Systems and methods for surgical navigation, including image-guided navigation of a patient's head

Abstract

Systems, methods and devices are described herein for performing a navigated surgical procedure involving a patient's anatomy in sterile and non-sterile surgical environments. A camera may be used to determine a registration of the camera coordinate-frame to the patient anatomy or optionally a tracker in relation to the patient anatomy. A drape may be applied to permit use in a sterile surgical environment. The camera may be moved from its original position to enable access to patient anatomy while maintaining a registration of the camera coordinate-frame with the patient anatomy. Alternatively, the camera may be used in a hand-held or head-mounted manner. A visualization of the patient anatomy may be displayed on a computing unit, with visualization reference planes defined by the pose of an instrument or the camera. The visualization may be presented on a display of a computing unit or as part of a head mounted augmented reality system.

1 . A computer implemented method comprising executing by a processor steps comprising:
 a) receiving optical information from a camera, the optical information comprising pose data for a tracker coupled in a fixed positional relationship with a patient anatomy, wherein each of the tracker and a three dimensional (“3D”) medical image is registered to the patient anatomy;   b) determining a pose of the camera in relation to the patient anatomy using the pose data of the tracker and the registration of the tracker;   c) displaying one or more two dimensional (“2D”) cross-sections of the 3D medical image, each of the one or more 2D cross-sections selected from the 3D medical image based on a camera coordinate frame, and the pose of the camera.   
     
     
         2 . The method of  claim 1 , wherein each 2D cross-section of the one or more 2D cross-sections is selected to comprise a respective view of the 3D medical image corresponding to an orthogonal camera-based reference plane defined by the camera coordinate frame. 
     
     
         3 . The method of  claim 1 , wherein the 3D medical image comprises a segmented image. 
     
     
         4 . The method of  claim 1  comprising, prior to step c):
 displaying the one or more 2D cross-sections based on an anatomical coordinate frame; 
 receiving user input to change a basis of the one or more 2D cross-sections to be based on the camera coordinate frame; and 
 performing step c) in response to receiving the user input. 
 
     
     
         5 . The method of  claim 4 , wherein each 2D cross-section of the one or more 2D cross-sections based on the anatomical coordinate frame is selected to comprise a respective view of the 3D image based on a coronal plane, a sagittal plane, or a transverse plane of the patient anatomy. 
     
     
         6 . The method of  claim 4 , where in the user input is received by way of a user interface of the camera. 
     
     
         7 . The method of  claim 1  comprising, following step c):
 d) receiving user input to change a basis of at least some of the 2D cross-sections to be based on an anatomical coordinate frame; and 
 e) updating the displaying of the at least some of the 2D cross-sections to be based on the anatomical coordinate frame in response to the user input. 
 
     
     
         8 . The method of  claim 1 , wherein each of the one or more 2D cross-sections is further selected based on a distance measured from a location of the camera along an optical axis in a field of view, wherein the distance defines an origin for determining the one or more 2D cross-sections from the 3D medical image. 
     
     
         9 . The method of  claim 1  comprising registering the tracker to the patient anatomy and registering the 3D medical image to the patient anatomy. 
     
     
         10 . The method of  claim 1  comprising providing an interface to receive input selecting a camera coordinate frame basis or an anatomical coordinate frame basis for displaying the 2D cross-sections of the 3D medical image. 
     
     
         11 . The method of  claim 1  comprising updating the displaying of the 2D cross-sections in response to an updated pose of the camera determined from updated pose data of the tracker. 
     
     
         12 . A system comprising:
 a tracker configured to couple with a patient anatomy in a fixed positional relationship;   a camera configured to provide optical information comprising pose data of the tracker;   an intraoperative computing unit having a processor, the computing unit configured to:
 receive optical information from a camera, the optical information comprising pose data for a tracker coupled in a fixed positional relationship with a patient anatomy, wherein each of the tracker and a three dimensional (“3D”) medical image is registered to the patient anatomy; 
 determine a pose of the camera in relation to the patient anatomy using the pose data of the tracker and the registration of the tracker; and 
 display one or more two dimensional (“2D”) cross-sections of the 3D medical image, each of the one or more 2D cross-sections selected based on a camera coordinate frame, and the pose of the camera. 
   
     
     
         13 . The system of  claim 12 , wherein each 2D cross-section of the one or more 2D cross-sections is selected to comprise a respective view of the 3D medical image corresponding to an orthogonal camera-based reference plane defined by the camera coordinate frame. 
     
     
         14 . The system of  claim 12 , wherein the computing device is configured to:
 provide an interface to receive input selecting a camera coordinate frame or an anatomical coordinate frame as a basis for displaying the 2D cross-sections of the 3D medical image;   receive user input selecting the anatomical coordinate frame; and   update the display of the one or more 2D cross-sections to be based on the anatomical coordinate frame.   
     
     
         15 . The system of  claim 14 , wherein at least one 2D cross-section of the one or more 2D cross-sections based on the anatomical coordinate frame is selected to comprise a respective view of the 3D image based on a coronal plane, a sagittal plane, or a transverse plane of the patient anatomy. 
     
     
         16 . The system of  claim 14 , where in the user input is received by way of a user interface of the camera. 
     
     
         17 . The system of  claim 12 , wherein the computing unit is configured to determine each of the one or more cross-sections further selected based on a distance measured from a location of the camera along an optical axis in a field of view, wherein the distance defines an origin for determining the one or more 2D cross-sections from the 3D medical image. 
     
     
         18 . The system of  claim 12 , wherein the camera comprises a hand-held camera. 
     
     
         19 . The system of  claim 12  wherein the computing unit is configured to update the display of the 2D cross-sections in response to an updated pose of the camera determined from updated pose data of the tracker. 
     
     
         20 . The system of  claim 12  comprising a projector coupled with the camera, the projector configured to project a visible pattern to visualize one or more camera reference planes on an outer surface of the patient anatomy. 
     
     
         21 . A method comprising steps of:
 operating a camera to provide optical information to an intraoperative computing unit, the optical information comprising pose data for a tracker coupled in a fixed positional relationship with a patient anatomy, wherein each of the tracker and a three dimensional (“3D”) medical image is registered to the patient anatomy by the intraoperative computing unit; and   receiving a display of one or more two dimensional (“2D”) cross-sections of the 3D medical image, each of the one or more 2D cross-sections based on a camera coordinate frame, and a pose of the camera in relation to the patient anatomy, the pose of the camera determined by the intraoperative computing unit using the pose data of the tracker and the registration of the tracker.   
     
     
         22 . The method of  claim 21  comprising operating a user interface to provide an input to configure the display of the one or more 2D cross-sections of the 3D medical image, the input provided to select a basis for the one or more 2D cross-sections, the basis comprising a camera coordinate frame basis or an anatomical coordinate frame basis. 
     
     
         23 . The method of  claim 21  comprising operating a projector coupled to the camera to project a visible pattern to visualize one or more camera reference planes on an outer surface of the patient anatomy. 
     
     
         24 . The method of  claim 21  comprising: moving the camera to provide updated optical information including updated pose data of the tracker; and receiving an update of the one or more 2D cross-sections responsive to the updated pose data of the tracker.