System and method for guiding an invasive device

Abstract

A system for guiding a medical intervention is disclosed. The system employs a device guide that operates on the surface of a sphere that is centered on a selected target.

1 . A system for guiding an interventional device to a selected target within a body comprising:
 a means to locate the target and body with respect to a first coordinate space;   a means to move the body to a second coordinate space;   a means to register the first and second coordinate spaces, thereby defining the location of the target in the second coordinate space; and   a means to position a device guide on a selected portion of the surface of a sphere wherein the center of said sphere is substantially coincident with the location of the target.   
     
     
         2 . The system of  claim 1 , wherein the means to locate the target is taken from a group consisting of: a Magnetic Resonance Imaging system, a Computed Tomography system, a Positron Emission Tomography system, a Gamma Camera system, and an ultrasound system. 
     
     
         3 . The system of  claim 2 , wherein the first coordinate space is coincident with the coordinate space of images taken from a group consisting of: Magnetic Resonance images acquired by a Magnetic Resonance Imaging system, Computed Tomography images acquired by a Computed Tomography system, Positron Emission Tomography images acquired by a Positron Emission Tomography system; Gamma Camera images acquired by a Gamma Camera system; and Ultrasound images acquired by an Ultrasound system. 
     
     
         4 . The system of  claim 1 , wherein the means to move the body to the second coordinate space is a moving table. 
     
     
         5 . The system of  claim 4 , wherein the table moves from the first coordinate space to the second coordinate space along a path taken from a group consisting of: a substantially straight line; a substantially curved line; a selected sequence of straight lines; and a combination of straight lines and curved lines. 
     
     
         6 . The system of  claim 1 , wherein the registration means is comprised of an alignment laser affixed to a frame. 
     
     
         7 . The system of  claim 1 , wherein the registration means is comprised of an alignment line projector affixed to a frame. 
     
     
         8 . The system of  claim 1 , wherein the means to position the device guide on the surface of a sphere is comprised of a an arc received within a guide bearing assembly, the guide bearing assembly coupled for rotation to a pivot mount, and the pivot mount coupled to a three-dimensional adjustment assembly, wherein the device guide is affixed to the arc so that the device guide is pointed towards the geometric center of the arc. 
     
     
         9 . The system of  claim 1 , wherein the means to position the device guide on the surface of a sphere is comprised of multi-axis articulated robotic arm. 
     
     
         10 . The system of  claim 8 , wherein the three-dimensional adjustment assembly, is under computer control. 
     
     
         11 . The system of  claim 8 , wherein the pivot mount is under computer control. 
     
     
         12 . The system of  claim 8 , wherein the guide bearing is under computer control. 
     
     
         13 . The system of  claim 1 , wherein the device guide includes a laser. 
     
     
         14 . The system of  claim 1 , wherein the device guide includes a needle guide. 
     
     
         15 . The system of  claim 1 , wherein the device guide includes a projector capable of projecting a symbol. 
     
     
         16 . The system of  claim 8 , further comprising a second device guide is positioned on the arc, said second device guide pointed towards the geometric center of the arc. 
     
     
         17 . The system of  claim 1 , wherein the means to position a device guide on a selected portion of the surface of a sphere is affixed to a movable frame. 
     
     
         18 . The system of  claim 1 , wherein the means to position a device guide on a selected portion of the surface of a sphere is affixed to the ceiling of a room. 
     
     
         19 . The system of  claim 1 , wherein the means to position a device guide on a selected portion of the surface of a sphere is affixed to a frame that can be expanded and contracted for transport or storage. 
     
     
         20 . A method for displaying images of a selected target within a body comprising the following steps:
 acquiring images of the selected target and its immediate surroundings within the body;   locating the target with respect to a first coordinate space;   moving the body to a second coordinate space;   registering the first and second coordinate spaces, thereby defining the location of the target in the second coordinate space;   positioning a pointer on the surface of a sphere wherein the center of said sphere is substantially coincident with the location of the target;   reporting the positon of the pointer to a controller;   processing the acquired images by the controller and presenting a processed image by the controller that shows the target and the path to target indicated by the pointer.   
     
     
         21 . A method for image-guided interventions comprising the following steps:
 selecting a feature on a patient as a landmark;   acquiring images of anatomy of interest in a patient;   identifying a target within the anatomy of interest;   determining the location of the target with respect to the landmark;   moving the patient to a guidance frame comprised of a device guide positioning system configured to move a device guide over the surface of a physical or imaginary sphere while maintaining the orientation of the device guide in an alignment that keeps the device guide pointed to the center of the sphere;   registering the patient with a coordinate space of the guidance frame using the landmark;   determining the location of the target in the coordinate space of the guidance frame with respect to the position of the landmark; and   moving the device guide to a desired intervention position and orientation about the surface of the sphere using the device guide positioning system.   
     
     
         22 . The method of  claim 21 , wherein the desired intervention is taken from a group consisting of: a biopsy, a laser ablation, and a cryogenic ablation. 
     
     
         23 . The method of  claim 21 , wherein the device guide includes a laser. 
     
     
         24 . The method of  claim 21 , wherein the device guide includes a needle guide. 
     
     
         25 . The method of  claim 21 , wherein movement of the device guide is performed under computer control for selected degrees of motion. 
     
     
         26 . The method of  claim 21 , wherein movement of the device guide is performed under manual control for selected degrees of motion. 
     
     
         27 . The method of  claim 21 , wherein the distance between the device guide and the patient's skin are used to determine the distance between the patient's skin and the target to inform the depth of device insertion. 
     
     
         28 . A system for guiding an interventional device to a selected target within a body, comprising:
 a device guide;   a first adjustment assembly retaining the device guide, the first adjustment assembly allowing adjustment of the position and orientation of the device guide along the surface of a mathematical sphere having a center C and a radius R, the first adjustment assembly retaining the device guide so that the device guide is directed towards the center C of the mathematical sphere at least during adjustment; and   a second adjustment assembly supporting the spherical guide assembly, the second adjustment assembly allowing adjustment of the position of the spherical guide assembly with respect to a patient in at least two linear dimensions.   
     
     
         29 . The system of  claim 28 , further comprising a guide frame configured to support the second adjustment assembly approximate the patient. 
     
     
         30 . The system of  claim 29 , further comprising a landmarking assembly configured to register the position of the patient with respect to a coordinate system of the guide frame. 
     
     
         31 . The system of  claim 30 , wherein the landmarking assembly includes a positional laser mounted to the guide frame. 
     
     
         32 . The system of  claim 30 , further comprising a computer control configured to receive or compute coordinates of an interventional target within the patient with respect to a landmark, receive or compute a position of the landmark with respect to the guide frame's coordinate system, and to control movement of the second adjustment assembly so that the center C of the mathematical sphere corresponds to the interventional target. 
     
     
         33 . The system of  claim 28 , wherein the device guide includes a positional laser emitting a laser beam. 
     
     
         34 . The system of  claim 33 , wherein the device guide further includes an intervention device wherein the laser beam of the device guide is coaxial or parallel with an intervention direction of the intervention device. 
     
     
         35 . The system of  claim 28 , wherein the first adjustment assembly comprises:
 an arc having the center C retaining the device guide so that the device guide is directed at center C;   a bearing retaining the arc for translational movement of the arc about center C; and   a pivot retaining the bearing for rotational movement of the arc on a diametrical axis passing through center C.   
     
     
         36 . The system of  claim 35 , wherein the arc retains two or more positional lasers emitting laser beams directed at center C. 
     
     
         37 . The system of  claim 28 , wherein the device guide includes a projector projecting a visual symbol. 
     
     
         38 . The system of  claim 28 , wherein the first adjustment assembly allows adjustment of the position and orientation of the device guide along only a portion of the mathematical sphere less than the entire mathematical sphere. 
     
     
         39 . The system of  claim 38 , wherein the portion of the mathematical sphere is positioned over the patient. 
     
     
         40 . The system of  claim 28 , wherein the mathematical sphere is a physical or an imaginary sphere. 
     
     
         41 . The system of  claim 28 , wherein the second adjustment assembly allows adjustment in three linear dimensions, X, Y and Z. 
     
     
         42 . The system of  claim 28 , wherein the first and second adjustment assemblies are integrated into an adjustment system allowing adjustment in X, Y, Z, Θ, and Φ coordinates. 
     
     
         43 . The system of  claim 42 , wherein the integrated adjustment system comprises a multi-axis articulated robotic arm and the system further comprises a landmarking assembly configured to register the position of the patient with respect to a coordinate system of the robotic arm. 
     
     
         44 . A system for guiding an interventional device to a selected target within a body comprising:
 an imaging system configured to compute and provide coordinates of a target within a patient with respect to a first coordinate system and with respect to a landmark on the patient;   a registration assembly configured to register the landmark with respect to a second coordinate system;   a device guide;   a first adjustment assembly retaining the device guide, the first adjustment assembly allowing adjustment of the position and orientation of the device guide along the surface of a mathematical sphere having a center C and a radius R, the first adjustment assembly retaining the device guide so that the device guide is directed towards the center C of the mathematical sphere at least during adjustment; and   a second adjustment assembly supporting the spherical guide assembly, the second adjustment assembly allowing adjustment of the position of the spherical guide assembly in three dimensions in the second coordinate system so that center C is located at the coordinates of the target with respect to the landmark.   
     
     
         45 . A method for guiding an interventional device to a selected target within a patient comprising:
 providing (i) a device guide, (ii) a first adjustment assembly retaining the device guide, the first adjustment assembly allowing adjustment of the position and orientation of the device guide along the surface of a mathematical sphere having a center C and a radius R, the first adjustment assembly retaining the device guide so that the device guide is directed towards the center C of the mathematical sphere at least during adjustment, (iii) a second adjustment assembly supporting the spherical guide assembly, the second adjustment assembly allowing adjustment of the position of the spherical guide assembly with respect to a patient in three dimensions, and (iv) a guide frame retaining the second adjustment assembly;   receiving or computing coordinates of an interventional target within the patient with respect to a landmark on the patient;   receiving or computing a position of the landmark with respect to the guide frame's coordinate system;   actuating the second adjustment assembly so that the center C of the mathematical sphere corresponds to the interventional target; and   actuating the first adjustment assembly to a desired interventional position and orientation of the device guide along the mathematical sphere with respect interventional target.   
     
     
         46 . The method of  claim 45 , wherein the step of receiving or computing coordinates of an interventional target within the patient with respect to a landmark on the patient is performed utilizing an imaging system taking from a group consisting of: a Magnetic Resonance Imaging system, a Computed Tomography system, a Positron Emission Tomography system, a Gamma Camera system, and an ultrasound system. 
     
     
         47 . The system of  claim 28 , further comprising:
 a control system including a computerized control and a display;   the computerized control configured to receive acquired images of a selected target within a patient's body and adjust the positioning of at least one of the first or second adjustment assemblies so that the device guide is directed to the selected target; and   the computerized control further configured to process the acquired images and present a processed image on the display that shows the target and a path to the target from the device guide.