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WO2015086848A1 - Système d'imagerie pour imager une région d'intérêt - Google Patents

Système d'imagerie pour imager une région d'intérêt Download PDF

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Publication number
WO2015086848A1
WO2015086848A1 PCT/EP2014/077657 EP2014077657W WO2015086848A1 WO 2015086848 A1 WO2015086848 A1 WO 2015086848A1 EP 2014077657 W EP2014077657 W EP 2014077657W WO 2015086848 A1 WO2015086848 A1 WO 2015086848A1
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WIPO (PCT)
Prior art keywords
ultrasound
interventional
image
endoprobe
imaging
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Ceased
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PCT/EP2014/077657
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English (en)
Inventor
Dirk Binnekamp
Amir Mohammad TAHMASEBI MARAGHOOSH
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Koninklijke Philips NV
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Koninklijke Philips NV
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Publication of WO2015086848A1 publication Critical patent/WO2015086848A1/fr
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    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A61B10/0241—Pointed or sharp biopsy instruments for prostate
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    • A61B2017/3411—Needle locating or guiding means using mechanical guide means with a plurality of holes, e.g. holes in matrix arrangement
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    • A61B2017/3413—Needle locating or guiding means guided by ultrasound
    • A—HUMAN NECESSITIES
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    • A61B8/08—Clinical applications
    • A61B8/0833—Clinical applications involving detecting or locating foreign bodies or organic structures
    • A61B8/085—Clinical applications involving detecting or locating foreign bodies or organic structures for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/28—Details of apparatus provided for in groups G01R33/44 - G01R33/64
    • G01R33/32—Excitation or detection systems, e.g. using radio frequency signals
    • G01R33/34—Constructional details, e.g. resonators, specially adapted to MR
    • G01R33/34084—Constructional details, e.g. resonators, specially adapted to MR implantable coils or coils being geometrically adaptable to the sample, e.g. flexible coils or coils comprising mutually movable parts
    • G—PHYSICS
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    • G06T2207/30004—Biomedical image processing
    • G06T2207/30081—Prostate

Definitions

  • Imaging system for imaging a region of interest
  • the invention relates to an interventional imaging system, method and computer program for imaging a region of interest within a living being during an interventional procedure.
  • the invention relates further to a pre-interventional imaging system and method for imaging a region of interest before performing the interventional procedure.
  • the invention relates also to a set of a magnetic resonance endoprobe and an ultrasound endoprobe for being used by the pre-interventional imaging system and to an interventional system comprising the interventional imaging system.
  • the prostate and the regions surrounding the prostate may be deformed substantially in the same way while generating the MR image and while generating the TRUS images.
  • the real time TRUS images are registered with the pre-operative MR image and the registered real time TRUS images are shown together with the registered pre-operative MR image, in order to provide anatomical information which can guide a physician during the prostate biopsy.
  • the provision of the anatomical information based on the registered pre- operative MR image may be relatively inaccurate, which can lead to a relatively inaccurate guidance during the prostate biopsy procedure.
  • an interventional imaging system for imaging a region of interest within a living being during an interventional procedure comprising:
  • a first ultrasound image providing unit for providing a first ultrasound image of the region of interest, which has been generated before performing the interventional procedure by a first ultrasound imaging device comprising a first ultrasound endoprobe for acquiring ultrasound data and an ultrasound reconstruction unit for reconstructing the first ultrasound image based on the acquired ultrasound data,
  • a pre-interventional image providing unit for providing a further pre- interventional image of the region of interest, which has been generated before performing the interventional procedure while an element, which has the same outer dimensions as the first ultrasound endoprobe, was arranged within the living being at the same location as the location at which the first ultrasound endoprobe was arranged during the acquisition of the ultrasound data, by using a pre-interventional imaging device,
  • a second ultrasound imaging device for generating a second ultrasound image of the region of interest during the interventional procedure
  • the second ultrasound imaging device comprises a second ultrasound endoprobe for acquiring ultrasound data and an ultrasound reconstruction unit for reconstructing the second ultrasound image based on the acquired ultrasound data
  • a registration unit for registering the second ultrasound image with the first ultrasound image, thereby determining a deformation
  • a pre-interventional image deformation unit for deforming the further pre- interventional image in accordance with the determined deformation. Since the registration for determining the deformation is applied to two ultrasound images, i.e. to the same kind of images, the registration and thus the
  • the corresponding determined deformation can be more accurate. Moreover, since this more accurate determined deformation is used for deforming the pre-interventional image, the pre- interventional image is more accurately deformed such that it corresponds to the structure of the region of interest during the interventional procedure. This more accurately deformed pre-interventional image can be shown to a physician performing the interventional procedure, in order to provide an improved guidance during the interventional procedure.
  • the first ultrasound image providing unit may be a storing unit, in which the first ultrasound image, which has been generated before performing the interventional procedure, is stored already and from which the stored first ultrasound image can be retrieved for providing the same.
  • the first ultrasound image providing unit can also be a receiving unit for receiving the first ultrasound image from another unit like the first ultrasound imaging device and for providing the received first ultrasound image.
  • the first ultrasound image providing unit can also be the first ultrasound imaging device for generating the first ultrasound image of the region of interest before performing the interventional procedure, wherein the first ultrasound imaging device can be adapted to provide the generated first ultrasound image.
  • the pre-interventional image providing unit can be a storing unit, in which the pre-interventional image of the region of interest is stored already, and from which the pre-interventional image can be retrieved for providing the same.
  • the pre- interventional image providing unit can be a receiving unit for receiving a pre-interventional image from a pre-interventional imaging device and for providing the received pre- interventional image.
  • the pre-interventional image providing unit can be the pre-interventional imaging device.
  • the pre-interventional imaging device may be a computed tomography (CT) imaging device or an MR imaging device.
  • the first and second ultrasound endoprobes and the element arranged within the living being during the pre-interventional imaging are preferentially configured to be introduced into the living being close to the region of interest.
  • the region of interest is the prostate
  • the first and second ultrasound endoprobes and the element arranged within the living being during pre-interventional imaging may be adapted to be transrectally introduced into the living being.
  • the living being is preferentially a person, but the living being may also be an animal.
  • the element arranged within the living being while generating the further pre-interventional image is an MR endoprobe, wherein the pre- interventional imaging device is adapted to acquire MR data by using the MR endoprobe and to reconstruct the further pre-interventional image based on the acquired MR data.
  • Generating the pre-interventional image based on MR data acquired by using an MR endoprobe allows generating a high quality anatomical image, which can be used to further improve the guidance of a physician during the interventional procedure.
  • first ultrasound endoprobe and the second ultrasound endoprobe have the same outer dimensions. If the first and second ultrasound endoprobes have the same outer dimensions, it may be assumed that an inner deformation of the living being caused by the introduction of the respective ultrasound endoprobe is substantially the same a) while acquiring the ultrasound data used for generating the first ultrasound image before performing the interventional procedure and b) while acquiring the ultrasound data used for generating the second ultrasound image during the interventional procedure. This can lead to a further improved registration of the two ultrasound images and thus to an even more accurate determined deformation, which in turn may lead to a further improved guidance of the physician during the interventional procedure.
  • the first ultrasound image and the further pre-interventional image have preferentially the same dimensions.
  • the first ultrasound image and the further pre-interventional image are three-dimensional images.
  • the second ultrasound image is preferentially a two-dimensional image.
  • the registration unit is preferentially adapted to perform a deformable image registration algorithm such that a deformation field is determined, which can be used to deform the pre-interventional image in accordance with a current deformation of the region of interest. For instance, the registration can lead to a deformation field describing a deformation of the first ultrasound image, which results in a deformed first ultrasound image matching the second ultrasound image.
  • This deformation field may be applied to the pre-interventional image, in order to deform the pre-interventional image such that it also matches the second ultrasound image and thus the current deformation of the region of interest.
  • the deformable image registration algorithm might be an intensity- based registration algorithm.
  • the intensity-based registration is especially suited for registering ultrasound images to each other such that by using the intensity -based registration the registration and thus the determined deformation can be even more accurate. This can lead to a further improved guidance of a physician during the interventional procedure.
  • a pre-interventional imaging system for imaging a region of interest before performing an interventional procedure is presented, wherein the pre- interventional imaging system comprises:
  • a first ultrasound imaging device for generating a first ultrasound image of the region of interest before performing the interventional procedure
  • the first ultrasound imaging device comprises a first ultrasound endoprobe for acquiring ultrasound data and an ultrasound reconstruction unit for reconstructing the first ultrasound image based on the acquired ultrasound data
  • a pre-interventional imaging device for generating a further pre-interventional image of the region of interest before performing the interventional procedure while the element, which has the same outer dimensions as the first ultrasound endoprobe, is arranged within the living being at the same location as the location at which the first ultrasound endoprobe is arranged during the acquisition of the ultrasound data.
  • a set of a magnetic resonance endoprobe and an ultrasound endoprobe for being used by the pre-interventional imaging system is presented, wherein the pre-interventional imaging device is an MR imaging device and wherein the MR endoprobe and the ultrasound endoprobe have the same outer dimensions.
  • an interventional system for performing an interventional procedure comprising:
  • an interventional imaging system for imaging a region of interest within a living being during the interventional procedure as defined in claim 1, and
  • an interventional imaging method for imaging a region of interest during an interventional procedure comprising:
  • a first ultrasound imaging device comprising a first ultrasound endoprobe for acquiring ultrasound data and an ultrasound reconstruction unit for reconstructing the first ultrasound image based on the acquired ultrasound data, by a first ultrasound image providing unit, providing a further pre-interventional image of the region of interest by a pre- interventional image providing unit, wherein the further pre-interventional image has been generated before performing the interventional procedure while an element, which has the same outer dimensions as the first ultrasound endoprobe, was arranged within the living being at the same location as the location at which the first ultrasound endoprobe was arranged during the acquisition of the ultrasound data, by using a pre-interventional imaging device,
  • the second ultrasound imaging device uses a second ultrasound endoprobe for acquiring ultrasound data and an ultrasound reconstruction unit for reconstructing the second ultrasound image based on the acquired ultrasound data
  • a pre-interventional imaging method for imaging a region of interest before performing an interventional procedure comprises:
  • the first ultrasound imaging device uses a first ultrasound endoprobe for acquiring ultrasound data and an ultrasound reconstruction unit for reconstructing the first ultrasound image based on the acquired ultrasound data, and
  • a computer program for imaging a region of interest during an interventional procedure comprising program code means for causing an interventional imaging system as defined in claim 1 to carry out the steps of the interventional imaging method as defined in claim 11, when the computer program is run on a computer controlling the interventional imaging system.
  • interventional imaging system of claim 1 the pre-interventional imaging system, the set of endoprobes, the interventional system of claim 10, the interventional imaging method of claim 11, the pre-interventional imaging method, and the computer program of claim 12 have similar and/or identical preferred embodiments, in particular, as defined in the dependent claims.
  • Fig. 1 shows schematically and exemplarily an embodiment of a pre- interventional imaging system for imaging a region of interest before performing an interventional procedure
  • Fig. 2 shows schematically and exemplarily an embodiment of an interventional system with an interventional imaging system for imaging the region of interest within the living being during an interventional procedure
  • Fig. 3 schematically and exemplarily illustrates a biopsy procedure
  • Fig. 4 schematically and exemplarily illustrates a brachytherapy procedure
  • Fig. 5 shows a flowchart exemplarily illustrating an embodiment of a pre- interventional imaging method for imaging a region of interest before performing an interventional procedure
  • Fig. 6 shows a flowchart exemplarily illustrating an embodiment of an interventional imaging method for imaging a region of interest within a living being during an interventional procedure
  • Fig. 7 illustrates different images generated by the pre-interventional imaging system and the interventional imaging system and their interrelations during image processing.
  • Fig. 1 shows schematically and exemplarily an embodiment of a pre- interventional imaging system for imaging a region of interest before performing an interventional procedure.
  • the pre-interventional imaging system 1 comprises a first ultrasound imaging device 15 for generating a first ultrasound image of the region of interest before performing the interventional procedure, wherein the first ultrasound imaging device 15 comprises a first ultrasound endoprobe 9 for acquiring ultrasound data and an ultrasound control unit 10 for controlling the first ultrasound imaging device 15 and for reconstructing the first ultrasound image based on the acquired ultrasound data. Since the ultrasound control unit 10 reconstructs the first ultrasound image, it can be regarded as being an ultrasound reconstruction unit.
  • the region of interest is the prostate of a person 2 lying on a support means 8 and the first ultrasound endoprobe 9 is adapted to be transrectally introduced into the person 2 close to the prostate.
  • the first ultrasound endoprobe 9 is therefore a TRUS endoprobe.
  • the first ultrasound imaging device 15 further comprises an input unit 11 for inputting commands like a start command for starting the generation of the first ultrasound image or a stop command for stopping the generation of the first ultrasound image, wherein the input unit 11 may include a keyboard, a computer mouse, a touch pad, a foot switch, et cetera.
  • the first ultrasound imaging device 15 further comprises a display 12 for displaying the generated first ultrasound image.
  • the pre-interventional imaging system 1 further comprises a pre- interventional imaging device 14 for generating a further pre-interventional image of the region of interest before performing the interventional procedure, while an element 4, which has the same outer dimensions as the first ultrasound endoprobe 9, is arranged within the person 2 at substantially the same location as the location at which the first ultrasound endoprobe 9 is arranged during the acquisition of the ultrasound data, wherein the person 2 lies on a support means 3.
  • the pre-interventional imaging device 14 is an MR imaging device and the element 4 is a transrectal MR endoprobe.
  • the MR imaging system 14 further comprises a casing 13 with a bore, wherein within the casing 13 coils are arranged for generating the magnetic fields used together with a coil within the MR endoprobe 4 for generating MR data.
  • the coils within the casing 13 and the MR endoprobe 4 are controlled by a control unit 5 such that the MR data are acquired.
  • the MR control unit 5 is adapted to reconstruct a pre-interventional MR image based on the acquired MR data.
  • the MR endoprobe 4 has been transrectally introduced into the person 2 such that the MR endoprobe 4 is arranged close to the prostate of the person 2, in order to generate a pre-interventional MR image showing the prostate.
  • the pre-interventional MR imaging device 14 further comprises an input unit 6 like a keyboard, a computer mouse, a touch pad, a foot switch, et cetera and a display 7.
  • the input unit 6 may be adapted to allow a user to select a desired MR imaging procedure, to start the MR procedure, to stop the MR procedure, et cetera.
  • the display 7 is preferentially used to display the generated pre-interventional MR image.
  • Fig. 2 shows schematically and exemplarily an interventional system 34 for performing an interventional procedure.
  • the interventional system 34 is adapted to perform a prostate interventional procedure.
  • the interventional system 34 may be adapted to perform a prostate biopsy procedure as schematically and exemplarily illustrated in Fig. 3.
  • the interventional system 34 comprises an interventional imaging system 16 with a pre-interventional image providing unit 29 for providing the pre-interventional image of the prostate 23, which has been generated before performing the interventional procedure by using the MR imaging device 14 while the MR endoprobe 4, which has the same outer dimensions as the first ultrasound endoprobe 9, was arranged within the person 2 at substantially the same location as the location at which the first ultrasound endoprobe 9 was arranged during the acquisition of the ultrasound data.
  • at the same location means that both, the first ultrasound endoprobe 9 and the MR endoprobe 4 were transrectally introduced into the person 2, while acquiring the ultrasound data and the MR data, respectively, pre-interventionally.
  • the pre-interventional MR image generated by the MR imaging device 14 before performing the interventional procedure is stored in the pre- interventional image providing unit 29 for allowing the pre-interventional image providing unit 29 to provide the pre-interventional MR image.
  • the pre-interventional MR image can be transferred from the MR imaging device 14 to the pre-interventional image providing unit 29 by using known wired or wireless data transferring techniques.
  • the interventional imaging system 16 further comprises a second ultrasound imaging device for generating a second ultrasound image of the prostate 23 of the person 2, who lies on a support means 17, during the interventional procedure, wherein the second ultrasound imaging device comprises a second ultrasound endoprobe 18 for acquiring ultrasound data and an ultrasound control unit 31 for controlling the second ultrasound endoprobe 18 and for reconstructing the second ultrasound image of the prostate 23 during the interventional procedure based on the acquired ultrasound data.
  • the second ultrasound endoprobe 18 is preferentially a transrectal ultrasound endoprobe, wherein the second transrectal ultrasound endoprobe 18 and the first transrectal ultrasound endoprobe 9 have the same outer dimensions.
  • the interventional imaging system 16 further comprises a first ultrasound image providing unit 30 for providing the first ultrasound image of the prostate 23, which has been generated before performing the interventional procedure by the first ultrasound imaging device 15 comprising the first transrectal ultrasound endoprobe 9 for acquiring ultrasound data and the ultrasound control unit 10 for controlling the first transrectal ultrasound endoprobe 9 and for reconstructing the first ultrasound image based on the acquired ultrasound data.
  • the first ultrasound image providing unit 30 is preferentially a storing unit, in which the first ultrasound image, which has been pre-interventionally generated, is stored and from which the stored first ultrasound image can be retrieved for providing the same.
  • the first ultrasound image can have been transferred from the first ultrasound imaging device 15 to the first ultrasound image providing unit 30 by using known wireless or wired data transferring techniques.
  • the interventional system 34 further comprises a registration unit 32 for registering the second ultrasound image with the first ultrasound image, thereby determining a deformation, and a pre-interventional image deformation unit 33 for deforming the pre- interventional image in accordance with the determined deformation.
  • the first ultrasound image is preferentially a three-dimensional image and the second ultrasound image is a preferentially a two-dimensional image.
  • the registration unit 32 is therefore preferentially adapted to perform a two-dimensional/three-dimensional registration technique, which is preferentially intensity-based.
  • known two-dimensional/three-dimensional intensity-based registration techniques can be used like the registration technique disclosed in, for instance, the article "A comparison of similarity measures for use in 2-D-3-D medical image registration" by G. P. Penney, J.
  • the pre-interventional MR image is preferentially a three-dimensional image, which is deformed in accordance with the deformation obtained from the two- dimensional/three-dimensional registration of the first-ultrasound image with the second- ultrasound image.
  • the deformed MR image and also the second ultrasound image, which is preferentially a real time ultrasound image, can be shown on a display 21 of the
  • the interventional system 34 further comprises an input unit 20 like a keyboard, a computer mouse, a touch pad, a foot switch, et cetera for inputting commands into the interventional system like a starting or a stopping command.
  • the interventional instrument 24 being in the embodiment shown in Fig. 3 a biopsy needle is moved within the person 2 to take a tissue sample from the prostate 23.
  • This movement of the biopsy needle 24 within the person 2 is guided by using a two-dimensional real time ultrasound image generated by using the second transrectal ultrasound probe 18.
  • the pre-interventional MR image can be deformed in accordance with the current deformation of the inner parts of the person 2, wherein this deformed MR image can be shown on the display 21, thereby allowing a physician to move the biopsy needle 24 within the person 2 such that the physician can take a tissue sample from the prostate 23 without unintentionally damaging surrounding tissue like the tissue of the bladder 22.
  • the movement of the needle is guided by a needle guide 35.
  • the needle may be moved within the person 2 without using the needle guide 35.
  • the interventional system can also be used to perform another interventional procedure like a prostate brachytherapy procedure as schematically and exemplarily illustrated in Fig. 4.
  • the second ultrasound endoprobe 26 is equipped with a template 28 comprising openings for holding a brachytherapy needle 27.
  • the brachytherapy needle 27 is adapted to place brachytherapy seeds 36 into the prostate 23 for performing the brachytherapy.
  • the brachytherapy seeds 36 are preferentially radioactive seeds comprising, for instance, iodine 125 or palladium 103.
  • the second transrectal ultrasound probe 26 is used to generate a real time two-dimensional ultrasound image.
  • the real time two-dimensional ultrasound image is used for determining a deformation, which is applied to the pre-interventional MR image for deforming the same in accordance with the current deformation of the inner parts of the person 2.
  • the physician can monitor the real time deformation of the inner parts of the person 2, in particular, of the prostate 23 and the surrounding of the prostate 23 like the bladder 22, by looking at the deformed pre-interventional MR image shown on the display 21. This allows the physician to accurately place the brachytherapy seeds 36 at desired locations within the prostate 23, without damaging, for instance, the bladder 22.
  • the deformation especially a deformation field describing the deformation, which has been determined by registering the first ultrasound image with the real time second ultrasound image, may be directly applied to the pre-interventional MR image for deforming the same, or the first ultrasound image and the pre-interventional MR image may be rigidly registered to each other before applying the determined deformation to the pre-interventional MR image, wherein the rigid registration does not include a deformation transformation, but only translations and/or rotations.
  • the rigid registration may be performed by segmenting an element visible in the first ultrasound image and in the pre-interventional MR image and by translating and/or rotating at least one of these images such that a degree of matching of the two segmentations is optimized.
  • the first ultrasound image providing unit 30, the pre-interventional image providing unit 29, the second ultrasound imaging device 18, 31, the registration unit 32 and the pre-interventional image deformation unit 23 are used for generating the deformed pre- interventional MR image for showing the deformation of the region of interest 23 during the interventional procedure.
  • These components of the interventional system 34 can therefore be regarded as being components of the interventional imaging system 16 for imaging the region of interest within the person during the interventional procedure.
  • a first ultrasound image of the region of interest is generated, before the interventional procedure is performed, by the first ultrasound imaging device 15, wherein the first ultrasound imaging device 15 uses the first ultrasound endoprobe 9 for acquiring ultrasound data and the ultrasound control unit 10 for reconstructing the first ultrasound image based on the acquired ultrasound data.
  • the first ultrasound endoprobe 9 is transrectally introduced into the person 2 for generating a TRUS image of the prostate 23.
  • the first TRUS image is preferentially a three-dimensional ultrasound image.
  • step 102 the further pre-interventional image of the region of interest 23 is generated by the pre-interventional imaging device 14, before the interventional procedure is performed, while an element 4, which has the same outer dimensions as the first ultrasound endoprobe 9, is arranged within the person 2 at the same location as the location at which the first ultrasound endoprobe 9 is arranged during the acquisition of the ultrasound data.
  • a pre-interventional MR image is generated by using the transrectal MR endoprobe 4.
  • the transrectal MR image is preferentially a three-dimensional image.
  • Step 102 may also be performed before step 101.
  • the first ultrasound image generated in above described step 101 may have been transferred to the first ultrasound image providing unit 30 by using known wired or wireless data transferring techniques, wherein the transferred first ultrasound image may be stored in the first ultrasound image providing unit 30.
  • the first ultrasound image providing unit 30 can then provide the stored first ultrasound image during the interventional procedure.
  • the provided first ultrasound image is preferentially a three-dimensional TRUS image.
  • a further pre-interventional image of the region of interest 23 is provided by the pre-interventional image providing unit 29, wherein the further pre- interventional image has been generated by using the pre-interventional imaging device 14 in above described step 102 before the interventional procedure is performed, while the element 4, which has the same outer dimensions as the first ultrasound endoprobe 9, was arranged within the person 2 at the same location as location at which the first ultrasound endoprobe 9 was arranged during the acquisition of the ultrasound data.
  • the pre-interventional imaging device 14 is an MR imaging device for generating a pre- interventional MR image, wherein the element 4 is a transrectal MR endoprobe used for generating the MR image.
  • the pre-interventional MR image is preferentially a three- dimensional image.
  • a second ultrasound image of the region of interest 23 is generated during the interventional procedure by the second ultrasound imaging device, wherein the second ultrasound imaging device uses the second ultrasound endoprobe 18 for acquiring ultrasound data and the ultrasound control unit 31 for reconstructing the second ultrasound image based on the acquired ultrasound data.
  • the second ultrasound endoprobe 18 is a transrectal ultrasound probe and the second ultrasound image is preferentially a real time two-dimensional TRUS image.
  • step 204 the second ultrasound image generated in step 203 is registered with the first ultrasound image provided in step 201 by the registration unit 32, thereby determining a deformation.
  • the first ultrasound image may be deformed by the registration process such that the first ultrasound image corresponds to the second ultrasound image. Since the first ultrasound image is preferentially a three-dimensional image and the second ultrasound image is preferentially a two-dimensional ultrasound image, the registration preferentially uses a two-dimensional/three-dimensional registration algorithm, which is preferentially intensity -based.
  • step 205 the further pre-interventional image is deformed by the pre- interventional image deformation unit 33 in accordance with the determined deformation.
  • the preferred pre-interventional MR image is deformed in accordance with a deformation of the first ultrasound image.
  • step 206 the deformed further pre-interventional image is shown on the display 21.
  • step 207 it is checked whether an abort criterion has been fulfilled.
  • the abort criterion may be, for instance, whether a user has input a stop command for stopping the interventional imaging procedure or not. If the abort criterion is not fulfilled, the method continues in a loop with step 203. Otherwise, the method ends in step 208.
  • steps 203 to 206 can be performed in a loop based on real time ultrasound images
  • the pre-interventional MR image which is deformed in accordance with the current deformation of the inner parts of the person 2
  • the pre-interventional MR image which is deformed in accordance with the current deformation of the inner parts of the person 2
  • the pre-interventional MR image can been shown on the display 21 during the interventional procedure, in order to allow the physician to perform the interventional procedure under guidance of the deformed pre-interventional MR image.
  • the interventional system described above with reference to Fig. 2 may be used to perform a sextant biopsy or a brachytherapy.
  • the interventional system may be used to treat prostate cancer.
  • Cancerous prostate tissue is generally not
  • MR imaging provides a high-resolution anatomical detailing of the prostate. This MR imaging can even be improved, in particular, a significant improvement in the spatial resolution and signal-to-noise ratio can be achieved, if the transrectal MR endoprobe is used, which is preferentially formed by a casing enclosing an endorectal coil.
  • the MR image may be fused with the second ultrasound image generated during the interventional procedure, in order to provide a good delineation of the cancer.
  • transrectal MR endoprobe including the endorectal coil in MR imaging causes a deformation of the prostate shape which may be different to the
  • Fig. 2 allows therefore fusing real time intra- procedural, i.e. intra-interventional, ultrasound images with pre-operative, i.e.
  • pre- interventional, MR images wherein organ, especially prostate, motion and deformation between two different modalities can be unified, motion and deformation between a preoperative three-dimensional ultrasound image and an intra- operative real time ultrasound image can be compensated and an ultrasound-to-ultrasound deformable registration can be used, without trying to solve a more complex inter-modality registration between an ultrasound image and an MR image for determining deformations.
  • a transrectal MR endoprobe For generating the pre-interventional MR image a transrectal MR endoprobe is preferentially used, wherein the transrectal MR endoprobe comprises a casing enclosing an MR endorectal coil, wherein the casing has the same outer dimensions as the outer dimensions of the first TRUS endoprobe and/or the second TRUS endoprobe.
  • a set of an MR endoprobe and an ultrasound endoprobe can be used for generating the pre- interventional MR image and the first ultrasound image and/or the second ultrasound image, wherein the MR endoprobe and the respective ultrasound endoprobe have the same outer dimensions.
  • the first TRUS endoprobe is preferentially a three-dimensional TRUS endoprobe being adapted for three-dimensional volumetric imaging of the prostate.
  • the three-dimensional TRUS endoprobe may be formed by a transesophageal echocardiogram (TEE) probe, which may be a probe of the company Philips, fitted into a transrectal ultrasound probe casing, which is generally used for generating two-dimensional ultrasound images transrectally.
  • TEE transesophageal echocardiogram
  • Fig. 7 schematically and exemplarily illustrates a pre-interventional MR image 302 generated by using a transrectal MR endoprobe 305 and a three-dimensional first ultrasound image 303 generated by using the first TRUS endoprobe 9.
  • the first TRUS endoprobe 9 and the transrectal MR endoprobe 305 have the same outer dimensions such that the deformation of the prostate can be assumed as being substantially the same in the MR image 302 and the first ultrasound image 303.
  • This matching of the deformation is indicated in Fig. 7 by the double arrow 304.
  • the box 301 indicates in Fig. 7 that the MR imaging and the three-dimensional TRUS imaging are carried out before performing the interventional procedure.
  • a two-dimensional TRUS image 307 which may be regarded as being a live two-dimensional ultrasound image, may be generated by using the second TRUS endoprobe 18.
  • the casing of the second TRUS endoprobe 18 may have the same outer dimensions as the outer dimensions of the casings of the first TRUS endoprobe 9 and of the MR endoprobe 305.
  • the two-dimensional second ultrasound image 307 is registered with the three-dimensional second ultrasound image 303
  • the registration is an intra-modality, i.e. an ultrasound-to-ultrasound, registration, wherein any intensity-based registration technique like a technique based on a normalized cross correlation may be used.
  • the pre-interventional MR image 302 of the prostate may then be deformed using the deformation resulting from the registration of the two ultrasound images to each other, i.e. a corresponding deformation field may be used, as indicated in Fig. 7 by the arrows 308 and 310.
  • the resulting deformed MR image is indicated in Fig. 7 by reference number 309.
  • the deformation field resulting from the two- dimensional/three-dimensional ultrasound registration can be utilized to calculate the deformed MR image 309 which matches the intra-interventional two-dimensional ultrasound image 307.
  • box 302 indicates that the two-dimensional second TRUS image 307 and the deformed MR image 309 are generated during the interventional procedure.
  • the deformed MR image 309 may be shown fused with the two-dimensional real time TRUS image 307.
  • the pre-interventional image which is finally deformed in accordance with the outcome of the ultrasound-to-ultrasound registration, is an MR image
  • this pre-interventional image can also be an image generated by another imaging modality like a CT image.
  • a single unit or device may fulfill the functions of several items recited in the claims.
  • the mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage.
  • Procedures like the provision of the first ultrasound image, the provision of the further pre-interventional image, the generation of the second ultrasound image, the registration of the second ultrasound image with the first ultrasound image, the deformation of the further pre-interventional image, et cetera performed by one or several units or devices can be performed by any other number of units or devices.
  • steps 201 to 207 can be performed by a single unit or by any other number of different units.
  • These procedures and/or the control of the interventional imaging system in accordance with the interventional imaging method can be implemented as program code means of a computer program and/or as dedicated hardware.
  • a computer program may be stored/distributed on a suitable medium, such as an optical storage medium or a solid-state medium, supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems. Any reference signs in the claims should not be construed as limiting the scope.
  • the invention relates to an interventional imaging system for imaging a region of interest within a living being during an interventional procedure.
  • a first ultrasound image is generated by using a first ultrasound endoprobe and a further pre-interventional image is generated, while an element having the same outer dimensions as the first ultrasound endoprobe is arranged within the living being.
  • a second ultrasound image is generated by using a second ultrasound endoprobe, the second ultrasound image is registered with the first ultrasound image, thereby determining a deformation, and the further pre-interventional image is deformed in accordance with the determined deformation.

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Abstract

La présente invention concerne un système d'imagerie interventionnelle (16) pour imager une région d'intérêt à l'intérieur d'un être vivant (2) pendant une intervention. Avant l'intervention, une première image échographique est générée en utilisant une première sonde endoscopique à ultrasons et une image pré-interventionnelle supplémentaire est générée, alors qu'un élément ayant les mêmes dimensions extérieures que la première sonde endoscopique à ultrasons est disposé à l'intérieur de l'être vivant. Durant l'intervention, une seconde image échographique est générée en utilisant une seconde sonde endoscopique à ultrasons (18), la seconde image ultrasonore est enregistrée avec la première image ultrasonore, déterminant ainsi une déformation, et l'image pré-interventionnelle supplémentaire est déformée selon la déformation prédéterminée. Ceci conduit à une image pré-interventionnelle, qui est précisément déformée en fonction de la structure actuelle de la région d'intérêt et qui peut être utilisée pour précisément guider un médecin durant l'intervention.
PCT/EP2014/077657 2013-12-13 2014-12-13 Système d'imagerie pour imager une région d'intérêt Ceased WO2015086848A1 (fr)

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CN110868939A (zh) * 2017-06-07 2020-03-06 皇家飞利浦有限公司 超声系统和方法
JP7281487B2 (ja) 2018-06-19 2023-05-25 コーニンクレッカ フィリップス エヌ ヴェ 超音波支援装置及び方法、医療システム
WO2019243389A1 (fr) 2018-06-19 2019-12-26 Koninklijke Philips N.V. Dispositif et procédé d'assistance ultrasonore, système médical
CN111479511A (zh) * 2018-06-19 2020-07-31 皇家飞利浦有限公司 超声辅助设备和方法、医学系统
JP2021529008A (ja) * 2018-06-19 2021-10-28 コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ． 超音波支援装置及び方法、医療システム
CN111479511B (zh) * 2018-06-19 2023-07-07 皇家飞利浦有限公司 超声辅助设备和方法、医学系统
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US20220192639A1 (en) * 2019-04-17 2022-06-23 Elesta S.p.A. Endocavity probe and method for processing diagnostic images
CN113729941A (zh) * 2021-09-23 2021-12-03 上海卓昕医疗科技有限公司 基于vr的手术辅助定位系统及其控制方法
CN113729941B (zh) * 2021-09-23 2024-01-30 上海卓昕医疗科技有限公司 基于vr的手术辅助定位系统及其控制方法
CN116096313A (zh) * 2021-12-17 2023-05-09 上海卓昕医疗科技有限公司 穿刺定位系统及其控制方法
WO2023108625A1 (fr) * 2021-12-17 2023-06-22 上海卓昕医疗科技有限公司 Système de positionnement de ponction et son procédé de commande
CN114305696A (zh) * 2021-12-17 2022-04-12 上海卓昕医疗科技有限公司 穿刺手术机器人及其控制方法
CN116096313B (zh) * 2021-12-17 2023-10-31 上海卓昕医疗科技有限公司 穿刺定位系统及其控制方法
EP4450008A4 (fr) * 2021-12-17 2025-01-22 Shanghai Droidsurg Medical Co., Ltd Système de positionnement de ponction et son procédé de commande

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