WO2018186518A1 - Triple fusion imaging apparatus for laparoscopic surgery - Google Patents

Abstract

The present invention provides a triple fusion imaging apparatus for laparoscopic surgery with which, during a laparoscopic surgery or robotic surgery, distortion can be minimized and tumor tissue or a sentinel lymph node can be excised accurately with high sensitivity and specificity.

Description

Triple Fusion Imaging Device for Laparoscopic Surgery

The present invention relates to a triple fusion imaging device for laparoscopic surgery.

Recently, as the incidence of various types of cancers such as prostate cancer, cervical cancer and gastric cancer increases in modern people, laparoscopic or robotic surgery is also increasing. In particular, laparoscopic surgery has greatly reduced the risk of surgery, stress, hospitalization, and recovery from surgery, and recently, computer chips are used to obtain a clearer and enlarged image than the naked eye. Hemostasis is possible without problems, and if the nerve needs to be preserved, it is easy to preserve the nerve through the enlarged image. Conventional devices for discriminating and resecting tumors and surveillance lymph nodes through laparoscopic surgery are often difficult to make accurate judgments because they are shown in a single image. In other words, when the ablation is performed by a robotic procedure in the prostate cancer with the help of a near-infrared camera, there is a problem in that the near-infrared camera is difficult to determine the exact position and shape when the target is located at the core due to the weak penetration of the near-infrared fluorescence. In addition, when the ablation is performed by a robotic procedure with the help of a gamma camera, the resolution of the image is low, making it difficult to distinguish the exact shape and location. In particular, the recent surgery is minimally invasive surgery, unlike the conventional surgery method, the rate of laparoscopic surgery and robotic surgery, which operates only a few or one port on the patient's body, is gradually increasing. An evaluation technique is needed to observe the shape. Since the evaluation of the resected tissue should ultimately be obtained from the operating room, there is a need for techniques and equipment that can be used to evaluate tumor tissue or surveillance lymph nodes with minimal impact on existing surgery. No equipment In this regard, Korean Patent No. 0980247 discloses a laparoscope including a wide-angle lens unit, an optical fiber, and an optical interface unit, and an image processing system using the same.

However, in the case of the prior art, it is only an anatomical image information including the visible light wavelength region (400-700 nm) as a device for imaging the visible light image in the abdominal cavity in a wide range, so that a near-infrared fluorescent substance or radiopharmaceutical is used. Imaging of used tumor tissue or surveillance lymph nodes is technically impossible.

The present invention is to solve a number of problems including the above problems, a laparoscopic triple fusion imaging apparatus for minimizing distortion during laparoscopic and robotic surgery, and can excise tumor tissue or surveillance lymph nodes with high sensitivity and specificity It aims to provide. However, these problems are exemplary, and the scope of the present invention is not limited thereby.

According to an aspect of the present invention, a flash crystal for obtaining a gamma ray scintillation image by reacting with gamma rays emitted from a gamma ray radiation material administered to visible light, near infrared rays and affected areas, and transmitting the optical signals of the visible light and near infrared rays to an optical fiber after focusing A front focusing lens having an optical lens attached thereto; Optical filter to prevent loss of gamma-ray flashing light due to light source and overload of SiPM detector, Simultaneous counting circuit to remove unnecessary background gamma rays for imaging or counting gamma rays, fusion image module and in vitro endo-PET / near-infrared including an optical tracker that tracks and displays distances, positions, and angles between endo-PET modules in real time, and an optical mechanism that adjusts the sensitivity and resolution of near-infrared, gamma-rays by varying the distance between components / Fusion image module for obtaining visible light; An in vitro endo-PET module installed under the fusion image module and detecting the gamma ray through a co-factor with the fusion image module; An optical fiber for transmitting a triple image obtained from the fused image module; A light source configured to excite a white infrared light to acquire a visible light image and a near infrared emitter to an affected part to generate a near infrared excitation light to obtain a near infrared image; A photoelectric conversion module that separates individual images of visible light, near infrared light, and gamma light from the triple image transmitted through the optical fiber and converts the individual images into electric signals; Matching means for matching a visible light image signal, a near infrared image signal and a gamma ray image signal of the photoelectric conversion module to one image; And a control unit including image display means for acquiring, amplifying, and simultaneously counting the image signal of the photoelectric conversion module and the image signal of the extracorporeal endo-PET module and displaying the image signal. To provide.

According to one embodiment of the present invention made as described above, the distortion is minimized to high sensitivity and specificity of the triple fusion imaging apparatus during laparoscopic and robotic surgery can implement an effective resection of tumor tissue or monitoring lymph nodes. Of course, the scope of the present invention is not limited by these effects.

1 is a block diagram showing a schematic structure of a triple fusion imaging apparatus for laparoscopic surgery according to an embodiment of the present invention.

Figure 2 is a configuration of gamma-ray detection of the laparoscopic triple fusion imaging apparatus of the present invention.

Figure 3 is a photograph showing the appearance of the optical tracker of the laparoscopic triple fusion imaging apparatus of the present invention.

4 is a block diagram of near-infrared fluorescence and visible light detection of the laparoscopic triple fusion imaging apparatus of the present invention.

5 is a picture and a picture showing that the image is distorted after being focused on the front focusing lens of the fusion image module.

FIG. 6 is a near-infrared fluorescence / visible ray image in which distortion is minimized by attaching a GRIN lens inside a front focusing lens.

7 is a diagram schematically showing a near-infrared fluorescence / visible ray image acquisition test method according to an embodiment of the present invention.

8 is a photograph showing a state in which a visible light image and a near infrared fluorescence are simultaneously acquired.

9 is a photograph showing a state in which a triple fusion image of gamma ray / near infrared fluorescence / visible ray is obtained according to an embodiment of the present invention.

Definition of term :

As used herein, the term "tumor tissue" refers to tissue that is a malignant neoplasm that is fast, invasive and metastatic.

As used herein, the term "sentinel lymph node" refers to the lymph node where metastasis occurs when tumor tissue invades and metastasis occurs. It acts as an indicator.

As used herein, the term "laparoscopic surgery" refers to a laparoscopic and video monitor with a full HD camera that looks through the abdomen without opening the abdomen and drills a hole of 0.5-1 cm in the navel area. It refers to microsurgery using special instruments such as special surgery techniques.

As used herein, the term "positron emission tomography" (PET) refers to two gamma rays (gamma) with 511 keV energy caused by positron disappearance after injecting a radiopharmaceutical into the living body by positron emission tomography. ray) It is a technique to reconstruct the distribution of positron emitting nuclide into tomographic image by measuring with a circular ring-shaped detector. In general, the extinction gamma rays generated by positron emission have an energy of 511 KeV, and thus the method of detecting the extinction radiation by the co-factor is used throughout the PET detection.

As used herein, the term "endo-PET module" refers to both the fusion imaging module and the in vitro endo-PET module of the present invention and is composed of a scintillation crystal and an optical sensor (PMT or SiPM) to enable simultaneous counting and improved sensitivity. And multiple modules to eliminate background events.

As used herein, the term "silicon photo-multipiler (SiPM) detector" refers to the release of positrons from a tracer integrated in a tumor, resulting in the release of two 511 keV evanescent radiation and the two evanescent gamma rays intraperitoneal fusion imaging module. And detects the flash generated by reaction with the scintillation crystal of the in vitro detector to obtain a simultaneous signal.

The term "optical mechanism" as used herein refers to an optical structure including a connected structure between the optical components of the fusion image module and the photoelectric conversion module, and a driving device and a control module that can adjust the distance between the optical components. By changing the distance between the optical components embedded in the optical mechanism, it is possible to adjust the sensitivity and resolution of the near infrared, visible light.

Detailed description of the invention:

According to an aspect of the present invention, a flash crystal for obtaining a gamma ray scintillation image by reacting with gamma rays emitted from a gamma ray radiation material administered to visible light, near infrared rays and affected areas, and transmitting the optical signals of the visible light and near infrared rays to an optical fiber after focusing A front focusing lens having an optical lens attached thereto; Optical filter to prevent loss of gamma-ray flashing light due to light source and overload of SiPM detector, Simultaneous counting circuit to remove unnecessary background gamma rays for imaging or counting gamma rays, fusion image module and in vitro endo-PET / near-infrared including an optical tracker that tracks and displays distances, positions, and angles between endo-PET modules in real time, and an optical mechanism that adjusts the sensitivity and resolution of near-infrared, gamma-rays by varying the distance between components / Fusion image module for obtaining visible light; An in vitro endo-PET module installed under the fusion image module and detecting the gamma ray through a co-factor with the fusion image module; An optical fiber for transmitting a triple image obtained from the fused image module; A light source configured to excite a white infrared light to acquire a visible light image and a near infrared emitter to an affected part to generate a near infrared excitation light to obtain a near infrared image; A photoelectric conversion module that separates individual images of visible light, near infrared light, and gamma light from the triple image transmitted through the optical fiber and converts the individual images into electric signals; Matching means for matching a visible light image signal, a near infrared image signal and a gamma ray image signal of the photoelectric conversion module to one image; And a control unit including image display means for acquiring, amplifying, and simultaneously counting the image signal of the photoelectric conversion module and the image signal of the extracorporeal endo-PET module and displaying the image signal. To provide.

In the laparoscopic triple fusion imaging apparatus, the forward focusing lens may be located inside or outside the scintillation crystal array of the fusion imaging module, and the optical lens may be a convex lens, a double-sided convex lens, an aspherical lens or a green lens. have.

In the laparoscopic triple fusion imaging apparatus, the near-infrared emitter may be indocyanine green and the gamma-ray emitter may be 11C, 13N, 150, 18F, 68Ga, 64Cu, 89Zr or 18F-FDG.

In the laparoscopic triple fusion imaging apparatus, the extracorporeal endo-PET module comprises a scintillation crystal to generate a flash in response to the tumor detection tracer integrated in the tumor; And a gamma ray detector for detecting the flash and converting the light into a signal.

In the laparoscopic triple fusion imaging apparatus, the tumor detection tracer may be 18FDG (fluorodeoxyglucose), 68Ga, 64Cu, ICG, C15O, [13N] ammonia, H215O or antibody + IRDye (NIRF).

In the laparoscopic triple fusion imaging apparatus, the control unit comprises: a first discriminator for amplifying an image signal obtained from the photoelectric conversion module; A second discriminator for amplifying the image signal obtained from the endo-PET module; A simultaneous coefficient circuit for processing the video signal obtained from the quantity discriminator; A data acquisition device for converting the electrical signal through a simultaneous coefficient; And a PC that matches the video signal into one video and outputs the same to the monitor.

In the laparoscopic triple fusion imaging apparatus, the scintillation crystals are pixelated or monolithic LYSO, GAGG, LaBr3 (Ce), CsI (Na), NaI (Tl), YAP: Ce, CdTe, It may be BGO (Bi 4 Ge 3 O 12), LSO (Lu 2 SiO 5: Ce), YSO (Y 2 SiO 5: Ce and / or Tb), GSO (Ga 2 SiO 5: Ce) or LGSO (Lu 1-x GdxSiO 5).

In the laparoscopic triple fusion imaging apparatus, the photoelectric conversion module comprises a first dichroic mirror for separating the gamma ray flash of 350 ~ 480 nm from the light incident through the optical fiber; A first rear focusing lens for focusing the gamma ray flash of 350 to 480 nm; A first band pass filter for passing only the gamma ray flash of 350 to 480 nm; A SiPM detector for converting the gamma ray flash of 350 to 480 nm into an electric signal; A second dichroic mirror for separating visible light in the range of 500 to 700 nm from the light passing through the first dichroic mirror; A second rear focusing lens 136 for focusing only the visible light in the 500 to 700 nm range; A second band pass filter for passing only the visible light in the 500 to 700 nm range; A first CCD camera for converting the visible light in the 500 to 700 nm range into an electrical signal; A third rear focusing lens for focusing only near-infrared rays of 780 to 820 nm in the light passing through the second dichroic mirror; A third band pass filter for passing only the near infrared rays in the 780-820 nm range; And a second CCD camera for converting the near infrared rays of the 780 to 820 nm band into an electrical signal.

In the laparoscopic triple fusion imaging apparatus, the photoelectric conversion module includes a second back focusing lens for focusing only visible light in the range of 500 to 700 nm from the light incident through the optical fiber and a second band for passing the visible light. The filter may include a CCD and a filter rotating body including a pass filter, a third rear focusing lens for focusing only near-infrared rays of 780 to 820 nm, and a third band pass filter for passing near-infrared rays.

In the laparoscopic triple fusion imaging apparatus, the matching means is implemented by a computer (PC) to have the same field of view of each CCD image input from the photoelectric conversion module to reconstruct the gamma ray flash signal image by a series of mathematical algorithms frame The median filter removes noise and calculates the number and total brightness of pixels having a threshold value or more, which can be used as a real-time counting mode.

Hereinafter, various exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings.

The embodiments of the present invention are provided to more fully explain the present invention to those skilled in the art, and the following examples can be modified in various other forms, and the scope of the present invention is It is not limited to an Example. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. In addition, the thickness or size of each layer in the drawings is exaggerated for convenience and clarity of description.

Throughout the specification, when referring to one component, such as a film, region, or substrate, being positioned on, "connected", "stacked" or "coupled" to another component, said one configuration It may be interpreted that an element may be in direct contact with, or "coupled" to, or "coupled" to another component, or that there may be other components interposed therebetween. On the other hand, when one component is said to be located on another component "directly on", "directly connected", or "directly coupled", it is interpreted that there are no other components intervening therebetween. do. Uniform reference refers to uniform elements. As used herein, the term "and / or" includes any and all combinations of one or more of the listed items.

Although the terms first, second, etc. are used herein to describe various members, parts, regions, layers, and / or parts, these members, parts, regions, layers, and / or parts are defined by these terms. It is obvious that not. These terms are only used to distinguish one member, part, region, layer or portion from another region, layer or portion. Thus, the first member, part, region, layer or portion, which will be discussed below, may refer to the second member, component, region, layer or portion without departing from the teachings of the present invention.

Also, relative terms such as "top" or "above" and "bottom" or "bottom" may be used herein to describe the relationship of certain elements to other elements as illustrated in the figures. It may be understood that relative terms are intended to include other directions of the device in addition to the direction depicted in the figures. For example, if the device is turned over in the figures, elements depicted as present on the face of the top of the other elements are oriented on the face of the bottom of the other elements. Thus, the exemplary term "top" may include both "bottom" and "top" directions depending on the particular direction of the figure. If the device faces in the other direction (rotated 90 degrees relative to the other direction), the relative descriptions used herein can be interpreted accordingly.

The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms "a", "an" and "the" may include the plural forms as well, unless the context clearly indicates otherwise. Also, as used herein, "comprise" and / or "comprising" specifies the presence of the mentioned shapes, numbers, steps, actions, members, elements and / or groups of these. It is not intended to exclude the presence or the addition of one or more other shapes, numbers, acts, members, elements and / or groups.

Embodiments of the present invention will now be described with reference to the drawings, which schematically illustrate ideal embodiments of the present invention. In the figures, for example, variations in the shape shown may be expected, depending on manufacturing techniques and / or tolerances. Accordingly, embodiments of the inventive concept should not be construed as limited to the specific shapes of the regions shown herein, but should include, for example, changes in shape resulting from manufacturing.

FIG. 1 is a schematic block diagram of a laparoscopic triple fusion imaging apparatus 100 according to some embodiments of the present invention, and illustrates an example of simultaneous detection of gamma rays, near infrared rays, and visible light. Laparoscopic triple fusion imaging apparatus 100 of the present invention is a 350 ~ 480 nm gamma scintillation image and a 500 ~ 700 nm visible light (visible light) image generated from scintillation crystals in response to 511 KeV gamma ray (gamma ray) And a near infrared (NIR) image of 780 to 820 nm wavelength emitted from near infrared fluorescence by near infrared (NIR) excitation light at a wavelength of 723 to 758 nm. After the signal processing, gamma-ray, near-infrared and visible light images are fused into one image to provide the surgeon with real-time images of the tumor, thereby effectively cutting off tumor tissue or surveillance lymph nodes.

Referring to the operation principle, as shown, first, the laparoscopic triple fusion imaging apparatus 100 of the present invention is a scintillation crystal (113,116) reacted with the decay gamma rays of 511 KeV energy generated from the radioactive material emitting a positron (positron) ) Excite near-infrared fluorescent material accumulated in the tumor with a flash, a light emitting diode (LED) or a halogen lamp, and transfer the near-infrared and visible light generated to the optical fiber 120 to the CCD cameras 138 and 141. ) Is detected. By detecting different wavelength bands, gamma rays, near infrared rays and visible rays can be measured separately, and respective fusion images can be obtained.

In order to use the laparoscopic triple fusion imaging apparatus 100, it is necessary to administer a multimodal tracer that is specifically integrated into a tumor. For PET imaging, radiopharmaceuticals are administered to the human body. The injected radiopharmaceuticals emit positrons in the body, where they combine with the surrounding electrons to annihilate and release two gamma rays with an energy of 511 keV in the 180 ° direction. Coincident detection by two detectors facing each other and reconstructed using a mathematical algorithm can image the distribution of radiopharmaceuticals in the body, and the in vitro endo-PET module 125 plays a role. In general, malignant tumor tissue consumes much more glucose than benign and normal tissues, so it is possible to see abnormal distribution of glucose through PET test and find various cancers. This can be of great help in the diagnosis and treatment of recurrences, metastasis to bone and other organs.

Laparoscopic triple fusion imaging apparatus 100 of the present invention is configured with a fusion image module 123 for acquiring triple images of visible light, near-infrared and gamma rays, respectively, and the fusion image module 123 has a scintillation crystal 116. In order to minimize the refraction and reflection of the near-infrared fluorescence due to the front focusing lens 124 is formed outside or inside the scintillation crystal array of the fusion image module 123 near-infrared wavelength of 720 ~ 280 nm generated in response to the excitation light After the fluorescence is focused through the front focusing lens 124, the optical signal is transmitted through the optical fiber 120. In addition, the optical filter 127 is located in the front of the fusion image module 123 to minimize the loss of gamma-ray flash light and the overload of the SiPM detector 134 during the operation using a laparoscope. Gamma-ray images can be obtained while the front focusing lens 124 is opened by blocking external light during the gamma-ray acquisition process, thus efficiently collecting three images (gamma rays / visible rays / near infrared rays) without loss of gamma-ray strobe light during laparoscopic surgery. Can be started on the screen. In this case, the front focusing lens 124 may use any optical lens including a plano convex lens, a double convex lens, an aspheric lens, or a green index lens, but is not limited thereto. It doesn't happen.

On the other hand, the upper part of the fusion image module 123 is composed of a photoelectric conversion module 130 for separating the individual images of visible light, near-infrared and gamma rays from the fused image transmitted by the optical fiber 120 is connected to each electric signal The controller 152 is formed to amplify the signals obtained from both modules, obtain an energy spectrum, and provide temperature compensation and power. In addition, a plurality of extracorporeal endo-PET modules, which are combined with a scintillation crystal 113 and a gamma ray detector 114, which generate scintillation under the fusion image module 123, are capable of co-factoring and improve sensitivity and eliminate background events. 125 is configured.

As shown in the drawing, the photoelectric conversion module 130 for processing each individual image includes a first dichroic mirror 131, a first rear focusing lens 132, and a first band for processing a gamma ray image. A second dichroic mirror 135, a second rear focusing lens 136, a second band pass filter 137 and a pass filter 133 and a SiPM detector 134, for processing visible light images; The first CCD camera 138 includes a third back focusing lens 139, a third band pass filter 140, and a second CCD camera 141 for processing a near infrared image. In general, the signal transmitted from the photoelectric conversion module 130 to the controller 152 is transmitted to the first discriminator 153 and the signal of the extracorporeal endo-PET module 125 is the second discriminator 151 of the controller 152. ) Is processed by the co-counter circuit 155 and converted into an electrical signal by the data acquisition device 154, and then the visible light image signal, near infrared image signal and gamma ray image signal by the PC 150 as one Matched images are displayed.

The process of detecting gamma rays, near infrared rays and visible rays using the laparoscopic triple fusion imaging apparatus 100 of the present invention will be described in detail with reference to FIGS.

2 is a diagram illustrating a gamma ray detection configuration of the triple fusion imaging apparatus 100 for laparoscopy according to an embodiment of the present invention. As described above, the fusion image module 123 for acquiring triple images of visible light, near infrared light, and gamma ray, respectively, performs gamma-ray scintillation crystals 113 and 116 and gamma-ray flashes to obtain gamma images from positron emission radioactive materials administered to the affected areas. Consists of optical fiber 120 to deliver. Although not shown in the drawing, the fusion image module 123 is provided with an optical mechanism that can adjust sensitivity and resolution of near infrared light and visible light by changing the distance between components.

Describing the gamma ray detection process, in order to obtain gamma ray image, the function of the forward focusing lens 124 of the fusion imaging module 123 is excluded, and a positron is emitted from the tracer integrated in the tumor, thereby releasing two 511 keV annihilation radiation. radiation is emitted and the two extinction gamma rays react with the scintillation crystal 116 of the intraperitoneal fusion imaging module 123 and the scintillation crystal 113 of the in vitro endo-PET module 125 to generate scintillation. . The flash is detected by the gamma ray detector 114 and the SiPM detector 134 to obtain a simultaneous signal. Thereafter, the photoelectric conversion module 130 is connected to the fusion image module 123 and the optical fiber 120 to separate individual images of visible light, near infrared light, and gamma ray from the triple image, and then convert them into electrical signals. The first dichroic mirror 131 separates the gamma-ray flash of 400 to 500 nm from the light incident through the first focusing lens, and the first rear focusing lens 132 focuses the gamma-ray flash. The first band pass filter 133 passes only the gamma ray flash of 350 to 480 nm and removes noise, and the SiPM detector 134 converts the gamma ray flash of 350 to 480 nm into an electric signal and transmits it to the control unit 152. . Afterwards, the optical signal generated by the photoelectric conversion module 130 passes through the first discriminator 153 and the optical signal generated by the extracorporeal endo-PET module 125 passes through the second discriminator 151. The signal is amplified by the signal 155 and converted into an electrical signal by the data acquisition device 154, and the image signals processed by the controller 152 are represented as one image through a series of processes.

The requirements of the scintillation crystals (crystal scintillators) that can be used for the detection of gamma rays above 511 keV should not be deliquescent, should not contain its own natural radioactivity and should be as large as possible the amount of scintillation, LYSO is suitable but also suitable for the detection of gamma rays Flash crystals representing LYSO, GAGG, LaBr3 (Ce), CsI (Na), NaI (Tl), YAP: Ce, CdTe, BGO (Bi4Ge3O12), LSO (Lu2SiO5: Ce), YSO (Y2SiO5: Ce and / or Tb), GSO (Ga2SiO5: Ce) or LGSO (Lu1-xGdxSiO5) can be used and tumor detection tracers are 18FDG (fluorodeoxyglucose), 68Ga, 64Cu, [13N] ammonia, H215O or antibody + IRDye (NIRF), ICG, 68Ga -HSA, 68Ga-HSA-ICG, 68Ga-labeled IRDye 800CW-tilmanocept can be used.

3 is coupled to the fusion image module 123 of the laparoscopic triple fusion imaging apparatus 100 of the present invention to real-time distance, position, angle, etc. between the fusion image module 123 and the extracorporeal endo-PET module 125 This is a photograph showing the state of an optical tracker (126) that is tracked and displayed. In general, the surgical equipment should be free to move the position according to the convenience of the doctor, but if the original position is moved, there is a problem that the resolution is lowered when reconstructing the gamma ray image by mathematical techniques. At this time, the optical tracker 126 plays a role of excluding the uncertainty of the position as much as possible by correcting the position in units of 0.1 mm.

4 is a block diagram for detecting near-infrared fluorescence and visible light of the triple fusion imaging apparatus 100 for laparoscopy according to an embodiment of the present invention. The configuration for detecting near-infrared fluorescence and visible light is almost similar to the configuration for detecting gamma-ray, but the near-infrared emitting material (ICG; indocyanine) in the white light and the affected part for acquiring the visible light image through the optical fiber 120 in the fusion imaging module 123 A light source 177 is configured to generate near-infrared excitation light in the 723-758 nm range to excite green to obtain a near-infrared image. Near-infrared fluorescence having a wavelength of 720 to 280 nm generated in response to the excitation light is focused through the front focusing lens 124 located inside or outside the fusion image module 123 as described above and then optically transmitted through the optical fiber 120. The call is forwarded.

First, the photoelectric conversion module 130 that separates individual images of visible light, near infrared light, and gamma ray from the triple image generated in the fusion image module 123 and converts the individual images into electric signals is applied to the light incident through the optical fiber 120. The first dichroic mirror 131 separates the gamma ray flash of 400 to 500 nm and the second dichroic mirror 135 is visible in the range of 500 to 700 nm in the light passing through the first dichroic mirror 131. Isolate the beam. Thereafter, the second rear focusing lens 136 focuses 500-700 nm visible light separated from the second dichroic mirror 135 and the second band pass filter 137 is 500-700 nm visible light. Passing through the bay and removing noise, the first CCD camera 138 converts visible light in the 500-700 nm range into an electrical signal. In addition, the third rear focusing lens 139 focuses near-infrared rays of 780 to 820 nm in the light passing through the second dichroic mirror 135, and the third band pass filter 140 includes a second dichroic mirror ( The light passing through 135 passes only near-infrared rays of 780-820 nm and removes noise, and the second CCD camera 141 converts near-infrared rays of 780-820 nm into electrical signals. Finally, the PC 150 matches the electric signals generated by the data acquisition device 154 in the photoelectric conversion module 130 with each individual CCD camera image input through the USB to have the same field of view, and executes software for removing noise. The synthesized image is output through the monitor.

Technical features of the laparoscopic triple fusion imaging apparatus 100 of the present invention is to significantly improve the quality of the image compared to the conventional fusion image in the detection of near-infrared fluorescence and visible light through the function of the front focusing lens 124 The key is to make it. As shown in FIG. 5, the forward focusing lens 124 of the fusion image module 123 minimizes the refraction and reflection of the near-infrared / visible light generated in response to the excitation light. ) Has a problem that the image is distorted after focusing. Such distortion of the image may act as a major obstacle in laparoscopic surgery that requires accurate diagnosis and resection of tumor tissue or surveillance lymph nodes. Therefore, the present inventors have made diligent efforts to solve the above problems. As shown in FIG. 6, the distortion of the near-infrared / visible light is minimized by attaching the GRIN lens to the front focusing lens 124. Near-infrared fluorescence / visible image acquisition was implemented.

Hereinafter, the present invention will be described in more detail through experimental examples. However, the present invention is not limited to the experimental examples disclosed below, but may be embodied in various different forms. The following experimental examples make the disclosure of the present invention complete and the scope of the invention to those skilled in the art. It is provided to inform you completely.

Experimental Example  One: Near infrared  Fluorescence / Visible Light Image Acquisition Experiment

In order to acquire near-infrared fluorescence / visible image using laparoscopic triple fusion imaging apparatus 100 according to an embodiment of the present invention, the center of the scintillation crystal was emptied and the GRIN lens was accommodated in the space of the phantom hole. An experiment was performed to insert a near-infrared fluorescent emitter called ICG and observe a region of 30 mm at a distance of 30 mm (FIG. 7).

As a result, an image obtained by matching the visible light image and the near infrared fluorescence (white) at the same time (red box) was obtained (FIG. 8).

Experimental Example  2: triple Convergence  Acquisition experiment

Based on the results of Example 1, an experiment was performed to obtain a triple fusion image by manufacturing the fusion image module 123 of FIG. 1. Acquisition of near-infrared fluorescence / visible light was performed in the same manner as in Experimental Example 1, and gamma ray images were detected by gamma rays generated from the corresponding sources using an isotope called 22-Na. In addition, the distance between the fusion imaging module 123 and the extracorporeal endo-PET module 125 is 70 mm and the 22-Na source was obtained at a distance of 10 mm and 60 mm from the in vitro module.

As a result, triple fusion images of clear gamma rays / visible rays / near infrared rays were obtained (FIG. 9).

In conclusion, in the evaluation of tumor tissue or surveillance lymph nodes in laparoscopic surgery or robotic surgery, near-infrared radiation has a weak permeability, and thus, it is difficult to resection tumor tissue or monitoring lymph nodes located in the core. Gamma rays can compensate for the shortcomings of near-infrared rays due to their good penetrating power. However, they are small because they must be able to be inserted into the body cavity, but they are not easy to develop devices with high gamma sensitivity, high spatial resolution, and wide field of view. Since it must be a device that can be used during surgery, it was not easy to develop a high-sensitivity imaging device that can provide an image within two to three minutes. In addition, the conventional optical signal focused on the front focusing lens has a problem that the image is distorted, so it was a priority to improve it. In order to solve the above problems, the present inventors have developed a laparoscopic or robotic surgical triple fusion imaging apparatus which minimizes distortion caused by the reduction of optical interference of near-infrared / visible light by attaching a GRIN lens inside the front focusing lens. Therefore, by providing endo-PET / near-infrared / visible light fusion image in a short time, it is possible to excise tumor tissue or surveillance lymph node with high sensitivity and specificity in laparoscopic and robotic surgery, and to reduce side effects caused by unnecessary excision of a wide range of normal tissue. It can provide optimized medical services and greatly improve the quality of life of the elderly.

Although the present invention has been described with reference to the embodiments shown in the drawings, this is merely exemplary, and those skilled in the art will understand that various modifications and equivalent other embodiments are possible. Therefore, the true technical protection scope of the present invention will be defined by the technical spirit of the appended claims.

Claims (12)

A scintillation crystal for reacting with gamma rays emitted from gamma rays emitted from visible light, near-infrared and affected areas to obtain a gamma-ray flash image, and focusing the optical signals of the visible light and near-infrared to an optical fiber after converging the optical signals. lens; Optical filter to prevent loss of gamma-ray flashing light due to light source and overload of SiPM detector, Simultaneous counting circuit to remove unnecessary background gamma rays for imaging or counting gamma rays, fusion image module and in vitro endo-PET / near-infrared including an optical tracker that tracks and displays distances, positions, and angles between endo-PET modules in real time, and an optical mechanism that adjusts the sensitivity and resolution of near-infrared, gamma-rays by varying the distance between components / Fusion image module for obtaining visible light; An in vitro endo-PET module installed under the fusion image module and detecting the gamma ray through a co-factor with the fusion image module; An optical fiber for transmitting a triple image obtained from the fused image module; A light source configured to excite a white infrared light to acquire a visible light image and a near infrared emitter to an affected part to generate a near infrared excitation light to obtain a near infrared image; A photoelectric conversion module that separates individual images of visible light, near infrared light, and gamma light from the triple image transmitted through the optical fiber and converts the individual images into electric signals; Matching means for matching a visible light image signal, a near infrared image signal and a gamma ray image signal of the photoelectric conversion module to one image; And And a control unit including image display means for acquiring, amplifying, and simultaneously counting the image signal of the photoelectric conversion module and the image signal of the extracorporeal endo-PET module, and displaying the image signal. The method of claim 1, Wherein the forward focusing lens is positioned inside or outside the scintillation crystal array of the fusion image module. The method of claim 1, Wherein the optical lens is a convex lens, a double-sided convex lens, an aspherical lens or a green lens. The method of claim 1, The near-infrared emitter is indocyanine green, triple fusion imaging device. The method of claim 1, The gamma-ray radiating material is 11C, 13N, 150, 18F, 68Ga, 64Cu, 89Zr or 18F-FDG triple fusion imaging device. The method of claim 1, The extracorporeal endo-PET module comprises: a scintillation crystal that generates flash in response to a tumor detection tracer integrated in the tumor; And And a gamma ray detector for detecting the flash and converting the light into a signal. The method of claim 6, The tumor detection tracer is 18FDG (fluorodeoxyglucose), 68Ga, 64Cu, ICG, C15O, [13N] ammonia, H215O or antibody + IRDye (NIRF), triple fusion imaging device. The method of claim 1, The control unit includes a first discriminator for amplifying the image signal obtained from the photoelectric conversion module; A second discriminator for amplifying the image signal obtained from the endo-PET module; A simultaneous coefficient circuit for processing the video signal obtained from the quantity discriminator; A data acquisition device for converting the electrical signal through a simultaneous coefficient; And And a PC that matches the image signal to one image and outputs the same to a monitor. The method of claim 1, The scintillation crystals are pixelated or monolithic LYSO, GAGG, LaBr3 (Ce), CsI (Na), NaI (Tl), YAP: Ce, CdTe, BGO (Bi4Ge3O12), LSO (Lu2SiO5: Ce) , YSO (Y2SiO5: Ce and / or Tb), GSO (Ga2SiO5: Ce) or LGSO (Lu1-xGdxSiO5) triple fusion imaging apparatus for laparoscopic surgery. The method of claim 1, The photoelectric conversion module comprises a first dichroic mirror for separating the gamma ray flash of 350 ~ 480 nm from the light incident through the optical fiber; A first rear focusing lens for focusing the gamma ray flash of 350 to 480 nm; A first band pass filter for passing only the gamma ray flash of 350 to 480 nm; A SiPM detector for converting the gamma ray flash of 350 to 480 nm into an electric signal; A second dichroic mirror for separating visible light in the range of 500 to 700 nm from the light passing through the first dichroic mirror; A second rear focusing lens 136 for focusing only the visible light in the 500 to 700 nm range; A second band pass filter for passing only the visible light in the 500 to 700 nm range; A first CCD camera for converting the visible light in the 500 to 700 nm range into an electrical signal; A third rear focusing lens for focusing only near-infrared rays of 780 to 820 nm in the light passing through the second dichroic mirror; A third band pass filter for passing only the near infrared rays in the 780-820 nm range; And Laparoscopic surgery triple fusion imaging device comprising a second CCD camera for converting the near-infrared ray of the 780 ~ 820 nm into an electrical signal. The method of claim 1, The photoelectric conversion module, the second back-pass focusing lens for focusing only visible light of 500 ~ 700 nm from the light incident through the optical fiber and the second band pass filter for passing visible light, focusing only near infrared of 780 ~ 820 nm Laparoscopic surgery triple fusion imaging device comprising a CCD and a filter rotating body consisting of a third rear focusing lens and a third band pass filter for passing near infrared. The method of claim 1, The matching means is implemented by a computer (PC) so that each CCD image input from the photoelectric conversion module has the same field of view, and the gamma ray flash signal image is reconstructed by a series of mathematical algorithms to remove noise with a median filter for each frame. Laparoscopic triple fusion imaging apparatus, characterized in that it can be used as a real-time counting mode by calculating the number of pixels and the total brightness value having a calculated threshold value or more.

Images