Multiprobe holder for positioning a biopsy needle, computer implemented method and computer program product

Abstract

Embodiments of the present disclosure may include a multiprobe holder for positioning a biopsy apparatus, the multiprobe holder comprising: a first holder configured to hold a first probe along a first probing axis; and a second holder configured to hold a second probe along a second probing axis, wherein the second holder is rotatably arranged with respect to the first holder, wherein the second holder is further configured to hold the biopsy apparatus, wherein the multiprobe holder is configured such that, when the second holder is rotated with respect to the first holder, a distance along the second probing axis and between the second holder and the first probing axis is substantially equal. In addition, there are disclosed a computer implemented method for assisting positioning of a multiprobe holder and a computer program product.

Description

[0001] MULTIPROBE HOLDER FOR POSITIONING A BIOPSY NEEDLE, COMPUTER IMPLEMENTED METHOD AND COMPUTER PROGRAM PRODUCT

[0002] The present patent disclosure concerns a multiprobe holder for positioning a biopsy needle, a computer implemented method for assisting a positioning of a multiprobe holder, and a computer program product. Particular embodiments concern multiprobe holders that allow for precise localization of small lymph nodes comprising cancer cells and / or precise positioning of the biopsy needle.

[0003] Lymph node investigation to find metastases is carried out in many cancer diseases, such as head / neck cancer, breast cancer, malignant melanoma, and skin cancer. Considering head / neck and breast cancer as an example, it is known that in approximately 50% (similar figures in other cancers) of the cases where there are changes in lymph nodes, these cannot be visualized with either ultrasound or other radiological methods such as MRI or CT. Gamma probes, however, are extremely sensitive to detect radioactive tracers and can sense the presence of an extremely small quantity of radioactive isotopes and in such a way identify sentinel lymph nodes (SLNS), which are tumour draining lymph nodes (TDLNs).

[0004] Presently, lymph nodes, such as TDLNs, are often surgically removed. If the TDLN is removed, the compartment that would react to future immunological changes is lost.

[0005] Another example is HPV positive oropharyngeal cancer that has increased in several western countries. If the TDLN is removed, the compartment that would react to future immunological changes is lost. Instead, human papillomavirus DNA detection from fine needle aspirates from sentinel node will indicate the status of the node, leaving the possibility for an eventual follow up of the response to immunotherapy open.

[0006] Patent document US2016 / 278723 describes a dual modality endorectal prostate probe having both a gamma probe sensor and an ultrasound sensor. The probe can be equipped with a biopsy gun equipped with a biopsy needle. The ultrasound component of the probe will then be used by a physician to guide the needle of the biopsy gun. This probe is suited for probing prostates, but not for lymph nodes, for instance due to the probe’s shape being for internal use and concomitant lack of resolving depth information.

[0007] Patent document US2006 / 106306A1 shows an ultrasound scanner with a gamma probe mounted thereto through a holder on a hinge arrangement. The ultrasound scanner is used to localize a labeled sentinel lymph node percutaneously and the gamma probe is positioned to obtain a greatest radiation count, indicating that the location of the labeled sentinel node has been determined. The position of the ultrasound scanner is held fixed, and the gamma probe is removed. Then, utilizing the established position of the holder along with the ultrasound image as a guide, a biopsy apparatus is inserted into the lymph node. A tissue collector or biopsy needle is then placed through the biopsy apparatus to collect a tissue sample from the lymph node. A very narrow radiation detector probe can be inserted through the biopsy apparatus to ascertain if the tip of that apparatus is inside the radioactive sentinel node. The position of the biopsy apparatus can then be adjusted if needed.

[0008] Patent document US 201642810 Al concerns a needle guide system comprising a mounting component that attaches to an ultrasound, and a guiding component which provides a groove or channel through which a biopsy needle can be inserted. The needle guide system can be used for out-of-plane ultrasound needle placement where the needle is not visible until it intersects a plane or axis of the ultrasound image.

[0009] It is an object, among objects, to provide an improved probe holder for positioning a biopsy needle, computer implemented method and computer program product.

[0010] To this end, in a first aspect, there is provided a multiprobe holder for positioning a biopsy apparatus, the multiprobe holder comprising: a first holder configured to hold a first probe along a first probing axis; and a second holder configured to hold a second probe along a second probing axis, wherein the second holder is rotatably arranged with respect to the first holder, wherein the second holder is further configured to hold the biopsy apparatus, wherein the multiprobe holder is configured such that, when the second holder is rotated with respect to the first holder, a distance along the second probing axis and between the second holder and the first probing axis is substantially equal.

[0011] The second holder can be used such that, when the first probing axis is directly above a region of interest, for example, a sentinel lymph node, the second holder, when holding the second probe (e.g. a gamma probe), is rotated until it is pointing at the sentinel lymph node. In this position, the crossing of the first probing axis and the second probing axis is at the sentinel lymph node. Then, the angle of the second holder is kept in a fixed position and the second probe is taken out. A biopsy apparatus may then be inserted in the second holder. Because the distance, along the second probing axis, between the second holder and the first probing axis is substantially equal, when, for example, using a biopsy needle, the tip of the needle will always be at the sentinel lymph node, that is, at the crossing of the first probing axis and the second probing axis. The first probing axis can be brought directly above a region of interest by using the first probe or by using the second probe. The first probe can be, for example, an ultrasound probe. Sometimes an ultrasound probe, or another type of first probe, gives no or little contrast for finding the region of interest. Then the second probe can be used to first find the position directly above of the region of interest, then using the first probe the holder is kept in position and the second holder is rotated until it is pointing at the region of interest, such as the sentinel lymph node.

[0012] Compared to the probe of US2006 / 106306A1, with the present multiprobe holder the positioning of the biopsy apparatus is simplified and more accurate. For instance, the multiprobe holder does not require the narrow radiation detector probe to check if the tip of the biopsy apparatus is in the correct position.

[0013] Compared to the needle guide system of US 201642810 Al, the present multiprobe holder has the effect of allowing one to determine both the position above the region of interest, as well as the depth of the region of interest to be biopsied by turning the second probe holder to the angle at which the region of interest is detected, as described above and below. Then, by being able to place the biopsy needle in the second holder, the needle tip will reach exactly the region of interest when performing the biopsy. This allows for a much greater precision when performing the biopsy. This precision is even enhanced further since the position of the multiprobe holder, the region of interest, and the biopsy needle can be monitored by the first probe when placed in the first probe holder.

[0014] In addition, the multiprobe holder is suitable for use with various ultrasound and gamma probes and therefore is adjustable to the needs of the physician and / or hospital.

[0015] The first holder may be configured to hold the first probe in a releasable way, such as by clamping and / or using complementary protrusions and extrusions . Alternatively, the first holder may be configured to be permanently attached to the first probe, such as by screws or adhesives and the like.

[0016] The second holder may be configured to be adapted to a biopsy depth of the biopsy apparatus. The biopsy depth is associated with the biopsy needle length. In particular, the position along the second probing axis of the second holder can be altered depending on the biopsy depth.

[0017] The biopsy apparatus may comprise, or be, a biopsy needle, or the biopsy apparatus may comprise a tissue collector. Embodiments may include that the second holder is rotatable from a first position having a corresponding first angle between the second probing axis and the first probing axis, to a second position having a corresponding second angle between the second probing axis and the first probing axis, wherein the second angle is smaller than the first angle.

[0018] Embodiments may include that, when the second holder is in the second position, the first probing axis and the second probing axis cross at a crossing point, wherein the multiprobe holder is configured such that the crossing point is at a substantially equal distance from the second holder along the second probing axis.

[0019] Embodiments may include that the second holder is further configured to hold the biopsy needle in a fixed position relative to the second holder. In this way, the biopsy needle tip will always end up at the crossing point, where the region of interest is.

[0020] Embodiments may comprise a connecting member which connects the first holder with the second holder.

[0021] Embodiments may be configured such that the connecting member comprises a curved recession in the connecting member. The second holder may comprise a complementary protrusion configured to slide in the recession and configured to keep a fixed angle relative to the recession.

[0022] In an embodiment, the recession is curved and positioned such that, when the second holder slides along the recession, the distance between the first probing axis and the second holder remains constant.

[0023] Embodiments may include that the first probe is of a first probe type and the second probe is of a second probe type, different from the first probe type.

[0024] Embodiments may include that the first probe type is an ultrasound probe type, and the second probe type is a gamma probe type.

[0025] Embodiments may include that first probe type is an ultrasound probe type, and the second probe type is a radiation probe type. The term radiation here indicates radiation including both non-ionizing and ionizing radiation. Non-ionizing radiation may include, for example, electromagnetic radiation. Ionizing radiation may include, for example, x-rays and gamma rays. These gamma rays can be emitted by radioisotope tracers.

[0026] The radiation probe type may include a gamma probe type and / or a magnetic probe type.

[0027] The magnetic probe can, for example, be a probe as described by Sekino et al., in “Handheld magnetic probe with permanent magnet and Hall sensor for identifying sentinel lymph nodes in breast cancer patients”, Sci Rep 8, 1195 (2018), DOI: 10.1038 / s41598-018- 19480- 1, or any other type of suitable magnetic probe, or magnetic field probe, configured to detect magnetic markers or tracers within a patient. The magnetic probe can be a magnetic probe configured to detect build-up of magnetic nanoparticles, such as superparamagnetic iron oxide nanoparticles (SPIONs) within sentinel lymph nodes as described by Sekino et al. The magnetic probe can additionally or alternatively be configured to detect magnetic fields generated by small magnetic objects left behind within tumorous regions before treatment. These small magnetic objects, for example the size of a seed or rice grain, can be placed in or near a tumorous region to identify the location of the tumour before treatment.

[0028] Embodiments may further include that multiprobe holder includes an oscillation generator arranged to oscillate the second holder such that it causes oscillation of the biopsy needle when held by the second holder. The oscillation generator may be or comprise an electromagnetic actuator, an ultrasonic transducer, a piezoelectric actuator, a micro-electro- mechanical system (MEMS), or a voice coil actuator. The oscillation may be vibration.

[0029] The oscillation generator may be arranged such that it generates longitudinal oscillation of the biopsy needle tip, lateral oscillation of the biopsy needle tip, or both. The oscillation results in probing a larger area or volume within the region from which a biopsy is to be taken. Also, tissue to be probed more easily enters the needle especially by the longitudinal oscillation. When the oscillation has a certain frequency, this can be used to increase the visibility of the needle when viewing with ultrasound, for example. The ultrasound probe can be setup to enhance the visibility by frequency adjustment or by doppler shift. In other words, the oscillations can be used to improve the visibility of the biopsy needle, to improve the harvesting of tissue, or both.

[0030] The amplitude of the oscillation may be varied to adapt to the size of the structure, region of interest, or volume of interest, to be probed. The amplitudes of either the longitudinal oscillation, the lateral oscillation, or both, may be varied. Embodiments may further comprise a third holder configured to hold the second probe along a third probing axis, wherein the third holder is arranged such that the third probing axis is substantially parallel to the first probe axis.

[0031] Embodiments may include a fourth holder configured to hold the second probe along a fourth probing axis, wherein the fourth holder is arranged such that the fourth probing axis is substantially parallel to the second probe axis, wherein the fourth holder is arranged in a fixed position relative to the second holder.

[0032] Embodiments may include the third holder and the fourth holder being positioned such that, when the second holder is rotated with respect to the first holder and therefore the fourth holder is rotated with respect to the first holder and the third holder, the third probing axis and the fourth probing axis cross each other.

[0033] In a second aspect, embodiments of the present disclosure may include a computer implemented method for assisting a positioning of a multiprobe holder into a biopsy position, the method including evaluating a position related to the multiprobe holder based on sensor data relating to a position of at least one of the first probe and the second probe and on probe data of the second probe. Embodiments may also include storing the position when one or more first predetermined conditions are met.

[0034] Embodiments may also include determining a displacement for the multiprobe holder relative to the stored position such that, when the multiprobe holder is displaced relative to the stored position, the first probe is in a position corresponding to a position of the second probe when the multiprobe holder is in the stored position. Embodiments may also include indicating the determined displacement of the multiprobe holder on a screen.

[0035] Embodiments may also include evaluating, when sensor data related to the multiprobe holder indicate that the multiprobe holder is displaced by the determined displacement, an angular position of the second probe holder based at least on probe data of the second probe.

[0036] Embodiments may also include indicating the multiprobe holder is in the biopsy position when one or more second predetermined conditions are met.

[0037] In an embodiment, the first predetermined conditions comprise a maximum count rate or maximum average count rate of the second probe, and the second predetermined conditions comprise a maximum count rate or maximum average count rate of the second probe. In an embodiment, the method comprises, when evaluating the angular position of the second probe holder, comparing a current count rate of the second probe with a stored count rate associated with the evaluated and stored position, and wherein the one or more second predetermined conditions comprise the current count rate being within 90% and 110% of the stored count rate.

[0038] In an embodiment, the method further comprises providing a visual indication on the screen of the area for puncture for a biopsy.

[0039] In an embodiment, the one or more first predetermined conditions comprise the second probe axis being parallel to the first probe axis.

[0040] In an embodiment, the method may additionally be for controlling an oscillation generator of the multiprobe holder, the oscillation generator being arranged to cause oscillation of a biopsy needle tip when inserted in the multiprobe holder. The method may include obtaining a measure for a size of a region or volume of interest for biopsy, and adapting the frequency and amplitude to be applied by the oscillation generator based on to the obtained measure for the size of the region or volume of interest.

[0041] In some embodiments, the adapting may depend on a mode of the oscillation generator stored in a memory of the computer.

[0042] In some embodiments, the adapting may comprise calculating the frequency and amplitude of the oscillation generator based on the obtained measure for the size of the region or volume of interest. Alternatively, one or more datasets corresponding to look-up table comprising various sizes of the region or volume of interest and frequencies and amplitudes are used to obtain the frequency and amplitude to be applied by the oscillation generator.

[0043] In some embodiments, the adapting may be based at least partially on a biopsy needle type stored in a memory of the computer. In this way, the adapting is done to take aspects of the needle into account, such as the weight and dimensions of the biopsy needle.

[0044] The obtaining may be partially or completely based on probe data from the first probe and / or the second probe, for instance by a classifying of the sensor data into categories corresponding to tissue types. These tissue types may include lymph node, muscle, cartilage, bone, etc. This classifying, sometimes called segmenting, can be done, for example, with known ultrasound probes and / or associated software. Alternatively, the obtaining may be based on data entered by a user of the computer and multiprobe holder.

[0045] An aspect of the present application is a method for controlling an oscillation generator of a multiprobe holder, such as any one of the multiprobe holders described above and below, the oscillation generator being arranged to cause oscillation of a biopsy needle tip when inserted in the multiprobe holder. The method may include obtaining a measure for a size of a region or volume of interest for biopsy, and adapting the frequency and amplitude to be applied by the oscillation generator based on to the obtained measure for the size of the region or volume of interest.

[0046] In some embodiments, the adapting may depend on a mode of the oscillation generator stored in a memory of the computer.

[0047] In some embodiments, the adapting may comprise calculating the frequency and amplitude of the oscillation generator based on the obtained measure for the size of the region or volume of interest. Alternatively, one or more datasets corresponding to look-up table comprising various sizes of the region or volume of interest and frequencies and amplitudes are used to obtain the frequency and amplitude to be applied by the oscillation generator.

[0048] In some embodiments, the adapting may be based at least partially on a biopsy needle type stored in a memory of the computer. In this way, the adapting is done to take aspects of the needle into account, such as the weight and dimensions of the biopsy needle.

[0049] The obtaining may be partially or completely based on probe data from the first probe and / or the second probe, for instance by a classifying of the sensor data into categories corresponding to tissue types. These tissue types may include lymph node, muscle, cartilage, bone, etc. This classifying, sometimes called segmenting, can be done, for example, with known ultrasound probes and / or associated software.

[0050] Alternatively, the obtaining may be based on data entered by a user of the computer and multiprobe holder.

[0051] According to a third aspect, there is provided a computer program product comprising a computer-executable program of instructions for performing, when executed on a computer, the steps of any one or more embodiments of the method according to second aspect. According to another aspect of the present invention, there is provided a digital storage medium encoding a computer-executable program of instructions to perform, when executed on a computer, the steps of the method of any one of the method embodiments described above.

[0052] According to yet another aspect of the present invention, there is provided a device programmed to perform a method comprising the steps of any one of the methods of the method embodiments described above.

[0053] According to yet another aspect of the present invention, there is provided a method for downloading to a digital storage medium a computer-executable program of instructions to perform, when executed on a computer, the steps of the method of any one of the method embodiments described above.

[0054] It will be understood that technical advantages and effects associated with features and / or embodiments of one aspect, apply to the corresponding, similar or equivalent features and / or embodiments the other aspects. It will also be apparent that the features of the various aspects and / or embodiments thereof may be applied to the other aspects and / or embodiments thereof.

[0055] Brief Description of the Drawings

[0056] The accompanying drawings are used to illustrate presently preferred non-limiting exemplary embodiments of devices of the present disclosure. The above and other advantages of the features and objects of the disclosure will become more apparent, and the aspects and embodiments will be better understood from the following detailed description when read in conjunction with the accompanying drawings, in which:

[0057] FIG. 1 is a perspective view of a multi probe holder according to an embodiment of the present patent disclosure holding an ultrasound probe and a biopsy needle;

[0058] FIG. 2 is a perspective view of a device according to an embodiment of the present patent disclosure holding an ultrasound probe and a gamma probe;

[0059] FIG. 3 is a side view of the device according to FIG. 2;

[0060] FIG. 4 is a schematic drawing showing a working principle of multi probe holders according to embodiments of the present patent disclosure;

[0061] FIG. 5 is a schematic side view of a multi probe holder according to the embodiment of the present patent disclosure in a first position;

[0062] FIG. 6 is a schematic top view of the multi probe holder of FIG. 5 in the first position; FIG. 7 is a schematic side view of the multi probe holder of FIG. 5 in a second position;

[0063] FIG. 8 is a schematic side view of the multi probe holder of FIG. 5 in the second position with a biopsy needle;

[0064] FIG. 9 is a schematic side view of a multi probe holder according to the embodiment of FIG. 2 in a first position;

[0065] FIG. 10 is a schematic top view of the multi probe holder of FIG. 9 in the first position; FIG. 11 is a schematic side view of the multi probe holder of FIG. 9 in a second position;

[0066] FIG. 12 is a schematic side view of the multi probe holder of FIG. 9 in the second position with a biopsy needle;

[0067] FIG. 13 is a schematic side view of a multi probe holder according to the embodiment of FIG. 1 in a first position;

[0068] FIG. 14 is a schematic top view of the multi probe holder of FIG. 13 in the first position; FIG. 15 is a schematic side view of the multi probe holder of FIG. 13 in a second position; FIG. 16 is a schematic side view of the multi probe holder of FIG. 13 in the second position with a biopsy needle; and

[0069] FIG. 17 is a flowchart illustrating a method for assisting, according to some embodiments of the present disclosure.

[0070] Detailed Description of Preferred Embodiments

[0071] A multiprobe holder 100 for positioning a biopsy needle 30 according to one or more embodiments is shown in FIG. 1. The multiprobe holder 100 comprises a first holder 102 configured to hold a first probe 10 along a first probing axis 1. The multiprobe holder 100 further comprises a second holder 104 configured to hold a second probe 20 along a second probing axis 2. The second holder 104 is rotatably arranged with respect to the first holder 102. The second holder 104 is further configured to hold the biopsy needle 30. The multiprobe holder 100 is configured such that, when the second holder 104 is rotated with respect to the first holder 102, a distance along the second probing axis 2 and between the second holder 104 and the first probing axis 1 is substantially equal (Fig 3). The first probe 10 is here embodied as an ultrasound probe 10, having a sensing head 12.

[0072] In some embodiments, the multiprobe holder 100 comprises a connecting member 110 which connects the first holder 102 with the rotatable second holder 104.

[0073] In some embodiments, the multiprobe holder 100 further comprises a third holder 106 and / or a fourth holder 108. Although the biopsy needle 30 is shown in FIG. 1 positioned within the fourth holder 108, the second holder 104 is configured to hold both the second probe 20 (not shown in FIG. 1) and the biopsy needle 30 in a fixed position relative to the second holder 104. The fourth holder 108 may be configured like the second holder 104, or only to hold the second probe 20 in a fixed position. The third holder 106 is configured to hold the second probe 20 in a fixed position. In the embodiment of FIG. 1, the second holder 104 is arranged at a first lateral side of the first holder 102.

[0074] A multiprobe holder 200 for positioning a biopsy needle 30 according to one or more embodiments is shown in FIG. 2. The multiprobe holder 200 comprises a first holder 202 configured to hold a first probe 10 along a first probing axis 1. The multiprobe holder 200 further comprises a second holder 204 configured to hold a second probe 20 along a second probing axis 2. The second holder 204 is rotatably arranged with respect to the first holder 202. The second holder 204 is further configured to hold the biopsy needle 30. The multiprobe holder 200 is configured such that, when the second holder 204 is rotated with respect to the first holder 202, a distance along the second probing axis 2 and between the second holder 204 and the first probing axis 1 is substantially equal (Fig 3). The first probe 10 is here embodied as an ultrasound probe 10, having a sensing head 12.

[0075] In some embodiments, the multiprobe holder 200 comprises a connecting member 210 which connects the first holder 202 with the rotatable second holder 204.

[0076] In some embodiments, the multiprobe holder 200 further comprises a third holder 206 and / or a fourth holder 208. The second probe 20, here embodied as a gamma probe 20, is held by the second holder 208 in FIG. 2. The second holder 104 is configured to hold both the second probe 20 and the biopsy needle 30 (not shown in FIG. 2) in a fixed position relative to the second holder 204. The fourth holder 208 may be configured like the second holder 204, or only to hold the second probe 20 in a fixed position relative to the fourth holder 208. The third holder 106 is configured to hold the second probe 20 in a fixed position relative to the third holder 106. The third holder 106 is arranged to have its associated third probing axis 3 parallel with respect to the first probing axis 1.

[0077] The embodiment of FIGS. 2 and 3 has the second holder 204 arranged on the second lateral side of the first holder 202. In this case, the second holder 204 is at a backside of the first probe 10. This makes handling the multiprobe holder 200 by hand easier, as the user can hold the multiprobe holder in his or her hand at the first holder 202 section thereof together with the first probe 10. As is shown in FIG. 3 for the multiprobe holder 200, the second holder 204, shown in a first position 204’ and a second position 204”, is rotatable from the first position 204’ having a corresponding first angle 50 between the second probing axis 2 and the first probing axis 1, to a second position 204” having a corresponding second angle 52 between the second probing axis 2 and the first probing axis 1, wherein the second angle 52 is smaller than the first angle 50.

[0078] When the second holder 204 is in the second position, the first probing axis 1 and the second probing axis cross 1 at crossing point, wherein second holder 204 is configured such that the crossing points 72 and 74 are at a substantially equal distance from the second holder along the second probing axis 2.

[0079] The multiprobe holder 200 comprises a curved recession, such as a slit, slot or groove, 230 in the connecting member 210. The second holder 204 comprises a complementary protrusion (not shown), such as a pin or bar, configured to slide in the groove 230 and configured to keep a fixed angle relative to the groove 230. The groove 230 is curved and positioned such that, when the second holder 204 slides along the groove 230, the distance between the first probing axis 1 and the second holder 204 remains constant.

[0080] The distance 60 between the first probing axis 1 and the second holder 204 in the first position 204’ is the same as the distance 62 between the first probing axis 1 and the second holder 204 in the second position 204” . In the first position, the protrusion of the second holder 204 is at a first end position 232 of the groove 230. In the second position 204”, the protrusion of the second holder 204 is at a second end position 234 of the groove 230.

[0081] FIG. 4 shows schematically the shape of a groove 430, which is similar to groove 230. The first probe 10 is shown, relative to which the two arrows (representing a biopsy needle arranged along the second probing axis) have two different positions. In the first position, the position of the end of the arrow at the y-axis, which represents the first probing axis, has a distance D from the first probe 10. In the second position, the position of the end of the arrow has a distance Dmax from the first probe 10. This is the maximum distance the needle tip can have in this schematic example. In the first position, a first angle 0i between the arrow and an axis perpendicular to the y-axis is indicated as equal to arctan(DZW). In the second position, a second angle 02 between the arrow and an axis perpendicular to the y-axis is indicated as equal to arctan(Dmax / W). In this case, the rotation point is at x = W, here at the edge of the first probe 10. It is preferred that the rotation point is as close to the first probe as possible, meaning W as close to L / 2 as possible, without the needle touching the first probe 10 in any position, to achieve the largest bandwidth in needle depths, that is, the largest range of D.

[0082] FIGS. 5-8 schematically show an embodiment of the multiprobe holder 300 with a first holder (not shown) holding the first probe 10 and a second holder 304 and how it is used to accurately perform a biopsy. The first probe 10 is here embodied as an ultrasound probe 10. In this embodiment, the second probe holder 304 is configured to be in a position wherein the second probing axis 2 is parallel to the first probing axis 1.

[0083] In this parallel position, first the second probe, in the following examples further referred to as the gamma probe is used to reach a position of the multiprobe holder 300 in which the second probing axis 2 is directly above a region of interest 40. This could be a sentinel lymph node having radioactive tracers in it, which are then detected by the gamma probe 20.

[0084] Alternatively, the gamma probe 20 or, for example, a magnetic probe, can be used to find the region of interest 40. This can be beneficial when the (initial) contrast with the ultrasound probe 10 are insufficient to detect the region of interest 40. Once the region interest is found using the gamma probe, then the ultrasound probe can be kept above that region, and thereafter the depth of the region of interest can be determined by rotating the second holder with the gamma probe 20 as described above and below.

[0085] After this position of FIG. 5 is reached, the multiprobe holder 300 is then moved a distance d, such that the first probing axis 1 is directly above the region of interest 40, as shown in FIG. 6, which is a top view of the multiprobe holder 300. A first lateral axis 5 crosses the ultrasound probe 10 through its center and is perpendicular to the first probing axis 1. A second lateral axis 6 crosses the second probe holder 304 through its center and is perpendicular to the second probing axis 2. A third lateral axis 7 crosses both the ultrasound probe 10 and the second probe holder 304 through their respective centers. The third lateral axis 7 is perpendicular to the first 1 and second 2 probing axes and the first 5 and second 6 lateral axes. Before moving, the region of interest lies underneath the crossing of a second lateral axis 6 and a third lateral axis 7. After moving the multiprobe holder 300, the region of interest lies underneath the crossing of the first lateral axis 5 and the third lateral axis 7. This movement can be guided by using a motion and / or position sensor in the for the gamma probe 20. This may be done using software on a computer that is communicatively connected to either the ultrasound probe 10 or the gamma probe 20 or both.

[0086] FIG. 7 shows the multiprobe holder 300 in the moved position, with the region of interest 40 directly below the ultrasound probe 10, with the first probing axis 1 crossing the region of interest 40. With the gamma probe 20 in the second holder 304, the second holder 304 is then rotated until a highest gamma ray count is observed. This means that the second probing axis 2 crosses the region of interest. Then, while keeping the multiprobe holder 300 in the same position with respect to the patient, the gamma probe 20 is removed and the biopsy needle 30 is inserted into the second holder 304 (FIG. 8). As explained above, the tip of the needle will end up at the region of interest 40 because of how the second holder 304 is configured to have an equal distance to the first probing axis 1. The biopsy can be observed using the ultrasound probe.

[0087] Generally, for example referring to FIG. 5, the second probe holder and the corresponding connecting member may be configured to fold to a folded position closer to the first probe 10, wherein the second probing axis 2 is parallel to the first probing axis 1. In this way, the distance d is shortened.

[0088] FIGS. 9-12 correspond to FIGS. 5-8, except that the multiprobe holder 200 of FIGS. 2 and 3 is used. In this case, the third probe holder 206 is used to first receive the gamma probe. The third probing axis is parallel to the first probing axis 1. Once over the region of interest 40, the multiprobe holder 200 is moved a distance d, such that the region of interest is directly underneath the first probing axis 1 (FIGS. 10 and 11). Then, the gamma probe (not shown) is inserted into the second probe holder 204, which is then rotated until a highest count rate is observed by the gamma probe, indicating that the second probing axis 2 crosses the first probing axis 1 at the region of interest 40. Then the biopsy is performed similar to what is described above for FIG. 8.

[0089] In this way, the distance d is shortened, as the rotatable second probe holder 304 may have a larger distance from the first probing axis when it is in the parallel position as in FIG. 5 than the third probing axis 206 in FIG. 9. Also, in this way the second holder 204 does not need to have a position in which its associated second probing axis 2 is parallel to the first probing axis 1, simplifying the construction of the multiprobe holder.

[0090] FIGS. 13-16 correspond to both FIGS. 5-8 and FIGS. 9-12, except that the multiprobe holder 100 of FIG. 1 is used. In this case, the third probe holder 106 is used to first receive the gamma probe 20. The third probing axis 3 is parallel to the first probing axis 1. Then Then, the gamma probe (not shown) is inserted into the fourth probe holder 108, which is then rotated until a highest count rate is observed by the gamma probe, indicating that the fourth probing axis 4 crosses the third probing axis 3 at the region of interest 40. In this way, by setting the angle of the fourth probe holder 108, the second probe holder 104, which has a fixed position relative to the fourth probe holder 108, has a correct angle with respect to the first probing axis 1. Once in this position of Fig. 13, the multiprobe holder 100 is moved a distance d shown in FIG. 14, such that the region of interest is directly underneath the first probing axis 1 (FIGS. 15 and 16). This movement may be guided by the gamma probe 20, when inserted into the second probe holder 104. Since the angle of the second probe holder and corresponding second probing axis 2 was already set correctly, the accuracy of positioning the multiprobe holder is increased and slight, erroneous movements from the user holding the multiprobe holder can be corrected for.

[0091] Finally, the biopsy is performed similar to what is described above for FIGS. 8 and 12.

[0092] FIG. 17 is a flowchart that describes method for assisting a positioning of a multiprobe holder according to some embodiments of the present disclosure. In some embodiments, at 1710, the method may include evaluating a position related to the multiprobe holder based on sensor data relating to a position of the first probe and / or the second probe, and on probe data of the second probe. At 1720, the method may include storing the position when one or more first predetermined conditions are met. At 1730, the method may include determining a displacement for the multiprobe holder relative to the stored position such that, when the multiprobe holder may be displaced relative to the stored position, the first probe is in a position corresponding to a position of the second probe when the multiprobe holder is in the stored position.

[0093] In some embodiments, at 1740, the method may include indicating the determined displacement of the multiprobe holder on a screen. At 1750, the method may include evaluating, when sensor data related to the multiprobe holder indicate that the multiprobe holder may be displaced by the determined displacement, an angular position of the second probe holder based at least on probe data of the second probe. At 1760, the method may include indicating the multiprobe holder is in the biopsy position when one or more second predetermined conditions are met.

[0094] The method may be for controlling an oscillation generator of a multiprobe holder, such as any one of the multiprobe holders described above and below, the oscillation generator being arranged to cause oscillation of a biopsy needle tip when inserted in the multiprobe holder. This method may be combined with the above method for positioning the multiprobe holder, or may be separately performed. The method may include obtaining a measure for a size of a region or volume of interest for biopsy, and adapting the frequency and amplitude to be applied by the oscillation generator based on to the obtained measure for the size of the region or volume of interest.

[0095] The adapting may depend on a mode of the oscillation generator stored in a memory of the computer.

[0096] The adapting may comprise calculating the frequency and amplitude of the oscillation generator based on the obtained measure for the size of the region or volume of interest. Alternatively, one or more datasets corresponding to look-up table comprising various sizes of the region or volume of interest and frequencies and amplitudes are used to obtain the frequency and amplitude to be applied by the oscillation generator.

[0097] The adapting may be based at least partially on a biopsy needle type stored in a memory of the computer. In this way, the adapting is done to take aspects of the needle into account, such as the weight and dimensions of the biopsy needle.

[0098] The obtaining may be partially or completely based on probe data from the first probe and / or the second probe, for instance by a classifying of the sensor data into categories corresponding to tissue types. These tissue types may include lymph node, muscle, cartilage, bone, etc. This classifying, sometimes called segmenting, can be done, for example, with known ultrasound probes and / or associated software.

[0099] Alternatively, the obtaining may be based on data entered by a user of the computer and multiprobe holder.

[0100] Although the present invention has been described with reference to specific embodiments, also shown in the appended drawings, it will be apparent to those skilled in the art that many variations and modifications can be done within the scope of the invention as described in the specification and defined with reference to the claims below.

Claims

CLAIMS1. Multiprobe holder for positioning a biopsy needle, the multiprobe holder comprising: a first holder configured to hold a first probe along a first probing axis; and a second holder configured to hold a second probe along a second probing axis, wherein the second holder is rotatably arranged with respect to the first holder, wherein the second holder is further configured to hold the biopsy needle, wherein the multiprobe holder is configured such that, when the second holder is rotated with respect to the first holder, a distance along the second probing axis and between the second holder and the first probing axis is substantially equal.

2. Multiprobe holder according to claim 1, wherein the second holder is rotatable from a first position having a corresponding first angle between the second probing axis and the first probing axis, to a second position having a corresponding second angle between the second probing axis and the first probing axis, wherein the second angle is smaller than the first angle.

3. Multiprobe holder according to claim 2, wherein, when the second holder is in the second position, the first probing axis and the second probing axis cross at a crossing point, wherein second holder is configured such that the crossing point is at a substantially equal distance from the second holder along the second probing axis.

4. Multiprobe holder according to any one of the preceding claims, wherein the second holder is further configured to hold the biopsy needle in a fixed position relative to the second holder.

5. Multiprobe holder according to any one of the preceding claims, comprising a connecting member which connects the first holder with the second holder.

6. Multiprobe holder according to claim 5, wherein the connecting member comprises a curved recession in the connecting member, and the second holder comprises a complementary protrusion configured to slide in the recession and configured to keep a fixed angle relative to the recession, wherein optionally the recession is curved and positioned such that, when the second holder slides along the recession, the distance between the first probing axis and the second holder remains constant.

7. Multiprobe holder according to any one of the preceding claims, wherein the first probe is of a first probe type and the second probe is of a second probe type, different from the first probe type, wherein optionally the first probe type is an ultrasound probe type, and / or the second probe type is a radiation probe type, wherein optionally the radiation probe type is a gamma probe type or a magnetic probe type.

8. Multiprobe holder according to any one of the preceding claims, comprising an oscillation generator arranged to vibrate the second holder such that it causes oscillation of the biopsy needle when held by the second holder.

9. Multiprobe holder according to any one of the preceding claims, further comprising a third holder configured to hold the second probe along a third probing axis, wherein the third holder is arranged such that the third probing axis is substantially parallel to the first probe axis.

10. Multiprobe holder according to any one of the preceding claims, further comprising a fourth holder configured to hold the second probe along a fourth probing axis, wherein the fourth holder is arranged such that the fourth probing axis is substantially parallel to the second probe axis, wherein the fourth holder is arranged in a fixed position relative to the second holder.

11. Multiprobe holder according to claim 10, in dependence of claim 9, wherein the third holder and the fourth holder are positioned such that, when the second holder is rotated with respect to the first holder and therefore the fourth holder is rotated with respect to the first holder and the third holder, the third probing axis and the fourth probing axis cross each other.

12. Computer implemented method for assisting a positioning of a multiprobe holder according to any one of claims 1 to 11 into a biopsy position, the method comprising:- evaluating a position related to the multiprobe holder based on sensor data relating to a position of the first probe and / or the second probe and on probe data of the second probe;- storing the position when one or more first predetermined conditions are met;- determining a displacement for the multiprobe holder relative to the stored position such that, when the multiprobe holder is displaced relative to the stored position, the first probe is in a position corresponding to a position of the second probe when the multiprobe holder is in the stored position;- indicating the determined displacement of the multiprobe holder on a screen;- when sensor data related to the multiprobe holder indicate that the multiprobe holder is displaced by the determined displacement, evaluating an angular position of the second probe holder based at least on probe data of the second probe; and- indicating the multiprobe holder is in the biopsy position when one or more second predetermined conditions are met.

13. Computer implemented method according to claim 12, in dependence of claim 6, wherein the first predetermined conditions comprise a maximum count rate or maximum average count rate of the second probe, and the second predetermined conditions comprise a maximum count rate or maximum average count rate of the second probe.

14. Computer implemented method according to claim 13, comprising, when evaluating the angular position of the second probe holder, comparing a current count rate of the second probe with a stored count rate associated with the evaluated and stored position, and wherein the one or more second predetermined conditions comprise the current count rate being within 90% and 110% of the stored count rate.

15. Computer implemented method according to claim 12, 13 or 14, further comprising providing a visual indication on the screen of the area for puncture for a biopsy.

16. Computer implemented method according to any one of claims 12 to 15, wherein the one or more first predetermined conditions comprise the second probe axis being parallel to the first probe axis.

17. Computer program product comprising a computer-executable program of instructions for performing, when executed on a computer, the steps of the method of any one of claims 12 to 16.

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