WO2001034050A9 - System for translation of electromagnetic and optical localization systems - Google Patents
System for translation of electromagnetic and optical localization systemsInfo
- Publication number
- WO2001034050A9 WO2001034050A9 PCT/US2000/041561 US0041561W WO0134050A9 WO 2001034050 A9 WO2001034050 A9 WO 2001034050A9 US 0041561 W US0041561 W US 0041561W WO 0134050 A9 WO0134050 A9 WO 0134050A9
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- navigation system
- navigation
- electromagnetic
- optical
- patient
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2055—Optical tracking systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2072—Reference field transducer attached to an instrument or patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0818—Redundant systems, e.g. using two independent measuring systems and comparing the signals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B2090/364—Correlation of different images or relation of image positions in respect to the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3983—Reference marker arrangements for use with image guided surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3995—Multi-modality markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
Definitions
- the present invention relates to localization of a position during surgery.
- the present invention relates more specifically to a system that facilitates combined electromagnetic and optical localization of a position during stereotactic surgery, such as brain surgery and spinal surgery.
- Stereotactic surgery minimizes invasiveness of surgical procedures by allowing a device to be guided through tissue that has been localized by preoperative scanning techniques, such as for example, MR, CT, ultrasound, fluoro and PET. Recent developments in stereotactic surgery have increased localization precision and helped minimize invasiveness of surgery.
- Stereotactic surgery is now commonly used in surgery of the brain. Such methods typically involve acquiring image data by placing fiducial markers on the patient's head, scanning the patient's head, attaching a headring to the patient's head, and determining the spatial relation of the image data to the headring by, for example, registration of the fiducial markers.
- Registration of the fiducial markers relates the information in the scanned image data for the patient's brain to the brain itself, and utilizes one-to-one mapping between the fiducial markers as identified in the image data and the fiducial markers that remain on the patient's head after scanning and throughout surgery. This is referred to as registering image space to patient space. Often, the image space must also be registered to another image space. Registration is accomplished through knowledge of the coordinate vectors of at least three non-collinear points in the image space and the patient space.
- point-to-point registration is accomplished by the user to identify points in image space and then touch the same points in patient space.
- surface registration involves the user's generation of a surface (e.g., the patient's forehead) in patient space by either selecting multiple points or scanning, and then accepting or rejecting the best fit to that surface in image space, as chosen by the processor.
- repeat fixation devices entail the user repeatedly removing and replacing a device in known relation to the fiducial markers. Such registration methods have additional steps during the procedure, and therefore increase the complexity of the system and increase opportunities for introduction of human error.
- scanners provide valuable information for stereotactic surgery, improved accuracy in defining the position of the target with respect to an accessible reference location can be desirable.
- Inaccuracies in defining the target position create inaccuracies in placing a therapeutic probe.
- One method for attempting to limit inaccuracies in defining the target position involves fixing the patient's head to the scanner to preserve the reference. Such fixation may be uncomfortable for the patient and creates other inconveniences, particularly if surgical procedures are involved. Consequently, a need exists for a system utilizing a scanner to accurately locate positions of targets, which allows the patient to be removed from the scanner.
- Stereotactic surgery utilizing a three-dimensional digitizer allows a patient to be removed from the scanner while still maintaining a high degree of accuracy for locating the position of targets.
- the three-dimensional digitizer is used as a localizer to determine the intra-procedural relative positions of the target.
- Three-dimensional digitizers may employ optical, acoustic, electromagnetic or other three-dimensional navigation technology for navigation through the patient space.
- electromagnetic navigation systems do not require line-of-sight between the tracking system components.
- electromagnetic navigation is beneficial for laproscopic and percutaneous procedures where the part of theinstrument tracked cannot be kept in the line-of sight of the other navigation system components.
- electromagnetic navigation allows a tracking element to be placed at the tip of an instrument, electromagnetic navigation allows the use of non-rigid instruments such as flexible endoscopes.
- use of certain materials in procedures employing electromagnetic tracking is disadvantageous since certain materials could affect the electromagnetic fields used for navigation and therefore affect system accuracy.
- optical navigation systems have a larger working volume than electromagnetic navigation systems, and can be used with instruments having any material composition.
- the nature of optical navigation systems does not accommodate tracking system components on any portion of an instrument to be inserted into the patient's body.
- optical navigation systems typically track portions of the system components that are in the system's line of sight, and then determine the position of any non-visible portions of those components based on system parameters.
- an optical navigation system can track the handle of a surgical instrument but not the inserted tip of the surgical instrument, thus the navigation system must track the instrument handle and use predetermined measurements of the device to determine where the tip of the instrument is relative to the handle. This technique cannot be used for flexible instruments since the relation between the handle and the tip varies.
- Stereotactic surgery techniques are also utilized for spinal surgery, in order to increase accuracy of the surgery and minimize invasiveness. Accuracy is particularly difficult in spinal surgery and must be accommodated in registration and localization techniques utilized in the surgery.
- the vertebra Prior to spinal surgery, the vertebra are scanned to determine their alignment and positioning. During imaging, scans are taken at intervals through the vertebra to create a three- dimensional pre-procedural data set for the vertebra.
- the patient must be moved to the operating table, causing repositioning of the vertebra.
- the respective positions of the vertebra may shift once the patient has been immobilized on the operating table because, unlike the brain, the spine is not held relatively still by a skull-like enveloping structure. Even normal patient respiration may cause relative movement of the vertebra.
- Computer processes discriminate the image data retrieved by scanning the spine so that the body vertebra remain in memory. Once the vertebra are each defined as a single rigid body, the vertebra can be repositioned with software algorithms that define a displaced image data set. Each rigid body element has at least three fiducial markers that are visible on the pre-procedural images and accurately detectable during the procedure. It is preferable to select reference points on the spinous process that are routinely exposed during such surgery.
- the system comprises a first surgical navigation system defining a first patient space, a second surgical navigation system defining a second patient space, and a translation device to register the coordinates of the first patient space to the coordinates of the second patient space.
- the translation device comprises a rigid body, at least one component for a first navigation system placed in or on the rigid body, and at least one component for a second navigation system placed in or on the rigid body, in known relation to the at least one component for the first navigation system.
- the translation device is positioned in a working volume of each of the at least two navigation systems.
- Figure 1 is a schematic diagram illustrating an embodiment of the system that facilitates combined electromagnetic and optical localization of a position du ⁇ ng stereotactic surgery according to the present invention
- Figure 2 illustrates a top view of a first embodiment of an optical-to-electromagnetic translation device
- Figure 3 illustrates a schematic perspective view of a second embodiment of an optical- to-electromagnetic translation device
- Figure 4 illustrates a schematic perspective view of a third embodiment of an optical-to- electromagnetic translation device
- Figure 5 illustrates a schematic perspective view of a fourth embodiment of an optical-to- electromagnetic translation device.
- the present invention contemplates a system for stereotactic surgery comprising a first surgical navigation system defining a first patient space, a second surgical navigation system defining a second patient space, a translation device to register (correlate the coordinates of) the first patient space to the second patient space, and an image data set generated from a scanning device that defines an image space.
- the image space is registered to at least one of the first and second patient spaces.
- FIG. 1 An exemplary embodiment of the system 10 of the present invention is illustrated in Figure 1.
- the system of the present invention will be discussed hereinafter with respect to a an optical navigation system in combination with an electromagnetic navigation system. However, the present invention similarly contemplates combining any two navigation systems including optical, acoustic, electromagnetic, or conductive.
- the system illustrated in Figure 1 includes a first navigation system that is optical.
- Elements of the optical navigation system include at least one optical element, and an optical receiving array 40 in line-of-sight communication with the optical element and in communication with a computer system 50.
- the optical element can either generate an optical signal independently or alternatively generate an optical signal by reflecting a signal received from an optical signal source.
- the line-of-sight of the optical receiving array defines a "working volume" of the optical system, which is the space in which the optical system can effectively navigate.
- At least one optical element is placed on a translation device.
- preferably at least three non-collinear optical elements are utilized by the system in order to obtain six degrees of freedom location and orientation information from the optical elements.
- the present invention also contemplates the use of more than one translation device for registration of different navigation systems.
- more than one translation device could be used for redundant registration of two navigation systems in order to obtain increased accuracy of registration.
- one translation device could be used to register (i.e., correlate the coordinates of) all three navigation systems, or one translation device could be used to register the first and second navigation systems while another translation device registered the second and third navigation systems.
- a dynamic translation device can be incorporated into a medical instrument 60 for use in the surgical procedure being navigated.
- the medical instrument 60 includes a handle 62, a tip portion 64 and a localization frame 66.
- At least three collinear optical elements 70 are placed on the localization frame for communication with the optical receiving array 40.
- the optical receiving array 40 sends a signal to the computer system 50 indicating the current position of the medical instrument 60.
- a translation device can also be incorporated into a rigid static translation device 100 that is added to the optical and electromagnetic navigation system working spaces specifically to register (i.e., correlate the coordinates of) the optical navigation system to the electromagnetic navigation system.
- the static translation device may have any configuration allowing optical elements 110 to be placed in such a manner to define six degrees of freedom in the optical system (e.g., three non-collinear optical elements).
- this embodiment provides a suitable translation device, it also adds undesirable complexity to the navigation systems by requiring the navigation systems to receive input from and identify an additional structure in their working volume.
- a translation device can also be incorporated into the operating table.
- Optical elements 85 defining six degrees of freedom in the optical system are placed on the operating table in such a manner that they will remain in the line-of-sight of the optical receiving array 40 du ⁇ ng the procedure
- a dynamic translation device can further be incorporated into one or more of the optical elements 20 placed on the patient 30 (or mounted to the patient via a frame)
- optical elements 20, 70 may be placed on the patient 30 or on the medical instrument 60 for tracking movement of the patient 30 and/or the medical instrument 60 du ⁇ ng the procedure, even if the optical elements 20, 70 on the patient 30 and the medical instrument 60 are not used as translation devices
- the system of the present invention also includes a second navigation system.
- the second navigation system is electromagnetic
- any translation device also has at least one component for the electromagnetic navigation system that is in known relationship to the optical elements placed on the device.
- the known relation of the optical and electromagnetic elements is received by the computer system 50 so that the computer system can generate a translation mat ⁇ x for registration (i.e., correlation of the coordinates) of the optical and electromagnetic navigation systems
- Elements of the illustrated electromagnetic navigation system include an electromagnetic element 90 (e.g., a sensor having at least one coil 92), and a magnetic field generator In the embodiment shown in Figure 1, the magnetic field generator is provided in the operating table 80.
- the magnetic field generator in the operating table 80 serves as the electromagnetic element on the translation device when placed in known relation to the optical elements 85 placed on the table 80.
- the known relation of the optical and electromagnetic elements is received by the computer system 50 so that the computer system can generate a translation matrix for correlation of the optical and electromagnetic navigation system coordinates.
- the electromagnetic element 90 is preferably a sensor having at least one coil 92.
- the sensor includes two coils 92 that are placed perpendicular to each other to create a sensor having six degrees of freedom.
- the sensor is placed in or on the localization frame 66 in known relation to the optical elements 70.
- the known relation of the optical and electromagnetic elements is received by the computer system 50 so that the computer system can generate a translation matrix for correlation of the optical and electromagnetic navigation system coordinates.
- the electromagnetic element 90 is preferably a sensor as described above with respect to Figure 2, placed in or on the rigid static device 100 in known relation to the optical elements 110.
- the known relation of the optical and electromagnetic elements is received by the computer system 50 so that the computer system can generate a translation matrix for correlation of the optical and electromagnetic navigation system coordinates.
- the electromagnetic element 90 is preferably a sensor as described above with respect to Figure 2.
- the sensor is preferably placed in or on the base 25 in known relation to the optical element 20
- the known relation of the optical and electromagnetic elements is received by the computer system 50 so that the computer system can generate a translation matrix for co ⁇ elation of the optical and electromagnetic navigation system coordinates
- the embodiment of Figure 5 shows the electromagnetic element being integrated with the optical element, the electromagnetic element may alternatively be attached to or interchanged with the optical element 20 placed on the patient 30 (or mounted to the patient via a frame)
- an electromagnetic element 90 may be placed on the patient 30 or on the medical instrument 60 for tracking movement of the patient 30 and or the medical instrument 60 during the procedure, e ⁇ en if the electromagnetic element 90 on the patient 30 and the medical instrument 60 is not used as translation devices
- fiducial markers are placed on the patient's head and the patient's head is scanned using, for example, a MR, CT, ultrasound, fluoro or PET scanner
- the scanner generates an image data set including data points corresponding to the fiducial markers
- the image data set is received and stored by the computer system
- the navigation systems track movement of the patients head and movement of the medical instrument Since the medical instrument is used as the translation device, both optical and electromagnetic navigation system elements are placed on the medical instrument and both the optical and electromagnetic systems track movement of the medical instrument
- optical or electromagnetic navigation system elements must be placed on the patient's head
- optical elements are placed on the patient's head Since the optical navigation system is tracking movement of the patient's head, the optical na igation system's patient space must be registered to the image space defined by the pre-operative scan
- the electromagnetic navigation system patient space After the optical navigation system patient space has been registered to the image space, the electromagnetic navigation system patient space must be registered to the optical navigation system patient space Having a known relation between the electromagnetic and optical elements in the medical instrument allows the computer to use a translation mat ⁇ x to register the optical navigation system patient space to the electromagnetic navigation system patient space Thus, the electromagnetic navigation patient space is registered to the image space
- the medical instrument has a ⁇ gid design
- knowing the dimensions of the medical instrument and the o ⁇ entation and location of the localization frame 66 allows the computer system to determine the position of the tip of the medical instrument
- merely knowing the location and o ⁇ entation of the localization frame 66 by tracking the position of the optical and electromagnetic elements cannot allow the computer to determine the position of the tip 64 of the medical instrument
- optical navigation systems are line-of-sight navigation systems and therefore do not allow direct tracking of the tip of a probe once it has been inserted into the patient (because the tip is out of the ne-of sight of the optical receiving array)
- electromagnetic navigation systems do not require line-of-sight and therefore can track the location and o ⁇ entation of the inserted tip of even a non- ⁇ gid medical instrument
- an electromagnetic element 90 is placed in the tip portion 64 of the medical instrument and is tracked by the electromagnetic navigation system Since the electromagnetic navigation system patient space has been registered to the image space, movement of the tip of the medical instrument within the patient's brain (within the image space) can be tracked
- the present invention allows increased accuracy and flexibility for users by utilizing the features of multiple navigation system to their respective advantages
- utilizing multiple navigation systems often increases the overall working volume du ⁇ ng the procedure
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10083670T DE10083670B4 (en) | 1999-10-28 | 2000-10-26 | System for the translation of electromagnetic and optical position measuring systems |
AU26178/01A AU2617801A (en) | 1999-10-28 | 2000-10-26 | System for translation of electromagnetic and optical localization systems |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/429,568 | 1999-10-28 | ||
US09/429,568 US6235038B1 (en) | 1999-10-28 | 1999-10-28 | System for translation of electromagnetic and optical localization systems |
Publications (3)
Publication Number | Publication Date |
---|---|
WO2001034050A2 WO2001034050A2 (en) | 2001-05-17 |
WO2001034050A3 WO2001034050A3 (en) | 2001-11-08 |
WO2001034050A9 true WO2001034050A9 (en) | 2001-12-06 |
Family
ID=23703800
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/US2000/041561 WO2001034050A2 (en) | 1999-10-28 | 2000-10-26 | System for translation of electromagnetic and optical localization systems |
Country Status (4)
Country | Link |
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US (2) | US6235038B1 (en) |
AU (1) | AU2617801A (en) |
DE (1) | DE10083670B4 (en) |
WO (1) | WO2001034050A2 (en) |
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1999
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-
2000
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- 2000-10-26 AU AU26178/01A patent/AU2617801A/en not_active Abandoned
- 2000-10-26 DE DE10083670T patent/DE10083670B4/en not_active Expired - Lifetime
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2001
- 2001-03-13 US US09/803,977 patent/US6402762B2/en not_active Expired - Lifetime
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US8989842B2 (en) | 2007-05-16 | 2015-03-24 | General Electric Company | System and method to register a tracking system with intracardiac echocardiography (ICE) imaging system |
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US6235038B1 (en) | 2001-05-22 |
WO2001034050A3 (en) | 2001-11-08 |
DE10083670B4 (en) | 2006-09-28 |
AU2617801A (en) | 2001-06-06 |
US6402762B2 (en) | 2002-06-11 |
WO2001034050A2 (en) | 2001-05-17 |
DE10083670T1 (en) | 2002-03-14 |
US20010011175A1 (en) | 2001-08-02 |
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