Combination of 3D ultrasound and computed tomography for guidance in interventional medical procedures

Abstract

In the present invention, an imaging system and method are provided to obtain a fusion image of a patient anatomy used as a navigational 3D roadmap to guide an interventional device into the anatomy. The fusion image fuses in real-time, fluoroscopy images taken during the interventional procedure with pre-operative CTA images, so that the operator can see the anatomy in the fluoroscopy image without having to inject contrast agent. To correct for the deformation in the anatomy from the pre-op CTA images formed by the insertion of interventional devices during the procedure, a 3D ultrasound image is obtained after the insertion of the devices. The 3D ultrasound images are then utilized to correct the pre-op CTA images and provide the current vascular anatomy of the patient. This updated CTA image is fused with the intra-op fluoro images to provide an accurate 3D roadmap image that matches the deformed anatomy.

Description

technical field [0001] The present invention relates generally to tracking or delivering medical instruments during medical procedures, and in particular to systems and methods for tracking and delivering medical instruments to accommodate deformations of a patient's anatomy caused during medical procedures. Background technique [0002] Image-guided surgery is a developing technology that allows surgeons to perform interventions or procedures in a minimally invasive manner while being guided by images, which can be " reality "images" or virtual images. For example, in laparoscopic surgery, a small video camera is inserted through a small incision made in the patient's skin. This camera provides the operator with a "real" image of the anatomy. Other types of image-guided surgery such as Endovascular surgery), in which the lesion is treated using a device inserted through a catheter and navigated into the patient's artery, is "image-guided" because low-dose x-ray images (also...

AI Technical Summary

Problems solved by technology

However, the use of contrast agents has several significant disadvantages

First, contrast agents take a long time to become effective and have a limited amount of time in the patient before additional contrast agents are required

Second, larger doses of contrast (such as required for multiple X-ray sequences) may have certain adverse effects on the patient, including the potential development of renal disease in the patient due to the amount of contrast injected

Third, since multiple X-ray sequences are taken, an increase in the number of X-ray sequences necessarily results in an increase in the total X-ray exposure to patients and staff

Second, the final alignment accuracy provided by DSA correction may still be limited

Since deformation of the anatomy occurs in 3D, it is not possible to find corrections that adequately reflect the deformation of all visceral arterial ostia with only one 2D DSA acquired from one angle

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