US-12622750-B2 - Method and apparatus for planning placement of an implant

US12622750B2US 12622750 B2US12622750 B2US 12622750B2US-12622750-B2

Abstract

Disclosed is a system to plan and position an implant in a subject. The planned position may be based upon various features and structures identified in a group of subjects for a current subject. The implant may then be positioned in a selected position including a relative position and orientation of one or more electrodes on the implant which may be identified as an optimal position for the selected current subject.

Inventors

Tyler S. Stevenson

Assignees

MEDTRONIC NAVIGATION, INC.

Dates

Publication Date: 20260512
Application Date: 20221027

Claims (20)

1 . A method of planning a procedure relative to a subject for placing an implant for brain stimulation, the method comprising: receiving a selected procedure type for the subject; receiving a selected outcome for the subject; receiving a determined correlation of the selected outcome to a related pose and volume of activation (VAT) of the implant for brain stimulation based on at least one prior subject; evaluating received subject data to determine a current subject planned implant pose of the implant for brain stimulation and a planned VAT in the subject that is equivalent to the received determined correlation of the selected outcome to the related pose and VAT of the implant for brain stimulation; receiving image data of the subject; receiving real time tracking information of an implant pose associated with an instrument operated by a user relative to the subject during implantation of the implant for brain stimulation; and generating an image, wherein the image comprises a graphical representation of the real time tracking information of the implant pose superimposed on one or more fiducial points associated with the current subject planned implant pose and the image data of the subject.
2 . The method of claim 1 , wherein generating the image further includes displaying a graphical representation of the current subject planned implant pose relative to a current tracked pose of the implant.
3 . The method of claim 1 , further comprising: determining a plan including a trajectory of the implant to achieve the current subject planned implant pose.
4 . The method of claim 3 , further comprising: generating a graphical representation of the determined plan; and outputting the generated graphical representation of the determined plan.
5 . The method of claim 1 , further comprising: tracking an implant tracking device; and determining a pose of the instrument based on the tracking of the implant tracking device; wherein receiving tracking information of the implant relative to the subject includes receiving a signal regarding the tracking the implant tracking device.
6 . The method of claim 5 , wherein tracking the implant tracking device includes providing a localizer configured to at least one of receive a signal from the implant tracking device or transmit a signal to the implant tracking device.
7 . The method of claim 6 , further comprising: receiving a tracked pose of a subject tracking device associated with the subject.
8 . The method of claim 1 , further comprising: displaying an image of the subject; and superimposing a graphical representation of a current tracked pose of the implant relative to the current subject planned implant pose.
9 . The method of claim 1 , wherein receiving the selected procedure type includes receiving a diagnosis of the subject.
10 . A system for planning a procedure relative to a subject for placing an implant for brain stimulation, the system comprising: a processor module configured to: receive a selected procedure type for the subject; receive a selected outcome for the subject; receive a determined correlation of the selected outcome to a related pose and volume of activation (VAT) of the implant based on at least one prior subject; execute instructions to evaluate received subject data to determine a current subject planned implant pose of the implant for brain stimulation and a planned VAT in the subject that is equivalent to the received determined correlation of the selected outcome to the related pose and VAT of the implant for brain stimulation; receive image data of the subject; receive real time tracking information of an implant pose associated with an instrument operated by a user relative to the subject during implantation of the implant for brain stimulation; and p 2 generate an image, wherein the image comprises a graphical representation of the real time tracking information of the implant pose superimposed on one or more fiducial points associated with the current subject planned implant pose and the image data of the subject; and a display device operable to display the generated image.
11 . The system of claim 10 , wherein the display device displays the image including a graphical representation of the current subject planned implant pose relative to a current tracked pose of the implant; wherein the processor module is configured to execute instructions to generate the graphical representation.
12 . The system of claim 10 , wherein the processor module is configured to execute instructions to determine a plan including a trajectory of the implant to achieve the current subject planned implant pose.
13 . The system of claim 12 , wherein the processor module is configured to execute instructions to: generate a graphical representation of the determined plan; and output the generated graphical representation of the determined plan.
14 . The system of claim 10 , further comprising: an implant tracking device; and a tracking system to track a pose of the implant tracking device and determine a pose of the instrument based on the tracking of the implant tracking device; wherein tracking information of the implant relative to the subject includes receiving a signal regarding the tracking the implant tracking device.
15 . The system of claim 14 , wherein the tracking system includes a localizer configured to at least one of receive a signal from the implant tracking device or transmit a signal to the implant tracking device.
16 . The system of claim 15 , further comprising: a subject tracking device associated with the subject; wherein the tracking system is operable to track the subject tracking device.
17 . The system of claim 10 , further comprising: a display device configured to display an image of the subject; wherein a graphical representation of a current tracked pose of the implant is superimposed relative to the current subject planned implant pose on the display device.
18 . The system of claim 10 , wherein the received selected procedure type includes receiving a diagnosis of the subject.
19 . A non-transitory computer-readable medium storing a set of instructions, the set of instructions comprising: one or more instructions that, when executed by one or more processors of a device, cause the device to: receive a selected procedure type for a subject; receive a selected outcome for the subject; receive a determined correlation of the selected outcome to a related pose and volume of activation (VAT) of an implant for brain stimulation based on at least one prior subject; evaluate received subject data to determine a current subject planned implant pose of the implant for brain stimulation and a planned VAT in the subject that is equivalent to the received determined correlation of the selected outcome to the related pose and VAT of the implant for brain stimulation; receive image data of the subject; receive real time tracking information of an implant pose associated with an instrument operated by a user relative to the subject during implantation of the implant for brain stimulation; and generate an image, wherein the image comprises a graphical representation of the real time tracking information of the implant pose superimposed on one or more fiducial points associated with the current subject planned implant pose and the image data of the subject.
20 . The non-transitory computer-readable medium of claim 19 , wherein the one or more instructions further cause the device to: determine a plan including a trajectory of the implant to achieve the current subject planned implant pose.

Description

FIELD The present disclosure is related to a system for planning a procedure on a subject, such as evaluating one or more placements (e.g., existing placements and stimulation regions or previously implanted) and stimulation regions in one or more subjects for planning a future procedure. BACKGROUND This section provides background information related to the present disclosure which is not necessarily prior art. In performing a procedure on a human subject, implants may be positioned in the human subject for various purposes. For example, an implant may be positioned within a brain of a human to provide stimulation or therapy at selected positions therein. Therapy within the brain, however, may vary in efficacy, speed, and the like based upon various parameters of the implantation including implantation location, brain network specifics, delivery features, or the like. According to various systems, an implant may be positioned within a subject to provide therapy thereto. The therapy may include electrical stimulation of portions of the brain adjacent to the implant. In various embodiments, for example, diffusion tensor image data may be used during a selected portion of a procedure, as disclosed in U.S. Pat. No. 8,532,741. In various embodiments, a non-electrical stimulation may also be provided through an implant or an instrument, such as the delivery of a pharmaceutical agent. The pharmaceutical agent may be delivered with a selected device and various image data may be analyzed to assist in determining a placement or delivery location for the pharmaceutical, such as disclosed at U.S. Pat. No. 8,335,552. SUMMARY This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features. A portion of a subject, such as a human anatomy, can be imaged to generate image data thereof that may be analyzed as data and/or visually by a user. It is understood, however, that a subject may include a non-human subject and/or non-living subject. Non-living subjects may include enclosed structures such as wings, robotic systems, etc. In analyzing the image data, various features may be identified and/or used to identify various additional features. For example, an anatomical landmark may be identifiable in a selected image data and may be used to assist in identifying a region or portion of image data that is not visually distinguishable therefrom. Various types of image data may include magnetic resonance imaging (MRI) data, x-ray image data, functional MRI data, diffusion data (such as MRI DTI data), and the like. For example, an anterior commissure and a posterior commissure may be identified in image data to assist in locating and/or approximating locations of a sub-thalamic nucleus in the image based upon a pre-determined co-location of the sub-thalamic nucleus relative to the anterior commissure and the posterior commissure such as disclosed at U.S. Pat. No. 8,160,677, incorporated herein by reference. In various embodiments, an implant may be positioned relative to an identified feature in the image. The implant may include a deep-brain stimulation (DBS) device. The DBS may also be referred to as and/or understood as a neuromodulation device. A stimulation to the brain, as discussed herein, may be a stimulation including an electrical stimulation, such as an application of a voltage, amperage, etc. As used herein, stimulation, including electrical stimulation may refer to neuromodulation. Thus, stimulation may result in excitatory or inhibitory response in a brain network. The treatment device, such as the DBS, may be used to provide therapy to a subject. In various embodiments, features identified in the image data may include an anterior nucleus of the thalamus (ANT) also referred to as the anterior thalamic nucleus (ATN). Stimulation of the ANT and/or portions of the brain relative to the ANT may assist in therapy for patients diagnosed with various conditions, e.g., epilepsy. In particular, a treatment, such as a stimulation, may assist in epilepsy treatment or therapy for patients that are pharmaco-resistant. Accordingly, analysis of image data may assist in identifying the ANT and/or portions of the brain relative to the ANT. These portions may be used for various purposes, such as therapy of epilepsy. A system is disclosed that is able to receive data, such as real time acquisition and/or transfer to a processor module. The received data may be used to make a determination based upon the data. The data may include inputs such as a type of procedure, positioning of an implant during a procedure, and use of the implant after the implantation procedure. Inputs may also include an outcome that are related to or specified for each of the other inputs. A correlation may be made based upon the outcome to the inputs. A further procedure, such as a current patient or current subject procedure, may be planned based upon the determined correlation. The d