Image-guided therapy of a tissue

• US 9,433,383 B2
• Filed: 03/18/2015
• Issued: 09/06/2016
• Est. Priority Date: 03/18/2014
• Status: Active Grant

• Current Assignee: Monteris Medical Incorporated (Monteris Medical US, Inc.)
• Original Assignee: Monteris Medical Incorporated (Monteris Medical US, Inc.)
• Inventors: Andrews, Eric, Grant, Mark, Ren, Brooke, Tyc, Richard
• Primary Examiner(s): NELSON, KERI JESSICA
• Application Number:
  US14/661,138
• Publication Number:
  US 20150265216A1
• Time in Patent Office: 538 Days
• Field of Search: 128/845, 128/846, 128/869, 600/410, 600414-417, 606/130, 560/1, 562/2, 563/7
• US Class Current: 1/1
• 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 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1739 specially adapted for particular parts of the body
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00321 Head or parts thereof
• CPC Class Codes: A61B 2018/00446 Brain
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/0293 using an instrument interstitially inserted into the body, e.g. needle
• CPC Class Codes: A61B 2018/1869 with an instrument interstitially inserted into the body, e.g. needles
• CPC Class Codes: A61B 2018/20361 with redirecting based on sensed condition, e.g. tissue analysis or tissue movement
• 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 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2090/103 Cranial plugs for access to brain
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/3954 : magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2576/026 : for the brain
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• 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 5/0035 : adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography
• CPC Class Codes: A61B 5/0042 : for the brain
• CPC Class Codes: A61B 5/01 : Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• 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 5/748 : Selection of a region of interest, e.g. using a graphics tablet
• CPC Class Codes: A61B 6/032 : Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/04 : Positioning of patients; Tiltable beds or the like operating tables A61G13/00; operating chairs A61G15/00
• CPC Class Codes: A61B 6/0421 : with immobilising means
• CPC Class Codes: A61B 6/0492 : using markers or indicia for aiding patient positioning
• 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: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61F 5/37 : Restraining devices for the body or for body parts , e.g. slings; Restraining shirts handcuffs E05B75/00
• CPC Class Codes: A61F 5/3707 : for the head cervical supports A61F5/055; splints A61F5/05883
• CPC Class Codes: A61N 2005/1051 : using an active marker
• CPC Class Codes: A61N 2005/1055 : using magnetic resonance imaging [MRI]
• CPC Class Codes: A61N 2005/1097 : Means for immobilizing the patient
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0047 : interstitial
• CPC Class Codes: A61N 2007/025 : interstitial
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent
• CPC Class Codes: A61N 5/1048 : Monitoring, verifying, controlling systems and methods
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 : intracavitary
• CPC Class Codes: G16H 30/40 : for processing medical images, e.g. editing

Abstract

In one aspect, the present disclosure relates to a head fixation apparatus including a number of support posts, and a curved ring portion including a number of connectors configured to adjustably and releasably mount support posts on the lower ring portion, such that the support posts are selectively mounted to a subset of the connectors in a customized arrangement for a patient. The apparatus may include a ring mount configured for fixation to a platform, including a curved channel substantially matching a curvature of the curved ring portion, and a mount locking mechanism for locking the curved ring portion within the channel of the ring mount. The curved ring portion may be configured to rotate within the channel of the ring mount while the ring mount is fixed to the platform, an angular head position of the patient being selectably adjustable while the patient is laying on the platform.

Claims

1. A head fixation apparatus comprising:

a plurality of support posts for supporting a head of a patient;

a curved ring portion including a lower ring portion, the curved ring portion comprising a plurality of connectors configured to adjustably and releasably mount the plurality of support posts on the lower ring portion, such that the plurality of support posts are selectively mounted to a subset of the plurality of connectors in a customized arrangement for the patient;

a ring mount configured for fixation to a platform, wherein the ring mount comprises a curved channel substantially matching a curvature of the curved ring portion; and

a mount locking mechanism for locking the curved ring portion mounted within the channel of the ring mount;

wherein,

the curved ring portion is configured to rotate within the channel of the ring mount while the ring mount is fixed to the platform, an angular head position of the patient being selectably adjustable while the patient is laying on the platform, and

the mount locking mechanism is configured to lockably engage the curved ring portion within the channel of the ring mount upon positioning of the angular head position of the patient.

2. The head fixation apparatus of claim 1, wherein the curved ring portion and the ring mount channel are semicircular.

3. The head fixation apparatus of claim 1 wherein the curved ring portion further comprises an upper ring portion including an upper locking mechanism, and

wherein the curved ring portion comprises a lower locking mechanism configured to mate with the upper locking mechanism such that the upper ring portion and the lower ring portion are adapted to encircle the head of the patient.

4. The head fixation apparatus of claim 3, wherein the upper ring portion comprises a nose indent in which a nose of the patient aligns when the head of the patient is positioned in the head fixation apparatus.

5. The head fixation apparatus of claim 3, wherein the lower locking mechanism is configured to engage with the upper locking mechanism at two or more mating positions to form a head fixation ring, and

wherein an interior area of the head fixation ring is adjustable.

6. The head fixation apparatus of claim 5, wherein one of the upper locking mechanism and the lower locking mechanism comprises a plurality of openings, and the other of the upper locking mechanism and the lower locking mechanism comprises a set screw.

7. The head fixation apparatus of claim 5, wherein one of the upper locking mechanism and the lower locking mechanism comprises a plurality of indents, and the other of the upper locking mechanism and the lower locking mechanism comprises a spring-loaded plunger.

8. The head fixation apparatus of claim 3, further comprising:

at least one additional upper ring portion, wherein one of the upper ring portion and the additional upper ring portion is selected based on a size of the head of the patient.

9. The head fixation system of claim 3, wherein the upper ring portion comprises a plurality of upper support posts, wherein each of the plurality of upper support posts comprises a respective fixation mechanism configured to fix a position of the head of the patient.

10. The head fixation apparatus of claim 1, wherein each of the plurality of support posts includes at least one connection point that releasably connects to a respective fixation mechanism that fixes a position of the head of the patient.

11. The head fixation apparatus of claim 10, wherein the respective fixation mechanism is one of a conforming abutment and a fixation pin.

12. The head fixation apparatus of claim 10, wherein each of the plurality of support posts includes a plurality of connection points, and

wherein positioning of the respective fixation mechanism upon the respective support post is adjustable.

13. The head fixation apparatus of claim 12, wherein the plurality of connection points are positioned upon each of the plurality of support posts in an arrangement providing at least one of a plurality of linear connection options and a plurality of radial connection options for connecting the respective fixation mechanism to the respective support post.

14. The head fixation apparatus of claim 1, wherein the mount locking mechanism comprises a clamp, and

wherein the angular head position is continuously adjustable by rotating the curved ring portion within the channel to a desired angular head position.

15. The head fixation apparatus of claim 1, wherein the curved ring portion comprises a plurality of mating features for mating with the mount locking mechanism.

16. A head fixation system for immobilizing a head of a patient, comprising:

a plurality of support posts, wherein each of the plurality of support posts includes a plurality of connection points for releasable connection of a respective fixation mechanism to fix a position of the head of the patient, such that positioning of the respective fixation mechanism upon the respective support post is adjustable; and

a curved ring portion including a lower ring portion, the curved ring portion comprising a plurality of connectors configured to adjustably and releasably mount the plurality of support posts on the lower ring portion, such that the plurality of support posts are selectively mounted to a subset of the plurality of connectors in a customized arrangement for a patient,

wherein the plurality of support posts are selectively positioned in a plurality of support post mounting slots arranged radially along the lower ring portion, to support the head of the patient.

17. The head fixation system of claim 16, further comprising:

a ring mount configured for fixation to a platform, wherein the ring mount comprises a curved channel substantially matching a curvature of the curved ring portion; and

a mount locking mechanism for locking the curved ring portion within the channel of the ring mount,

wherein the curved ring portion is configured to rotate within the channel of the ring mount while the ring mount is fixed to the platform, an angular head position of the patient being selectably adjustable while the patient is laying on the platform, and

wherein the mount locking mechanism is configured to lockably engage the curved ring portion within the channel of the ring mount upon positioning of the angular head position of the patient.

18. The head fixation system of claim 17, wherein the curved ring portion includes an upper ring portion configured to releasably mate with the lower ring portion to encircle the head of the patient, and

wherein at least one of the lower ring portion and the upper ring portion comprises at least one fiducial marker, such that, upon positioning the angular head position of the patient and lockably engaging the curved ring portion with the mount locking mechanism, the at least one fiducial marker identifies the angular head position within the channel of the ring mount.

19. The head fixation system of claim 18, further comprising:

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

identify, within one or more images, the at least one fiducial marker, and calculate, based upon a position of the at least one fiducial marker, an angle of rotation of the head fixation system.

20. The head fixation system of claim 19, wherein the one or more images comprise magnetic resonance (MR) images.

21. The head fixation system of claim 19, wherein the instructions, when executed, cause the processor to present a model on a graphical user interface, based upon the calculated angle of rotation of a patient positioning relative to a neurosurgical apparatus.