Handling respiration during navigational bronchoscopy
Methods of respiration compensation including detecting a position of a catheter proximate a target within a patient, performing a local registration to update a displayed relative position and orientation of the catheter and the target in a three-dimensional model, detecting movement of a plurality of sensors, determining a respiration waveform from the detected movement of the plurality of sensors, and indicating on a user-interface a period during which advancement of a biopsy or therapy tool from the catheter is most likely to intersect the target, wherein the period corresponds to a portion of the respiration waveform during which the movement of the plurality of sensors is within a desired range.
1 . A method of respiration compensation comprising:
detecting a position of a catheter proximate a target within a patient;
performing a local registration to update a displayed relative position and orientation of the catheter and the target in a three-dimensional model;
detecting movement of a plurality of sensors;
determining a respiration waveform from the detected movement of the plurality of sensors;
receiving a ventilation waveform from a ventilator operably connected to the patient to undertake respiration wherein the ventilation waveform is configured to achieve a desired respiration waveform;
detecting achievement of a breath hold of the patient wherein breath hold is achieved following cessation of ventilation of the patient and an off-set period to allow for expansion of lungs of the patient wherein the off-set period is calculated based on comparison of the ventilation waveform and the respiration waveform; and
indicating on a user-interface a period during which advancement of a biopsy or therapy tool from the catheter is most likely to intersect the target, wherein the period corresponds to a portion of the respiration waveform during which the movement of the plurality of sensors is within a desired range.
2 . The method of claim 1 , wherein the period is during an expiration phase of the respiration waveform.
3 . The method of claim 1 , further comprising displaying the respiration waveform on the user-interface.
4 . The method of claim 1 , wherein performing the local registration further comprises receiving fluoroscopic images and identifying those images acquired during a desired portion of the respiration waveform.
5 . The method of claim 4 , further comprising determining angles at which additional images are required to complete a fluoroscopic sweep.
6 . The method of claim 5 , further comprising orienting a fluoroscope to the determined angles and collecting the additional images during a desired portion of the respiration waveform to complete the fluoroscopic sweep.
7 . The method of claim 6 further comprising, wherein the orienting of the fluoroscope is performed automatically.
8 . The method of claim 1 , wherein performing the local registration further comprises receiving fluoroscopic images and identifying those images acquired during a desired portion of the respiration waveform.
9 . The method of claim 8 , further comprising determining angles at which additional images are required to complete a fluoroscopic sweep.
10 . The method of claim 9 , further comprising orienting a fluoroscope to the determined angles and collecting the additional images during a desired portion of the respiration waveform to complete the fluoroscopic sweep.
11 . The method of claim 10 further comprising, wherein the orienting of the fluoroscope is performed automatically.
12 . A method of respiration compensation comprising:
detecting movement of a plurality of sensors;
determining a respiration waveform from the detected movement of the plurality of sensors;
detecting a position of a catheter proximate a target within a patient;
determining a respiration waveform from the detected movement of the plurality of sensors;
receiving a ventilation waveform from a ventilator operably connected to the patient to undertake respiration wherein the ventilation waveform is configured to achieve a desired respiration waveform;
detecting achievement of a breath hold of the patient, wherein breath hold is achieved following cessation of ventilation of the patient and an off-set period to allow for expansion of lungs of the patient wherein the off-set period is calculated based on comparison of the ventilation waveform and the respiration waveform;
acquiring a plurality of fluoroscopic images with a fluoroscope, wherein the fluoroscopic images include a distal portion of the catheter and the target;
identifying individual images of the plurality of fluoroscopic images acquired during a desired portion of the respiration waveform;
determining angles at which additional images are required to complete a fluoroscopic sweep;
orienting the fluoroscope to the determined angles and collecting additional images during a desired portion of the respiration waveform to complete the fluoroscopic sweep;
performing a local registration, by identifying the catheter and the target in two or more images from the fluoroscopic sweep;
updating a displayed relative position and orientation of the catheter and the target in a 3D model; and
indicating on a user-interface a period during which advancement of a biopsy or therapy tool from the catheter is most likely to intersect the target, wherein the period corresponds to the desired portion of the respiration waveform.
13 . The method of claim 12 , wherein the desired portion of the respiration waveform is a portion with a slowest rate of change of position of the plurality of sensors.
14 . The method of claim 13 , wherein the desired portion of the respiration waveform is a part of an expiration phase.
15 . The method of claim 12 , wherein the ventilation waveform is configured to minimize movement of the plurality of sensors and achieve a desire state of inflation of lungs of the patient.
16 . The method of claim 15 , further comprising inflating a balloon configured proximate a distal end of the catheter, wherein the balloon is configured to reduce blood and airflow distal of the balloon in the lungs of the patient.
17 . A method of respiration compensation comprising:
detecting a position of a catheter proximate a target within a patient;
detecting movement of a plurality of sensors;
determining a respiration waveform from the detected movement of the plurality of sensors;
receiving a ventilation waveform from a ventilator operably connected to the patient to undertake respiration wherein the ventilation waveform is configured to achieve a desired respiration waveform;
detecting achievement of a breath hold of the patient wherein breath hold is achieved following cessation of ventilation of the patient and an off-set period to allow for expansion of lungs of the patient wherein the off-set period is calculated based on comparison of the ventilation waveform and the respiration waveform; and
indicating on a user-interface a period during which advancement of a biopsy or therapy tool from the catheter is most likely to intersect a target, wherein the period corresponds to a portion of the respiration waveform during which the movement of the plurality of sensors is within a desired range.
18 . The method of claim 17 , further comprising performing a local registration to update a displayed relative position and orientation of the catheter and a target in a three-dimensional model.
19 . The method of claim 17 , wherein the period is during an expiration phase of the respiration waveform.
20 . The method of claim 17 , further comprising displaying the respiration waveform on the user-interface.