[go: up one dir, main page]

WO2010055193A1 - Dispositifs de poursuite pour navigation optique d'outils guidés par image - Google Patents

Dispositifs de poursuite pour navigation optique d'outils guidés par image Download PDF

Info

Publication number
WO2010055193A1
WO2010055193A1 PCT/FI2008/050658 FI2008050658W WO2010055193A1 WO 2010055193 A1 WO2010055193 A1 WO 2010055193A1 FI 2008050658 W FI2008050658 W FI 2008050658W WO 2010055193 A1 WO2010055193 A1 WO 2010055193A1
Authority
WO
WIPO (PCT)
Prior art keywords
tracking
radiation
reflectors
enclosure
tracking apparatus
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/FI2008/050658
Other languages
English (en)
Inventor
Jarmo Ruohonen
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Nexstim Oyj
Original Assignee
Nexstim Oyj
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Nexstim Oyj filed Critical Nexstim Oyj
Priority to PCT/FI2008/050658 priority Critical patent/WO2010055193A1/fr
Publication of WO2010055193A1 publication Critical patent/WO2010055193A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A61B2017/00907—Material properties transparent or translucent for light
    • 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
    • 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
    • A61B2090/3937—Visible 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
    • A61B90/39—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
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N2/00—Magnetotherapy
    • A61N2/004—Magnetotherapy specially adapted for a specific therapy
    • A61N2/006—Magnetotherapy specially adapted for a specific therapy for magnetic stimulation of nerve tissue

Definitions

  • the present invention relates to image-guided placement of tools in medical procedures.
  • this invention relates to tracking tools used for measurement or research of biological tissue, and for therapy thereof, by stimulating the tissue electromagnetically.
  • Another particular field of interest for the invention is image-guided surgery, where a surgical or biopsy tool or is guided to the tissue based on tomographic images.
  • the present invention relates to what is stated in the preamble portion of the independent claims.
  • Biological tissue can be stimulated using electromagnetic pulses. This is beneficial for measuring the condition of the patient or for therapeutic purposes.
  • One application is transcranial magnetic stimulation (TMS), where an electromagnetic pulse is generated by a current-carrying coil placed over the head. The pulse has the capacity to stimulate neu- rons in the brain.
  • TMS transcranial magnetic stimulation
  • the resulting neuronal stimulation depends on the characteristics of the applied electromagnetic field; important characteristics include the field strength, its vector direction with respect to the stimulated neurons, and the pulse shape and length. Therefore, in TMS it is important to be fully aware of the location and orientation of the stimulating coil with respect to the head. Image-guidance tools are used for this purpose.
  • Image-guidance refers to the application of tools with respect to anatomical structures in the human body on the one hand, and to tomographic images of the body on the other.
  • the tomographic images are acquired by using magnetic resonance imaging, computed tomography, ultrasound or other techniques.
  • a tool is then placed into the tissue with the help of 3D stereotactic tracking.
  • the tomographic images are first co- registered to the living body, thereby creating a virtual 3D world on a computer screen with the tool visible as on overlay on the anatomical images.
  • the operator is capable of placing and orienting the tool in the desired location within the body.
  • a particular field of interest related to image-guidance in the scope of this invention is stereotactic guidance of non- invasive nerve stimulation to the human body. This can be done by a changing magnetic field that induces a stimulating electric field in the tissue.
  • magnetic nerve stimulation is capable of trigger- ing activity in neurons in selected parts of the brain.
  • Image-guided method of magnetic stimulation is particularly useful for mapping cortical functions and for detecting changes in the neuronal excitability due to disorders, trauma etc.
  • the surgical intervention can be a biopsy, where a biopsy needle is placed, e.g., into a location of the body where MRI shows contrast-enhancement possibly related to a cancerous tissue.
  • the intervention can also be a resection of tissue.
  • Image- guided surgeries are performed everywhere in the body.
  • a frequently used tool for stereotactic localization is an optical tracking unit.
  • Optical tracking units send infrared light and measure, using CCD cameras, the light that is reflected back by a plurality of reflectors.
  • the reflectors are placed on the tools that are to be tracked. Traditionally, these reflectors are plastic spheres with reflective surface mate- rial.
  • the reflectors are conventionally placed accurately in predefined geometry and at least 3 reflectors are needed to determine the location and orientation of the tool with respect to the tracking unit.
  • a reference tracker equipped with three to four reflectors is placed on the forehead of a subject, and a set of three to 12 or more reflectors are placed on the stimulating coil.
  • the tracking unit then sends the coordinates and orientations of the reference tracker and the coil to a computer.
  • a commercially available NDI Polaris Spectra (also Vicra) unit locates tools by measuring the location of infrared- reflecting spheres. At least three of these spheres are attached to a tool, such as transcranial magnetic stimulation coil, in a known geometry. The system then can measure the 3D location with 6 degrees of freedom with respect to the localization unit.
  • the present invention is based on a tracking apparatus that has a plurality of reflectors attached to the subject of tracking, i.e. the tool, such as a stimulator coil.
  • the tracking apparatus further has at least one tracking unit having means for emitting and receiving radiation and also being able to locate the plurality of reflectors with aid of the tracking radiation.
  • the plurality of reflectors is enclosed in an enclosure that is made of shielding material essentially transparent to the tracking radiation.
  • the invention is characterized by what is stated in the characterizing portion of the independent claim 1.
  • the reflector spheres are protected by an enclosure, they are not exposed to everyday wearing making them more robust and their maintenance easier while not compromising tracking accuracy. Since the enclosure is made of protective material, it receives all the wearing leaving the reflectors undamaged. According to one embodiment of the invention, further advantages can be gained by making the enclosure of a material such as acryl or plexiglass that is easy to clean and maintain, which improves already enhanced maintenance.
  • the reflector spheres are fitted within a tube-like enclosure, which improves the visibility of the reflectors while there is reduced need for complex supporting structures impeding visibility. Therefore a tracker can be constructed with at least 3 reflectors always visible in each orientation and location of the tool. In addition, the described arrangement requires less reflector spheres compared to conventional apparatuses.
  • the invention enables the above-mentioned solutions and advantages to be obtained also in other medical applications utilizing 3D optical localization.
  • Fig. 1 shows a traditional stimulator coil with exposed reflectors.
  • Fig. 2 shows a stimulator coil according to the invention with enclosed reflectors.
  • Fig. 3 shows the trajectory of the enclosure according to one embodiment of the invention.
  • Fig. 4 shows an overview of a tracking system according to prior art.
  • a plurality of reflectors 2 has traditionally been attached to tools, such as a stimulator coil 1, without shielding structures.
  • tools such as a stimulator coil 1, without shielding structures.
  • at least three reflectors are usually required.
  • the three reflectors must naturally not be aligned on the same imaginary straight line.
  • the more trackers are coupled to the object of tracking 1, the more accurate information can be gathered about the location and position of the object.
  • a stimulator coil 1 has been equipped with 12 reflectors 2 to provide a sufficient amount of vital tracking information assisting with firing stimulating pulses to the correct part of the patient's brain in the right angle.
  • a large number of reflectors 2 is needed for ensuring that at least one reflector 2 is always visible to the detecting device regardless of the position and orientation of the tool 1 under observation.
  • the reflectors 2 are usually spherical plastic protuberances equipped with a reflecting surface, similar to retrorefiecting material used in reflective stripes found on high- visibility jackets, for example.
  • the reflectors 2 are therefore adapted to reflect tracking radiation emitted by at least one tracking unit 4.
  • These tracking units 4 emit radiation, such as infrared radiation, which is reflected back to the units.
  • An often used tracking unit 4 is the Polaris Passive, or Spectra or Vicra Optical Tracking Unit manufactured by Northern Digital Inc. (Canada). Based on the emitted and received radiation pattern, the tracking units 4 (Fig. 4) are able to conclude the location and position of the object of tracking. This naturally requires establishing a fixed pattern of reflectors 2 so that the reflected radiation pattern is unequivocal.
  • the tracking unit 4 then sends the coordinates and orientations of the tracking object to a computer 7, or a suchlike data processor.
  • the system can then measure the 3D location with 6 degrees of freedom with respect to the tracking unit.
  • the reflectors 2 are vulnerable to wear and tear because they are exposed to superficial damages caused by everyday use. Wearing of the reflecting surface of the reflectors 2 impede their ability to reflect tracking radiation, which compromises the whole tracking process.
  • an enclosure is provided according to the present invention. As illustrated in Fig. 2, the reflectors 2 of the stimulator coil 1 are enclosed in a shielding enclosure 3. According to one embodiment, a similar enclosed reflector arrangement is also provided for the patient.
  • the enclosure 3 is made of shield- ing material, such as acryl glass. The material material is preferably suitable for cleaning, disinfection or sterilization through application of heat, chemicals, irradiation, high pressure or filtration, or their combination.
  • the material shall also be essentially transparent to the tracking radiation 5 emitted by the tracking unit 4.
  • essentially transparent material is adapted to allow at least 50 % of the radiation in ques- tion to permeate.
  • the enclosure 3 protects reflectors 2 from wearing while letting tracking radiation 5 through.
  • the enclosure 3 lets at least 85 per cent of the tracking radiation 5 through to the reflectors 2.
  • the wall thickness of the enclosure 3 is preferably as thin as possible to avoid excess weight making the structure light and easy to operate.
  • the suitable thickness varies with the geometrical shape of the tracker. The thickness can vary along the length of the tracker. The farther off the enclosure 3 is adapted from the reflectors 2, the thicker its surface can be. As a rule of thumb, the wall thickness near the reflectors 2 can vary between 0.5 and 5 mm.
  • the material and its thickness should be such that the radiated light does not significantly refract in the material.
  • Refraction bends the light and can in- troduce errors in the localization.
  • Snell's law of refraction can be used to choose the material and the wall thickness.
  • the deflection y of the light rays in a material of thickness x, and refractory index of n, can be estimated as:
  • ⁇ ⁇ i - ⁇ 2 , with ⁇ i as the incidence angle.
  • the wall thickness of 3 mm would result in 0.55 mm error in localization due to the enclosure.
  • the trackers may be equipped with an enclosure 3 conforming to allowable error tolerances described above.
  • the surface shape of the protective enclosure is circular in shape when the reflectors are spherical in shape.
  • a tube-like structure is one solution, which limits refraction in one direction and thereby allows use of thicker wall of the protective enclosure.
  • At least three, preferably four, spherical reflectors 2 are attached to a stimulator coil 1.
  • the reflectors 2 are fitted within a tube- like enclosure 3 having a circular cross-section.
  • the plurality of reflectors 2 is required for the tracking unit 4 to determine the locations of the stimulator coil 1 for all rotation angles.
  • the reflectors 2 may also be fitted into a large essentially transparent enclosure of another shape.
  • the casing can be a prism accommodating the reflectors 2 in such a manner that the sphere locations appear the same from all directions, i.e., light refraction is minimized.
  • the coating can be used on the surface of the enclosure to reduce reflection of the infrared light of the tracking unit.
  • the coating naturally needs to be essentially transparent to the IR radiation.
  • the enclosure can be made of composite materials, or even of compos- ite materials where one part has positive refractory index and the other part has negative refractory index, whereby the refractoriness of the enclosure is further limited, preferably cancelled out.
  • the outer surface of the enclosure 3 is coated with an antireflective material, whereby the tracking radiation is further prevented from reflecting away from the tool 1.
  • tracking radiation 5 is emitted and received with a tracking unit 4 as described above and based on the received radiation 5 pattern, the position of the tool 1 is computed. This naturally requires first establishing, how the reflectors 2 are positioned relative to the tool 1.
  • reflectors are attached to a TMS coil and a patient under treatment.
  • the tracking radiation 5, such as infrared light is reflected by the reflectors through an enclosure 3 that is essentially permeable to the radiation 5.
  • essentially permeable is meant that the material in question is adapted to allow at least 50 % of the radiation in question to permeate.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Radiation-Therapy Devices (AREA)

Abstract

L'invention porte sur un appareil de poursuite destiné à la navigation optique d'outils guidés par image, l'appareil comprenant une pluralité de réflecteurs (2) fixés à l'objet de la poursuite (1) et au moins une unité de poursuite (4) comportant un moyen d'émission et de réception d'un rayonnement (5) et étant apte à déterminer la position de l'objet de la poursuite (1) par un rayonnement de poursuite à réflexion (5) sur les réflecteurs (2). L'appareil comprend également une enceinte (3) apte à renfermer la pluralité de réflecteurs (2) et constituée d'un matériau de protection fondamentalement transparent au rayonnement de poursuite (5).
PCT/FI2008/050658 2008-11-14 2008-11-14 Dispositifs de poursuite pour navigation optique d'outils guidés par image Ceased WO2010055193A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/FI2008/050658 WO2010055193A1 (fr) 2008-11-14 2008-11-14 Dispositifs de poursuite pour navigation optique d'outils guidés par image

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/FI2008/050658 WO2010055193A1 (fr) 2008-11-14 2008-11-14 Dispositifs de poursuite pour navigation optique d'outils guidés par image

Publications (1)

Publication Number Publication Date
WO2010055193A1 true WO2010055193A1 (fr) 2010-05-20

Family

ID=42169667

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/FI2008/050658 Ceased WO2010055193A1 (fr) 2008-11-14 2008-11-14 Dispositifs de poursuite pour navigation optique d'outils guidés par image

Country Status (1)

Country Link
WO (1) WO2010055193A1 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9993273B2 (en) 2013-01-16 2018-06-12 Mako Surgical Corp. Bone plate and tracking device using a bone plate for attaching to a patient's anatomy
US10531925B2 (en) 2013-01-16 2020-01-14 Stryker Corporation Navigation systems and methods for indicating and reducing line-of-sight errors
US10537395B2 (en) 2016-05-26 2020-01-21 MAKO Surgical Group Navigation tracker with kinematic connector assembly
US11832892B2 (en) 2019-07-10 2023-12-05 Mako Surgical Corp. Navigation systems for communicating tracker status conditions
US12059804B2 (en) 2019-05-22 2024-08-13 Mako Surgical Corp. Bidirectional kinematic mount
US12369988B2 (en) 2021-01-06 2025-07-29 Mako Surgical Corp. Tracker for a navigation system

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020198448A1 (en) * 2001-06-20 2002-12-26 Yuval Zuk Dual pointer device and method for surgical navigation
US20060140464A1 (en) * 2004-11-18 2006-06-29 Thomas Feilkas Transparent marker casing
EP1764059A1 (fr) * 2005-09-16 2007-03-21 Depuy International Limited Instrument navigable
WO2008031847A1 (fr) * 2006-09-13 2008-03-20 Nexstim Ltd. Procédé et appareil pour corriger une erreur dans le co-référencement de systèmes de coordonnées utilisés pour représenter des objets affichés pendant une stimulation du cerveau par navigation
WO2008091780A2 (fr) * 2007-01-25 2008-07-31 Warsaw Orthopedic, Inc. Visualisation intégrée d'informations de navigation chirurgicale et de surveillance neurale

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020198448A1 (en) * 2001-06-20 2002-12-26 Yuval Zuk Dual pointer device and method for surgical navigation
US20060140464A1 (en) * 2004-11-18 2006-06-29 Thomas Feilkas Transparent marker casing
EP1764059A1 (fr) * 2005-09-16 2007-03-21 Depuy International Limited Instrument navigable
WO2008031847A1 (fr) * 2006-09-13 2008-03-20 Nexstim Ltd. Procédé et appareil pour corriger une erreur dans le co-référencement de systèmes de coordonnées utilisés pour représenter des objets affichés pendant une stimulation du cerveau par navigation
WO2008091780A2 (fr) * 2007-01-25 2008-07-31 Warsaw Orthopedic, Inc. Visualisation intégrée d'informations de navigation chirurgicale et de surveillance neurale

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9993273B2 (en) 2013-01-16 2018-06-12 Mako Surgical Corp. Bone plate and tracking device using a bone plate for attaching to a patient's anatomy
US10531925B2 (en) 2013-01-16 2020-01-14 Stryker Corporation Navigation systems and methods for indicating and reducing line-of-sight errors
US10932837B2 (en) 2013-01-16 2021-03-02 Mako Surgical Corp. Tracking device using a bone plate for attaching to a patient's anatomy
US11369438B2 (en) 2013-01-16 2022-06-28 Stryker Corporation Navigation systems and methods for indicating and reducing line-of-sight errors
US11622800B2 (en) 2013-01-16 2023-04-11 Mako Surgical Corp. Bone plate for attaching to an anatomic structure
US12102365B2 (en) 2013-01-16 2024-10-01 Mako Surgical Corp. Bone plate for attaching to an anatomic structure
US12290321B2 (en) 2013-01-16 2025-05-06 Stryker Corporation Navigation systems and methods for indicating and reducing line-of-sight errors
US10537395B2 (en) 2016-05-26 2020-01-21 MAKO Surgical Group Navigation tracker with kinematic connector assembly
US11559358B2 (en) 2016-05-26 2023-01-24 Mako Surgical Corp. Surgical assembly with kinematic connector
US12059804B2 (en) 2019-05-22 2024-08-13 Mako Surgical Corp. Bidirectional kinematic mount
US11832892B2 (en) 2019-07-10 2023-12-05 Mako Surgical Corp. Navigation systems for communicating tracker status conditions
US12369988B2 (en) 2021-01-06 2025-07-29 Mako Surgical Corp. Tracker for a navigation system

Similar Documents

Publication Publication Date Title
CA2964494C (fr) Outil de reference de patient pour une inscription rapide
US11712307B2 (en) System and method for mapping navigation space to patient space in a medical procedure
US10993771B2 (en) Trackable apparatuses and methods
EP1795142B1 (fr) Système de suivi médical utilisant une camera pour les rayons gamma
ES2396029T3 (es) Métodos y sistemas para guiar instalaciones de radioterapia
US9649168B2 (en) Systems and methods for frameless image-guided biopsy and therapeutic intervention
RU2492884C2 (ru) Способ и устройство для отслеживания положения терапевтического ультразвукового преобразователя
WO2010055193A1 (fr) Dispositifs de poursuite pour navigation optique d'outils guidés par image
GB2556363A (en) Operating room safety zone
US10639503B2 (en) Handheld devices for projecting focused ultrasound and related methods
CA2811648A1 (fr) Procede et appareil destines a la chirurgie de l'implant cochleaire
CN105324155A (zh) 治疗过程中移动的管理系统和方法
CA2959222C (fr) Outil de reperage d'orifice d'acces
Boctor et al. Robotically assisted intraoperative ultrasound with application to ablative therapy of liver cancer
EP3234832B1 (fr) Procédé d'optimisation de la position d'une partie du corps d'un patient par rapport à une source d'imagerie
WO2014207622A1 (fr) Curiethérapie adaptative guidée par ultrasons
EP3796844B1 (fr) Déclenchement d'images radiographiques sur la base de mesures de surface
Xu et al. An efficient needle insertion robotics system for ultrasound-guided hepatic microwave coagulation therapy
Bucholz et al. Image-guided surgery
Vo-Dinh Image-Guided Surgery
Nizkovolos et al. PET in stereotactic neurosurgery

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 08878086

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 08878086

Country of ref document: EP

Kind code of ref document: A1