System and method for determining deployment orientation of medical device

Abstract

A medical system includes a control system configured to receive first imaging data of a patient anatomy and identify an anatomical target in the patient anatomy. The control system is additionally configured to generate a treatment zone having a first axis. The treatment zone includes an anatomical target. The control system is additionally configured to determine a deployment position of an elongate device configured to receive a medical instrument for treating an anatomical target. The deployment position is aligned with a first axis of the treatment zone.

Description

[0001] Cross-referenced applications

[0002] This application claims priority to and the benefit of U.S. Provisional Application No. 63 / 356,902, filed on June 29, 2022, and entitled “Systems and Methods for Determining a Deployment Location of a Medical Instrument,” which is incorporated herein by reference in its entirety. Technical Field

[0003] Examples described herein relate to systems and methods for determining a deployment orientation of a medical device, such as systems and methods for planning a treatment volume that includes an anatomical target in a patient's anatomy to determine an optimal deployment orientation for a medical device that is aligned with the treatment volume. Background Art

[0004] Minimally invasive medical techniques are intended to reduce the amount of tissue damaged during medical procedures, thereby reducing patient recovery time, discomfort, and harmful side effects. Such minimally invasive techniques can be performed through natural orifices in the patient's anatomical structure or through one or more surgical incisions. Through these natural orifices or incisions, the operator can insert minimally invasive medical tools to reach the target tissue location. Minimally invasive medical tools include instruments such as treatment, diagnosis, biopsy, and surgical instruments. Minimally invasive medical tools can also include imaging instruments such as endoscopic instruments. Imaging instruments provide users with a field of view within the patient's anatomical structure. Some minimally invasive medical tools and imaging instruments can be remotely operated or otherwise computer-assisted. These tools and instruments can be registered with image data of the patient's anatomical structure to improve performance. Summary of the invention

[0005] The following presents a simplified summary of various examples described herein and is not intended to identify key or critical elements or to delineate the scope of the claims.

[0006] In accordance with some examples, a medical system is provided. The medical system includes a control system configured to receive first imaging data of a patient's anatomy, identify an anatomical target in the patient's anatomy, and generate a treatment volume having a first axis. The treatment volume includes the anatomical target. The control system is further configured to determine a deployment position of an elongated device configured to receive a medical device for treating the anatomical target. The deployment position is aligned with the first axis of the treatment volume.

[0007] In accordance with some examples, a medical system is provided. The medical system includes an elongated device configured to receive a medical device within the elongated device. The medical system further includes a control system configured to receive first imaging data of a patient's anatomical structure, identify an anatomical target in the patient's anatomical structure, and generate a treatment zone having a first axis. The treatment zone includes the anatomical target. The control system is further configured to determine a deployment range of the elongated device based on the first axis of the clinical treatment zone.

[0008] In accordance with some examples, a medical system is provided. The medical system includes an elongated device configured to receive a medical device within the elongated device. The medical system further includes a control system configured to receive first imaging data of a patient's anatomical structure, identify an anatomical target in the patient's anatomical structure, determine a deployment range of the elongated device, and generate a composite treatment volume based on the deployment range. The composite treatment volume includes the anatomical target.

[0009] In accordance with some examples, a method is provided. The method includes receiving first imaging data of an anatomical structure of a patient, receiving information identifying an anatomical target in the anatomical structure of the patient, generating a treatment volume including the anatomical target, and determining a first axis of the treatment volume to identify a deployment orientation of an elongated device. The deployment orientation is aligned with the first axis of the treatment volume.

[0010] In accordance with some examples, a medical system is provided. The medical system includes a display system, an elongated device, a medical instrument configured to extend within the elongated device, and a control system communicatively coupled to the display system. The control system is configured to display a graphical user interface via the display system. The graphical user interface includes a virtual navigation view. The control system is further configured to display an image of the elongated device in the virtual navigation view, display an anatomical target in the virtual navigation view, and generate a treatment zone having a first axis. The treatment zone includes the anatomical target. The control system is further configured to determine a deployment orientation of the elongated device. The deployment orientation is aligned with the first axis of the treatment zone.

[0011] Other examples include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each configured to perform the actions of the method.

[0012] It should be understood that both the foregoing general description and the following detailed description are illustrative and explanatory in nature, and are intended to provide an understanding of the various examples described herein without limiting the scope of the various examples described herein. In this regard, additional aspects, features and advantages of the various examples described herein will be apparent to those skilled in the art through the following detailed description. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] Figure 1A patient anatomy including an anatomical target according to some examples is described.

[0014] Figure 2A and Figure 2B A graphical user interface in a planning or navigation mode is illustrated according to some examples.

[0015] Figure 3A-3C A graphical user interface in a planning or navigation mode is illustrated according to some examples.

[0016] Figure 4 A system including a control map for creating a treatment plan is described according to some examples.

[0017] Figure 4A Methods for determining a clinical treatment zone according to some examples are described.

[0018] Figure 4B Methods for determining one or more ablation zones covering an optimal treatment area are described according to some examples.

[0019] Figure 5A and Figure 5B Alternative methods for determining one or more composite treatment zones according to some examples are described.

[0020] Figure 6 An image of a medical device registered with an anatomical model according to some examples is illustrated.

[0021] Figure 7 A graphical user interface for displaying intraoperative external imaging data and a pathway view according to some examples is described.

[0022] Fig. 8A A graphical user interface for adjusting a size or shape of one or more ablation zones is described according to some examples.

[0023] Figure 8B and Figure 8C A graphical user interface for adjusting a position of a medical tool according to some examples is described.

[0024] Fig. 9 Optional methods for planning a medical procedure and navigating a medical device during a medical procedure are described according to some examples.

[0025] Fig.10 is a simplified diagram of a robotic-assisted medical system according to some examples.

[0026] Fig.11 is a simplified diagram of a medical device system according to some examples.

[0027] The various examples described herein and their advantages are described in the following detailed description.It should be understood that for purposes of illustrating but not limiting the various examples described herein, like reference numerals are used to identify like elements illustrated in one or more figures. DETAILED DESCRIPTION

[0028] The techniques disclosed in this document can be used to enhance the workflow of minimally invasive procedures (such as ablation procedures). In some examples, the optimal deployment position of a medical device can be determined to ensure full coverage of a clinical treatment area provided by the medical device. In some examples, image data generated by one or more intraoperative external imaging devices can be used to refine the position of medical devices, tools, anatomical structures, and / or targets in a model constructed by preoperative imaging.

[0029] Figure 1 is an illustration of a patient anatomy 100, specifically a lung 106 of the patient, including an airway 102 and an anatomical target 108, such as a lesion or nodule of interest having a margin 110 surrounding the anatomical target 108. The patient anatomy 100 includes surrounding anatomical structures, such as blood vessels, organs, pleura, fissures, etc. (not shown) proximate to the lung 106. A medical device 104 may be navigated through the airway 102 to the anatomical target 108 to perform a medical procedure, such as diagnosis, biopsy, treatment, identification, examination, etc. For treatment of the anatomical target 108, treatment planning may be performed to optimize the ideal delivery of a treatment device to provide optimal treatment.

[0030] Figure 2A-Figure 3C In method 160 ( Figure 4A ) during execution of a graphical user interface (GUI) 300 in a planning or navigation mode. Figure 2A and Figure 2B , the display system 200 can display an image 205 that represents an area surrounding an anatomical target 220 (eg, target 108), an edge 230 (eg, edge 110), and a critical structure (eg, Figure 1 205 ). In some examples, image 205 shows a deployment range 210 of a medical device, such as medical device 104. Image 205 may additionally show target 220, edge 230, clinical treatment area 235, long axis 225 of clinical treatment area 235, ablation zone 240, long axis 245 of ablation zone 240, and one or more key structures 260 (e.g., heart, blood vessels, and / or airways). In some examples, image 205 may also show one or more anatomical structures, such as a fissure in a lung or the pleura.

[0031] refer to Figure 3A-3C, GUI 300 (which may be displayed on a display (e.g., display 200)) includes a virtual navigation view 310. Virtual navigation view 310 may illustrate a medical device 312 (e.g., medical device 104), one or more anatomical corridors 316, an anatomical target 320 (e.g., target 108), a deployment range 315 of medical device 312, a longitudinal axis A of medical device 312, an edge 330, a clinical treatment area 335 (e.g., clinical treatment area 235), a long axis 325 of clinical treatment area 335, an ablation zone 340, a long axis 345 of ablation zone 340, and a probe safety edge 355.

[0032] In some examples, the different regions, axes, and features discussed above can be displayed in the image with different colors. For example, the target can be shown in one color (e.g., blue), and the edge can be shown in another color (e.g., yellow). Any other color can be used to display the different regions, axes, and features discussed above. In some examples, the different regions, axes, and features discussed above can be displayed in the image with different patterns, symbols, reference numerals, or any other graphical identifiers.

[0033] although Figure 2A-Figure 3C , it will be appreciated that GUI 300 may display any number of views in any arrangement and / or on any number of screens. In some examples, the number of concurrently displayed views may be varied by turning views on and off, minimizing and maximizing views, moving views between the foreground and background of GUI 300, switching between screens, and / or otherwise completely or partially obscuring views. Similarly, the arrangement of views, including their size, shape, orientation, ordering (in the case of overlapping views), etc., may vary and / or may be user-configurable. Although described above in the context of a planning procedure, GUI 300 may be displayed during the planning phase, the navigation phase, or both the planning and navigation phases of the procedure.

[0034] In some examples, a control system or processing system can be used to identify and determine anatomical targets, margins, critical structures, various zones, and deployment ranges for determining an optimal deployment orientation to create an ablation plan to optimize ablation therapy.

[0035] Figure 4A system including a display system 120 (e.g., display system 200 / 300) is described, which is coupled to a control system 125 or a processing system including one or more processors. According to some examples, the control system 125 can perform a process according to a control map 130 for creating an optimization framework for a treatment plan. The optimization process described herein is described as a set of parameters for performing a process that can be performed sequentially or simultaneously. In some examples, one or more of the described processes can be omitted. Additionally, one or more processes that are not explicitly described can be included before, after, between, or as part of the described process. In some examples, one or more of the processes can be implemented at least in part by a control system (e.g., control system 125) executing code stored on a non-transitory, tangible machine-readable medium, which code, when executed by one or more processors (e.g., a processor of a control system (such as control system 125)), can cause the one or more processors to perform one or more of the processes.

[0036] like Figure 4 As shown, the control map 130 includes a set of initial input parameters 132, a set of optimization parameters 134, and a set of output parameters 136. The initial input parameters 132 may include a clinical treatment area 132A (e.g., clinical treatment area 235), a critical structure 132B (e.g., critical structure 260), an anatomical airway 132C (e.g., anatomical airway 102), and device information 132D (e.g., information of the medical device 104). Once the input parameters 132 have been defined, the control system 125 can use the input to determine the optimization parameters 134. The optimization parameters 134 may include an optimal clinical treatment area 134A, a deployment range 134B of the device 104 (e.g., deployment range 210), and one or more ablation zones 134C (e.g., ablation zone 240). Based on the optimization parameters 134, the control system 125 may determine one or more of the output parameters 136. The output parameters 136 may include one or more deployment postures 136A and one or more deployment paths 136B.

[0037] Figure 4AA flowchart of a method 160 for determining a clinical treatment area is provided to illustrate the method according to some examples. The method 160 and other methods described herein are described as a set of operations or processes that can be performed in the same or different order as shown in the figure. In some examples of the method, one or more of the processes described may be omitted. Additionally, one or more processes not explicitly described in the flowchart may be included before, after, between, or as part of the process described. In some examples, one or more of the processes in the flowchart may be implemented at least in part by a control system that executes code stored on a non-transitory, tangible machine-readable medium, which, when executed by one or more processors (e.g., a processor of a control system), may cause one or more processors to execute one or more of the processes.

[0038] At process 162, imaging data of the patient's anatomical structure is received. The imaging data may be received at the control system 125. The imaging data may be preoperative imaging data. For example, a CT scan of the patient's anatomical structure (which may be a cone beam CT scan) may be performed with a CT scanner, and the CT image data may be received by the control system 125. Alternatively, the preoperative imaging data may be received from other types of imaging systems, including magnetic resonance imaging (MRI) systems, fluoroscopic systems, or any other suitable method for obtaining the size of the anatomical structure. At process 163, the anatomical airways are segmented from the imaging data of the patient's anatomical structure. The anatomical airways may be identified in the imaging data of the patient's anatomical structure. In some examples, a model of the anatomical airways may be generated based on the segmented anatomical airways. Various segmentation functions may be used to create the model. In some examples, the segmentation function may rely on a set of seed points selected by a user. For example, a clinician may view the imaging data of the patient's anatomical structure and manually select seed points that identify one or more anatomical airways within the patient's anatomical structure. Additionally or alternatively, one or more processors (eg, one or more image processors) of the control system 125 may identify anatomical airways in the patient's anatomy and set seed points for the segmentation function based on the identified anatomical airways.

[0039] At process 164, a target (e.g., target 108) may be identified in the patient's anatomy. In some examples, such as Figure 3AAs illustrated, a target 108 is identified in preoperative imaging data of the patient's anatomy. For example, the target 108 may be identified in a CT slide as shown in window 305 as a region of interest for investigation and / or treatment. The target 108 may be automatically identified by the control system 125 and confirmed by the user, or the target 108 may be visually identified by the user and manually selected or indicated in the 3D model 106, for example, via the display system 100. In some examples, the control system 125 and / or the user may determine one or more parameters of the target 108 based on the imaging data. For example, the long axis, density, hardness, and / or any other physical property of the target 108 may be determined.

[0040] At process 166, key structures near the target 108, such as organs (e.g., heart), blood vessels, and / or nearby anatomical passages (e.g., airways of the lungs) may also be identified in the imaging data. Additionally or alternatively, tissue characteristics of the patient's anatomical structure (e.g., percentage of emphysema, fibrosis, necrotic tissue, etc. surrounding the target) and / or other anatomical structures, such as fissures or pleura of the lungs, may be identified in the imaging data. In some examples, a safety score for one or more of the key structures may be determined. The safety score may be determined based on the size of the structure, the proximity to the target 108, the potential heat dissipation effect during ablation, and / or any one or more additional similar factors. In some examples, a target block around the target 108 may be determined. The target block may be a sphere or ellipsoid centered on the target 108. The target block may have a radius of 5 cm, 10 cm, 15 cm, or any other suitable radius.

[0041] In some examples, such as Figure 3A-3C As illustrated in window 310 of , a 3D model of the anatomical structure (e.g., anatomical model 106) may be constructed from preoperative imaging data by control system 125. Any one or more of targets 108, key structures (e.g., organs, vessels, nearby anatomical passages, etc.), anatomical passages (e.g., additional anatomical passages within a full lung), tissue features, or anatomical structures may be identified in 3D model 106 and / or from preoperative imaging data from which it was constructed.

[0042] At process 168, a clinical treatment volume 235 is determined. In some examples, clinical treatment volume 235 represents an area within the patient's anatomy to which treatment should be applied by a medical device, such as medical device 104. For example, clinical treatment volume 235 may be an area within the patient's anatomy to which treatment should be applied by an ablation probe, which may extend from medical device 104. Figure 2A and Figure 2B As shown, clinical treatment volume 235 may be defined by target 108 and surrounding margin 110 .

[0043] Edge 230 surrounds target 220 to act as a safety margin to ensure that all diseased cells are ablated. The size and shape of the edge can also be set to account for portions of target 220 that are not visible in image 205. Alternatively or additionally, the size of edge 230 can be set to account for any computational errors and / or implementation errors that may exist in determining the size and shape of target 220. Clinical treatment area 235 includes the area covered by target 220 and edge 230.

[0044] In some examples, edge 230 may be uniform around the entire target 220. For example, edge 230 may provide a 5 mm buffer around target 220. Edge 230 may provide any other size buffer, such as 3 mm, 8 mm, 10 mm, or any other size that may include a portion of target 220 that may not be visible in image 205. In some examples, one or more portions of edge 230 may be non-uniform around the entire target 220 and may be different lengths at different portions of target 220. For example, a portion of edge 230 may provide a 5 mm buffer, while another portion of edge 230 may provide a 3 mm buffer. Edge 230 may be non-uniform due to, for example, the type of target 220, the proximity of critical structure 260, the proximity of anatomical structures, or any other similar factors.

[0045] In some examples, the size of edge 230 can be automatically set and / or adjusted by a control system (e.g., control system 125) based on the type of target 220 to be ablated. For example, the control system can retrieve information from a target database that includes the sizes and other physical characteristics of different types of anatomical targets. Additionally or alternatively, an image processor of the control system can perform image analysis of image 205 to determine the size and shape of target 220.

[0046] In some examples, the size of edge 230 can be set and / or adjusted by the user. The size and / or shape of edge 230 can be adjusted or altered to account for patient movement (e.g., respiratory or circulatory motion) and / or deviation of the CT from the body. Figure 3A-3C , the control system may receive user input of the resize edge icon 372 via the target menu 370 of the GUI 300. In some examples, a table or menu (not shown) may be displayed in the GUI 300, which includes a list of spheres and / or ellipses with pre-specified sizes. The control system may receive user input selecting one or more of the spheres and / or ellipses. The selected sphere and / or ellipse may be displayed in the virtual navigation view 310. In some examples, the control system may receive user input via the GUI 300. Additionally or alternatively, the user input may be a numerical value defining a distance that the edge 330 should extend beyond the outer edge of the target 320.

[0047] In some examples, the control system adjusts edge 330. Edge 330 may be displayed in virtual navigation view 310 before or after any adjustments are made to the size / shape of edge 330. In some examples, the adjustments made to edge 330 may be shown as animations in virtual navigation view 310 to allow a user to visualize the changes made to edge 330. In examples where edge 330 is user adjustable, the control system may receive one or more user inputs indicating how to adjust edge 330 via a GUI such as GUI 300. In some examples, GUI 300 includes a touch screen. In such examples, the control system may receive user input indicating how to adjust edge 330 via a touch screen.

[0048] Return to reference Figure 4 In some examples, the control system 125 may receive user input indicating the type of treatment device (e.g., medical device 104) to be used for the procedure via the GUI 300. In some examples, the control system 125 may receive user input indicating ablation zone information (e.g., ablation zone size, orientation, location, etc.) with reference to one or more physical properties of the treatment device (e.g., bending stiffness, maximum bending angle, outer diameter, etc.). Alternatively, the user may enter the medical procedure information, and the system may recommend the type of treatment device based on the medical procedure. The device-specific information may be entered into the control system or saved and accessed through internal memory. In some examples, the user may enter clinical constraints including maximum total procedure time, maximum allowable energy delivery time per treatment, maximum allowable treatment power level, etc.

[0049] Using the input parameters 132 , optimized parameters 134 may be determined including an optimal clinical treatment zone 134A, a deployment range 134B (eg, deployment range 210 ), and one or more ablation zones 134C (eg, ablation zone 240 ). Figure 4B An example method 170 for determining optimization parameters 134 from input parameters 132 is described.

[0050] refer to Figure 4BAt process 171, one or more deployment ranges (e.g., deployment ranges 210 / 315) are determined based on the airway geometry and device information determined based on the input parameters 132. The deployment range 210 may be a boundary within which a medical device (e.g., medical device 104) can approach an anatomical target (e.g., target 108), thereby establishing an area that the medical device can reach. The deployment range may include a range of insertion depths of the medical device in three-dimensional space and an angular range in which the medical device can approach the anatomical target. In one example, the deployment range 210 may be established by determining a deployment posture that may include a deployment position and a deployment orientation. The deployment position is the parking position of the distal end or distal portion of a catheter (e.g., medical device 104), from which an instrument (such as an ablation probe) extends to perform treatment. The deployment orientation is the direction of the distal end of the catheter (e.g., medical device 104), from which an instrument (such as an ablation probe) extends to perform treatment. Additional descriptions of deployment postures will be provided below.

[0051] The deployment range 210 may indicate a boundary within which a medical device may approach an anatomical target 220 (e.g., target 108). In some examples, the deployment range 210 may be limited based on the mechanical properties of the medical device (e.g., bending stiffness, maximum bending angle, or outer diameter) defined by the type of medical device / medical probe and / or the physical properties of the anatomical passage (e.g., maximum bending angle or diameter). In some examples, the medical device 104 includes a therapeutic device, such as an ablation probe. In other examples, the medical device 104 may include a delivery device, such as a delivery catheter and a therapeutic device delivered through the lumen of the delivery catheter. In this case, the combined mechanical properties of both the delivery catheter and the medical device may affect the deployment range.

[0052] The boundaries and size of the deployment range 210 may be based on one or more constraints imposed by the anatomical channel in which the medical device is located. For example, when the medical device is located in an anatomical channel that includes a bend with a radius of curvature that is less than the maximum bend radius of the medical device, or if the diameter of the channel is less than the outer diameter of the medical device or is too small to allow the medical device to bend toward the target, then the medical device may not be able to be oriented toward the target outside of a certain range of angles. Other physical characteristics of the channel may affect the ability of the medical device to pass through the channel. One or more of these constraints may limit the available deployment orientations of the medical device. The size of the deployment range 210 is set to include some or all available deployment orientations in which the medical device can enter the target 220.

[0053] like Figure 3BAs shown, a deployment range 315 similar to the deployment range 210 discussed above can be established by initially aligning the longitudinal axis A of the medical device 312 with the long axis 325 of the clinical treatment area 335 such that the distal end 314 of the medical device 312 points along the long axis 325. The deployment range 315 can include all possible deployment orientations established by articulating the medical device 312 from an initial position in which such alignment between the medical device 312 and the long axis 325 of the clinical treatment area 335 establishes a cone or three-dimensional fan that creates the deployment range 315.

[0054] In some examples (not shown), when there may be multiple paths to the target 320 - for example, when the medical device 312 can approach the target 320 through different groups of multiple anatomical channels 316, multiple deployment ranges can be determined. For example, the deployment range 315 can be determined based on which group of anatomical channels 316 the medical device 312 can pass through to reach the target 320. If the target 108 is between two branches, if the medical device 104 approaches the target 108 from one branch through one path along a group of anatomical channels, then a deployment range can be established, and if the medical device 104 approaches the target 108 from a different branch through different paths along a group of at least some different anatomical channels, then a second deployment range can be established. Each of the available paths through different anatomical channels 102 includes a maximum bend angle that is less than the maximum bend radius of the medical device 104, but based on different geometries, different paths provide deployment ranges of different angles. The deployment range 315 can exclude paths that do not allow the longitudinal axis A of the medical device 312 to be aligned with the long axis 325 of the clinical treatment area 335.

[0055] Return to reference Figure 4B At process 172, an optimal treatment zone may be determined. The optimal treatment zone may be determined by adjusting the clinical treatment zone (e.g., the shape may be altered, the orientation may be shifted, the zone may be rotated, etc.) to take into account key structures (e.g., blood vessels, nearby airways, organs, etc.). For example, Figure 2A As illustrated, clinical treatment volume 235 is shown overlapping critical structure 260, resulting in a shift of clinical treatment volume 235 to form optimal treatment volume 235A. Additionally, in some examples where edge 230 can maintain an acceptable size for clinical treatment, the size and shape of clinical treatment volume 235 can be altered (not shown) to avoid one or more critical structures, such as the heart, blood vessels, nearby airways, the pleura of the lungs, the fissures of the lungs, and the borders of the lungs. For example, Figure 3BCritical structures 360 near target 320 are illustrated. Critical structures 360 may represent the boundaries of the lungs. In some examples, only critical structures located near target 320 are displayed in virtual navigation view 310. For example, critical structures within 15 cm of target 320 may be displayed. Any other proximity range (e.g., 5 cm, 10 cm, or 20 cm) may be used to determine which critical structures, if any, are displayed.

[0056] In some examples, the clinical treatment area 335 can be adjusted or shifted to account for the critical structure 360. For example, the long axis 325 of the clinical treatment area 335 can be laterally shifted away from the critical structure 360. In examples when the critical structure 360 ​​is a blood vessel, shifting the long axis 325 away from the blood vessel can avoid hemoptysis of the blood vessel. In other examples where the critical structure 360 ​​is a nearby airway, shifting the long axis 325 away from the airway can avoid undesirable cooling effects caused by airflow through the airway. In some examples, the shifted long axis 325 can be substantially perpendicular to the critical structure 360. In some examples, the clinical treatment area 335 can be rotated based on the position of the critical structure 360.

[0057] Return to reference Figure 4B In the method 170, at process 173, after adjusting the clinical treatment area 235 to create the optimal treatment area 235A, the long axis 225A of the optimal treatment area 235A is determined, such as Figure 2A The method 170 may then continue to process 180 where one or more ablation zones covering the optimal treatment zone 235A may be determined.

[0058] Ablation zone 240 represents a predicted area to be treated (e.g., ablated) by a medical device (such as an ablation probe) during a single treatment procedure, such as a single energy delivery over an uninterrupted duration during an ablation procedure. The area covered by ablation zone 240 can be an ablation patch. Additional uninterrupted energy delivery at different times and / or different locations can create additional individual ablation zones covering individual ablation patches. In some cases, individual ablation zones and ablation patches can be used, as will be described in more detail below.

[0059] The predicted size and shape of ablation zone 240 is based on the design configuration of the ablation probe, the amount of energy applied to the probe, the duration of energy applied to the probe, and one or more tissue characteristics of target 220 within which the ablation probe is deployed. The tissue characteristics of target 220 may include density, hardness, percentage of emphysema surrounding target 220, fibrosis, necrotic tissue, proximity to critical structure 260, or any other physical characteristic of target 220 or anatomical structures surrounding target 220. In some examples, in Figure 4AThe tissue properties are determined at process 168 of method 160. Thus, ablation zones of various shapes and sizes can be predicted by varying the power and duration of energy delivery at different ablation probe transducer locations within anatomical structures having different tissue properties.

[0060] In some examples, the optimal treatment zone 235A may be completely covered by one ablation zone. Figure 3B and Figure 3C An ablation zone 340 is illustrated. The size of ablation zone 340 can be set to be as small as possible while still fully covering clinical treatment zone 335. Reducing the size of ablation zone 340 can limit the impact of ablation therapy on anatomical structures surrounding clinical treatment zone 335, such as any critical structures that may be near target 320.

[0061] like Figure 3A-3C As shown, the ablation zone 340 is three-dimensional. The size and shape of the ablation zone 340 can be determined based on ablation parameters (such as power, time, and ablation probe insertion distance). If more than one ablation zone is required to completely ablate the clinical treatment area 335 (as will be described in more detail below), the ablation parameters required for each ablation zone may be different. In some examples, some or all of the ablation parameters may be adjusted by the user. For example, the control system may receive one or more user inputs to adjust one or more of the probe power icon 382, ​​the treatment time icon 384, and the probe insertion distance icon 386 via the probe menu 380 of the GUI 300. Additionally or alternatively, the ablation parameters may be adjusted by the control system.

[0062] In some examples, the maximum size of the ablation zone 340 may be determined based on the design of the ablation probe and the characteristics of the patient's anatomical structure near the target 320. For example, the control system may include or access a database that includes the characteristics of one or more different types of ablation probes that may come from different manufacturers or suppliers. Each ablation probe includes a set of physical characteristics, such as maximum length, diameter, maximum available power, or other physical characteristics. Based on these characteristics, each ablation probe has a maximum ablation zone size that each probe can generate. In some examples, a table of ablation zone sizes may be displayed in a GUI 300 showing various ablation zone sizes based on input characteristics such as input power, input duration, time, etc. The control system may select or receive user input selecting the type of ablation probe to be used for the treatment procedure as previously described via the GUI 300, and access (and in some examples display) a table of selected ablation probes. The GUI 300 may display the ablation zone 340 in the virtual navigation view 310, and the size of the ablation zone 340 may be set to the maximum ablation zone size based on the selected ablation probe. The size and / or shape of the ablation zone 340 may then be additionally adjusted by the control system and / or the user by changing the power setting, duration setting, or orientation of the ablation probe (which may change the center of the ablation zone 340).

[0063] In some examples, more than one energy delivery treatment (e.g., ablation treatment) is required. Therefore, the number, position, and orientation of multiple ablation zones can be determined. The size of the ablation zone can be set to minimize the total number of ablation zones required to cover the clinical treatment area 335. This can reduce the number of ablation treatments required to fully treat the target 320 and the edge 330, and can reduce the amount of healthy tissue ablated during the ablation treatment. In some examples, in order to obtain ablation zones of different sizes, the ablation treatment can have different power outputs and durations, and for each ablation treatment, the ablation probe can be inserted at different insertion distances.

[0064] Return to reference Figure 4B, process 180 is an example of an iterative process for determining one or more ablation zones to optimally cover the optimal treatment zone 235A. At process 174, an ablation zone 240 may be determined along the axis used. Initially, when process 174 is performed after process 173, the axis used is the long axis of the optimal treatment zone from process 173. The ablation zone 240 may be sized to cover the optimal clinical treatment zone 235, as shown in image 205. In some examples, the long axis 245 of the ablation zone 240 may coincide with the long axis 225A of the optimal treatment zone 235A. In some examples, the long axis 245 of the ablation zone 240 may be parallel or substantially parallel to the long axis 225 of the clinical treatment zone 235, but not coincident. In some examples, the long axis 225 of the clinical treatment zone 235 may coincide with the long axis of the target 220. In some examples, the long axis 225 of the clinical treatment zone 235 may be parallel or substantially parallel to the long axis of the target 220, but not coincident.

[0065] Return to reference Figure 4B At process 175, it is verified whether the ablation zone 240 fits within the deployment range 215. For example, the control system and / or the user may verify whether the ablation probe can be delivered to create the ablation zone 240 determined at process 174. If it is determined that the ablation zone 240 fits within the deployment range 315, the method 170 may proceed to process 177. If it is determined that the ablation zone 240 does not fit within the deployment range, the method 170 proceeds to process 176, in which the ablation zone 240 may be modified to fit within the deployment range 215. The position and orientation of the ablation zone 240 may be shifted and rotated, respectively, to adjust the position and orientation of the ablation zone 240 according to the deployment range 215. In some examples, the updated position or orientation may require adjustment of the size of the ablation zone 240 to continue to provide maximum coverage of the optimal treatment zone 235A. The control system can limit the maximum size of the ablation zone 240 during resizing based on the new position of the ablation zone 240 (e.g., updated proximity to key structures and tissue properties that affect the size of the ablation zone) as previously described. Once the ablation zone 240 has been updated to fit within the deployment range 215, the method 170 can proceed to process 177.

[0066] At process 177, the ablation zone 240 is verified to avoid the critical structure 260. If the ablation zone 240 avoids the critical structure 260, the method 170 may continue to process 179. If the ablation zone 240 overlaps with the critical structure 260, the method 170 continues to process 178, in which the ablation zone 240 is changed to avoid the critical structure 260. For example, the ablation zone parameters shown in the probe menu 280 can be adjusted based on the proximity of the ablation zone 240 to one or more critical structures (such as critical structure 260A). In some examples, if ablation is performed near one or more blood vessels and / or nearby airways, a heat dissipation or cooling effect can be created by blood flow through the blood vessels and / or air flow through the nearby airways. The blood vessels and airways can act as a heat sink / cooling mechanism and take away some of the heat from the ablation probe that would otherwise be applied to the target 220 and edge 230. In such examples, it may be necessary to increase treatment parameters, such as the power output of the ablation probe, the duration of the ablation treatment, or both, to ensure that the target 220 and the edge 230 are fully treated. In some examples, the ablation zone parameters may be adjusted based on tissue characteristics of the patient's anatomy within the ablation zone 240. For example, the density, hardness, material composition, or any other characteristics of the tissue within the ablation zone 240 may affect how much power the ablation probe should output and / or the duration of the ablation treatment to fully treat the target 220 and the edge 230. In some examples, the ablation zone 240 may be rotated based on the proximity of the ablation zone 240 to one or more critical structures 260.

[0067] Once the ablation zone has been sufficiently modified to avoid critical structures, method 170 may proceed to process 179 to determine whether ablation zone 240 completely covers optimal treatment zone 235A. If optimal treatment zone 235A is completely covered by ablation zone 240, such as Figure 2A As illustrated, the method 170 may then proceed to determine the output parameter 136. However, if the ablation zone 240 does not completely cover the optimal treatment zone 235A, the method 170 returns to process 174 to determine additional ablation zones based on the updated axis of use.

[0068] like Figure 2BAs shown, in some examples, more than one ablation zone 240A, 240B may be required to cover the entire edge 230. For example, due to the physical characteristics of the target 220, the anatomical structures surrounding the target 220, the program time constraints and / or the limitations of the ablation probe, more than one ablation treatment may be required to completely treat the optimal treatment zone 235A. Depending on the proximity of the critical structure 260, for example, one ablation zone 240 covering the entire optimal treatment zone 235A may require a certain amount of energy or time to complete the ablation treatment, which may cause damage to the surrounding critical structures 260. To avoid such damage, the size of the ablation zone 240 can be reduced and / or the shape of the ablation zone 240 can be adjusted or changed. For example, the treatment settings can be adjusted to provide less energy in a shorter time. In some examples, the orientation and / or insertion depth of the ablation probe can be adjusted, which can modify the size and / or shape of the ablation zone 240. For example, when the ablation probe is deployed from the medical device 104, the ablation probe can remain aligned with the longitudinal axis of the medical device 104. When the longitudinal axis of the medical device 104 is aligned with the long axis of the additional ablation zone and the ablation probe is deployed, the ablation probe may also be aligned with the long axis of the additional ablation zone. Additionally or alternatively, the ablation probe may be realigned as needed to align with the long axis of each additional ablation zone. The distal end of the medical device 104 may remain stationary while the ablation probe is bent to realign with the long axis of each additional ablation zone. When the ablation probe is aligned with the long axis of each additional ablation zone, a separate ablation treatment may be performed.

[0069] In another example, probe design constraints, proximity to critical structures such as blood vessels acting as heat sinks or airways acting as cooling mechanisms, and tissue types requiring higher power / durations may result in a smaller maximum ablation zone that does not fully treat the optimal treatment zone. Thus, if a smaller ablation zone, such as ablation zone 240A, does not surround the entire optimal treatment zone 235A, then additional ablation zone 240B may be required to fully treat the optimal treatment zone 235A. Thus, reference Figure 4B , method 170 may proceed to process 174, which includes determining the displacement axis and the size and shape of the additional ablation zone along the displacement axis. Figure 2B As shown, ablation zone 240A includes long axis 245A, and ablation zone 240B includes long axis 245B. In one example, ablation zone 240A may be displaced in one direction from the long axis of the optimal treatment zone, and additional ablation zones may be determined by identifying additional axes displaced in the opposite direction from the long axis of the optimal treatment zone, such as Figure 2BAs illustrated. As illustrated, one or both of the long axes 245A, 245B may be parallel or substantially parallel to the long axis 225 of the optimal treatment zone 235A. In some examples, one or both of the long axes 245A, 245B are not parallel or substantially parallel to the long axis 225 of the optimal treatment zone 235A. For example, one or both of the long axes 245A, 245B may be perpendicular or substantially perpendicular to the long axis 225.

[0070] Because the ablation zone has been displaced, the proximity to critical structures such as blood vessels / airways and the proximity to variable tissue types may have changed, resulting in a change in the size of the ablation zone. Therefore, a new size and shape of the ablation zone can be determined based on the new orientation. As previously described, the power setting and energy application duration can be changed to adjust the size and shape of each of the ablation zones 240A and 240B. Therefore, method 170 can continue through processes 175-179, changing the power, duration, orientation, and orientation of the ablation zone until both ablation zones 240A and 240B are within the deployment range 215 and avoid critical structures. At process 179, if the ablation zones 240A and 240B do not completely cover the optimal treatment zone 235A together, then process 180 can continue in a loop to add additional ablation zones and adjust the size and reposition of existing ablation zones until all ablation zones completely cover the optimal treatment zone 235A. Once all ablation zones completely cover the optimal treatment zone 235A, process 180 may continue to determine output parameters 136 .

[0071] In some examples, one or more of the resizing, shifting, and / or rotating of the ablation zone may be set by a user and / or may be automatically performed by a control system. Figure 5A Included is a flow chart illustrating method 174A, which is an alternative method for determining ablation zones. Figure 5B A flow chart illustrating method 174B is included, which is another alternative method for determining an ablation zone. Figure 2A , Figure 2B and Figure 3A-3C Methods 174A and 174B are described below. In some examples, each of methods 174A, 174B can be used to determine where an ablation zone should be placed. In some examples, either method 174A or method 174B can be used to determine where an ablation zone should be placed.

[0072] Referring to method 174A, at process 502, the control system receives a request to set an initial ablation zone (such as Figure 3AAs discussed above, the control system may receive input from the user to adjust the size or shape of the initial ablation zone as needed. In some examples, the input from the user may be a touch input on a touch screen of the display system 200. For example, when the touch input is received, a graphical indicator may be displayed via the GUI 300. Additionally or alternatively, the input from the user may be input from a mouse received by the control system. For example, a graphical indicator identifying the cursor position of the mouse may be displayed via the GUI 300. After setting the size and shape of the initial ablation zone, the control system may determine whether one or more additional ablation zones are needed based on the size and shape of the initial ablation zone at process 504.

[0073] Referring to method 174B, at process 506, the control system receives user input for setting an initial ablation zone (such as ablation zone 340). As discussed above, the control system may receive input from the user to adjust the size or shape of the initial ablation zone as needed. After setting the size and shape of the initial ablation zone, the control system may determine whether the size of the initial ablation zone is feasible at process 508. For example, the size of the initial ablation zone may be set based on the amount of power applied to the ablation probe. The control system may determine whether the ablation probe to be used to perform the ablation treatment is able to output the desired amount of power. If the ablation probe cannot output the desired amount of power, the control system may reduce the size of the initial ablation zone. The control system may automatically and / or in response to one or more user inputs to reduce the size of the initial ablation zone. For example, the control system may receive one or more user inputs of adjusting one or more of the probe power icon 382, ​​the treatment time icon 384, and the probe insertion distance icon 386 via the probe menu 380 of the GUI 300. Additionally or alternatively, the control system may automatically adjust one or more of the probe power, the treatment time, and the probe insertion distance. Automatic adjustments may modify the values ​​shown in the probe power icon 382 , the treatment time icon 384 , and / or the probe insertion distance icon 386 .

[0074] At process 510, the control system may determine whether the orientation of the initial ablation zone is safe. For example, the control system may determine that the initial ablation zone is placed too close to one or more critical structures 360 to safely perform ablation therapy. The control system may adjust the size of the ablation zone and / or shift the placement of the ablation zone to provide more space between the ablation zone and the critical structure 360. The control system may adjust the size of the ablation zone and / or shift the placement of the ablation zone automatically and / or in response to one or more user inputs. For example, the control system may receive one or more user inputs to adjust the size of the ablation zone and / or shift the placement of the ablation zone via the target menu 370 of the GUI 300. Additionally or alternatively, the control system may automatically adjust the size of the ablation zone and / or shift the placement of the ablation zone. Automatic adjustment / shifting may change the values ​​shown in the target menu 370.

[0075] After setting the size and shape of the initial ablation zone, the control system may determine whether one or more additional ablation zones are needed based on the size and shape of the initial ablation zone at process 512. In some examples, the control system may perform one or more of processes 508 and 510 for one, some, or all additional ablation zones that may be needed.

[0076] In some examples, the size of ablation zone 240 may be automatically set and / or adjusted or modified by the control system based on the size / shape of edge 230. For example, an image processor of the control system may perform an image analysis of image 205 to determine the size and shape of edge 230. In some examples, the size of ablation zone 240 may be set and / or adjusted or modified by a user.

[0077] In some examples, the following may be provided: Figure 2A and Figure 2B The illustrated probe safety margin 255. The probe safety margin 255 can take into account potential movement or displacement of the ablation probe position. For example, once the probe is placed in its final position prior to ablation, the actual deployment position of the probe may be slightly displaced. In some examples, the displacement may be caused by patient movement. The size and shape of the probe safety margin 255 can be set to surround the ablation zone 240.

[0078] If the probe shifts position, the probe may be easier to move in the axial direction than in the lateral direction. In some examples, the axial movement of the probe may be parallel or substantially parallel to the long axis 225 of the clinical treatment area 235. In some examples, the lateral movement of the probe may be perpendicular or substantially perpendicular to the long axis 225 of the clinical treatment area 235. Figure 2A and Figure 2BAs shown, because the probe may be more easily moved in the axial direction than in the lateral direction, the probe safety edge 255 can be sized to be longer in the axial direction than in the lateral direction. This can allow the probe to have greater potential movement in the axial direction than in the lateral direction.

[0079] In some examples, based on the probe safety margin 255, the control system can determine which (if any) critical structures 260 are at greater risk of being affected by the ablation procedure than other critical structures. Figure 2A and Figure 2B In FIG. 2 , critical structure 260A faces a greater risk than critical structure 260B because the distance between probe safety edge 255 and critical structure 260A is smaller than the distance between probe safety edge 255 and critical structure 260B.

[0080] Return to reference Figure 4B , after determining the optimization parameters, output parameters 136 can be identified based on the ablation zone. Output parameters 136 can be used to generate an optimized ablation treatment plan. Output parameters 136 can include one or more deployment postures (e.g., deployment posture 136A) of a medical device (e.g., medical device 104), which can include a delivery catheter and an ablation probe. As previously described, the deployment posture provides the position and orientation of a delivery catheter for delivering the ablation probe toward a target. By determining the optimal deployment posture, a minimum number of ablations can be performed to effectively treat lesions (e.g., anatomical target 108) and edges (e.g., edge 110), thereby reducing procedural time and improving procedural outcomes. After identifying the deployment posture, a deployment path (e.g., deployment path 136B) can be planned to help navigate the medical device to the desired deployment posture. The deployment path and deployment posture can be used to create an optimized ablation treatment plan.

[0081] To determine each of the deployed postures, each of the ablation zones (e.g., ablation zones 240 / 340) determined from process 180 of method 170 may be utilized. Each ablation zone is created by an ablation probe positioned within an optimal treatment zone (e.g., optimal treatment zone 235A). In some examples, the shape of the ablation zone is determined in part by the type and configuration of the ablation probe. Figure 2A-Figure 3C As illustrated, the ablation zone may be oval. Thus, by determining the desired position of the transducer centered about the long axis of the ablation zone, the deployment orientation of the delivery catheter may be determined along a line projected from the long axis. In some examples, the distance that the ablation probe may extend is set to a default insertion distance, or may be limited by mechanical constraints. Thus, the deployment position of the delivery catheter may be determined based on the default insertion distance.

[0082] Fig. 8A and Figure 8BGUI 300 is illustrated in a planning or navigation mode. Ablation probe 402 is shown extending from distal end 314 of medical device 312 by an insertion distance D1, which may be shown in icon 410 ( Figure 8B ). The insertion distance D1 can be measured from the distal end 314 of the medical device 312 to the distal end 404 of the ablation probe 402. In some examples, when the ablation probe 402 is extended from the medical device 312, the ablation probe 402 extends a known default insertion distance. The synthetic image of the ablation probe 402 can generate the insertion distance D1 based on the known default insertion distance. Fig. 8A As shown, the default insertion distance may be 10 mm, but may be 5 mm, 15 mm, or any other desired distance. In some cases, the insertion distance D1 may be adjusted, such as by a user via user input received at GUI 300 and / or automatically by a control system. Fig. 8A and Figure 8B Additional details of are discussed below.

[0083] In some examples, the available deployment postures of the medical device 312 within the deployment range 315 can orient the medical device 312 and / or a tool (such as an ablation probe) within the medical device 312 toward the target 320 in a direction perpendicular or substantially perpendicular to any critical structures near the target 320. This can help reduce the impact of treatment (such as ablation treatment) on critical structures. In examples where more than one ablation treatment is required to completely treat the clinical treatment area 335, the medical device 312 can perform treatment from the same deployment position within the deployment range 315 or from different deployment positions within the deployment range 315. In some examples, the different deployment positions may be located in different anatomical channels 316. In some examples, the deployment position 318 (e.g., deployment position 168) and / or deployment orientation (e.g., deployment orientation 170) of the medical device 312 is determined within the deployment range 315.

[0084] In some examples, the route of the medical device 312 through the patient's anatomy to the deployed position 318 can be automatically generated by the control system. Additionally or alternatively, the control system can generate the route based on one or more user inputs. In some examples, the route can indicate a path along which the medical device 312 can be navigated to be in close proximity to the target 320. In some examples, the route can be stored in the control system (e.g., stored in a memory of the control system) and incorporated into the image displayed on the GUI 300. A view of the planned path from the current or selected position of the distal end 314 of the medical device 312 can be provided as part of the GUI 300 ( Figure 7) is provided in a path view 415 in the anatomical passage 316. Path view 415 may provide a composite view from within anatomical passage 316 and may include graphical indicia (e.g., lines, arrows, etc.) indicating a path toward a target, such as target 320. Path view 415 may optionally depict structures outside the wall of the anatomical passage (such as the target) that would not be visible with an endoscope camera located within the anatomical passage.

[0085] In some examples, the patient anatomy may include more than one target. Figure 3C As shown, the virtual navigation view 310 can display more than one target, such as target 320, target 321, and target 322. Any other number of targets can be shown. The virtual navigation view 310 can also display corresponding edges for each target displayed. For example, a clinical treatment area 335 including an edge 330 corresponding to target 320 can be displayed. A clinical treatment area 333 can be displayed in addition or in lieu thereof, including an edge 331 corresponding to target 321. A clinical treatment area 334 can be displayed in addition or in lieu thereof, including an edge 332 corresponding to target 322. Thus, a clinical treatment area can be displayed for each target 320, 321, 322. This can be similar to the previously described reference. Figure 2A-Figure 5B A deployment posture and deployment path are determined for each of the targets in a similar manner as described.

[0086] Figure 3C A medical device 312 is shown positioned along a path toward a target 322. A target menu 370 indicates that the target 322 is selected. For example, characteristics of the target 322 are shown in the target menu 370. Additionally or alternatively, when the target 322 is selected, the ablation zone 340 may be shown around the target 322, and a key structure 360 ​​near the target 322 may be displayed. In some examples, the control system and / or the user may plan a path to one or more of the targets shown in the virtual navigation view 310. The path may be stored at the control system, such as in a memory of the control system. When a particular target is selected by the user, the virtual navigation view 310 may display a path corresponding to the particular target. For example, when the user selects the target 320, the path for the target 320 may be displayed. In some examples, the virtual navigation view 310 may simultaneously display the path for each of the targets 320, 321, and 322.

[0087] In some examples, potential airway exit points may be displayed in the virtual navigation view 310. Potential airway exit points may be displayed as numbered symbols, symbols of different colors, and / or symbols having any other identifying features. In examples when potential airway exit points are displayed as numbered symbols, the numbering may prioritize exit points that provide optimal ablation probe placement over exit points that provide the worst ablation probe placement. The control system may prioritize by determining how the ablation probe will function and / or how effective the ablation procedure will be when each airway exit point is used. In some examples, the numbering may prioritize exit points that provide the worst ablation probe placement over exit points that provide the best ablation probe placement. Potential airway exit points may additionally or alternatively be displayed during an image-guided medical procedure.

[0088] Once treatment planning is complete, it can be exported and used during image-guided medical procedures. Figure 6 , an image-guided medical procedure that may be manually performed, robot-assisted, or otherwise remotely operated may be performed, wherein the display system 150 may display an image reference system (X I , Y I , Z I ) 153. An elongated device, such as a medical instrument 154 (which may be medical instrument 104), may be registered (e.g., dynamically referenced) to an anatomical model 156 of the patient derived from preoperative image data obtained, for example, from a computed tomography (CT) scan. The anatomical model 156 may be Figure 1 anatomical model 106. Anatomical model 156 may include a target 158, such as a lesion or nodule of interest, that the treatment plan and procedure are intended to address (e.g., biopsy, treatment, observation, etc.). Target 158 ​​may be target 108. Target 158 ​​may include a margin 159 (e.g., margin 110) surrounding target 158. In some examples, virtual navigation image 152 may also or alternatively present to the physician a virtual image of the internal surgical site as viewed from the perspective of medical device 154 (such as from the distal tip of medical device 154). In some examples, display system 150 may also or alternatively present a real-time view from the distal tip of medical device 154, such as when medical device 154 includes an endoscope. In some examples, medical device 154 may be manipulated by a robotic-assisted manipulator controlled by control system 125 or a processing system including one or more processors. Examples of robotic-assisted medical systems will be described in detail below. Fig.10 In some examples, the ablation probe can extend through the lumen of the medical device 154. In some examples, the ablation probe is the medical device 154.

[0089] Generating the virtual navigation image 152 involves converting the image reference system (X I , YI , Z I )153 and the surgical reference system of anatomical structure (X S , Y S , Z S ) and / or the medical device reference system (X) of the medical device 154 M , Y M , Z M ) registration. Such registration may be achieved by rotating, translating, or otherwise manipulating points associated with the segmented instrument shape from the image data and / or points associated with shape data from a shape sensor disposed along the length of the medical instrument 154 through rigid or non-rigid transformations. For example, such registration between the image and instrument reference frames may be achieved using the point-based iterative closest point (ICP) technique described in U.S. Provisional Patent Application No. 62 / 205,440, filed on August 14, 2015, entitled “Systems and Methods of Registration for Image-Guided Surgery” and U.S. Provisional Patent Application No. 62 / 205,433, filed on August 14, 2015, entitled “Systems and Methods of Registration for Image-Guided Surgery,” which are incorporated herein by reference in their entirety. Registration may additionally or alternatively be achieved through another point cloud registration technique.

[0090] refer to Figure 3A-3C , although previously described in the context of treatment planning, the GUI 300 can be used for intraoperative navigation guidance when performing a medical procedure. A virtual navigation view 310 can be generated by registering preoperative imaging data (and subsequently constructed three-dimensional (3D) models, such as model 156 / 106) with the current position of a medical device 312. The GUI 300 can also include one or more windows 305 that illustrate a target 320 in one or more cross-sections of the patient's anatomy from various views (e.g., top view, side view, front view). The GUI 300 can also include a target menu 370 and a probe menu 380. Additional details of the GUI 300 will be described below.

[0091] like Figure 3B As shown, GUI 300 may display virtual navigation view 310 without window 305. This may allow a user to more closely analyze the details of virtual navigation view 310, which may assist in planning a path for medical instrument 312 and / or navigating medical instrument 312 along the path. Figure 3BThe virtual navigation view 310 shown may be replaced with Figure 3A The virtual navigation view 310 in FIG. Figure 3B As shown, the distal end 314 of the medical instrument 312 can be navigated to a position near the target 320. The current shape of the medical instrument 312 and the position of the distal end 314 can be displayed in the virtual navigation view 310. The medical instrument 312 can be navigated by a user, a remotely operated control system (e.g., the control system 125), or a combination of manual and automatic input.

[0092] refer to Figure 7 , the GUI 300 may also include an intraoperative external image 400 and an icon menu 405. The intraoperative external image 400 may be received at a control system (e.g., the control system 125) from an intraoperative external imaging system. In some examples, the intraoperative external imaging system may be a fluoroscopic imaging system that generates intraoperative fluoroscopic image data, although any suitable imaging technology, such as conventional CT or cone beam CT ("CBCT") technology, may be used without departing from the examples of the present disclosure. The intraoperative external imaging data may be received at a control system or other processing platform associated with the medical device 312. It is also contemplated that in some examples, shape data associated with the medical device 312 may be passed to the imaging system, or both the shape data and the intraoperative external imaging data may be passed to a common platform for processing. In this regard, the registration of the shape data of the medical device 312 with the intraoperative external imaging data may be performed by the control system, the imaging system, or another platform in operable communication with the intraoperative external imaging system and the control system. In some examples, receiving the intraoperative external imaging data may include receiving one or more timestamps associated with the intraoperative external imaging data. The first timestamp may indicate the start time of the intraoperative external imaging, and the second timestamp may additionally indicate the stop time of the intraoperative external imaging. Alternatively, a timestamp may be associated with each instance of the intraoperative external imaging data. To ensure accurate correlation, the clock of the control system of the medical device 312 may be synchronized with the clock of the intraoperative external imaging system, and each instance of the shape data may also be associated with a timestamp. In this regard, each timestamp instance of the intraoperative external imaging data may be paired with a corresponding timestamp instance of the shape data.

[0093] In some examples, ablation can be performed when the medical device 312 reaches the deployed orientation 318. Ablation can be performed by an ablation probe 402, which can be deployed through the lumen of the medical device 312. Alternatively, the ablation probe 402 can be inserted into the anatomical passage 316 independently of the medical device 312. In some examples, the ablation probe 402 can be independently manipulated relative to the medical device 312. For example, the ablation probe 402 can be articulated independently of the medical device 312. The ablation probe 402 can be coupled to one or more wires or optical fibers for activating the ablation probe 402, modulating its output, capturing return signals, etc.

[0094] In some examples, the anatomical channel 316 can be hidden from view and removed from the virtual navigation view 310 displayed in the GUI 300. The control system can receive user input selecting a "hide airway" icon (not shown) on the GUI 300, or the control system can hide the anatomical channel 316 in response to other triggers such as starting ablation. With the anatomical channel 316 hidden, the user can more easily see the medical device 312 in the virtual navigation view 310. This can allow the user to more clearly visualize the orientation of the medical device 312 in the virtual navigation view 310. This can additionally or alternatively allow for more delicate and precise adjustments to the shape of the medical device 312, which will be discussed in additional detail below. Additionally or alternatively, the anatomical channel 316 can be made transparent, wherein the outline of the anatomical channel 316 is still visible in the virtual navigation view 310. In some examples, the target 320 can be similarly hidden and removed from the virtual navigation view 310. In some examples, the key structure 360 ​​can remain visible in the virtual navigation view 310 when the anatomical channel 316 is hidden. In some examples, the critical structures 360 may be hidden from view and removed from the virtual navigation view 310. The control system may receive user input selecting a “hide critical structures” icon (not shown) on the GUI 300, or the control system may hide the critical structures 360 in response to other triggers, such as initiating ablation.

[0095] refer to Fig. 8A and Figure 8B , the GUI 300 can be displayed in a planning or navigation mode. In the planning mode, the position and orientation of the medical device 312 can be determined as an optimal deployment posture or a selected deployment posture using the process previously described above. In the navigation mode, the position and orientation of the medical device 312 can be determined using a positioning sensor (such as a fiber optic shape sensor, an electromagnetic sensor, etc.) connected to the medical device 312, as will be described in additional detail below. Some exemplary details regarding the use of the GUI 300 in the navigation mode will now be discussed. In some examples, a composite image of the ablation probe 402 may be shown in the virtual navigation view 310 of the GUI 300. In Fig. 8A, ablation probe 402 is shown extending from distal end 314 of medical device 312 by an insertion distance D1, which can be shown in icon 410 ( Figure 8B ). The insertion distance D1 can be measured from the distal end 314 of the medical device 312 to the distal end 404 of the ablation probe 402. In some examples, when the ablation probe 402 is extended from the medical device 312, the ablation probe 402 extends a known default insertion distance. The synthetic image of the ablation probe 402 can generate the insertion distance D1 based on the known default insertion distance. Fig. 8A As shown, the default insertion distance may be 10 mm, but may be 5 mm, 15 mm, or any other desired distance. In some cases, the insertion distance D1 may be adjusted.

[0096] like Figure 8B As shown, GUI 300 may include an increase icon 412 and a decrease icon 414. When the control system receives user input selecting increase icon 412, insertion distance D1 may be increased. Similarly, when the control system receives user input selecting decrease icon 414, insertion distance D1 may be decreased. Insertion distance D1 may be increased or decreased in increments of 1 mm, but may be increased or decreased in increments of 0.5 mm, 2 mm, 3 mm, or any other desired distance. To reset insertion distance D1 to a default insertion distance, icon 416 may be selected. In some examples, ablation probe 402 is hidden and removed from virtual navigation view 310, as described above with respect to FIG. Figure 7 When the control system receives user input selecting the "Done" icon 418, any adjustments made to the insertion distance D1 and / or any other adjustments made to the ablation probe 402 may be confirmed. Confirmed adjustments may be revisited and additionally adjusted at any time.

[0097] In some examples, the control system can receive user input selecting (e.g., touching or clicking) the distal end 314 of the medical instrument 312 and the distal edge of the target 320 to measure the distance between the distal end 314 of the medical instrument and the distal edge of the target 320. The distance can be displayed in the GUI 300, such as in the virtual navigation view 310, or in any other location in the GUI 300. Additionally or alternatively, the control system can use imaging analysis to determine the distance between the distal end 314 of the medical instrument 312 and the distal edge of the target 320.

[0098] like Figure 8C As shown, ablation probe 402 is shown to be bent away from the longitudinal axis A of medical device 312 at an angle 420. Angle 420 can be measured from the longitudinal axis A of medical device 312 to ablation probe 402. The degree of angle 420 can be shown in icon 422 of GUI 300. Figure 8CAs shown, GUI 300 may additionally include an increase icon 424 and a decrease icon 426. When the control system receives user input selecting increase icon 424, angle 420 may increase. Similarly, when the control system receives user input selecting decrease icon 426, angle 420 may decrease. Angle 420 may increase or decrease in increments of 1° (i.e., one degree), but may increase or decrease in increments of 0.5°, 2°, 3°, or any other desired amount of degrees. Figure 8C As shown, angle 420 may be 30°. In some examples, ablation probe 402 may be bent to any angle within deployment range 315.

[0099] In some examples, when the ablation probe 402 is bent away from the longitudinal axis A, the ablation probe 402 can be shown within an image of an anatomical channel, such as one of the anatomical channels 316. This can help illustrate that the ablation probe 402 can remain within the anatomical channel even when bent away from the longitudinal axis A. When the control system receives user input selecting the "done" icon 418, any adjustments made to the angle 420 and / or any other adjustments made to the ablation probe 402 can be confirmed. Confirmed adjustments can be reviewed and additionally adjusted at any time.

[0100] In some examples, the virtual navigation view 310 may display the medical device 312 at any position with a deployed orientation 318 within a deployment range 315 where the maximum bend radius of the medical device 312 is below a threshold bend radius. The control system may generate a mechanical model of the medical device 312 within a model of the anatomical passage 316. In some examples, as the bend radius of the medical device 312 changes, the curved portion of the medical device 312 may change color or may change in any other graphical manner. For example, when a portion of the medical device 312 is bent, the portion may change from green to red as the bend radius increases.

[0101] In some examples, the control system can receive user input at the GUI 300 to switch between different workflow modes / steps displayed on the GUI 300. For example, the workflow mode / step can switch between a needle insertion workflow, an ablation probe insertion workflow, and a medical device retraction workflow. In some examples, more than one workflow can be displayed on the GUI 300 at the same time. For example, the workflows can be displayed in separate windows of the GUI 300 or as a picture-in-picture display.

[0102] In some examples, when ablation probe 402 is installed and inserted through medical device 312, the displayed bending angle of medical device 312 can be adjusted or changed because the shape of medical device 312 is affected by the change in stiffness. The shape of medical device 312 can be measured using a fiber optic shape sensor and / or any positioning sensor (such as an electromagnetic sensor). Additional details about measuring the shape of medical device 312 are provided below. Fig.11 Discussion. In some examples, the control system can determine the stiffness of the medical device 312 by measuring the force applied to the traction wire in the medical device 312 when the medical device 312 is bent. In some examples, as the stiffness of the medical device 312 changes, the portion of the medical device 312 with the changed stiffness can change color or can change in any other graphical manner. For example, when a portion of the medical device 312 becomes more rigid, the portion can change from green to red as the stiffness increases.

[0103] Reference now Fig. 9 , Fig. 9 A flow chart is included that illustrates an optional method 700 for planning a medical procedure (such as an ablation procedure) and navigating a medical device during the medical procedure. The method 700 is illustrated as a set of operations or processes 702-726. At process 168, after determining one or more deployment parameters based on a clinical treatment area (e.g., clinical treatment area 235), the method 700 can be optionally performed. Processes 702-726 can be performed in conjunction with Fig. 9 The method 700 may be performed in the same or different order as shown. In some examples of method 700, one or more of the described processes may be omitted. Additionally, one or more processes not explicitly described in the flowchart may be included before, after, between, or as part of the described processes. In some examples, one or more of the processes of the flowchart may be implemented at least in part by a control system executing code stored on a non-transitory, tangible machine-readable medium, which, when executed by one or more processors (e.g., a processor of the control system), may cause the one or more processors to perform one or more of the processes.

[0104] To provide accurate navigation through the anatomical passage, the reference frame 120 of the preoperative imaging data (and subsequently constructed 3D model) can be registered with the reference frame of the medical device 312 at process 702. For example, shape sensors (e.g., fiber optic shape sensors and / or one or more position sensors) disposed along the length of the medical device 312 can be used to provide real-time shape data (e.g., information regarding the shape of the medical device 312 and / or the position of one or more points along the length of the medical device 312). This shape data can be used to register the medical device 312 with the 3D model constructed from the preoperative imaging data and to track the orientation of the medical device 312 during use. Upon successful registration, process 704 can include generating a virtual navigation view (e.g., Figure 3A-3C A virtual navigation view 310).

[0105] At process 705, a treatment plan is received by the control system. For example, the ablation treatment plan discussed above may be received by the control system 125. The treatment plan may be used during an image-guided medical procedure.

[0106] At process 706, navigation guidance is provided as the medical device 312 navigates through the anatomical passage 316 to a predetermined deployment position proximate to the target 320. The predetermined deployment position may be the deployment position 318 determined during the treatment planning process discussed above. Figure 3B As shown, distal end 314 of medical device 312 may be navigated to a deployment position 318 proximate target 320. Navigation may be performed manually by a user with provided navigation guidance, automatically by a control system, or via a combination of both.

[0107] In some examples, navigation guidance can be provided by superimposing a fluoroscopic reference of a guide hole and / or biopsy marker on top of the measured shape of the medical device 312. This can allow the control system and / or the user to adjust the position of the distal end 314 of the medical device 312 to be parallel to the fluoroscopic reference or coincident with the biopsy marker. In some examples, the measured shape of the medical device 312 can be displayed as a shape superimposed on the fluoroscopic reference.

[0108] With the medical device 312 in the deployed position 318, preferably in close proximity to the target 320, an intraoperative external imaging scan can be performed. At process 708, intraoperative external imaging data can be received at the control system from the intraoperative external imaging system. In some examples, the intraoperative external imaging system can be a fluoroscopic imaging system that generates intraoperative fluoroscopic image data, although any suitable imaging technology, such as conventional CT or cone beam CT ("CBCT") technology, can be used without departing from the examples of the present disclosure. The intraoperative external imaging data can be displayed in the GUI 300 as an intraoperative external image 400 (e.g., a fluoroscopic image). At process 710, the medical device 312 and the ablation probe 402 can be identified in the intraoperative external image 400. Identification can be performed by the control system (e.g., using image processing) and / or an operator.

[0109] In order to register the fluoroscopic image 400 with the medical device 312 when performing intraoperative external imaging, shape data from the medical device 312 captured during the intraoperative external imaging process 708 may be received at process 712. The shape data may be captured only for a short period of time, or may be captured during the entire image capture period of the intraoperative external imaging process.

[0110] At process 714, the deployment position 318 of the medical device 312 is updated as needed. The deployment position 318 can be updated based on the intraoperative external imaging data. The position of the ablation probe 402 can also be adjusted as needed based on the intraoperative external imaging data. The updated deployment position can be within the deployment range 315.

[0111] At process 716, the target 320 is ablated. The control system can perform and / or assist in the ablation procedure. Figure 3B The amount of time indicated by the time icon 384 is Figure 3B The amount of power illustrated by the power icon 382 is supplied to the ablation probe 402. If more than one ablation zone is required to fully cover the clinical treatment area 335, then ablation therapy is applied to each ablation zone according to the treatment plan. At process 718, after the ablation therapy is completed, intraoperative external imaging data may be received at the control system from the intraoperative external imaging system. In some examples, the intraoperative external imaging system may be a fluoroscopic imaging system that generates intraoperative fluoroscopic image data, although any suitable imaging technology may be used without departing from the examples of the present disclosure, such as conventional CT or cone beam CT ("CBCT") technology. The intraoperative external imaging data may be displayed in the GUI 300. For example, Figure 7The pre-ablation intraoperative external image 400 (e.g., a fluoroscopic image) shown in the GUI 300 may be replaced with a post-ablation intraoperative external image. Each ablation zone in the treatment plan may be displayed in the post-ablation intraoperative external image. In some examples, both the pre-ablation intraoperative external image 400 and the post-ablation intraoperative external image may be displayed simultaneously in the GUI 300. The two images may be displayed in different windows of the GUI 300, as a picture-in-picture display in the same window of the GUI 300, or in any other arrangement in the GUI 300. At process 720, the medical device 312 and the ablation probe 402 may be identified in the post-ablation intraoperative external image. Identification may be performed by a control system (e.g., using image processing) and / or an operator.

[0112] At process 722, the post-ablation intraoperative image data is registered with the pre-operative imaging data. As discussed above at process 712, the pre-ablation intraoperative image data can be registered with the pre-operative imaging data. In a manner similar to that described above at process 712, the post-ablation intraoperative image data can be registered with the pre-operative imaging data. For example, when performing post-ablation intraoperative external imaging, shape data from the medical device 312 captured during the post-ablation intraoperative external imaging process 718 can be received. The shape data may be captured only for a short period of time, or may be captured during the entire image capture period of the post-ablation intraoperative external imaging process. As discussed above with respect to process 712, in some examples, each timestamp instance of the post-ablation intraoperative external imaging data can be paired with a corresponding timestamp instance of the shape data from the medical device 312.

[0113] At process 724, the post-ablation intraoperative external imaging data is compared with the pre-ablation intraoperative external imaging data. The comparison can be performed by the control system and / or the operator. In some examples, the control system can use image analysis and / or imaging processors to compare the image data. During the comparison, the control system can determine whether the ablation zone 340 actually covers the entire clinical treatment area 335. If the ablation zone 340 does not cover the entire clinical treatment area 335, one or more additional ablation treatments may be required to completely ablate the clinical treatment area 335. For example, the actual ablation zone 340 applied during the ablation treatment may have changed from the planned ablation zone (e.g., in size and / or shape). The change in the ablation zone 340 may be the result of one or more factors (such as the density of the target 320, the density of nearby blood vessels, the size of nearby blood vessels, the orientation of one or more key structures 360, or any other similar factors).

[0114] In some examples, when comparing the post-ablation intraoperative external imaging data with the pre-ablation intraoperative external imaging data, the control system can determine the proximity between the current position of the target 320 and the current position of the medical device 312. When comparing the post-ablation intraoperative external imaging data with the pre-ablation intraoperative external imaging data, the control system can additionally or alternatively determine the proximity between the current position of the target 320 and the current position of one or more of the critical structures 360. In some examples, the position of the critical structure 360 ​​in the post-ablation intraoperative external imaging data may have shifted relative to the position of the critical structure 360 ​​in the pre-ablation intraoperative external imaging data. When comparing the post-ablation intraoperative external imaging data with the pre-ablation intraoperative external imaging data, the control system can determine the proximity between the current position of the target 320 in the post-ablation intraoperative external imaging data and the current position of the critical structure 360. In some examples, when comparing post-ablation intraoperative external imaging data with pre-ablation intraoperative external imaging data, the control system can determine the proximity between the current position of the target 320 in the post-ablation intraoperative external imaging data and the current position of one or more anatomical channels 316.

[0115] At process 726, the ablation zone 340 and any other necessary ablation zones are updated based on the comparison between the post-ablation intraoperative external imaging data and the pre-ablation intraoperative external imaging data. One or more additional ablation treatments may be performed based on the updated ablation zone 340 as needed. An updated deployment position may be determined for each updated ablation zone. The updated deployment position may be determined in a manner similar to that described at process 714. In some examples, the medical device 312 may be repositioned to a different anatomical corridor 316 to reach the updated deployment position.

[0116] In some examples, the GUI 300 may include one or more windows for displaying a preview of the ablation procedure for one or more selected deployment positions. This may allow the control system and / or the user to determine the effectiveness of the ablation procedure if the ablation probe 402 is deployed from a particular selected deployment position. The ablation simulation may be provided based on tissue type (e.g., lung, airway). In some examples, the ablation simulation may be a three-dimensional simulation. Additionally or alternatively, the ablation simulation may be a two-dimensional simulation.

[0117] In some examples, the components discussed above may be part of a robot-assisted system, as described in additional detail below. The robot-assisted system may be applicable, for example, to surgery, robot-assisted surgery, diagnosis, treatment, or biopsy procedures. Although some examples of such procedures are provided herein, any reference to medical or surgical instruments and medical or surgical methods is non-limiting. The systems, instruments, and methods described herein may be used for animals, human cadavers, animal cadavers, portions of human or animal anatomical structures, non-surgical diagnostics, and for industrial systems and general-purpose robots, general-purpose robot-assisted or robotic medical systems.

[0118] like Fig.10 As shown, the medical system 800 generally includes a manipulator assembly 802 for operating a medical device 804 (e.g., medical device 104) when performing various procedures on a patient P located on a table T. The manipulator assembly 802 may be a robot-assisted, non-robotic-assisted, or hybrid robot-assisted and non-robotic-assisted assembly having selected degrees of freedom of motion that may be motorized and / or robot-assisted, and selected degrees of freedom of motion that may be non-motorized and / or non-robotic-assisted. The medical system 800 may additionally include a main assembly 806, which generally includes one or more control devices for controlling the manipulator assembly 802. The manipulator assembly 802 supports the medical device 804 and may optionally include a plurality of actuators or motors that drive inputs on the medical device 804 in response to commands from a control system 812. The actuator may optionally include a drive system that, when coupled to the medical device 804, can advance the medical device 804 into a natural or surgically created anatomical orifice.

[0119] The medical system 800 also includes a display system 810 for displaying images or representations of the surgical site and medical device 804 generated by the subsystems of the sensor system 808. The display system 810 and the main assembly 806 can be oriented so that the operator O can control the medical device 804 and the main assembly 806 using the perception of the telepresence. Additional information about the medical system 800 and the medical device 804 can be found in International Application Publication No. WO 2018 / 195216, filed on April 18, 2018, entitled "Graphical User Interface for Monitoring an Image-Guided Procedure", which is incorporated herein by reference in its entirety.

[0120] In some examples, the medical device 804 may include components of an imaging system (discussed in more detail below), which may include an imaging scope assembly or imaging instrument that records concurrent or real-time images of the surgical site and provides the images to an operator or operator O through one or more displays of the medical system 800 (such as one or more displays of the display system 810). The concurrent image may be, for example, a two-dimensional or three-dimensional image captured by the imaging instrument located within the surgical site. In some examples, the imaging system includes an endoscopic imaging instrument component that may be integrally or removably coupled to the medical device 804. However, in some examples, a separate endoscope attached to a separate manipulator assembly may be used with the medical device 804 to image the surgical site. In some examples, as described in detail below, the imaging instrument, alone or in combination with other components of the medical device 804, may include one or more mechanisms for cleaning one or more lenses of the imaging instrument when fluids and / or other materials encountered by the distal end of the imaging instrument partially and / or completely obscure one or more lenses. In some examples, one or more cleaning mechanisms may optionally include an air and / or other gas delivery system that can be used to discharge a puff of air and / or other gas to blow one or more lenses clean. Examples of one or more cleaning mechanisms are discussed in more detail in International Application Publication No. WO / 2016 / 025465, filed on August 11, 2016, entitled “Systems and Methods for Cleaning an Endoscopic Instrument”; U.S. Patent Application No. 15 / 508,923, filed on March 5, 2017, entitled “Devices, Systems, and Methods Using Mating Catheter Tips and Tools”; and U.S. Patent Application No. 15 / 503,589, filed on February 13, 2017, entitled “Systems and Methods for Cleaning an Endoscopic Instrument”, each of which is incorporated herein by reference in its entirety. The imaging system may be implemented as hardware, firmware, software, or a combination thereof, interacting with or otherwise executed by one or more computer processors, which may include a processor of the control system 812 .

[0121] The control system 812 includes at least one memory and at least one computer processor (not shown) for implementing control between the medical device 804, the main component 806, the sensor system 808, and the display system 810. The control system 812 also includes programming instructions (e.g., a non-transitory machine-readable medium storing instructions) for implementing some or all of the methods described according to the aspects disclosed herein, including instructions for providing information to the display system 810.

[0122] Fig.11 is a simplified diagram of a medical device system 900 according to some examples. The medical device system 900 includes an elongated device 902, such as a flexible catheter (e.g., medical device 312), coupled to a drive unit 904. The elongated device 902 includes a flexible body 916 having a proximal end 917 and a distal end or tip portion 918. The medical device system 900 further includes a tracking system 930 for determining the position, orientation, speed, velocity, posture, and / or shape of the distal end 918 and / or one or more segments 924 along the flexible body 916 using one or more sensors and / or imaging devices, as described in further detail below.

[0123] Tracking system 930 may optionally track distal end 918 and / or one or more of segments 924 using shape sensor 922. Shape sensor 922 may optionally include an optical fiber aligned with flexible body 916 (e.g., provided within an internal passageway (not shown) or mounted externally). The optical fiber of shape sensor 922 forms a fiber optic bend sensor for determining the shape of flexible body 916. In an alternative, an optical fiber including a fiber Bragg grating (FBG) is used to provide strain measurements in the structure in one or more dimensions. Various systems and methods for monitoring the shape and relative position of an optical fiber in three dimensions are described in U.S. Patent Application No. 11 / 180,389, entitled "Fiber Optic Position and Shape Sensing Device and Method Relating Thereto," filed on July 13, 2005; U.S. Patent Application No. 12 / 047,056, entitled "Fiber-Optic Shape and Relative Position Sensing," filed on July 16, 2004; and U.S. Patent No. 6,389,187, entitled "Optical Fiber Bend Sensor," filed on June 17, 1998, each of which is incorporated herein by reference in its entirety. In some examples, the sensor may employ other suitable strain sensing techniques, such as Rayleigh scattering, Raman scattering, Brillouin scattering, and fluorescence scattering. In some examples, the shape of the elongated device may be determined using other techniques. For example, the history of the distal end posture of the flexible body 916 can be used to reconstruct the shape of the flexible body 916 over a period of time. In some examples, the tracking system 930 can optionally and / or additionally track the distal end 918 using a position sensor system 920. The position sensor system 920 can be a component of an EM sensor system, wherein the position sensor system 920 includes one or more conductive coils that can be affected by an externally generated electromagnetic field. Each coil of the EM sensor system then generates an induced electrical signal having characteristics that depend on the position and orientation of the coil relative to the externally generated electromagnetic field. In some examples, the position sensor system 920 can be configured and positioned to measure six degrees of freedom, such as three position coordinates X, Y, Z and three orientation angles of pitch, yaw and roll indicating a base point, or five degrees of freedom, such as three position coordinates X, Y, Z and two orientation angles of pitch and yaw indicating a base point.Additional description of position sensor systems is provided in U.S. Patent No. 6,380,732, filed on August 11, 1999, entitled "Six-Degree of Freedom Tracking System Having a Passive Transponder on the Object Being Tracked," which is incorporated herein by reference in its entirety.

[0124] The flexible body 916 includes a passageway 921 sized and shaped to receive a medical device 926. Additional description of a medical device received by the flexible body is provided in U.S. Provisional Patent Application No. 63 / 077,059, filed on September 11, 2020, entitled “Systems for Coupling and Storing an Imaging Instrument,” which is incorporated herein by reference in its entirety.

[0125] The flexible body 916 may also house cables, linkages, or other steering control devices (not shown) that extend between the drive unit 904 and the distal end 918 to controllably bend the distal end 918, for example, as shown by the dashed line depiction 919 of the distal end 918. In some examples, at least four cables are used to provide independent "up and down" steering to control the pitch of the distal end 918, and "side to side" steering to control the yaw of the distal end 918. Steerable elongated devices are described in detail in U.S. Patent Application No. 13 / 274,208, filed on October 14, 2011, entitled "Catheter with Removable Vision Probe," which is incorporated herein by reference in its entirety.

[0126] Information from the tracking system 930 can be sent to the navigation system 932 where it is combined with information from the image processing system 931 and / or preoperatively acquired models to provide real-time position information to the operator. In some examples, the real-time position information can be displayed on a Fig.10 on the display system 810 for controlling the medical device system 900. In some examples, Fig.10The control system 812 can utilize the position information as feedback for positioning the medical instrument system 900. Various systems for registering and displaying surgical instruments and surgical images using fiber optic sensors are provided in U.S. Patent Application No. 13 / 107,562, filed May 13, 2011, entitled “Medical System Providing Dynamic Registration of a Model of an Anatomic Structure for Image-Guided Surgery,” which is incorporated herein by reference in its entirety.

[0127] In some examples, the medical device system 900 is Fig.10 The medical system 800 may be robot-assisted. In some examples, Fig.10 The manipulator assembly 802 may be replaced by direct operator control. In some examples, the direct operator control may include various handles and operator interfaces for hand-held operating instruments.

[0128] The singular forms "a", "an", and "the" are intended to include the plural forms as well, unless the context indicates otherwise. And the terms "comprises", "comprising", "including", "having", etc. specify the presence of stated features, steps, operations, elements, and / or parts, but do not exclude the presence or addition of one or more other features, steps, operations, elements, parts, and / or groups. The parts described as coupled may be directly electrically or mechanically coupled, or they may be indirectly coupled via one or more intermediate parts. The parts described as coupled may be directly or indirectly communicatively coupled. The auxiliary verb "may / could" also means that the features, steps, operations, elements, or parts are optional.

[0129] In the description, the specific details describing some examples are set forth. Many specific details are set forth in order to provide a thorough understanding of the examples. However, it is apparent to those skilled in the art that some examples may be practiced without some or all of these specific details. The specific examples disclosed herein are meant to be illustrative, not restrictive. Although not specifically described herein, those skilled in the art may realize other elements within the scope and spirit of the present disclosure.

[0130] Where feasible, elements described in detail with reference to one example, implementation or application may optionally be included in other examples, implementations or applications in which they are not specifically shown or described. For example, if an element is described in detail with reference to one example, and is not described with reference to a second example, the element may still be required to be included in the second example. Therefore, in order to avoid unnecessary repetition in the following description, one or more elements shown and described in association with an example, implementation or application may be incorporated into other examples, implementations or aspects, unless specifically described otherwise, unless one or more elements will render an example or implementation inoperative, or unless two or more elements provide conflicting functions.

[0131] As generally thought by those skilled in the art in the field to which the present disclosure relates, any changes and further modifications to the described devices, apparatuses, methods and any further applications of the principles of the present disclosure are fully contemplated. In addition, the dimensions provided herein are for specific examples, and it is contemplated that different sizes, dimensions and / or ratios can be used to implement the concepts of the present disclosure. In order to avoid unnecessary descriptive repetitions, one or more components or actions described according to an illustrative example may be used or omitted from other illustrative examples where applicable. For the sake of brevity, multiple iterations of these combinations will not be described separately. For the sake of simplicity, in some instances, the same reference numerals are used throughout the accompanying drawings to refer to the same or similar parts.

[0132] The systems and methods described herein may be applicable to navigating and treating anatomical tissues via natural or surgically created connecting channels in any of the various anatomical systems including the lungs, colon, intestines, kidneys and calyces, brain, heart, circulatory systems including vascular systems, etc. Although some of the examples described herein relate to surgical procedures or instruments, or medical procedures and medical instruments, the disclosed technology is applicable to non-medical procedures and non-medical instruments. For example, the instruments, systems and methods described herein may be used for non-medical purposes, including industrial uses, general robotic uses, and sensing or manipulating non-tissue artifacts. Other example applications relate to cosmetic improvements, imaging of human or animal anatomical structures, collecting data from human or animal anatomical structures, and training medical or non-medical personnel. Additional example applications include procedures for performing procedures on tissues removed from human or animal anatomical structures (not returned to human or animal anatomical structures) and performing procedures on human or animal corpses. In addition, these technologies may also be used for surgical and non-surgical medical treatment or diagnostic procedures.

[0133] Additionally, while some of the examples presented in this disclosure discuss robotically assisted systems or remotely operable systems, the disclosed techniques may also be applicable to computer-assisted systems that are partially or entirely moved directly and manually by an operator.

[0134] Additionally, one or more elements in the examples of the present disclosure may be implemented in software to be executed on a processor of a computer system such as a control processing system. When implemented in software, the elements of the examples of the present disclosure are essentially code segments that perform necessary tasks. A program or code segment may be stored in a processor-readable storage medium (e.g., a non-temporary storage medium) or device, which may be downloaded in the form of a computer data signal embodied in a carrier wave over a transmission medium or a communication link. A processor-readable storage device may include any medium that can store information, including optical media, semiconductor media, and magnetic media. Examples of processor-readable storage devices include electronic circuits, semiconductor devices, semiconductor storage devices, read-only memories (ROMs), flash memories, erasable programmable read-only memories (EPROMs); floppy disks, CD-ROMs, optical disks, hard disks, or other storage devices. Code segments may be downloaded via computer networks such as the Internet, intranets, etc. Any of a variety of centralized or distributed data processing architectures may be used. Programming instructions may be implemented as multiple separate programs or subroutines, or they may be integrated into multiple other aspects of the system described herein. In some examples, the control system may support wireless communication protocols such as Bluetooth, Infrared Data Association (IrDA), HomeRF, IEEE 802.11, Digital Enhanced Cordless Telecommunications (DECT), Ultra-Wideband (UWB), ZigBee, and wireless telemetry.

[0135] A computer is a machine that performs mathematical or logical functions on input information in accordance with programmed instructions to produce processed output information. A computer includes a logic unit that performs the mathematical or logical functions, and a memory that stores the programmed instructions, input information, and output information. The term "computer" and similar terms such as "processor" or "controller" or "control system" are similar.

[0136] It should be noted that the processes and displays presented may not be inherently related to any particular computer or other device, and various systems may be used with the programs according to the teachings herein. The structures required for the various systems discussed above will appear as elements in the claims. In addition, the examples of the present disclosure are not described with reference to any particular programming language. It should be understood that various programming languages ​​can be used to implement the teachings of the present disclosure as described herein.

[0137] Although certain examples of the present disclosure have been described and shown in the accompanying drawings, it should be understood that such examples are merely illustrative of the broadly disclosed concepts and not restrictive, and that since various other modifications may occur to those skilled in the art, the examples of the present disclosure are not limited to the specific constructions and arrangements shown and described.

Claims

1. A medical system comprising: A control system configured to: receiving first imaging data of an anatomical structure of a patient; identifying an anatomical target in the patient's anatomy; generating a treatment volume having a first axis, wherein the treatment volume includes the anatomical target; and A deployment position of an elongated device configured to receive a medical device for treating the anatomical target is determined, wherein the deployment position is aligned with the first axis of the treatment region.

2. The medical system of claim 1, wherein the deployment position comprises a deployment position or a deployment orientation.

3. The medical system of claim 1, wherein the control system is further configured to identify one or more critical structures in the patient's anatomy. 4 . The medical system of claim 3 , wherein the control system is further configured to modify the treatment area based on the one or more critical structures.

5. The medical system of claim 4, wherein said modifying said treatment volume comprises adjusting said treatment volume to avoid said one or more critical structures.

6. The medical system of one of claim 4 or claim 5, wherein modifying the treatment volume comprises modifying at least one of a position, orientation, size or shape of the treatment volume.

7. The medical system of any one of claims 1-6, wherein the treatment volume is a clinical treatment volume comprising a margin, wherein the margin surrounds the anatomical target.

8. The medical system of claim 1, wherein the control system is further configured to identify one or more anatomical passages in close proximity to the anatomical target in the patient anatomy.

9. The medical system of claim 8, wherein the control system is further configured to determine a deployment range of the elongated device.

10. The medical system of claim 9, wherein the size of the deployment range is determined based on one or more deployment postures of the elongated device.

11. The medical system of claim 10, wherein the dimension comprises a deployment distance or a deployment angle of the elongated device.

12. The medical system of claim 9, wherein the size of the deployment range is determined based on at least one of: an angle of each of the one or more anatomical passages or a diameter of each of the one or more anatomical passages.

13. The medical system of claim 9, wherein the size of the deployment range is determined based on a size or stiffness of the elongated device.

14. The medical system of claim 9, wherein an orientation of the deployment range is determined based on a long axis of the anatomical target.

15. The medical system according to any one of claims 1-14, wherein the control system is further configured to determine at least one ablation zone, wherein the at least one ablation zone covers the treatment zone.

16. The medical system of claim 15, wherein determining the at least one ablation zone further comprises minimizing a size of an ablation area of ​​the at least one ablation zone outside of the treatment zone.

17. A medical system according to one of claims 15 or claim 16, wherein the control system is further configured to determine at least one second deployment position of the slender device for delivering the medical device, wherein each of the at least one second deployment position is based on an axis of the at least one ablation zone.

18. The medical system of claim 17, wherein the at least one second deployment position is within a deployment range of the elongated device.

19. The medical system of claim 17, wherein the size of the ablation zone is based on at least one of ablation time or ablation power.

20. The medical system of claim 19, wherein the control system is further configured to determine the time or the power based on tissue characteristics of the patient anatomy within the ablation zone.

21. The medical system of claim 20, wherein the tissue characteristics include critical structures.

22. The medical system of any one of claims 1-20, further comprising the elongated device.

23. The medical system of claim 22, further comprising the medical device, wherein the ablation zone comprises a maximum size based on a design of the medical device.

24. The medical system of claim 16, wherein the control system is further configured to receive user input to adjust a size of the at least one ablation zone.

25. The medical system of claim 24, wherein the control system is further configured to adjust ablation parameters based on the proximity of the at least one ablation zone to one or more critical structures.

26. The medical system according to any one of claims 1-23, further comprising a display system, the display system comprising a graphical user interface GUI.

27. The medical system of claim 26, wherein the control system is further configured to display an image of the treatment volume and an image of the anatomical target via the GUI.

28. A medical system comprising: an elongated device configured to receive a medical device within said elongated device; as well as A control system configured to: receiving first imaging data of an anatomical structure of a patient; identifying an anatomical target in the patient's anatomy; generating a treatment volume having a first axis, wherein the treatment volume includes the anatomical target; as well as A deployment range of the elongated device is determined based on the first axis of the clinical treatment area.

29. A medical system comprising: an elongated device configured to receive a medical device within said elongated device; as well as A control system configured to: receiving first imaging data of an anatomical structure of a patient; identifying an anatomical target in the patient's anatomy; determining a deployment range of the elongated device; and A composite treatment volume is generated based on the deployment range, wherein the composite treatment volume includes the anatomical target.

30. A method comprising: receiving first imaging data of an anatomical structure of a patient; receiving information identifying an anatomical target in the patient's anatomy; generating a treatment volume including the anatomical target; and A first axis of the treatment zone is determined to identify a deployed orientation of the elongated device, wherein the deployed orientation is aligned with the first axis of the treatment zone.

31. The method of claim 30, wherein the treatment area comprises a limbus.

32. The method of claim 30, further comprising determining a safety margin around the treatment area.

33. The method of claim 32, wherein the safety margin is sized and shaped to be based on potential movement of a position of a medical device configured to be received within the elongated device, wherein the treatment zone is positioned based on the position of the medical device.

34. The method of claim 32, further comprising displaying the image of the treatment volume and the image of the safety margin via a graphical user interface (GUI) of a display system.

35. The method of claim 30, further comprising receiving information to identify critical structures in the patient's anatomy.

36. The method of claim 35, further comprising adjusting the treatment volume based on the critical structure.

37. The method of claim 35, wherein adjusting the treatment volume comprises displacing the first axis of the treatment volume laterally from a long axis of the anatomical target, and wherein the displaced first axis is parallel to the long axis.

38. The method of claim 37, wherein the critical structure is a blood vessel, and wherein displacing the first axis laterally from the long axis avoids bleeding in the blood vessel.

39. The method of claim 37, wherein the critical structure is an airway, and wherein displacing the first axis laterally from the long axis prevents heat from being transferred from tissue through the airway.

40. The method of claim 37, wherein the first axis of displacement is substantially perpendicular to a critical structure in the patient's anatomy.

41. The method of claim 35, wherein the critical structure comprises at least one of an organ, a vessel, an airway, a fissure, or a pleura.

42. The method of claim 30, further comprising determining at least one anatomical corridor in the patient anatomy surrounding the anatomical target.

43. The method of claim 42, further comprising determining a deployment range for one or more deployment postures of the elongated device.

44. The method of any one of claims 30-43, further comprising determining a deployed position of a medical device, wherein the deployed position is aligned with the first axis of the treatment area.

45. The method of claim 44, wherein in the deployed position, a longitudinal axis of the medical device is aligned with the long axis of the anatomical target.

46. ​​The method of any one of claims 30-43, further comprising: receiving second imaging data of an anatomical structure of the patient; and A second treatment volume is generated based on the second imaging data.

47. The method of claim 46, wherein the first imaging data is pre-operative imaging data comprising pre-operative images of the anatomical target, and the second imaging data is intra-operative imaging data.

48. The method of claim 47, wherein the intraoperative imaging data is received before ablation begins, the intraoperative imaging data comprising an intraoperative image of the anatomical target.

49. The method of claim 46, further comprising: comparing the first imaging data of the anatomical target with the second imaging data of the anatomical target; and The second treatment volume is generated by adjusting the first treatment volume based on the comparison.

50. The method of claim 49, wherein comparing the first imaging data to the second imaging data comprises determining a proximity between a current position of the anatomical target and a current position of the elongated device.

51. The method of claim 49, further comprising identifying one or more additional key structures in the second imaging data, wherein comparing the first imaging data with the second imaging data comprises determining a proximity between a current position of the anatomical target and a current position of the one or more additional key structures.

52. A method according to claim 49, wherein the position of the one or more additional key structures in the second imaging data is shifted relative to the position of the key structure in the first imaging data, and wherein comparing the first imaging data with the second imaging data includes determining the proximity between the current position of the anatomical target and the current position of the key structure in the second imaging data.

53. The method of claim 49, further comprising identifying one or more anatomical channels in the second imaging data, wherein comparing the first imaging data to the second imaging data comprises determining a proximity between a current position of the anatomical target and a current position of the one or more anatomical channels.

54. The method of claim 53, wherein the one or more anatomical passages comprise a blood vessel.

55. The method of claim 53, wherein the one or more anatomical passages include an airway.

56. The method of claim 46, wherein the second imaging data is CBCT imaging data.

57. A method according to claim 46, wherein the first imaging data is intraoperative imaging data received before ablation begins, the first intraoperative imaging data includes a first intraoperative image of the anatomical target, and wherein the second imaging data is received after ablation is completed, the second imaging data includes a second intraoperative image of the anatomical target.

58. The method of claim 57, further comprising: comparing the first intraoperative image of the anatomical target with the second intraoperative image of the anatomical target; and The second treatment volume is generated based on the comparison.

59. The method of claim 30, further comprising displaying the image of the treatment volume and the image of the anatomical target via a graphical user interface (GUI) of a display system.

60. A medical system comprising: Display system; Slender device; a medical device configured to extend within the elongated device; as well as a control system communicatively coupled to the display system, the control system being configured to: displaying a graphical user interface via the display system, the graphical user interface comprising a virtual navigation view; displaying an image of the elongated device in the virtual navigation view; displaying an anatomical target in the virtual navigation view; generating a treatment volume having a first axis, wherein the treatment volume includes the anatomical target; as well as A deployed orientation of the elongated device is determined, wherein the deployed orientation is aligned with the first axis of the treatment area.

61. The medical system of claim 60, wherein the control system is further configured to display the treatment area in the virtual navigation view.

62. The medical system of claim 60, wherein the control system is further configured to display the deployed position and deployed range of the medical device in the virtual navigation view.

63. The medical system of claim 60, wherein the control system is further configured to identify one or more critical structures in close proximity to the anatomical target.

64. The medical system of claim 63, wherein the control system is further configured to receive user instructions to adjust the size or shape of the treatment volume based on the one or more critical structures.

65. The medical system of claim 60, wherein the control system is further configured to determine at least one ablation zone covering the treatment area.

66. The medical system of claim 65, wherein the control system is further configured to display the at least one ablation zone in the virtual navigation view.

67. The medical system of claim 65, wherein the control system is further configured to receive user input to adjust a size of the at least one ablation zone.

68. The medical system of claim 65, wherein the control system is further configured to receive user input to adjust one or more ablation parameters based on the proximity of the at least one ablation zone to one or more critical structures.

69. The medical system of claim 65, wherein the control system is further configured to receive user input to adjust one or more ablation parameters based on proximity of the at least one ablation zone to one or more anatomical corridors in close proximity to the anatomical target.

70. The medical system of claim 60, wherein the control system is further configured to determine a safety margin around the treatment area, wherein the safety margin is sized and shaped based on potential movement of the position of the medical device.

71. The medical system of claim 70, wherein the control system is further configured to display the safety margin in the virtual navigation view.

Images