Methods and systems for intraoperatively confirming location of tissue structures

Abstract

Systems, methods, and devices 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.

What is claimed: 
     
         1 . A computer-implemented method of intraoperatively confirming a location of organized tissue structures in relation to a patient's skeletal structure, comprising:
 acquiring global preoperative image data of a patient's skeletal structure in an anatomical part;   after exposing tissue, during a medical procedure, in the anatomical part, acquiring local intraoperative image data by scanning a selected local region of tissue in the anatomical part undergoing the medical procedure using Polarization Sensitive-Optical Coherence Tomography (PS-OCT), the image data usable to locate organized tissue structures relative to the patient's skeletal structure;   identifying, from the local intraoperative (PS-OCT) image data, regions of tissue, exhibiting structural organization immediately proximal in relation to the skeletal structure;   identifying, from the local intraoperative (PS-OCT) image data, attachment points of tissue, exhibiting structural organization immediately proximal in relation to the skeletal structure, relative to landmark positions on the skeletal structure;   using a priori anatomical information about the regions of tissue, exhibiting structural organization, for geometrically correlating and registering the local intraoperative (PS-OCT) image data with the global preoperative image data of the skeletal structure in the anatomical part for determining location of the selected local region of tissue within 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 a global vascular structure geometrically matching the local vascular structure;   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 global vascular structure within the tissue for confirming location of the local vasculature structures; and   using registered hyperspectral image data with the preoperative image data of vascular structure of the anatomical part to intraoperatively update a plan of a surgical trajectory for navigating the selected regions of tissue exhibiting vascular structure, wherein registration data, comprising the registered hyperspectral data, is intraoperatively updated with a navigation system,   wherein the a priori anatomical information about the regions of tissue, exhibiting structural organization, comprises information about attachment points of tissue, exhibiting structural organization immediately proximal in relation to the skeletal structure, relative to landmark positions on the skeletal structure, said landmark positions being identifiable from the global preoperative image data and local intraoperative (PS-OCT) image data, and   wherein the vascular structure comprises blood vessel walls.   
     
     
         2 . The method of  claim 1 , wherein the pre-operative image data of the skeletal structure immediately proximal in relation to an anatomical part is acquired using one of computed tomography (CT), magnetic resonance imaging (MRI), and optical coherence tomography (OCT). 
     
     
         3 . The method of  claim 2 , wherein the magnetic resonance imaging comprises T1 magnetic resonance imaging (T1 MRI). 
     
     
         4 . The method of  claim 1 , wherein the tissue, exhibiting structural organization, further comprises one of ligaments, tendons, muscle, cartilage, connective membranes, nerves, some bone structures, trachea, esophagus, tongue, teeth, and other connective tissues. 
     
     
         5 . 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 local region of tissue to acquire local intraoperative image data of the selected region of tissue;   a computer processor having a memory storage, said Polarization Sensitive-Optical Coherence Tomography coupled with the computer processor, said memory storage having stored therein global preoperative image data of a patient's skeletal structure in an anatomical part, said memory storage having stored therein a priori anatomical information about regions of tissue, exhibiting structural organization, and the computer processor programmed with instructions to:   identify, from the local intraoperative (PS-OCT) image data, regions of tissue, exhibiting structural organization immediately proximal in relation to the skeletal structure, the image data usable to locate the organized tissue structures immediately proximal in relation to the patient's skeletal structure;   identify, from the local intraoperative (PS-OCT) image data, attachment points of tissue, exhibiting structural organization immediately proximal in relation to the skeletal structure relative to landmark skeletal structures on the skeletal structure said landmark skeletal sections being identifiable from the global preoperative image data and local intraoperative (PS-OCT) image data;   use the stored a priori anatomical information about the regions of tissue, exhibiting structural organization, to geometrically correlate and register the local intraoperative (PS-OCT) image data with the global preoperative image data of the skeletal structure immediately proximal in relation to the anatomical part to determine the location of the selected local region of tissue within 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 a global vascular structure geometrically matching the local vascular structure;   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 global vascular structure within the tissue for confirming location of the local vasculature structures; and   using registered hyperspectral image data with the preoperative image data of vascular structure of the anatomical part to intraoperatively update a plan of a surgical trajectory for navigating the selected regions of tissue exhibiting vascular structure, wherein registration data, comprising the registered hyperspectral data, is intraoperatively updated with a navigation system,   wherein the vascular structure comprises blood vessel walls.   
     
     
         6 . The system of  claim 5 , wherein the preoperative image data of the skeletal structure immediately proximal in relation to an anatomical part is acquired using one of computed tomography (CT), magnetic resonance imaging (MRI), and optical coherence tomography (OCT). 
     
     
         7 . The system of  claim 6 , wherein the magnetic resonance imaging comprises T1 magnetic resonance imaging (T1 MRI). 
     
     
         8 . The system of  claim 5 , wherein the tissue, exhibiting structural organization, further comprises one of ligaments, tendons, muscle, cartilage, connective membranes, nerves, some bone structures, trachea, esophagus, tongue, teeth, and other connective tissues. 
     
     
         9 . The system of  claim 5 , wherein the a priori known anatomical information about the regions of tissue, exhibiting structural organization, comprises information about attachment points of tissue, exhibiting structural organization immediately proximal in relation to the skeletal structure relative to landmark skeletal sections on the skeletal structure. 
     
     
         10 . The system of  claim 5 , wherein the preoperative image data of the skeletal structure, within the PS-OCT FoV, immediately proximal in relation to an anatomical part is acquired using one of computed tomography (CT), magnetic resonance imaging (MRI), and optical coherence tomography (OCT). 
     
     
         11 . The system of  claim 6 , wherein the magnetic resonance imaging comprises T1 magnetic resonance imaging (T1 MRI). 
     
     
         12 . The system of  claim 5 , wherein the tissue, exhibiting structural organization, further comprises one of ligaments, tendons, muscle, cartilage, connective membranes, nerves, bone structures, trachea, esophagus, tongue, teeth, and other connective tissues. 
     
     
         13 . The system of  claim 5 , wherein the a priori known anatomical information about the regions of tissue, exhibiting structural organization, comprises attachment points of tissue, exhibiting structural information immediately proximal in relation to the skeletal structure relative to landmark positions on the skeletal structure. 
     
     
         14 . A computer implemented method of intraoperatively confirming a location of organized tissue structures in relation to a patient's skeletal structure, comprising:
 acquiring global preoperative image data of a patient's skeletal structure in an anatomical part;   after exposing tissue, during a medical procedure, in the anatomical part, acquiring local intraoperative image data by scanning, using Polarization Sensitive-Optical Coherence Tomography (PS-OCT) having a PS-OCT field of view (FoV), a selected local region of tissue, perceived within the PS-OCT FoV, immediately proximal in relation to the skeletal structure in the anatomical part undergoing the medical procedure;   identifying, from the local intraoperative PS-OCT image data, regions of tissue, exhibiting structural organization, perceived within the PS-OCT FoV, immediately proximal in relation to the skeletal structure;   identifying, from the local intraoperative PS-OCT image data, attachment points of tissue, exhibiting structural organization immediately proximal and in relation to the skeletal structure relative to landmark positions on the skeletal structure;   using a priori anatomical information about the local regions of tissue, exhibiting structural organization, for geometrically correlating and registering the local intraoperative PS-OCT image data with the global preoperative image data of the skeletal structure in the anatomical part for determining the location of the selected local region of tissue within 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 a global vascular structure geometrically matching the local vascular structure;   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 global vascular structure within the tissue for confirming location of the local vasculature structures; and   using registered hyperspectral image data with the preoperative image data of vascular structure of the anatomical part to intraoperatively update a plan of a surgical trajectory for navigating the selected regions of tissue exhibiting vascular structure, wherein registration data, comprising the registered hyperspectral data, is intraoperatively updated with a navigation system,   wherein the vascular structure comprises blood vessel walls.   
     
     
         15 . The method of  claim 14 , wherein the pre-operative image data of the skeletal structure in relation to an anatomical part is acquired using one of computed tomography (CT), magnetic resonance imaging (MRI), and optical coherence tomography (OCT). 
     
     
         16 . The method of  claim 15 , wherein the magnetic resonance imaging comprises T1 magnetic resonance imaging (T1 MRI). 
     
     
         17 . The method of  claim 10 , wherein the tissue, exhibiting structural organization, further comprises any one of ligaments, tendons, muscle, cartilage, connective membranes, nerves, bone structures, trachea, esophagus, tongue, teeth, and other connective tissues. 
     
     
         18 . 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, having a PS-OCT field of view (FoV), configured to scan a selected local region of tissue to acquire local intraoperative image data of the selected local region of tissue;   a videoscope, having a hyperspectral imaging feature, for acquiring intraoperative image data by scanning, using hyperspectral imaging, a selected local region of the tissue in an anatomical part undergoing a medical procedure;   a computer processor having a memory storage, said PS-OCT apparatus coupled with the computer processor, said memory storage having stored therein global preoperative image data of a patient's skeletal structure in an anatomical part, said memory storage having stored therein a priori anatomical information about regions of tissue, exhibiting structural organization, and said computer processor programmed with instructions to:   identify, from the local intraoperative PS-OCT image data, the regions of tissue, exhibiting structural organization, perceived within the PS-OCT FoV, immediately proximal in relation to the skeletal structure;   identify, from the local intraoperative PS-OCT image data, attachment points of tissue, exhibiting structural organization immediately proximal in relation to the skeletal structure relative to landmark positions on the skeletal structure;   use the stored a priori anatomical information about the regions of tissue, exhibiting structural organization, to geometrically correlate and register the local intraoperative PS-OCT image data with the global preoperative image data of the skeletal structure, perceived within the PS-OCT FoV, immediately proximal in relation to the anatomical part to determine location of the selected local region of tissue within the anatomical part;   identify, from the intraoperative hyperspectral image data, a local vascular structure in the selected local region of the tissue;   search the global vascular image data for identifying and locating a portion of a global vascular structure geometrically matching the local vascular structure;   upon identifying and locating matching vascular structure, geometrically correlate and register the local vascular structure in the selected local region of the tissue with the global vascular structure within the tissue for confirming location of the local vasculature structures; and   use registered hyperspectral image data with the preoperative image data of vascular structure of the anatomical part to intraoperatively update a plan of a surgical trajectory for navigating the selected regions of tissue exhibiting vascular structure, wherein registration data, comprising the registered hyperspectral data, is intraoperatively updated with a navigation system,   wherein the vascular structure comprises blood vessel walls.