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WO2015079456A2 - Système et procédé de suivi optique d'une aiguille pour une procédure de biopsie percutanée guidée par image - Google Patents

Système et procédé de suivi optique d'une aiguille pour une procédure de biopsie percutanée guidée par image Download PDF

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Publication number
WO2015079456A2
WO2015079456A2 PCT/IN2014/000735 IN2014000735W WO2015079456A2 WO 2015079456 A2 WO2015079456 A2 WO 2015079456A2 IN 2014000735 W IN2014000735 W IN 2014000735W WO 2015079456 A2 WO2015079456 A2 WO 2015079456A2
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WIPO (PCT)
Prior art keywords
needle
patient
cameras
marker
planes
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Ceased
Application number
PCT/IN2014/000735
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English (en)
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WO2015079456A3 (fr
Inventor
Anand Jayanthi
Gururajan Kumar
Roy Santosham Dr.
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.)
Tuscano Equipments Pvt Ltd
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Tuscano Equipments Pvt Ltd
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Publication of WO2015079456A2 publication Critical patent/WO2015079456A2/fr
Publication of WO2015079456A3 publication Critical patent/WO2015079456A3/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
    • A61B6/04—Positioning of patients; Tiltable beds or the like
    • A61B6/0492—Positioning of patients; Tiltable beds or the like using markers or indicia for aiding patient positioning
    • 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
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computed tomography [CT]
    • A61B6/032—Transmission computed tomography [CT]
    • 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]

Definitions

  • the embodiments herein generally relate to medical devices and particularly relate to an improved system and method for a percutaneous biopsy.
  • the embodiments herein more particularly relate to a real time needle tracking system and a method for performing a percutaneous biopsy procedure with a minimal patient compliance, reduced radiation exposure and reduced needle pass.
  • a Percutaneous biopsy is recognized to be a safe, effective procedure. Successful percutaneous needle biopsy has been applied in most of the organs with excellent results and few complications.
  • the key to the percutaneous biopsy procedures has been the use of imaging guidance systems, such as Computer Tomography (CT), Magnetic Resonance Imaging (MRI), ultrasound, etc., which allows for a safe passage of a needle into an organ or mass, to obtain a tissue for the cytologic or histologic examinations.
  • CT Computer Tomography
  • MRI Magnetic Resonance Imaging
  • ultrasound etc.
  • a tissue sampling accuracy and a patient safety are the critical issues in the CT biopsy.
  • An accurate needle placement depends on the skill of the radiologist, patient compliance (breathing) and a size & location of an organ itself.
  • the complications due to an inaccurate needle placement are bleeding, infection, peritonitis in case of abdominal procedure etc.
  • Respiratory motion poses a considerable problem in the CT-guided biopsy of the lung or upper abdomen in which the structures can vary in position from 1 to 6 cm in the superior-to-inferior direction during a normal breathing.
  • the ability to reproduce the consistent levels of suspended inspiration or expiration on command is a challenge for many patients and especially for the people above 50 yrs.
  • the primary object of the embodiments herein is to provide a real time optical needle tracking system and a method for aiding a medical practitioner in an image guided percutaneous biopsy.
  • Another object of the embodiments herein is to provide a method and system for tracking a breath movement of a patient in a plurality of body planes and guiding the medical practitioner for inserting a needle.
  • Yet another object of the embodiments herein is to provide a method and system for tracking the needle angulations and estimating an insertion depth based on the patient breathing phase.
  • Yet another object of the embodiments herein is to provide a plurality of cameras for capturing the images of a region of interest (ROI) at different field of views (FOV) and constructing a three dimensional (3D) image.
  • ROI region of interest
  • FOV field of views
  • Yet another object of the embodiments herein is to provide a method and system for performing the biopsy procedure with a little patient compliance, reduced radiation exposure and reduced needle pass.
  • the embodiments herein provide a real time optical needle tracking system and method in a percutaneous biopsy procedure.
  • a real time optical needle tracking method in a percutaneous biopsy procedure comprises the following steps.
  • a patient is subjected to X-ray sonogram to obtain a scanogram image to localize body structures or a region of interest (ROI) for subsequent computer tomography (CT) scans and to display the locations of acquired CT slices.
  • a desired ROI is selected from the scanogram.
  • the selected ROI of the patient is aligned to a field of view (FOV) of a plurality of cameras.
  • a plurality of first reference markers is pasted in the selected ROI region on a body of the patient body. The patient is instructed to do breathing and to hold the breath at a comfort level.
  • a movement of the plurality of the first reference markers is captured by the plurality of cameras in a plurality of planes.
  • a movement of the plurality of the first reference markers is captured by the plurality of cameras in all planes during normal breathing.
  • the patient is scanned at the selected ROI with an imaging process.
  • a slice number and an entry point are input in an imaging device based on the imaging process.
  • a couch is moved and positioned to a required slice by the imaging system.
  • a needle insertion point is marked with a second marker in the patient body by a radiologist.
  • a check scan is performed to validate a position of the second marker, a needle trajectory and needle angles are calculated from a DICOM image based on the first reference markers and second marker.
  • the calculated needle trajectory and needle angles information is communicated from the imaging device to a processor of an optical tracking system.
  • the calculated needle trajectory and needle angles information is overlaid on a display monitor.
  • the second marker is aligned with the needle entry point either by moving a camera or the couch, based on the calculated needle trajectory and needle angles information displayed on the display screen.
  • the needle orientation is adjusted using a real time image displayed on the display screen, after adjusting the needle insertion point.
  • a needle insertion depth is computed with the processor to guide a medical practitioner to reach a target location, after matching the needle orientation.
  • the selected ROI of the patient is aligned to the field of view (FOV) of the plurality of cameras manually.
  • FOV field of view
  • the movement of the plurality of the first reference markers is captured by the plurality of cameras in a plurality of planes that are mutually different to one another during the breath hold process.
  • the movement of the first reference markers during a normal breathing is captured in all planes by the plurality of cameras, when the patient is unable to hold the breath.
  • the imaging process is selected from a group consisting of CT, Magnetic Resonance Imaging (MRI) and ultrasound, and the number of slices depends on the selected imaging process.
  • the second marker is contrast in color, size and shape to the first marker.
  • the needle trajectory and needle angles are calculated from a DICOM image based on the first reference markers and second marker for mutually different planes.
  • the second marker is aligned with the needle entry point by the user either by moving a camera or the couch, based on the calculated needle trajectory and needle angles displayed on the display screen.
  • the needle orientation is adjusted by the user using real time image displayed on the display screen, after adjusting the needle insertion point.
  • a real time optical needle tracking system in a percutaneous biopsy procedure comprises an imaging system for taking an image of a patient, a processor, a plurality of cameras for taking a real time image of the patient in a plurality of planes, a camera positioning system for positioning the plurality of cameras in a mutually perpendicular planes and to adjust a field of view of the plurality of cameras and a display device.
  • the processor calculates a needle orientation angle and trajectory based on a movement of reference markers pasted on the body of the patient during a breathing phase to compute a needle insertion depth to guide a medical practitioner to reach a target location.
  • the imaging system is selected is selected from a group consisting of CT, Magnetic Resonance Imaging (MRI) and ultrasound.
  • the imaging system is configured to obtain a scanogram image to localize body structures or a region of interest (ROI) for subsequent computer tomography (CT) scans and to display the locations of acquired CT slices.
  • ROI region of interest
  • CT computer tomography
  • the number of slices depends on the selected imaging system.
  • the selected ROI of the patient is aligned to the field of view (FOV) of the plurality of cameras manually.
  • FOV field of view
  • the patient is selected at the selected ROI with the imaging system.
  • the plurality of reference markers comprises a first reference marker and a second reference marker.
  • the first reference marker is pasted in the selected ROI region on a body of the patient body.
  • the second reference marker is pasted in the patient body by a radiologist to mark a needle insertion point.
  • the second marker is contrast in color to the first marker.
  • the plurality of cameras is configured to capture a movement of the plurality of the first reference markers during a normal breathing process and during a breathing hold process.
  • the plurality of cameras is configured to capture a movement of the plurality of the first reference markers in a plurality of planes that are mutually different to one another during the breath hold process.
  • the plurality of cameras is configured to capture a movement of the plurality of the first reference markers during a normal breathing process in all the planes, when the patient is unable to hold the breath.
  • the processor is configured to calculate the needle trajectory and needle angles from a DICOM image based on the first reference markers and second marker for mutually different planes.
  • the camera or a couch is moved by a user to align the second marker with the needle entry point based on the calculated needle trajectory and needle angles displayed on the display screen.
  • the processor is configured to enable the User to adjust a needle orientation using real time image displayed on the display screen, after adjusting the needle insertion point.
  • the embodiments herein provide an optical needle tracking system for an image guided percutaneous biopsy procedure.
  • the embodiments herein provide a method for operating a needle tracking system in real time with the use of an imaging guidance system which allows a medical practitioner to perform the biopsy procedure with a little patient compliance, reduced radiation exposure and reduced needle pass.
  • the imaging technology comprises a CT, MRI, Ultrasound, etc.
  • the optical needle tracking system comprises a plurality of markers, medical imaging equipment preferably a CT scanner, a plurality of cameras, a processor, a display unit and a camera positioning system.
  • the plurality of markers is placed on the region of interest (ROI) of the patient's body which assists in acquiring the breathing pattern of the patient.
  • the plurality of cameras captures the real time images and is controlled by the camera positioning system.
  • the processor controls the entire operation of the optical needle tracking system.
  • a real time optical tracking mechanism for aligning the needle to a preplanned needle path with very little patient compliance.
  • the needle is aligned with the help of the plurality of markers pasted in the region of interest (ROI) on the patient skin surface.
  • ROI region of interest
  • the optical needle tracking system tracks the patient breathing movement in all body planes as well as needle angulations.
  • the tracked and captured image information is overlaid on the selected CT DICOM image.
  • the optical tracking mechanism also tracks the needle angulations and insertion depth to improve the biopsy sampling accuracy.
  • the optical needle tracking system allows the radiologist to know about a current patient breathing level and also any bodily movement (physical movement) that is bound to happen when the patient lies on the table.
  • the optical needle tracking system guides the radiologist to reach the target point by providing the required needle angulationsand as well as the needle depth based on the estimated current patient breathing level so that the needle procedures are performed easily even in the case of patients with a breathing difficulty (not able reproduce same breath holding).
  • the optical needle tracking system allows the clinician/radiologist to decide a further course of action.
  • a method for improving the accuracy of the biopsy sampling procedure comprises monitoring the critical parameters of the percutaneous biopsy procedure.
  • the accuracy of the biopsy procedure depends mainly on the factors including but not limited to a needle placement and orientation, a sample collection from a right location using the needle, number of samples/size, a patient compliance (breathing) / movement of patient during the procedure and a size and location of the organ.
  • the needle placement and orientation factor is dependent on the skill of the radiologist.
  • the embodiments herein monitor the crucial factors in real time and thereby improve the accuracy of the biopsy procedures.
  • a processor of the optical needle tracking system correlates the attached markers to a skin displacement and overlay the correlated information on the 3D reconstructed images of CT.
  • the processor is a computer system with processing software.
  • the processor receives the DICOM images from the CT Console by means of a wired or wireless connection which includes but not limited to LAN, WAN, MAN, Wireless- Fidelity (Wi-Fi), Bluetooth communication, etc.
  • the processing software computes the co-ordinates for each camera and sends the information to the camera positioning system to position the individual cameras.
  • the processor starts receiving the images from the cameras.
  • the correlation is performed in the processing software and real time information about a patient breath and a needle position are displayed on the monitor.
  • the markers used for correlating the information are of any type, size and shapes.
  • the markers when pasted/placed on the patient skin surface are visible in the CT scan image.
  • the image allows the radiologist to correlate the skin surface and the CT image.
  • the real time 3D reconstructed images guide a radiologist to reach a target area in the body of the patient with a limited number of the needle pass and reduced check scans.
  • the plurality of cameras is mounted inside the area where the patient undergoes scanning through any one of the medical imaging procedures such as CT, MRI, Ultrasound, etc.
  • the plurality of cameras captures the real time images of the patient with respect to the OI.
  • the pluralities of cameras are mounted in such a way that they are perpendicular to each other.
  • a camera positioning system is provided which ensures the pluralities of cameras are perpendicular to each other with the respective adjustable field of view (FOV).
  • the cameras images of the skin are overlaid on the 3D reconstructed images of CT in each plane to assist the radiologist.
  • the pluralities of cameras are placed near the patient couch so that the movements in all planes are captured.
  • the entire assembly of the plurality of cameras is mounted on the floor.
  • the entire assembly of the plurality of cameras is suspended from the ceiling.
  • the mounting shaft of each camera has freedom to move in the respective planes.
  • the movement of each mounting shaft is done by means of a stepper motor which is controlled by a control mechanism.
  • a relationship is established between the plurality of mounted cameras and the CT patient couch. This relationship is constant at all times for each site.
  • the camera positioning system controls at least three positional cameras comprising a side camera, a front camera and a top camera.
  • the three positional cameras capture the movement of the patient in a supine and a prone position.
  • the side camera captures anterior, superior and inferior images
  • the front camera captures lateral, median and anterior images
  • the top camera captures lateral, median, inferior and superior images of the patient. Every movement is captured by two cameras to keep the error at a minimal level.
  • the side camera captures and shows the posterior region. The part of the patient's body which is in contact with the couch experiences a negligible movement due to contact with the couch.
  • the plurality of positional cameras are mounted perpendicular to each other and placed near the couch of the patient so that the information regarding the patient contour in all the planes are captured.
  • a relationship between the patient couch and the cameras is established.
  • the relationship indirectly establishes and defines a relationship between the plurality of cameras and the patient.
  • a surface contouring software processes the captured image and creates the 3D images of the patient surface from the information acquired with the camera in all the planes. Further the surface contouring software enables to overlay the same with the CT images. relationship is established between the plurality of mounted cameras and the CT patient couch. This relationship is constant at all times for each site.
  • the camera positioning system controls at least three positional cameras comprising a side camera, a front camera and a top camera.
  • the three positional cameras capture the movement of the patient in a supine and a prone position.
  • the side camera captures anterior, superior and inferior images
  • the front camera captures lateral, median and anterior images
  • the top camera captures lateral, median, inferior and superior images of the patient. Every movement is captured by two cameras to keep the error at a minimal level.
  • the side camera captures and shows the posterior region. The part of the patient's body which is in contact with the couch experiences a negligible movement due to contact with the couch.
  • the plurality of positional cameras are mounted perpendicular to each other and placed near the couch of the patient so that the information regarding the patient contour in all the planes are captured.
  • a relationship between the patient couch and the cameras is established.
  • the relationship indirectly establishes and defines a relationship between the plurality of cameras and the patient.
  • a surface contouring software processes the captured image and creates the 3D images of the patient surface from the information acquired with the camera in all the planes. Further the surface contouring software enables to overlay the same with the CT images.
  • FIG. 1 illustrates a block diagram of an optical needle tracking system used in image guided percutaneous biopsy, according to an embodiment herein.
  • FIG. 2 illustrates a schematic arrangement of the three positional cameras in an optical needle tracking system for capturing the movement of the patient in a plurality of planes, according to an embodiment herein.
  • FIG. 3 illustrates a flow chart explaining a method of estimating needle depth and needle insertion position in the image guided percutaneous biopsy procedures using the optical needle tracking system, according to an embodiment herein.
  • FIG. 4 illustrates a CT DICOM image displayed along with planned and real time needle angulations on a display screen, according to an embodiment herein.
  • the various embodiments herein provide a real time optical needle tracking system and method in a percutaneous biopsy procedure.
  • a real time optical needle tracking method in a percutaneous biopsy procedure comprises the following steps.
  • a patient is subjected to X-ray sonogram to obtain a scanogram image to localize body structures or a region of interest (ROI) for subsequent computer tomography (CT)
  • ROI region of interest
  • CT computer tomography
  • a desired ROI is selected from the scanogram.
  • the selected ROI of the patient is aligned to a field of view (FOV) of a plurality of cameras.
  • a plurality of first reference markers is pasted in the selected ROI region on a body of the patient body.
  • the patient is instructed to do breathing and to hold the breath at a comfort level.
  • a movement of the plurality of the first reference markers is captured by the plurality of cameras in a plurality of planes.
  • a movement of the plurality of the first reference markers is captured by the plurality of cameras in all planes during normal breathing.
  • the patient is scanned at the selected ROI with an imaging process.
  • a slice number and an entry point are input in an imaging device based on the imaging process.
  • a couch is moved and positioned to a required slice by the imaging system.
  • a needle insertion point is marked with a second marker in the patient body by a radiologist.
  • a check scan is performed to validate a position of the second marker.
  • a needle trajectory and needle angles are calculated from a DICOM image based on the first reference markers and second marker.
  • the calculated needle trajectory and needle angles information is communicated from the imaging device to a processor of an optical tracking system.
  • the calculated needle trajectory and needle angles information is overlaid on a display monitor.
  • the second marker is aligned with the needle entry point either by moving a camera or the couch, based on the calculated needle trajectory and needle angles information displayed on the display screen.
  • the needle orientation is adjusted using a real time image displayed on the display screen, after adjusting the needle insertion point.
  • 16 insertion depth is computed with the processor to guide a medical practitioner to reach a target location, after matching the needle orientation.
  • the selected ROI of the patient is aligned to the field of view (FOV) of the plurality of cameras manually.
  • FOV field of view
  • the movement of the plurality of the first reference markers is captured by the plurality of cameras in a plurality of planes that are mutually different to one another during the breath hold process.
  • the movement of the first reference markers during a normal breathing is captured in all planes by the plurality of cameras, when the patient is unable to hold the breath.
  • the imaging process is selected from a group consisting of CT, Magnetic Resonance Imaging (MRI) and ultrasound, and the number of slices depends on the selected imaging process.
  • the second marker is contrast in color, size and shape to the first marker.
  • the needle trajectory and needle angles are calculated from a DICOM image based on the first reference markers and second marker for mutually different planes.
  • the second marker is aligned with the needle entry point by the user either by moving a camera or the couch, based on the calculated needle trajectory and needle angles displayed on the display screen.
  • the needle orientation is adjusted by the user using real time image displayed on the display screen, after adjusting the needle insertion point.
  • a real time optical needle tracking system in a percutaneous biopsy procedure comprises an imaging system for taking an image of a patient, a processor, a plurality of cameras for taking a real time image of the patient in a plurality of planes, a camera positioning system for positioning the plurality of cameras in a mutually perpendicular planes and to adjust a field of view of the plurality of cameras and a display device.
  • the processor calculates a needle orientation angle and trajectory based on a movement of reference markers pasted on the body of the patient during a breathing phase to compute a needle insertion depth to guide a medical practitioner to reach a target location.
  • the imaging system is selected is selected from a group consisting of CT, Magnetic Resonance Imaging (MRI) and ultrasound.
  • the imaging system is configured to obtain a scanogram image to localize body structures or a region of interest (ROI) for subsequent computer tomography (CT) scans and to display the locations of acquired CT slices.
  • ROI region of interest
  • CT computer tomography
  • the number of slices depends on the selected imaging system.
  • the selected ROI of the patient is aligned to the field of view (FOV) of the plurality of cameras manually.
  • FOV field of view
  • the patient is selected at the selected ROI with the imaging system.
  • the plurality of reference markers comprises a first reference marker and a second reference marker.
  • the first reference marker is pasted in the selected ROI region on a body of the patient body.
  • the second reference marker is pasted in the patient body by a radiologist to mark a needle insertion point.
  • the second marker is contrast in color to the first marker.
  • the plurality of cameras is configured to capture a movement of the plurality of the first reference markers during a normal breathing process and during a breathing hold process.
  • the plurality of cameras is configured to capture a movement of the plurality of the first reference markers in a plurality of planes that are mutually different to one another during the breath hold process.
  • the plurality of cameras is configured to capture a movement of the plurality of the first reference markers during a normal breathing process in all the planes, when the patient is unable to hold the breath.
  • the processor is configured to calculate the needle trajectory and needle angles from a DICOM image based on the first reference markers and second marker for mutually different planes.
  • the camera or a couch is moved by a user to align the second marker with the needle entry point based on the calculated needle trajectory and needle angles displayed on the display screen.
  • the processor is configured to enable the user to adjust a needle orientation using real time image displayed on the display screen, after adjusting the needle insertion point.
  • the various embodiments herein provide an optical needle tracking system for an image guided percutaneous biopsy procedure.
  • the embodiments herein provide a method for operating a needle tracking system in real time with the use of an imaging guidance system which allows a medical practitioner to perform the biopsy procedure with a little patient compliance, reduced radiation exposure and reduced needle pass.
  • the imaging technology comprises a CT, MRI, Ultrasound, etc.
  • the optical needle tracking system comprises a plurality of markers, medical imaging equipment preferably a CT scanner, a plurality of cameras, a processor, a display unit and a camera positioning system.
  • the plurality of markers is placed on the region of interest (ROI) of the patient's body which assists in acquiring the breathing pattern of the patient.
  • the plurality of cameras captures the real time images and is controlled by the camera positioning system.
  • the processor controls the entire operation of the optical needle tracking system.
  • a real time optical tracking mechanism for aligning the needle to a preplanned needle path with very little patient compliance.
  • the needle is aligned with the help of the plurality of markers pasted in the region of interest (ROI) on the patient skin surface.
  • ROI region of interest
  • the optical needle tracking system tracks the patient breathing movement in all body planes as well as needle angulations. The tracked and captured image information is overlaid on the
  • the optical tracking mechanism also tracks the needle angulations and insertion depth to improve the biopsy sampling accuracy.
  • the optical needle tracking system allows the radiologist to know about a current patient breathing level and also any bodily movement (physical movement) that is bound to happen when the patient lies on the table.
  • the optical needle tracking system guides the radiologist to reach the target point by providing the required needle angulations and as well as the needle depth based on the estimated current patient breathing level so that the needle procedures are performed easily even in the case of patients with a breathing difficulty (not able reproduce same breath holding).
  • the optical needle tracking system allows the clinician/radiologist to decide a further course of action.
  • a method for improving the accuracy of the biopsy sampling procedure comprises monitoring the critical parameters of the percutaneous biopsy procedure.
  • the accuracy of the biopsy procedure depends mainly on the factors including but not limited to a needle placement and orientation, a sample collection from a right location using the needle, number of samples/size, a patient compliance (breathing) / movement of patient during the procedure and a size and location of the organ.
  • the needle placement and orientation factor is dependent on the skill of the radiologist.
  • the embodiments herein monitor the crucial factors in real time and thereby improve the accuracy of the biopsy procedures. ⁇
  • a processor of the optical needle tracking system correlates the attached markers to a skin displacement
  • the processor is a computer system with processing software.
  • the processor receives the DICOM images from the CT Console by means of a wired or wireless connection which includes but not limited to LAN, WAN, MAN, Wireless- Fidelity (Wi-Fi), Bluetooth communication, etc.
  • the processing software computes the co-ordinates for each camera and sends the information to the camera positioning system to position the individual cameras. Once the camera positioning system ensures the position and orientation of the camera and establishes the relationship of the patient position with respect to the plurality of cameras, the processor starts receiving the images from the cameras.
  • the correlation is performed in the processing software and a real time information about a patient breath and a needle position are displayed on the monitor.
  • the markers used for correlating the information are of any type, size and shapes.
  • the markers when pasted/placed on the patient skin surface are visible in the CT scan image.
  • the image allows the radiologist to correlate the skin surface and the CT image.
  • the real time 3D reconstructed images guidea radiologist to reach a target area in the body of the patient with a limited number of the needle pass and reduced check scans.
  • the plurality of cameras is mounted inside the area where the patient undergoes scanning through any one of the medical imaging procedures such as CT, MRI, Ultrasound, etc.
  • the plurality is mounted inside the area where the patient undergoes scanning through any one of the medical imaging procedures such as CT, MRI, Ultrasound, etc.
  • the 22 of cameras captures the real time images of the patient with respect to the ROI.
  • the pluralities of cameras are mounted in such a way that they are perpendicular to each other.
  • Acamera positioning system is provided which ensures the pluralities of cameras are perpendicular to each other withthe respective adjustable field of view (FOV).
  • the cameras images of the skin are overlaid on the 3D reconstructed images of CT in each plane to assist the radiologist.
  • the pluralities of cameras are placed near the patient couch so that the movements in all planes are captured.
  • the entire assembly of the plurality of cameras is mounted on the floor. Alternately, the entire assembly of the plurality of cameras is suspended from the ceiling.
  • the mounting shaft of each camera has freedom to move in the respective planes. The movement of each mounting shaft is done by means of a stepper motor which is controlled by a control mechanism.
  • a relationship is established between the plurality of mounted cameras and the CT patient couch. This relationship is constant at all times for each site.
  • the camera positioning system controls at least three positional cameras comprising a side camera, a front camera and a top camera.
  • the three positional cameras capture the movement of the patient in a supine and a prone position.
  • the side camera captures anterior, superior and inferior images
  • the front camera captures lateral, median and anterior images
  • the top camera captures lateral, median, inferior and superior images of the patient. Every movement is captured by two cameras to keep the error at a minimal level.
  • the side camera captures and shows the posterior region.
  • the plurality of positional cameras are mounted perpendicular to each other and placed near the couch of the patient so that the information regarding the patient contour in all the planes are captured.
  • a relationship between the patient couch and the cameras is established.
  • the relationship indirectly establishes and defines a relationship between the plurality of cameras and the patient.
  • a surface contouring software processes the captured image and creates the 3D images of the patient surface from the information acquired with the camera in all the planes. Further the surface contouring software enables to overlay the same with the CT images.
  • FIG. 1 illustrates a block diagram of an optical needle tracking system used in an image guided percutaneous biopsy, according to an embodiment herein.
  • the optical needle tracking system 100 comprises a processor 101, a plurality of positional cameras 103, a camera positioning system 104, a medical imaging device 105 and a displayscreen 102.
  • the processor 101 controls the operation of all the components of the optical needle tracking system 100.
  • the processer 101 also computes the data provided by the connected components and displays the result on the display screen 102.
  • the medical imaging device such as a CT console 105 is used to scan the body of the patient to produce the images at different slices with respect to the region of interest (ROI).
  • the processor 101 also controls the pluralities of positional cameras 103 with the help of the camera positioning system 104.
  • the camera positioning system 104 ensures that the
  • plurality of positional cameras 103 are arranged perpendicular to each other and performs the necessary correction automatically through the processor.
  • the pluralities of positional cameras 103 are preferably but not limited to three in number.
  • the plurality of positional camerasl 03 captures the movement of the patient body in different planes and helps in constructing a 3D image. The generated 3D image assists a medical practitioner to perform the biopsy.
  • FIG. 2 illustrates a schematic arrangement of the three positional cameras in an optical needle tracking system for capturing the movement of the patient in a plurality of planes, according to an embodiment herein.
  • the three positional cameras comprise a side camera 203, a front camera 202 and a top camera 201.
  • the three positional cameras 201-203 capture the patient movement in different planes and create 3D images of the ROl.
  • the generated 3D image assist the medical practitioner by providing a guidance to perform needle biopsy with minimal insertion, less patient compliance and less number of needle passes.
  • the side camera 203 captures and displays the anterior, superior and inferior images of the ROI.
  • the front camera 202 captures and shows the lateral, median and anterior images of the ROI.
  • the top camera 201 captures and shows the lateral, median, inferior and superior images of the ROI. Every movement is captured by the positional cameras to keep the error to minimum.
  • the side camera 203 shows the posterior areaof the ROI. The part of the patient body which is in contact with the couch has negligible movement due to contact with the couch.
  • FIG. 3 illustrates a flow chart explaining a method of estimating needle depth and needle insertion position in the image guided percutaneous biopsy procedures using the optical needle tracking system, according to an embodiment herein.
  • a patient undergoes an X-ray scanogram before a biopsy procedure for the examination of tissues or cells.
  • the images obtained from the X- ray scanography is used to determine the ROI (301).
  • the images obtained in this process are similar in general appearance to a conventional projection radiography image.
  • the scanogram has lower spatial resolution but much wider dynamic range. Scanograms are used primarily to localize body structures (Region of interest ROI) for subsequent CT scans and to display the locations of acquired CT slices.
  • a plurality of positional cameras is mounted near a couch.
  • the patient undergoing the needle biopsy procedure or the scanning process lies on the couch.
  • the couch is adjusted in such a manner that the ROI of the patient is in within the Field Of View (FOV) of the plurality of mounted positional cameras. This is done manually by the patient with the help of the technicians. Further, the FOV of the plurality of positional camera are ensured to be perpendicular to each other by a camera positioning system (302).
  • a plurality of reference markers are pasted on the skin surface of the patient. The reference markers are pasted to indicate the ROI and compute the breathing movement of the patient (303). Now the patient undergoes a medical imaging procedure based on the instructions given to the patient by the medical practitioner regarding the holding of the breath. When the patient is instructed not to hold any breath, then
  • the movement of the reference markers during the holding of the breath is captured by the mounted positional cameras (304).
  • the movement of the reference markers during the holding of the breath is captured by the mounted positional cameras (305).
  • the patient is instructed not to hold any breath, then the patient is scanned normally at the ROI without holding the breath.
  • the plurality of positional cameras indicate the movement of the reference marker and the same isused as a reference during the biopsy procedure (306). If the patient is unable to hold the breath, then in such case, the movement of reference markers during normal breathing is captured in all planes by multiple cameras. Once the camera capturing is completed, the patient is scanned at ROI with a suitable imaging procedure.
  • a slice number and a specific entry point of the needle is planned and determined in the CT console (307).
  • the number of slices obtained depends on the imaging procedure. Later, the slice number and entry point are planned in the CT image of the CT console. Based on the determined slice number, the couch is moved to the required slice as per the instruction from the medical practitioner (308).
  • An insertion or entry point for the needle is marked on the patient surface with a second contrast marker (309). Also, a check scan is performed for the patient to validate the second marker position corresponding to skin surface (310). After a successful validation of the markers positions, the needle insertion trajectory and angles in the different planes are calculated based on the Digital
  • the processor overlays the received information in the display (313). Based on the displayed information, the needle entry point is aligned with the DICOM image by moving the plurality of positional cameras or the couch (313). Once the entry point is adjusted, the medical practitioner adjusts the needle orientation based on the images acquired with an image guidance system. The second marker is aligned with the needle entry point in DICOM image by moving camera or couch based on feedback from camera image guidance (314). The user adjusts the needle orientation using camera image guidance (315). Once needle orientation matches, the processor computes the insertion depth and guides the medical practitioner to insert the needle at a right position with the help of the reference marker during a breath hold condition. Thusa medical practitioner is able to perform a percutaneous biopsy procedure with minimal patient compliance, reduced radiation exposure and reduced needle pass (316).
  • FIG. 4 illustrates a CT DICOM image displayed along with planned and real time needle angulationson a display screen, according to an embodiment herein.
  • a display screen 401 is provided for displaying the image captured by a suitable medical imaging procedure and real time mage during the biopsy.
  • a CT scan slice 404 is exhibited to depict the ROI of the patient, where the biopsy is to be conducted.
  • the objects in solid lines correspond to the planned image and planned needle angulations whereas the real time information is overlaid in dotted lines.
  • the radiologist is guided to insert the
  • needle angulations along Y&X axis are tracked respectively.
  • the real time angulations guide the radiologist to align the needle angulationsaccording to the planned path.
  • the plurality of cameras has a relationship with the CT patient table in each plane. The relationship is definitive for each site.
  • the optical needle tracking system monitors the patient breathing in real time and displays the information thereby allowing the radiologist to reach the target point without any subsequent check scans.

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Abstract

Les modes de réalisation de l'invention proposent un système et un procédé de suivi optique d'une aiguille pour une procédure de biopsie percutanée guidée par image, avec une faible observance thérapeutique, une exposition minimale aux rayonnements et un passage d'aiguille réduit. Le système de suivi optique d'une aiguille comprend une pluralité de caméras, un processeur, une unité d'affichage, une pluralité de marqueurs, un équipement d'imagerie médicale tel qu'un tomodensitomètre et un système de positionnement de caméras. La pluralité de marqueurs est placée sur la région d'intérêt du corps du patient et contribue à l'acquisition du profil respiratoire du patient. La pluralité de caméras capture les images en temps réel et est commandée par le système de positionnement de caméras. Le processeur commande tout le fonctionnement du système de suivi optique d'une aiguille.
PCT/IN2014/000735 2013-11-28 2014-11-27 Système et procédé de suivi optique d'une aiguille pour une procédure de biopsie percutanée guidée par image Ceased WO2015079456A2 (fr)

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IN3823/CHE/2013 2013-11-28
IN3823CH2013 IN2013CH03823A (fr) 2013-11-28 2014-11-27

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3628263A1 (fr) 2018-09-27 2020-04-01 Koninklijke Philips N.V. Guidage lors de procédures d'intervention du poumon
CN114343845A (zh) * 2022-01-11 2022-04-15 上海睿触科技有限公司 一种用于辅助穿刺系统的病灶位置动态跟踪方法

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1691666B1 (fr) * 2003-12-12 2012-05-30 University of Washington Systeme de guidage et d'interface en 3d pour catheterscope
DE102005044033B4 (de) * 2005-09-14 2010-11-18 Cas Innovations Gmbh & Co. Kg Positionierungssystem für perkutane Interventionen

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3628263A1 (fr) 2018-09-27 2020-04-01 Koninklijke Philips N.V. Guidage lors de procédures d'intervention du poumon
WO2020064924A1 (fr) 2018-09-27 2020-04-02 Koninklijke Philips N.V. Guidage dans des procédures d'intervention pulmonaire
CN114343845A (zh) * 2022-01-11 2022-04-15 上海睿触科技有限公司 一种用于辅助穿刺系统的病灶位置动态跟踪方法
CN114343845B (zh) * 2022-01-11 2023-12-12 上海睿触科技有限公司 一种用于辅助穿刺系统的病灶位置动态跟踪方法

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