Electromagnetic navigation device for guiding and tracking an interventional tool
11259877 · 2022-03-01
Assignee
Inventors
- Neriman Nicoletta Kahya (Eindhoven, NL)
- Molly Lara FLEXMAN (MELROSE, MA, US)
- David Paul Noonan (New York, NY, US)
- Aryeh Leib Reinstein (Bronx, NY, US)
Cpc classification
A61B6/12
HUMAN NECESSITIES
A61B5/06
HUMAN NECESSITIES
A61B34/20
HUMAN NECESSITIES
A61B5/066
HUMAN NECESSITIES
International classification
A61B5/00
HUMAN NECESSITIES
A61B34/20
HUMAN NECESSITIES
Abstract
An electromagnetic navigation device for guiding and tracking an interventional tool (40) within an anatomical region. The electromagnetic navigation device employs a guidewire (20) insertable into the anatomical region, and a hub (30) translatable and/or rotatable in conjunction with the interventional tool (40) relative to the guidewire (20). In operation, the guidewire (20) includes one or more guidance electromagnetic sensors generating guidance data informative of an electromagnetic sensing of a position and/or an orientation of the guidewire (20) relative to the anatomical region, and the hub (30) includes a tracking electromagnetic sensor (31) generating tracking data informative of an electromagnetic sensing of a position and/or an orientation of the hub (30) relative to the guidewire (20). Responsive to the electromagnetic sensing data, a navigation controller (76) controls a determination of a position and/or an orientation of the interventional tool (40) relative to the guidewire (20).
Claims
1. An electromagnetic navigation system for guiding and tracking an interventional tool within an anatomical region, the electromagnetic navigation system comprising: a guidewire structurally configured to be inserted into the anatomical region, wherein the guidewire includes a plurality of guidance electromagnetic sensors structurally configured to generate guidance data informative of an electromagnetic sensing of at least a position and an orientation of the guidewire relative to the anatomical region; a hub structurally configured, in conjunction with the interventional tool, to be at least one of translated and rotated relative to the guidewire, wherein the hub includes a tracking electromagnetic sensor structurally configured to generate tracking data informative of an electromagnetic sensing of at least one of a position and an orientation of the hub relative to the guidewire, and wherein the guidance data and the tracking data are collectively informative of at least one of a position and an orientation of the interventional tool relative to the guidewire; and a navigation controller structurally configured, in response to a generation of the guidance data by the plurality of guidance electromagnetic sensors and a generation of the tracking data by the tracking electromagnetic sensor, to determine the at least one of the position and the orientation of the interventional tool relative to the guidewire by performance of: (i) an interpolation of a spatial distance between electromagnetic sensed positions of the plurality of guidance electromagnetic sensors and an electromagnetic sensed position of the tracking electromagnetic sensor, or (ii) a projection of a position of the tracking electromagnetic sensor onto the guidewire derived from an interpolation of the spatial distance between the electromagnetic sensed positions of the plurality of guidance electromagnetic sensors and the electromagnetic sensed position of the tracking electromagnetic sensor.
2. The electromagnetic navigation system of claim 1, wherein the plurality of guidance electromagnetic sensors is evenly spaced along the guidewire.
3. The electromagnetic navigation system of claim 1, wherein the plurality of guidance electromagnetic sensors is unevenly distributed between a distal segment and a proximal segment of the guidewire.
4. The electromagnetic navigation system of claim 1, wherein the hub further includes at least one of: a radio-opaque marker for registering the hub, an orientation marker for visually orienting the hub relative to the guidewire, a torqueing groove for manually orienting the hub relative to the guidewire, and a locking mechanism for clamping the hub onto the guidewire.
5. The electromagnetic navigation system of claim 1, wherein the hub has an annular configuration; and wherein the guidewire is extendable through the hub.
6. The electromagnetic navigation system of claim 1, wherein the hub is one of adjoinable to or integrated with a proximal end of the interventional tool.
7. The electromagnetic navigation system of claim 1, wherein determination by the navigation controller of the at least one of the position and the orientation of the interventional tool relative to the guidewire further includes: the navigation controller further structurally configured to determine the at least one of the position and the orientation of the interventional tool relative to the anatomical region derived from a projection of the position of the tracking electromagnetic sensor onto the guidewire.
8. A method for guiding and tracking an interventional tool within an anatomical region, the method comprising: inserting a guidewire into the anatomical region, the guidewire including a plurality of guidance electromagnetic sensors; at least one of translating and rotating a hub, in conjunction with the interventional tool, relative to the guidewire, the hub including a tracking electromagnetic sensor; generating, by the plurality of guidance electromagnetic sensors, guidance data informative of an electromagnetic sensing of at least a position and an orientation of the guidewire relative to the anatomical region; generating, by the tracking electromagnetic sensor, tracking data informative of an electromagnetic sensing of at least one of a position and an orientation of the hub relative to the guidewire; and in response to generation of the guidance data and the tracking data, determine the at least one of the position and the orientation of the interventional tool relative to the guidewire by: (i) interpolating a spatial distance between electromagnetic sensed positions of the plurality of guidance electromagnetic sensors and an electromagnetic sensed position of the tracking electromagnetic sensor, or (ii) projecting a position of the tracking electromagnetic sensor onto the guidewire derived from an interpolation of the spatial distance between the electromagnetic sensed positions of the plurality of guidance electromagnetic sensors and the electromagnetic sensed position of the tracking electromagnetic sensor.
9. The method of claim 8, wherein the plurality of guidance electromagnetic sensors is evenly spaced along the guidewire.
10. The method of claim 8, wherein the plurality of guidance electromagnetic sensors is unevenly distributed between a distal segment and a proximal segment of the guidewire.
11. The method of claim 8, wherein the hub further includes at least one of: a radio-opaque marker for registering the hub, an orientation marker for visually orienting the hub relative to the guidewire, a torqueing groove for manually orienting the hub relative to the guidewire, and a locking mechanism for clamping the hub onto the guidewire.
12. The method of claim 8, wherein the hub has an annular configuration; and wherein the guidewire is extendable through the hub.
13. The method of claim 8, wherein the hub is one of adjoinable to or integrated with a proximal end of the interventional tool.
14. The method of claim 8, wherein determination of the at least one of the position and the orientation of the interventional tool relative to the guidewire further includes: determining the at least one of the position and the orientation of the interventional tool relative to the anatomical region derived from a projection of the position of the tracking electromagnetic sensor onto the guidewire.
15. A non-transitory computer-readable storage medium having stored a computer program comprising instructions for guiding and tracking an interventional tool within an anatomical region, the instructions, when the computer program is executed by a computer, cause the computer to: receive guidance data informative of an electromagnetic sensing of at least a position and an orientation of the guidewire relative to the anatomical region, the guidance data generated by a plurality of guidance electromagnetic sensors disposed on a guidewire positioned within the anatomical region; receive tracking data informative of an electromagnetic sensing of at least one of a position and an orientation of the hub relative to the guidewire, the tracking data generated by a tracking electromagnetic sensor disposed on a hub that at least one of translates and rotates, in conjunction with the interventional tool, relative to the guidewire; and based on the received guidance data and the received tracking data, determine the at least one of the position and the orientation of the interventional tool relative to the guidewire by performance of: (i) an interpolation of a spatial distance between electromagnetic sensed positions of the plurality of guidance electromagnetic sensors and an electromagnetic sensed position of the tracking electromagnetic sensor, or (ii) a projection of a position of the tracking electromagnetic sensor onto the guidewire derived from an interpolation of the spatial distance between the electromagnetic sensed positions of the plurality of guidance electromagnetic sensors and the electromagnetic sensed position of the tracking electromagnetic sensor.
16. The non-transitory computer-readable storage medium of claim 15, wherein the plurality of guidance electromagnetic sensors is evenly spaced along the guidewire.
17. The non-transitory computer-readable storage medium of claim 15, wherein the plurality of guidance electromagnetic sensors is unevenly distributed between a distal segment and a proximal segment of the guidewire.
18. The non-transitory computer-readable storage medium of claim 15, wherein the hub further includes at least one of: a radio-opaque marker for registering the hub, an orientation marker for visually orienting the hub relative to the guidewire, a torqueing groove for manually orienting the hub relative to the guidewire, and a locking mechanism for clamping the hub onto the guidewire.
19. The non-transitory computer-readable storage medium of claim 15, wherein the hub has an annular configuration; and wherein the guidewire is extendable through the hub.
20. The non-transitory computer-readable storage medium of claim 15, wherein determination of the at least one of the position and the orientation of the interventional tool relative to the guidewire further includes: determining the at least one of the position and the orientation of the interventional tool relative to the anatomical region derived from a projection of the position of the tracking electromagnetic sensor onto the guidewire.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
(11) To facilitate an understanding of the various inventions of the present disclosure, the following description of
(12) Referring to
(13) By being adjoined to or integrated with interventional tool 40, EM-sensed hub 30 may be mapped 1-1 to any point of interventional tool 40 (e.g., a distal tip) or to any deployable device deployed by interventional tool 40 (e.g., a balloon, a valve, a endograft, a stent, etc.).
(14) Furthermore, the tracking by the EM-sensed hub 30 of the position and/or orientation of interventional tool 40 relative to EM-sensed guidewire 20 may be utilized to display a virtual representation (e.g., an overlay) of interventional tool 40 and any deployable device within an image of the anatomical region (e.g., a magnetic resonance image, a computed-tomography image, an x-ray image, a positron emission tomography image, an ultrasound image and/or an optical image).
(15) In practice, EM-sensed guidewire 20, a EM-sensed hub 30 and an interventional tool 40 may be assembled in any arrangement that facilitates the aforementioned guiding and tracking of interventional tool 40.
(16) For example,
(17) By further example,
(18) From the examples of
(19) Referring back to
(20) For example,
(21) By further example,
(22) Furthermore, referring back to
(23) For example, referring to
(24) From the examples of
(25) Referring back to
(26) For example,
(27) From the examples of
(28) Referring back to
(29) For example,
(30) By further example,
(31) Also by example,
(32) From the examples of
(33) Referring back to
(34) Additionally, in practice, EM-sensed hub 30 interventional tool 40 as adjoined or integrated may be back-loaded or front-loaded on EM-sensed guidewire 20 in an “over-the-wire” manner and/or adjacent guidewire 20.
(35) To facilitate a further understanding of the various inventions of the present disclosure, the following description of
(36) Please note
(37) Referring to
(38) For tracking purposes of catheter 49, EM-sensed hub 30 and catheter 49 as adjoined or integrated are passed over EM-sensed guidewire 20b into anatomical region AR. The tracking electromagnetic sensor 31 of EM-sensed hub 30a is operated to generate tracking data informative of an electromagnetic sensing of a position and/or an orientation of EM-sensed hub 30a within anatomical region AR. More particularly, in the presence of an electromagnetic field generator (not shown), tracking electromagnetic sensor 31 generates a reference position signal P.sub.EMH relative to reference position P.sub.REF. Reference position signal P.sub.EMH represents tracking data informative of the position and/or the orientation of EM-sensed hub 30a relative to guidewire 20b.
(39) From the guiding and tracking of catheter 49, a position and/or an orientation of catheter 49 within anatomical region AR may be determined as EM-sensed hub 30 and catheter 49 as adjoined or integrated are passed over EM-sensed guidewire 20b into anatomical region AR. In practice, the determination of the position and/or the orientation of catheter 49 within anatomical region AR may be focused on a particular point of catheter 49 (e.g., a distal tip of catheter 49) or a particular segment of catheter 49 (e.g., a distal segment of catheter 49).
(40) More particularly, the determination of the position and/or the orientation of catheter 49 within anatomical region AR is derived from an interpolation of a distance of sensed reference position P.sub.EMH of tracking electromagnetic sensor 31 of EM-sensed hub 30 from sensed reference positions P.sub.EMG of two (2) or more guidance electromagnetic sensors 22 of EM-sensed guidewire 20b. The sensor distance interpolation facilitates a guidewire position projection of tracking electromagnetic sensor 31 upon an alignment of the guidance electromagnetic sensors 22 of EM-sensed guidewire 20c, and the guidewire position projection facilitates a determination of the position and/or the orientation of catheter 49 within anatomical region AR based on a combined length of EM-sensed hub 30a and catheter 49 relative to a larger length of EM-sensed guidewire 20b.
(41) For example,
(42) Alternatively, an interpolation of the distance between the sensed reference position P.sub.EMGX of the guidance electromagnetic sensor 21X and a sensed reference position P.sub.EMH of tracking electromagnetic sensor 31 may be utilized to project guidewire position P.sub.PJH of tracking electromagnetic sensor 31 unto guidewire 20b.
(43) In practice, as described for
(44) For a determination of the position and/or the orientation of catheter 49 within anatomical region AR, a length L.sub.GW of EM-sensed guidewire 20b, a length L.sub.HUB of EM-sensed hub 30a and a length L.sub.CAT of catheter 49 are known either by construction and/or calibration. Additionally, respective position lengths L.sub.EMG1−L.sub.EMG10 of guidance electromagnetic sensors 21(1)-21(10) as adjoined to or integrated within EM-sensed guidewire 20b is known either by construction and/or calibration.
(45) From the sensor distance interpolation/guidewire position projection, the position and/or the orientation of catheter 49 within anatomical region AR is determined based on the known combined length L.sub.HUB+L.sub.CAT of EM-sensed hub 30a and catheter 49 relative to the known larger length L.sub.GW of EM-sensed guidewire 20b.
(46) For example,
(47) By further example,
(48) Also by example,
(49) One technique involves an extrapolation along a vector of P.sub.EMG10 for a length of L.sub.CAT that extends beyond length L.sub.EMG10. A second technique involves a prediction of reference position P.sub.TIP using other information such as the properties of catheter 49, a known configuration of anatomical region AR, and an imaging of anatomical region AR. A third technique involves utilization of a probability map of likely reference positions P.sub.TIP.
(50) From the examples of
(51) To facilitate a further understanding of the various inventions of the present disclosure, the following description of
(52) Referring to
(53) As known in the art, electromagnetic field generator 50 is operated by EM sensor data controller 74 via a communication channel 80 for generating electromagnetic field (not shown) within a reference coordinate system 51 occupied by electromagnetic sensors 21 and 31 of EM-sensed guidewire 20 and EM-sensed hub 30, respectively, whereby EM sensor data controller 74 receives guidance sensing data from guidance electromagnetic sensors 21 and tracking sensing data from tracking electromagnetic sensor 31 as previously described herein in connection with
(54) Alternatively to be installed on workstation 70, electromagnetic sensor data controller 74 may be installed on an electromagnetic field generator workstation as known in the art.
(55) As known in the art, medical imaging modality 60 (e.g., a magnetic resonance modality, a computed-tomography modality, an x-ray modality, a positron emission tomography modality, an ultrasound modality and/or an optical modality) is operated by imaging data controller 75 via a communication channel 81 for generating imaging data illustrative of anatomical region AR within an imaging coordinate system 61.
(56) Alternatively to be installed on workstation 70, imaging data controller 75 may be installed on an medical imaging modality workstation as known in the art.
(57) Navigation controller 76 receives the EM sensing data from EM sensor data controller 74 via a communication channel 82 and receives the imaging data from imaging data controller 75 via a communication channel 83 for processing the EM sensing data and the imaging data to determine a position and/or an orientation of interventional tool 40 within an anatomical region AR that is derived from a sensor distance interpolation/guidewire position projection of the electromagnetic sensors of EM-based guidewire 20 and EM-sensed hub 30 as previously exemplary described herein as will be further described herein in connection with
(58) From the position/orientation determination of interventional tool 40, navigation controller 76 renders a display of navigation images 77 on monitor 71 whereby navigation images 77 are illustrative of a guided and tracked interventional tool 40 and tracked guidewire 21 represented within the images of anatomical region AR as will be further described herein in connection with
(59) Referring to
(60) As known in the art, fluoroscopic imager 110 generally includes an X-ray generator 111, an image intensifier 112 and a collar 113 for rotating fluoroscopic imager 110. In operation, fluoroscopic imager 110 generates imaging data 116 as controlled by an X-ray controller 114 whereby imaging data 116 is illustrative of a fluoroscopic image of an anatomical area of patient 100 lying prone on an operating table 101 within an imaging coordinate system 115. X-ray controller 114 may be installed on workstation 150 or alternatively installed on an imaging workstation as known in the art.
(61) As known in the art, electromagnetic field generation system 150 generally includes an electromagnetic field generator (“EMFG”) 151, EFMG controller 153 and electromagnetic sensors (not shown) adjoined to or integrated within EM-sensed guidewire 120 and EM-sensed hub 130. In operation, EMFG controller 153 controls a generation by EFMG 151 generates of electromagnetic field (not shown) within an EMF coordinate system 152 occupied by the electromagnetic sensors whereby the electromagnetic sensors generate EM sensing data 144 informative of a position and/or an orientation of EM-sensed guidewire 120 and EM-sensed hub 130 within EMF coordinate system 152.
(62) A navigation controller 170 is installed within workstation 160 for executing an electromagnetic navigation method of the present disclosure as will be further described herein in connection with
(63) Image generator 171 processes imaging sensing data 116 for generating fluoroscopic images for display as known in the art.
(64) Guidewire/hub monitor 172 processes EM sensing data 144 for monitoring a position and/or an orientation of EM-sensed guidewire 120 within anatomical region 100 and for monitoring a position and/or an orientation of EM-sensed hub 130 relative to EM-sensed guidewire 120.
(65) Patient monitor 173 monitors a motion of patient 100 within imaging coordinate system 115 as known in the art.
(66) Surgical applications 174 includes one or more known applications for performing the surgical procedure including, but not limited to, an image planning application for plaining trajectories and positioning of stent-deployment device 140 for deployment of a stent (not shown) within patient 100, and an image guidance application for displaying an overlay of stent-deployment device 140 and the stent onto the generated fluoroscopic images as exemplary shown in
(67) More particularly, based on a registration of coordinate systems 115 and 152, the image guidance application determines a position and/or an orientation of stent-deployment device 140 within patient 100 that is derived from a sensor distance interpolation/guidewire position projection of the electromagnetic sensors of EM-based guidewire 120 and EM-sensed hub 130 as previously exemplary described herein as will be further described herein in connection with
(68) To facilitate a further understanding of the various inventions of the present disclosure, the following description of
(69) Referring to
(70) A stage S182 of flowchart 180 encompasses a guiding and a tracking of an interventional tool by a navigation controller of the present disclosure derived from a sensor distance interpolation/guidewire position projection technique of the present disclosure. Generally, an execution of a sensor distance interpolation/guidewire position projection technique of the present disclosure during stage S182 as EM-sensed hub and an interventional tool are passed over an EM-sensed guidewire includes:
(71) (1) a sensing of reference positions of guidance EM sensors of an EM-sensed guidewire as exemplary illustrated in
(72) (2) a sensing of reference position(s) of tracking EM sensor(s) of an EM-sensed hub as exemplary illustrated in
(73) (3) a projection of a guidewire position(s) of tracking EM sensor(s) of the EM-sensed hub as exemplary illustrated in
(74) (4) an estimating a guidewire position of an interventional tool as exemplary illustrated in
(75) The execution of a sensor distance interpolation/guidewire position projection technique of the present disclosure during stage S182 as EM-sensed hub and an interventional tool are passed over an EM-sensed guidewire may further include a EM sensing of a reference position or a projection of a guidewire position of an interventional device deployed by the interventional tool (e.g., a balloon of a catheter and a stent of a stent-deployment device).
(76) A stage S184 of flowchart 180 encompasses a display of a virtual representation of the interventional tool derived from the guiding and tracking of the interventional tool during stage S182. Generally, as EM-sensed hub and an interventional tool are passed over an EM-sensed guidewire, stage S184 includes a display of an image of the anatomical region with a display of an overlay of the interventional tool as known in the art.
(77) Additional features of stage S184 may include, but are not limited to: (1) a registration of a key feature of an unsensed interventional device such as the position of an endograft using intraoperative imaging, pre-op imaging of the device, or known mechanical positioning; (2) a tracking of orientation by tracking the hub orientation in space and using a mapping between the hub and the distal part of the device (in endograft deployment, this can be close to a 1-to-1 relationship); (3) a visualization and a positioning of a model along the unsensed device (e.g., endograft, balloon catheter, or other therapy device); and (4) a tracking the state of deployment of therapy by putting an additional EM sensor on a portion of interventional tools. For example, in endograft systems, this could be on the sliding handle that deploys the endograft. With the EM-sensed hub tracking the proximal part of the deployment system, then the attachment of one additional EM sensor onto the sliding handle would be informative of a state of deployment of the endograft, which could then be modelled and shown to the operator (thus eliminating the need for x-ray).
(78) Stages S182 and S184 are continually executed until the terminate of flowchart 180.
(79) Referring to
(80) Further, as one having ordinary skill in the art of the present disclosure will appreciate in view of the teachings provided herein, features, elements, components, etc. described in the present disclosure/specification and/or depicted in the Figures may be implemented in various combinations of hardware and software, and provide functions which may be combined in a single element or multiple elements. For example, the functions of the various features, elements, components, etc. shown/illustrated/depicted in the Figures can be provided through the use of dedicated hardware as well as hardware capable of executing software in association with appropriate software for added functionality. When provided by a processor, the functions can be provided by a single dedicated processor, by a single shared processor, or by a plurality of individual processors, some of which can be shared and/or multiplexed. Moreover, explicit use of the term “processor” or “controller” should not be construed to refer exclusively to hardware capable of executing software, and can implicitly include, without limitation, digital signal processor (“DSP”) hardware, memory (e.g., read only memory (“ROM”) for storing software, random access memory (“RAM”), non-volatile storage, etc.) and virtually any means and/or machine (including hardware, software, firmware, combinations thereof, etc.) which is capable of (and/or configurable) to perform and/or control a process.
(81) Moreover, all statements herein reciting principles, aspects, and embodiments of the invention, as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents as well as equivalents developed in the future (e.g., any elements developed that can perform the same or substantially similar function, regardless of structure). Thus, for example, it will be appreciated by one having ordinary skill in the art in view of the teachings provided herein that any block diagrams presented herein can represent conceptual views of illustrative system components and/or circuitry embodying the principles of the invention. Similarly, one having ordinary skill in the art should appreciate in view of the teachings provided herein that any flow charts, flow diagrams and the like can represent various processes which can be substantially represented in computer readable storage media and so executed by a computer, processor or other device with processing capabilities, whether or not such computer or processor is explicitly shown.
(82) Having described preferred and exemplary embodiments of novel and inventive electromagnetic guiding and tracking device for interventional tools, (which embodiments are intended to be illustrative and not limiting), it is noted that modifications and variations can be made by persons skilled in the art in light of the teachings provided herein, including the Figures. It is therefore to be understood that changes can be made in/to the preferred and exemplary embodiments of the present disclosure which are within the scope of the embodiments disclosed herein.
(83) Moreover, it is contemplated that corresponding and/or related systems incorporating and/or implementing the device/system or such as may be used/implemented in/with a device in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure. Further, corresponding and/or related method for manufacturing and/or using a device and/or system in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure.