

a tracking device communications system wherein the tracking device communications system is operable to transmit to the processor a tracked position of the sensing device;

wherein the display is operable to display an icon superimposed on the image data of a position of the sensing device relative to the anatomy.

34. The system of claim 33, further comprising:

a user input wherein a user is operable to indicate to the processor a portion of the image data based at least in part on the determined third ventricle, the determined second region, the tracked position of the sensing device, or combinations thereof.

35. The system of claim 34, further comprising:

a human readable planning display; and

a planning processor operable to output a plan to reach at least one of the third ventricle, the second region, determined an anatomical target, or combinations thereof;

wherein the plan is operable to be displayed on the human readable planning display.

36. The system of claim 35, further comprising:

a surgical instrument;

a surgical instrument tracking device;

wherein the tracking system is operable to track the surgical instrument tracking device to track a position of the surgical instrument relative to the anatomy to achieve the plan.

37. The system of claim 36, wherein the surgical instrument includes a deep brain stimulator operable to stimulate a portion of the brain.

38. The system of claim 37, wherein the plan includes a trajectory of the deep brain stimulator to reach the determined anatomical target that is a functional region of the brain that is relatively indistinguishable relative to surrounding structures, including the sub-thalamic nucleus in the brain.

39. The system of claim 38, wherein the second region includes both an anterior commissure and a posterior commissure, wherein determine the location of at least one of an anterior commissure or a posterior commissure at an edge of the segmented third ventricle includes:

determine the anterior commissure as a transition in intensity at an anterior edge of the segmented third ventricle and determine the posterior commissure as a transition in intensity at a posterior edge of the segmented third ventricle;

wherein the trajectory is selected from a plurality of trajectories output by the planning processor, where the trajectories are determined to the sub-thalamic nucleus based on executing the instructions to automatically identify a location of the sub-thalamic nucleus relative to the determined anterior commissure and the determined posterior commissure.

40. The system of claim 27, wherein the imaging system includes at least one of a magnetic resonance imaging system, a computer tomography imaging system, an x-ray imaging system, an ultrasound imaging system, a positron emission tomography system, planar gamma scintigraphy system, single photon emission computed tomography system, multi-slice computed tomography system, or combinations thereof.