Method and apparatus to optimize electrode placement for neurological stimulation

• US 8,532,741 B2
• Filed: 03/08/2007
• Issued: 09/10/2013
• Est. Priority Date: 09/08/2006
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Heruth, Kenneth T., Miyazawa, Gabriela C., Wacnik, Paul W., Molnar, Gregory F.
• Primary Examiner(s): Le, Long V.
• Assistant Examiner(s): HOFFA, ANGELA MARIE
• Application Number:
  US11/683,695
• Publication Number:
  US 20080064947A1
• Time in Patent Office: 2,378 Days
• Field of Search: None
• US Class Current: 600/424
• 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 2034/2074 Interface software
• 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 2090/376 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 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61N 1/36128 Control systems

Abstract

A method and apparatus can be used to guide or navigate an instrument relative to a body. Various types of information can be used to assist in the navigation, such as MRI data, diffusion tensor image data, and the like. The information can assist in identifying the portions of the body.

Claims

1. A method of performing a procedure on a selected portion of an anatomy, comprising:

accessing image data of the selected portion of the anatomy;

accessing a second source of data relating to the selected portion of the anatomy;

analyzing the second source of data;

identifying a fiber tract in the accessed image data based on the analyses of the second source of data;

determining a selected position of treatment in the anatomy based on the accessed image data and the identified fiber tract to initially and directly affect the identified fiber tract with a treatment;

providing an output from a processor to display a target icon on a display device superimposed on the accessed image data to illustrate the selected position in the anatomy;

determining a location of an instrument with the processor via tracking a tracking device associated with the instrument by interaction with a localizer of a tracking system;

providing an output from the processor to display an instrument icon superimposed on the accessed image data on the display based upon the determined location;

moving and navigating the instrument to the selected position of treatment identified by the superimposed target icon, further comprising,

executing instructions with the processor to plan at least a portion of a planned trajectory;

superimposing a planned trajectory icon on the accessed image data relative to the superimposed target icon on the display device illustrating the planned trajectory; and

updating the display to illustrate the determined location of the instrument as the instrument icon representing the location of the instrument relative to the target icon and the planned trajectory icon; and

applying a treatment to the selected position in the anatomy with the instrument to efficiently affect the fiber tract after the instrument reaches the selected position illustrated by the target icon that is superimposed on or adjacent to a portion of the accessed image data, wherein the fiber tract includes at least an axon.

2. The method of claim 1, wherein accessing imaging data includes with an imaging system at least one of accessing magnetic resonance image data, accessing x-ray image data, accessing computer aided tomography image data, accessing PET image data, accessing ultrasound image data, accessing SPECT image data, or combinations thereof.

3. The method of claim 1, wherein accessing a second source of data includes accessing diffusion data of a material in the anatomy.

4. The method of claim 3, wherein accessing the image data of the anatomy and accessing the diffusion data of the anatomy occurs substantially simultaneously.

5. The method of claim 3, wherein analyzing the second source of data includes determining a diffusion direction of the material diffused in the anatomy.

6. The method of claim 5, further comprising:

superimposing a fiber tract icon representing the identified fiber tract onto the obtained image data at the selected position of the anatomy.

7. The method of claim 6, wherein the fiber tract icon includes at least one of a line, an arrow, a plurality of lines, or combinations thereof.

8. The method of claim 1, wherein determining a selected position includes selecting at least one of an intracranial fiber tract, a dorsal fiber tract, a peripheral nerve fiber tract, an axon, a cell body, a dendrite, or combinations thereof and selecting the identified fiber tract to apply the therapy initially and directly.

9. The method of claim 1, wherein applying a treatment to the selected position includes applying an electrical current, a chemical therapy, a biological therapy, a radiation therapy, an implant, or combinations thereof.

10. The method of claim 1, wherein determining the selected position consists of determining a location of a peripheral nerve tract.

11. A method for performing a surgical procedure on an anatomy, comprising:

obtaining data regarding the anatomy;

analyzing the obtained data;

selecting an identified fiber tract in the anatomy based upon the analyzed obtained data to apply a selected therapy, wherein the selected therapy includes applying stimulation to a fiber tract within the anatomy;

executing instructions with a processor to determine a target location relative to the selected and identified fiber tract where the selected therapy is operable to be efficiently applied to directly affect the selected and identified fiber tract; and

displaying;

a target location icon representing the determined target location on a display device;

an instrument icon representing a navigated instrument relative to the anatomy and the selected and identified fiber tract at least by viewing the display; and

wherein the selected therapy is applied with the instrument that has been navigated relative to the anatomy and the selected identified fiber tract as illustrated with the instrument icon relative to the displayed target icon to stimulate the selected identified fiber tract.

12. The method of claim 11, wherein the obtained data includes at least one of image data, diffusion data, or combinations thereof.

13. The method of claim 12, wherein analyzing the obtained data includes determining a diffusion tensor of the diffusion data.

14. The method of claim 13, wherein selecting the identified a fiber tract includes determining and identifying the fiber tract based upon the diffusion tensor.

15. The method of claim 14, further comprising:

planning a path to the target location;

displaying a path icon representing the planned path to the target location near the selected fiber tract;

wherein navigating the instrument includes tracking the instrument with a tracking system relative to the anatomy and determining the location of the instrument relative to the target location and the planned path and displaying an instrument icon representing the tracked location of the instrument.

16. The method of claim 15, further comprising:

displaying on the display device a fiber tract icon representing the selected and identified fiber tract of the anatomy and the target location icon near or at the fiber tract icon.

17. The method of claim 16, further comprising:

obtaining image data of the region of the anatomy; and

superimposing on the image data at least one of the instrument icon, the fiber tract icon, the planned path icon, or combinations thereof.

18. The method of claim 15,

wherein planning the path includes determining, with a processor, a plan path for moving the instrument to the target location;

wherein navigating the instrument to the selected position of treatment, further comprises;

superimposing the path icon on the displayed image data representing the plan path relative to the superimposed target icon on a display device; and

updating the display to illustrate the determined position of the instrument as the instrument icon relative to the target location icon and the path icon.

19. The method of claim 15, further comprising executing instructions with the processor to generate a signal to display an icon illustrating a forward projected path of the instrument based on the current tracked location of the instrument.

20. The method of claim 11, wherein identifying a region of the anatomy relative to the identified fiber tract includes identifying at least one of a cell body, a neurological feature, a ganglia, a dorsal fiber tract, a synapse, or combinations thereof.

21. The method of claim 11, wherein the selected therapy includes an electrical current, applying a radiation, applying a thermal energy, and combinations thereof.

22. The method of claim 11, further comprising:

wherein selecting the fiber tract relative to a selected region of the anatomy includes identifying a peripheral nerve tract;

wherein applying a therapy includes applying an electrical stimulation to the fiber tract.

23. The method of claim 11, wherein selecting a fiber tract includes identifying a fiber tract in a brain, a fiber tract in a spinal column, a fiber tract in a peripheral nerve, or combinations thereof.

24. A method for performing a surgical procedure on an anatomy, comprising:

operating a processor system, including;

obtaining image data of a selected portion of the anatomy;

obtaining a diffusion tensor data relating to the selected portion of the anatomy;

analyzing the diffusion tensor data;

identifying a fiber tracts in the obtained image data at least in part with the analyses of the diffusion tensor data;

selecting at least one of the identified fiber tracts;

determining a target location near the selected fiber tract so that a selected therapy is to initially affect the selected fiber tract and where the selected therapy is operable to be efficiently applied to directly affect the selected fiber tract, and

displaying a target location icon representing the determined target location on a display device;

navigating an instrument relative to the anatomy and the selected fiber tract at least by viewing the display for applying the selected therapy with the instrument that has been navigated relative to the anatomy and the selected fiber tract to stimulate the selected fiber tract; and

applying the selected therapy by stimulating the selected fiber tract within the selected portion of the anatomy.

25. The method of claim 24, wherein navigating the instrument further comprises:

determining a location of the instrument via tracking a tracking device by interaction with a localizer of a tracking system;

providing an output from the processor to display an instrument icon superimposed on the obtained image data on the display; and

moving the instrument to the selected position of treatment identified by the superimposed target location icon.

26. The method of claim 25, wherein navigating the instrument further comprises,

executing instructions with the processor to plan at least a portion of the procedure;

superimposing a planned trajectory icon on the image data relative to the superimposed target location icon on the display device illustrating the plan of at least a portion of the procedure; and

updating the display to illustrate movement of the instrument with the instrument icon representing the location of the instrument as the instrument is moved relative to the target icon and the planned trajectory icon.

27. The method of claim 26, wherein the superimposed target location icon is on or adjacent to a portion of the image data representing an axon, and wherein applying the selected therapy is applying the selected therapy to the axon.

28. The method of claim 26, further comprising:

selecting the instrument to be at least one of a stimulation probe, an ablation device, an electrical lead, an electrical recorder, or combinations thereof.

29. The method of claim 26, further comprising:

executing instructions with the processor to provide an output to the display device to display a treatment affect area as a treatment icon on the display device while applying the selected therapy or immediately prior to applying the selected therapy to illustrate a predicted therapy region.

30. The method of claim 29, wherein executing the instructions with the processor to provide an output to the display device includes providing an output to the display device to change intraoperatively the treatment icon to show effects of the selected therapy.