US-12622755-B2 - Method and device for generating an uncertainty map for guided percutaneous procedures

US12622755B2US 12622755 B2US12622755 B2US 12622755B2US-12622755-B2

Abstract

Guided percutaneous uncertainty mapping device and method for providing visual representations of an uncertainty map with respect to an organ during a guided percutaneous procedure using an electromagnetic tracking (EMT) system comprising an EMT field generator and tracker, a catheter with a EMT sensor for placing in the organ to mark a percutaneous procedure target, and a needle with an EMT sensor and an electronic data processor configured for carrying out the steps of: receiving an indication of a percutaneous procedure target; receiving three-dimensional (3D) positions and orientations of the catheter and the needle tracked in real-time from the EMT system; estimating the uncertainty of the received position and orientation of the needle; estimating the uncertainty of the received position and orientation of the catheter: estimating a trajectory uncertainty of the needle departing from a current position and orientation of the needle; generating a visual representation of the estimated trajectory uncertainty and catheter uncertainty with respect to the EMT coordinate system for displaying on a user interface.

Inventors

João Luís GOMES DA FONSECA
João Luís ARAÚJO MARTINS VILAÇA
Sandro Filipe MONTEIRO QUEIRÓS
Estevão Augusto RODRIGUES DE LIMA
Jorge Manuel NUNES CORREIA PINTO

Assignees

UNIVERSIDADE DO MINHO
INSTITUTO POLITÉCNICO DO CÁVADO E DO AVE
KARL STORZ SE & CO. KG

Dates

Publication Date: 20260512
Application Date: 20220429
Priority Date: 20210429

Claims (20)

1 . A guided percutaneous uncertainty mapping device for providing visual representations of an uncertainty map with respect to an organ during a guided percutaneous procedure using an electromagnetic tracking (EMT) system comprising an EMT field generator and tracker defining an EMT coordinate system, a catheter with a catheter EMT sensor for placing in the organ to mark a percutaneous procedure target, a needle with a needle EMT sensor and an electronic data processor configured for carrying out the steps of: receiving an indication of the percutaneous procedure target; receiving three-dimensional (3D) positions and orientations of the catheter and the needle tracked in real-time from the EMT system; estimating the uncertainty of the received position and orientation of the needle; estimating the uncertainty of the received position and orientation of the catheter; estimating a trajectory uncertainty of the needle departing from a current position and orientation of the needle; and generating a visual representation of the estimated trajectory uncertainty and catheter uncertainty with respect to the EMT coordinate system for displaying on a user interface.
2 . The device according to claim 1 , wherein the organ is a kidney and the guided percutaneous procedure is a percutaneous renal access.
3 . The device according to claim 1 , wherein the electronic data processor is further configured for repeatedly estimating one or more of the uncertainty of the needle, the uncertainty of the catheter and the trajectory uncertainty, and the generating said visual representations.
4 . The device according to claim 1 , wherein the percutaneous procedure target is a catheter tip.
5 . The device according to claim 1 , wherein the user interface is a 2D display, a 3D display, a virtual-reality display or an augmented-reality display.
6 . The device according to claim 1 , wherein the catheter is for positioning in a working channel in the organ by a flexible ureterorenoscope.
7 . The device according to claim 1 , for providing visual representations of the uncertainty map during the guided percutaneous procedure using an ultrasound (US) probe with a probe EMT sensor, wherein the electronic data processor is configured for previously carrying out the calibration steps of: tracking a reference object using the EMT system, said reference object comprising a plurality of reference points with known positions in said reference object; receiving, from the US probe, US imaging data from the reference object and, simultaneously, receiving from the EMT system a set of 3D positions and orientations of the US probe when imaging said reference object; identifying said reference points in the received US imaging data; calculating a probe calibration transform matrix and a probe calibration uncertainty by matching the identified reference points in the received US imaging data with the tracked reference points in the EMT coordinate system; and wherein the electronic data processor is configured for carrying out the steps of: receiving a 3D position and orientation of the US probe tracked in real-time from the EMT system; receiving intraoperative US imaging data from the US probe; transforming the intraoperative US imaging data with the calculated probe calibration transform matrix; estimating the uncertainty of the received position and orientation of the US probe; estimating the uncertainty of the transformed intraoperative US imaging data by linearly combining, through error propagation, the calculated probe calibration uncertainty with the uncertainty of the received position and orientation of the US probe; and generating a visual representation of the estimated uncertainty of the transformed intraoperative US imaging data for displaying on the user interface.
8 . The device according to claim 7 , wherein the electronic data processor is configured for carrying out the steps of: loading the preoperative imaging data; receiving a 3D position and orientation of the US probe tracked in real-time from the EMT system; receiving intraoperative US imaging data from the US probe; registering the loaded preoperative imaging data with the intraoperative US imaging data; transforming the intraoperative US imaging data with the calculated probe calibration transform matrix; transforming the registered preoperative imaging data to the EMT system with the calculated probe calibration transform matrix; estimating the uncertainty of the received position and orientation of the US probe; estimating the uncertainty of the transformed intraoperative US imaging data by linearly combining, through error propagation, the calculated probe calibration uncertainty with the uncertainty of the received position and orientation of the US probe; estimating the uncertainty of the registered preoperative imaging data; estimating an uncertainty of the registered preoperative imaging data in respect of the EMT system, by linearly combining, through error propagation, the estimated uncertainty of the transformed intraoperative US imaging data with the estimated uncertainty of the registered preoperative imaging data; generating a visual representation of the estimated uncertainty of the transformed intraoperative US imaging data for displaying on a user interface; and generating a visual representation of the estimated uncertainty of the preoperative imaging data in respect of the EMT system for displaying on the user interface.
9 . The device according to claim 7 , wherein intraoperative imaging data comprises 3D organ model or models reconstructed from intraoperative US images, and the estimating of the uncertainty of the transformed intraoperative imaging data comprises: estimating the uncertainty of the intraoperative imaging model or models; and linearly combining, by error propagation, the estimated uncertainty of the intraoperative imaging model or models with the calculated probe calibration uncertainty and with the uncertainty of the received position and orientation of the US probe.
10 . The device according to claim 2 , wherein estimating the uncertainty of position and orientation of at least one of the catheter, needle, and probe comprises receiving an uncertainty value from the EMT system, the uncertainty value being an electromagnetic interference value from the EMT system.
11 . The device according to claim 10 , wherein estimating the uncertainty of position and orientation of a certain of the catheter, needle or probe further comprises using a pre-obtained calibration curve on the received electromagnetic interference value to obtain a respective calibrated uncertainty estimate.
12 . The device according to claim 1 , wherein the electronic data processor is further configured for carrying out the steps of: loading preoperative imaging data; registering the loaded preoperative imaging data into the EMT system; estimating the uncertainty of the registered preoperative imaging data; and generating a visual representation of the estimated uncertainty of the registered preoperative imaging data for displaying on the user interface.
13 . The device according to claim 12 , wherein the preoperative imaging data comprises 3D organ model or models previously reconstructed from preoperative MRI or CT images, and the estimating the uncertainty of the registered preoperative imaging data further comprises: estimating the uncertainty of the preoperative imaging model or models; estimating the uncertainty of the registering of the preoperative imaging data; and linearly combining, by error propagation, the estimated uncertainty of the preoperative imaging model or models with the estimated uncertainty of the registering of the preoperative imaging data.
14 . The device according to claim 13 , wherein the electronic data processor is configured for calculating the uncertainty of the preoperative imaging model or models, wherein said preoperative imaging model or models comprise a plurality of vertices, by calculating and representing the uncertainty of the plurality of vertices, each said vertex having an independently calculated uncertainty.
15 . The device according to claim 13 , wherein the electronic data processor is configured for calculating the uncertainty of the preoperative imaging model or models, wherein said preoperative imaging model or models comprise a plurality of vertices, by calculating and representing the uncertainty of the plurality of vertices, each said vertex having the same globally calculated uncertainty.
16 . The device according to claim 1 , wherein the 3D positions and orientations tracked in real-time via the EMT system are tracked through point EMT sensors.
17 . The device according to claim 16 , wherein the point EMT sensors are placed on a tip of the catheter and on a tip of the needle.
18 . A guided percutaneous uncertainty mapping device for providing visual representations of an uncertainty map with respect to an organ during a guided percutaneous procedure using an electromagnetic tracking (EMT) system comprising an EMT field generator and tracker defining an EMT coordinate system, a catheter with a catheter EMT sensor for placing in the organ to mark a percutaneous procedure target, a needle with a needle EMT sensor and an electronic data processor configured for carrying out the steps of: receiving an indication of the percutaneous procedure target; receiving a set of 3D positions and orientations of the catheter and the needle tracked in real-time from the EMT system; estimating the uncertainty of the received position and orientation of the needle; estimating the uncertainty of the received position and orientation of the catheter; linearly combining the estimated needle and catheter uncertainties by error propagation; estimating a trajectory uncertainty of the needle departing from a current position and orientation of the needle; and generating a visual representation of the estimated trajectory uncertainty with respect to the percutaneous procedure target for displaying on a user interface.
19 . A method for providing visual representations of an uncertainty map with respect to an organ during a guided percutaneous procedure using an electromagnetic tracking (EMT) system comprising an EMT field generator and tracker defining an EMT coordinate system, a catheter with a catheter EMT sensor for placing in the organ to mark a percutaneous procedure target, a needle with a needle EMT sensor and an electronic data processor, the method comprising: receiving an indication of the percutaneous procedure target; receiving 3D positions and orientations of the catheter and the needle tracked in real-time from the EMT system; estimating the uncertainty of the received position and orientation of the needle; estimating the uncertainty of the received position and orientation of the catheter; estimating a trajectory uncertainty of the needle departing from a current position and orientation of the needle; and generating a visual representation of the estimated trajectory uncertainty and catheter uncertainty with respect to the EMT coordinate system for displaying on a user interface.
20 . The method according to claim 19 , wherein the method further comprises: loading the preoperative imaging data; receiving a 3D position and orientation of the US probe tracked in real-time from the EMT system; receiving intraoperative US imaging data from the US probe; transforming the intraoperative US imaging data with the calculated probe calibration transform matrix; registering the loading preoperative imaging data with the transformed intraoperative US imaging data; estimating the uncertainty of the received position and orientation of the US probe; estimating the uncertainty of the transformed intraoperative US imaging data by linearly combining, through error propagation, the calculated probe calibration uncertainty with the uncertainty of the received position and orientation of the US probe; estimating the uncertainty of the registered preoperative imaging data; estimating an uncertainty of the registered preoperative imaging data in respect of the EMT system, by linearly combining, through error propagation, the estimated uncertainty of the transformed intraoperative US imaging data with the estimated uncertainty of the registered preoperative imaging data; generating a visual representation of the estimated uncertainty of the transformed intraoperative US imaging data for displaying on a user interface; and generating a visual representation of the estimated uncertainty of the preoperative imaging data in respect of the EMT system for displaying on the user interface.

Description

CROSS REFERENCE TO RELATED APPLICATIONS This application is a National Phase Application under 35 U.S.C. 371 of PCT Application No. PCT/IB2022/053989 having an international filing date of 29 Apr. 2022 which designated the United States, which PCT application claimed the benefit of Portuguese Patent Application No. 117202 filed 29 Apr. 2021; Portuguese Patent Application No. 117204 filed 30 Apr. 2021; and Portuguese Patent Application No. 117205 filed 30 Apr. 2021, each of which are incorporated herein by reference in their entirety. TECHNICAL FIELD The present disclosure relates to a method and device for generating an uncertainty map system for providing visual representations of uncertainty during guided percutaneous procedures to an internal organ, in particular the kidney. BACKGROUND In percutaneous procedures, reaching a target site precisely without damaging adjacent organs or tissues is a well desired outcome. Providing tools for aiding surgeons in safely performing percutaneous procedure access is an important need addressed by the present disclosure. In particular, safely performing percutaneous procedure access to the kidney is of interest. Document WO2018/222751 A1 discloses systems and methods for guiding the delivery of therapeutic radiation using incomplete or partial images acquired during a treatment session. A partial image does not have enough information to determine the location of a target region due to, for example, poor or low contrast and/or low SNR. The radiation fluence calculation methods described herein do not require knowledge or calculation of the target location, and yet may help to provide real-time image guided radiation therapy using arbitrarily low SNR images. Document WO2010/067188A1 discloses a method of determining a treatment parameter, includes determining an accumulated dose at a target region that undergoes motion, determining an accumulated dose at a critical region, and determining the treatment parameter based on the determined accumulated dose at the target region and the determined accumulated dose at the critical region, wherein the act of determining the treatment parameter is performed during a treatment session. A method of determining a treatment parameter, includes tracking a position of a target, delivering radiation to the target based on the tracked position, and compensating for an inaccuracy of the tracked position by using information regarding a delivered dose to determine a treatment parameter for a next beam delivery. These facts are disclosed in order to illustrate the technical problem addressed by the present disclosure. General Description The present disclosure relates to a method and device for generating an uncertainty map system for providing visual representations of uncertainty during guided percutaneous procedures to an internal organ. The disclosure uses intraoperative images (normally US—ultrasound) tracked with an unobstructed real-time tracking system, and visual reconstructions of the intraoperative imaging data and preoperative imaging data (for example, obtained by CT—computed tomography, or by MRI—magnetic resonance imaging) of the patient's anatomy to identify targets and important anatomical structures in an internal organ, the kidney in particular, and nearby organs. With the final purpose of reaching the target site precisely without damaging adjacent organs/tissues, a method for surgical navigation is proposed here which creates an uncertainty map to help surgeons safely perform percutaneous access. This method is used for surgical navigation during percutaneous access that computes and displays on a user interface a virtual uncertainty information based on medical imaging and tracking systems. This method estimates the uncertainty associated to the path of a tracked surgical needle, which is linked to the probability of hitting adjacent anatomical structures while trying to reach a target site defined as a physical reference inside the body. The representation of uncertainty may be obtained by changing the boundaries of the three-dimensional (3D) virtual models. Interaction, or not, between the needle boundaries and the boundaries of organs other than the target one, defines an unsafe or safe trajectory to reach the target. One of the main advantages of the present disclosure is that it allows minimizing the risk of puncturing organs other than the organ of interest, e.g., the kidney, reducing surgical complications associated with this surgical step. Another advantage of the disclosure is to promote a fast and straight puncturing to the organ of interest (e.g. the kidney), reducing puncture time, avoiding the formation of tortuous puncture tracts, decreasing patient harm, and improving the clinical outcome of subsequent surgical steps. Furthermore, by providing an uncertainty assessment, when combining use of an electromagnetic real-time tracking system with reconstructions of the intraoperative data and preoperative d