Systems And Methods for Guiding Tissue Resection

Abstract

A method for guiding resection of local tissue from a patient includes generating at least one image of the patient, automatically determining a plurality of surgical guidance cues indicating three-dimensional spatial properties associated with the local tissue, and generating a visualization of the surgical guidance cues relative to the surface. A system for generating surgical guidance cues for resection of a local tissue from a patient includes a location module for processing at least one image of the patient to determine three-dimensional spatial properties of the local tissue, and a surgical cue generator for generating the surgical guidance cues based upon the three-dimensional spatial properties. A patient-specific locator form for guiding resection of local tissue from a patient includes a locator form surface matching surface of the patient, and a plurality of features indicating a plurality of surgical guidance cues, respectively.

What is claimed is: 
     
         1 . A method for guiding resection of local tissue from a patient, comprising:
 generating at least one first image, of the patient, including image of the local tissue and image of at least a portion of surface of the patient;   automatically determining, at least in part based upon the first image, a plurality of surgical guidance cues indicating three-dimensional spatial properties associated with the local tissue; and   generating a visualization of the surgical guidance cues relative to the surface.   
     
     
         2 . The method of  claim 1 , the step of generating at least one first image comprising:
 capturing at least one volumetric image, of the patient, including the image of the local tissue; and   capturing at least one surface image, of the patient, including the image of at least a portion of surface of the patient.   
     
     
         3 . The method of  claim 1 , the step of generating at least one first image comprising:
 capturing at least one volumetric image, of portion of the patient, including the image of a local tissue and the image of at least a portion of surface of the patient.   
     
     
         4 . The method of  claim 1 , the step of generating at least one first image comprising:
 capturing at least one second image of the patient when the patient is in a second position, the second image including a second-position image of the local tissue and second-position image of at least a portion of the surface;   capturing at least one surface image of the patient when the local tissue and the portion of the surface is in a first position associated with the resection; and   transforming the second image to register the surface as captured in the second image to the surface as captured in the surface image, to produce the first image.   
     
     
         5 . The method of  claim 4 , the local tissue being a tumor in a breast of the patient, each of the first position and the second position being a supine position, the step of transforming comprising producing the first image by performing a rigid-body transformation of the second image to register the surface as captured in the second image to the surface as captured in the surface image. 
     
     
         6 . The method of  claim 4 , the local tissue being a tumor in a breast of the patient, the first position being a supine position, the second position being a prone position, the step of transforming comprising producing the first image by deformably transforming of the second image to register the surface as captured in the second image to the surface as captured in the surface image while accounting for tissue displacement of the breast between the prone position and the supine position. 
     
     
         7 . The method of  claim 1 , the step of generating a visualization comprising:
 generating a model of the surface; and   superimposing at least one of the surgical guidance cues on the model of the surface.   
     
     
         8 . The method of  claim 7 , the step of superimposing comprising superimposing, onto the model, an incision site for resection surgery, and projection of the local tissue onto the surface along direction from the local tissue to incision site. 
     
     
         9 . The method of  claim 1 , the local tissue being a tumor in a breast of the patient, the first image being of the breast when the patient is in supine position, further comprising:
 manufacturing a locator form that fits the breast, when in supine position, the locator form including features indicating at least a portion of the surgical guidance cues.   
     
     
         10 . The method of  claim 9 , the locator form indicating incision site for resection surgery and projection of the tumor onto the surface along direction from tumor to incision site for the resection. 
     
     
         11 . The method of  claim 1 , further comprising:
 in the step of automatically determining, analyzing the first image to automatically determine an optimal incision site; and   in the step of generating a visualization, indicating the optimal incision site relative to the surface.   
     
     
         12 . The method of  claim 1 , further comprising:
 receiving a user-defined incision site location; and   in the step of automatically determining, determining the plurality of surgical guidance cues based upon the user-defined incision site location and the first image.   
     
     
         13 . The method of  claim 1 , further comprising:
 performing a tissue resection procedure that utilizes the surgical guidance cues to resect the local tissue.   
     
     
         14 . A system for generating surgical guidance cues for resection of a local tissue from a patient, comprising:
 a location module for processing at least one image of the patient to determine three-dimensional spatial properties of the local tissue; and   a surgical cue generator for generating the surgical guidance cues based upon the three-dimensional spatial properties.   
     
     
         15 . The system of  claim 14 , the location module including a position calculator for determining centroid position of the local tissue from the image. 
     
     
         16 . The system of  claim 15 , the location module further including a direction calculator for determining a vector from the centroid position to incision site for resection surgery. 
     
     
         17 . The system of  claim 16 , the surgical cue generator including an incision site calculator for determining the incision site as point on surface of the patient closest to perimeter of the local tissue. 
     
     
         18 . The system of  claim 16 , further comprising an interface for receiving location information for the incision site. 
     
     
         19 . The system of  claim 16 , the surgical cue generator comprising a projection calculator for determining projection of the local tissue onto surface of the patient along the vector. 
     
     
         20 . The system of  claim 16 , the location module further comprising a perimeter calculator for determining (a) an anterior point of perimeter of the local tissue where the vector intersects the perimeter, and (b) a posterior point of the perimeter where the perimeter intersects a line passing through the centroid position and the incision site. 
     
     
         21 . The system of  claim 14 , further comprising a visualization module for generating a model of the surface of the patient with the surgical guidance cues superimposed thereon. 
     
     
         22 . The system of  claim 14 , the at least one image including (a) a volumetric image of a portion of the patient including the local tissue and (b) a three-dimensional surface image of surface of the patient including location of incision site used for resection surgery, the system further comprising:
 an image registration module for registering the volumetric image to the surface image.   
     
     
         23 . The system of  claim 14 , the at least one image including (a) a volumetric image of a portion of the patient including the local tissue and (b) a three-dimensional surface image of surface of the patient including location of incision site used for resection surgery, the system further comprising an optical surface imager for generating the three-dimensional surface image. 
     
     
         24 . A patient-specific locator form for guiding resection of local tissue from a patient, comprising:
 a first locator form surface matching surface of the patient near location of the local tissue, such that the patient-specific locator form fits the surface; and   a plurality of features indicating a plurality of surgical guidance cues, respectively.   
     
     
         25 . The patient-specific locator form of  claim 24 , the local tissue being a tumor in a breast of the patient, the first locator form surface matching surface of the breast. 
     
     
         26 . The patient-specific locator form of  claim 24 , further comprising one or more markers positioned to match one or more respective fiducials on the surface, such that the markers aid positioning of the patient-specific locator form on the surface. 
     
     
         27 . The patient-specific locator form of  claim 26 , the local tissue being a tumor in a breast of the patient, the first locator form surface matching surface of the breast, the markers including an opening positioned to match nipple of the breast. 
     
     
         28 . The patient-specific locator form of  claim 24 , the plurality of features including at least one raised needle port, each of the at least one raised needle port having shape and position to passively direct a respective needle to a respective location associated with the local tissue when the patient-specific locator form is placed on the surface. 
     
     
         29 . The patient-specific locator form of  claim 28 , one of the at least one raised needle port being located at incision site for resection surgery. 
     
     
         30 . The patient-specific locator form of  claim 24 , the plurality of features including a cut-out at incision site for tissue resection surgery to provide access to the local tissue when the patient-specific locator form is placed on the surface.