Probe driver

• US 9,211,157 B2
• Filed: 12/01/2014
• Issued: 12/15/2015
• Est. Priority Date: 08/13/2009
• Status: Active Grant

• Current Assignee: Monteris Medical Incorporated (Monteris Medical US, Inc.)
• Original Assignee: Monteris Medical Incorporated (Monteris Medical US, Inc.)
• Inventors: Tyc, Richard, Qureshi, Salman, Grant, Mark Andrew, Fernandes, Luis Filipe Silva, Carreira, Daniel Prazeres, Schellhorn, John
• Primary Examiner(s): SHI, KATHERINE MENGLIN
• Application Number:
  US14/557,164
• Publication Number:
  US 20150088108A1
• Time in Patent Office: 379 Days
• Field of Search: 606/129, 606/130
• US Class Current: 1/1
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/0206 ultrasonic, e.g. for destroying tissue or enhancing freezing
• CPC Class Codes: A61B 18/06 caused by chemical reaction , e.g. moxaburners
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 18/28 for heating a thermal probe or absorber
• CPC Class Codes: A61B 2017/00017 Electrical control of surgical instruments
• CPC Class Codes: A61B 2017/00911 for fields applied by a magnetic resonance imaging system
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2018/00017 with gas
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00446 Brain
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00702 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00994 combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0293 : using an instrument interstitially inserted into the body, e.g. needle
• CPC Class Codes: A61B 2018/1807 : using light other than laser radiation
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2018/20351 : Scanning mechanisms
• CPC Class Codes: A61B 2018/2211 : Plurality of fibres
• CPC Class Codes: A61B 2018/2261 : with scattering, diffusion or dispersion of light
• CPC Class Codes: A61B 2034/107 : Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2068 : using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/301 : for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/374 : 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: A61B 34/71 : Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 5/015 : By temperature mapping of body part
• CPC Class Codes: A61B 5/055 : involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/4839 : combined with drug delivery
• CPC Class Codes: A61B 5/702 : Posture restraints
• CPC Class Codes: A61B 5/742 : using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 : Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61B 90/10 : for stereotaxic surgery, e.g. frame-based stereotaxis
• CPC Class Codes: A61B 90/11 : with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/14 : Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61N 5/0601 : Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent
• CPC Class Codes: A61N 7/022 : intracavitary
• CPC Class Codes: G01R 33/285 : Invasive instruments, e.g. catheters or biopsy needles, specially adapted for tracking, guiding or visualization by NMR
• CPC Class Codes: G01R 33/4804 : Spatially selective measurement of temperature or pH

Abstract

Image-guided therapy of a tissue can utilize magnetic resonance imaging (MRI) or another medical imaging device to guide an instrument within the tissue. A workstation can actuate movement of the instrument via a probe driver, and can actuate energy emission and/or cooling of the instrument to effect treatment to the tissue. The workstation and/or an operator of the workstation can be located outside a vicinity of an MRI device or other medical imaging device, and drive means for positioning the instrument can be located within the vicinity of the MRI device or the other medical imaging device. The instrument can be an MRI compatible laser probe that provides thermal therapy to, e.g., a tissue in a brain of a patient. The probe driver allows for precise positioning, stabilization and manipulation of a probe.

Claims

1. A system for automated guidance of a therapy instrument during treatment of a tissue, comprising:

a drive mechanism that is compatible with and can operate within an operational field of a medical imaging system to image the tissue without substantially disrupting imaging performed by the medical imaging system, the drive mechanism comprising a holder configured to secure the therapy instrument;

a flexible umbilical configured to couple to the drive mechanism, wherein

the flexible umbilical is compatible with and can operate within the operational field of the medical imaging system, and

translation of the flexible umbilical effects at least one of a longitudinal displacement and a rotation of the instrument holder;

an electronic controller configured to couple to the flexible umbilical, wherein the electronic controller is configured to

receive at least one position control signal, and

effect translation, based upon the at least one position control signal, of the flexible umbilical;

a processor; and

a memory having instructions stored thereon, wherein the instructions, when executed by the processor, cause the processor to;

receive, from the electronic controller, one or more initial position feedback signals, wherein the drive mechanism obtained at least one position measurement and generated, based upon the at least one position measurement, the one or more initial position feedback signals;

determine, based upon the one or more initial feedback position signals, an initial position of at least one of the holder and the therapy instrument therein;

determine a desired position of the at least one of the holder and the therapy instrument;

determine a sequence of position control signals to effect movement from the initial position to the desired position; and

issue the sequence of position control signals to the electronic controller.

2. The system of claim 1, wherein the instructions, when executed by the processor, cause the processor to:

receive, from the electronic controller, one or more position feedback signals; and

confirm, based upon the one or more position feedback signals, that the sequence of position control signals effected movement to the desired position.

3. The system of claim 2, further comprising a position feedback plug configured to connect the drive mechanism to the controller, wherein the drive mechanism issues the one or more position feedback signals via the position feedback plug.

4. The system of claim 2, wherein the drive mechanism comprises a position feedback assembly configured to issue the one or more position feedback signals.

5. The system of claim 2, wherein the instructions, when executed by the processor, cause the processor to, responsive to confirming that the sequence of position control signals effected movement to the desired position:

identify a difference between a current position represented by the position feedback signals and the desired position; and

issue a warning notification.

6. The system of claim 5, wherein the difference between the current position and the desired position is greater than a slippage tolerance value.

7. The system of claim 5, wherein the instructions, when executed by the processor, cause the processor to, responsive to identifying the difference between the current position and the desired position:

determine a correction sequence of position control signals to effect movement from the current position to the desired position; and

issue the correction sequence of position control signals to the electronic controller.

8. The system of claim 1, wherein the electronic controller comprises the processor.

9. A system for automated guidance of a therapy instrument during treatment of a tissue, comprising:

a drive mechanism that is compatible with and can operate within an operational field of a medical imaging system to image the tissue without substantially disrupting imaging performed by the medical imaging system, the drive mechanism comprising;

a holder configured to accept insertion of the therapy instrument, and

a position feedback assembly configured to

track at least one of a longitudinal displacement and a rotational angle of the holder, and

issue at least one position feedback signal corresponding to at least one of the longitudinal displacement and the rotational angle of the holder;

an umbilical configured to couple to the drive mechanism, wherein

the umbilical is compatible with and can operate within the operational field of the medical imaging system, and

translation of the umbilical effects at least one of a longitudinal displacement and a rotation of the instrument holder;

an electronic controller configured to couple to the umbilical, wherein the electronic controller is configured to

receive at least one position control signal, and

effect translation, based upon the at least one position control signal, of the umbilical;

a processor; and

a memory having instructions stored thereon, wherein the instructions, when executed by the processor, cause the processor to;

determine, based upon at least one initial position feedback signal generated by the position feedback assembly, an initial position of at least one of the holder and the therapy instrument therein;

determine a desired position of the at least one of the holder and the therapy instrument;

determine a sequence of position control signals to effect movement from the initial position to the desired position;

issue the sequence of position control signals to the electronic controller; and

confirm, based upon one or more additional position feedback signals generated by the position feedback assembly, that the sequence of position control signals effected movement to the desired position.

10. The system of claim 9, wherein the electronic controller comprises an input interface, wherein the electronic controller is configured to receive the at least one position control signal via the input interface.

11. The system of claim 10, wherein the input interface comprises a graphical user interface that accepts user position commands as inputs.

12. The system of claim 9, wherein the instructions, when executed by the processor, cause the processor to:

acquire, from the medical imaging system, image data comprising a volume of a patient including a region of deployment of the therapy instrument;

present, upon a graphical user interface, a rendering of the image data; and

overlay, upon the rendering of the image data, a rendering of a placement and trajectory of the therapy instrument in the desired position.

13. The system of claim 12, wherein:

the image data comprises a therapy instrument artifact representing an actual position of the therapy instrument within the image data; and

the instructions, when executed by the processor, cause the processor to;

receive, as user input via a graphical user interface, an adjustment of the alignment of the rendering of the placement and trajectory of the therapy instrument, and

present, upon the graphical user interface, an adjusted rendering of the placement and trajectory of the therapy instrument.

14. The system of claim 13, wherein the instructions, when executed by the processor, cause the processor to:

receive, responsive to presenting the adjusted rendering of the placement and trajectory of the therapy instrument, user confirmation of alignment of the adjusted rendering; and

store a spatial relationship between the adjusted rendering and the current position to use in image guidance during tissue treatment.

15. The system of claim 12, wherein the instructions, when executed by the processor, cause the processor to, responsive to confirming that the sequence of position control signals effected movement to the desired position, initiate treatment of the tissue by the therapy instrument.

16. The system of claim 12, wherein the instructions, when executed by the processor, cause the processor to continuously present, upon a graphical user interface, renderings of real time image data of the tissue while the electronic controller effects movement between the initial position and the desired position.

17. The system of claim 9, wherein a remote workstation comprises the processor, the remote workstation being external to an imaging room containing the controller.

18. A system for automated guidance of a therapy instrument during treatment of a tissue, comprising:

a motorless drive mechanism comprising a holder configured to accept the therapy instrument;

an umbilical configured to couple to the motorless drive mechanism, wherein translation of the umbilical effects at least one of a longitudinal displacement and a rotation of the instrument holder;

an electronic controller configured to couple to the umbilical, wherein the electronic controller is configured to

receive at least one position control signal, and

effect translation, based upon the at least one position control signal, of the flexible umbilical;

a position feedback assembly configured to collect position measurements of an actual position of at least one of the holder and the therapy instrument therein, and issue position feedback signals to the electronic controller according to position measurements;

a processor; and

a memory having instructions stored thereon, wherein the instructions, when executed by the processor, cause the processor to;

determine, based at least in part upon one or more feedback signals received from the position feedback assembly, an initial position of at least one of the holder and the therapy instrument therein;

determine a desired position of the at least one of the holder and the therapy instrument;

determine a sequence of position control signals to effect movement from the initial position to the desired position; and

issue the sequence of position control signals to the electronic controller.

19. The system of claim 18, wherein the position feedback assembly connects to the controller, and the processor receives the one or more feedback signals from the controller.

20. The system of claim 18, wherein the position feedback assembly comprises a potentiometer.