Method and system for guiding a diagnostic or therapeutic instrument towards a target region inside the patient's body

• US 20010041835A1
• Filed: 07/09/2001
• Published: 11/15/2001
• Est. Priority Date: 02/22/1999
• Status: Active Grant

• Current Assignee: Spectrum Dynamics Medical Ltd
• Original Assignee: Gal Ben-David, Yaron Front
• Inventors: Ben-David, Gal, Front, Yaron
• Granted Patent: US 6,567,687 B2
• Time in Patent Office: Days
• US Class Current: 600/429
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• 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 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/5235 combining images from the same or different ionising radiation imaging techniques, e.g. PET and CT
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 5/1049 for verifying the position of the patient with respect to the radiation beam

Abstract

Method and system are presented for guiding a diagnostic or therapeutic instrument towards a correct target inside the patient'"'"'s body. A combined image obtained by registering structural and functional images of at least a portion of the patient'"'"'s body including the target is used together with a guiding device. The guiding device has an indicator associated with the instrument, and is operable for presenting data indicative of a position of a location on the instrument relative to any other point in the at least portion of the patient'"'"'s body. The guiding device is connectable to a computer device displaying the combined image and operable thereby for guiding the instrument towards the target.

Claims

1. A method for guiding an instrument towards a correct target inside the patient'"'"'s body, the method comprising the steps of:

(i) providing an image of at least a portion of the patient'"'"'s body including said target, wherein said image presents a combined image of registered structural and functional images of said at least portion of the patient'"'"'s body;

(ii) providing data indicative of a position of a location on the instrument relative to any other point in said at least portion of the patient'"'"'s body;

and

(iii) directing the instrument to said target.

2. A method according to

claim 1

, wherein the registered structural and functional images used for providing the combined image are obtained with, respectively, structural and functional modalities.

3. A method according to

claim 2

, wherein the structural modality is Computed Tomography (CT).

4. A method according to

claim 2

, wherein said structural modality is Magnetic Resonance Imaging (MRI).

5. A method according to

claim 2

, wherein the functional modality is Single Photon Emission Computed Tomography (SPECT).

6. A method according to

claim 2

, wherein the functional modality is and Positron Emission Tomography (PET).

7. A method according to

claim 1

, wherein the structural and functional images used for providing said combined image are, respectively, of higher and lower resolution, as compared to each other.

8. A method according to

claim 1

, wherein at least one additional image of said at least portion of the patient'"'"'s body is acquired, and at least one additional combined image is obtained, while directing the instrument towards the target.

9. A method according to

claim 8

, wherein the combined image is provided by registering a high-resolution structural image with relatively low resolution functional image, and said at least one additional image is a low-resolution functional image.

10. A method according to

claim 8

, wherein the combined image is provided by registering a high-resolution structural image with relatively low resolution functional image, and said at least one additional image is a high-resolution structural image.

11. A method according to

claim 8

, wherein the combined image is provided by registering a low-resolution functional image with a low-resolution structural image, and said at least one additional image is a relatively high-resolution structural image.

12. A method according to

claim 1

, wherein the step (i) and (ii) comprise:

attaching a frame to the patient'"'"'s body in a rigidly secured position, the frame carrying an indicator in the form of at least three markers;

acquiring the structural image using a structural imaging modality, the acquired structural image including at least the portion of the patient'"'"'s body and at least one of the markers, thereby determining a position of any point in said structural image relative to the frame;

acquiring the functional image;

registering the acquired structural and functional images and providing said combined image showing a location of the target relative to other elements in the combined image;

rigidly attaching a stereotactic guide assembly to said frame, and determining a position of the target relative to the stereotactic guide.

13. A method for accessing a target in a patient'"'"'s body with an instrument, the method comprising the steps of:

(a) providing a guiding device having a frame to be secured to the patient and a stereotactic guide assembly, wherein the frame carries an indicator in the form of at least three markers;

(b) rigidly securing said frame to the patient;

(c) imaging at least a portion of the patient'"'"'s body including the target, using a structural imaging modality, to produce a structural image of the at least portion of the patient'"'"'s body, and acquiring a series of images to image all the markers and estimate their location in said structural image;

(d) imaging the at least portion of the patient'"'"'s body using a functional imaging modality to produce a functional image of the at least portion of the patient'"'"'s body; and

(e) registering the functional image with the structural image to produce a combined image,

(f) rigidly attaching said stereotactic guide assembly to said frame, and

(g) directing the instrument to the target, using the stereotactic guide, with reference to said markers as imaged in the combined image.

14. A system for guiding an instrument towards a correct target inside the patient'"'"'s body, the system comprising:

a computer device for displaying an image of at least a portion of the patient'"'"'s body including said target, wherein said displayed image presents a combined image of registered structural and functional images of said at least portion of the patient'"'"'s body;

a guiding device having an indicator associated with said instrument, said guiding device being operable for presenting data indicative of a position of a location on the instrument relative to any other point in said at least portion of the patient'"'"'s body, said guiding device being connectable to said computer device and operable thereby for directing the instrument to said target.

15. A system according to

claim 14

, wherein the guiding device comprises a frame attachable to the patient'"'"'s body and a stereotactic guide assembly attachable to the frame, said frame carrying said indicator in the form of at least three markers to be imaged in the combined image.

16. A system according to

claim 14

, wherein said guiding device is a position racking system capable of providing data indicative of six degrees of freedom for a movement of the instrument.

17. A system according to

claim 16

, wherein said position tracking system comprises a guiding reference unit providing data indicative of 3 position coordinates and 3 rotation angles of the indicator in the form of a sensor attached to the instrument, and a guiding controller connected to said computer device displaying the combined image.

18. A system according to

claim 17

, wherein the tracking system is of a magnetic type.

19. A system according to

claim 17

, wherein the tracking system is of an optical type.

20. A system according to

claim 14

, wherein the indicator comprises an identification chip attached to a handle-portion of the instrument, said identification providing information indicative of physical dimensions of the instrument.

21. A system according to

claim 14

, further comprising an additional imaging modality capable of acquiring at least one of structural and functional images of said at least portion of the patient'"'"'s body, said computer device being operable to use the at least one additional image for obtaining and displaying at least one additional combined image.

22. A system according to

claim 14

, wherein the indicator at a predetermined location thereon carries a highlight material of a kind to be imaged in at least one of structural and functional images.

23. A system according to

claim 22

, wherein said predetermined location is a distal end of the instrument, said highlight material being mixed with a therapeutic substance, thereby enabling treatment of the target with the therapeutic substance.