Methods and systems for performing medical procedures with reference to projective image and with respect to pre-stored images

Abstract

A catheter ( 26 ) is navigated within a body cavity ( 28 ) of a patient ( 24 ). This navigation is enabled by the provision of the transmitter ( 30 ) of electromagnetic radiation under platform ( 34 ), a receiver ( 40 ) of electromagnetic radiation rigidly attached to fluoroscope ( 22 ), and a receiver ( 32 ) of radiation rigidly attached to the catheter ( 26 ), all three of which are connected by wires ( 51 ) to a computer ( 50 ). The computer ( 50 ) displays, on a display unit ( 48 ), the image of the body cavity ( 28 ) acquired by the fluoroscope ( 22 ), with an icon representing the catheter ( 26 ) superposed on the image in the location and orientation of catheter ( 26 ) relative to the body ( 28 ). There is no representational imaging device equipped with a receiver in the apparatus of the current invention.

What is claimed is:  
     
         1 . A method of navigating a probe to a target point-of-interest in a body cavity of a patient, comprising the steps of: 
 (a) acquiring a plurality of projective images of at least a portion of the body cavity, using a projective imaging device, each said projective image being acquired with said projective imaging device in a different respective disposition relative to a reference frame;    (b) for each said projective image, measuring said respective disposition of said projective imaging device;    (c) estimating a location of the target point-of-interest, relative to said reference frame, from said projective images, said estimating being based on said measured dispositions of said projective imaging device;    (d) inserting the probe into the body cavity;    (e) measuring a location of the probe relative to said reference frame; and    (f) moving the probe, within the body cavity, so as to minimize a difference between said measured location of the probe and said estimated location of the target point-of-interest.    
     
     
         2 . The method of  claim 1 , wherein said projective imaging device is a fluoroscope.  
     
     
         3 . The method of  claim 1 , wherein each said projective image includes a projection of the target point-of-interest, and wherein said estimating of said location of the target point-of-interest is effected by steps including: 
 (i) picking said projection on each said projective image;    (ii) for each said projective image, constructing a ray corresponding to said picked projection; and    (iii) computing a location, relative to said reference frame, of a point-of-nearest-mutual-approach of said rays;    said estimated location of the target point-of-interest being said computed location of said point-of-nearest-mutual-approach.    
     
     
         4 . The method of  claim 3 , wherein only two of said projective images are acquired.  
     
     
         5 . The method of  claim 3 , wherein said picking is effected manually.  
     
     
         6 . The method of  claim 3 , wherein said picking is effected manually on a first said projective image and automatically on subsequent said projective images, said picking on each said subsequent projective image being with reference to an immediately preceding said projective image thereof.  
     
     
         7 . The method of  claim 1 , wherein each said projective image includes a projection of the target point-of-interest, and wherein said estimating of said location of the target point-of-interest is effected by steps including: 
 (i) displaying said projective images successively and repeatedly, along with an icon representing a point in space having certain coordinates; and    (ii) varying said coordinates until said icon substantially coincides with all said projections of the target point-of-interest.    
     
     
         8 . The method of  claim 1 , wherein said estimating of said location of the target point-of-interest is effected by steps including: 
 (i) transforming said projective images into an image volume; and    (ii) picking the target point-of-interest in said image volume.    
     
     
         9 . The method of  claim 8 , wherein said transforming of said projective images into said image volume is effected by backprojection.  
     
     
         10 . The method of  claim 1 , wherein said measuring of said dispositions of said projective imaging device is effected using a disposing system that includes a disposition implement associated with said projective imaging device and a disposing implement associated with said reference frame.  
     
     
         11 . The method of  claim 1 , wherein said measuring of said dispositions of said projective imaging device is effected using a disposing system that includes a disposing implement associated with said projective imaging device and a disposition implement associated with said reference frame.  
     
     
         12 . The method of  claim 1 , wherein said measuring of said dispositions of said projective imaging device is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         13 . The method of  claim 1 , wherein said measuring of said location of the probe is effected using a locating system that includes a location implement associated with the probe and a locating implement associated with said reference frame.  
     
     
         14 . The method of  claim 1 , wherein said measuring of said location of the probe is effected using a locating system that includes a locating implement associated with the probe and a location implement associated with said reference frame.  
     
     
         15 . The method of  claim 1 , wherein said locating system is selected from the group consisting of electromagnetic locating systems, magnetic locating systems and acoustic locating systems.  
     
     
         16 . The method of  claim 1 , wherein said measuring of said dispositions of said projective imaging device and said measuring of said location of the probe are effected using a common disposing system that includes a disposition implement associated with said projective imaging device, a location implement associated with the probe and a disposing implement associated with said reference frame.  
     
     
         17 . The method of  claim 1 , wherein said measuring of said dispositions of said projective imaging device and said measuring of said location of the probe are effected using a common disposing system that includes a disposing implement associated with said projective imaging device, a locating implement associated with the probe and a disposition implement associated with said reference frame.  
     
     
         18 . The method of  claim 1 , further comprising the step of: 
 (g) introducing a contrast agent to said at least portion of the body cavity, prior to said acquiring of said projective images.    
     
     
         19 . The method of  claim 1 , further comprising the steps of: 
 (g) estimating a location of at least one intermediate point-of-interest, relative to said reference frame, from said projective images, said estimating being based on said measured dispositions of said projective imaging device; and    (h) displaying icons representative of said estimated locations of said target point-of-interest and said at least one intermediate point of interest, along with an icon representative of said measured location of the probe;    said moving of the probe being effected with reference to said display.    
     
     
         20 . The method of  claim 19 , wherein each said projective image is acquired from a respective point of view, and wherein said displaying of said icons is effected from a point of view different from any of said respective points of view.  
     
     
         21 . A navigating system for navigating a probe to a point-of-interest in a body cavity of a patient, comprising: 
 (a) a projective imaging device for acquiring a plurality of projective images of at least a portion of the body cavity;    (b) a disposing system for measuring, for each said projective image, a respective disposition of said projective imaging device relative to a reference frame;    (c) a mechanism for estimating a location of the point-of-interest, relative to said reference frame, from said projective images, said estimating being based on said measured dispositions of said projective imaging device; and    (d) a locating system for measuring a location of the probe relative to said reference frame.    
     
     
         22 . The navigating system of  claim 21 , wherein said disposing system includes a disposition implement associated with said projective imaging device and a disposing implement associated with said reference frame.  
     
     
         23 . The navigating system of  claim 21 , wherein said disposing system includes a disposing implement associated with said projective imaging device and a disposition implement associated with said reference frame.  
     
     
         24 . The navigating system of  claim 21 , wherein said disposing system is selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         25 . The navigating system of  claim 21 , wherein said locating system includes a location implement associated with the probe and a locating implement associated with said reference frame.  
     
     
         26 . The navigating system of  claim 21 , wherein said locating system includes a locating implement associated with the probe and a location implement associated with said reference frame.  
     
     
         27 . The navigating system of  claim 21 , wherein said locating system is selected from the group consisting of electromagnetic locating systems, magnetic locating systems and acoustic locating systems.  
     
     
         28 . The navigating system of  claim 21 , wherein said disposing system includes a disposition implement associated with said projective imaging device, wherein said locating system includes a location implement associated with the probe, and wherein said disposing system and said locating system share a common disposing implement associated with said reference frame.  
     
     
         29 . The navigating system of  claim 21 , wherein said disposing system includes a disposing implement associated with said projective imaging device, wherein said locating system includes a locating implement associated with the probe, and wherein said disposing system and said locating system share a common disposition implement associated with said reference frame.  
     
     
         30 . A method of acquiring an image volume of a body, comprising the steps of: 
 (a) for each of a plurality of nominal dispositions of a projective imaging device relative to a reference frame: 
 (i) measuring an actual disposition of said projective imaging device relative to said reference frame,  
 (ii) if said actual disposition is not substantially the same as said each nominal disposition, moving said projective device until said actual disposition is substantially the same as said each nominal disposition, and  
 (iii) acquiring a respective projective image of the body, using said projective imaging device at said each nominal disposition; and  
   (b) transforming said plurality of projective images into the image volume.    
     
     
         31 . The method of  claim 30 , wherein said transforming is effected by backprojection.  
     
     
         32 . The method of  claim 30 , wherein said moving of said projective imaging device is effected manually.  
     
     
         33 . The method of  claim 30 , wherein said moving of said projective imaging device is effected automatically via a feedback loop.  
     
     
         34 . The method of  claim 30 , wherein said projective imaging device is a fluoroscope.  
     
     
         35 . An imaging system for acquiring an image volume of a body, comprising: 
 (a) a projective imaging device for acquiring projective images of the body;    (b) a disposing system for measuring dispositions of said projective imaging device relative to a reference frame;    (c) a mechanism for moving said projective imaging device among a plurality of nominal dispositions thereof, with reference to said measured disposition; and    (d) a processor for transforming said projective images into the image volume, each said projective image having been acquired at a different respective said nominal disposition.    
     
     
         36 . The imaging system of  claim 35 , wherein said disposing system includes a disposition implement associated with said projective imaging device and a disposing implement associated with said reference frame.  
     
     
         37 . The imaging system of  claim 35 , wherein said disposing system includes a disposing implement associated with said projective imaging device and a disposition implement associated with said reference frame.  
     
     
         38 . The imaging system of  claim 35 , wherein said disposing system is selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         39 . The imaging system of  claim 35 , wherein said projective imaging device is a fluoroscope.  
     
     
         40 . A method of acquiring an image volume of a body, comprising the steps of: 
 (a) for each of a plurality of dispositions of a projective imaging device relative to a reference frame: 
 (i) moving said imaging device to said disposition as measured by a disposing system, and  
 (ii) acquiring a respective projective image of the body; and  
   (b) transforming said projective images into the image volume according to said measurements of said dispositions.    
     
     
         41 . The method of  claim 40 , wherein said transforming is effected by backprojection.  
     
     
         42 . An imaging system for acquiring an image volume of a body, comprising: 
 (a) a projective imaging device for acquiring projective images of the body;    (b) a disposing system for measuring dispositions of said projective imaging device relative to a reference frame; and    (c) a processor for transforming said projective images into the image volume according to said measured dispositions.    
     
     
         43 . The imaging system of  claim 42 , wherein said disposing system includes a disposition implement associated with said projective imaging device and a disposing implement associated with said reference frame.  
     
     
         44 . The imaging system of  claim 42 , wherein said disposing system includes a disposing implement associated with said projective imaging device and a disposition implement associated with said reference frame.  
     
     
         45 . The imaging system of  claim 42 , wherein said disposing system is selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         46 . The imaging system of  claim 42 , wherein said projective imaging device is a fluoroscope.  
     
     
         47 . A method of acquiring an output image volume of a body, comprising the steps of: 
 (a) for each of a plurality of actual dispositions of a projective imaging device: 
 (i) moving said projecting imaging device to said each actual disposition, and  
 (ii) acquiring a respective projective image of the body, using said projective imaging device at said each actual disposition;  
   (b) based on said projective images, estimating said actual dispositions; and    (c) based on said estimated dispositions, transforming said projective images into the output image volume.    
     
     
         48 . The method of  claim 47 , wherein said estimating of said actual dispositions is effected by steps including: 
 (i) transforming said projective images into a working image volume, said transforming assuming that each said acquired projective image was acquired at a respective computational disposition of said projective imaging device; and    (ii) based on said working image volume, correcting said computational dispositions to obtain said estimated dispositions.    
     
     
         49 . The method of  claim 48 , wherein said correcting is effected by steps including: for each said computational disposition: 
 (A) computing a respective synthetic projective image of the body from said working image volume;    (B) comparing said synthetic projective image to said respective acquired projective image;    (C) estimating, according to said comparison, a difference between said computational disposition and said respective actual disposition; and    (D) adjusting said computational disposition by subtracting said difference therefrom.    
     
     
         50 . The method of  claim 49 , wherein said transforming of said projective images into said working image volume and said correcting of said computational dispositions are iterated until said estimated differences between said computational dispositions and said actual dispositions are negligible.  
     
     
         51 . The method of  claim 47 , wherein said transforming is effected by backprojection.  
     
     
         52 . The method of  claim 47 , wherein said projective imaging device is a fluoroscope.  
     
     
         53 . The method of  claim 47 , wherein said estimating is based only on said projective images.  
     
     
         54 . An imaging system for acquiring an image volume of a body, comprising: 
 (a) a projective imaging device for acquiring a plurality of projective images of at least a portion of the body at actual respective dispositions of said projective imaging device; and    (b) a processor for estimating said actual dispositions from said projective images and for transforming said projective images into the image volume, said transforming being based on said estimated dispositions.    
     
     
         55 . The system of  claim 54 , wherein said projective image device is a fluoroscope.  
     
     
         56 . A method of navigating a probe in a body cavity of a patient, comprising the steps of: 
 (a) acquiring a plurality of images of at least a portion of the body cavity, using an imaging device, while measuring, for each said image, a respective disposition of said imaging device relative to a reference frame, each said image being acquired at a different said respective disposition;    (b) selecting one of said first images to use as a guide image; and    (c) displaying said guide image along with an icon representative of a disposition of the probe within the body cavity.    
     
     
         57 . The method of  claim 56 , wherein said imaging device is a protective imaging device, so that said images are projective image.  
     
     
         58 . The method of  claim 57 , wherein said imaging device is a fluoroscope.  
     
     
         59 . The method of  claim 56 , wherein said measuring of said dispositions of said imaging device is effected using a disposing system that includes a disposition implement associated with said imaging device and a disposing implement associated with said reference frame.  
     
     
         60 . The method of  claim 56 , wherein said measuring of said dispositions of said imaging device is effected using a disposing system that includes a disposing implement associated with said imaging device and a disposition implement associated with said reference frame.  
     
     
         61 . The method of  claim 56 , wherein said measuring of said dispositions of said imaging device is effected using a disposing system elected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         62 . The method of  claim 56 , further comprising the step of: 
 (d) introducing a contrast agent to said at least portion of the body, prior to said acquiring of said images.    
     
     
         63 . The method of  claim 56 , further comprising the step of: 
 (d) measuring a disposition of the probe relative to said reference frame, said disposition of the probe within the body cavity being obtained from said respective disposition of said guide image and said measured disposition of the probe relative to said reference frame.    
     
     
         64 . The method of  claim 63 , wherein said measuring of said disposition of the probe is effected using a disposing system that includes a disposition implement associated with the probe and a disposing implement associated with said reference frame.  
     
     
         65 . The method of  claim 63 , wherein said measuring of said disposition of the probe is effected using a disposing system that includes a disposing implement associated with the probe and a disposition implement associated with said reference frame.  
     
     
         66 . The method of  claim 63 , wherein said measuring of said disposition of the probe is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems and acoustic disposing systems.  
     
     
         67 . The method of  claim 63 , wherein said measuring of said dispositions of said imaging device and said measuring of said disposition of the probe are effected using a common disposition system that includes a first disposition implement associated with said imaging device, a second disposition implement associated with the probe and a common disposing implement associated with said reference frame.  
     
     
         68 . The method of  claim 63 , wherein said measuring of said dispositions of said imaging device and said measuring of said disposition of the probe are effected using a common disposition system that includes a first disposing implement associated with said imaging device, a second disposing implement associated with the probe and a common disposition implement associated with said reference frame.  
     
     
         69 . A method of treating a body of a patient, comprising the steps of: 
 (a) simultaneously: 
 (i) acquiring a first image of at least a portion of the body, using an imaging device,  
 (ii) measuring a disposition of said imaging device relative to a reference frame, and  
 (iii) measuring a disposition of the body relative to said reference frame:  
   (b) restoring said imaging device and the body to respective dispositions that are equivalent to said measured dispositions; and    (c) performing a medical procedure on the body with reference to said first image after said restoring of said imaging device and of the body to said equivalent dispositions.    
     
     
         70 . The method of  claim 69 , wherein said imaging device is a projective imaging device, so that said first image is a projective image.  
     
     
         71 . The method of  claim 69 , wherein said imaging device is a fluoroscope.  
     
     
         72 . The method of  claim 69 , wherein said measuring of said disposition of said imaging device is effected using a disposing system that includes a disposition implement associated with said imaging device and a disposing implement associated with said reference frame.  
     
     
         73 . The method of  claim 69 , wherein said measuring of said disposition of said imaging device is effected using a disposing system that includes a disposing implement associated with said imaging device and a disposition implement associated with said reference frame.  
     
     
         74 . The method of  claim 69 , wherein said measuring of said disposition of said imaging system is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         75 . The method of  claim 69 , wherein said measuring of said disposition of the body is effected using a disposing system that includes a disposition implement associated with the body and a disposing implement associated with said reference frame.  
     
     
         76 . The method of  claim 69 , wherein said measuring of said disposition of the body is effected using a disposing system that includes a disposing implement associated with the body and a disposition implement associated with said reference frame.  
     
     
         77 . The method of  claim 69 , wherein said measuring of said disposition of the body is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         78 . The method of  claim 69 , further comprising the step of: 
 (d) introducing a contrast agent to said at least portion of the body, prior to said acquiring of said first image.    
     
     
         79 . The method of  claim 69 , further comprising the step of: 
 (d) acquiring a second image of said at least portion of the body, using said imaging device, after said imaging device and the body have been restored to said equivalent dispositions thereof; said medical procedure being performed with reference to both said images.    
     
     
         80 . The method of  claim 69 , wherein said performing of said medical procedure includes navigating a probe to a point-of-interest in said at least portion of the body with reference to said first image.  
     
     
         81 . The method of  claim 80 , further comprising the steps of: 
 (d) acquiring a second image of said at least portion of the body, using said imaging device, after said imaging device and the body have been restored to said equivalent dispositions; said navigating being with reference to both said images.    
     
     
         82 . The method of  claim 80 , wherein said navigating includes measuring a disposition of said probe relative to said reference frame.  
     
     
         83 . The method of  claim 80 , wherein said measuring of said disposition of said probe is effected using a disposing system that includes a disposition implement associated with said probe and a disposing implement associated with said reference frame.  
     
     
         84 . The method of  claim 80 , wherein said measuring of said disposition of said probe is effected using a disposing system that includes a disposing implement associated with said probe and a disposition implement associated with said reference frame.  
     
     
         85 . The method of  claim 80 , wherein said measuring of said disposition of said probe is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems and acoustic disposing systems.  
     
     
         86 . The method of  claim 82 , wherein said measuring of said disposition of said imaging device, said measuring of said disposition of the body and said measuring of said disposition of said probe are effected using a common disposing system that includes a first disposition implement associated with said imaging device, a second disposition implement associated with the body, a third disposition implement associated with said probe and a common disposing implement associated with said reference frame.  
     
     
         87 . The method of  claim 82 , wherein said measuring of said disposition of said imaging device, said measuring of said disposition of the body and said measuring of said disposition of said probe are effected using a common disposing system that includes a first disposing implement associated with said imaging device, a second disposing implement associated with the body, a third disposing implement associated with said probe and a common disposition implement associated with said reference frame.  
     
     
         88 . A method of treating a body of a patient, comprising the steps of: 
 (a) simultaneously: 
 (i) acquiring a first image of at least a portion of the body, using an imaging device,  
 (ii) measuring a disposition of said imaging device relative to a reference frame, and  
 (iii) measuring a first disposition of the body relative to said reference frame;  
   (b) measuring a second disposition of the body relative to said reference frame; and    (c) performing a medical procedure on the body with reference to said first image and with reference to all three said dispositions.    
     
     
         89 . The method of  claim 88 , wherein said imaging device is a projective imaging device, so that said first image is a projective image.  
     
     
         90 . The method of  claim 89 , wherein said imaging device is a fluoroscope.  
     
     
         91 . The method of  claim 88 , wherein said measuring of said disposition of said imaging device is effected using a disposing system that includes a disposition implement associated with said imaging device and a disposing implement associated with said reference frame.  
     
     
         92 . The method of  claim 88 , wherein said measuring of said disposition of said imaging device is effected using a disposing system that includes a disposing implement associated with said imaging device and a disposition implement associated with said reference frame.  
     
     
         93 . The method of  claim 88 , wherein said measuring of said disposition of said imaging system is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         94 . The method of  claim 88 , wherein said measuring of said dispositions of the body is effected using a disposing system that includes a disposition implement associated with the body and a disposing implement associated with said reference frame.  
     
     
         95 . The method of  claim 88 , wherein said measuring of said dispositions of the body is effected using a disposing system that includes a disposing implement associated with the body and a disposition implement associated with said reference frame.  
     
     
         96 . The method of  claim 88 , wherein said measuring of said dispositions of the body is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems, acoustic disposing systems and stereopair optical systems.  
     
     
         97 . The method of  claim 88 , further comprising the step of: 
 (d) introducing a contrast agent to said at least portion of the body, prior to said acquiring of said first image.    
     
     
         98 . The method of  claim 88 , wherein said performing of said medical procedure includes navigating a probe to a point-of-interest in said at least portion of the body.  
     
     
         99 . The method of  claim 98 , wherein said navigating includes measuring a disposition of the probe relative to said reference frame.  
     
     
         100 . The method of  claim 99 , wherein said measuring of said disposition of said probe is effected using a disposing system that includes a disposition implement associated with said probe and a disposing implement associated with said reference frame.  
     
     
         101 . The method of  claim 99 , wherein said measuring of said disposition of said probe is effected using a disposing system that includes a disposing implement associated with said probe and a disposition implement associated with said reference frame.  
     
     
         102 . The method of  claim 99 , wherein said measuring of said disposition of said probe is effected using a disposing system selected from the group consisting of electromagnetic disposing systems, magnetic disposing systems and acoustic disposing systems.  
     
     
         103 . The method of  claim 99 , wherein said measuring of said disposition of said imaging device, said measuring of said dispositions of the body and said measuring of said disposition of said probe are effected using a common disposing system that includes a first disposition implement associated with said imaging device, a second disposition implement associated with the body, a third disposition implement associated with said probe and a common disposing implement associated with said reference frame.  
     
     
         104 . The method of  claim 99 , wherein said measuring of said disposition of said imaging device, said measuring of said dispositions of the body and said measuring of said disposition of said probe are effected using a common disposing system that includes a first disposing implement associated with said imaging device, a second disposing implement associated with the body, a third disposing implement associated with said probe and a common disposition implement associated with said reference frame.