JP2020520744A - 画像の三次元再構成及び改善された対象物定位のために、放射状気管支内超音波プローブを用いるための方法 - Google Patents
画像の三次元再構成及び改善された対象物定位のために、放射状気管支内超音波プローブを用いるための方法 Download PDFInfo
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Abstract
Description
本出願は国際(PCT)出願であり、2017年5月24日に出願された、共有でありかつ同時係属中の米国特許仮出願第62/510,729号(発明の名称「画像の三次元再構成及び改善された対象物定位のために、放射状気管支内超音波プローブを用いるための方法」)に関連し、当該仮出願の内容は全体を通して参照により本明細書に組み込まれる。
実施形態の医療適用の例が、以下の予言的な例を通じて示される。
1.対象領域への気管支内ナビゲーション。ナビゲーションは、例えばPCT/US15/56489に記載の方法を用いて(ただしこれに限定されない)実行され得る。
2.対象領域内のREBUS画像を取得する。
3.REBUS画像から対象物を抽出し、術中画像に投影する。
4.気管支内器具を対象物の中心に配置し、切除または生検を行う。
5.切除が実行されて解剖学的構造が変化した場合、ステップ2−4が再度実行されてもよい。
Claims (17)
- イメージングモダリティから少なくとも1つの術前画像を取得するステップと、
前記少なくとも1つの術前画像において、関心領域内に位置する少なくとも1つの要素を識別するステップと、
少なくとも1つの術中画像を取得するステップと、
前記少なくとも1つの術中画像上の前記少なくとも1つの要素をハイライトするステップと、少なくともハイライトされた少なくとも1つの要素を用いて、放射状気管支内超音波プローブを前記関心領域にナビゲートするステップと、
複数の放射状気管支内超音波画像を取得するステップと、
前記要素の複数の二次元表現を抽出するステップであって、前記要素の前記複数の二次元表現の各々は前記複数の放射状気管支内超音波画像のうちの対応するものから抽出される、ステップと、
前記要素の前記複数の二次元表現から前記要素の三次元表現を再構築するステップと、
前記少なくとも1つの術中画像のうちの少なくとも1つに、前記要素の前記三次元表現の二次元投影を投影するステップとを含む、
方法。 - 前記少なくとも1つの術中画像のうちの少なくとも1つに前記要素の前記三次元表現の二次元投影を投影するステップは、リアルタイムで実行される、
請求項1に記載の方法。 - 前記関心領域から前記放射状気管支内超音波プローブを除去するステップと、
更なる気管支内ツールを前記関心領域にナビゲートするステップとを更に含む、
請求項1に記載の方法。 - 前記更なる気管支内ツールを用いて前記要素に手続を実行するステップを更に含む、
請求項3に記載の方法。 - 前述の更なる気管支内ツールを除去するステップと、放射状気管支内超音波プローブを関心領域にナビゲートするステップと、複数の更新された放射状気管支内超音波画像を取得するステップと、要素の複数の更新された二次元表現を抽出するステップであって、要素の複数の更新された二次元表現の各々は、複数の更新された放射状気管支内超音波画像のうちの対応するものから抽出される、ステップと、並びに、要素の複数の二次元表現から要素の更新された三次元表現を再構築するステップとを更に含む、
請求項4に記載の方法。 - 前記放射状気管支内超音波プローブの中心と前記対象物の境界上の複数の境界点との間の距離を計算するステップと、及び、
前記距離のうちの最大値に基づいて切除のマージンサイズを推定するステップとを更に含む、
請求項1に記載の方法。 - 前記少なくとも1つの術中画像は、X線画像を含む、
請求項1に記載の方法。 - 前記要素の前記三次元表現は、前記複数の術中画像のうちの1つからの体積の再構築のための前段階として用いられる、
請求項1に記載の方法。 - 前記対象物の前記三次元表現を、三次元の計算された断層撮影体積に位置合わせするステップと、
前記三次元の計算された断層撮影体積からの、前記要素の前記三次元表現を、前記少なくとも1つの術中画像のうちの少なくとも1つの上に投影するステップとを更に含む、
請求項1に記載の方法。 - 前記三次元の計算された断層撮影体積は、術前の計算された断層撮影スキャン体積、又は、前記少なくとも1つの術中画像から再構築された三次元の計算された断層体積である、
請求項9に記載の方法。 - 放射状気管支内超音波プローブを関心領域にナビゲートするステップと、
複数の放射状気管支内超音波画像及び複数の術中画像を取得するステップであって、前記複数の放射状気管支内超音波画像は、前記複数の術中画像のうちの1つ及び前記超音波プローブの異なる位置に対応している、ステップと、
前記複数の術中画像の各々から、放射状気管支内超音波プローブ先端の位置を抽出するステップと、
前記術中画像及び前記気管支内超音波画像の組のデータベースを生成するステップであって、前記組の各々は、前記術前画像の座標系におけるプローブ先端の特定の位置及び向きに対応している、ステップと、
前記関心領域から前記放射状気管支内超音波プローブを除去するステップと、
更なる気管支内器具を前記関心領域にナビゲートするステップと、
更なる複数の術中画像を取得するステップと、
前記更なる複数の術中画像から前記更なる気管支内器具の位置を抽出するステップと、
前記データベースにおける前記組のうちで、前記更なる気管支内器具の前記位置と最も接近して対応する前記組を識別するステップと、及び、
前記識別された前記組に対応する前記超音波画像を表示するステップとを含む、
方法。 - 前記更なる気管支内器具は、生検器具又は切除カテーテルである、
請求項11に記載の方法。 - イメージングモダリティから少なくとも1つの術前画像を取得するステップと、
前記少なくとも1つの術前画像上で、関心領域内に位置する少なくとも1つの要素を識別するステップと、
少なくとも1つの術中画像を取得するステップと、及び、
前記少なくとも1つの術中画像上の前記少なくとも1つの要素をハイライトするステップとを更に含み、
前記放射状気管支内超音波プローブを関心領域にナビゲートするステップは、前記ハイライトされた少なくとも1つの要素を用いて実行される、
請求項11に記載の方法。 - 放射状気管支内超音波プローブを関心領域にナビゲートするステップと、
前記放射状気管支内超音波プローブの確認された位置を選択するステップと、
前記放射状気管支内超音波プローブが前記確認された位置に位置づけられる間に、前記関心領域の少なくとも1つの術中画像を取得するステップと、
前記少なくとも1つの術中画像のうちの少なくとも1つから、前記放射状気管支内超音波プローブ位置を抽出するステップと、及び、
前記少なくとも1つの術中画像のうちの少なくとも1つの上に、前記気管支内超音波プローブの前記確認された位置をオーバレイするステップとを含む、
方法。 - 少なくとも2つの更なる術中画像を取得するステップであって、前記少なくとも2つの更なる術中画像の各々は、前記放射状気管支内超音波プローブの前記確認された位置の既知の幾何学的関係を持つ、ステップと、
前記少なくとも2つの更なる術中画像に基づいて、三次元空間中に前記確認された位置を再構築するステップと、及び、
既知の幾何学的関係を持つ前記更なる術中画像のうちの少なくとも1つの上に、前記放射状気管支内超音波プローブの前記確認された位置をオーバレイするステップとを更に含む、
請求項14に記載の方法。 - 前記放射状気管支内超音波プローブを除去するステップと、及び、
前記確認された位置に更なる気管支内器具をナビゲートするステップであって、前記更なる気管支内器具の正確な位置決めが保証される、ステップとを更に含む、
請求項14に記載の方法。 - 前記更なる気管支内器具は、生検器具又は切除カテーテルである、
請求項16に記載の方法。
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