Methods and systems for intraoperatively confirming location of tissue structures

Abstract

Systems, methods and devices are provided for intraoperatively confirming location of tissue structures during medical procedures. Preoperative image data of a patient's skeletal structure in a vicinity of an anatomical part undergoing a medical procedure is acquired. During the procedure, after exposing tissue intraoperative image data is acquired by scanning a selected region of tissue, in a vicinity of the skeletal structure using Polarization Sensitive-Optical Coherence Tomography (PS-OCT). Regions of tissue exhibiting structural organization in the vicinity of the skeletal structure are identified from the intraoperative (PS-OCT) image data. Geometrically correlating and registering the intraoperative (PS-OCT) image data with the preoperative image data of the skeletal structure in the vicinity of the anatomical part is then performed using a priori known anatomical information about the regions of tissue exhibiting structural information.

1 . A computer implemented method of intraoperatively confirming location of organized tissue structures in relation to a patient's skeletal structure, comprising:
 acquiring preoperative image data of a patient's skeletal structure in a vicinity of an anatomical part;   after exposing tissue during a medical procedure in the anatomical part, acquiring intraoperative image data by scanning a selected region of tissue, in a vicinity of the skeletal structure in the anatomical part undergoing the medical procedure using Polarization Sensitive-Optical Coherence Tomography (PS-OCT);   identifying, from the intraoperative (PS-OCT) image data, regions of tissue exhibiting structural organization in the vicinity of the skeletal structure; and   using a priori known anatomical information about the regions of tissue exhibiting structural information for geometrically correlating and registering the intraoperative (PS-OCT) image data with the preoperative image data of the skeletal structure in the vicinity of the anatomical part.   
     
     
         2 . The method according to  claim 1 , wherein the pre-operative image data of the skeletal structure in a vicinity of an anatomical part is acquired using any one of computed tomography (CT), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). 
     
     
         3 . The method according to  claim 2 , wherein the magnetic resonance imaging is T1 magnetic resonance imaging (T1 MRI). 
     
     
         4 . The method according to  claim 1 , wherein the tissue exhibiting structural organization includes, ligaments, tendons, muscle, cartilage, connective membranes, nerves, retina, blood vessel walls, some bone structures, trachea, esophagus, tongue, teeth and other connective tissues. 
     
     
         5 . The method according to  claim 1 , wherein the a priori known anatomical information about the regions of tissue exhibiting structural information include attachment points of tissue exhibiting structural information to the skeletal structure relative to landmark positions on the skeletal structure. 
     
     
         6 . A method, comprising the steps of:
 a) intraoperatively confirming location of organized tissue structures in relation to a patient's skeletal structure during a medical procedure, by:
 acquiring preoperative image data of a patient's skeletal structure in a vicinity of an anatomical part undergoing a medical procedure; 
 after exposing tissue during a medical procedure in the anatomical part, acquiring intraoperative image data by scanning a selected region of tissue, in a vicinity of the skeletal structure in the anatomical part undergoing the medical procedure using Polarization Sensitive-Optical Coherence Tomography (PS-OCT); 
 identifying, from the intraoperative (PS-OCT) image data, regions of tissue exhibiting structural organization in the vicinity of the skeletal structure; and 
 using a priori known anatomical information about the regions of tissue biting structural information for geometrically correlating and registering the intraoperative (PS-OCT) image data with the preoperative image data of the skeletal structure in the vicinity of the anatomical part; and 
   b) using the registered intraoperative (PS-OCT) image data with the preoperative image data of the skeletal structure in the vicinity of the anatomical part to plan a surgical trajectory to avoid selected regions of the tissue exhibiting structural information.   
     
     
         7 . The method according to  claim 6 , wherein the pre-operative image data of the skeletal structure in a vicinity of an anatomical part undergoing a medical procedure is acquired using any one of computed tomography (ct), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). 
     
     
         8 . The method according to  claim 7 , wherein the magnetic resonance imaging is T1 magnetic resonance imaging (T1 MRI). 
     
     
         9 . The method according to  claim 6 , wherein the tissue exhibiting structural organization includes, ligaments, tendons, muscle, cartilage, connective membranes, nerves, retina, blood vessel walls, some bone structures, trachea, esophagus, tongue, teeth and other connective tissues. 
     
     
         10 . The method according to  claim 6 , wherein the a priori known anatomical information about the regions of tissue exhibiting structural information include attachment points of tissue exhibiting structural information to the skeletal structure relative to landmark positions on the skeletal structure. 
     
     
         11 . A computer implemented system for intraoperatively confirming location of organized tissue structures in relation to a patient's skeletal structure, comprising:
 a Polarization Sensitive-Optical Coherence Tomography (PS-OCT) apparatus configured to scan a selected region of tissue to acquire intraoperative image data of the selected region of tissue;   a computer processor having a memory storage, said Polarization Sensitive-Optical Coherence Tomography being connected to the computer processor, said memory storage having stored therein preoperative image data of a patient's skeletal structure in a vicinity of an anatomical part, said memory storage having stored therein a priori known anatomical information about the regions of tissue exhibiting structural information;   said computer processor being programmed with instructions to
 a) identify, from the intraoperative (PS-OCT) image data, regions of tissue exhibiting structural organization in the vicinity of the skeletal structure; and 
 b) use the stored priori known anatomical information about the regions of tissue exhibiting structural information to geometrically correlate and register the intraoperative (PS-OCT) image data with the preoperative image data of the skeletal structure in the vicinity of the anatomical part. 
   
     
     
         12 . A computer implemented method of intraoperatively confirming location of vasculature structures located below a surface tissue during a medical procedure, comprising:
 acquiring global preoperative image data of tissue in anatomical part undergoing a medical procedure using contrast based magnetic resonance imaging and identifying, from the image data, a global vascular structure within the tissue;   after exposing tissue during a medical procedure in the anatomical part, acquiring intraoperative image data by scanning, using hyperspectral imaging, a selected local region of the tissue in the anatomical part undergoing the medical procedure;   identifying, from the intraoperative hyperspectral image data, a local vascular structure in the selected local region of the tissue; and   searching the global vascular image data for identifying and locating a portion of the global vascular structure geometrically matching the local vascular structure, and upon identifying and locating matching vascular structure, geometrically correlating and registering the local vascular structure in the selected local region of the tissue with the a global vascular structure within the tissue for confirming location of the local vasculature structures.   
     
     
         13 . The method according to  claim 12  wherein the contrast agent is a Gadolinium contrast agent. 
     
     
         14 . A method, comprising the steps of:
 acquiring global preoperative image data of tissue in an anatomical part undergoing a medical procedure using contrast based magnetic resonance imaging and identifying, from the image data, a global vascular structure within the tissue;   after exposing tissue during a medical procedure in the anatomical part, acquiring intraoperative image data by scanning, using hyperspectral imaging, a selected local region of the tissue in the anatomical part undergoing the medical procedure;   identifying, from the intraoperative hyperspectral image data, a local vascular structure in the selected local region of the tissue;   searching the global vascular image data for identifying and locating a portion of the global vascular structure geometrically matching the local vascular structure, and upon identifying and locating matching vascular structure, geometrically correlating and registering the local vascular structure in the selected local region of the tissue with the a global vascular structure within the tissue for confirming location of the local vasculature structures; and   b) using the registered hyperspectral image data with the preoperative image data of the vascular structure in the tissue of the anatomical part to plan a surgical trajectory to navigate through selected regions of the tissue exhibiting vascular structure.   
     
     
         15 . The method according to  claim 14  wherein the contrast agent is a Gadolinium contrast agent. 
     
     
         16 . A computer implemented method of intraoperatively confirming location of vasculature structures located below a surface tissue during a medical procedure, comprising:
 hyperspectral imaging apparatus configured to scan a selected region of tissue below a surface of the tissue after the tissue is exposed during the medical procedure to acquire intraoperative image data of vascular structure in the selected region of tissue;   a computer processor having a memory storage, said hyperspectral imaging apparatus being connected to the computer processor, said memory storage having stored therein preoperative image data of tissue in anatomical part undergoing a medical procedure acquired using contrast based magnetic resonance imaging, said image data containing a global vascular structure within the tissue;   said computer processor being programmed with instructions to
 a) identify, from the intraoperative hyperspectral image data, one or more local regions of tissue exhibiting vascular structure; and 
 b) search the global vascular image data to identify and locate one or more portions of the global vascular structure that geometrically matches the one or more local vascular structures, and upon identifying and locating one or more matching vascular structures, geometrically correlate and register the one or more local vascular structures in the selected local region of the tissue with corresponding regions of the global vascular structure within the tissue for confirming location of the one or more local vasculature structures. 
   
     
     
         17 . The system according to  claim 11 , wherein the preoperative image data of the skeletal structure in the vicinity of an anatomical part is acquired using any one of computed tomography (CT), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). 
     
     
         18 . The system according to  claim 17 , wherein the magnetic resonance imaging is T1 magnetic resonance imaging (T1 MRI). 
     
     
         19 . The system according to  claim 11 , wherein the tissue exhibiting structural organization includes, ligaments, tendons, muscle, cartilage, connective membranes, nerves, retina, blood vessel walls, some bone structures, trachea, esophagus, tongue, teeth and other connective tissues. 
     
     
         20 . The system according to  claim 11 , wherein the a priori known anatomical information about the regions of tissue exhibiting structural information include attachment points of tissue exhibiting structural information to the skeletal structure relative to landmark positions on the skeletal structure.