MRI-GUIDED STEREOTACTIC SURGERY METHOD
20230060614 · 2023-03-02
Inventors
- Ming-Shaung JU (Tainan City, TW)
- Chou-Ching LIN (Tainan City, TW)
- Bing-Lin Ho (Pingtung County, TW)
- Huang-Lin CHEN (Kaohsiung City, TW)
- Yu-Nung Peng (Hsinchu County, TW)
Cpc classification
A61B90/11
HUMAN NECESSITIES
A61B34/20
HUMAN NECESSITIES
A61B2562/182
HUMAN NECESSITIES
A61B90/10
HUMAN NECESSITIES
G01R33/285
PHYSICS
A61B2034/107
HUMAN NECESSITIES
International classification
A61B34/20
HUMAN NECESSITIES
A61B90/11
HUMAN NECESSITIES
Abstract
A MRI-guided stereotactic surgery method including the following steps: assigning coordinates of a surgery target point of a surgery cannula and an insertion direction of the surgery cannula; performing coordinate transformation to transform the coordinates of the surgery target point into an insertion position of the surgery target point; substituting the insertion position and the insertion direction into an inverse kinematics model to obtain five parameters respectively corresponding to five degrees of freedom of a MRI-compatible stereotactic surgery device; controlling the MRI-compatible stereotactic surgery device according to the parameters to start a stereotactic surgery procedure, thereby inserting the surgery cannula; obtaining an actual cannula position according to a magnetic resonance (MR) image; comparing the actual cannula position with the surgery target point to obtain a position error vector; and withdrawing the surgery cannula to finish the stereotactic surgery procedure when the position error vector is acceptable.
Claims
1. A MRI-guided stereotactic surgery method, comprising: assigning coordinates of a surgery target point of a surgery cannula and an insertion direction of the surgery cannula; performing coordinate transformation to transform the coordinates of the surgery target point into an insertion position of the surgery target point; substituting the insertion position and the insertion direction into an inverse kinematics model to obtain five parameters respectively corresponding to five degrees of freedom of a MRI-compatible stereotactic surgery device; controlling the MRI-compatible stereotactic surgery device according to the parameters to start a stereotactic surgery procedure, thereby inserting the surgery cannula; obtaining an actual cannula position according to a magnetic resonance (MR) image providing by a magnetic resonance imaging (MRI) scanner; comparing the actual cannula position with the surgery target point to obtain a position error vector; and withdrawing the surgery cannula to finish the stereotactic surgery procedure when the position error vector is acceptable.
2. The MRI-guided stereotactic surgery method of claim 1, wherein when the position error vector is not acceptable, the MRI-guided stereotactic surgery method further comprises: calculating a compensation quantity according to the position error vector; adjusting three of the parameters according to the compensation quantity; controlling the MRI-compatible stereotactic surgery device according to the adjusted parameters, thereby withdrawing the surgery cannula, adjusting the insertion position and the insertion direction of the surgery cannula, and inserting the surgery cannula again; updating the actual cannula position according to the MR image updating by the MRI scanner; comparing the updated actual cannula position with the surgery target point to update the position error vector; and withdrawing the surgery cannula to finish the stereotactic surgery procedure when the updated position error vector is acceptable.
3. The MRI-guided stereotactic surgery method of claim 2, wherein the compensation quantity is calculated by a Taylor series expansion and by utilizing a Jacobian square matrix based on the position error vector.
4. The MRI-guided stereotactic surgery method of claim 1, wherein the parameters are obtained by utilizing a Newton-Raphson iterative method.
5. The MRI-guided stereotactic surgery method of claim 1, wherein the MRI-compatible stereotactic surgery device comprises a based plate, a horizontal arc-shaped slide fixed on the base plate and a horizontal sliding stage disposed on the horizontal arc-shaped slide, wherein the horizontal sliding stage comprises a first friction wheel in rolling friction contact with the horizontal arc-shaped slide, wherein the horizontal sliding stage moves along the horizontal arc-shaped slide in a first direction through the first friction wheel, wherein the first direction corresponds to a first degree of freedom of a MRI-compatible stereotactic surgery device, wherein the horizontal arc-shaped slide comprises a first driven wheel for recording relative movement between the first friction wheel and the horizontal arc-shaped slide, wherein the MRI-guided stereotactic surgery method further comprises: measuring amount of rotation of the first driven wheel by utilizing a first optical encoder connected to the first driven wheel, thereby recording relative movement between the first friction wheel and the horizontal arc-shaped slide.
6. The MRI-guided stereotactic surgery method of claim 5, wherein the MRI-compatible stereotactic surgery device further comprises a vertical arc-shaped slide fixed on the horizontal sliding stage and a vertical sliding stage disposed on the vertical arc-shaped slide, wherein the vertical sliding stage comprises a second friction wheel in rolling friction contact with the vertical arc-shaped slide, wherein the vertical sliding stage moves along the vertical arc-shaped slide in a second direction through the second friction wheel, wherein the second direction corresponds to a second degree of freedom of a MRI-compatible stereotactic surgery device, wherein the vertical arc-shaped slide comprises a second driven wheel for recording relative movement between the second friction wheel and the vertical arc-shaped slide, wherein the MRI-guided stereotactic surgery method further comprises: measuring amount of rotation of the second driven wheel by utilizing a second optical encoder connected to the second driven wheel, thereby recording relative movement between the second friction wheel and the vertical arc-shaped slide.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0026] The invention can be more fully understood by reading the following detailed description of the embodiment, with reference made to the accompanying drawings as follows:
[0027]
[0028]
[0029]
[0030]
[0031]
[0032]
[0033]
DETAILED DESCRIPTION
[0034] Specific embodiments of the present invention are further described in detail below with reference to the accompanying drawings, however, the embodiments described are not intended to limit the present invention and it is not intended for the description of operation to limit the order of implementation. Moreover, any device with equivalent functions that is produced from a structure formed by a recombination of elements shall fall within the scope of the present invention. Additionally, the drawings are only illustrative and are not drawn to actual size.
[0035] Moreover, unless specified otherwise, “first,” “second,” or the like are not intended to imply a temporal aspect, a spatial aspect, an ordering, etc. Rather, such terms are merely used as identifiers, names, etc. for features, elements, items, etc. For example, a first element and a second element generally correspond to element A and element B or two different or two identical elements or the same element.
[0036]
[0037] As shown in
[0038] As shown in
[0039] As shown in
[0040] It is worth mentioning that the movement of the horizontal sliding stage 130 and the movement of the vertical sliding stage 150 are driven by rolling friction force. Comparing with the known gear driving devices, the present disclosure could avoid the problem of position errors caused by gear backlash.
[0041] It is worth mentioning that, when the horizontal sliding stage 130 moves along the horizontal arc-shaped slide 120, the movement drag of the horizontal sliding stage 130 is only friction between the horizontal sliding stage 130 and the horizontal arc-shaped slide 120, and when the vertical sliding stage 150 moves along the vertical arc-shaped slide 140, the movement drag of the vertical sliding stage 150 is only the friction between the vertical sliding stage 150 and the vertical arc-shaped slide 140 and the weight of the vertical sliding stage 150. Therefore, such a low drag design can reduce the high torque requirement of the driving motor (i.e., the piezoelectric motor 131 and the piezoelectric motor 151), and therefore the volume of the piezoelectric motor 131 and the piezoelectric motor 151 could be reduced. In other words, the volume of the MRI-compatible stereotactic surgery device 10 could be reduced accordingly.
[0042]
[0043]
[0044] The rotary piezoelectric motor 260 and the linear piezoelectric motors 240 are respectively configured to drive the surgery cannula 210 to move along the third direction θ.sub.3 and the fourth direction δ. The rotary piezoelectric motor 260 drives the surgery cannula 210 through a synchronous timing belt 262 and a belt pulley 264. The linear piezoelectric motor 250 is configured to drive the surgery cannula 210 to move along the fifth direction ζ. Specifically, the insertion direction (i.e., a tilt angle) of the surgery cannula 210 corresponds to the third direction θ.sub.3 and the fourth direction δ, and thus the insertion direction of the surgery cannula 210 is controlled by the rotary piezoelectric motor 260 and the linear piezoelectric motors 240. Specifically, an insertion depth of the surgery cannula 210 corresponds to the fifth direction ζ, and thus the insertion depth of the surgery cannula 210 is controlled by the linear piezoelectric motors 250.
[0045] In some other embodiments of the present disclosure, the guiding element of the MRI-compatible stereotactic surgery device may include only one linear piezoelectric motor, instead of two linear piezoelectric motors. The only one linear piezoelectric motor of the guiding element of the MRI-compatible stereotactic surgery device of some other embodiments of the present disclosure is configured to drive the surgery cannula to move along the fourth direction. It is noted that, in some other embodiments of the present disclosure, the fifth direction is reserved for manual insertion of the surgery cannula by the surgeon. Furthermore, in some other embodiments of the present disclosure, there are scales labeled on the surgery cannula and/or there is a positioning component matching the surgery cannula, so as to control the amount of insertion.
[0046] It is noted that the MRI-compatible stereotactic surgery device 10 of the present disclosure only needs five degrees of freedom (DOF), i.e., the first direction θ.sub.1, the second direction θ.sub.2, the third direction θ.sub.3, the fourth direction δ, and the fifth direction ζ. In contrast, the traditional stereotactic surgery environments need six degrees of freedom or more than six degrees of freedom. Although more degrees of freedom represents larger stereotactic operating space, however, from a medical point of view, the stereotactic operating space of the brain neurosurgery for biopsy, ablation and/or deep brain stimulation (DBS) only need to cover the brain, and therefore the stereotactic surgery does not need too much work space. Therefore, the MRI-compatible stereotactic surgery device 10 having five degrees of freedom could reduce the requirement of the amount of the motors, thereby reducing the interference to the magnetic resonance (MR) image and reducing the volume of the entire device.
[0047] It is worth mentioning that the piezoelectric motor 131, the piezoelectric motor 151, the linear piezoelectric motor 240 and 250, and the rotary piezoelectric motor 260 are anti-magnetic piezoelectric motors which are made of non-magnetic piezoelectric ceramic material. The anti-magnetic piezoelectric motors are not driven by magnetic force, and therefore the anti-magnetic piezoelectric motors could be normally operated in environment with strong magnetic field. In addition, the anti-magnetic piezoelectric motors have a relatively high holding torque at rest, and thus when the MRI-compatible stereotactic surgery device 10 introduces external force to perform surgery cannula insertion, the motor shaft angle errors caused by the external force could be reduced.
[0048] It is worth mentioning that the MRI-compatible stereotactic surgery device 10 further includes plural electromagnetic interference shielding covers (not shown) respectively configured to cover the horizontal sliding stage 130, the vertical sliding stage 150, and the guiding element 200. The electromagnetic interference shielding covers are configured to electromagnetically shield the aforementioned anti-magnetic piezoelectric motors and the aforementioned optical encoders from interfering with the magnetic resonance (MR) image. The electromagnetic interference shielding covers could be copper shielding covers, but the present invention is not limited thereto. For example, aluminum or a material having low magnetic susceptibility or non-ferromagnetic material may be used as a material for forming the electromagnetic interference shielding covers.
[0049] It is worth mentioning that the MRI-compatible stereotactic surgery device 10 further includes plural fixed accessories (not shown) (e.g., screws, nuts, and so on) configured to fix plural mechanics parts of the base plate 110, the horizontal arc-shaped slide 120, the horizontal sliding stage 130, the vertical arc-shaped slide 140, the vertical sliding stage 150, the guiding element 200, the friction wheels 132 and 152, and the driven wheels 133 and 153. The fixed accessories could be made of copper, but the present invention is not limited thereto. For example, aluminum or a material having low magnetic susceptibility or non-ferromagnetic material may be used as a material for forming the fixed accessories with high tensile strength. Therefore, these fixed accessories having low magnetic susceptibility could avoid missile effect caused by the strong magnetic field, and reduce the eddy current generated by the RF pulse, and further reduce the heating effect and electromagnetic wave interference.
[0050] It is worth mentioning that the mechanics parts of the base plate 110, the horizontal arc-shaped slide 120, the horizontal sliding stage 130, the vertical arc-shaped slide 140, the vertical sliding stage 150, and the guiding element 200 are made of engineering plastics, such as polyoxymethylene (POM). The friction wheels 132 and 152, and the driven wheels 133 and 153 are made of synthetic rubber. The Young's modulus and the shear modulus of the engineering plastics are high enough and the magnetic susceptibility is low, and therefore the engineering plastics are suitable for the MRI-compatible stereotactic surgery device 10 because the engineering plastics could avoid electromagnetic wave interference and maintain the rigidity of the MRI-compatible stereotactic surgery device 10.
[0051]
[0052] The MRI-compatible stereotactic surgery device 10 further includes plural signal lines (not shown) connected from the controlling computer 160 to the piezoelectric motors 131 and 151, the linear piezoelectric motors 240 and 250, and the rotary piezoelectric motor 260. It is noted that the aforementioned signal lines are covered by electromagnetic interference shielding material (such as the tinned copper wire wrap) so as to avoid electromagnetic wave interference.
[0053] The controlling computer 160 is built in a forward kinematics model and an inverse kinematics model so as to calculate parameters corresponding to five degrees of freedom of the MRI-compatible stereotactic surgery device 10 and the perform a MRI-guided stereotactic surgery method, thereby driving the piezoelectric motors 131 and 151, the linear piezoelectric motors 240 and 250, and the rotary piezoelectric motor 260 to control the surgery cannula 210 to insert into suitable positon for the stereotactic surgery.
[0054]
[0055] In step 1300, the insertion position and the insertion direction are substituted into the inverse kinematics model built in the controlling computer 160 to obtain five parameters respectively corresponding to five degrees of freedom of the MRI-compatible stereotactic surgery device 10. In some embodiments of the present disclosure, the parameters in step 1300 are obtained by utilizing a Newton-Raphson iterative method. Please note that the coordinate transformation in step 1200 and the computation of the inverse kinematics model in step 1300 are known in the related technical field, and thus the present disclosure will not further discuss.
[0056] In step 1400, the piezoelectric motors 131 and 151, the linear piezoelectric motors 240 and 250, and the rotary piezoelectric motor 260 of the MRI-compatible stereotactic surgery device 10 are controlled according to the parameters obtained in step 1300 so as to start a stereotactic surgery procedure, thereby inserting the surgery cannula 210 to perform the stereotactic surgery.
[0057] In step 1500, an actual cannula position is obtained according to a magnetic resonance (MR) image providing by a magnetic resonance imaging (MRI) scanner. It is noted that due to several kinds of the reasons, the actual cannula position of the surgery cannula 210 may not the same as the insertion position of the surgery cannula 210. Therefore, the MR image is required for fine tuning the inserting of the surgery cannula 210.
[0058] In step 1600, the actual cannula position is compared with the surgery target point to obtain a position error vector. In some embodiments of the present disclosure, the position error vector is obtained by subtracting the actual cannula position from the surgery target point.
[0059] After the step 1600, performing step 1700: determining whether the position error vector is acceptable. When the position error vector is acceptable, performing step 1800: withdrawing the surgery cannula to finish the stereotactic surgery procedure. When the position error vector is not acceptable, performing step 1900.
[0060]
p=(p.sub.x, p.sub.y, p.sub.z). θ=(θ.sub.3, θ.sub.4, ζ). θ.sub.4=tan.sup.−1(δ/112.7). θ.sub.0 represents the parameters θ.sub.3, θ.sub.4, ζ corresponding to the actual cannula position. The above equation (1) represents that the compensation quantity Δθ is calculated by a Taylor series expansion around θ.sub.0. The above equations (1) and (2) represent that the compensation quantity Δθ is calculated by utilizing a Jacobian square matrix
based on the position error vector Δp, and the Jacobian square matrix
are 3×3 square matrix so as to improve the compensating efficiency. The above equation (1) represents that the relationship between the compensation quantity Δθ and the position error vector Δp. It is noted that the compensation (the compensation quantity Δθ) and the corresponding adjustment are only directed at the third direction θ.sub.3, the fourth direction δ, and the fifth direction ζ so as to fine tune the surgery cannula 210.
[0061] In step 1920, three of the parameters are adjusted according to the compensation quantity obtained in step 1910. In step 1930, the linear piezoelectric motors 240 and 250, and the rotary piezoelectric motor 260 of the MRI-compatible stereotactic surgery device 10 are controlled according to the adjusted parameters, thereby withdrawing the surgery cannula 210, adjusting the insertion position and the insertion direction of the surgery cannula 210, and inserting the surgery cannula 210 again. In step 1940, the actual cannula position is updated according to the MR image updating by the MRI scanner. In step 1950, the updated actual cannula position is compared with the surgery target point to update the position error vector. After the step 1950, performing step 1960: determining whether the updated position error vector is acceptable. When the updated position error vector is acceptable, performing step 1970: withdrawing the surgery cannula to finish the stereotactic surgery procedure. When the updated position error vector is not acceptable, performing back to step 1910.
[0062] It is noted that the traditional stereotactic surgery needs relatively long time for preoperative preparation and performing the operation. For example, the traditional stereotactic surgery needs to perform computed tomography (CT) and image registration between the MR image and CT image for preoperative preparation. The present disclosure does not need the computed tomography (CT) or the image registration between the MR image and CT image for preoperative preparation. For example, the traditional stereotactic surgery needs to perform the medical test (i.e., biopsy) to confirm the inserting position because the traditional stereotactic surgery does not have MR image to assist the inserting surgery. The present disclosure does not need to perform the biopsy medical test, the present disclosure utilizes the MR image for instantly feedback the cannula position. In other words, the MRI-guided stereotactic surgery method 1000 save more time for stereotactic surgery.
[0063] From the above description, the present disclosure provides the MRI-compatible stereotactic surgery device 10 and the MRI-guided stereotactic surgery method 1000. The MRI-compatible stereotactic surgery device 10 with five degrees of freedom is designed to be MRI-compatible, and therefore the MRI-compatible stereotactic surgery device 10 could be directly operated in the MRI environment. In other words, the MRI-compatible stereotactic surgery device 10 could avoid electromagnetic wave interference, thereby suitable for the MRI stereotactic surgery. The MRI-guided stereotactic surgery method 1000 utilizes the MR image to instantly guide the actual cannula position so as to correct inserting of the surgery cannula based on the instantly feedback MR image, thereby enhancing the accuracy and the efficiency of the stereotactic surgery and enhancing safety of the patients.
[0064] Although the present invention has been described in considerable detail with reference to certain embodiments thereof, other embodiments are possible. Therefore, the spirit and scope of the appended claims should not be limited to the description of the embodiments contained herein. It will be apparent to those skilled in the art that various modifications and variations can be made to the structure of the present invention without departing from the scope or spirit of the invention. In view of the foregoing, it is intended that the present invention cover modifications and variations of this invention provided they fall within the scope of the following claims.