Method and apparatus for instrument placement

• US 8,335,552 B2
• Filed: 04/28/2009
• Issued: 12/18/2012
• Est. Priority Date: 03/20/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Stiles, David
• Primary Examiner(s): CASLER, BRIAN L
• Assistant Examiner(s): Huynh, Phong K
• Application Number:
  US12/431,108
• Publication Number:
  US 20100240986A1
• Time in Patent Office: 1,330 Days
• Field of Search: 600/411, 600/416, 600/420, 600/424, 600/427, 600/439, 600/461, 382/128, 382/131
• US Class Current: 600/407
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• 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 5/06 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 5/062 using magnetic field
• CPC Class Codes: A61B 5/415 the glands, e.g. tonsils, adenoids or thymus
• CPC Class Codes: A61B 5/418 lymph vessels, ducts or nodes
• CPC Class Codes: A61B 5/7289 Retrospective gating, i.e. associating measured signals or images with a physiological event after the actual measurement or image acquisition, e.g. by simultaneously recording an additional physiological signal during the measurement or image acquisition
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies

Abstract

When delivering a therapy to a patient, such as a drug to a brain of a patient, an optimized delivery point can be selected. The optimized point can be based on physics, physiology, and pharmacology. The optimized point can be used for planning a surgical navigation procedure.

Claims

1. A method of determining a delivery location within a volume, comprising:

selecting a physical region within the volume for a drug delivery;

determining a volume of efficacy for the drug within the physical region where the delivered drug achieves a tissue concentration to elicit a meaningful physiological effect in the selected physical region;

acquiring image data of the volume;

determining an image region of therapy in the image data that is the physical region within the image data; and

determining an optimized delivery point within the selected physical region to achieve the volume of efficacy wherein determining an optimized delivery point includes operating a processor to execute instructions for;

identifying a plurality of points within the image region of therapy and a plurality of line segments radially extending from each point of the plurality of points,

measuring a length of each line segment of the plurality of line segments from each point,

assigning a weight to each line segment based at least on a location of a second end of each line segment relative to at least one of a border of the image region of therapy or a structure in the image data,

determining a weighted average length of the plurality of line segments extending from each point, and

outputting the optimized delivery point based on the determined weighted average of the line segments extending from each point.

2. The method of claim 1, further comprising:

displaying the outputted optimized delivery point superimposed on the image data; and

navigating an instrument to the outputted optimized delivery point.

3. The method of claim 1, further comprising:

segmenting the image data into at least a selected segmented region relating to the selected physical region and an unselected segmented region relating to an unselected physical region.

4. The method of claim 3, wherein determining an optimized delivery point within the selected physical region further includes determining the optimized point to achieve the volume of efficacy substantially only in the selected segmented region, wherein assigning the weight to each line segment includes assigning a greater weight to a line segment that contacts a border of the selected segmented region.

5. The method of claim 1, wherein assigning a weight to each line segment based at least on the location of the second end of each line segment relative to the border of the image region of therapy includes assigning a greater weight to the line segment that has the second end further from white matter;

wherein determining an optimized delivery point further includes;

determining which point of the identified plurality of points has a maximum determined weighted average length of the plurality of line segments.

6. The method of claim 1, wherein each point of the plurality of points within the image region of therapy is a center of a sphere that is completely within the image region of therapy, and wherein each line segment is a radius of at least one sphere of a plurality of spheres based on the identified plurality of points;

and

wherein determining an optimized delivery point further includes determining which one sphere of the plurality of spheres has a maximum radius.

7. The method of claim 1, wherein each point of the plurality of points within the image region of therapy is a center of a sphere that completely encompasses the image region of therapy and wherein each line segment is a radius of at least one sphere of a plurality of spheres based on the identified plurality of points;

and

wherein determining an optimized delivery point further includes determining which one sphere of the plurality of spheres has a minimum radius.

23. The method of claim 1, wherein each of line segments extends from one point of the identified plurality of points to at least one of a surface of the image region of therapy or structures outside of the image region of therapy.

24. The method of claim 23, wherein assigning weights to each line segment is further based on at least one of assigning a different weight to each line segment based on difference of a length of the second end point of each line segment relative to the surface of the image region of therapy, a difference of length of the second end point of each line segment from each point to a portion of white matter, or combinations thereof.

8. A method of determining an optimized location for delivering a compound of interest within a brain, comprising:

selecting a physical region within the brain for the compound of interest delivery;

selecting an instrument for the compound of interest delivery;

determining a volume of efficacy for the compound of interest, including evaluating the interaction of the compound of interest within the selected physical region within the brain;

acquiring image data of the brain;

identifying an image region of therapy that is a representation in the acquired image data of the selected physical region; and

determining at least a single optimized delivery point within the image region of therapy to achieve the volume of efficacy at least within a portion of the selected physical region, including operating a processor to automatically execute instructions after identifying the image region of therapy, wherein the instructions include;

identifying a plurality of points within the image region of therapy;

determining a plurality of line segments radially extending from each point of the plurality of points to at least one of a surface of the image region of therapy or structures outside of the image region of therapy;

measuring a length of each line segment; and

determining an average length of the plurality of line segments extending from each point;

wherein the single optimized delivery point is based at least on the determined average length of the plurality of line segments extending from each point, and

superimposing at least the determined single optimized delivery point as an icon on the acquired image data.

9. The method of claim 8, wherein identifying an image region of therapy includes segmenting the image data by at least selecting a seed point.

10. The method of claim 8, wherein determining the optimized delivery point is substantially automatically determined by operating the processor after a user selects the physical region.

11. The method of claim 8,

wherein the optimized delivery point includes one point of the plurality of points with a determined maximum average length of the plurality of line segments.

12. The method of claim 11, wherein the determined maximum average line segment length includes weighting each of the sub-plurality of line segment lengths extending from each point.

13. The method of claim 8, wherein each point of the identified plurality of points is a center of a sphere that is completely within the image region of therapy;

wherein each line segment is a radius of at least one sphere of a plurality of spheres based on the identified plurality of points; and

wherein determining the optimized delivery point further includes determining which sphere of the plurality of spheres has a maximum radius.

14. The method of claim 13, wherein determining which sphere of the plurality of spheres has the maximum radius includes weighting each of the plurality of spheres.

15. The method of claim 8, wherein each point of the identified plurality of points within the image region of therapy is a center of a sphere that completely encompasses the image region of therapy;

wherein each line segment is a radius of at least one sphere of a plurality of spheres based on the identified plurality of points; and

wherein determining the optimized delivery point further includes determining which sphere of the plurality of spheres has a minimum radius.

16. The method of claim 15, wherein determining which sphere of the plurality of spheres has a minimum radius includes weighting each sphere of the plurality of spheres.

17. The method of claim 8, further comprising:

segmenting the selected physical region into a segmented selected region and a segmented unselected region;

wherein determining an optimized delivery point includes determining an optimized delivery point only to the segmented selected region.

25. The method of claim 8, wherein the determined optimized delivery point includes one point that has the plurality of line segments with a minimum average length.

26. The method of claim 25, further comprising:

weighting each line segment of the plurality of line segments from each point prior to determining the average length of each plurality of line segments from each point, wherein the determined average length of the plurality of line segments can be augmented by the weighting.

27. The method of claim 8, wherein determining a volume of efficacy for the compound of interest, further includes evaluating at least one of a mass transport for the compound of interest, pharmacokinetics for the compound of interest in the selected physical region, or pharmacodynamics for the compound of interest in the selected physical region.

18. A system to determine a delivery location within a volume, comprising:

a storage system operable to store acquired image data of the volume;

an input device operable to input a selected physical region within the volume for compound of interest delivery;

an instrument configured to be positioned within the volume to deliver the compound of interest;

a processor operable to execute instructions to identify an image region of therapy that is a representation of the selected physical region, wherein the processor is further operable to execute instructions to determine an optimized delivery point within the image region of therapy to position at least a portion of the instrument to achieve a volume of efficacy at least within a portion of the selected physical region, wherein the instructions include;

identifying a plurality of points within the image region of therapy;

determining a plurality of line segments radially extending from each point of the plurality of points to at least one of a surface of the image region of therapy or structures outside of the image region of therapy;

measuring a length of each line segment; and

determining an average length of the plurality of line segments extending from each point;

wherein the optimized delivery point is based at least on the determined average length of the plurality of line segments extending from each point; and

an output device operable to output the determined optimized delivery point relative to the acquired image data.

19. The system of claim 18, wherein the output device includes a display device;

wherein the display device is operable to display the acquired image data and an icon superimposed on the acquired image data as the determined optimized delivery point.

20. The system of claim 18, further comprising:

an imaging system operable to acquire three dimensional image data of the volume.

21. The system of claim 18, further comprising:

a navigation system having a localizer and a trackable portion;

wherein the navigation system is operable to track the trackable portion and superimpose an icon representing a position of the trackable portion relative to the image data viewable with the output from the output device.

22. The system of claim 21, wherein the trackable portion includes the instrument;

wherein the icon is operable to represent a delivery portion of the instrument.

28. The method of claim 18, wherein to achieve the volume of efficacy at least within a portion of the selected physical region the processor is operable to further execute instructions to evaluate at least one of a mass transport for the compound of interest, pharmacokinetics for the compound of interest in the selected physical region, or pharmacodynamics for the compound of interest in the selected physical region.