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WO2015185665A1 - Dispositif pour détecter une distribution de rayonnement nucléaire - Google Patents

Dispositif pour détecter une distribution de rayonnement nucléaire Download PDF

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Publication number
WO2015185665A1
WO2015185665A1 PCT/EP2015/062452 EP2015062452W WO2015185665A1 WO 2015185665 A1 WO2015185665 A1 WO 2015185665A1 EP 2015062452 W EP2015062452 W EP 2015062452W WO 2015185665 A1 WO2015185665 A1 WO 2015185665A1
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WO
WIPO (PCT)
Prior art keywords
nuclear
nuclear probe
probe
end effector
coupling
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/EP2015/062452
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German (de)
English (en)
Inventor
Thomas Wendler
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.)
SURGICEYE GmbH
Original Assignee
SURGICEYE GmbH
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 SURGICEYE GmbH filed Critical SURGICEYE GmbH
Publication of WO2015185665A1 publication Critical patent/WO2015185665A1/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
    • A61B6/42—Arrangements for detecting radiation specially adapted for radiation diagnosis
    • A61B6/4208—Arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector
    • A61B6/4258—Arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector for detecting non x-ray radiation, e.g. gamma radiation
    • 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
    • A61B6/42—Arrangements for detecting radiation specially adapted for radiation diagnosis
    • A61B6/4208—Arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector
    • A61B6/425—Arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector using detectors specially adapted to be used in the interior of the body
    • 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
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4429—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units
    • A61B6/4458—Constructional features of apparatus for radiation diagnosis related to the mounting of source units and detector units the source unit or the detector unit being attached to robotic arms
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01T—MEASUREMENT OF NUCLEAR OR X-RADIATION
    • G01T1/00—Measuring X-radiation, gamma radiation, corpuscular radiation, or cosmic radiation
    • G01T1/16—Measuring radiation intensity
    • G01T1/161—Applications in the field of nuclear medicine, e.g. in vivo counting
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01T—MEASUREMENT OF NUCLEAR OR X-RADIATION
    • G01T1/00—Measuring X-radiation, gamma radiation, corpuscular radiation, or cosmic radiation
    • G01T1/16—Measuring radiation intensity
    • G01T1/161—Applications in the field of nuclear medicine, e.g. in vivo counting
    • G01T1/163—Whole body counters
    • 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]
    • A61B6/037—Emission tomography
    • 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
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5205—Devices using data or image processing specially adapted for radiation diagnosis involving processing of raw data to produce diagnostic 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
    • A61B6/54—Control of apparatus or devices for radiation diagnosis
    • A61B6/547—Control of apparatus or devices for radiation diagnosis involving tracking of position of the device or parts of the device

Definitions

  • the present invention relates to an apparatus for detecting a nuclear transmission disorder in a patient by means of a nuclear probe coupleable to a robot arm such that the nuclear probe and a part of the robotic arm can be introduced into the patient.
  • aspects of the invention relate to such a device which tracks the nuclear probe and which determines a target position and orientation of the nuclear probe so as to improve the image quality of a nuclear radiation distribution three-dimensional nuclear image.
  • High quality imaging is of great interest to a wide range of applications. Particularly in the medical field, where the health of a patient may depend on it, the best possible imaging is required, for example, as a basis for operations on the patient.
  • medical images are either generated preoperatively, such as computed tomography (CT), magnetic resonance imaging (NMR, MRI, MRI), positron emission tomography (PET), single photon emission tomography (SPECT), ultrasound (US) or otherwise intraoperatively (io), such as by io CT, io MRI, io US, or freehand SPECT.
  • CT computed tomography
  • NMR magnetic resonance imaging
  • MRI positron emission tomography
  • PET single photon emission tomography
  • US ultrasound
  • io intraoperatively
  • such medical images may help in tumor surgery to decide which tissue pieces to excerpt from the combined anatomical and functional information. It is desirable to have the most up-to-date and high-quality images, as this can avoid harming healthy tissue or accidentally removing it by accident.
  • Image generation and an evaluation system that has to process this data is especially true for the processing of detector data with movable detectors, which are carried in the hand, for example.
  • the prior art in connection with the present invention is disclosed, for example, in US 6,602,488, US 6,456,869, US 6,317,622, US 6,167,296 or DE 10 201 1 053 708 AI and enables tracking (tracking) of the hand-held probes as conventional diagnostic equipment, especially during of a surgical procedure, as well as tracking systems for determining the position and orientation of surgical instruments and imaging devices.
  • nuclear probes can be structurally integrated with a camera.
  • the output signal from nuclear probes is usually just a one-dimensional signal that is not constant over time.
  • the main advantages of such devices are the portability, simplicity, and the possibility of their miniaturization for examining cavities, for example when mounted on endoscopes. Further, because each measurement is not limited to a particular position with respect to the previous one, probes allow the sampling of arbitrary surfaces with spatial accuracy limited only by the size of the sensor and the range of the detected nuclear radiation.
  • Freely movable nuclear probes such.
  • Gamma and beta probes can measure the radioactive decay of radionuclides in tracers injected into the patient prior to the procedure.
  • the disadvantage of these nuclear probes is the fact that they are only point measurements. This makes it difficult to weigh the physical value on a surface if it changes significantly with position.
  • Another problem is the fluctuation of the measurement results, which is based on the statistical nature of the decay and detection process, making the interpretation of the measurement data difficult and potentially unreliable.
  • Other possible inaccuracies can be added to aggravating, such as tracking.
  • the known nuclear probes are usually designed for measurements outside the patient's body and are therefore guided over the body surface, whereby the accessible perspectives for the radiation measurement relative to the target tissue are severely limited.
  • DE 10 201 1 121 708 AI beyond designed as an elongated endoscope nuclear probe is described, one end of which along the longitudinal axis of the nuclear probe in a compassionöff can be introduced and thus also allows measurements inside the body. Nevertheless, the movement possibilities of the probe are also limited here.
  • the object of the present invention is to provide a system and method for intracorporeal imaging, especially in computer-guided operation with nuclear probes, which provides improved image quality and / or a shortened detection time over known methods.
  • the device comprises a robotic arm having a plurality of joints (comprising a distal joint) and an end effector movable by at least three degrees of freedom by the joints: a nuclear probe with a nuclear detector for detecting radioactive radiation and a coupling element for coupling the nuclear probe in a defined position on the end effector of the robot arm; a tracking system for determining pose data indicating a position and orientation of the nuclear probe; and a control unit.
  • the nuclear probe, the end effector and the distal joint can be sterilized and dimensioned so that the nuclear probe, the end effector and the distal joint are completely insertable into the body of the patient and in the patient's body in a defined position are coupled to each other.
  • the control unit includes: a pose module connected to the tracking system for receiving the pose data with the position and orientation of the nuclear probe; a radiation module connected to the nuclear probe for receiving radiation data containing information about the detected radioactive radiation; a synchronization module for synchronizing the pose data with the radiation data; and a bi generation module! for repeatedly calculating a nuclear radiation distribution three-dimensional nuclear image from the synchronized pose data and radiation data.
  • Fig. 1 shows schematically a device according to an embodiment on an operating table
  • Fig. 2a and 2b respectively show a schematic side view of a nuclear probe of a respective embodiment form; 3 shows possible states of motion of a robotic arm with a nuclear probe according to an embodiment;
  • Fig. 6a shows a perspective view of a nuclear probe according to an embodiment
  • Fig. 6b shows a schematic cross-sectional view of the coupling element of the nuclear probe of Figure 6a together with an associated coupling mechanism of the robot arm.
  • FIG. 6c shows a perspective view of a nuclear probe together with an associated coupling mechanism according to another embodiment
  • FIG. 6d shows a schematic cross-sectional view of the coupling element of the nuclear probe of FIG. 6c;
  • Fig. 7 shows a perspective view of a coupling element together with an associated coupling mechanism according to another embodiment
  • FIG. 10 shows schematic cross-sectional views of respective coupling mechanisms according to further embodiments.
  • FIG. 11a and 11b show views of a nuclear probe (FIG. 11a) and of the nuclear probe together with an associated coupling mechanism (FIG. 11b) according to a further embodiment;
  • FIGS. 12a and 12b as well as 13a and 13b show views analogous to those of FIGS. 11a and 11b for nuclear probes and associated coupling mechanisms according to further embodiments.
  • Fig. 14 shows possible configurations of coupling elements according to further embodiments; and Fig. 15 shows schematically the control unit of one embodiment of the device.
  • the methods described herein use computer software to calculate various types of image information from detected information.
  • the methods and algorithms used are either known or can be known to the person skilled in the art be readily written using its standard expertise based on the information provided herein. They are therefore not dealt with in detail.
  • modules and subsystems described herein are interfaced to at least one evaluation unit, output unit, and / or each other.
  • evaluation unit e.g., nuclear probe, camera, robotic arm, control unit, etc.
  • output unit e.g., a laser scanner
  • means for the purpose of calculating 3-D images, transformations, synchronization means, etc. are generally implemented here as commercial computer systems (personal computers or workstations) on which algorithms in the form of computer programs are implemented according to the exemplary embodiments are.
  • Embodiments relate to a device for detecting a nuclear radiation distribution in a patient (preferably a human patient, but the invention is also applicable to animals), in which a nuclear probe is coupled via a coupling in a defined position to the end effector of a robot arm.
  • a defined position is understood to mean a precisely defined relative arrangement of end effector and nuclear probe by the geometry of the coupling element.
  • the defined position is preferably uniquely predetermined, or at least one of a few discrete possible positions, for example of a maximum of four, particularly preferably of a maximum of two possible positions.
  • the robotic arm permits movement of the nuclear probe by at least three degrees of freedom, preferably in all six degrees of freedom, and more preferably even allows redundant movement, i.
  • a position of the nuclear probe is achievable by more than one position of the robotic arm. This allows high flexibility of movement, even in the presence of obstacles to the robot arm.
  • the distal articulation unit of the robotic arm i.e., the end effector and the distal articulation, the distal articulation unit corresponding to a wrist, English "wrist" preferably allows rotational movement about all three spatial axes.
  • the nuclear probe can be inserted uncoupled from the robot arm into the body of the patient and can only be coupled to the robot arm in the body of the patient.
  • the nuclear probe may be fully insertable into the body of the patient according to a preferred but not mandatory aspect, and the robot arm can be introduced into the body of the patient at least from its distal joint unit, for example via an operating opening during a surgical procedure on a patient.
  • the nuclear probe, the end effector and the distal joint may in particular be dimensioned such that they can be inserted completely into the body of the patient even when coupled. This includes both the case in which these units are already coupled to one another during insertion and can be inserted into the surgical opening in the coupled state, as well as the case that they are coupled only after uncoupled, separate insertion into the body of the patient.
  • the apparatus includes a tracking system for determining pose data indicating a position and orientation of the nuclear probe.
  • pose is understood here as indicating the (3D) position of an object in space as well as its orientation
  • the pose is generally expressible by six coordinates (3 position coordinates for the position and 3 solid angles for the orientation).
  • the tracking system determines this pose data preferably from the position of the robot arm, more precisely from the position of the end effector, which can be calculated from the state of motion (diffraction state) of the robot joints by means of corresponding sensors or servomotors in a known manner.
  • Knowledge of the position of the robot arm is sufficient for the pose calculation of the nuclear probe, since the nuclear probe is due to the coupling element according to the invention in a defined (known) position relative to the end effector.
  • the tracking system can also be provided independently of the robot arm, for example by an electromagnetic tracking system which monitors the position of the nuclear probe or the end effector.
  • the nuclear probe for the ing track is equipped with an electromagnetic sensor.
  • a (visible) tracked portion of the robotic arm (eg, above the end effector) is provided with optical markers for tracking.
  • the pose of the nuclear probe is then calculated from the pose of the tracked part and the position of those robot joints that connect the tracked part with the nuclear sensor.
  • the tracking system may also include a fixed or sensed camera system and an image recognition system.
  • the image recognition system is configured to detect the nuclear probe in a camera image taken by the camera system and to calculate the pose of the nuclear probe from the camera image.
  • the nuclear probe includes a recognition pattern attached (eg, engraved or painted or attached) to a defined position of the nuclear probe, and the image recognition system is configured to recognize the recognition pattern.
  • the image recognition system can also be set up to recognize an image of the nuclear probe in the camera image and to determine a pose of the nuclear probe from the detected image.
  • the image recognition system can additionally be set up to also recognize at least one section of the robot arm and to calculate its pose, for example by recognizing a further identification feature attached to a defined position of the robot arm section.
  • the pose data in one aspect, is synchronized with the radiation data obtained by the nuclear detector, and the resulting pose-dependent measured radiation intensities allow a three-dimensional nuclear image to be calculated by a reconstruction algorithm in a manner known to those skilled in the art.
  • a device 1 for detecting a nuclear radiation distribution distribution in a patient 2 is shown.
  • the patient 2 lies on an operating table 4.
  • the device 1 comprises a robot arm 20 which is mounted on a base 5 located opposite the operating table in a defined position.
  • the robotic arm 20 has arm joints 22 and a wrist (distal hinge assembly) 24 which allows at least partial rotation about all three solid angles.
  • On a distal side of the wrist 24 is the end effector 25.
  • the end effector 25 is movable by means of the hinges 22 and 24 by all six degrees of freedom.
  • FIG. 1 shows a control unit 40, which is operatively connected to the robot arm 20 and to the nuclear probe 100.
  • another nuclear detector 4a may be operatively connected to the control unit 40.
  • the further nuclear detector 4a is stationary mounted on the operating table, such as below the operating table.
  • the further nuclear detector 4a may optionally have a collimator and / or a nuclear camera to perform a spatially resolved nuclear measurements.
  • the control unit 40 is equipped to synchronize detector data of the further nuclear detector 4a with the detector data of the nuclear probe 100 and to reconstruct a three-dimensional nuclear image from both detector data, for example by means of a PET reconstruction method or a Compton camera reconstructing method. In this way, with the aid of the nuclear detector 4a, an even more accurate or less noise-generating or rapidly generated image of the three-dimensional radiation distribution can be obtained.
  • the end effector 25, or the nuclear probe 100 coupled in a defined manner is in embodiments tracked by a tracking system, i. a pose of them is continuously recorded.
  • the tracking system typically detects the pose in a coordinate system relative to the operating table 4. In order for the patient 2 to assume a defined position in the coordinate system, it is preferable for the patient to remain stationary relative to the operating table 4 for the duration of the measurement.
  • At least one marker can be fixed to the patient 20 as a patient reference.
  • the position of this patient reference is determined during the application of the method according to the invention via means for determining the reference pose of the patient reference relative to the coordinate system of the tracking system (for example via an optical tracking system).
  • a coordinate transformation of the nuclear probe pose is then performed into an effective coordinate system which is fixed relative to the patient reference and thus to the location of the patient 2 (the at least one marker).
  • the nuclear probe 100 is shown in greater detail in FIG. 2a.
  • the nuclear probe 100 has a sheath 140 of a nuclear radiation shielding material, such as tungsten for gamma radiation, on.
  • a detector 116 for Detection of radioactive radiation appropriate.
  • the detector 116 and thus the nuclear probe 100 is typically designed for the detection of gamma radiation, beta radiation, or both.
  • the detector 16 comprises as a detecting element e.g. a scintillator crystal and a photomultiplier which converts light generated by the scintillator into electricity. Through a cable 102, the photomultiplier is connected to the outside world. Through an opening in the casing 140, nuclear radiation can reach the detector and be detected by it. The aperture defines a field of view 15 about a viewing axis A of the detector. The jacket 1 14 surrounds the detector 16 so that the detector 16 is substantially only sensitive to nuclear radiation from the field of view.
  • the detector may also be formed only by a scintillator and be connected by an optical fiber to a photomultiplier located outside the nuclear probe.
  • the detector may also be of the "direct conversion" type, which converts gamma radiation directly (without the intermediate step via a photodetector) into an electrical signal, as is the case with a CdZnTe detector.
  • FIG. 2a also has a coupling element 130 for coupling the nuclear probe 100 in a defined position to the end effector 25 of the robot arm (see FIG.
  • the coupling element is shown in Fig. 2a only schematically and described in more detail below.
  • the nuclear probe 100 is shown in the schematic drawing of Fig. 2a rectangular. However, it is preferred that the nuclear probe is edgeless, e.g. is designed substantially cylindrical.
  • FIG. 2b shows further optional details of the nuclear probe 100 for which the description of FIG. 2a otherwise applies.
  • the nuclear probe 100 may include a collimator 12 made of a nuclear radiation shielding material such as tungsten.
  • the collimator in this case defines the view described above and the line of sight A.
  • the collimator 112 may be a pinhole collimator with a single aperture or a multi-hole collimator such as shown in Fig. 2b, eg of the multi-pinhole type , Parallel-Hole, Converging, Diverging, and / or Aperture-Coded.
  • the nuclear probe may also include multiple detectors, such as an array (nuclear camera) or a detector stack of detectors.
  • the collimator 112 corresponds to the opening of Fig. 2a and has a field of view 115 with a viewing axis A, wherein the visual axis A of the field of view is directed parallel to an axis (longitudinal axis) of the nuclear probe 100 and its casing 114.
  • the collimator 1 12 is not mandatory.
  • the detector included in the nuclear probe is a first detector of the detector pair, and another detector of the detector pair is mounted outside the nuclear probe, such as optional detector 4a described further below.
  • an optical camera 9 is further attached rigidly to the nuclear probe 100.
  • the camera may be an endoscopic camera, such as for (non-limiting) a laparoscope, a laryngoscope, a rynoscope, an arthroscope, an epiduroscope, an esophagoscope, a gastroscope, an enteroscope, an anoscope, a rectoscope, a colonoscope, a symodoiscope , a proctoscope, a cystoscope, a gynecoscope, a colposcope, a hysteroscope, a falloposcope, a bronchoscope, a thoracoscope, a mediastinoscope, an otoscope, or a ductoscope.
  • An optical axis of the camera is preferably aligned parallel to the axis A.
  • an ultrasound transducer and probe may be attached to the nuclear probe to generate additional image information from U 1 traschal l horren.
  • a maximum diameter dmax of the nuclear probe 100 (without cable) is less than 3 cm.
  • dmax is the largest diameter in any direction, or the nuclear probe 100 fits completely into an imaginary sphere of diameter dmax.
  • the nuclear probe has a longitudinal axis, and the viewing axis A of the collimator extends parallel to the longitudinal axis.
  • a length 1 of the nuclear probe (along the longitudinal axis or the visual axis A) is less than 4 cm.
  • a maximum transverse diameter h of the nuclear probe (transverse to the longitudinal axis or to the visual axis A) is less than 5 cm.
  • an aspect ratio Lmax / Lmin of the nuclear probe is between 1 and 2 (the maximum extent Lmax being in the direction of the largest maximum extent Lmax and the minimum extent Lmin in the direction of the smallest maximum extent Lmin is measured).
  • Robot Arm, Movement Figure 3 illustrates the possibilities of movement of the nuclear probe 100 through the robotic arm 20 inserted through an operative opening 2b inside the body 2 of the patient.
  • the robot arm allows positioning of the nuclear probe 100 in a wide range. This is possible in particular in that the end effector 25 and preferably also the distal joint 24 are completely insertable into the body 2 of the patient, and can be coupled to one another in the body 2 of the patient in a defined position.
  • the robotic arm allows positioning on different sides of the target tissue 2a and thus viewing of the target tissue by the nuclear probe 100 from different sides. This allows optimized imaging. This positioning is achieved by the high number of degrees of freedom of the distal joint 24 and by the compact dimensions of the nuclear probe 100.
  • FIG. 4 and Fig. 5 Dimensions and configurations of the robotic arm and the nuclear probe, which allow a particularly favorable viewing of the target tissue are shown in Fig. 4 and Fig. 5. Illustrated by these figures, some general preferred aspects of the invention will now be described in terms of dimensions and configurations of the robotic arm and the nuclear probe.
  • the robotic arm is designed such that an angle between an axis of the end effector 25 (defined by a central connecting line between the distal joint 24 (or its center of motion) and the coupling mechanism 23) and a visual axis A of the Nuclear probe 100 is less than 60 ° and preferably less than 45 °. It is another preferred aspect that the end effector 25 and / or the distal hinge 24 and / or the coupled nuclear probe 100 at no point have a cross section (transverse to the connecting line) with a diameter of more than 8 cm. It is a further preferred aspect that a distance dl between the distal joint 24 (more precisely, its center of motion) and the nuclear probe 100 (more precisely, its Visual axis) is less than 6 cm.
  • a distance d2 between the distal joint and the further joint in front of it is between 5 cm and 20 cm (distance between the respective movement centers of the joints).
  • the end effector 25 has a length of less than 7 cm and / or a maximum transverse diameter of less than 2 cm.
  • the above-mentioned distal joint 24 may also be formed by a joint group.
  • the distal joint group has at least one hinge and preferably allows rotation about two or even three independent solid angles.
  • the swivel joint permits rotation about a maximum angle of rotation ⁇ of at least 180 °, at least by one solid angle (see FIG. 5).
  • the hinge allows at least two independent solid angles to rotate through a maximum angle of rotation ⁇ of at least 90 ° or even 180 ° (see FIG. 5).
  • the pivot about each of the three independent space angle allows rotation about a maximum angle of rotation ⁇ of at least 60 °.
  • Fig. 6a shows a perspective view of a nuclear probe 100.
  • the nuclear probe 100 has a cylindrical housing with axis A, which at the same time also represents the visual axis of the nuclear detector (see Fig. 2a, 2b).
  • the nuclear probe 100 has a coupling element 130 which is formed by a profiled rear end portion of the nuclear probe.
  • the coupling mechanism is here formed by a gripper 230 with two fingers 232a, 232b.
  • it is a gripper of the minimally invasive da VinciCD system.
  • the fingers 232a, 232b are pivotable towards and away from each other about an axis toward and away from each other.
  • the coupling element 130 is designed to be gripped by fingers 232a, 232b of the gripper 230.
  • the coupling element 130 on two parallel to the axis A extending gripping portions 132a, 132b.
  • the Grei sections 132 a, 132 b define respective planes that intersect in a line extending outside the nuclear probe 100 parallel to the axis A extending straight line.
  • Figs. 6c and 6d show a possible embodiment of the structure shown in Fig. 6b in greater detail.
  • the gripping portions 132a (not visible in Figs. 6c) and 132b of the coupling member 130 are mounted in a respective recess of the nuclear probe 100, and these recesses define a unique longitudinal position for the gripper 230 or its fingers 232a, 232b along the axis A (see Figs Fig. 6a).
  • the coupling daemon 130 further has on each of the gripping portions 132a, 132b a projection member 136 which is designed to engage with an opening 236 of the corresponding finger 232a and 232b, respectively.
  • the opening 236 is configured as a slot
  • the projection element 136 is designed to engage in a distal end of the slot. This ensures that the Nuklcarsonde 100 can be securely gripped by the gripper 230 and fixed in a unique position.
  • the coupling element 130 is designed such that the axis A of the nuclear probe 100 perpendicular to a central axis of the gripper 230 (central axis of the lines defined by the fingers 232a, 232b) runs.
  • FIG. 7 illustrates an alternative embodiment in which the axis A of the nuclear probe 100 is parallel to the central axis of the gripper 230.
  • the embodiment of Fig. 7 has the advantage that the field of view of the nuclear probe 100 is intuitively easy for the user to grasp, as it is directed forward with respect to control of the gripper.
  • the angle between the axis A of the nuclear probe 100 and the central axis of the gripper 230 is less than 45 °, preferably even less than 30 °, and more preferably the two axes are substantially parallel (ie, less than 10 ° deviation ).
  • the coupling element 130 is designed mirror-symmetrical, as can be seen in Fig. 6d.
  • FIGS. 8 and 9a-9b schematically show possible variations of the coupling element 130 of FIG. 6d, in which the projection element 136 is varied or replaced.
  • one projection member 136a is provided on one of the two gripping portions, and two projection members 136b are provided on the other.
  • the coupling element 130 is no longer designed mirror-symmetrically.
  • the fingers of the gripper have recesses complementary to the projection elements 136a, 136b, so that the gripper can grip the coupling element in exactly one orientation, whereas the other orientation is excluded.
  • the projection elements of the coupling element 130 are replaced by recesses 137, and the fingers of the gripper (not shown) have to the recesses 137 complementary Vorsprungsel em duck on.
  • a combination of recesses and Vorsprungsel elements on the coupling element 130 is possible.
  • Fig. 9b shows a possible arrangement of recesses 137 in a plan view of a gripping portion 132 (corresponding to the gripping portion 132a and / or 132b shown in Figs. 6a-d).
  • the defined position of the nuclear probe relative to the coupling mechanism has a tolerance of less than 1 mm, ie the defined position is reproducible within this tolerance.
  • FIG. 10a-10c show schematic cross-sectional views of respective coupling mechanisms that can be used interchangeably or even in combination in any embodiment according to one aspect of the invention, with the coupling elements of the nuclear probe 100 then being adjusted accordingly.
  • the arrows in Figs. 10a-10h illustrate the movement of elements of the respective coupling mechanism for fixing the nuclear probe 100.
  • Fig. 10a illustrates the gripper 230 already shown in Fig. 6b with two pivotal fingers 232a, 232b.
  • Fig. 10b illustrates Variation thereof, in which the fingers 232a, 232b are aligned parallel to each other and can be moved to fix the nuclear probe 100 laterally to each other. Accordingly, the gripping portions of the nuclear probe 100 are arranged parallel to each other.
  • the gripper 230 shown in Fig. 10a, 10b is thus provided with gripping areas on the inner sides of the fingers 232a, 232b, which may have an adhesion-enhancing coating and / or texture.
  • the inner grippers 250 shown in Figs. 10c and 1d0 are variations of the grippers of Figs. 10a and 10b in which the nuclear probe 100 is fixed by moving the fingers 252a, 252b apart from each other.
  • the coupling element 130 is designed as an opening with two zuwei nanderwei send gripping portions
  • the inner hook 250 is designed to retract into the opening and by moving apart the fingers 252 a, 252 b can be pressed from the inside against the gripping portions.
  • the inner hook shown in Fig. 10c, l OD 250 is thus provided with gripping areas on the outsides of the fingers 252a, 252b, which may have a laterally increasing coating and / or texture.
  • the general aspect illustrates that the fingers 252a, 252b need not be straight but may also have kinks or, more generally, a curved shape.
  • This aspect is also shown in FIG. 10e-g for the gripper 230.
  • the gripping portions of the coupling element 130 are correspondingly curved to contact the fingers, so that the coupling is fixed by the curvature and kept stable.
  • Fig. 10h shows a further variation in which the Grei it is replaced by a screw coupling mechanism 260.
  • the coupling member 130 has a through hole
  • the screw coupling mechanism 260 has a nut.
  • a screw 262 can be screwed through the through hole on the screwable coupling mechanism echani smus 260 and thus fix the coupling member 130 on the screw coupling mechanism 260.
  • Figs. 10a-10g only one of the fingers may be movable and the other finger may be rigid. Any releasable attachment can be used as a coupling mechanism.
  • the coupling mechanism is couplable and releasable within the patient's body (which, for example, does not apply to the screwable coupling mechanism 260 of FIG. 10h, for which reason the other embodiments are even more preferred).
  • Fig. 1 la shows a nuclear probe 100 with a coupling element 130, which is adapted to the coupling mechanism 230 of FIG. 1 Ob.
  • Fig. 1 l b this nuclear probe is shown in a lateral cross section together with the coupling mechanism 230 of Fig. 10b.
  • the coupling element 130 has two gripping sections 132a, 132b, which are arranged flat and parallel to one another in order to be gripped by the fingers 232a, 232b of the coupling mechanism 230.
  • FIGS. 12a and 12b show a further embodiment of a nuclear probe 100 with coupling element 134 (FIG. 12a) and an associated coupling mechanism 240 (FIG. 12b).
  • the coupling element 134 is designed as an opening (more accurately as a blind hole) in the nuclear probe 100, and the coupling mechanism 240 is designed to be complementary to the opening, so that the coupling mechanism 240 can be introduced into the coupling element 134 and, in the fully inserted state, the nuclear probe 100 in a unique manner Relation holds.
  • the coupling element 134 and the coupling mechanism 240 on a fixing device (not shown) for fixing the fully inserted into the coupling element 134 coupling mechanism 240.
  • the fixing device can be about a mechanical snap device or a hydraulic fixing device (in which the coupling element 134 and / or the coupling mechanism 240 for clamping / releasing the fixation can change their volume) or a permanent magnet and / or El ektromagneten comprehensive magnetic device.
  • the coupling element 134 comprises a (para- or ferro-) magnetizable material
  • the coupling mechanism 240 comprises an electromagnet (a solenoid), which is arranged such that when the electromagnet is turned on, the coupling mechanism 240 inserted into the coupling element 134 through the Electromagnet is held in it, and with the electromagnet off, the holding is released.
  • the electromagnet may also be mounted in the coupling element 134 instead of in the coupling mechanism 240; This has the advantage that the power supply of the nuclear probe 100 can also be used for the electromagnet.
  • Figures 13a and 13b show another embodiment of a nuclear probe 100 with coupling element 135 (Figure 13a) and an associated coupling mechanism 250 ( Figure 13b).
  • the coupling mechanism 250 has an opening 254 (more precisely a blind hole) and the coupling element 135 is designed to be complementary to the opening so that the coupling element 135 can be inserted into the opening 254 is and is recorded in a completely established state in a unique relation.
  • Mechanism 250 is a (para- or ferro-) magnetizable material, and the coupling element 135 comprises an electromagnet which is arranged such that when El ektromagneten the inserted into the opening 254 of the coupling mechanism coupling element 135 is held by the electromagnet therein, and the detent is released when the electromagnet is switched off;
  • the electromagnet may also be mounted in the coupling mechanism 250, instead of in the coupling element 135.
  • FIG. 14 shows possible further configurations of the opening 134 which may alternatively be used, such as a trapezoidal shape (FIG. 14a), a triangular shape as in FIG. 12a (FIG. 14b), a circular shape (FIG. 14c) or an oval shape (Fig. 14d).
  • the coupling mechanism 240 is then made complementary and has the analogous cross-sectional shape.
  • FIGS. 3a, 13b can be adapted analogously.
  • the end effector 25 has a coupling mechanism 23 configured to interact (eg, engage) with the coupling member such that the defined position of the nuclear probe to the end effector is determined by the interaction between the coupling mechanism 23 and the coupling member 130.
  • the coupling mechanism can, as shown in Fig. 6- 1 1, realized by a gripping hand 230 of the end effector. It may, for example, be the grasping hand of the DaVinci (brand name) surgical robot.
  • the coupling element 130 is realized by a holding element fastened to the nuclear probe, which is shaped such that the holding element 130 is held stable in exactly one position by the gripping hand.
  • the holding member 130 may include a protrusion; it may alternatively be formed by a plurality of notches in the nuclear probe.
  • the interaction between the Koppelmechani smus 23 and the coupling element 130 by a screw connection, a magnetic connection, a plug connection, by means of negative pressure, terminals, or by a combination thereof.
  • the interaction may be non-positive or positive.
  • coupling element 130 and Koppelm echan i smus 23 mechanical engagement or stop elements, which define a clear relative position between the nuclear probe and end effector.
  • coupling element 130 and coupling mechanism 23 are designed asymmetrically.
  • the coupling element 130 may, for example, have a profile for engagement with the coupling mechanism (23, 230, 240, 250, 260) on two mutually opposite sides of the nuclear probe 100, respectively.
  • the profiles on the two opposite sides may differ from each other.
  • At least one of the profiles and preferably both profiles may be a survey for engagement with a corresponding recess of the Coupling mechanism, and / or have a recess for engagement with a corresponding elevation of the coupling mechanism.
  • the coupling mechanism may have such a profile with survey (s) and / or recess (s).
  • the connection between robot arm or coupling mechanism 23 and nuclear probe or coupling elements 130 is releasably, preferably even in the interior of the patient's body 2 solvable.
  • Fig. 15 shows the control unit 40 shown in Fig. 1, further elements and connections therebetween in greater detail.
  • the nuclear probe 100 and the robot arm 20 are as described in FIG. Furthermore, a robot controller 55 and a tracking system 56 are shown.
  • the robot controller 55 is equipped to send commands to actuators that cause movement of the joints 22, 24 of the robot arm.
  • the tracking system 56 is equipped to determine pose data indicating a position and orientation of the nuclear probe 100.
  • various techniques may be considered, such as an optical or a magnetic tracking system. Preferred is a system which retrieves the state of motion (diffraction state) of the joints of the robot arm and determines therefrom the pose of the effectuator or of the nuclear probe.
  • This tracking system 56 may be integrated in the robot controller.
  • the control unit 40 has a pose module 50, a radiation module 60, a synchronization module 70, an imaging module 80, a quality value module 90, and a target pose module 95.
  • the pose module 50 is identical to the Tracking system 56 is connected to receive the pose data with the information about the position and orientation of the nuclear probe 100.
  • the radiation module 60 is connected to the nuclear probe 100 (more precisely to the one shown in FIG Detector 16) connected to receive radiation data with information about the detected radioactive radiation or their intensity. Both modules 50 and 60 are equipped to store the respective received data with associated time information.
  • the synchronization module 70 is connected to the modules 50, 60 to synchronize the pose data with the radiation data, ie to associate simultaneous measurement information (pose data and radiation data). As a result, the synchronization module 70 therefore provides data pairs of radiation data (intensities) with associated pose data of the nuclear probe 100.
  • the imaging module 80 is coupled to the synchronization module 70 for receiving these data pairs and configured to repeatedly compute a nuclear radiation distribution three-dimensional nuclear image from the data pairs.
  • the imaging module is configured, in one embodiment, to iteratively determine a three-dimensional radiation distribution that is at most consistent with the measured radiation data.
  • a program is known to the person skilled in the art (for example the freehand SPECT image reconstruction mentioned at the beginning) and described, for example, in DE 10 201 1 053 708 A1 and the references cited therein.
  • a (always "at least") quality value Q is calculated which indicates an image quality of the calculated three-dimensional nuclear image
  • the term "quality value”, generally referred to herein as Q represents a parameter used in the context of this application that is capable of improving the quality of the images discussed herein. Examples of the quality value are given below: The quality value thus defined can also be calculated directly from the data of the synchronization module, without necessarily reconstructing an image.
  • This parameter Q can then be used to optimize the image, for example, to alert the user that he should move the probe to another location / position to improve the recorded database.
  • the quality assessment can be used to specifically suggest to the user a particular (or several different / al ternati ve) new position / location of the probe to pass through a targeted position and / or position change of the probe by the user to increase the quality of the determined from the probe data 3 D image;
  • the quality value can be used to change the position of the probe without actuation of a user by actuators, such as by driving a robot arm that guides the nuclear probe.
  • the representation of the image quality by Q allows a target pose (target position and target orientation) of the nuclear probe to be determined under the constraint that a corresponding placement of the nuclear probe results in an improvement of the at least one quality value Q.
  • a prognosis value for Q serves as a function of the pose, which is simulated as a function of the pose (and optionally of previously taken poses).
  • the target pose is then the pose that optimizes the forecast value for Q according to an optimization algorithm-optionally with further boundary conditions. The activation of the target pose thus leads to an increase in the quality value Q, which in turn results in an increase in image quality or reliability.
  • the target pose may follow: outputting a binary information - whether the probe should be moved further or not; or outputting one or more possible movements of the robotic arm which should drive the nuclear probe towards the target pose or bring it closer to it; and / or the output of target coordinates of the target pose.
  • the output may be for instance to a controller of the robot arm or to a user controlling the robot arm manually or semi-automatically.
  • the target pose can also indirectly determine the pose of the nuclear probe only by describing the target pose as by coordinates of the effector.
  • control unit 40 comprises a quality value module 90 with a program for determining from the pose data at least one quality value Q which indicates an image quality of the calculated three-dimensional nuclear image; and a target pose module for determining a target position and target orientation of the nuclear probe under the constraint that a corresponding placement of the nuclear probe results in an improvement of the at least one quality value Q.
  • the quality value module 90 is configured to determine at least one quality value Q indicating an image quality of the calculated three-dimensional nuclear image.
  • the previously covered poses relative to the target tissue can be taken into account. If, for example, a perspective on the target tissue has not yet been taken at all, a considerable improvement in the information situation can be expected by taking this perspective.
  • the quality value Q may vary depending on the method, e.g. a scalar, a vector, a scalar field, a vector field, a tensor, or a 3 D matrix.
  • Q can associate different poses with the expected improvement potential that would be expected for a given time in this pose when (further) measuring.
  • Q may e.g. Express how large the variance between the count rates from different solid angle elements for each different directions.
  • the larger Q in this case the higher the variance of the quality of the data acquired between different solid angles or partial volumes from certain directions, which is generally undesirable, because then certain sub-volumes e.g. have too low image resolution or too high image noise.
  • the recording time is significantly lower in relation to other areas, so where the quality of the presentation is lower.
  • the evaluation unit 60 decides that data has to be retrieved. The range for which this is true is then known from the previous calculation.
  • the evaluation unit can calculate in which target direction, based on the actual position of the nuclear probe, data should still be collected in order to improve the image quality or at the same time to lower Q.
  • a program for calculating possible quality values is described, for example, in DE 10 201 1 121 708 A1, paragraphs [038] - [046], the teaching of which in this respect is hereby complete by reference is involved. Further methods for determining quality values Q of a computer-generated image from a nuclear probe are described in DE 10 2008 025 151 A1 on pages 37 to 42, the relevant teaching of which is hereby incorporated by reference in its entirety.
  • the quality value module 90 is equipped to calculate Q as a function of a pose, ie to calculate for multiple pose values (or at least for multiple orientation and / or position values).
  • the target pose module 95 is connected to the quality value module 90 for receiving Q. From Q, the target pose module 95 determines a target pose (target position and target orientation). Here, the target pose is determined under the constraint that a corresponding placement of the nuclear probe leads to an improvement of the at least one quality value Q. For example, if Q expresses a pose-dependent information deficit, a target pose may be defined as a pose with maximum Q (optional under other constraints). Corresponding placement of the nuclear probe on this pose is likely to result in an improvement (or better enhancement, i.e., greater improvement than any other of the considered poses) of the quality value Q, since the value Q (the information deficit) will fall the most there.
  • a target direction (variation of the pose) can be determined, for example as the pose change, in which the determined gradient of Q is extremal.
  • the following described for the target pose can be analogously modified for a target direction.
  • the stated target values for the pose of the nuclear probe 100 can be determined, such as the amount of movement in which the nuclear probe can be moved, the possible directions in which the nuclear probe can be directed (inter alia, depending on the preoperative image data known anatomy of the patient), the position or pose of the patient and the organs in the body, the expected radioactivity distribution in the body, etc.
  • This information can be from preoperative data of the patient (registered or not), statistical models, information of the movement of Nuclear probe or other endoscopic instruments, etc., to be won.
  • This information can be used, for example, to check the plausibility of the target values, or to weight them. So must be ensured be that a pose is not proposed in which the location of the probe would overlap with an organ.
  • the instruction is output from the target pose module 90 either to the robot arm 20 or its controller 55, or it is output to a user.
  • the instruction can be given: signaling whether further movement is to take place or not; Issuing one or more new target poses; Output of motion sequences (e.g., vectors) leading to these poses; or control commands for the robot arm or for one or more actuators thereof for movement of the probe.
  • a target position and target orientation of the nuclear probe 100 is now calculated from the information derived from Q; As described above with the Maubedi tion that a corresponding change in position of the nuclear probe leads to an improvement of the quality value Q.
  • an output system e.g.
  • the calculated target information after being converted into instructions for moving the robot arm, is output to a user.
  • a possible corresponding representation is shown in FIG.
  • the output system 90 is typically a screen, but may also include a variety of other variants, e.g. a voice output system or a haptic output by means of force feedback to controls of the robot controller.
  • the user can move the probe to the target position and target orientation so that additional events can improve the count rate for the particular solid angle.
  • the output system is for outputting a representation of the nuclear image and the embedded position and orientation of the nuclear probe, and optionally the target position and target orientation of the nuclear probe.
  • the corresponding movements are performed by the robot arm so as to improve the imaging by the nuclear probe 100.
  • the control commands can initially be further processed by the robot controller and adjusted if necessary.
  • the adaptation can be done using sensor data and / or anatomical model data.
  • the nuclear probe and / or the end effector may include an ultrasonic sensor, and the fitting is done using sensor data from the ultrasonic sensor.
  • the Adaptation may include suppressing or modifying motions that would interfere with patient tissue.
  • the drive commands specify a target pose
  • the adaptation includes calculating a path that calculates an optimal path, taking into account additional conditions (eg, sensor data and / or anatomical model data), to maximize the target's nuclear sensor to bring close.
  • additional conditions eg, sensor data and / or anatomical model data
  • the robot arm has redundant degrees of freedom, that is to say it can reach a predetermined pose of the nuclear probe through a plurality of positions of the robot arm. This redundancy allows for an increased number of options in calculating the optimal path.
  • the control unit 40 may comprise an augmented reality engine (not shown).
  • the augmented reality engine is connected to the image generation module 80 to reproduce a two-dimensional image of the three-dimensional nuclear image in a perspective of the optical camera, and is connected to the optical camera 190 to form an optical image of the optical camera superimpose two-dimensional image, so that the superimposed image represents an augmented reality image.
  • such an augmented reality engine can also be realized with a tracking camera decoupled from the nuclear probe.
  • the camera may be provided on another part of the robotic arm 20 or on a separate tracking system (such as a separate laparoscope).

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Abstract

L'invention concerne un dispositif (7) pour détecter une distribution de rayonnement nucléaire dans un patient, qui comprend : un bras robotisé (20) comportant une pluralité d'articulations (22, 24) et un effecteur terminal (25) mobile au moyen des articulations (22, 24) autour d'au moins trois degrés de liberté, les articulations comportant une articulation distale (24) ; une sonde nucléaire (100) comportant un détecteur nucléaire (110) pour la détection de rayonnement radioactif et un élément de couplage (130) pour coupler la sonde nucléaire dans une position définie à l'effecteur terminal (25) du bras robotisé ; un système de suivi pour déterminer des données de pose, qui indiquent une position et une orientation de la sonde nucléaire (100) ; et une unité de contrôle (40). La sonde nucléaire (100), l'effecteur terminal (25) et l'articulation distale (24) sont aptes à être stérilisées et sont dimensionnées de telle sorte que la sonde nucléaire (100), l'effecteur terminal et l'articulation distale sont aptes à être insérés en entier dans le corps (2) du patient et sont aptes à être couplés dans le corps (2) du patient les uns aux autres dans une position définie.
PCT/EP2015/062452 2014-06-06 2015-06-03 Dispositif pour détecter une distribution de rayonnement nucléaire Ceased WO2015185665A1 (fr)

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CN113468985A (zh) * 2021-06-16 2021-10-01 北京科技大学 一种可疑辐射源携带人员的锁定方法
CN114740523A (zh) * 2022-04-01 2022-07-12 杭州湘亭科技有限公司 一种核辐射探测器

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WO2019155196A1 (fr) * 2018-02-06 2019-08-15 Lightpoint Medical, Ltd Sonde laparoscopique attachée
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CN113468985A (zh) * 2021-06-16 2021-10-01 北京科技大学 一种可疑辐射源携带人员的锁定方法
CN113468985B (zh) * 2021-06-16 2023-09-05 北京科技大学 一种可疑辐射源携带人员的锁定方法
CN114740523A (zh) * 2022-04-01 2022-07-12 杭州湘亭科技有限公司 一种核辐射探测器

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