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Having thus described the preferred embodiment, the invention is now
claimed to be:
1. A stereotaxy system comprising:
a subject support;
a means for securing a preselected portion of a subject to the subject
support;
a frame assembly which mounts at least three receivers in a fixed
relationship to the subject support closely adjacent the means for
securing a portion of the subject to the subject support;
at least one reference emitter mounted a fixed, known distance from the
receivers, the reference emitter emitting a reference signal which travels
from the reference emitter the fixed distance to the receivers;
a calibration means for measuring a reference travel time of the reference
signal over the preselected distance and generating a corresponding
calibration factor;
a wand having a pointer and at least two emitters mounted thereto, the two
wand emitters selectively emitting wand signals which are received by the
at least three receivers;
a wand position determining means for determining a position of the wand
pointer by measuring wand signal travel times of the wand signals between
the two wand emitters and the at least three receivers, the wand position
determining means being connected with the calibration means for
calibrating the wand signal travel times with the reference travel time.
2. The system as set forth in claim 1 further including:
a three-dimensional image memory means for storing image data indicative of
a three-dimensional region of the portion of the subject which is secured
to the subject support;
a plane selecting means for selecting planar slices of data from the
three-dimensional image memory means;
a display means for converting the selected slices of data from the plane
selecting means into human-readable displays;
a transform means for transforming with a wand pointer coordinate system to
image data coordinate system transform a position of the wand pointer into
a coordinate system of the image data stored in the three-dimensional
image memory means, the transform means being connected with the plane
selecting means such that the displayed images have a preselected
relationship to the position of the wand pointer.
3. The system as set forth in claim 2 wherein the frame assembly is mounted
directly to the subject support to be movable therewith such that movement
of the subject support does not alter the subject coordinate system.
4. The system as set forth in claim 2 wherein the frame assembly is mounted
to the subject support angled from a perpendicular relationship to focus
on the secured subject region, even when mounted away from the secured
region of the subject.
5. The system as set forth in claim 1 wherein a plurality of reference
emitters are mounted to the frame in fixed relationship to the receivers.
6. The system as set forth in claim 1 wherein the wand includes a physical
tip portion, a portion extending along a pointing axis of the wand, and an
offset portion which is offset from the pointing axis of the wand, the
wand emitters being mounted in a spaced relationship to the offset section
in alignment with the pointing axis of the wand such that the wand tip and
the two actuators are co-linear.
7. A stereotaxy system comprising:
a subject support;
a means for securing a preselected portion of a subject to the subject
support;
at least three markers adapted to be disposed on the preselected subject
portion;
a frame assembly which mounts at least three receivers in a fixed
relationship to the subject support;
at least one reference emitter mounted a fixed, known distance from the
receivers, the reference emitter emitting a reference signal which travels
from the reference emitter the fixed distance to the receivers;
a calibration means for measuring a reference travel time of the reference
signal over the preselected distance and generating a corresponding
calibration factor;
a wand having a pointer and at least two emitters mounted thereto, the two
wand emitters selectively emitting wand signals which are received by the
at least three receivers;
a wand position determining means for determining a position of the wand
pointer by measuring wand signal travel times of the wand signals between
the two wand emitters and the at least three receivers, the wand position
determining means being connected with the calibration means for
calibrating the wand signal travel times with the reference travel time;
a three-dimensional image memory means for storing image data indicative of
a three-dimensional region of the preselected subject portion and the
markers in an image data coordinate system;
a plane selecting means for selecting planar slices of data from the
three-dimensional image memory means;
a display means for converting the selected slices of data from the plane
selecting means into human-readable displays;
a transform means for transforming a position of the wand pointer into a
coordinate system of the image data stored in the three-dimensional image
memory means with a wand pointer position to image data coordinate system
transform, the transform means being connected with the plane selecting
means such that the displayed images have a preselected relationship to
the position of the wand pointer; and
a transform calculating means for calculating the wand pointer to image
data coordinate system transform from positions of the markers in the
image data coordinate system determined by selectively placing the wand
pointer on each of the markers.
8. The system as set forth in claim 7 wherein the markers contain materials
which are visible in both magnetic resonance and CT imaging techniques
such that the same markers can be used for both CT and magnetic resonance
examinations.
9. A stereotaxy apparatus comprising:
a patient support;
a means for securing a preselected portion of a patient to the patient
support;
a frame assembly which mounts at least three receivers in a fixed
relationship to the patient support closely adjacent the means for
securing a portion of the patient to the patient support;
a wand having a tip end and at least two emitters mounted thereto, the two
wand emitters selectively emitting signals which are received by the at
least three receivers;
a wand position determining means for determining a position of the wand
tip in accordance with travel times of the signals between the two wand
emitters and the at least three receivers; at least one reference emitter
mounted a fixed, known distance from the receivers, the reference emitter
emitting a reference signal which travels from the emitter the fixed
distance to the receivers, a calibration means for measuring a travel time
of the reference signal over the preselected distance, the wand position
determining means being connected with the calibration means for
correcting the wand tip position in accordance with the travel time of the
reference signal over the fixed distance;
a three-dimensional memory means for storing image data indicative of a
three-dimensional region of the portion of the patient which is secured to
the patient support;
a slice selecting means for selecting slices of data from the
three-dimensional memory means;
a display means for converting the selected slices of data into a
human-readable display;
a transform means for transforming a position of the wand tip into a
coordinate system of the image data stored in the three-dimensional image
memory, the transform means being connected with the slice selecting means
such that the displayed images have a preselected relationship to the
position of the wand tip.
10. A stereotaxy method comprising:
a) securing a portion of a subject to a subject supporting surface in close
proximity to at least three signal receivers that are mounted in a fixed
relationship to the patient supporting surface;
b) positioning a wand to designate selected locations on the subject
portion, the wand having at least two wand emitters mounted thereon for
selectively emitting signals which are received by the receivers;
c) actuating the wand emitters to emit wand signals;
d) from the wand emitter signals, calculating a calculated wand emitter
distance between the wand emitters in a coordinate system of the subject
support;
e) comparing the calculated wand emitter distance with a physical distance
between the wand emitters;
f) in response to the comparison of step e) exceeding a preselected
standard, providing an error signal.
11. A stereotaxy method comprising:
a) securing a portion of a subject to a subject supporting surface in close
proximity to at least three signal receivers that are mounted in a fixed
relationship to the patient supporting surface, a reference signal emitter
fixedly mounted at a fixed, known distance from the plurality of
receivers;
b) positioning a wand to designate selected locations on the subject
portion, the wand having at least two wand emitters mounted thereon for
selectively emitting signals which are received by the receivers;
c) actuating the wand emitters individually and the reference emitter in
close temporal proximity to emit wand and reference signals;
d) measuring travel durations for the wand and reference signals to travel
from each of the wand emitters to the receivers and from the reference
emitter to the receivers;
e) from the travel times, calculating coordinates of the locations
designated by the wand in a coordinate system of the subject support.
12. The method as set forth in claim 11 further including:
calculating a distance between the wand emitters;
comparing the calculated distance between the wand emitters with a
premeasured physical distance between the emitters to verify an acceptable
accuracy of the measurement.
13. The method as set forth in claim 12 further including sterilizing the
wand.
14. The method as set forth in claim 12 further including repeating steps
(b)-(e) with the wand in a second location to calculate coordinates of the
second location and further including from the coordinates of the first
and second locations, determining a distance therebetween.
15. The method as set forth in claim 12 wherein the subject support
coordinate system coordinates calculating step includes:
determining travel times between the wand emitters and the plurality of
receivers, the relative travel times between each emitter and the
receivers being indicative of a location of each emitter;
correcting at least one of (i) the relative travel times between the wand
emitters and the receivers and (ii) the determined positions of the
emitters in accordance with the travel time between the reference emitter
and at least one of the receivers, whereby the position of the wand is
corrected for variations in signal transmission speed attributable to
changes in temperature, humidity, and other conditions adjacent the
subject.
16. The method as set forth in claim 15 wherein:
the two wand emitters are actuated alternately a plurality of times;
the reference emitter is actuated at least once;
the travel times are adjusted for delays between (i) actuation of the
emitter and emission of the signal and between (ii) the signal reaching
the receiver and being converted into an electronic timing signal;
the correcting step includes correcting the travel times between the wand
emitters and the receivers in accordance with the travel time between the
reference emitter and the receivers; and further including:
averaging the corrected travel times and determining coordinates for each
wand emitter;
from the wand emitter coordinates calculating a coordinate of a tip portion
of the wand.
17. The method as set forth in claim 12 further including:
conducting a first non-invasive diagnostic examination of the subject
portion and generating three-dimensional electronic image data thereof;
storing the three-dimensional image data;
determining a transform between the a first image data coordinate system
and the subject support coordinate system.
18. The method as set forth in claim 17 further including:
conducting a second non-invasive diagnostic examination of the subject
portion and generating three-dimensional electronic image data thereof;
storing the second examination three-dimensional image data;
determining a transform between the second image data coordinate system and
the subject support coordinate system;
determining a relationship between the first and second image data
coordinate systems.
19. The method as set forth in claim 17 wherein the transform determining
step includes:
mounting at least three non-invasive examination visible markers to the
subject portion such that the three-dimensional diagnostic image data
includes indications of the at least three markers;
with the wand designating a position of each of the three markers and
determining a coordinate of each marker in the subject support coordinate
system;
comparing the coordinates of the markers in the subject support coordinate
system and a position of the marker indications in the image data
coordinate system to determine at least a translation offset between the
image data and subject support coordinate systems and a rotational offset
between the subject support and image data coordinate systems. |
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Description |
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BACKGROUND OF THE INVENTION
The present invention relates to the medical diagnostic and surgical arts.
It finds particular application in conjunction with neurosurgery and will
be described with particular reference thereto. However, it is to be
appreciated, that the invention will also find application in conjunction
with other medical procedures, industrial quality control procedures, and
the like.
Three-dimensional diagnostic image data of the brain and other body
portions are commonly available with CT scanners, magnetic resonance
imagers, and other medical diagnostic equipment. These imaging modalities
provide structural detail with a resolution of a millimeter or better.
Various stereotaxy procedures have been developed which require extreme
accuracy. Typical neurosurgical procedures included guided-needle
biopsies, shunt placements, craniotomies for lesion or tumor resection,
and the like. A three-dimensional "localizer" is attached to the patient's
skull. The localizer is a mechanical device with precisely known geometry
and dimensions for guiding or positioning surgical instruments. The
localizer is commonly attached to a ring or frame of metal or plastic from
which the name "framed" stereotaxy has evolved. This frame is typically
affixed to the patient using various mounting hardware methods that
include sharp points or pins that pierce the skin and locate into the
skull. The localizer is then mounted onto a frame. The localizer and frame
provide the surgeon with the ability to position surgical instruments
mechanically with a mechanical accuracy of a millimeter or better.
However, anatomically, accuracy is somewhat less due to inaccuracies in
the diagnostic imaging and patient motion.
One of the difficulties that has arisen is accurately coordinating the
coordinate system of the patient's skull or stereotaxy localizer with the
coordinate system of the diagnostic data. One solution has been to image
the patient with the stereotaxic frame attached. Because the stereotaxic
frame appears in the resultant images, the surgeon is provided with a
frame of reference in the images. Although relatively accurate in
coordinating the two frames of reference, the use of the frame has
numerous drawbacks including the need to mount the frame to the patient's
head for both the imaging and the surgical procedures and the associated
cost.
The present invention provides a new and improved technique which simply
and painlessly coordinates the coordinate system of three-dimensional
image data obtained from one or more imaging modalities with the
coordinate system of the patient prior to or during surgery.
SUMMARY OF THE INVENTION
In accordance with one aspect of the present invention, three or more
markers are mounted to the patient's skull prior to a medical diagnostic
imaging procedure. The markers contain a material which causes them to
become identifiable marks in the collected medical diagnostic image. In
the operating room, the patient's skull is mounted in a fixed position.
The coordinates of the three markers in a coordinate system of the
operating room are determined. The coordinates of the markers in the
operating room and the coordinates of the markers in the three-dimensional
diagnostic data are correlated. Thereafter, the surgeon denotes locations
and/or directions in the coordinate system of the operating room and the
corresponding image representations are retrieved from the diagnostic data
for display.
In accordance with a more limited aspect of the present invention, points
in the operating room coordinate system are designated through the use of
a wand. The wand includes at least two emitters which emit signals on
command. The signals are received by at least three receivers which
triangulate or otherwise measure the location of each emitter. From a
predetermined relationship between the emitters and the structure of the
wand, the location and/or trajectory designated by the wand are
determined.
In accordance with another more limited aspect of the present invention, a
display is provided of various internal slices of the head, such as the
axial, coronal, sagittal, or oblique planes through the point designated
by the wand as well as a surface rendering is provided.
In accordance with another more limited aspect of the present invention,
the emitters are sonic emitters. Reference emitters are provided at fixed,
known distances from the receivers. The reference emitters periodically
emit sonic signals, which are received by the receivers. Using the known
distance from the reference emitters to the receivers, the speed of sound
is recalculated to correct for temperature, humidity, air composition,
etc. induced variations affecting the speed of sound.
One advantage of the present invention is that it provides a precise and
accurate correlation between the reference systems of the diagnostic image
data and the patient.
Another advantage of the present invention is that no frame is needed
during the image acquisition scan.
Another advantage is that sterilization of necessary parts of the system is
facilitated.
Another advantage of the present invention is that it is easy to use and
very user friendly.
Still further advantages of the present invention will become apparent to
those of ordinary skill in the art upon reading and understanding the
following detailed description of the preferred embodiments.
BRIEF DESCRIPTION OF THE DRAWINGS
The invention may take form in various steps and arrangements of steps and
in various components and arrangements of components. The drawings are
only for purposes of illustrating the preferred embodiments and are not to
be construed as limiting the invention.
FIG. 1A is a perspective view of an operating room in which the present
invention is deployed;
FIG. 1B is a block diagram of the image data manipulation of the system of
FIG. 1A;
FIGS. 2A, 2B and 2C illustrate the wand of FIGS. 1A and 1B;
FIG. 3 is a detailed illustration of the locator assembly of FIG. 1;
FIG. 4 is a diagrammatic illustration of one embodiment of calibration
procedure in accordance with the present invention;
FIGS. 5A and 5B are diagrammatic illustrations of the wand and locator
relationship;
FIG. 5C is a flow diagram of the wand location procedure;
FIGS. 6A, 6B, 6C, and 6D are illustrative of a preferred coordinate
transform between the coordinate system of the data and the patient.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
With reference to FIG. 1A, a subject, such as a human patient, is received
on an operating table or other subject support 10 and appropriately
positioned within the operating room. A frame 12 is fixed to the patient
support such that it is precisely positioned within the subject or subject
support coordinate system. Mounting the frame 12 to the patient support
permits the patient support to be turned, raised, lowered, wheeled to
another location, or the like, without altering the patient coordinate
system. The frame 12 supports a plurality of emitter/receiver combinations
14 mounted at fixed, known locations thereon. Preferably, a head clamp 16
or other means securely positions the patient's head or other portion of
the subject under consideration in the subject support coordinate system.
The frame is mounted at a fixed or selectable angle from vertical such
that the frame is positionable more toward the patient, yet still focusing
on the region of interest of the patient.
With continuing reference to FIG. 1A and further reference to FIG. 1B, an
operator console 18 houses a computer system 20. Alternately, the computer
system can be remotely located and connected with the control console 18
by cabling. The computer system includes a three-dimensional data memory
22. The stored three-dimensional image data preferably contains a video
pixel value for each voxel or point in a three-dimensional rectangular
grid of points, preferably a 256.times.256.times.256 grid. When each image
value represents one millimeter cube, the image data represents about a
25.6 centimeter cube through the patient with one millimeter resolution.
Because the data is in a three-dimensional rectangular grid, selectable
orthogonal and other oblique planes of the data can readily be withdrawn
from the three-dimensional memory using conventional technology. A plane
selecting computer routine 24 selects various two-dimensional planes of
pixel values from the three-dimensional memory for display.
In the preferred embodiment, the plane selecting computer routine selects
at least four planes: axial, sagittal, coronal, and oblique planes through
a selectable point of the patient. The pixel values which lie on the
selected axial, sagittal, coronal, and oblique planes are copied into
corresponding image memories 26a, 26b, 26c, and 26d. A video processor 28
converts the two-dimensional digital image representations from one or
more of image memories 26 into appropriate signals for display on video
monitors 30 or other appropriate display means.
With continuing reference to FIG. 1A and further reference to FIG. 2A, in
order to designate a position on the patient, the surgeon positions a tip
40 of a wand 42 at the desired location. The locator system locates the
coordinate of the tip and the trajectory of the wand. More specifically,
the wand includes a pair of emitters 44 and 46 which selectively emit
positioning signals, ultrasonic signals in the preferred embodiment. With
reference to FIG. 2B, the first emitter 44 has a fixed, known distance
l.sub.1 from the tip 40 and the second emitter has a fixed, known distance
l.sub.2 from the first emitter 44. The wand is readily sterilized by
conventional techniques. For simplicity of mathematical calculation, the
two emitters and the tip are preferably in linear alignment. Optionally,
as illustrated in FIG. 2C, the wand 42 may have a jog 48 which enables the
tip and the two emitters to be disposed along a central axis or pointing
direction of the wand.
With reference to FIG. 3, the frame 12 includes not only the plurality of
receivers, e.g. microphones 50 in the preferred ultrasonic embodiment, but
also a plurality of reference emitters 52. The reference receivers are
each spaced along side edges of the frame from adjacent receivers or
microphones 50 by distances S.sub.1 and S.sub.2. Preferably S.sub.1
=S.sub.2 =S. Each reference receiver is also spaced by a distance D across
the frame from an oppositely disposed emitter 52. The emitters and the
microphones are normally not coplanar with the frame 12. Preferably, both
distances or range values D are equal in length.
In the preferred embodiment, the distance from the wand emitters to the
frame, hence the position of the wand relative to the patient, is
determined by the travel time of the sound. The velocity of the sound
pulse through air is dependent upon both the temperature, the humidity,
and the chemical composition of the air. These factors can and do vary
significantly during an operation and from procedure to procedure. As
shown in FIG. 4, a calculation is performed to determine the speed of
sound in the operating room. More specifically, a calibrating computer
routine 60 selectively pulses the reference emitters 52, receives the
signals at receivers 50, and processes the elapsed time information in
accordance with the procedure of FIG. 4. More specifically, the
calibration computer routine 60 includes a step or computer routine 62 for
causing a first of the reference emitters 50 to emit a signal pulse. A
step or computer routine 64 acquires the range values D', i.e. the time
required for the ultrasonic pulses to traverse the distance D. A step or
computer routine 66 causes this procedure to be repeated a preselected
number of times, such as once for each of the four emitters illustrated in
FIG. 3.
Once the travel time between each emitter and receiver pair has been
obtained a preselected number of times, a step or computer routine 70
corrects the times for fixed machine delays. That is, there is a fixed,
small delay between the time when the command is given to fire the
reference emitters 52 and the time that they actually produce a detectable
ultrasonic signal. Analogously, there is a small delay between the time
that the ultrasonic pulses reach the receiver or microphone 50 and the
time that it becomes a measurable electrical signal received by the
computer processor. These delays are subtracted from the times measured by
step or computer routine 64. An averaging computer routine 72 averages the
actual times after correction for the machine delays for transmission of
the ultrasonic pulse between the transmitter and receiver. The time over
the range values D' provide the most accurate results. A step or computer
routine 74 computes a calibration factor F indicative of the current speed
of the ultrasound signal adjacent the patient in the operating room. In
the preferred embodiment, the calibration factor F is a ratio of the
sonically measured distance D' versus a precise mechanical measurement of
the distance D.
With reference to FIGS. 5A, 5B, and 5C, a wand coordinate and trajectory
determining computer routine 80 determines the position of the two
emitters 44 and 46, respectively. More specifically, a step or computer
routine 82 causes the emitter 44 to emit an ultrasonic signal. The
receivers 50 on the frame 12 receive the ultrasonic signal at
corresponding times L.sub.1 -L.sub.4. A step or computer routine 84
acquires and retains these times. A step or computer routine 86 causes the
second emitter 46 to transmit. A step or means 88 acquires the four times
L.sub.1 -L.sub.4 which are required for the ultrasonic signals to pass
from the second emitter to the microphones 50. The speed of ultrasonic
transmission and accuracy of transmission times are such that these
distances can be measured to within a millimeter or better. A step or
computer routine 90 causes the emitters to emit and corresponding data
values L.sub.1 -L.sub.4 to be acquired each of a plurality of times to
improve digitation accuracy, e.g. two times.
A step or computer routine 92 causes the calibration computer routine 60 to
perform the steps described in conjunction with FIG. 4 in order to provide
a current indication of the velocity of sound adjacent the patient. Of
course, the calibration procedure of FIG. 4 may be performed immediately
before steps 82-88 or intermittently during the collection of several data
values for averaging. A step or computer routine 94 corrects the values
L.sub.1 -L.sub.2 for the fixed machine delay discussed above in
conjunction with step or computer routine 70. A step or computer routine
96 corrects each of the times L.sub.1 -L.sub.4 that were required for the
ultrasonic signals to travel from the first and second emitters 44, 46 to
the microphones 50 in accordance with the correction factor F determined
by step or computer routine 74. An averaging computer routine 98 averages
the delay and calibration corrected times L.sub.1 -L.sub.4, hence
distances between each of the wand emitters 44, 46 and each of the
microphones 50. From these distances, provided at least three receivers 50
are provided, a step or computer routine 100 calculates the Cartesian
coordinates (x.sub.1,y.sub.1,z.sub.1) and (x.sub.2,y.sub.2,z.sub.2) in the
patient space for the two emitters 44 and 46. The first emitter
coordinates x.sub.1,y.sub.1,z.sub.1 are calculated from three coordinates
are calculated as follows:
##EQU1##
where S=S.sub.1 =S.sub.2 as defined in FIG. 3. Preferably, the three
selected range values are the three shortest of L.sub.1 -L.sub.4. Similar
computations are calculated for x.sub.2, y.sub.2, and z.sub.2 coordinates
of the second emitter. A step or computer routine 102 checks the validity
of the measurement. More specifically, the known separation between the
wand emitters is compared with the separation between the measured
coordinates x.sub.1,y.sub.1,z.sub.1 and x.sub.2,y.sub.2,z.sub.2 of the
wand emitters, i.e.:
.vertline.Sep.sub.known -[(x.sub.1 -x.sub.2).sup.2 +(y.sub.1
-y.sub.2).sup.2 +(z.sub.1 -z.sub.2).sup.2 ].sup.1/2.vertline..ltoreq.
error. (2).
If the measured and known separation is greater than the acceptable error,
e.g. 0.75 mm when measuring with a resolution of 1 mm, an erroneous
measurement signal is given. The measurement is discarded and the surgeon
or other user is flagged to perform the measurement process 80 again. A
step or computer routine 104 from the coordinates of the two emitters 44,
46, and from the geometry of the wand discussed in FIG. 2, calculates the
Cartesian coordinates (x.sub.0,y.sub.0,z.sub.0) for the wand tip 40.
The tip coordinates x.sub.0, y.sub.0, z.sub.0 are defined by:
##EQU2##
With reference to FIG. 6, a transform computer routine 110 transforms the
coordinates of patient space into the coordinate system of the image data
and vice versa. More specifically, prior to the imaging, three or more
fiducials or markers are affixed at three or more spaced points on the
patient's head. The fiducials are visible in the imaging medium selected
such that they show up as readily identifiable dots 112 in the resultant
image data. In the preferred embodiment, the fiducials are markers or
small beads 114 that are injected with radiation opaque and magnetic
resonance excitable materials. A small dot or tattoo is made on the
patient's skin and a fiducial is glued to each dot. This enables the
position of the fiducials to be denoted even if the fiducials are removed
in the interval between the collection of the image data and the surgical
procedure. Alternately, portions of the markers can be portions of the
patient's anatomy which are readily identifiable in both patient and image
space, e.g. the tip of the nose. To align the images of the fiducials with
the fiducial positions in patient space, the tip of the wand is placed on
each fiducial or tattooed marker point. The coordinates in patient space
of each fiducial are determined with the procedure described in
conjunction with FIGS. 5A-5C.
The position of the three or more fiducials on the patient's scalp are
compared with the relative position of the pixels 112 in the image space.
The patient space coordinates of marks 114 on the patient's skull in the
coordinate system of the patient support are measured. A like coordinate
system through the pixels 112 is defined and compared to the patient space
coordinate system. The translation and rotational relationship between
image space and patient space coordinate systems is determined. With
reference to FIG. 6A, the position of the patient in operating room space
(x,y,z) and the relative position in image space (x', y',z') are
determined. That is, two coordinate systems are defined. The translation
computer routine first determines the offset x.sub.offset, y.sub.offset,
z.sub.offset between the barycenters 116, 118 of the triangles defined by
the coordinates of three fiducials in data and patient space,
respectively. This provides a translation or an offset in the x, y, and
z-directions between the two coordinate systems. The values of
x.sub.offset, y.sub.offset, and z.sub.offset are added or subtracted to
the coordinates of the patient space and the coordinates of image space,
respectively, to translate between the two.
With reference to FIG. 6B, translating the origins of the two coordinate
systems into alignment, however, is not the complete correction. Rather,
the coordinate systems are normally also rotated relative to each other
about all three axes whose origin is at the barycenter. As illustrated in
FIGS. 6B, 6C, and 6D, the angle of rotation in the (y,z), (x,z), and (x,y)
planes are determined. Having made these determinations, it is a simple
matter to transform the patient support space coordinates into the image
space coordinates and, conversely, to rotate the image space coordinates
into patient space coordinates. The ward coordinate computer routine 80 is
connected through the transform computer routine 110 with one of the plane
selecting computer routine 24 and the video processor 28 to cause a
marker, e.g. cross hairs, to be displayed on the monitors 30 at the
coordinates of the wand tip. This enables the surgeon to coordinate
specific points on the patient or in the incision with the images.
Having aligned the data and patient coordinate systems, numerous techniques
can be performed in addition to surgery planning and verification. One can
denote two locations in the patient and have them displayed on the monitor
in data space. Because the measurement scale in data space is fixed, the
distance between the two points is readily determined. The wand can be
used to denote points on the patient and mark corresponding points in data
space. The marked points can denote electrode locations for example. The
present system can be used for out-patient procedures, examinations, and
the like, of various parts of the patient's anatomy. Further, more than
one set of diagnostic data can be coordinated with the patient.
Optionally, an additional three-dimensional data memory 22' may store
additional diagnostic data, e.g. from another modality, from the same
modality, but at different time or with different imaging characteristics,
or the like. Once both sets of diagnostic data are coordinated with the
patient coordinate system, they are coordinated with each other.
The invention has been described with reference to the preferred
embodiment. Obviously, modifications and alterations will occur to others
upon reading and understanding the preceding detailed description. It is
intended that the invention be construed as including all such
modifications and alterations insofar as they come within the scope of the
appended claims or the equivalents thereof.
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