Catheterscope 3D guidance and interface system

• US 9,554,729 B2
• Filed: 11/24/2015
• Issued: 01/31/2017
• Est. Priority Date: 12/12/2003
• Status: Active Grant

• Current Assignee: University of Washington
• Original Assignee: University of Washington
• Inventors: Soper, Timothy D., Glenny, Robb W., Seibel, Eric J.
• Primary Examiner(s): Sweet, Thomas J
• Assistant Examiner(s): NEWTON, ALEXANDRA L
• Application Number:
  US14/951,279
• Publication Number:
  US 20160073928A1
• Time in Patent Office: 434 Days
• Field of Search: 600/101, 600/103, 600/109, 600117-118, 600/424
• US Class Current: 1/1
• CPC Class Codes: A61B 1/000096 using artificial intelligence
• CPC Class Codes: A61B 1/00016 using wireless means
• CPC Class Codes: A61B 1/00045 Display arrangement
• CPC Class Codes: A61B 1/00172 with means for scanning
• CPC Class Codes: A61B 1/005 Flexible endoscopes
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• 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 5/065 Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/066 Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal

Abstract

Visual-assisted guidance of an ultra-thin flexible endoscope to a predetermined region of interest within a lung during a bronchoscopy procedure. The region may be an opacity-identified by non-invasive imaging methods, such as high-resolution computed tomography (HRCT) or as a malignant lung mass that was diagnosed in a previous examination. An embedded position sensor on the flexible endoscope indicates the position of the distal tip of the probe in a Cartesian coordinate system during the procedure. A visual display is continually updated, showing the present position and orientation of the marker in a 3-D graphical airway model generated from image reconstruction. The visual display also includes windows depicting a virtual fly-through perspective and real-time video images acquired at the head of the endoscope, which can be stored as data, with an audio or textual account.

Claims

1. A method for visually guiding a flexible endoscope through linked passages within a patient'"'"'s body, the method comprising:

providing the flexible endoscope to guide through the linked passages within the patient'"'"'s body;

determining positions of branching points of a three-dimensional model of the linked passages;

using the flexible endoscope to generate a current view from within the linked passages as the flexible endoscope is advanced therethrough;

producing an output signal at a distal end of the flexible endoscope, the output signal indicating coordinates that define a three-dimensional disposition of the distal end of the flexible endoscope relative to the three-dimensional model as the flexible endoscope is advanced;

displaying the current view from within the linked passages and a current position of the flexible endoscope relative to the three-dimensional model of the linked passages, wherein the current position is determined from the output signal;

advancing the distal end of the flexible endoscope through the linked passages along a path determined at least in part by the current view and the current position; and

updating the three-dimensional model based on the coordinates indicated by the output signal in response to the flexible endoscope being advanced beyond a limit of the three-dimensional model.

2. The method of claim 1, further comprising imaging a region of the linked passages using the flexible endoscope so as to generate image data thereof.

3. The method of claim 2, further comprising modifying the three-dimensional model based on the image data.

4. The method of claim 3, wherein modifying the three-dimensional model based on the image data comprises mapping the image data to the three-dimensional model.

5. The method of claim 2, wherein imaging the region of the linked passages comprises driving an optical fiber in order to scan light onto the region of the linked passages.

6. The method of claim 1, further comprising identifying bifurcations of the three-dimensional model based on the current view from within the linked passages in order to confirm alignment of the three-dimensional disposition of the distal end with the three-dimensional model.

7. The method of claim 1, wherein producing the output signal comprises transmitting an electromagnetic signal that penetrates the patient'"'"'s body, the electromagnetic signal providing a three-dimensional reference for determining the current position of the distal end of the flexible endoscope relative to the linked passages, as indicated by the output signal.

8. The method of claim 7, wherein producing the output signal further comprises determining the current position of the distal end of the flexible endoscope relative to the linked passages using the three-dimensional reference provided by the electromagnetic signal.

9. The method of claim 1, further comprising providing the three-dimensional model of the linked passages for use in tracking the three-dimensional disposition of the distal end of the flexible endoscope.

10. The method of claim 9, wherein providing the three-dimensional model comprises:

(a) non-invasively imaging the patient'"'"'s body where the linked passages are disposed, thereby generating an image of the linked passages within the patient'"'"'s body; and

(b) producing the three-dimensional model from the image of the linked passages within the patient'"'"'s body.

11. The method of claim 10, wherein advancing the distal end comprises:

(a) establishing an arbitrary reference point relative to the three-dimensional model for use in determining a path through the linked passages to a desired location;

(b) with regard to the arbitrary reference point, establishing three-dimensional model frame coordinates for bifurcations in the linked passages and the desired location; and

(c) determining at least a portion of the path through the linked passages to the desired location, by reference to the three-dimensional model frame coordinates and by visually detecting each bifurcation as the distal end of the flexible endoscope is advanced through the linked passages.

12. The method of claim 11, wherein advancing the distal end further comprises:

(a) displaying a graphic image of the three-dimensional model; and

(b) indicating the current position of the distal end of the flexible endoscope on the graphic image.

13. The method of claim 12, wherein advancing the distal end further comprises:

(a) plotting the path of the distal end of the flexible endoscope as a virtual fly-through of the three-dimensional model before advancing the flexible endoscope through the linked passages; and

(b) resolving a direction to take at each bifurcation of the linked passages in the graphic image that is displayed in real-time as the flexible endoscope is advanced through the linked passages, using the model and through direct comparison of the path that was plotted with the current position of the distal end of the flexible endoscope indicated on the graphic image.

14. The method of claim 1, further comprising displaying the three-dimensional model in order to enable determining at least an initial path along which to advance the flexible endoscope through the linked passages.

15. The method of claim 1, wherein the three-dimensional model is derived from an image of a portion of the patient'"'"'s body in which the linked passages are disposed, the three-dimensional model providing an indication of an orientation and a disposition of the linked passages relative to a specific anatomical feature.

16. The method of claim 1, wherein the output signal is produced using a signal source and a sensor, the signal source comprising an electromagnetic field source, wherein the signal source and sensor together comprise at least five coils configured to sense at least a three-dimensional position of the flexible endoscope relative to the electromagnetic field source.

17. The method of claim 16, wherein the sensor comprises at least one coil configured to sense both a three-dimensional position and an orientation of the distal portion of the flexible endoscope.

18. The method of claim 1, further comprising monitoring at least one body function of the patient, the at least one body function comprising one or more of breathing, a chest orientation, or a deformation of the linked passages.

19. The method of claim 18, further comprising at least one of:

updating the three-dimensional model in response to changes in the at least one body function or gating a determination of a disposition of the distal end of the flexible endoscope in response to the at least one body function.

20. The method of claim 1, wherein the flexible endoscope is sized to be advanced through an 8th generation bronchiole in a patient'"'"'s lung.