Intraoperative C-arm fluoroscope datafusion system

Abstract

In one form of the present invention, there is provided an apparatus for producing a virtual road map of a patient's vascular anatomy for use by a surgeon while conducting a procedure on the patient's vascular anatomy, the apparatus comprising: a virtual 3D model of the patient's anatomy, wherein the virtual 3D model comprises a virtual 3D structure representing bony structure of the patient and a virtual 3D structure representing vascular structure of the patient, with the virtual 3D structure representing bony structure of the patient being in proper registration with the virtual 3D structure representing vascular structure of the patient; a fluoroscope for providing real-time images of the bony structure of the patient and a surgical device being used in the procedure; registration apparatus for placing the virtual 3D model in proper registration with the patient space of the fluoroscope; bone mask subtraction apparatus for (i) generating a bone mask of the bony structure of the patient, and (ii) subtracting the same from the real-time images provided by the fluoroscope, whereby to create modified fluoroscope images omitting bony structure; and image generating apparatus for generating the virtual road map, wherein the virtual road map comprises a composite image combining (i) images of the virtual 3D structure representing vascular structure of the patient, and (ii) modified fluoroscope images omitting bony structure, wherein the images of the virtual 3D structure representing vascular structure of the patient are in proper registration with the modified fluoroscope images omitting bony structure.

1 . Apparatus for producing a virtual road map of a patient's vascular anatomy for use by a surgeon while conducting a procedure on the patient's vascular anatomy, the apparatus comprising:
 a virtual 3D model of the patient's anatomy, wherein the virtual 3D model comprises a virtual 3D structure representing bony structure of the patient and a virtual 3D structure representing vascular structure of the patient, with the virtual 3D structure representing bony structure of the patient being in proper registration with the virtual 3D structure representing vascular structure of the patient;   a fluoroscope for providing real-time images of the bony structure of the patient and a surgical device being used in the procedure;   registration apparatus for placing the virtual 3D model in proper registration with the patient space of the fluoroscope;   bone mask subtraction apparatus for (i) generating a bone mask of the bony structure of the patient, and (ii) subtracting the same from the real-time images provided by the fluoroscope, whereby to create modified fluoroscope images omitting bony structure; and   image generating apparatus for generating the virtual road map, wherein the virtual road map comprises a composite image combining (i) images of the virtual 3D structure representing vascular structure of the patient, and (ii) modified fluoroscope images omitting bony structure, wherein the images of the virtual 3D structure representing vascular structure of the patient are in proper registration with the modified fluoroscope images omitting bony structure.   
     
     
         2 . Apparatus according to  claim 1  wherein the virtual 3D model of the patient's anatomy is constructed from scan data. 
     
     
         3 . Apparatus according to  claim 2  wherein the scan data is obtained from apparatus selected from the group consisting of CT, CT-angiography and MRA. 
     
     
         4 . Apparatus according to  claim 1  wherein each virtual 3D structure comprises at least one virtual 3D object. 
     
     
         5 . Apparatus according to  claim 1  wherein the virtual 3D structure representing bony structure of the patient is capable of being visualized separately and independently from the virtual 3D structure representing vascular structure of the patient. 
     
     
         6 . Apparatus according to  claim 1  wherein the fluoroscope comprises a C-arm fluoroscope. 
     
     
         7 . Apparatus according to  claim 1  wherein the fluoroscope comprises radial and orbital settings for establishing its scanning direction. 
     
     
         8 . Apparatus according to  claim 1  wherein the surgical device comprises a catheter and stent. 
     
     
         9 . Apparatus according to  claim 1  wherein the registration apparatus achieves proper registration by manual registration. 
     
     
         10 . Apparatus according to  claim 1  wherein the registration apparatus achieves proper registration by semi-automatic registration. 
     
     
         11 . Apparatus according to  claim 10  wherein the registration apparatus achieves proper registration using landmark or fiducial points. 
     
     
         12 . Apparatus according to  claim 1  wherein the registration apparatus achieves proper registration by automatic registration of the two-dimensional fluoroscopic images with the three-dimensional model of the patient's anatomy. 
     
     
         13 . Apparatus according to  claim 1  wherein the registration apparatus achieves proper registration when the bony structure of the patient is being viewed in the Anterior-Posterior (AP) view. 
     
     
         14 . Apparatus according to  claim 1  wherein the bone mask subtraction apparatus uses the fluoroscope to generate the bone mask of the bony structure of the patient. 
     
     
         15 . Apparatus for visualizing a surgical site, the apparatus comprising:
 data fusion apparatus for merging (i) virtual images of vascular structures of a patient, wherein the virtual images are created from pre-acquired scan data; and (ii) real-time images acquired by a fluoroscope.   
     
     
         16 . A method for visualizing anatomical structures, the method comprising the steps of:
 (1) processing pre-acquired scanned patient-specific data so as to produce a virtual 3D model of appropriate anatomical structures, wherein processing is effected so that separate views of the bone and blood flow structures can be generated;   (2) positioning a C-arm fluoroscope with standard Anterior-Posterior (AP) orientation relative to the patient;   (3) conducting fluoroscopic imaging so as to provide good images of the patient's bone structure;   (4) overlaying, on top of the fluoroscopic images, virtual images from the virtual 3D model, with those images representing only the patient's bone structure;   (5) placing the virtual images of the patient's bone structure generated from the virtual 3D model in proper registration with the fluoroscope images of the patient's bone structure, whereby the coordinate system of the virtual 3D model is correlated to the coordinate system of the fluoroscope;   (6) imaging the patient's bone structure using fluoroscopy so as to create a standard mask image of the patient's bone structure;   (7) turning off the virtual images of the virtual bone structure and turning on the virtual images of the blood flow structure, so as to show the blood flow structure from the virtual 3D model overlaid on top of the fluoroscopic images in a semi-transparent mode, whereby to provide a composite view simultaneously showing the patient's blood flow structure from the virtual 3D model and the patient's bone structure from the fluoroscopic images;   (7A) using the mask image to subtract out the bone structure from the composite view, whereby to produce the virtual road map which will be used by the surgeon.   
     
     
         17 . A method for visualizing a surgical site, the method comprising:
 pre-acquiring scan data of the surgical site; and   merging (i) virtual images of vascular structures, wherein the virtual images are created from pre-acquired scan data; and (ii) real-time images acquired by a fluoroscope.