System and method for percutaneous needle insertion
A system and method for evaluating percutaneous needle pathways provides an automatic segmentation of local tissue structures and performs a weighting to rank a large number of paths to quickly identify clinically favorable choices.
1 . A system for percutaneous needle insertion along a trajectory comprising:
a user terminal including a graphic display; and
an electronic computer including a memory for holding volumetric medical image data including a needle target structure and a stored program executing to:
display the volumetric medical image data to allow identification by a user of the terminal of the needle target structure;
segment the volumetric medical data to identify subset volumes of predetermined body anatomy for avoidance during needle insertion;
evaluate a set of trajectories over two dimensions of angular range through the needle target structure according to:
(i) a set of anatomical rules assessing each needle trajectory with a likelihood of intersecting a predetermined body structure and trajectory length; and
(ii) a set of physician practice rules different from the anatomical rules assessing each needle trajectory; and
output at least one needle trajectory according to an ordering of the needle trajectories as assessed by the anatomical rules and physician practice rules; and
wherein the physician rule assesses a trajectory length through a specified tissue occurring along only a portion of the trajectory length through tissue.
2 . The system of claim 1 wherein the output provides a set of preferred multiple needle trajectories together with corresponding cost values, the cost values providing a quantitative representation of the assessment of the set of trajectories according to the anatomical rules and physician practice rules.
3 . The system of claim 1 wherein the program further executes to receive a proposed trajectory by a physician and to match that trajectory to one of the needle trajectories and to output at least one alternative needle trajectory preferred over the proposed trajectory based on the ordering.
4 . The system of claim 3 wherein the output includes corresponding cost values for the proposed needle trajectory and the at least one alternative needle trajectory.
5 . The system of claim 1 further including an electronically controlled needle guide adapted to guide a needle according to the at least one output needle trajectory.
6 . The system of claim 5 wherein the needle guide is selected from the group consisting of a robotic guide arm, robotic laser pointer, and a needle tracking system.
7 . The system of claim 1 further including a medical imaging device having a gantry positionable about a patient at a range of gantry angles defining slice planes and wherein the angular range is limited to no more than the range of gantry angles.
8 . The system of claim 1 wherein the anatomical rules include a weighting table associated with different anatomical structures and wherein weights of the weighting table control an ordering of the needle trajectories.
9 . The system of claim 1 wherein the predetermined body structure include heart, aorta, bone, and spine.
10 . The system of claim 1 wherein the anatomical rules penalize trajectories determined to intersect the predetermined body structures.
11 . The system of claim 1 wherein anatomical rules also penalize trajectories identified to be proximate to but outside the predetermined body structures.
12 . The system of claim 1 wherein the physician practice rules describe limiting trajectory path length and limiting trajectory angle with respect to tissue structures.
13 . The system of claim 1 wherein the anatomical rules limit a deviation of the trajectory from a tissue surface.
14 . The system of claim 1 wherein the target structure is a lung malignancy.
15 . The system of claim 14 wherein the predetermined structure includes emphysematous blebs and airways greater than 1.5 mm in radius.
16 . The system of claim 15 wherein a segmentation of emphysematous blebs employs a median filter, a threshold of Hounsfield units, and a size threshold.
17 . The system of claim 1 wherein the physician rule assesses an angle of the trajectory with respect to an organ surface.
18 . A system for percutaneous needle insertion along a trajectory comprising:
a user terminal including a graphic display; and
an electronic computer including a memory for holding volumetric medical image data including a needle target structure and a stored program executing to:
display the volumetric medical image data to allow identification by a user of the terminal of the needle target structure;
segment the volumetric medical data to identify subset volumes of predetermined body anatomy for avoidance during needle insertion;
evaluate a set of trajectories over two dimensions of angular range through the needle target structure according to:
(i) a set of anatomical rules assessing each needle trajectory with a likelihood of intersecting a predetermined body structure and trajectory length; and
(ii) a set of physician practice rules different from the anatomical rules assessing each needle trajectory; and
output at least one needle trajectory according to an ordering of the needle trajectories as assessed by the anatomical rules and physician practice rules; and
wherein the set of needle trajectories is greater than 10,000.
19 . A system for percutaneous needle insertion along a trajectory comprising:
a user terminal including a graphic display; and
an electronic computer including a memory for holding volumetric medical image data including a needle target structure and a stored program executing to:
display the volumetric medical image data to allow identification by a user of the terminal of the needle target structure;
segment the volumetric medical data to identify subset volumes of predetermined body anatomy for avoidance during needle insertion;
evaluate a set of trajectories over two dimensions of angular range through the needle target structure according to:
(i) a set of anatomical rules assessing each needle trajectory with a likelihood of intersecting a predetermined body structure and trajectory length; and
(ii) a set of physician practice rules different from the anatomical rules assessing each needle trajectory; and
output at least one needle trajectory according to an ordering of the needle trajectories as assessed by the anatomical rules and physician practice rules; and
wherein the physician rule assesses relative proportions of fat and muscle along the trajectory.