Method and device for navigation of a surgical tool

• US 8,611,985 B2
• Filed: 01/28/2010
• Issued: 12/17/2013
• Est. Priority Date: 01/29/2009
• Status: Active Grant

• Current Assignee: Imactis, Co.
• Original Assignee: Imactis, Co.
• Inventors: Lavallee, Stephane, Carrat, Lionel
• Primary Examiner(s): Le, Long V.
• Assistant Examiner(s): FERNANDEZ, KATHERINE L
• Application Number:
  US13/146,206
• Publication Number:
  US 20110295109A1
• Time in Patent Office: 1,419 Days
• Field of Search: 600/426, 600/424, 600/407, 600/425, 382/128, 382/131
• US Class Current: 600/424
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00699 correcting for movement caused by respiration, e.g. by triggering
• CPC Class Codes: A61B 2034/2046 Tracking techniques
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/3995 Multi-modality markers
• 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 5/062 using magnetic field
• CPC Class Codes: A61B 6/03 Computed tomography [CT] echo-tomography A61B8/14
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

The invention relates to a method of navigation of a tool to be used in a surgical operation for treating a target region within the body of a patient.

Claims

1. A method of navigation of a tool to be used in a surgical intervention for treating a target region within the body of a patient, comprising the following steps for preparing the navigation:

detecting an image position of a first reference marker disposed on the body of the patient by an imaging system, and detecting a spatial position of said first reference marker by a localizing system, wherein said localizing system is a magnetic tracking system, and wherein said first reference marker comprises;

a magnetic element having at least two coils arranged in a manner to define at least two vectors in a coordinate system of the magnetic tracking system, and a geometric element comprising components visible on image data of the imaging system and having a unique geometry detectable by the imaging system, said components comprising hollow plastic tubes having an external part and an internal part filled with air,

wherein detecting the image position of the first reference marker comprises searching for said external part having a density in Hounsfield values equal to a plastic material Hounsfield value and said internal part having a null Hounsfield value, in an image provided by the imaging system;

calculating a first transform matrix between an image coordinate system of the imaging system and a spatial coordinate system associated with the first reference marker by using detected image and spatial positions of the first reference marker, in order to register data of the localizing system and imaging system together;

detecting a spatial position of a pointer by the localizing system;

constructing and displaying a navigation image, wherein a representation of the spatial position of the pointer is displayed on image data from the imaging system using the first transform matrix; and

determining an entry point through which the tool should be inserted for reaching the target region by using the representation of the pointer in the navigation image.

2. The method of claim 1, further comprising the step of imaging a zone of the body of the patient with the imaging system to get image data of the zone, said zone including the entry point.

3. The method of claim 2, wherein the step of imaging a zone of the body of the patient is regularly and automatically performed, and wherein subsequent steps are performed using the last image data of the imaged zone.

4. The method of claim 1, further comprising the steps of:

detecting a presence of the tool with the localizing system;

determining a spatial position of the tool; and

constructing and displaying a navigation image, wherein a representation of the spatial position of the tool is displayed on image data from an imaged zone.

5. The method of claim 4, further comprising the steps of:

detecting a presence of the pointer with the localizing system;

determining a spatial position of the pointer; and

constructing and displaying a navigation image, wherein a representation of the spatial position of the tool is displayed on the image data from the imaged zone.

6. The method of claim 4, comprising correcting the navigation data, said correction comprising the steps of:

searching for a presence of linear shapes on the image data of the imaged zone;

selecting a linear shape having the nearest position from the position of the tool on the navigation image;

compute a correction matrix to make the position of the tool on the navigation image correspond to the position of the selected linear shape; and

apply said correction matrix to a construction of further navigation images.

7. The method of claim 1, wherein the imaging system is based on X-ray detection.

8. The method of claim 1, further comprising the following steps:

detecting image position and spatial position of a second reference marker disposed under sterile conditions on the body of the patient in a vicinity of the entry point,

wherein said second reference marker comprises;

a magnetic element having at least two coils arranged in a manner to define at least two vectors in a coordinate system of the magnetic tracking system, and a geometric element comprising components visible on image data of the imaging system and having a unique geometry detectable by the imaging system, said components comprising hollow plastic tubes having an external part and an internal part filled with air,

wherein detecting the image position of the second reference marker comprises searching for said external part having a density in Hounsfield values equal to a plastic material Hounsfield value and said internal part having a null Hounsfield value, in an image provided by the imaging system; and

calculating a second transform matrix between the image coordinate system of the imaging system and the spatial coordinate system associated with the second reference marker by using detected image and spatial positions of the second reference marker, in order to register data of the localizing system and imaging system together.

9. The method of claim 8, further comprising the step of:

searching for a presence of the first and second reference markers on a image data of an imaged zone; and

if the second reference marker is present on the image data of the imaged zone, then constructing a navigation image wherein registration of the data of the localizing systems together with image data of the imaged zone is performed by using the second transform matrix, and

if the first reference marker is present on the image data of the imaged zone whereas the second reference marker is not present, then constructing a navigation image wherein registration of the data of the localizing systems together with image data of the imaged zone is performed by using the first transform matrix.

10. The method of claim 1, wherein the geometric element of the first reference marker comprises eight hollow plastic tubes filled with air, said tubes being arranged spatially so as to constitute a star configuration.

11. A method of navigation of a tool to be used in a surgical operation for treating a target region within the body of a patient, comprising the following steps for preparing the navigation:

disposing a first reference marker on the body of the patient, wherein said first reference marker comprises;

a magnetic element having at least two coils arranged in a manner to define at least two vectors in a coordinate system of a magnetic tracking system, and a geometric element comprising components visible on image data of an imaging system and having a unique geometry detectable by the imaging system, said components comprising hollow plastic tubes having an external part and an internal part filled with air;

detecting an image position of said first reference marker by the imaging system, and detecting a spatial position of said first reference marker by a localizing system, wherein said localizing system is a magnetic tracking system,

wherein detecting the image position of the first reference marker comprises searching for said external part having a density in Hounsfield values equal to a plastic material Hounsfield value and said internal part having a null Hounsfield value, in an image provided by the imaging system;

calculating a first transform matrix between an image coordinate system of the imaging system and a spatial coordinate system associated with the first reference marker by using detected image and spatial positions of the first reference marker, in order to register data of the localizing and imaging systems together;

detecting a spatial position of a pointer by the localizing system;

constructing and displaying a navigation image, wherein a representation of the spatial position of the pointer is displayed on image data from the imaging system using the first transform matrix; and

determining an entry point through which the tool should be inserted for reaching the target region by using the representation of the pointer in the navigation image.

12. A navigation device for navigation of a tool to be used in a surgical intervention for treating a target region within the body of a patient, comprising:

an imaging system for providing image data relative to the patient;

a localizing system for providing spatial data, wherein said localizing system is a magnetic tracking system;

a computer system for processing the image data and spatial data from the imaging system and localizing system respectively and

a first reference marker adapted to be detected by both the imaging and

localizing systems, wherein the first reference marker comprises;

a magnetic element having at least two coils arranged in a manner to define at least two vectors in a coordinate system of the magnetic tracking system, and a geometric element comprising components visible on image data of the imaging system and having a unique geometry detectable by the imaging system, said

components comprising hollow plastic tubes having an external part and an internal part filled with air,

wherein said computer system is configured to search for said external part having a density in Hounsfield values equal to a plastic material Hounsfield value and said internal part having a null Hounsfield value in the image data in order to detect an image position of the first reference marker.

13. The device of claim 12, wherein the reference marker comprises magnetic elements having coils arranged in a different manner, and geometric elements having components of different shapes and/or arranged in a different manner.

14. The device of claim 12, wherein the magnetic tracking system comprises at least an emitter for emitting an electromagnetic field.

15. The device of claim 14, wherein the emitter is the magnetic element of the first reference marker.

16. The device of claim 12, further comprising tracking elements adapted to be arranged on a pointer and/or on the tool to be used in the surgical intervention for treating the target region within the body of a patient, said tracking elements being adapted to be detected by the tracking system.

17. The device of claim 16, wherein the tracking elements are connected to the pointer and/or the tool with a connecting device, said connecting device comprising means for fixing pointers and/or tools of different diameters always along a same axis.

18. The device of claim 16, wherein the tracking elements are connected to the pointer and/or the tool with a connecting device, said connecting device comprising clamping means for fixing the pointer and/or the tool on said connecting device, said clamping means being adapted for allowing the pointer and/or the tool to slide relative to the connecting device on application of a pressure on said clamping means.

19. The device of claim 12, wherein the imaging system is a Computed Tomography (CT) imaging system.

20. The device of claim 12, wherein the geometric element of the first reference marker comprises eight hollow plastic tubes filled with air, said tubes being arranged spatially so as to constitute a star configuration.

21. The device of claim 12, further comprising:

a second reference marker adapted to be detected by both the imaging and localizing systems, wherein the second reference marker is sterile and comprises;

a magnetic element having at least two coils arranged in a manner to define at least two vectors in a coordinate system of the magnetic tracking system, and a geometric element comprising components visible on image data of the imaging system and having a unique geometry detectable by the imaging system, said components comprising hollow plastic tubes filled with air.