Systems and methods for using registered fluoroscopic images in image-guided surgery
A method performed by a computing system comprises receiving a fluoroscopic image of a patient anatomy while a portion of a medical instrument is positioned within the patient anatomy. The fluoroscopic image has a fluoroscopic frame of reference. The portion has a sensed position in an anatomic model frame of reference. The method further comprises identifying the portion in the fluoroscopic image and identifying an extracted position of the portion in the fluoroscopic frame of reference using the identified portion in the fluoroscopic image. The method further comprises registering the fluoroscopic frame of reference to the anatomic model frame of reference based on the sensed position of the portion and the extracted position of the portion.
1. A robotic medical system comprising:
a flexible tubular instrument with a distal portion including a camera and a channel opening for deploying a medical instrument;
a display system; and
one or more computer readable media with instructions for:
controlling movement of the distal portion as the flexible tubular instrument is advanced toward an anatomical target in a patient's anatomy;
receiving intraoperative fluoroscopic image data of the distal portion of the flexible tubular instrument and the anatomical target, wherein the intraoperative fluoroscopic image data is taken from multiple viewpoints;
displaying, on the display system, at least part of the intraoperative fluoroscopic image data showing the distal portion;
receiving input from a user identifying an intraoperative location of the distal portion;
displaying, on the display system, at least part of the intraoperative fluoroscopic image data showing the anatomical target side-by-side with preoperative CT image data to help identify an intraoperative location of the anatomical target; and
providing real-time information to the user on whether a medical instrument deployed through the channel opening has intercepted the intraoperative location of the anatomical target.
2. The system of claim 1 wherein the computer readable media further includes instructions for determining a distance between the intraoperative location of the distal portion and the intraoperative location of the anatomical target.
3. The system of claim 1 wherein the computer readable media further includes instructions for receiving additional intraoperative fluoroscopic image data and extracting the medical instrument from the additional intraoperative fluoroscopic image data.
4. The system of claim 3 wherein the medical instrument is a biopsy needle.
5. The system of claim 3 wherein the computer readable media further includes instructions for receiving additional intraoperative fluoroscopic image data and displaying, on the display system, at least part of the additional intraoperative fluoroscopic image data showing the medical instrument.
6. The system of claim 5 wherein the displaying of at least part of the additional intraoperative fluoroscopic image data uses a plane of view that allows the user to visualize movement of the medical instrument.
7. The system of claim 6 wherein the medical instrument is a biopsy needle.
8. The system of claim 1 wherein the computer readable media further includes instructions for receiving additional intraoperative fluoroscopic image data and displaying, on the display system, at least part of the additional intraoperative fluoroscopic image data showing the medical instrument.
9. The system of claim 8 wherein the displaying of at least part of the additional intraoperative fluoroscopic image data uses a plane of view that allows the user to visualize movement of the medical instrument.
10. The system of claim 9 wherein the medical instrument is a biopsy needle.
11. The system of claim 1 wherein the computer readable media further includes instructions for extracting the distal portion from the intraoperative fluoroscopic image data.
12. The system of claim 11 wherein the extracting is performed automatically.
13. The system of claim 11 wherein the extracting is performed semiautomatically.
14. The system of claim 1 wherein the computer readable media further includes instructions for determining an intraoperative orientation of the distal portion in a three-dimensional fluoroscopic reference frame.
15. The system of claim 1 wherein the computer readable media further includes instructions for reconstructing the anatomical target in three dimensions based at least in part on the intraoperative fluoroscopic image data.
16. A method comprising:
controlling movement of a distal portion of a flexible tubular instrument as it advances toward an anatomical target in a patient's anatomy, wherein the distal portion includes a camera and a channel opening for deploying a medical instrument;
receiving intraoperative fluoroscopic image data of the distal portion of the flexible tubular instrument and the anatomical target, wherein the intraoperative fluoroscopic image data is taken from multiple viewpoints;
displaying, on a display system, at least part of the intraoperative fluoroscopic image data showing the distal portion;
receiving input from a user identifying an intraoperative location of the distal portion;
displaying, on the display system, at least part of the intraoperative fluoroscopic image data showing the anatomical target side-by-side with preoperative CT image data to help identify an intraoperative location of the anatomical target; and
providing real-time information to the user on whether a medical instrument deployed through the channel opening has intercepted the intraoperative location of the anatomical target.
17. The method of claim 16 further comprising determining a distance between the intraoperative location of the distal portion and the intraoperative location of the anatomical target.
18. The method of claim 16 further comprising receiving additional intraoperative fluoroscopic image data and extracting the medical instrument from the additional intraoperative fluoroscopic image data.
19. The method of claim 18 wherein the medical instrument is a biopsy needle.
20. The method of claim 18 further comprising receiving additional intraoperative fluoroscopic image data and displaying, on the display system, at least part of the additional intraoperative fluoroscopic image data showing the medical instrument.
21. The method of claim 20 wherein the displaying of at least part of the additional intraoperative fluoroscopic image data uses a plane of view that allows the user to visualize movement of the medical instrument.
22. The method of claim 21 wherein the medical instrument is a biopsy needle.
23. The method of claim 16 further comprising receiving additional intraoperative fluoroscopic image data and displaying, on the display system, at least part of the additional intraoperative fluoroscopic image data showing the medical instrument.
24. The method of claim 23 wherein the displaying of at least part of the additional intraoperative fluoroscopic image data uses a plane of view that allows the user to visualize movement of the medical instrument.
25. The method of claim 24 wherein the medical instrument is a biopsy needle.
26. The method of claim 16 further comprising extracting the distal portion from the intraoperative fluoroscopic image data.
27. The method of claim 26 wherein the extracting is performed automatically.
28. The method of claim 26 wherein the extracting is performed semiautomatically.
29. The method of claim 16 further comprising determining an intraoperative orientation of the distal portion in a three-dimensional fluoroscopic reference frame.
30. The method of claim 16 further comprising reconstructing the anatomical target in three dimensions based at least in part on the intraoperative fluoroscopic image data.