C-Arm Targeting Device for Image-Guided Biopsy Path Planning
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Solution Overview
Problem
Current image-guided percutaneous targeting techniques, such as ultrasonic and CT-based methods, face challenges like poor visualization of anatomical structures filled with air, low signal quality in obese patients, and poor patient access, while X-ray devices offer limited contrast resolution, making precise targeting in procedures like biopsies and ablations inefficient.
Innovation Solution
A targeting device and system that utilize a C-arm apparatus to select a two-dimensional image slice containing the entry and target points, determining a direct path and recording fluoroscopic images in that direction, allowing for efficient control of the object's movement by comparing its shape and position to a 3D graphic, and using 3D roadmap functionality to ensure accurate path planning and tracking, even with limited contrast resolution.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If CT-based imaging is used for image guidance, then contrast resolution and visualization of anatomical structures is improved, but patient access and room sterility are worsened
Solution Approach 1:
The system separates the imaging function (CT scanner) from the intervention function (operating room with sterile environment). Pre-procedure CT scanning is performed separately to acquire high-resolution anatomical data, which is then integrated with real-time fluoroscopic imaging during the procedure. This segmentation allows each modality to operate in its optimal environment without compromising the other.
Solution Approach 2:
A computer-based image integration system acts as an intermediary, combining pre-acquired CT volumetric data with real-time fluoroscopic images. The system overlays CT-derived anatomical structures onto fluoroscopic images, providing CT-level contrast resolution guidance while maintaining the advantages of fluoroscopy for real-time monitoring and patient access.
2Ease of operation
If rotational X-ray device is used for intervention, then room sterility and patient access are improved, but contrast resolution is worsened
Solution Approach 1:
High-resolution CT imaging is performed as a preliminary action before the intervention procedure. The acquired volumetric CT data is processed to create three-dimensional roadmaps and anatomical overlays that are then superimposed on real-time fluoroscopic images during the procedure. This preliminary acquisition of high-resolution data compensates for the lower contrast resolution of the rotational X-ray device used during the sterile intervention.
Solution Approach 2:
The system transitions from two-dimensional fluoroscopic imaging to three-dimensional CT-based roadmaps and overlays. By acquiring volumetric CT data and rendering three-dimensional anatomical structures, the system provides enhanced spatial context and contrast resolution that complements the real-time two-dimensional fluoroscopic guidance, enabling more precise targeting while maintaining room sterility.
3Speed
If ultrasonic imaging is used for guidance, then real-time monitoring is improved, but visualization of air-filled structures and bony anatomy is worsened
Solution Approach 1:
The system merges the real-time monitoring capability of ultrasonic imaging with the superior anatomical visualization of CT and fluoroscopic imaging. By integrating multiple imaging modalities into a unified guidance system, the advantages of each modality are combined while compensating for their individual limitations, providing both real-time monitoring and accurate anatomical structure visualization.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach enables precise and efficient targeting and tracking of objects, such as needles, within the body by providing clear visualization and alignment with planned paths, reducing the risk of vessel perforation and improving procedural accuracy, even in cases with low contrast resolution, and allows for reduced patient radiation exposure.
Implementation Method 1
The fluoroscopic image is also a two-dimensional image which normal is parallel with the first direction, i.e. the fluoroscopic image is recorded in the direction of the determined path
Data Source
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AI summary
According to an exemplary embodiment a targeting method for targeting a first object from an entry point to a target point in an object (110) under examination is provided, wherein the method comprises selecting a two-dimensional image (301) of the object under examination depicting the entry point (305) and the target point (303) and determining a planned path (304) from the entry point to the target point, wherein the planned path has a first direction. Furthermore, the method comprises recording data representing a fluoroscopic image of the object under examination, wherein the fluoroscopic image is recorded under a second direction so that a normal of the image coincide with the first direction and determining whether the first object is on the determined planned path based on shape and/or position of the projection of the first object in the fluoroscopic image.