Systems and methods for navigation within a branched structure of a body

• US 8,219,179 B2
• Filed: 03/06/2008
• Issued: 07/10/2012
• Est. Priority Date: 03/06/2008
• Status: Active Grant

• Current Assignee: VIDA Diagnostics, Inc.
• Original Assignee: VIDA Diagnostics, Inc.
• Inventors: Ganatra, Jenelle M., Tschirren, Juerg, Garber, John T.
• Primary Examiner(s): Kish, James
• Assistant Examiner(s): FISHER, MICHAEL NAPOLEON
• Application Number:
  US12/043,518
• Publication Number:
  US 20090227861A1
• Time in Patent Office: 1,587 Days
• Field of Search: 600/101, 600/117, 600/160, 600/407, 600/410, 600/414, 600/415, 600/416, 600/423, 600/424, 600/426, 600/429, 600/433, 600/434, 600/462, 600/475
• US Class Current: 600/424
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• 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 2090/3954 magnetic, e.g. NMR or MRI
• 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: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A system and method for navigating a medical instrument in a branched structure of a body employs a tracking system, for collecting positional information for the medical instrument, and data, which defines a geometrical model of the branched structure, in particular, coordinates for predetermined points defining a pathway extending along branches of the model. Coordinates are identified for each Euclidean distance of the instrument, from an anchor point of a coordinate system for the tracking system, that corresponds to a Euclidean distance of a designated point, of the predetermined points, from a reference point of a coordinate system for the model, wherein the anchor point of the tracking coordinate system has been established to correspond to the reference point of the model coordinate system. The two coordinate systems are registered to one another using the identified coordinates of the instrument and the corresponding coordinates of each designated point.

Claims

1. A method for navigating a medical instrument within a branched structure of a body, the medical instrument including a tracking sensor attached thereto, the sensor being part of a tracking system, and the method comprising:

providing data, which defines a geometrical model of the branched structure, the data including coordinates for predetermined points, with respect to a frame of reference of the model, the predetermined points defining a pathway, which pathway extends along branches of the model of the structure;

displaying a representation of the model;

positioning the medical instrument within the branched structure of the body such that a location of the tracking sensor approximately coincides with a location in the structure that corresponds to one of the predetermined points of the pathway that has been designated as a reference point of a model coordinate system in the model frame of reference;

establishing an anchor point for a tracking coordinate system, in a frame of reference of the tracking system, that corresponds to the reference point of the model coordinate system, when the location of the tracking sensor coincides with the predetermined point of the pathway designated as the reference point of the model coordinate system;

advancing the medical instrument along a registration path, within the branched structure, from the anchor point of the tracking coordinate system, while simultaneously collecting positional information from the tracking sensor to track a Euclidean distance between the sensor and the anchor point of the tracking coordinate system, the registration path including a plurality of non-collinear points;

determining if the tracked Euclidean distance between the sensor and the anchor point of the tracking coordinate system for each of the plurality of non-collinear points equals a corresponding Euclidean distance for each of a plurality of other designated predetermined points, of the pathway, from the reference point of the model coordinate system, and the medical instrument being advanced, at least, until the tracked Euclidean distance for each of the plurality of non-collinear points equals the corresponding Euclidean distance for each of the plurality of other designated predetermined points;

identifying a set of coordinates specifying the position of the tracking sensor, in the tracking coordinate system, where the tracking sensor is located at the equal Euclidean distance for each of the other designated predetermined points, of the pathway, from the reference point of the model coordinate system;

registering the tracking coordinate system to the model coordinate system by deriving a mathematical transformation, which relates the model frame of reference to the tracking system frame of reference, using the identified sets of coordinates for the tracking sensor and the corresponding coordinates of the other designated predetermined points of the pathway;

collecting registered sets of coordinates of the tracking sensor while moving the medical instrument within the branched structure of the body; and

displaying, on the displayed presentation of the model, a virtual representation of the tracking sensor corresponding to at least some of the collected registered sets of coordinates, in order to provide navigation guidance for the movement of the instrument.

2. The method of claim 1, wherein another of the predetermined points of the pathway is designated as a target site, and the medical instrument is moved to the target site, after registering the tracking coordinate system.

3. The method of claim 1, further comprising:

performing a procedure with the medical instrument on the body at a site within the branched structure to which the instrument is moved after registering the tracking coordinate system to the model coordinate system;

collecting a registered set of coordinates for the tracking sensor at the site where the procedure is performed; and

storing the registered set of coordinates for the tracking sensor at the site.

4. The method of claim 3, further comprising displaying an indicator, at a location on the displayed presentation of the model, which location corresponds to the registered set of coordinates for the tracking sensor at the site of the procedure, after the medical instrument is moved from the site, following the procedure.

5. The method of claim 1, wherein the predetermined point of the pathway that is designated as the reference point of the model coordinate system corresponds to an anatomical landmark of the branched structure.

6. The method of claim 1, wherein at least one of the other designated predetermined points of the pathway corresponds to a branching point of the pathway.

7. The method of claim 1, wherein:

the data, which defines the geometrical model of the branched structure, further includes an anatomical identification associated with each of at least some of the predetermined points of the pathway; and

displaying the representation of the model includes labeling of each of the at least some of the predetermined points according to the associated anatomical identification.

8. The method of claim 1, wherein:

the registration path extends in first, second and third directions; and

advancing the medical instrument comprises sequentially advancing the instrument in each of the first, second and third directions, according to a predetermined sequence.

9. The method of claim 8, wherein the predetermined sequence is communicated by a visual indicator overlaid on the displayed representation of the model.

10. The method of claim 1, wherein:

the registration path extends in first, second and third directions; and

further comprising identifying each of the first, second and third directions prior to advancing the instrument in each of the corresponding directions.

11. The method of claim 1, further comprising displaying on the displayed representation of the model an indication of whether or not the medical instrument has been advanced over the Euclidean distance for each of the other designated predetermined points, of the pathway, from the reference point of the model coordinate system, along the registration path.

12. The method of claim 1, further comprising re-registering the tracking coordinate system to the model coordinate system by:

monitoring additional Euclidean distances of the tracking sensor from the anchor point of the tracking coordinate system, as the medical instrument is advanced within the branched structure, after registering the tracking coordinate system;

identifying at least one additional set of coordinates for the tracking sensor, in the tracking coordinate system, when one of the monitored distances corresponds to a distance of an additional designated predetermined point of the pathway from the reference point of the model coordinate system; and

deriving another mathematical transformation relating the model frame of reference to the tracking system frame of reference using the identified additional set of coordinates for the tracking sensor and the coordinates of the additional designated predetermined point of the pathway.

13. The method of claim 12, wherein the additional designated predetermined point of the pathway corresponds to a branching point of the pathway downstream of one of the other designated predetermined points of the pathway.

14. The method of claim 1, wherein the predetermined points defining the pathway comprise centerline points along the branches of the model of the structure.

15. The method of claim 1, wherein collecting the registered sets of coordinates of the tracking sensor comprises mapping the coordinates to a closest point of the predetermined points defining the pathway.

16. The method of claim 1, further comprising:

measuring a time between the collection of two of the registered sets of coordinates of the tracking sensor; and

storing the measured time.

17. The method of claim 16, further comprising displaying the time alongside the displayed representation of the model.

18. The method of claim 16, wherein:

a first of the two registered sets of coordinates corresponds to a branching point of the pathway, which branching point defines a first end of a segment of the pathway; and

a second of the two registered sets of coordinates corresponds to another branching point of the pathway, which other branching point defines a second end of the segment of the pathway.

19. The method of claim 16, wherein each of the two registered sets of coordinates corresponds to a same branching point of the pathway.

20. The method of claim 1, further comprising:

measuring a distance between two of the collected registered sets of coordinates of the tracking sensor; and

storing the measured distance.

21. The method of claim 20, further comprising displaying the stored distance as a visual indicator overlaid on the displayed representation of the model.

22. The method of claim 20, further comprising displaying the stored distance as a quantity alongside the displayed representation of the model.

23. The method of claim 20, wherein:

a first of the two registered sets of coordinates corresponds to a branching point of the pathway, which branching point defines a first end of a segment of the pathway; and

a second of the two registered sets of coordinates corresponds to a point downstream of the branching point at which a direction in which the medical instrument is moved is changed.

24. The method of claim 1, wherein the medical instrument includes a camera attached thereto in proximity to the tracking sensor and further comprising collecting a stream of images from the camera while advancing the instrument.

25. A method for registering a coordinate system of a frame of reference of a tracking system to a coordinate system of a frame of reference of a geometrical model, the tracking system collecting information defining a position of a medical instrument, to be navigated in a branched structure of a body, the position with respect to the frame of reference of the tracking system, the geometrical model being defined by data which includes coordinates for predetermined points defining a pathway along branches of the branched structure, and the method comprising:

positioning the medical instrument within the branched structure of the body such that a location of the instrument approximately coincides with a location in the structure that corresponds to one of the predetermined points of the pathway that has been designated as a reference point of the model coordinate system;

establishing an anchor point for the tracking coordinate system that corresponds to the reference point of the model coordinate system, when the location of the instrument coincides with the predetermined point of the pathway designated as the reference point of the model coordinate system;

advancing the medical instrument along a registration path, within the branched structure, from the anchor point of the tracking coordinate system, while simultaneously collecting positional information from the tracking system to track a Euclidean distance between the instrument and the anchor point of the tracking coordinate system, the registration path including a plurality of non-collinear points;

determining if the tracked Euclidean distance between the instrument and the anchor point of the tracking coordinate system for each of the plurality of non-collinear points equals a corresponding Euclidean distance for each of a plurality of other designated predetermined points, of the pathway, from the reference point of the model coordinate system, and the instrument being advanced, at least, until the tracked Euclidean distance for each of the plurality of non-collinear points equals the corresponding Euclidean distance for each of the plurality of other designated predetermined points;

identifying a set of coordinates specifying the position of the instrument, in the tracking coordinate system, where the instrument is located at the equal Euclidean distances for each of the other designated predetermined points, of the pathway, from the reference point of the model coordinate system; and

deriving a mathematical transformation, which relates the model frame of reference to the tracking system frame of reference, using the identified sets of coordinates for the instrument and the corresponding coordinates of the other designated predetermined points of the pathway, to register the tracking coordinate system to the model coordinate system.

26. The method of claim 25, wherein the predetermined point of the pathway that is designated as the reference point of the model coordinate system corresponds to an anatomical landmark of the branched structure.

27. The method of claim 25, wherein at least one of the other designated predetermined points of the pathway corresponds to a branching point of the pathway.

28. The method of claim 25, wherein:

the registration path extends in first, second and third directions; and

advancing the medical instrument comprises sequentially advancing the instrument in each of the first, second and third directions, according to a predetermined sequence.

29. The method of claim 28, further comprising:

displaying a representation of the model; and

wherein the predetermined sequence is communicated by a visual indicator overlaid on the displayed representation of the model.

30. The method of claim 25, wherein:

the registration path extends in first, second and third directions; and

further comprising identifying each of the first, second and third directions prior to advancing the instrument in each of the corresponding directions.

31. The method of claim 25, further comprising displaying a representation of the model and an indication, on the displayed model, of whether or not the medical instrument has been advanced over the Euclidean distance, of each of the other designated predetermined points of the pathway, from the reference point of the model coordinate system, along the registration path.

32. The method of claim 25, wherein the predetermined points defining the pathway comprise centerline points along the branches of the model of the structure.