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WO2018186518A1 - Appareil d'imagerie à triple fusion pour chirurgie laparoscopique - Google Patents

Appareil d'imagerie à triple fusion pour chirurgie laparoscopique Download PDF

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Publication number
WO2018186518A1
WO2018186518A1 PCT/KR2017/004697 KR2017004697W WO2018186518A1 WO 2018186518 A1 WO2018186518 A1 WO 2018186518A1 KR 2017004697 W KR2017004697 W KR 2017004697W WO 2018186518 A1 WO2018186518 A1 WO 2018186518A1
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WO
WIPO (PCT)
Prior art keywords
image
gamma
infrared
visible light
light
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/KR2017/004697
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English (en)
Korean (ko)
Inventor
홍성종
강한규
송성현
김경민
이호영
정대홍
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.)
Industry Academic Cooperation Foundation of Eulji University
Korea Institute of Radiological and Medical Sciences
Original Assignee
Industry Academic Cooperation Foundation of Eulji University
Korea Institute of Radiological and Medical Sciences
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 Industry Academic Cooperation Foundation of Eulji University, Korea Institute of Radiological and Medical Sciences filed Critical Industry Academic Cooperation Foundation of Eulji University
Publication of WO2018186518A1 publication Critical patent/WO2018186518A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/0638—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements providing two or more wavelengths
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B13/00—Optical objectives specially designed for the purposes specified below
    • G02B13/18—Optical objectives specially designed for the purposes specified below with lenses having one or more non-spherical faces, e.g. for reducing geometrical aberration
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/10—Beam splitting or combining systems
    • G02B27/14—Beam splitting or combining systems operating by reflection only
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B27/00—Optical systems or apparatus not provided for by any of the groups G02B1/00 - G02B26/00, G02B30/00
    • G02B27/10—Beam splitting or combining systems
    • G02B27/14—Beam splitting or combining systems operating by reflection only
    • G02B27/141—Beam splitting or combining systems operating by reflection only using dichroic mirrors

Definitions

  • the present invention relates to a triple fusion imaging device for laparoscopic surgery.
  • the ablation is performed by a robotic procedure in the prostate cancer with the help of a near-infrared camera
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • problems are exemplary, and the scope of the present invention is not limited thereby.
  • 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
  • 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.
  • the scope of the present invention is not limited by these effects.
  • FIG. 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.
  • FIG. 4 is a block diagram of near-infrared fluorescence and visible light detection of the laparoscopic triple fusion imaging apparatus of the present invention.
  • FIG. 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.
  • FIG. 8 is a photograph showing a state in which a visible light image and a near infrared fluorescence are simultaneously acquired.
  • FIG. 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.
  • tumor tissue refers to tissue that is a malignant neoplasm that is fast, invasive and metastatic.
  • PET positron emission tomography
  • gamma gamma rays
  • ray It is a technique to reconstruct the distribution of positron emitting nuclide into tomographic image by measuring with a circular ring-shaped detector.
  • 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.
  • optical mechanism 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.
  • 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.
  • 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).
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • FIG. 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • Example 1 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.
  • 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.
  • 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.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • Optics & Photonics (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biophysics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • General Physics & Mathematics (AREA)
  • Endoscopes (AREA)

Abstract

La présente invention concerne un appareil d'imagerie par fusion triple pour chirurgie laparoscopique avec lequel, pendant une chirurgie laparoscopique ou une chirurgie robotique, la distorsion peut être réduite au minimum et un tissu tumoral ou un ganglion lymphatique sentinelle peut être excisé précisément avec une sensibilité et une spécificité élevées.
PCT/KR2017/004697 2017-04-04 2017-05-02 Appareil d'imagerie à triple fusion pour chirurgie laparoscopique Ceased WO2018186518A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2017-0043736 2017-04-04
KR1020170043736A KR101941223B1 (ko) 2017-04-04 2017-04-04 복강경 수술용 삼중 융합영상장치

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WO2018186518A1 true WO2018186518A1 (fr) 2018-10-11

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111528764A (zh) * 2020-05-15 2020-08-14 张云峰 一种视野智能配置的3d腔镜显示系统

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR102787437B1 (ko) * 2022-02-21 2025-03-27 을지대학교 산학협력단 수술용 복합 비디오 영상시스템

Citations (5)

* Cited by examiner, † Cited by third party
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KR20110074988A (ko) * 2008-10-21 2011-07-05 지이 헬쓰케어 리미티드 영상화 및 방사선요법을 위한 방법
KR101351411B1 (ko) * 2011-12-16 2014-01-15 전북대학교산학협력단 피오글리타존을 이용한 ｆ-18 ｆｄｇ 양전자방출단층촬영에서 악성 종양과 염증 병변을 구분하여 악성 종양을 선택적으로 진단하는 방법
KR20150007679A (ko) * 2013-07-12 2015-01-21 한국전기연구원 감시림프절의 근적외선 형광 검출 장치 및 방법
KR20160118922A (ko) * 2015-04-02 2016-10-12 을지대학교 산학협력단 복강경 수술중 감시림프절 절제술을 위한 삼중 융합 영상장치
US20160306054A1 (en) * 2013-12-04 2016-10-20 Koninklijke Philips N.V. Reconstruction apparatus for reconstructing a pet image

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR20110074988A (ko) * 2008-10-21 2011-07-05 지이 헬쓰케어 리미티드 영상화 및 방사선요법을 위한 방법
KR101351411B1 (ko) * 2011-12-16 2014-01-15 전북대학교산학협력단 피오글리타존을 이용한 ｆ-18 ｆｄｇ 양전자방출단층촬영에서 악성 종양과 염증 병변을 구분하여 악성 종양을 선택적으로 진단하는 방법
KR20150007679A (ko) * 2013-07-12 2015-01-21 한국전기연구원 감시림프절의 근적외선 형광 검출 장치 및 방법
US20160306054A1 (en) * 2013-12-04 2016-10-20 Koninklijke Philips N.V. Reconstruction apparatus for reconstructing a pet image
KR20160118922A (ko) * 2015-04-02 2016-10-12 을지대학교 산학협력단 복강경 수술중 감시림프절 절제술을 위한 삼중 융합 영상장치

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111528764A (zh) * 2020-05-15 2020-08-14 张云峰 一种视野智能配置的3d腔镜显示系统

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KR101941223B1 (ko) 2019-01-22
KR20180112534A (ko) 2018-10-12

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