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WO2011138172A1 - Procédé pour la création de représentations de données médicales en 3d - Google Patents

Procédé pour la création de représentations de données médicales en 3d Download PDF

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Publication number
WO2011138172A1
WO2011138172A1 PCT/EP2011/056371 EP2011056371W WO2011138172A1 WO 2011138172 A1 WO2011138172 A1 WO 2011138172A1 EP 2011056371 W EP2011056371 W EP 2011056371W WO 2011138172 A1 WO2011138172 A1 WO 2011138172A1
Authority
WO
WIPO (PCT)
Prior art keywords
image
image data
patient
treatment
data set
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/EP2011/056371
Other languages
German (de)
English (en)
Inventor
Rainer Graumann
Gerhard Kleinszig
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.)
Siemens AG
Siemens Corp
Original Assignee
Siemens AG
Siemens Corp
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 Siemens AG, Siemens Corp filed Critical Siemens AG
Publication of WO2011138172A1 publication Critical patent/WO2011138172A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • A61B6/466—Displaying means of special interest adapted to display 3D data
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/46—Arrangements for interfacing with the operator or the patient
    • A61B6/461—Displaying means of special interest
    • A61B6/463—Displaying means of special interest characterised by displaying multiple images or images and diagnostic data on one display
    • 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
    • A61B90/37—Surgical systems with images on a monitor during operation
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/70—Determining position or orientation of objects or cameras
    • G06T7/73—Determining position or orientation of objects or cameras using feature-based methods
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
    • A61B2090/3762—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy using computed tomography systems [CT]
    • A61B2090/3764—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy using computed tomography systems [CT] with a rotating C-arm having a cone beam emitting source
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10072—Tomographic images
    • G06T2207/10088—Magnetic resonance imaging [MRI]
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/10—Image acquisition modality
    • G06T2207/10116—X-ray image
    • G06T2207/10121—Fluoroscopy
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30052—Implant; Prosthesis

Definitions

  • the invention relates to a method for generating medical 3D image data.
  • Medical image data are generated by a patient by imaging, ie examining, at least a part of the patient's body in the image data.
  • Image data are for example a two-dimensional (2D) x-ray image or a dreidi ⁇ -dimensional (3D) magnetic resonance image in the form of 3D image data or a 3D image data set. Is performed on the patient to me ⁇ dizinische treatment, the treatment usually takes place locally; eg in the context of an operation as
  • Treatment at the hip of the patient to be placed an implant Treatment at the hip of the patient to be placed an implant.
  • the hip region of the patient and their surroundings - sometimes even outside the patient - then represent the treatment goal in the patient.
  • Relevant medical measures eg the provision of instruments or implants or the actual intervention in the body of the patient, are carried out there.
  • the image data is usually generated by the treatment goal, especially because here Profinfor ⁇ mation wishes overall by the patient and implants or tools is.
  • the knowledge of the relative posi ⁇ tion of tools and patient anatomy This serves to decorate the medical tools locally accurately on the patient to plat ⁇ to, for example, to place a hole or an implant location right in the patient.
  • the anatomy of the patient is completely described by 3D image data of the treatment target.
  • the object of the present invention is to specify an improved method for generating 3D medical image data.
  • a method for generating medical 3D image data of a treatment target in a patient with the following steps: In a step a), a 3D image data set of the treatment target is generated at a first time before or during the treatment of a patient. It will be a pre- or made intra-operative 3D image of the treatment or surgery ⁇ area.
  • a step b) during the treatment with the aid of an imaging device, at least one - as a rule also several - 2D
  • the treatment target contains an object (22) of known geometry that can be at least partially imaged in the 2D fluoroscopy image (26).
  • a transformation rule is determined between the 3D image data record and the 2D fluoroscopic image.
  • the 2D / 3D transformation between the 3D image data set and the real-time 2D projection exposure is calculated.
  • a step d) is then determined on the basis of the
  • the known geometry makes it possible to determine the SD location information from the image of the object, since the relative geometric position of characteristic points of the object in the 2D image is recognizable.
  • a step e) the steps b) to d) are repeated when the relative position between the treatment target and the object changes.
  • the above Rivregistrie- tion between 2D fluoroscopic image and 3D image data set is per ⁇ recalculated wells if the geometries between the preoperative 3D image and the imaging device, ie between 2D and 3D change. This could be done, for example, by an object movement, Thus, the movement of the patient or the operation target ge ⁇ Schehen. Possible movements in or on the patient can be detected in a known manner, for example by a marker affixed to the patient and his location tracking, for example in 2D X-ray images taken after each other.
  • the problem of the invention can be solved very easily by the above-mentioned tech ⁇ nology associated with the above sequence.
  • the inventive method is a simple method on the 2D fluoroscopy image position information of the object to ge ⁇ Visa, for example, the visible image in a 2D x-ray current implant or instrument position.
  • the 3D position of the implant or instrument is then also known through the 2D-3D transformation and can be made available to the user, for example, in relation to the preoperative or intraoperative 3D patient anatomy.
  • the user is therefore offered SD information.
  • the image information can be, for example, an abstract mark such as a crosshair, a symbol of the object, an outline or the like.
  • an image of the object is combined with the 3D image data record in the correct location in step d) as image information on the basis of the transformation rule.
  • this information can be used, for example, together with the known projection geometry of Schmge- exercise device.
  • the projection geometry can - if not known - also be determined by known methods.
  • 3D spatial coordinates of the object or characteristic points of it can actually be determined in the coordinate system of the 3D image data set and thus in the image data. It is then possible, even abstract information about the object, for example, represent a marker cross for an implant bore or a virtual projection line of a Bohrermit ⁇ center axis in the 3D image data.
  • the object used is an implant and / or an instrument of known geometry.
  • the geometry of the instrument and / or implant itself is not known, this can be equipped with markers detectable in the 2D fluoroscopy image, in which case the geometry of the markers or their relative arrangement must be known.
  • markers or marker arrangements of known geometries are fastened or integrated on the tools or implants, for example on K-wires. These can then be used to calculate the 3D geometries in the coordinate system of the 2D fluoroscopic images, ie projection images. Implants can be used, for example, by their 3D geometries known from design drawings directly for the calculation of 3D positions and orientations in the coordinate system of the 2D projection capture. Finally, the position and orientation of the tools or implants in the coordinate system of the 2D projection receptacle, and thus in the coordinate system of the imaging device, for example an X-ray C-arm, is known.
  • a 3D image containing planning data is used as the 3D image.
  • the fiction, ⁇ contemporary approach can be combined with planning data, for example, have been obtained from the preoperative 3D dataset.
  • the 2D / 3D image registration according to step c) can be performed very simply.
  • the transformation specification is then given by the acquisition geometry or de ⁇ ren determination can strictly speaking be omitted if the 2D fluoroscopic images are obtained in a known to the 3D image data acquisition geometry.
  • FIG. 1 shows a medical work station 2, which essentially comprises an imaging system 4, here an X-ray system and a patient table 6.
  • an imaging system 4 here an X-ray system
  • a patient table 6 On the patient table 6, a patient is positioned 8 to which the medical treatment Be ⁇ an intervention on the spine 10 to be performed. Therefore, a thoracic vertebra 12 and its immediate ambient represents the target area for treatment, therefore, the goal of treatment 14th This is in other words, in ⁇ teressierende (ROI, region of interest) of the patient 8, of which an imaging in the form of medical image data.
  • ROI teressierende
  • Imaging system 4 as imaging device 16, includes an X-ray C-arm that is capable of producing both 2D and 3D image data.
  • processing or sons ⁇ term data processing steps take place in a computing unit 18 of the imaging system 4.
  • the image data generated and Sons ⁇ term are displayed on screens 20 of thessen mattersssys ⁇ tems. 4
  • the medical measure is carried out with a needle as a medical instrument or object 22.
  • the SD image data set 24 is already on the patient's 8 at the time Tl, for example, with a magnetic resonance tomograph.
  • the at least one 2D fluoroscopic image 26 allows in one
  • Coordinate system 28 of the imaging device 16 the spatial determination of the position of the in the 2D fluoroscopic image 26 gebil ⁇ Deten objects, in particular the thoracic vertebrae 12 and the Ob ⁇ jects 22nd
  • the computing unit 18 determines in a calculation step 30 a transformation rule 32, such as e.g. within the coordinate system 28 - the 2D fluoroscopic image 26 or the objects imaged therein are spatially related to the 3D image data set 24.
  • 3D image data set 24 an image information is now displayed, which represents the position of the object 22.
  • this is a real image - in an alternative embodiment of at least a part - of the object 22. This results in 3D image data 34th
  • the method is not the image of the object 22 itself, but only an abstract symbol or image 36 of which, namely shown in the form shown in Fig. 1 dashed line.
  • the line is an imaginary image of the object 22 in the sense that this represents the profile of the needle when it is in the currently supported ⁇ requested direction advanced in the direction of its central longitudinal axis in the patent tienten.
  • the object 22 also has an array of instruments with the imaging device as an instrument 16 detectable, so here radiopaque markers 38, which are shown in particular in the 2D fluoroscopic images 26 with.
  • the projection geometry of the imaging device 16 is determined on the basis of the marker 38 imaged in the 2D drone illumination image 26.
  • the location of the object 22 in the coordinate system of the Schmge ⁇ exercise device 16 is not determined based on the image of the object 22 itself, but the image of the marker 38th The Geo ⁇ geometry of the object 22 then does not need to be known.
  • the object 22 is a dashed-line implant to be inserted into the patient during the treatment. This was previously planned in advance in the 3D image data record 24 in the form of planning data 40, ie its planned position determined. In the image data 34, in this case, both the
  • X-ray images 26 shown actual implant 22 and the position of the implant 22 in the form of the planning data 40 simultaneously displayed, whereby the viewer of the image data 34 can check a deviation between the planned and real location.
  • new 2D fluoroscopic images 26 are taken at a renewed time T2 and, as explained above, new 3D image data 34 is generated or refreshed with altered image contents.
  • the relative position R changes, for example, by the movement of the thoracic vertebra 12, of the entire patient 8 or of the object 22.
  • Reference sign list

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Human Computer Interaction (AREA)
  • Optics & Photonics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Biophysics (AREA)
  • Theoretical Computer Science (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • General Physics & Mathematics (AREA)
  • Gynecology & Obstetrics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

L'invention concerne un procédé pour la création de représentations de données médicales en 3D (34) d'un objectif de traitement (14) chez un patient (8) comprenant les étapes suivantes : a) en un premier instant (T1), avant ou pendant un traitement du patient (8), est créé un jeu (24) de représentations de données en 3D de l'objectif de traitement (14), b) en un second instant postérieur (T2) pendant le traitement est créé à l'aide d'un appareil de fourniture d'image (16), au moins une image radioscopique en 2D (26) de l'objectif de traitement (14) qui contient au moins un objet (22) d'une géométrie connue pouvant être au moins partiellement représenté sur une image radioscopique en 2D (26), c) une prescription de transformation (32) est émise entre le jeu (24) de représentations de données en 3D et l'image radioscopique en 2D (26), d) à l'aide de l'objet (22) représenté par l'image radioscopique en 2D (26), sa position spatiale est déterminée dans le système de coordonnées de l'appareil de fourniture d'image (16), et une information d'image représentative de la position à l'aide de la prescription de transformation (32) est rassemblée en conformité spatiale avec le jeu (24) de représentations de données en 3D en représentations de données en 3D (34), e) les étapes b) à d) sont répétées lors de la modification d'une position relative (R) entre l'objectif de traitement (14) et l'objet (22).
PCT/EP2011/056371 2010-05-06 2011-04-20 Procédé pour la création de représentations de données médicales en 3d Ceased WO2011138172A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102010019645.2 2010-05-06
DE102010019645A DE102010019645A1 (de) 2010-05-06 2010-05-06 Verfahren zum Erzeugen von medizinischen 3D-Bilddaten

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Publication Number Publication Date
WO2011138172A1 true WO2011138172A1 (fr) 2011-11-10

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PCT/EP2011/056371 Ceased WO2011138172A1 (fr) 2010-05-06 2011-04-20 Procédé pour la création de représentations de données médicales en 3d

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DE (1) DE102010019645A1 (fr)
WO (1) WO2011138172A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102012200921B4 (de) * 2012-01-23 2014-08-21 Siemens Aktiengesellschaft Verfahren zum Ermitteln einer Abweichung eines medizinischen Instruments von einer Zielposition

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10141406A1 (de) * 2001-08-23 2003-03-13 Siemens Ag Verfahren zum Detektieren der dreidimensionalen Position eines in einen Körperbereich eingeführten Untersuchungsinstruments
US20060235287A1 (en) * 2003-07-10 2006-10-19 Desmedt Paul A C Apparatus and method for navigating an instrument through an anatomical structure

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7778686B2 (en) * 2002-06-04 2010-08-17 General Electric Company Method and apparatus for medical intervention procedure planning and location and navigation of an intervention tool
DE102005028746B4 (de) * 2005-06-21 2018-02-22 Siemens Healthcare Gmbh Verfahren zum Ermitteln der Position und Orientierung eines Objekts, insbesondere eines Katheters, aus zweidimonsionalen Röntgenbildern
DE102008006516A1 (de) * 2008-01-29 2009-08-13 Siemens Aktiengesellschaft Röntgeneinrichtung und Verfahren für eine Röntgeneinrichtung zur Ermittlung der Position und/oder der Orientierung eines in einen Körper eines Lebewesens eingeführten medizinischen Objektes

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10141406A1 (de) * 2001-08-23 2003-03-13 Siemens Ag Verfahren zum Detektieren der dreidimensionalen Position eines in einen Körperbereich eingeführten Untersuchungsinstruments
US20060235287A1 (en) * 2003-07-10 2006-10-19 Desmedt Paul A C Apparatus and method for navigating an instrument through an anatomical structure

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Publication number Publication date
DE102010019645A1 (de) 2011-11-10

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