Method and system for surgical navigation during resection procedures using spatial registration of tissue fluorescence

Abstract

A neurosurgical method of determining a tumor resection status is described. The method includes acquiring a medical image of a human organ including a segmented tumor. The method further includes determining a pose of a suction tool including the at least one optical fiber and a navigation tracker. The method further includes generating excitation light with which the at least one optical fiber excites a target region including the tumor and a marginal region around the tumor. The method further includes receiving the collected fluorescence emitted from the target region. The method further includes determining whether tissue in the target region corresponds to a tumor based on the fluorescence collected under the pose of the aspiration tool. The method further includes displaying a resection state of the target region relative to the medical image.

Description

[0001] Related Applications

[0002] The present applicant claims priority to and all benefits of U.S. Provisional Patent Application No. 63 / 364,695 filed on May 13, 2022, the entire contents of which are incorporated herein by reference. Background Art

[0003] Gliomas may originate from glial cells in the brain or spine. A surgical procedure, more specifically a tumor resection, is usually performed to remove the tumor. The goal of a tumor resection surgical procedure is to achieve a gross total resection (GTR). A very aggressive type of glioma is glioblastoma. For patients with glioblastoma, GTR has been shown to prolong the patient's life. For example, one study showed that patients who underwent a GTR had a 16-month post-resection survival, but patients who had only 60% of the tumor removed had a survival of only 10 months, resulting in a 60% increase in post-resection survival.

[0004] Before the resection procedure, preoperative images of the patient can be captured by a magnetic resonance imaging (MRI) system. Healthcare professionals can use preoperative images to plan the resection procedure. However, brain shift (i.e., brain deformation) may occur during the resection procedure. Brain shift may be caused by a variety of factors, such as gravity, head position, fluid drainage, brain tissue swelling, tissue manipulation, tissue size, and changes in intracranial pressure caused by tumor tissue resection or craniotomy. In some cases, an intraoperative magnetic resonance image (iMRI) can be captured at the beginning of the resection procedure to account for brain shift that occurs after the craniotomy is performed. By capturing iMRI, brain shift caused by craniotomy can be captured and considered. Subsequent intraoperative iMRIs can be captured throughout the procedure, such as after the medical staff has completed a portion of the resection procedure to ensure that additional brain shift does not occur during the resection of tumor tissue, and after the medical staff has completed the resection procedure to confirm that the medical staff has achieved GTR. However, iMRI systems can be very expensive, and it can take 30 minutes to 1 hour to capture each MRI, which makes it very cumbersome to capture multiple iMRIs during the resection procedure. As an alternative to performing iMRI, ultrasound images of the tumor tissue can also be captured and then correlated with preoperative images to account for brain shift. Such ultrasound systems may help account for brain shift but do not provide any other useful information, such as information related to the biochemical / cellular information of the tumor tissue.

[0005] For patients with high-grade gliomas, fluorescence-guided surgery may be used. Fluorescence-guided surgery improves the chances of achieving GTR. 5-aminolevulinic acid (5-ALA) is usually administered to the patient a few hours before surgery. 5-ALA is a naturally occurring compound in the hemoglobin synthesis pathway. In cancer cells, hemoglobin synthesis is disturbed and the pathway stalls at an intermediate compound called protoporphyrin IX (PpIX). During surgery, a healthcare professional can illuminate an area of ​​brain tissue with an excitation light (i.e., blue light) emitted by a surgical microscope. The surgery can be performed in a dark or dim operating room environment. High-grade tumor cells containing PpIX absorb the excitation light and emit fluorescence with specific optical characteristics (i.e., red fluorescence). The healthcare professional can observe this fluorescence from the surgical microscope.

[0006] Fluorescence-guided surgery increases the chances of GTR for high-grade tumors, such as glioblastoma. Currently, GTR for low-grade tumors is relatively low because it is difficult to find margins. 5-ALA cannot be used to improve the outcome of low-grade tumor resection because tumor cells only emit low levels of fluorescence, and the human eye is not adequate to detect such low levels of fluorescence even with a surgical microscope. The different fluorescence emitted by cells associated with specific parts of the brain provides rich biochemical / cellular information about the cells of the tumor tissue. However, current systems do not link the collected fluorescence to the MRI images displayed on the surgical navigation display. Therefore, there is a need for systems and methods that correlate fluorescence levels with MRI images to account for brain shift, confirm GTR, and provide biochemical / cellular information about cells associated with tumor tissue.

[0007] The background description provided here is to generally present the context of the present disclosure. The work of the currently designated inventors (to the extent described in this background section) and aspects of this description that may not be prior art at the time of filing are neither explicitly nor implicitly admitted to be prior art against the present disclosure. Summary of the invention

[0008] In one feature, a neurosurgical method for determining a resection status of a tumor during a resection procedure is described. The method includes acquiring at least one medical image of a human organ including a segmented tumor. The method includes determining a posture of a suction tool including at least one optical fiber and a navigation tracker based on a navigation tracker. The method includes generating excitation light so that the at least one optical fiber excites a target area of ​​the human organ with it. The target area includes the tumor and a marginal area around the tumor. The method includes receiving collected fluorescence emitted from the target area from at least one optical fiber. The method includes determining whether tissue in the target area corresponds to the tumor based on the fluorescence collected at the posture of the suction tool. The method includes displaying the resection status of the target area relative to at least one medical image based on the determination of whether the tissue corresponds to the tumor and the posture of the suction tool.

[0009] In one feature, a neurosurgical system for determining the resection state of tumor tissue in a target area is described. The neurosurgical system includes a suction tool, a navigation tracker, an optical fiber, an excitation source, an optical instrument, and a surgical navigation system. The suction tool is configured to apply suction to the patient's brain tissue. The suction tool includes a suction cannula defining a lumen. The navigation tracker is connected to the suction tool. The optical fiber is connected to the suction cannula. The optical fiber is configured to transmit fluorescence emitted by brain tissue. The excitation source is configured to emit excitation light of a wavelength for inducing fluorescence of tumor tissue. The optical instrument is connected to the optical fiber. The optical instrument is configured to convert fluorescence emitted by brain tissue and transmitted through the optical fiber into an electrical signal. The surgical navigation system is configured to receive at least one medical image of a human organ including a segmented tumor. The surgical navigation system is also configured to determine the posture of the suction tool based on the navigation tracker. The surgical navigation system is also configured to determine whether the tissue in the target area corresponds to the tumor tissue based on the fluorescence collected in this state of the suction tool. The surgical navigation system is also configured to display at least one indicator with respect to the at least one medical image based on the determination of whether the tissue in the target area corresponds to the tumor tissue and the posture of the suction tool.

[0010] In one feature, a neurosurgical method for determining a resection status of a tumor of a human organ during a resection procedure is described. The neurosurgical method includes navigating a suction tool including a navigation tracker within the human organ to a target region corresponding to a segmented tumor of at least one medical image. The method includes determining a pose of the suction tool based on the navigation tracker. The method includes applying excitation light to the target region using an optical fiber coupled to the suction tool, the optical fiber coupled to an excitation source. The method includes removing tissue from the target region using the suction tool while collecting fluorescence from the target region using an optical fiber coupled to an optical instrument, the target region including tumor tissue and a margin region surrounding the tumor tissue. The method includes: in response to a surgical navigation system connected to the optical instrument determining that the tissue corresponds to a tumor, observing at least one virtual indicator marker overlaid on at least one medical image of the human organ including the segmented target region based on the pose of the suction tool. The method includes comparing the at least one virtual indicator marker with the shape of the segmented target region to determine whether any residual tumor remains.

[0011] In one feature, a neurosurgical method for determining the extent of tumor material removed from a human organ is described. The neurosurgical method includes acquiring at least one medical image of a human organ including a segmented tumor. The method includes navigating a surgical tool, the surgical tool including navigating a surgical tool including a navigation tracker and at least one optical fiber within the human organ to a target region corresponding to the segmented tumor of the at least one image. The method includes determining a pose of the surgical tool based on the navigation tracker. The method includes determining whether tissue in the target region is a tumor at the determined pose of the surgical tool based on fluorescence emitted from the tissue. The method includes using a surgical navigation system to (i) display a first indicator mark overlaid on at least one medical image of the human organ based on the pose of the surgical tool in response to the step of determining that the tissue is a tumor; and (ii) display a second indicator mark overlaid on at least one medical image of the human organ based on the pose of the surgical tool in response to the step of determining that the tissue is not a tumor.

[0012] In one feature, a neurosurgical system for determining the extent of tumor material removed from a human organ is described. The neurosurgical system includes a surgical tool, an optical system, and a surgical navigation system. The surgical tool system includes a surgical tool, wherein a navigation tracker is disposed on the surgical tool. The surgical tool is configured to remove tissue from a target area of ​​a human organ. The optical system includes at least one optical fiber connected to the surgical tool, the at least one optical fiber being configured to irradiate excitation light at the target area and collect fluorescence emitted from the target area. The optical system is configured to convert the fluorescence into an electrical signal. The surgical navigation system is configured to receive at least one medical image of a human organ including a segmented tumor. The surgical navigation system is configured to determine a posture of the surgical tool based on the navigation tracker. The surgical navigation system is configured to determine whether the tissue of the target area is a tumor based on the electrical signal under the determined posture of the surgical tool. The surgical navigation system is configured to (i) display a first indicator mark overlaid on the at least one medical image of the human organ based on the posture of the surgical tool in response to determining that the tissue is a tumor, and (ii) display a second indicator mark overlaid on the at least one medical image of the human organ based on the posture of the surgical tool when it is determined that the tissue is not a tumor.

[0013] In one feature, a neurosurgical method for determining the resection status of a tumor during a resection procedure is described. The method includes acquiring at least one medical image of a human organ including a segmented tumor. The method includes determining the posture of a suction tool including at least one optical fiber and the navigation tracker based on a navigation tracker. The method includes generating excitation light so that the at least one optical fiber excites a target area of ​​the human organ with it, and the target area includes the tumor and a marginal area around the tumor. The method includes receiving collected fluorescence emitted from the target area from the at least one optical fiber. The method includes determining the intensity of the collected fluorescence. The method includes generating a point cloud based on the intensity of the collected fluorescence and the posture of the suction tool.

[0014] Further areas of applicability of the present disclosure will become apparent from the detailed description, claims and drawings.The detailed description and specific examples are intended for illustrative purposes only and are not intended to limit the scope of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The present disclosure will be more fully understood from the detailed description and accompanying drawings.

[0016] Figure 1 A neurosurgical system in accordance with the teachings of the present disclosure is depicted.

[0017] Figure 2 Depicted is a functional block diagram of a neurosurgical system in accordance with the teachings of the present disclosure.

[0018] Figure 3 An example suction tool of a neurosurgical system in accordance with the teachings of the present disclosure is shown.

[0019] Figure 4 Depicted is a functional block diagram of a tissue detection system of a neurosurgical system in accordance with the teachings of the present disclosure.

[0020] Figure 5 A tissue detection system of a neurosurgical system in accordance with the teachings of the present disclosure is depicted.

[0021] Fig. 6A and 6B An optical system of a tissue detection system of a neurosurgical system in accordance with the teachings of the present disclosure is depicted.

[0022] Fig. 7A and 7B Depicted are exploded views of several components of an optical system of a tissue detection system of a neurosurgical system in accordance with the teachings of the present disclosure.

[0023] Figure 8 Depicted is a sampling element of a suction tool coupled to a neurosurgical system and with the sheath removed in accordance with the teachings of the present disclosure.

[0024] Fig. 9 Depicted is a sampling element of a suction tool coupled to a neurosurgical system in accordance with the teachings of the present disclosure.

[0025] Fig.10 Depicted is a graphical user interface of a navigation computer of a neurosurgical system including multiple views of a patient's brain in accordance with the teachings of the present disclosure.

[0026] Figures 11A-11F Depicted is a graphical user interface of a navigation computer of a neurosurgical system including an axial view of a patient's brain in accordance with the teachings of the present disclosure.

[0027] Figures 12A-12E Depicted is a graphical user interface of a navigation computer of a neurosurgical system including an axial view of a patient's brain in accordance with the teachings of the present disclosure.

[0028] Fig.13A and 13B Depicted is a graphical user interface of a navigation computer of a neurosurgical system including an axial view of a patient's brain in accordance with the teachings of the present disclosure.

[0029] Fig.14 Depicted is a graphical user interface of a navigation computer of a neurosurgical system including an axial view of a patient's brain in accordance with the teachings of the present disclosure.

[0030] Fig.15 A graphical user interface of a navigation computer of a neurosurgical system is depicted, the graphical user interface including a three-dimensional (3D) point cloud of resected tissue, a three-dimensional (3D) model of resected tumor tissue, and a three-dimensional (3D) model of tumor tissue in accordance with the teachings of the present disclosure.

[0031] Fig.16 Exemplary methods performed by a neurosurgical system in accordance with the teachings of the present disclosure are depicted.

[0032] Fig.17 Exemplary methods performed by a neurosurgical system in accordance with the teachings of the present disclosure are depicted.

[0033] Among the drawings, reference numerals may be repeated to identify similar and / or identical elements. DETAILED DESCRIPTION

[0034] refer to Figure 1 , the neurosurgery system 100 may include a surgical navigation system 104, a surgical microscope 108, a surgical cart 114, and a suction system 113. The surgical navigation system 104 includes a cart assembly 106 that houses a navigation computer 110. The navigation computer 110 may also be referred to as a navigation controller. A navigation interface is in operational communication with the navigation computer 110. The navigation interface may include one or more displays 120. The navigation interface may include one or more input devices that can be used to input information into the navigation computer 110 or otherwise select / control certain aspects of the navigation computer 110. Such input devices may include an interactive touch screen display / menu, a keyboard, a mouse, a microphone (voice activated), a gesture control device, etc.

[0035] The navigation computer 110 can be configured to store one or more preoperative or intraoperative images of the brain. Any suitable imaging device can be used to provide preoperative or intraoperative images of the brain. For example, any 2D, 3D or 4D imaging device, such as isocentric fluoroscopy, biplane fluoroscopy, ultrasound, computed tomography (CT), multi-slice computed tomography (MSCT), magnetic resonance imaging (MRI), positron emission tomography (PET), optical coherence tomography (OCT). These images can also be acquired and displayed in two-dimensional, three-dimensional or four-dimensional form. In a more advanced form, a four-dimensional surface rendering area of ​​the body can also be achieved by combining patient data or other data from atlases or anatomical model maps or from preoperative images captured by MRI, CT or echocardiography modes. Since the phrase "one or more images" will be mentioned throughout the disclosure, it can be understood that the phrase can refer to preoperative images or intraoperative images captured during the resection procedure.

[0036] The navigation computer 110 may generate one or more images of the brain on a display 120. The navigation computer 110 may also be connected to the surgical microscope 108. For example, the display 120 may display an image corresponding to the field of view of the surgical microscope 108. The navigation computer 110 may include more than one display, where one such display displays the field of view of the surgical microscope 108 and another such display may display one or more images of the brain.

[0037] The tracking system 124 can be an optical tracking system and can be coupled to the navigation computer 110. The tracking system 124 is configured to sense the pose (i.e., position and orientation) of a navigation tracker attached to or integrated with each of one or more of the various surgical tools described herein (e.g., the suction tool 156, the bipolar forceps 160, the ultrasonic handpiece assembly 130) and provide the pose to the navigation computer 110 to determine the pose of the surgical tool (e.g., relative to a target area of ​​the patient), as discussed in more detail below. Each navigation tracker can include one or more tracking elements, which can be active or passive infrared tracking elements detectable by a camera of the optical tracking system. An example of a surgical navigation system 104 that includes a tracking system is the Nav3i 3D Surgical Navigation System 104 commercially available from Stryker. TM The surgical navigation system 104 may have various functions and features as described in U.S. Patent No. 7,725,162 B2 and U.S. Patent Publication No. 2020 / 0100849 A1, the contents of which are hereby incorporated by reference in their entirety. Although this example provides an example where the tracking system 124 is an optical tracking system, other tracking systems may also be employed.

[0038] For example, in some embodiments, the tracking system 124 can be implemented as an electromagnetic tracking system, wherein each navigation tracker includes a position sensor disposed at and / or embedded within the distal end of one of the various surgical tools, enabling tracking of the distal end of the surgical tool, such as relative to a target area of ​​the patient. More specifically, the position sensor can include a coil in communication with one or more electrical conduits extending along the length of the surgical tool. When the position sensor (or more specifically the coil) is positioned within an electromagnetic field, movement of the position sensor within the magnetic field can generate an electric current in the coil, which can then be transmitted along the electrical conduit to the navigation computer 110. This phenomenon can enable the navigation computer 110 to determine the location of the distal end of the surgical tool in three-dimensional space, such as relative to a target area of ​​the patient's tissue.

[0039] By way of example only, the position sensor may be constructed and operated in accordance with at least some of the teachings of: U.S. Patent No. 8,702,626, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,320,711, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,190,389, the disclosure of which is incorporated herein by reference; U.S. Patent No. 8,123,722, the disclosure of which is incorporated herein by reference; U.S. Patent No. 7,720,521, the disclosure of which is incorporated herein by reference; U.S. Patent No. 20 14 / 0364725, the disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 2014 / 0200444, the disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 2012 / 0245456, the disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 2011 / 0060214, the disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 2008 / 0281156, the disclosure of which is incorporated herein by reference; and / or U.S. Patent Publication No. 2007 / 0208252, the disclosure of which is incorporated herein by reference.

[0040] The surgical microscope 108 includes one or more objective lenses configured to provide a magnification within a certain range (e.g., from about 2 times to about 50 times). The surgical microscope 108 can have a field of view of a predetermined range area. The surgical microscope 108 is configured as a fluorescence microscope, for example, for detecting PpIX. The surgical microscope 108 can include one or more excitation sources (e.g., an excitation source configured to emit light in the visible light spectrum or an excitation source configured to emit light in the infrared spectrum) for irradiating the brain tissue 111 with excitation light to cause PpIX to fluoresce. The surgical microscope 108 can also include a camera capable of detecting radiation at the fluorescence wavelength of PpIX or ICG.

[0041] The surgical cart 114 may include a surgical system 112, a suction system 113, a tissue detection system 116, and an ultrasonic surgical system 118. A display 121 may be coupled to the surgical cart and operably connected to the surgical system 112, the tissue detection system 116, and / or the ultrasonic surgical system 118 to display information related to each respective system 112, 116, and 118.

[0042] Suction tool 156 can be connected to suction system 113 via suction tube. Suction system 113 may include one or more containers for storing waste collected by suction tool 156. Suction system 113 may receive suction from a vacuum source (e.g., a vacuum outlet of a medical facility). Suction system 113 may include one or more regulators or one or more regulating valves for controlling the suction pressure received from the vacuum source. The one or more regulators or one or more regulating valves may be omitted, and the suction tube may be directly or indirectly connected to the vacuum outlet via the one or more containers. In one example, suction system 113 may correspond to a wall suction unit. In another example, suction system 113 may correspond to a portable suction unit. Suction system 113 and suction tool 156 may have various features, as described in U.S. Patent No. 9,066,658 and U.S. Patent Publication No. 20180344993, the entire contents of which are incorporated herein by reference.

[0043] The surgical system 112 may include surgical tools (such as bipolar forceps 160) and a surgical console 115 for controlling various aspects of the surgical tools. For example, the surgical system 112 may be configured to control the current output by the system. The healthcare professional may also use the surgical tool to perform any surgical operation on the tissue. For example, ablation of tissue or cauterization of tissue. The bipolar forceps may have features as described in U.S. Patent No. 8,361,070B2, which is incorporated herein by reference in its entirety. Although the present disclosure discusses and illustrates that the surgical tool may include bipolar forceps 160, the surgical system 112 and the surgical tool may include other tools, such as a neurostimulator, a dissector, or an ablation device (e.g., an RF ablation device and / or a laser ablation device). For example, the surgical system and / or the surgical tool may have various features as described in U.S. Patent No. 8,267,934B2, which is incorporated herein by reference in its entirety. The healthcare professional may employ any number of surgical systems and any number of surgical tools when performing a surgical procedure.

[0044] The ultrasonic surgical system 118 may include an ultrasound console 128 and an ultrasound handpiece assembly 130 used by a healthcare professional to ablate a brain tumor. The ultrasound console 128 may also be configured to provide irrigation and / or aspiration through one or more tubes (not shown) connected to the ultrasound handpiece assembly 130, and to adjust the irrigation and / or aspiration functions of the ultrasound handpiece assembly 130 to optimize the performance of the ultrasound handpiece assembly 130. The ultrasound handpiece assembly 130 may have various features, as described in U.S. Patent Nos. 6,497,715B2; 6,955,680B2; and 6,984,220B2 and PCT Publication WO 2020 / 068756Al, which are incorporated herein by reference in their entirety. Examples of ultrasonic surgical systems that may be used are commercially available from Stryker, including the Sonopet IQ Ultrasonic Aspirator. The ultrasound console 128 may control various operating parameters based on signals received from the tissue detection system 116.

[0045] The tissue detection system 116 can include a console 168 and a sampling element 164. When the brain tissue 111 corresponds to tumor tissue, the console 168 can generate a real-time indication that can be seen within the sterile field via the sampling element 164. The sampling element 164 can also be connected to bipolar forceps 160, a suction tool 156, or other surgical tools, as will be described in more detail below. The tissue detection system 116 determines when the brain tissue 111 corresponds to tumor tissue based on the fluorescence caused by the fluorophore emitted by the target tissue. In one example, the fluorophore may correspond to PpIX. In another example, the fluorophore may correspond to ICG. As will be discussed in more detail below, based on the intensity and wavelength of the fluorescence emitted by PpIX, the tissue detection system 116 can determine the presence of tumor tissue.

[0046] refer to Figure 2 , a schematic diagram of a neurosurgical system 100 is shown. The tissue detection system 116 allows a healthcare professional to detect the presence of PpIX in real time and can be used in conjunction with a surgical microscope 108 to improve the outcome of a tumor resection and the chance of achieving a GTR. During a surgical procedure, initially a healthcare professional can use a surgical microscope 108 to observe the patient's brain tissue 111 under excitation light (e.g., blue light) to identify which portion of the brain tissue 111 corresponds to the target tissue as evidenced by red fluorescence. The healthcare professional can switch the surgical microscope 108 back to standard white light illumination for better visibility and begin resecting the target tissue. Since the sampling element 164 can be connected to the suction tool 156, the healthcare professional does not have to consider any additional surgical tools (i.e., optical probes, etc.) in the sterile field. The healthcare professional can hold the bipolar forceps 160 in one hand and the suction tool 156 in the other hand to resect the target tissue.

[0047] As the healthcare professional resects the target tissue, the console 168 can provide the healthcare professional with a real-time indication of the target tissue in the brain tissue 111 by activating an indicator of the sampling element 164 (discussed in more detail below). In accordance with the teachings of the present disclosure, the tissue detection system 116 prevents the healthcare professional from having to switch back and forth between various illumination settings of the surgical microscope 108 (i.e., illuminating the tissue with excitation light and white light) while the healthcare professional is performing the resection of the target tissue. This is particularly beneficial when the healthcare professional is approaching the margin of the target tissue, as the healthcare professional wishes to achieve GTR but at the same time leave as much healthy tissue intact as possible.

[0048] refer to Figure 3 , the suction tool includes a suction cannula 157 and a handle 159. The suction cannula 157 defines a lumen for aspirating fluid, debris, and tissue from a patient. The handle 159 is tubular and has a control portion 167. The distal end 162 of the handle 159 (or the distal end 162 of the control portion 167) can be tapered and configured to receive the proximal end 161 of the suction cannula 157. The proximal end 165 of the handle 159 includes a vacuum connector, which can be configured to receive a suction tube 169 connected to a vacuum source that generates suction pressure. The vacuum connector can be a standard hook connector, a quick disconnect connector, or any other suitable connector known in the art that allows the suction tube fluid to be connected to a vacuum source.

[0049] The control portion 167 may include a teardrop-shaped controller 170 for adjusting the suction pressure. For example, when no portion of the teardrop-shaped controller 170 is covered by the healthcare professional, the suction pressure may be minimal, and when the teardrop-shaped controller 170 is completely covered, the suction pressure may be maximal. Although the control portion 167 is described as including a teardrop-shaped controller, the control portion 167 may include another suitable input device, such as a button or a controller of a different shape, to allow the healthcare professional to change the suction pressure. The control portion 167 may include a through hole 171 for receiving the sampling element 164, as will be discussed in more detail below. The healthcare professional holds the handle 159 of the suction tool 156 and manipulates the suction tool 156 so that the distal end 163 contacts the patient's tissue during the surgical procedure to provide suction at the desired location. Although the suction tool 156 is described as having a Fukushima configuration, other configurations, such as a Frazier or Poole configuration, are also contemplated.

[0050] refer to Figure 4 and Figure 5, the tissue detection system 116 includes a sampling element 164 and a console 168. As shown, the sampling element 164 can be connected to the suction tool 156. The sampling element 164 can be connected to the console 168 via a connector 172. The sampling element 164 may include a detection optical fiber 264 and an indicator element 296, as discussed in more detail below. The console 168 may include a controller 204, a user interface 208, a power supply 212, an optical system 215, and a microcontroller 220. The optical system 215 may include an optical block 216, a spectrometer 224, an excitation source 228, and an optical connector 229. The functions of each component will be discussed in more detail below.

[0051] The user interface 208 may include a display for displaying output from the controller 204 related to fluorescence collected from the tissue. The user interface 208 may also include one or more input devices (e.g., buttons, touch buttons, switches, etc.) configured for engagement by a healthcare professional. A power supply 212 may provide power to the components of the console 168. The console 168 may include a probe port 173 into which the connector 172 of the sampling element 164 is connected. The detection fiber 264 may then be connected to the optical block 216 via an optical connector 229, Fig. 6A and 6B An example of an optical connector is shown in . The console 168 may also include an electrical port 174 for establishing a communication link (eg, to the surgical system 112 and the ultrasonic surgical system 118). The communication link may also be established wirelessly.

[0052] The excitation source 228 can generate excitation light, which is irradiated onto the target tissue by the healthcare professional through the detection optical fiber 264. The excitation source 228 can be configured to emit excitation light within a predetermined wavelength range (e.g., blue light of about 405nm or blue light in the range of 400nm to 500nm). The excitation source 228 can also be configured to emit excitation light corresponding to other wavelengths, such as wavelengths associated with the remaining visible light spectrum other than blue light (e.g., greater than 500nm but less than 700nm), as well as wavelengths associated with the ultraviolet light spectrum (less than 400nm) and / or wavelengths associated with the infrared light spectrum (greater than 700nm). The excitation source 228 can include any number of light sources, such as light emitting diodes (LEDs), pulsed lasers, continuous wave lasers, modulated lasers, filtered white light sources, etc.

[0053] The system may include other excitation sources that may be further configured to emit excitation light corresponding to different wavelengths other than those described above. In this embodiment, the excitation source may be referred to as a first excitation source 228, which is configured to emit a first excitation light within a first predetermined wavelength range of the visible light spectrum, and the second excitation source may be configured to emit infrared light within a second wavelength range (e.g., 700nm to 1mm) corresponding to the infrared light spectrum. The first excitation source 228 may be configured to emit light that will excite a first fluorophore (e.g., PpIX), while the second excitation source is configured to emit light that will excite a second fluorophore (e.g., ICG).

[0054] The controller 204 can control the operation of the excitation source 228 by changing the operating parameters of the excitation source 228. The operating parameters can correspond to time settings, power settings, or other suitable settings. The time settings can include pulse widths. The pulse widths can be based on the integration time of the spectrometer 224. The integration time of the spectrometer 224 will be discussed in more detail below.

[0055] The detection fiber 264 may be coupled to the optical connector 229. When the sampling element 164 is coupled to the suction tool 156, the distal end 272 of the detection fiber 264 is adjacent to the working portion of the surgical tool and allows excitation light to be delivered to the target tissue.

[0056] refer to Fig. 6A and 6B , an optical block 216 is shown. An optical connector 229 may be coupled to the optical block 216. The optical block 216 may include a housing 274 constructed of metal or another suitable material and may completely enclose the component 232 of the optical block 216. The optical block 216 may be L-shaped and include a first portion 280 and a second portion 284. An excitation source 228 may be coupled to the first portion 280 of the optical block 216. A spectrometer 224 may be coupled to the second portion 284 of the optical block 216.

[0057] Additional references Fig. 7A and 7B, shows an exploded view of the components 232 of the optical system 215, showing an optical path 285 of the excitation light and an optical path 287 of the light collected from the brain tissue 111. The first portion 280 may include an optical path 285 for the excitation light to travel from the one or more excitation sources 228 to the brain tissue 111 via the detection optical fiber 264. The optical path 285 may be defined by the components 232 in the first portion 280 of the optical block 216. The second portion 284 may include an optical path 287 for the collected light to propagate from the brain tissue 111 to the spectrometer 224 via the detection optical fiber 264. The optical path 287 may be defined by the components 232 in the second portion 284 of the optical block 216. The components 232 of the optical block 216 may include optical components such as one or more laser line filters and one or more long pass filters. The optical block 216 may include other optical components such as one or more mirrors, lenses, optical connectors, optical fibers, and / or any other suitable optical components.

[0058] exist Fig. 7A In the method, the excitation source 228 emits excitation light, which passes through one or more components 232, such as a laser line filter and / or a bandpass filter. The laser line filter or the bandpass filter can be configured to reject unwanted noise (e.g., lower level transitions, plasma, and glow) generated by the excitation source 228. In other words, the laser line filter can be configured to purify the excitation light or make the excitation light more monochromatic. The long pass filter can be configured to reflect the light along the detection fiber 264 and reflect it to the brain tissue 111. The excitation source 228 can be configured to transmit unfiltered excitation light (i.e., the filter can be omitted) to the target tissue via the detection fiber 264. The detection fiber 264 can guide the excitation light to the brain tissue 111 via the sampling element 164.

[0059] The detection fiber 264 can be configured to collect light (i.e., fluorescent light and ambient light) from the brain tissue 111. The coupling of the sampling element 164 to the surgical tool places the distal end 272 adjacent to the working portion of the surgical tool, thereby allowing light to be collected from the target tissue. The light collected from the brain tissue 111 may include ambient light and / or background light due to the presence of ambient light and / or background light caused by various sources in the operating room (e.g., surgical microscope 108, surgical lights, or any other equipment in the operating room). Reference Figure 7B The light collected by the detection fiber 264 passes through components 232 (eg, a long pass filter) of the second portion 284 of the optical block 216. After passing through the components 232, the light may enter a spectrometer 224 coupled to the optical block 216.

[0060] The detection fiber 264 can be coupled to the optical connector 229. As discussed in more detail below, the distal end 272 of the detection fiber 264 can include a lens or other transparent material so that when the sampling element 164 is positioned on a surgical tool (i.e., an ultrasonic hand piece, a suction tool, or bipolar forceps or other working surgical tool), the coupling of the sampling element 164 to the surgical tool places the distal end 272 of the detection fiber 264 adjacent to the working portion of the surgical tool to allow excitation light to be transmitted to the target tissue.

[0061] The spectrometer 224 can be configured to convert the filtered optical light into a spectral signal in the form of an electrical signal, which can represent the fluorescence collected from the tissue of the target area when the target area is excited by the excitation light. The microcontroller 220 is configured to control the operation of the spectrometer 224. Examples of spectrometer systems that can be used are available from Hamamatsu, including the Mini-spectrometer micro series C12880MA. Although the spectrometer 224 is considered throughout the disclosure, other optical instruments can be used instead of the spectrometer 224.

[0062] refer to Figure 8 , the figure shows that the sampling element 164 and the tracking element 166 are connected to the suction tool 156. The tracking element 166 is shown as being connected to the handle 159 of the suction tool 156, but can be connected to any part of the suction tool 156. The tracking element 166 can also be connected to a portion of the sampling element 164. The indicator element 296 may include a transmission member 297 connected to an indicator light 298. The indicator light 298 may include one or more light emitting diodes or other suitable light sources. The indicator light 298 can be configured to emit light based on an activation signal received from the controller 204. The controller can be configured to generate an activation signal in response to the controller 204 detecting tumor tissue. The indicator light 298 can be spherical, dome-shaped, cylindrical, or other suitable shapes. The sheath 306 can enclose a portion of the detection optical fiber 264 and a portion of the indicating element 296, in particular the transmission member 297. As Fig. 9 As shown, the jacket 306 does not cover the distal end 272 of the detection fiber 264 or the indicator light 298. The jacket 306 may be made of any of polyvinyl chloride, polyethylene, chlorinated polyethylene, chlorosulfonated polyethylene / neoprene, and / or another suitable material.

[0063] The detection fiber 264 and a portion of the indicator element 296 (i.e., the transmission member 297 and the indicator light 298) can be guided through the through hole 171 of the handle 159. The distal end 272 of the detection fiber 264 can be positioned close to the distal end 163 of the suction cannula 157. The indicator light 298 can be positioned near the distal end of the detection fiber 264, but closer to the distal end 162 of the handle 159 (or the distal end 162 of the control portion 167) than the distal end 272 of the detection fiber is positioned. In other words, the distal end 272 of the detection fiber 264 can be arranged closer to the distal end 163 of the suction cannula 157 than the indicator light 298. Also refer to Fig. 9 , after the detection optical fiber 264 and the portion of the indicating element 296 pass through the through hole 171, the sheath 306 can be assembled on the suction cannula 157, the detection optical fiber 264 and the transmission member 297. The sheath 306 can be fitted to the distal end 162 of the control portion 167, thereby covering the distal end 162 and the through hole 171. The sheath 306 can terminate just before the position where the indicator light 298 is connected to the suction cannula 157. The detection optical fiber 264 can extend from under the sheath 306 so that the sheath 306 does not interfere with the delivery of the excitation light or the collection of fluorescence from the tissue. As also shown in the figure, the indicator light 298 is fully exposed, but may be partially covered by the sheath 306. In some configurations, the sheath 306 can be omitted.

[0064] Although the sampling element 164 is shown coupled to the suction tool 156, the sampling element 164 may be coupled to another surgical tool (e.g., the ultrasonic handpiece assembly 130, the bipolar forceps 160, etc.). The distal end 272 of the detection fiber 264 may include a lens, a collimator, or another suitable optical component that allows the detection fiber 264 to deliver excitation light to the brain tissue 111 and collect light from the brain tissue 111.

[0065] As previously described, the detection fiber 264 can transmit excitation light from the optical system 215 to the brain tissue 111, and the detection fiber 264 can also collect light from the brain tissue 111 and deliver the light to the optical system 215. Although the example provided is that the detection fiber 264 delivers excitation light to the tissue and also collects light from the tissue, the system can include two independent optical fibers, such as a collection fiber and an excitation fiber. The collection fiber can collect light from the tissue and the excitation fiber can deliver the excitation light to the tissue. Although the detection fiber 264 is envisioned as a single optical fiber for simplicity, it is understood that the detection fiber 264 can include more than one optical fiber. For example, the detection fiber 264 can include a bundle of detection optical fibers, all of which are connected in a manner similar to the single optical fiber connection described above. In addition, the detection fiber 264 can include any number of optical fibers connected in series.

[0066] The controller 204 can be configured to use the spectral signal provided by the microcontroller 220 to determine or detect one or more characteristics of the collected fluorescence represented by the signal, and determine or detect the presence of tumor tissue. The controller 204 can apply or utilize any suitable algorithm or combination of algorithms to detect the presence of tumor tissue based on the fluorescence intensity of PpIX determined from the spectral signal. Example algorithms are disclosed in PCT application PCT / IB2022 / 052294, the contents of which are incorporated herein by reference. Based on the detection of tumor tissue or fluorescence intensity, the controller 204 can provide an indication to a healthcare professional that tumor tissue has been detected.

[0067] The controller 204 can activate the indicator light 298 in response to detecting the target tissue. The indicator light 298 can emit light when activated to signal the healthcare professional that tumor tissue has been detected. The controller 204 can control the LED or other light source to emit different colors of light, depending on whether the controller 204 detects PpIX or ICG (i.e., whether the brain tissue 111 corresponds to the target tissue or the blood vessel). For example, when PpIX above a threshold is detected, the controller 204 can control the LED to emit green light (e.g., a wavelength of approximately 520-564nm), or when ICG is detected, the controller 204 can control the LED to emit yellow light (e.g., a wavelength of 565-590nm).

[0068] The controller 204 can be configured to communicate with the navigation computer 110 or any other system of the neurosurgery system 100 (e.g., the surgical system 112, the ultrasonic surgical system 118, etc.) via a communication link established through the electrical port 174. For example, a wire can be plugged into the electrical port 174 and can also be plugged into the navigation computer 110 to establish a communication link. The communication link can also be established wirelessly. The controller 204 can provide the navigation computer 110 with the spectral signal, the determination of the detected fluorescence level, and / or the determination of whether the tissue corresponds to healthy tissue or tumor tissue.

[0069] refer to Fig.10, the navigation computer 110 can be configured to display a graphical user interface (GUI) 131 having an axial view 133 of the brain tissue 111 including the tumor tissue, a coronal view 134 of the brain tissue 111 including the tumor tissue, a sagittal view 135 of the brain tissue 111 including the tumor tissue, and a 3D model 136 of the brain tissue including the tumor tissue. The navigation computer 110 can be configured to display the posture of one or more of the surgical instruments (e.g., the suction tool 156 and the bipolar forceps 160) relative to the target area of ​​the image based on the tracking information received from the tracking system 124. The navigation computer 110 can be configured to segment the tumor tissue of the image using any suitable segmentation technique (e.g., an automatic segmentation technique, a semi-automatic segmentation technique, or a manual segmentation technique) or a combination of segmentation techniques. The automatic or semi-automatic segmentation technique can use any suitable segmentation method, such as a region growing method, a watershed method, a morphology-based method, a pixel-based method, an edge-based method, a model-based method, a fuzzy clustering method, or a k-means clustering.

[0070] As will be described in FIGS. 11-14 , the navigation computer 110 can display one or more indicators based on the detected fluorescence level, the determination of the tissue type, and / or the posture of one or more of the surgical instruments to reflect the resection status of the tumor tissue in real time. The displayed resection status can be configured to alert the healthcare professional to any remaining portion of the tumor. The indicator can be overlaid on the image, on the 3D model, or displayed separately. The indicator can be displayed in a variety of different forms, such as one or more masks (such as a mask) overlaid on one or more images. Figures 11A-11F ), 2D points with different shapes / patterns / colors (such as Fig.13A and 13B ), 3D point cloud models with different shapes / patterns / colors (such as Fig.15 The indicator may also include a modification of an existing graphic relative to the one or more image overlays (e.g. Figures 11A-11F and Figures 12A-12E shown).

[0071] Special References Fig.11A, in which an axial view 133 of the GUI 131 is shown. During the segmentation process, the navigation computer 110 may overlay a segmentation mask 404 onto the tumor tissue to highlight the area of ​​interest. Alternatively, the navigation computer 110 may draw or outline the tumor tissue to highlight the area of ​​interest. The navigation computer 110 may prompt the healthcare professional to provide input to indicate a margin around the tumor tissue for resection. The margin is the plane along which the resection is performed, which ideally bisects healthy tissue surrounding and outside the tumor tissue. Based on the input provided by the healthcare professional, the navigation computer 110 may display an edge mask 408 representing the margin around the segmentation mask 404. The margin in combination with the tumor tissue may be referred to as a target region. The edge mask 408 may be visually different from the segmentation mask 404, such as having a different color or a different pattern than the segmentation mask 404. As shown in FIG. Fig.11A As shown, the edge mask 408 is displayed as a white pattern (eg, a first pattern).

[0072] The navigation computer 110 can be configured to generate one or more three-dimensional models (3D) of the brain, tumor tissue and / or target area based on the image. The 3D model of the tumor tissue can be reconstructed based on the tumor tissue segmented from each 2D image processed from the 3D image. For example, once the tumor tissue is segmented, the 2D image containing the tumor tissue can be reconstructed into a 3D model by putting the 2D image back into the sequence (arranged in order), thereby providing a 3D model. Based on the reconstructed 3D model of the tumor tissue, the navigation computer 110 can calculate the volume or other parameters of the tumor tissue, such as positioning, shape, etc. in the brain. The navigation computer 110 can also be configured to include the margin selected by the healthcare professional in the 3D model. The navigation computer 110 can be configured to calculate one or more volume calculations of the target area, including the volume of the tumor tissue to be removed, the volume of the margin to be removed, and the total volume including the volume of the tumor tissue to be removed and the volume of the margin. The calculation results can be displayed relative to the image.

[0073] The navigation computer 110 can be configured to perform image or patient registration using any suitable registration method to associate the patient's intraoperative posture with each image. The navigation computer 110 can use automatic image registration or manual image registration methods to perform image or patient registration. For example, the navigation computer 110 can be configured to perform a point-based registration method. The navigation computer 110 can use one of the registration methods described in U.S. Patent No. 10,506,962B2, the contents of which are incorporated herein by reference. After performing the registration, the posture of the suction tool 156 and / or bipolar forceps 160 or other surgical tools can be displayed relative to each image.

[0074] like Fig. 11BAs shown, before starting the resection procedure, the navigation computer 110 may overlay the second mask 412 onto the segmentation mask 404. Fig. 11B As shown, the second mask 412 is displayed over the entire portion of the initial segmentation mask 404. When the second mask 412 is initially displayed before the resection of the target area 402 begins, no portion of the initial segmentation mask 404 is visible. Figures 11C-11F As the healthcare professional resects the target region 402, the navigation computer 110 may modify the margin mask 408 and the second mask 412 to reflect the resection status of the target region 402. For example, the navigation computer 110 may change the color or pattern of the second mask 412 and / or the margin mask 408 corresponding to the resected portion of the target region 402. In another example, the navigation computer 110 may remove or delete the second mask 412 and / or the margin mask 408 as the healthcare professional resects the tissue of interest. In other words, as the healthcare professional resects the tumor tissue, the portion of the second mask 412 covering the corresponding portion of the tumor tissue may be removed. In addition, the navigation computer 110 may display a resection pane 440 that displays various calculations of the navigation computer 110, such as the total volume of the target region 402 or tumor that has been resected, the total volume of the target region 402 or tumor that remains to be resected, and / or the extent of the resection (e.g., a completion percentage), wherein the latter may be determined based on one or more of the aforementioned calculations.

[0075] Special References Fig. 11C As the healthcare professional is performing ablation of the target area 402, the navigation computer 110 can update the ablation pane 440 to reflect various real-time calculations. Fig. 11C , the resection pane 440 shows that the healthcare professional has resected a total target area of ​​50 cm 3 12.5cm in 3 , which corresponds to a resection completion percentage of 25%. As shown, the navigation computer 110 has changed the target area 402 displayed on the screen to reflect the removal extent of the target area 402. The navigation computer 110 has removed the portion of the second mask 412 associated with the removed portion of the tumor tissue. The navigation computer 110 also changes the edge mask 408 by changing the pattern of a portion of the edge mask 408, which is proportional to the amount of edge tissue removed by the healthcare professional.

[0076] Special References Fig.11D As shown, the resection pane 440 indicates to the healthcare professional that 50% of the target region 402 has been resected. Thus, the navigation computer 110 has removed 50% of the second mask 412 and has accordingly changed the edge mask 408 to reflect the removed portion of the target region 402. Fig.11E , as shown in the resection pane 440, the healthcare professional has now removed 37.5 cm 3 , corresponding to 75% of the target area 402. Thus, the navigation computer 110 has removed 75% of the second mask 412 and changes the edge mask 408 accordingly to reflect the removed portion of the target area 402.

[0077] refer to Fig.11F When the total volume resected is 50 cm 3 Equal to the total volume of target area 402 50cm 3 , the excision pane 440 indicates that the excision is 100% complete. As shown, when the target area 402 has been completely excised, the navigation computer 110 no longer displays any portion of the second mask 412. In addition, the navigation computer 110 can display the entire edge mask 408 as a changed edge mask to indicate that the entire edge area has been excised.

[0078] refer to Figures 12A-12E , the navigation computer 110 may generate a contour 409 around the tumor tissue based on one or more images, rather than Figures 11A-11F The segmentation mask 404 is shown. Figures 12B-12E , when the healthcare professional resects tumor tissue, the navigation computer 110 can be configured to fill in the area inside the contour 409 based on the posture of one or more of the surgical instruments (i.e., the suction tool 156 and / or the bipolar forceps 160), the fluorescence level detected at each posture, and / or the determination of the tissue type at each posture.

[0079] like Fig. 12A As shown, the healthcare professional has not yet started the resection procedure for the tumor tissue indicated by the outline 409. Therefore, the outline 409 of the tumor tissue is displayed as unfilled, and the resection pane 440 indicates the associated resection status, i.e., 0% resection completion and 0 cm total resection volume. 3 , the total volume of the target area to be resected is 50cm 3 .like Fig. 12B As shown, the outline 409 of the tumor tissue is shown as being approximately 25% filled based on the posture of one or more of the surgical instruments (i.e., the suction tool 156 and / or the bipolar forceps 160), the fluorescence level detected at each posture, and / or the determination of the tissue type at each posture. The resection pane 440 shows that the resection is 25% complete and the total volume resected is 12.5 cm 3 , and the total volume of the target area to be resected is 50cm 3 .like Fig. 12CAs shown, the outline 409 of the tumor tissue is shown as being approximately 50% filled based on the posture of one or more of the surgical instruments (i.e., the suction tool 156 and / or the bipolar forceps 160), the fluorescence level detected at each posture, and / or the determination of the tissue type at each posture. The resection pane 440 shows that the resection is 50% complete and the total volume resected is 25 cm cm 3 The total volume of the target area to be removed is 50 cm 3 .like Fig.12D As shown, the outline 409 of the tumor tissue is shown as being approximately 75% filled based on the posture of one or more of the surgical instruments (i.e., the suction tool 156 and / or the bipolar forceps 160), the fluorescence level detected at each posture, and / or the determination of the tissue type at each posture. The resection pane 440 shows that the resection is 75% complete and the total volume resected is 37.5 cm 3 , the total volume of the target area to be resected is 50cm 3 .like Fig.12E As shown, the outline 409 of the tumor tissue is shown as being filled 100% based on the posture of one or more of the surgical instruments (i.e., the suction tool 156 and / or the bipolar forceps 160), the fluorescence level detected at each posture, and / or the determination of the tissue type at each posture. The resection pane 440 shows that the resection is 100% complete and the total volume resected is 50 cm 3 , and the total volume of the target area to be resected is 50 cm 3 .

[0080] refer to Fig.13A and 13B ,and Figures 12A-12E Similarly, the segmented tumor tissue is indicated by the outline 409. As previously discussed, during the resection procedure, brain shift may occur, causing the tumor tissue to move away from the initially registered pose. As such, the pose of the tumor tissue in the patient space may not correspond to the pose of the tumor tissue in the image space. However, when brain shift occurs, using prior art neurosurgical systems, a healthcare professional is unable to know that brain shift has occurred by examining typical preoperative images or intraoperative images captured before brain shift occurs. Using the neurosurgical system of the present disclosure, the navigation computer 110 can overlay one or more indicator markers relative to each image based on the pose of one or more of the surgical instruments (i.e., the suction tool 156 and / or the bipolar forceps 160), the detected fluorescence level, and / or the determination of tissue type. The healthcare professional can examine the one or more images with the indicator markers overlaid on the images to assess how much brain shift may have occurred and whether additional intraoperative imaging is required. With particular reference to Fig.13A , the indicator marks are displayed as point-by-point indicator marks 413 and 414. Fig.13A, the navigation computer 110 overlays a first point-by-point indicator 413 to indicate locations where fluorescence was detected, or more specifically, locations where fluorescence corresponding to a given type of tissue (e.g., target or tumor tissue) was detected. The first point-by-point indicator 413 is shown displayed in solid color. The navigation computer 110 overlays a second point-by-point indicator 414 onto one or more images to indicate locations where fluorescence was not detected, or more specifically, locations where fluorescence corresponding to a given type of tissue (e.g., target or tumor tissue) was not detected. The second point-by-point indicator 414 is represented by a hollow circle. From Fig.13A It can be seen that the first point-by-point indicator 413 is all located within the segmented tumor tissue contour 409, while the second point-by-point indicator is all located outside the segmented tumor tissue contour 409. Therefore, the healthcare professional can determine that no brain metastasis has occurred, or only a small amount of brain metastasis has occurred. Fig. 13B , the first point-by-point indicator 413 (i.e., the point indicating the detection of fluorescence) is displayed outside the segmented tumor tissue outline 409, while the second point-by-point indicator 414 (i.e., the point indicating the detection of no fluorescence) is located within the segmented tumor tissue outline 409. In this way, the healthcare professional can determine that significant brain shift has occurred. In some cases, when it is determined that significant brain shift has occurred, the healthcare professional may choose to perform additional intraoperative imaging to re-evaluate the tumor tissue relative to healthy tissue.

[0081] The navigation computer 110 may be configured to store as resection data: the posture of the surgical instrument (i.e., the suction tool 156 and / or the bipolar forceps 160) relative to the target area including the tumor tissue, and the associated determination of whether the tissue associated with each posture is tumor tissue or healthy tissue based on the collected fluorescence emitted from the tissue. Once the navigation computer 110 has collected sufficient resection data, the navigation computer 110 may use the resection data to account for brain shift. More specifically, once sufficient resection data is collected, the navigation computer 110 may be configured to match the resection data to the shape or contour of a portion of the tumor tissue. Referring to FIG. 13 , the tumor tissue indicated by the segmentation mask 404 may include one or more unique (or "unique") portions defined by a unique (or "distinctive") shape. The navigation computer 110 may use the unique portion to derive one or more transformation functions between the patient space and the image space for the unique shape. The navigation computer 110 may then use the derived one or more transformation functions to infer an updated posture of the tumor tissue relative to each image due to brain shift. In this way, a system according to the present disclosure can help account for brain shift that occurs during a resection procedure.

[0082] Based on the known spatial relationship between tumor tissue and important / eloquent structures (e.g., sensorimotor cortex, language cortex, subcortical structures (e.g., basal ganglia and internal capsule) collected from the images, the navigation computer 110 can derive one or more transformation functions for determining a revised pose of one or more landmark structures affected by brain shift. In one example, the navigation computer 110 can be configured to derive transformation functions for landmark structures within a threshold range of tumor tissue. In other words, in the example provided, the navigation computer 110 can be configured to derive transformation functions for landmark structures that are most likely to be affected during the resection procedure.

[0083] refer to Fig.14 Once the navigation computer 110 has derived the transformation function for the characteristic portion of the tumor tissue, the navigation computer 110 may be configured to calculate a revised pose of one or more of the tumor tissue and / or landmark structures. Fig.14 As shown, the navigation computer 110 overlays a third mask 420 representing the calculated revised pose of the tumor tissue onto the one or more images. Fig.14 Not shown in FIG. 1 , the navigation computer 110 may also be configured to overlay one or more graphical representations of the revised poses of the calculated landmark structures that are at greatest risk of being affected during the resection procedure.

[0084] refer to Fig.15, the navigation computer 110 can be configured to display a graphical user interface (GUI) 137, which includes a 3D point cloud 504 containing the measured fluorescence intensity of PpIX of the resected tissue, a 3D model of the resected tumor tissue 520, and a 3D model of the tumor tissue 530. The 3D point cloud can be generated based on the posture of the surgical instrument (i.e., the suction tool 156 and / or the bipolar forceps 160) and the detected fluorescence level. The navigation computer 110 can draw various points with different levels of RGB (red, green, blue) graphics to represent different detected fluorescence levels. For example, the navigation computer 110 can draw red points to indicate that the fluorescence intensity of PpIX is greater than or equal to a first threshold (i.e., the tissue corresponds to tumor tissue), green to indicate that no fluorescence is detected or the fluorescence intensity of PpIX is lower than a second threshold (i.e., the tissue corresponds to healthy tissue), or other colors to indicate that the fluorescence intensity of PpIX is less than the first threshold but greater than or equal to the second threshold (i.e., the tissue type cannot be easily determined from the fluorescence level). The 3D point cloud 504 with different levels of RGB indicators can better help healthcare professionals understand the heterogeneity of tumor tissue. The 3D point cloud 504 can also generate various shapes / patterns to represent different fluorescence intensity levels of PpIX. Healthcare professionals can gather additional knowledge about where the most invasive and cancerous cells exist and where tumor tissue is most likely to occur based on the 3D point cloud 504.

[0085] exist Fig.15 In the 3D point cloud 504, the solid circle 508 indicates that the fluorescence intensity of PpIX is greater than or equal to the first threshold, the hollow circle 512 indicates that no fluorescence is detected or the fluorescence intensity of PpIX is lower than the second threshold, and the square 510 indicates that the fluorescence intensity of PpIX is less than the first threshold but greater than or equal to the second threshold (i.e., a medium level of fluorescence is detected). Based on the point cloud data, the navigation computer 110 can generate a 3D model of the resected tumor tissue 520. For example, the navigation computer 110 can generate a convex hull based on the 3D point cloud 504 (particularly 3D point cloud data in which the fluorescence intensity of PpIX is greater than or equal to the first threshold). A healthcare professional can compare the shape of the 3D model of the resected tumor tissue with the shape of the 3D model of the tumor tissue 530 to evaluate the resection status.

[0086] refer to Fig.16 and 17, two flow charts illustrating methods implemented by the neurosurgical system 100 are shown. It will be appreciated from the following description that these methods merely represent exemplary, non-limiting flow charts describing specific methods implemented by the neurosurgical system 100. These methods are by no means intended to be a complete or universal method implemented by the neurosurgical system 100. Although the method is illustrated as ending, the method may return to the beginning and be executed as a continuous loop.

[0087] Special References Fig.16 , describing method 600. At 604, method 600 can receive one or more medical images. At 608, method 600 can segment tumor tissue of the medical image. At 612, method 600 can perform image / patient registration. At 612, method 600 can track the posture of one or more of the surgical instruments (e.g., suction tool 156 or bipolar forceps 160). At 620, method 600 can receive collected light from target area 402. At 624, the method can determine fluorescence intensity. At 628, method 600 can determine whether the tissue corresponds to tumor tissue or healthy tissue based on the fluorescence intensity. At 632, method 600 can overlay one or more indicator marks onto the one or more medical images, and the method can end or continue back to 604.

[0088] Special References Fig.17 , wherein method 700 is depicted. At 704, method 700 may receive one or more medical images and segment tumor tissue of the medical images. At 708, method 700 may perform image / patient registration. At 712, method 700 may track the posture of one or more of the surgical instruments (e.g., suction tool 156 or bipolar forceps 160). At 716, method 700 may receive the collected light from the target area. At 720, the method may determine the fluorescence intensity. At 724, method 700 may determine whether the fluorescence intensity is less than a first threshold. If so, method 700 may continue at 728; otherwise, method 700 continues to 732. At 728, method 700 may draw 3D points with a first color and / or a first symbol based on the posture of one of the surgical instruments, and continue to 744. At 744, method 700 determines whether input to generate a model has been received from a healthcare professional. If so, method 700 may continue to 748 where method 700 generates a model based on the 3D point cloud. If no input is received from the healthcare professional to generate a model, method 700 may end or continue back to 704.

[0089] At 732, method 700 may determine whether the fluorescence intensity is less than a second threshold. If so, method 700 may continue at 736; otherwise, method 700 may continue to 740. At 736, method 700 may draw the 3D point with a second color and / or a second symbol based on the pose of one of the surgical instruments, and method 700 may continue to 744. At 740, method 700 may draw the 3D point with a third color and / or a third symbol based on the pose of one of the surgical instruments, and the method may continue to 744.

[0090] Although several of the functions, features, and processes described above are described with reference to brain surgeries or procedures, it will be appreciated that these functions, features, and processes may also be applied to other human organs. In other words, the navigation computer 110 may be configured to track resection status and / or account for organ displacement during a resection procedure, including alternative organs, as described above.

[0091] The broad teachings of the present disclosure can be implemented in many forms. Therefore, although the present disclosure includes specific examples, the true scope of the present disclosure should not be limited thereto, because other modifications will become apparent after studying the drawings, the specification and the following claims. It should be understood that one or more steps in the method can be performed in different orders (or simultaneously) without changing the principles of the present disclosure. In addition, although each example is described above as having certain features, any one or more of those features described for any example of the present disclosure can be implemented in the features of any other example and / or combined with the features of any other example, even if the combination is not explicitly described. In other words, the examples described are not mutually exclusive, and the permutation or combination of one or more examples with each other is still within the scope of the present disclosure.

[0092] Spatial and functional relationships between elements (e.g., between controllers, circuit elements, semiconductor layers, etc.) are described using various terms, including "connected," "engaged," "coupled," "adjacent," "next to," "on," "above," "below," and "arranged." Unless explicitly described as "directly," when the relationship between a first and a second element is described in the above disclosure, the relationship may be a direct relationship in which there are no other intervening elements between the first and second elements, or an indirect relationship in which there are one or more intervening elements (spatially or functionally) between the first and second elements.

[0093] As used herein, the phrase "at least one of A, B, and C" should be interpreted to mean a logical (A OR B OR C), using a non-exclusive logical OR, and should not be interpreted as "at least one of A, at least one of B, and at least one of C". The term subset does not necessarily require a true subset. In other words, a first subset of a first set may be contiguous (equal) to the first set.

[0094] In a diagram, the direction of an arrow (as indicated by the arrow) generally indicates the flow of information (e.g., data or instructions) of interest to the diagram. For example, when component A and component B exchange multiple types of information, but the information transmitted from component A to component B is relevant to the diagram, an arrow may be directed from component A to component B. This unidirectional arrow does not mean that no other information is transmitted from component B to component A. In addition, for information sent from component A to component B, component B may send a request or a receipt confirmation to component A for the information.

[0095] In this application, including the following definitions, the term "controller" or "module" may be replaced with the term "circuit". The term "controller" may refer to, be part of, or include: an application specific integrated circuit (ASIC); a programmable system on chip (PSoC); a digital, analog, or analog / digital hybrid discrete circuit; a digital, analog, or analog / digital hybrid integrated circuit; a combinational logic circuit; a field programmable gate array (FPGA); a processor circuit (shared, dedicated, or group) that executes code; a memory circuit (shared, dedicated, or group) that stores code executed by the processor circuit; other suitable hardware components that provide the described functionality; or a combination of some or all of the above, such as a system on a chip.

[0096] The controller may include one or more interface circuits with one or more transceivers. In some examples, the interface circuit may implement a wired or wireless interface connected to a local area network (LAN) or a wireless personal area network (WPAN). Examples of LANs are Institute of Electrical and Electronics Engineers (IEEE) Standard 802.11-2016 (also known as the WIFI wireless network standard) and IEEE Standard 802.3-2015 (also known as the ETHERNET wired network standard). Examples of WPANs are the BLUETOOTH wireless network standard of the Bluetooth Special Interest Group and IEEE Standard 802.15.4.

[0097] The controller can use the interface circuit to communicate with other controllers. Although the controller may be depicted as logically communicating directly with other controllers in the present disclosure, the controller can actually communicate through the communication system in different embodiments. The communication system may include physical and / or virtual network devices, such as hubs, switches, routers, gateways, and transceivers. In some embodiments, the communication system is connected to or traverses a wide area network (WAN) such as the Internet. For example, the communication system may include multiple LANs interconnected by the Internet or point-to-point dedicated lines using technologies such as Multiprotocol Label Switching (MPLS) and virtual private networks (VPNs).

[0098] In various embodiments, the functionality of a controller may be distributed among multiple controllers connected by a communication system. For example, multiple controllers may implement the same functionality distributed by a load balancing system. In yet another example, the functionality of a controller may be divided between a server (also referred to as a remote or cloud) controller and a client (or user) controller.

[0099] Some or all of the hardware features of the controller may be defined using a hardware description language, such as IEEE Standard 1364-2005 (commonly referred to as "Verilog") and IEEE Standard 1076-2008 (commonly referred to as "VHDL"). Hardware description languages ​​may be used to manufacture and / or program hardware circuits. In some embodiments, some or all of the functions of the controller may be defined by a language, such as IEEE 1666-2005 (commonly referred to as "SystemC"), which contains both code (described below) and hardware descriptions.

[0100] As described above, the term "code" may include software, firmware, and / or microcode, and may refer to a program, a routine, a function, a class, a data structure, and / or an object. The term shared processor circuit includes a single processor circuit that executes some or all of the code from multiple controllers. The term "group processor circuit" includes such a processor circuit that, in combination with other processor circuits, executes some or all of the code from one or more controllers. References to multi-processor circuits include multiple processor circuits on discrete chips, multiple processor circuits on a single chip, multiple cores of a single processor circuit, multiple threads of a single processor circuit, or a combination of the above. The term "shared memory circuit" includes a single memory circuit that stores some or all of the code from multiple controllers. The term "group memory circuit" includes a memory circuit that is combined with other memories to store some or all of the code from one or more controllers.

[0101] The term memory circuit is a subset of the term computer-readable medium. The term computer-readable medium as used herein does not cover transient electrical or electromagnetic signals propagated through a medium (e.g., a carrier wave); therefore, the term computer-readable medium may be considered to be tangible and non-transient. Non-limiting examples of non-transitory computer-readable media are non-volatile memory circuits (e.g., flash memory circuits, erasable programmable read-only memory circuits, or mask read-only memory circuits), volatile memory circuits (e.g., static random access memory circuits or dynamic random access memory circuits), magnetic storage media (e.g., analog or digital tapes or hard drives), and optical storage media (e.g., CDs, DVDs, or Blu-ray discs).

[0102] The apparatus and methods described in this application may be implemented in part or in whole by a special-purpose computer created by configuring a general-purpose computer to perform one or more specific functions embodied by a computer program. The functional blocks and flow chart elements described above may serve as software specifications that may be converted into computer programs by the routine work of a skilled technician or programmer.

[0103] The computer program includes processor executable instructions stored on at least one non-transitory computer readable medium. The computer program may also include or rely on stored data. The computer program may include a basic input / output system (BIOS) that interacts with the hardware of the special-purpose computer, device drivers that interact with specific devices of the special-purpose computer, one or more operating systems, user applications, background services, background applications, etc.

[0104] A computer program may include: (i) descriptive text that needs to be parsed, such as HTML (Hypertext Markup Language), XML (Extensible Markup Language), or JSON (JavaScript Object Notation), (ii) assembly code, (iii) target code generated by a compiler from source code, (iv) source code for execution by an interpreter, (v) source code for compilation and execution by a just-in-time compiler, etc. By way of example only, the source code may be written in C, C++, C#, Objective-C, Swift, Haskell, Go, SQL, R, Lisp, Fortran, Perl, Pascal, Curl, OCaml, HTML5 (Hypertext Markup Language 5th Edition Revised Edition), Ada, ASP (Active Server Pages), PHP (PHP: Hypertext Preprocessor), Scala, Eiffel, Smalltalk, Erlang, Ruby, Visual Lua, MATLAB, SIMULINK, and The grammar of the language included is written.

Claims

1. A neurosurgical method for determining resection status during a tumor resection procedure, the method comprising: acquiring at least one medical image of a human organ including a tumor; Determining the posture of a suction tool relative to a target area of ​​a human organ based on a navigation tracker, the suction tool comprising at least one optical fiber and the navigation tracker, the target area comprising a tumor and a margin area around the tumor; generating excitation light so that the at least one optical fiber can use the excitation light to excite a target area of ​​a human organ; receiving from the at least one optical fiber the collected fluorescent light emitted from the target area and associated with the posture of the suction tool; determining, based on the collected fluorescence associated with the gesture of the suction tool, whether tissue in the target area and associated with the gesture of the suction tool corresponds to a tumor; and Based on the determination of whether the tissue corresponds to a tumor and the posture of the suction tool, a resection status of the target area is displayed with respect to the at least one medical image.

2. The neurosurgical method according to claim 1, wherein: Displaying the resection status includes alerting the healthcare professional to any remaining portions of the tumor.

3. The neurosurgical method according to claim 1 or 2, wherein: Displaying the resection status includes: in response to determining that the tissue corresponds to a tumor, overlaying a first indicator mark on the at least one medical image of the human organ based on the posture of the suction tool, and in response to determining that the tissue does not correspond to the tumor, overlaying a second indicator mark on the at least one medical image of the human organ based on the posture of the suction tool.

4. The neurosurgical method according to claim 3 further includes generating a 3D model of the brain, wherein the first indicator mark and the second indicator mark are displayed as a point cloud model relative to the 3D model.

5. The neurosurgical method according to any one of claims 1-4, further comprising storing a posture of the suction tool and an associated determination of whether the tissue is a tumor as resection data. 6 . The neurosurgical method according to claim 5 , further comprising calculating at least one of: a volume of remaining tissue corresponding to the tumor, and a volume of resected tissue corresponding to the tumor based on the resection data. 7 . The neurosurgical method of claim 6 , further comprising calculating the extent of resection based on at least one of the volume of the tissue corresponding to the tumor that remains and the volume of the tissue corresponding to the tumor that has been resected.

8. The neurosurgical method according to any one of claims 1-7 further includes storing the following as resection data: characteristics of fluorescence emitted from the target area collected in each of a plurality of stored postures of the suction tool relative to the target area, and an associated determination of whether the tissue associated with the stored posture corresponds to a tumor.

9. The neurosurgical method according to any one of claims 1 to 8, wherein: The human organ is a brain, and the method further comprises accounting for displacement of at least a portion of the brain occurring during the resection procedure.

10. The neurosurgical method according to claim 9, wherein: Considering the displacement of at least a portion of the brain includes predicting a posture of the tumor relative to the at least one medical image based on resection data indicating the following: at each of a plurality of stored postures of the suction tool relative to the target area, an associated determination is made based on collected fluorescence emitted from the tissue as to whether tissue of the target area associated with the stored posture corresponds to a tumor.

11. The neurosurgical method according to claim 10, wherein: Predicting the tumor's posture includes: matching a portion of the resection data to a portion of the contour of the tumor; and Based on the portion of the resection data that has been matched to the portion of the contour of the tumor, a pose of the tumor is inferred relative to the at least one medical image.

12. A neurosurgical system for determining a resection status during a tumor resection procedure, the neurosurgical system comprising: a suction tool configured to apply suction to a target area of ​​a patient, the target area comprising tumor tissue, the suction tool comprising a suction cannula defining a lumen, and the suction tool comprising a navigation tracker; an optical fiber coupled to the aspiration cannula, the optical fiber being configured to collect fluorescent light emitted from the target area; an excitation source configured to emit excitation light having a wavelength that induces the fluorescence emitted from the target area; an optical device coupled to the optical fiber, the optical device being configured to convert fluorescent light emitted from the target area and collected by the optical fiber into an electrical signal; as well as A surgical navigation system configured to: receiving at least one medical image of a human organ including a tumor corresponding to the tumor tissue of the target region; determining a pose of the suction tool relative to the target area based on the navigation tracker; determining whether tissue in the target area corresponds to tumor tissue based on the collected fluorescence associated with the posture of the suction tool; as well as Based on the determination of whether the tissue in the target area corresponds to tumor tissue and the posture of the suction tool, at least one indicator is displayed relative to the at least one medical image.

13. The neurosurgical system of claim 12, wherein: The at least one indicator alerts the healthcare professional to any remaining portions of tumor tissue.

14. The neurosurgical system of claim 12, wherein: The surgical navigation system is configured to overlay a first indicator mark onto the at least one medical image of the human organ based on the posture of the suction tool in response to determining that the tissue corresponds to tumor tissue, and to overlay a second indicator mark onto the at least one medical image of the human organ based on the posture of the suction tool in response to determining that the tissue does not correspond to tumor tissue.

15. The neurosurgical system of claim 14, wherein: The first indicator mark and the second indicator mark are displayed as point cloud models relative to the 3D model of the human organ.

16. The neurosurgical system according to any one of claims 12 to 15, wherein: The surgical navigation system is configured to store the gesture of the suction tool and an associated determination of whether tissue associated with the gesture of the suction tool is a tumor as resection data.

17. The neurosurgical system of claim 16, wherein: The surgical navigation system is configured to calculate at least one of a volume of remaining tissue corresponding to the tumor tissue and a volume of resected tissue corresponding to the tumor tissue based on the resection data.

18. The neurosurgical system of claim 17, wherein: The surgical navigation system is configured to calculate the extent of resection based on the at least one of the volume of the remaining tissue corresponding to the tumor tissue and the volume of the resected tissue corresponding to the tumor tissue.

19. The neurosurgical system according to any one of claims 12 to 18, wherein: The human organ is a brain, and the surgical navigation system is configured to account for displacement of at least a portion of the brain that occurs during a resection procedure.

20. The neurosurgical system of claim 19, wherein: The surgical navigation system is configured to account for displacement of at least a portion of the brain by predicting a posture of the tumor tissue relative to the at least one medical image based on resection data indicating the following: in each of a plurality of stored postures of the suction tool, an associated determination is made based on collected fluorescence emitted from the tissue as to whether the tissue associated with the stored posture corresponds to tumor tissue.

21. The neurosurgical system of claim 20, wherein: Predicting the posture of tumor tissue includes: matching a portion of the resection data to a portion of the contour of the tumor; and Based on the portion of the resection data that has been matched to the portion of the contour of the tumor, a pose of the tumor tissue is inferred relative to the at least one medical image.

22. A neurosurgical method for determining resection status during a tumor resection procedure, comprising: navigating a suction tool including a navigation tracker to a target region corresponding to a segmented tumor of at least one medical image within a human organ, the target region including the tumor tissue and a margin region around the tumor tissue; determining a pose of the suction tool relative to the target area based on the navigation tracker; applying excitation light to the target area using an optical fiber coupled to an aspiration tool, the optical fiber being connected to an excitation source; Using a suction tool to remove tissue from the target area, while using an optical fiber to collect fluorescence from the target area; observing at least one virtual indicator marker overlaid onto at least one medical image of a human organ including the segmented tumor based on the posture of the suction tool and a surgical navigation system connected to the optical fiber to determine based on the collected fluorescence that tissue removed from the target area corresponds to tumor tissue; as well as The at least one virtual indicator is compared to the shape of the segmented tumor to determine whether any residual tumor remains.

23. A neurosurgical method for determining the resection status of a tumor target area, the method comprising: acquiring at least one medical image of a human organ including a tumor; determining a pose of a surgical tool including an optical fiber and a navigation tracker relative to a target region of a human organ, the target region including a tumor and a margin around the tumor; receiving an electrical signal representing fluorescence collected from the target area when the target area is excited with excitation light via the optical fiber; analyzing the electrical signal to determine one or more characteristics of the collected fluorescence; and Based on the one or more characteristics of the collected fluorescence and the posture of the surgical tool, a resection status of the target area is displayed relative to the at least one medical image.

24. A neurosurgical method for determining the extent of tumor material to be removed from a human organ, the method comprising: acquiring at least one medical image of a human organ including a tumor; navigating a surgical tool including a navigation tracker and at least one optical fiber within a human organ to a target region corresponding to a tumor of the at least one medical image; determining a pose of the surgical tool relative to the target area based on the navigation tracker; determining whether the tissue of the target area associated with the gesture of the surgical tool is a tumor based on the fluorescence emitted from the tissue; and Using a surgical navigation system, in response to determining that the tissue is a tumor, a first indicator mark is displayed overlaid on at least one medical image of a human organ based on the posture of the surgical tool, and in response to determining that the tissue is not a tumor, a second indicator mark is displayed overlaid on at least one medical image of a human organ based on the posture of the surgical tool.

25. A neurosurgical system for determining the extent of tumor material to be removed from a human organ, the neurosurgical system comprising: A surgical tool system comprising a surgical tool with a navigation tracker, the surgical tool being configured to remove tumor tissue from a target region of a human organ; an optical system including at least one optical fiber coupled to the surgical tool, the at least one optical fiber configured to illuminate a target area with excitation light and collect fluorescent light emitted from the target area, the optical system configured to convert the fluorescent light into an electrical signal; as well as A surgical navigation system configured to: receiving at least one medical image of a human organ including a tumor corresponding to the tumor tissue; determining a pose of a surgical tool relative to a target region of a human organ based on a navigation tracker; determining whether tissue in the target area associated with the gesture of the surgical tool is a tumor based on the electrical signal; and In response to determining that the tissue is a tumor, a first indicator mark is displayed overlaid on at least one medical image of a human organ based on the posture of the surgical tool, and in response to determining that the tissue is not a tumor, a second indicator mark is displayed overlaid on at least one medical image of a human organ based on the posture of the surgical tool.

26. A neurosurgical method for determining resection status during a tumor resection procedure, the method comprising: acquiring at least one medical image of a human organ including a tumor; Determining the posture of a suction tool relative to a target area of ​​a human organ based on a navigation tracker, the suction tool comprising at least one optical fiber and the navigation tracker, the target area comprising a tumor and a margin area around the tumor; generating excitation light so that the at least one optical fiber can use the excitation light to excite a target area of ​​a human organ; receiving from the at least one optical fiber the collected fluorescent light emitted from the target area; determining the intensity of the collected fluorescence; as well as A point cloud is generated based on the intensity of the collected fluorescence and the posture of the suction tool.

27. The neurosurgical method of claim 26, further comprising generating a 3D model based on the point cloud.

28. A neurosurgical method for accounting for organ displacement during a tumor resection procedure, the method comprising: acquiring at least one medical image of a human organ including a tumor; Determining the posture of a suction tool relative to a target area of ​​a human organ based on a navigation tracker, the suction tool comprising at least one optical fiber and the navigation tracker, the target area comprising a tumor and a margin area around the tumor; generating excitation light so that the at least one optical fiber can use the excitation light to excite a target area of ​​a human organ; receiving collected fluorescent light emitted from the target area from the at least one optical fiber at each posture of the suction tool; For each gesture of the suction tool, determining whether tissue in the target area associated with the gesture of the suction tool corresponds to a tumor based on the fluorescence collected at the gesture of the suction tool; and The posture of the tumor is predicted relative to the at least one medical image based on determining whether tissue in the target area associated with each posture of the suction tool corresponds to the tumor based on the fluorescence collected at the posture.

29. A neurosurgical system for accounting for organ displacement during a tumor resection procedure, the neurosurgical system comprising: an aspiration tool configured to apply suction to a target area of ​​a patient, the target area comprising tumor tissue, and the aspiration tool comprises a suction cannula defining a lumen, and the aspiration tool comprises a navigation tracker; an optical fiber coupled to the aspiration cannula, the optical fiber being configured to collect fluorescent light emitted from a target area; an excitation source configured to emit excitation light having a wavelength that induces the fluorescence emitted from the target area; an optical device coupled to the optical fiber, the optical device configured to convert fluorescent light emitted from the target area and collected by the optical fiber into an electrical signal; as well as A surgical navigation system configured to: receiving at least one medical image of a human organ including a tumor corresponding to the tumor tissue of the target region; determining a pose of the suction tool relative to the target area based on the navigation tracker; For each gesture of the suction tool, determining whether tissue in the target area associated with the gesture of the suction tool corresponds to tumor tissue based on the collected fluorescence associated with the gesture of the suction tool; and The posture of the tumor is predicted relative to the at least one medical image based on determining whether tissue in the target area associated with each posture of the suction tool corresponds to tumor tissue based on the fluorescence collected at the posture.

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