Devices and methods for performing medical procedures in tree-like luminal structures

Abstract

Apparatus and methods are described for use with an imaging device that acquires an external image of a multi-lumen structure within a subject's body. A tool with a location sensor coupled thereto is moved along branches of the structure. The multi-lumen structure is registered with the external image, such that the multi-lumen structure and the external image of the multi-lumen structure have a common frame of coordinates, by sensing the location coordinates of the tool while the tool moves along a plurality of branch lines within the multi-lumen structure, the branch lines defining a plurality of paths within the multi-lumen structure. The branch lines are identified within the image, and a correspondence between the sensed location coordinates of the tool and the plurality of branch lines within the image is determined. Other applications are also described.

1 . (canceled) 
     
     
         2 . Apparatus for use with an imaging device configured to acquire an image of a multi-lumen structure within a body of a subject from outside of the structure, the apparatus comprising:
 a tool configured to move along branches of the multi-lumen structure;   at least one location sensor coupled to the tool, the location sensor being configured to facilitate sensing of location coordinates of the tool; and   a computer processor configured to:   register the multi-lumen structure with the image of the multi-lumen structure, such that the multi-lumen structure and the image of the multi-lumen structure have a common frame of coordinates, by:   using the location sensor, sensing location coordinates of the tool while the tool moves along a plurality of branch lines within the multi-lumen structure, each of the branch lines passing through at least a portion of at least one branch of the multi-lumen structure, the branch lines defining a plurality of paths within the multi-lumen structure;   identifying the plurality of branch lines within the image; and   determining a correspondence between the sensed location coordinates of the tool and the plurality of branch lines within the image of the multi-lumen structure; and   generate an output in response thereto.   
     
     
         3 . The apparatus according to  claim 2 , wherein the computer processor is configured to identify the plurality of branch lines within the image, prior to sensing location coordinates of the tool while the tool moves along a plurality of branch lines within the multi-lumen structure. 
     
     
         4 . The apparatus according to  claim 2 , wherein the computer processor is configured to sense location coordinates of the tool while the tool moves along the plurality of branch lines within the multi-lumen structure, at least one of the branch lines not meeting any other one of the branch lines. 
     
     
         5 . The apparatus according to  claim 2 , wherein the computer processor is configured to determine the correspondence between the plurality of branch lines along which the tool moves and the plurality of branch lines within the image, by assigning respective, different weights to respective portions of at least one of the branch lines. 
     
     
         6 . The apparatus according to  claim 2 , wherein the computer processor is configured to determine the correspondence between the plurality of branch lines along which the tool moves and the plurality of branch lines within the image, by assigning respective, different weights to respective branch lines. 
     
     
         7 . The apparatus according to  claim 2 , wherein, subsequent to registering the multi-lumen structure with the image of the multi-lumen structure, the computer processor is configured to:
 receive an image acquired from within the multi-lumen structure, and   in response thereto, modify registration of the multi-lumen structure with the image of the multi-lumen structure.   
     
     
         8 . The apparatus according to  claim 2 , wherein the computer processor is configured to sense location coordinates of the tool while the tool moves along the plurality of branch lines within the multi-lumen structure, at least two of the branch lines meeting with one another. 
     
     
         9 . The apparatus according to  claim 8 , wherein the computer processor is configured to sense location coordinates of the tool while the tool moves along the plurality of branch lines within the multi-lumen structure, the at least two of the branch lines branching from a common bifurcation point. 
     
     
         10 . The apparatus according to  claim 2 , wherein:
 the multi-lumen structure includes at least a portion of a bronchial tree of the subject;   the image includes an image of the portion of the subject's bronchial tree; and   the computer processor is configured to sense location coordinates of the tool while the tool moves along a plurality of branch lines within the portion of the subject's bronchial tree.   
     
     
         11 . The apparatus according to  claim 10 , wherein the computer processor is configured to sense location coordinates of the tool while the tool moves along the plurality of branch lines within the portion of the subject's bronchial tree, at least one of the branch lines being at least partially within a left lung of the subject, and at least one of the branch lines being at least partially within a right lung of the subject. 
     
     
         12 . The apparatus according to  claim 10 , wherein the computer processor is configured to sense location coordinates of the tool while the tool moves along the plurality of branch lines within the portion of the subject's bronchial tree, at least one of the branch lines being at least partially within an upper lobe of lungs of the subject, and at least one of the branch lines being at least partially within a lower lobe of the subject's lungs. 
     
     
         13 . The apparatus according to  claim 10 , wherein the computer processor is configured to:
 sense location coordinates of the tool while the tool moves along a plurality of branch lines that are disposed along central airways of the subject's bronchial tree, and   in response thereto, register even peripheral airways of the subject's bronchial tree with the image of the portion of the subject's bronchial tree.   
     
     
         14 . The apparatus according to  claim 2 , wherein the computer processor is configured to determine the correspondence between the sensed location coordinates of the tool with the plurality of branch lines within the image of the multi-lumen structure, by:
 based upon the sensed location coordinates of the tool, determining locations of lines that are representative of the branch lines; and   determining locations of lines within the image that correspond to the lines that are representative of the branch lines.   
     
     
         15 . The apparatus according to  claim 14 , wherein the computer processor is configured to determine locations of lines that are representative of the branch lines by determining locations of center lines of branches through which the branch lines pass. 
     
     
         16 . A method for use with an imaging device configured to acquire an image of a multi-lumen structure within a body of a subject from outside of the structure, the method comprising:
 moving a tool along branches of the multi-lumen structure, at least one location sensor coupled to the tool, the location sensor being configured to facilitate sensing of location coordinates of the tool;   using a computer processor, registering the multi-lumen structure with the image of the multi-lumen structure, such that the multi-lumen structure and the image of the multi-lumen structure have a common frame of coordinates, by:   sensing the location coordinates of the tool while the tool moves along a plurality of branch lines within the multi-lumen structure, each of the branch lines passing through at least a portion of at least one branch of the multi-lumen structure, the branch lines defining a plurality of paths within the multi-lumen structure;   identifying the plurality of branch lines within the image; and   determining a correspondence between the sensed location coordinates of the tool and the plurality of branch lines within the image of the multi-lumen structure; and   using the computer processor, generating an output in response to the registering.   
     
     
         17 . The method according to  claim 16 , wherein identifying the plurality of branch lines within the image comprises identifying the plurality of branch lines prior to sensing location coordinates of the tool while the tool moves along a plurality of branch lines within the multi-lumen structure. 
     
     
         18 . The method according to  claim 16 , wherein sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along the plurality of branch lines within the multi-lumen structure, at least one of the branch lines not meeting any other one of the branch lines. 
     
     
         19 . The method according to  claim 16 , wherein the multi-lumen structure includes a structure selected from the group consisting of: a coronary structure of the subject, a biliary structure of the subject, and a duodenum of the subject, and wherein sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along a plurality of branch lines within the selected structure. 
     
     
         20 . The method according to  claim 16 , wherein determining the correspondence between the plurality of branch lines along which the tool moves and the plurality of branch lines within the image comprises assigning respective, different weights to respective portions of at least one of the branch lines. 
     
     
         21 . The method according to  claim 16 , wherein determining the correspondence between the plurality of branch lines along which the tool moves and the plurality of branch lines within the image comprises assigning respective, different weights to respective branch lines. 
     
     
         22 . The method according to  claim 16 , further comprising subsequent to registering the multi-lumen structure with the image of the multi-lumen structure:
 using the computer processor, receiving an image acquired from within the multi-lumen structure, and   in response thereto, using the computer processor, modifying registration of the multi-lumen structure with the image of the multi-lumen structure.   
     
     
         23 . The method according to  claim 16 , wherein sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along the plurality of branch lines within the multi-lumen structure, at least two of the branch lines meeting with one another. 
     
     
         24 . The method according to  claim 23 , wherein sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along the plurality of branch lines within the multi-lumen structure, the at least two of the branch lines branching from a common bifurcation point. 
     
     
         25 . The method according to  claim 16 , wherein:
 the multi-lumen structure includes at least a portion of a bronchial tree of the subject;   the image includes an image of the portion of the subject's bronchial tree; and   sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along the plurality of branch lines within the portion of the subject's bronchial tree.   
     
     
         26 . The method according to  claim 25 , wherein sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along the plurality of branch lines within the portion of the subject's bronchial tree, at least one of the branch lines being at least partially within a left lung of the subject, and at least one of the branch lines being at least partially within a right lung of the subject. 
     
     
         27 . The method according to  claim 25 , wherein sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along the plurality of branch lines within the portion of the subject's bronchial tree, at least one of the branch lines being at least partially within an upper lobe of lungs of the subject, and at least one of the branch lines being at least partially within a lower lobe of the subject's lungs. 
     
     
         28 . The method according to  claim 25 , wherein:
 sensing location coordinates of the tool comprises sensing location coordinates of the tool while the tool moves along a plurality of branch lines that are disposed along central airways of the subject's bronchial tree; and   registering the multi-lumen structure with the image of the multi-lumen structure comprises registering even peripheral airways of the subject's bronchial tree with the image of the portion of the subject's bronchial tree.   
     
     
         29 . The method according to  claim 16 , wherein determining the correspondence between the sensed location coordinates of the tool and the plurality of branch lines within the image of the multi-lumen structure comprises:
 based upon the sensed location coordinates of the tool, determining locations of lines that are representative of the branch lines; and   determining locations of lines within the image that correspond to the lines that are representative of the branch lines.   
     
     
         30 . The method according to  claim 29 , wherein determining the locations of lines that are representative of the branch lines comprises determining locations of center lines of branches through which the branch lines pass. 
     
     
         31 . A computer software product, for use with an imaging device configured to acquire an image of a multi-lumen structure within a body of a subject from outside of the structure, and a tool configured to be moved along branches of the multi-lumen structure, at least one location sensor coupled to the tool, the location sensor being configured to facilitate sensing of location coordinates of the tool, the computer software product comprising a non-transitory computer-readable medium in which program instructions are stored, which instructions, when read by a computer cause the computer to perform the steps of registering the multi-lumen structure with the image of the multi-lumen structure, such that the multi-lumen structure and the image of the multi-lumen structure have a common frame of coordinates, by (a) sensing the location coordinates of the tool while the tool moves along a plurality of branch lines within the multi-lumen structure, each of the branch lines passing through at least a portion of at least one branch of the multi-lumen structure, the branch lines defining a plurality of paths within the multi-lumen structure, (b) identifying the plurality of branch lines within the image, and (c) determining a correspondence between the sensed location coordinates of the tool and the plurality of branch lines within the image of the multi-lumen structure, and generating an output in response to the registering.