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CN-122003216-A - Systems, methods, and devices for in vivo ultrasound guidance during arthroscopic surgery

CN122003216ACN 122003216 ACN122003216 ACN 122003216ACN-122003216-A

Abstract

Systems and methods for 3D in vivo ultrasound imaging of a tissue surface (e.g., a tissue surface located within an articular capsule) during arthroscopic surgery are provided. An in vivo ultrasound probe is provided having a rotatable distal region supporting an ultrasound transducer array. An ultrasound array is controlled to collect image data at several elevation angles while rotating the distal region of the probe to acquire a local 3D image dataset spanning a local 3D volume associated with a current probe pose. This process is repeated as the probe pose changes, producing a set of partial 3D image datasets, each partial 3D image dataset corresponding to a different probe pose. The local 3D image dataset is processed to segment a tissue surface contour and generate a corresponding set of surface patches. The surface tiles are optionally processed and combined based on input from one or more sensors to generate a composite 3D image.

Inventors

  • R. ADAMSON
  • J. Lidbert
  • J. BROWN
  • I.Huang

Assignees

  • 阿索尼克斯有限公司

Dates

Publication Date
20260508
Application Date
20241011
Priority Date
20231011

Claims (20)

  1. 1. An ultrasound system for 3D imaging of a tissue surface in a human joint during arthroscopic surgery, the ultrasound system comprising: an ultrasonic probe, the ultrasonic probe comprising: A proximal handle portion configured to be held outside the body, and A hollow rigid shaft extending from the proximal handle portion, the hollow rigid shaft having a distal region configured for insertion into a joint space, the hollow rigid shaft defining a probe axis, and An ultrasound transducer array supported by the hollow rigid shaft at a location remote from a proximal end of the hollow rigid shaft, the ultrasound transducer array comprising a plurality of ultrasound transducer elements; a beamformer operatively coupled to the ultrasound transducer array, the beamformer forming an image from ultrasound echoes recorded from the ultrasound transducer elements, and Control and processing circuitry operatively coupled to the beamformer, the control and processing circuitry comprising at least one processor and associated memory storing instructions executable by the processor for performing operations comprising: i) Receiving volumetric image data from the beamformer; ii) segmenting one or more tissue surface contours from the volumetric image data to obtain a three-dimensional surface map segment; repeating steps i) through ii) with a plurality of probe poses to produce a plurality of spatially overlapping three-dimensional surface patches; Processing the plurality of surface tiles to arrange and align the surface tiles in a virtual three-dimensional space, and A composite image is generated based on the plurality of surface patches.
  2. 2. The system of claim 1, wherein the control and processing circuitry is configured to update the composite image during acquisition of a plurality of surface patches as the position and/or orientation of the ultrasound probe changes relative to an anatomical region of interest.
  3. 3. The system of claim 2, wherein the control and processing circuitry is further configured to perform image registration between two or more of the composite images and process the co-registered composite images to generate feedback that facilitates intra-operative evaluation of the arthroscopic procedure.
  4. 4. The system of claim 3, wherein the control and processing circuitry is configured such that the feedback includes an image identifying a change between at least two co-registered images.
  5. 5. The system of claim 1, wherein the resonant frequency of the ultrasound transducer array is greater than 20 MHz.
  6. 6. The system of any one of claims 1 to 5, wherein the proximal handle portion comprises a motor, and wherein the hollow rigid shaft is mechanically coupled to the motor for rotating the hollow rigid shaft about a central motor axis, thereby rotating an image plane of the ultrasound transducer array about the probe axis defined by the hollow rigid shaft.
  7. 7. The system of claim 6, further comprising an encoder configured to measure an angle of rotation of the hollow rigid shaft.
  8. 8. The system of any one of claims 1 to 7, wherein electrical signals are transmitted from the ultrasound transducer array to the proximal end of the hollow rigid shaft via a flexible printed circuit board bonded to an inner surface of the hollow rigid shaft, and wherein a set of traces within a distal portion of the flexible printed circuit board are oriented in a circumferential direction and extend to a side surface of the flexible printed circuit board to form bond pads for forming electrical connections with the ultrasound transducer array.
  9. 9. The system of claim 8, wherein the ultrasound transducer array and distal end of the flexible printed circuit board are at an oblique angle relative to the probe axis.
  10. 10. The system of claim 8, wherein the ultrasound transducer array and the distal portion of the flexible printed circuit board are supported within a distal cutout region of the hollow rigid shaft.
  11. 11. The system of any of claims 8 to 10, further comprising a rotational interconnect printed circuit board that rotates with the hollow rigid shaft, and wherein a flexible printed circuit board connection exposed from the proximal end of the hollow rigid shaft terminates in the rotational interconnect printed circuit board such that the flexible printed circuit board is not subject to strain during rotation of the hollow rigid shaft.
  12. 12. The system of any of claims 8 to 11, wherein the flexible printed circuit board comprises: A first portion bonded to the inner surface of the hollow rigid shaft, the first portion configured to rotate in unison with the hollow rigid shaft, and A second portion extending from a proximal region of the hollow rigid shaft in a helical configuration to connect with a non-rotating interconnecting element supported within the proximal handle portion of the probe such that torsional strain during rotation of the hollow rigid shaft is relieved by the second portion of the flexible printed circuit board.
  13. 13. The system of any of claims 8 to 10, wherein an electrical connection is provided between the ultrasound transducer element and the bond pad by wire bonding.
  14. 14. The system of claim 11, wherein the rotating interconnect printed circuit board includes a multiplexer that switches a large number of electrical signals propagating to and from the ultrasound transducer array to a small number of electrical signals propagating to and from the beamformer.
  15. 15. The system of any of claims 1 to 14, wherein the control and processing circuitry is configured to cause the beamformer to employ plane wave beamforming to generate an image.
  16. 16. The system of any of claims 1 to 14, wherein the control and processing circuitry is configured to cause the beamformer to employ divergent wave beamforming to generate an image.
  17. 17. The system of any one of claims 1 to 14, wherein the ultrasound transducer array is a sparse ultrasound transducer array having an average spacing greater than one wavelength.
  18. 18. The system of any of claims 1 to 14, wherein a length of the ultrasound transducer array is approximately equal to a width of a B-mode image window.
  19. 19. The system of any of claims 1 to 18, wherein the control and processing circuitry is configured such that processing the surface tiles to arrange the surface tiles in the virtual three-dimensional space includes rotating and translating the surface tiles using a set of rotations and translations obtained by minimizing a cost function quantifying three-dimensional distances between adjacent surface tiles.
  20. 20. The system of claim 19, wherein the control and processing circuitry is configured such that the three-dimensional distance employed by the minimized cost function is a Haussdorf distance.

Description

Systems, methods, and devices for in vivo ultrasound guidance during arthroscopic surgery Cross Reference to Related Applications The present application claims priority from U.S. provisional patent application No. 63/543,621 entitled "system, method, and device for endoscopic ultrasound guidance during arthroscopic surgery (SYSTEMS, METHODS AND DEVICES FOR ENDOSCOPIC ULTRASOUND GUIDANCE DURING ARTHROSCOPIC PROCEDURES)", filed on 10/11 of 2023, the entire contents of which are incorporated herein by reference. Background The present disclosure relates to ultrasound guided surgery. More particularly, the present disclosure relates to ultrasound guided arthroscopic surgery. Real-time surgical image guidance is an important component of arthroscopic surgery. In arthroscopic resection and reconstruction procedures, the surgeon relies heavily on intra-operative image guidance to assess the current state of tissue, monitor the position of the surgical tool relative to the tissue, and assess the results of shaving, cutting, reshaping or reconstruction of the tissue. Currently, arthroscopic surgery of joints (e.g., knee, shoulder, hip, ankle, wrist) is performed under optically rigid endoscopic guidance, with the assistance of intraoperative fluoroscopic or intraoperative computed tomography imaging. Current imaging techniques have significant limitations for many arthroscopic procedures, such as the treatment of hip femoral acetabular impingement. Visualization of bone by optical endoscopy is limited by the 2D nature of the optical image and the limited field of view. Endoscopy is also limited to visualizing tissue surfaces, and is unable to visualize tissue obscured by more proximal end tissue, such as bone surfaces covered by cartilage or blood. Fluoroscopy images bone through soft tissue, but only produces a 2D image of integrated bone density through the image volume. Fluoroscopy does not provide 3D images. Thus, the shape of the bone structure measured under 2D X-ray fluoroscopy depends largely on the positioning and orientation of the bone relative to the scanner. This introduces non-repeatability and inaccuracy in the measurement because if multiple images are needed during the procedure, it is difficult to reposition the patient in exactly the same way each time a fluoroscopic image is taken. Computed Tomography (CT) can produce 3D images of bone tissue that are less sensitive to positioning, but CT is a non-real-time imaging modality, expensive and of poor resolution. Furthermore, both CT and fluoroscopy can introduce significant radiation doses to the patient and to the surgical personnel, which can increase the risk of cancer. In recent years, in vitro ultrasound imaging has become an alternative technique to 3D surgical guidance because of its ability to visualize various tissue types, including soft tissue, cartilage tissue, and bone tissue. For example, U.S. patent 6,106,464 describes an in vitro ultrasound imaging system in combination with a surgical tracking system to generate a 3D physical model of bone that can be registered with previously acquired images and can be used to locate surgical tools and instruments in a surgical space. However, surgical guidance using in vitro ultrasound has limited applicability to arthroscopy because relatively low frequency ultrasound (typically 2-5 MHz) must be used to penetrate soft tissue overlying bone. Low frequency ultrasound has poor axial and lateral resolution (e.g., about 0.5 mm at 3 MHz) and exhibits aberrations and clutter from overlying soft tissue, which limits the geometric accuracy of the resulting 3D image. In addition, extracorporeal ultrasound cannot image tissue that cannot be brought into line of sight from outside the body. For example, bone surfaces within the knee, hip and shoulder joints are often obscured by surrounding bone and cannot be imaged from outside the body. Thus, despite the above-described limitations and drawbacks of radiation imaging techniques, the current state of the art ultrasound guided arthroscopic surgery is less accurate than radiation imaging in intra-operative guidance and less useful than radiation imaging. Disclosure of Invention Systems and methods for 3D ultrasound imaging of a tissue surface located within an joint capsule during arthroscopic surgery are provided. An in vivo ultrasound probe is provided having a rotatable distal region supporting an ultrasound transducer array. An ultrasound array is controlled to collect 2D image data at several elevation angles while rotating the distal region of the probe to acquire a local 3D image dataset spanning a local 3D volume associated with a current probe pose. This process is repeated as the probe pose changes, producing a set of partial 3D image datasets, each partial 3D image dataset corresponding to a different probe pose. The local 3D image dataset is processed to segment a tissue surface contour and generate a corresponding set of surface patches. The surf