Steerable Catheter Navigation with Respiratory Motion Compensation
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Solution Overview
Problem
Current medical devices and procedures for image-guided lung procedures face challenges in accurately visualizing, accessing, and confirming the location of target tissues in the lungs, particularly for peripheral tissues that are small or hard to reach, due to limitations in bronchoscope design and respiratory motion.
Innovation Solution
A navigation system using a steerable catheter with a localization element and a tissue sensing device, combined with a hybrid 'Inspiration-Expiration' 3D airway model, allows for precise localization and tracking of target tissues, enabling accurate navigation and sampling even in challenging anatomical locations by accounting for respiratory motion and correcting image distortion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If standard bronchoscopes are used for lung procedures, then the procedure can be performed with conventional equipment, but the ability to accurately locate and access peripheral lung tissues is limited
Solution Approach 1:
The navigation system integrates multiple functions including image guidance, real-time tracking, respiratory motion compensation, and tissue sampling capabilities into a unified platform. The system can navigate both flexible and rigid bronchoscopes, and performs multiple tasks (localization, navigation, confirmation) that previously required separate devices and procedures.
Solution Approach 2:
The system introduces intermediate components including localization elements attached to the bronchoscope, tracking cameras, and image fusion software that acts as a mediator between the physical bronchoscope and the virtual navigation space. These intermediaries enable precise tracking and visualization without requiring modification of the core bronchoscope functionality.
2Loss of information
If image guidance is used to locate target tissues, then visualization capability is improved, but real-time confirmation of target tissue location remains challenging
Solution Approach 1:
The system implements continuous feedback loops where the tracking system monitors the bronchoscope position in real-time, compares it with the pre-procedural imaging data, and provides ongoing confirmation of target tissue location. The overlay visualization continuously updates to show the relationship between the bronchoscope tip and the target tissue, enabling real-time verification.
Solution Approach 2:
The system performs preliminary actions by pre-acquiring detailed imaging data (CT, PET, or other modalities) and creating a three-dimensional virtual model of the airways and target tissues before the procedure. This pre-procedural planning and localization is stored and used to guide the bronchoscope navigation, reducing the need for exploratory maneuvers during the procedure.
3Measurement precision
If respiratory motion is not accounted for, then the navigation system is simpler, but the accuracy of target tissue localization deteriorates due to lung movement
Solution Approach 1:
The system transitions from static pre-procedural images to dynamic real-time tracking that adapts to respiratory motion. The navigation system continuously updates the position of the bronchoscope and the target tissue throughout the respiratory cycle, using registration techniques that account for lung movement between breaths and during the procedure.
Solution Approach 2:
The system employs asymmetric approaches by using different strategies for different phases of respiration or different anatomical regions. The registration and tracking algorithms can be customized to account for the specific motion patterns of different lung zones, allowing for more accurate localization in areas with greater respiratory excursion.
4Loss of time
If pre-acquired imaging data is used for navigation, then the procedural time is reduced, but the images may not reflect the current anatomical position due to respiratory changes
Solution Approach 1:
The system replaces mechanical repositioning or repeated imaging with computational image registration and fusion techniques. Instead of physically adjusting equipment or acquiring new images during the procedure, the system uses software algorithms to align and fuse pre-acquired imaging data with real-time bronchoscope position data, maintaining anatomical accuracy without additional procedural time.
Data Source
AI summary
A method of confirming the location of a target tissue within a patient using a navigation system is provided. The navigation system displays images from a pre-acquired image dataset and provides location information of a medical device within a patient in relation to a patient tracking device affixed to the patient. The method includes determining an initial location of the target tissue, navigating a steerable catheter through the airway of the patient to a position proximate the initial location, tracking the location of the steerable catheter in the airway using the navigation system, generating information regarding the presence of the target tissue using a tissue sensing device inserted into the steerable catheter, and determining a confirmed location of the target tissue in relation to the patient tracking device using the generated information regarding the presence of the target tissue and the tracked location of the steerable catheter.