Abstract: In order to later identify the location of a biopsy or surgery, various means and methods for permanently and non-surgically marking selected tissue in the human body are used. Later visualization of the markers is readily accomplished using state-of-the-art imaging systems.

Abstract: A system and method for generating three dimensional CT-type information from a conventional C-arm fluoroscope imaging system. A small number of fluoroscope images are used, taken from angles whose pose is determined by means of a three-dimensional target attached to the region of interest, aided by the participation of the surgeon or an image processing routine to pinpoint known anatomical features in the region of interest of the patient. This procedure enables the reconstruction of virtual images in any desired plane, even in planes other than those accessible by the C-arm imaging process, such as the axial plane of a vertebra. Use of this system and method of marking of the feature to be treated in a small number of angularly dissimilar images, enables the generation of CT-type information which can be used to accurately align a robotically guided surgical tool with the anatomical feature.

Abstract: A shape of a medical device to be implanted into a subject is verified by acquiring a plurality of inter-fiduciary marker dimensions from the subject. Three-dimensional image data of the markers and a tissue of interest, included in the subject, is obtained. Respective measurements between the fiduciary markers around the subject and in the image data are confirmed. The tissue of interest and the fiduciary markers are identified in the image data. Points of the tissue of interest and the fiduciary markers are rendered as a 3-dimensional surface representation. A 3-dimensional model of the tissue of interest and the fiduciary markers is generated as a function of the surface representation. A shape of the medical device to be implanted into the subject is determined as a function of the 3-dimensional model.

Abstract: An implantable tissue marker incorporates a contrast agent sealed within a chamber in a container formed from a solid material. The contrast agent is selected to produce a change, such as an increase, in signal intensity under magnetic resonance imaging (MRI). An additional contrast agent may also be sealed within the chamber to provide visibility under another imaging modality, such as computed tomographic (CT) imaging or ultrasound imaging.

Abstract: The present invention relates to a system (1) for determining a functional property of a moving object (2), wherein the system (1) comprises a tag (3) contactable to the object (2) such that the tag (3) follows the movement of the object (2) and movement determination device (4) for determining the movement of the tag (3). The system (1) comprises further a functional property determination device (5) for determining a functional property of the object (2) from the determined movement of the tag (3).

Abstract: An object of the present invention is to accurately display to which region of a patient, a part the image of which is being picked up by an endoscope corresponds without the need to newly use a special endoscope.

Abstract: A method of preplanning for guided medical procedures includes obtaining a first 3D diagnostic dataset for a region of interest of a subject. This first dataset can be a non-stereotactic dataset and provide sufficient contrast to identify target tissue in the region of interest. A treatment preplan is developed to treat the target tissue using the first dataset exclusive of stereotactic data. The treatment preplan includes placement locations for a plurality of initial radiation beams and their respective dose intensities. A second, stereotactic 3D dataset can be obtained for the region of interest. A registered dataset can then be created by registering the first dataset to the second dataset. The treatment preplan can be modified using data associated with the registering step to generate a stereotactic treatment plan including a plurality of radiation treatment beams with respective placement positions based on the registered dataset to treat the target tissue.

Abstract: Medical imaging and navigation system including a processor, a display unit, a database, a medical positioning system (MPS), a two-dimensional imaging system, an inspected organ monitor interface, and a superimposing processor, the MPS including a transducer MPS sensor and a surgical tool MPS sensor, the two-dimensional imaging system including an imaging transducer, the processor being connected to the display unit, to the database, to the MPS, to the two-dimensional imaging system, to the inspected organ monitor interface, and to the superimposing processor, the inspected organ monitor interface being connected to an organ monitor, the surgical tool MPS sensor being firmly attached to a surgical tool, the transducer MPS sensor being firmly attached to the imaging transducer, the organ monitor monitoring an organ timing signal associated with an inspected organ.

Abstract: The invention relates to a method, which assists the doctor in orientation in 2D fluoroscopy images. The invention relates to a method for contour visualization of regions of interest in fluoroscopy images by: firstly generating a 3D raw data set comprising at least one region of interest in which the contour of the at least one region of interest is visible, secondly generating a segmented 3D data set from the 3D raw data set in which the contour in at least one region of interest is clearly delimited, thirdly generating a 2D fluoroscopy image which contains the at least one region of interest, fourthly generating a 2D projection from the segmented 3D data set which is congruent with the 2D fluoroscopy image, fifthly determining the optionally approximated contour of the at least one region of interest in the 2D projection, and finally overlaying the contour with the 2D fluoroscopy image.

Abstract: An embodiment is directed to a method and a system for assisting the targeting of a target with an elongate instrument, wherein the instrument is to be inserted into a living object's body part along a predetermined trajectory extending between an entry point of said instrument into said body part and a target point associated with said target. The method comprises an instrument directing assisting step for generating and displaying an image allowing a user to assess to which extend the longitudinal axis of the instrument is aligned with the vector connecting the target point and the tip portion of said instrument. Also, the method comprises an instrument guiding assisting step of generating and displaying an image allowing a user to assess to which extent the instrument motion during insertion thereof coincides with the predetermined trajectory.

Abstract: A navigation system for tracking an object during surgery, comprises markers adapted to be connected to an object in a known relation. An optical camera detects a light signal from the at least one marker, the optical camera generating tracking data associated with a position of the markers from the light signal. A transparent shield is positioned between the optical camera and the markers during surgery to allow the optical camera to be within the sterile field. Calibration data is associated with an effect of the shield on the light signal passing therethrough to be detected by the optical camera. A position and orientation calculator calculates a position and/or orientation of the object as a function of the tracking data, of the calibration data, and of the known relation between the object and the markers. A method is provided for tracking an object in computer-assisted surgery.

Abstract: A method of determining the prospective location of two or more fiducial markers includes the steps of: with respect to the work piece, defining a path having a radius from an origin which varies in a non-repetitive manner with respect to the angular displacement of the path from the origin; and selecting two or more prospective locations of respective fiducial markers. The prospective locations are positioned relative to the work piece substantially at points along the defined path.

Abstract: The invention relates to a pointing device (40) for indicating the spatial position of markers (2) to a localization system (10). The pointing device (40) comprises a sensor (42) that detects if a definite interaction with the marker (2) takes place. The sensor (42) may for example be a pressure sensor (42) that determines if the contact force exceeds a threshold which could lead to undesired shifts of the marker (2). The pointing device (40) is used to determine the spatial coordinates of the marker (2), which can then be registered with the image coordinates of the marker (2) in a stored image, e.g. a CT-image.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined computed tomography (CT) imageable fiducial locator head, an integral bone screw, and an integral divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example includes a fluid/gel-absorbing coating or cover into which a magnetic resonance (MR) imageable fluid is introduced, thereby permitting both CT and MR imaging. Protective caps and collars may be used to protect the fiducial marker from mechanical impact and/or to guide the fiducial marker during affixation. A bull's-eye or other template is used to select a center of a substantially spherical fiducial marker head on an image, such as for use during patient registration.

Abstract: The present invention includes a method of pre-planning a spherical fixed point stereotactic radiosurgery by obtaining an image from a patient having a target, the image comprising coordinates of the actual patient target in 3 dimensions on a first day; planning an optimal stereotactic radiosurgery using the patient's actual target using actual coordinates in 3 dimensions prior to the day of surgery by creating virtual radiosurgical coordinates and plans to maximize target exposure and minimize the patient's waiting time in radiosurgery, thereby allowing evaluation of several plans to maximize plan conformality and safety; and treating the patient based on the virtual stereotactic radiosurgery plans on a second day.

Abstract: The invention relates to a method for the determination of the position of a radiographic or radioscopic unit (16) with relation to a reference point (Rref) on producing a radiographic image of an object (10). The position of the unit (16) with relation to a reference point (Rref) is determined from the determination of the position of a test pattern (25), with relation to the unit (16), which is mechanically fixed to the object, by using the image of the test pattern with relation to the reference point (Rref). The invention further relates to a determining device for carrying out said method.

Abstract: A spinal midline indicator (10) has a body (14) of radiolucent material for insertion between adjacent vertebrae (18, 20) and a radiographic marker (12) located centrally with the body to indicate the position of the spinal midline (22) in anterior-posterior images when the body is centrally located between the vertebrae. The radiographic marker is typically an elongate metal handle. The body may carry secondary radiographic markers (16) on opposite sides of and equidistant from the handle so that the handle indicates the position of the spinal midline when the body is placed centrally between the vertebrae.

Abstract: An interface apparatus (20) for tracking by a tracking system (40) of an object(s) in space for position and orientation and for interacting with the tracking system (40). The interface apparatus (30) comprises passive detectable devices (12,14,16,22) trackable for position by the tracking system (40). A mounting device (10,24) receives the passive detectable devices (12,14,16,22) in a known geometry, and is secured to the object(s) such that a position and orientation of the object(s) is calculable by the tracking system (40) as a function of a tracking of the known geometry of the passive detectable devices (12,14,16,22). One of the passive detectable devices (22) is displaceable with respect to the object(s). A displacement of the passive detectable device (22) with respect to the object(s) is detectable to initiate an interaction with the tracking system (40) while maintaining the tracking of the object(s).

Abstract: These are biopsy site marking devices. More particularly, the devices include a body of gelatin and an x-ray detectable body of a specific, predetermined non-biological configuration embedded in the body of gelatin. In one embodiment, the x-ray detectable body is made from metal. In alternative embodiments, the x-ray detectable body can be made from stainless steel or metal oxides.

Abstract: Digital x-ray images taken before a surgical procedure by a fluoroscopic C-arm imager are displayed by a computer and overlaid with graphical representations of instruments being used in the operating room. The graphical representations are updated in real-time to correspond to movement of the instruments in the operating room. A number of different techniques are described that aid the physician in planning and carrying out the surgical procedure.

Abstract: In a method and apparatus to detect position changes of an implant x-ray detectable markers are arranged in the environment of the implant, and 2D x-ray exposures are obtained at temporal intervals of a region containing the implant in which a distribution of the markers as well as of marked points of the implant are visible in each 2D x-ray exposure. A first of the 2D x-ray exposures is obtained at a first point in time from one projection direction, and a second of the 2D x-ray exposures is obtained at a second point in time from another projection direction. The distribution of the markers and marked points is determined in the first and second 2D x-ray exposure by an evaluation device, and from the distributions a degree of probability is calculated that the distribution of the first 2D x-ray exposure and the distribution of the second 2D x-ray exposure are projections of the same three-dimensional distribution of markers and marked points.

Abstract: The present invention provides a method for positioning an electromagnetic tracking sensor. The method includes attaching a sensor to an anatomy, obtaining an image of the anatomy, indicating a size of each of a plurality of volumes on the image, where the volumes include a smaller and larger volume, and making a determination of whether a region of interest is encompassed by one or more of the volumes. The present invention also provides a system for positioning an electromagnetic tracking sensor. The system includes a sensor attached to a patient anatomy, an imaging modality obtaining an image of the anatomy, an image processor indicating a size of each of a plurality of volumes on the image, where the plurality of volumes includes a smaller and larger volume, and an operator making a determination of whether a region of interest is encompassed by one or more of the volumes.

Abstract: A system and method of processing images of a region of interest of a patient is provided. The method comprises acquiring a reference image of the region of interest of the patient; during a pullback of an intravascular sensor in the region of interest, triggering simultaneously the steps of: acquiring a data collected by the sensor characteristic of the region of interest; and acquiring a succession of images of the region of interest associated with the location of the intravascular sensor when acquiring the data, respectively. The method further includes registering the succession of images; associating the location of the intravascular sensor relative to the step of acquiring the data collected by the intravascular sensor; and displaying and positioning the data collected by the intravascular sensor on the reference image in correspondence to the location of the intravascular sensor at the respective step of acquiring the data.

Abstract: A tracking and positioning system and method to enable the precise positioning of an object or tool relative to its surgical surroundings, and in accordance with preoperative CT images of the operating site. When used for artificial spinal disc positioning, the system comprises a computing system incorporating in memory the preoperative CT data showing the two vertebrae and the predetermined disc position between them; a 3-D target having radio-opaque markers for attaching to one of the vertebrae to define the position of the vertebra in an intra-operative fluoroscope image of the spine; a tool for intra-operative insertion of the artificial disc, and a registration system for relating the intra-operative fluoroscope image to the preoperative CT data, such that the predetermined disc position is displayed in the fluoroscope image of the subject, thereby enabling the surgeon to place the artificial disc accurately in its intended position.

Abstract: A method for use during a procedure on a body. The method generates a display representing relative positions of two structures during the procedure.

Abstract: A fiducial marker for use in a gamma-guided stereotactic localization system for imaging a suspected cancer and guiding a physician in the removal of tissue samples for biopsy. The fiducial marker includes a fiducial source that can be accurately located in a positioning system and used to correlate the location of the positioning system with the detector and therefore the region-of-interest. The fiducial can be made radioactive such that it can be seen by the gamma camera. The fiducial marker enables the accurate positioning of other hardware in proximity to the object to be viewed.

Abstract: The present invention provides a three section skin marking system combining target placement, lancing, marking, cleanup and protective bandaging comprising a positioning target, an ink application pad and a bandage pad, wherein the ink application pad is attached to the positioning target and the bandage pad is attached to the positioning target, wherein the positioning target is an appliqué with a top side and a bottom side and a peripheral border of material with a center portion of the appliqué removed and free of material, wherein the bottom side has an adhesive for adhering to skin of a patient; wherein the application pad comprises an absorbent pad surrounding micro-encapsulated or macro-encapsulated ink for marking the patient's skin; and wherein the bandage pad comprises an absorbent pad and an adhesive strip.

Abstract: A method of performing a surgery is provided including a surgical navigation system having a tracking system, computer and monitor placed outside of a sterile field. An input pad and a tracking array attachable to a surgical instrument or bone are placed into the sterile field along with a probe having a probe array. The tracking array and the probe array are acquired by the tracking system and a virtual mouse is activated by positioning the probe relative to the input pad, thereby causing a mouse input to the computer with the virtual mouse.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined computed tomography (CT) imagable fiducial locator head, an integral bone screw, and an integral divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example includes a fluid/gel-absorbing coating or cover into which a magnetic resonance (MR) imagable fluid is introduced, thereby permitting both CT and MR imaging. Protective caps and collars may be used to protect the fiducial marker from mechanical impact and/or to guide the fiducial marker during affixation. A bull's-eye or other template is used to select a center of a substantially spherical fiducial marker head on an image, such as for use during patient registration.

Abstract: A spinal midline indicator (10) has a body (14) of radiolucent material for insertion between adjacent vertebrae (18, 20) and a radiographic marker (12) located centrally with the body to indicate the position of the spinal midline (22) in anterior-posterior images when the body is centrally located between the vertebrae. The radiographic marker is typically an elongate metal handle. The body may carry secondary radiographic markers (16) on opposite sides of and equidistant from the handle so that the handle indicates the position of the spinal midline when the body is placed centrally between the vertebrae.

Abstract: Disclosed are devices and methods for correlating or aligning pre-surgical image(s) with image(s) observed during a surgical procedure to aid in orientation of tissues and devices for performing a surgical procedure. In a preferred embodiment, the invention provides devices and methods for aligning pre-surgical image(s) of optical tissues or structures, e.g., the retina, with real-time images observed or obtained with a slit lamp, or other optical viewing device. The ability of the subject invention to correlate these images can advantageously provide the physician with greater accuracy when administering surgical treatment, such as with a laser, and can significantly reduce surgery time.

Abstract: Presented herein are methods, systems, devices, and computer-readable media for correction of relative tracking error based on a fiducial. One embodiment is a method for the correction of obtained emplacement data of two surgical instruments by the detection of a detectable fiducial coupled to first surgical instrument by a second surgical instrument or something thereto coupled. The corrected relative emplacements of both surgical instruments is then determined based on the emplacement of the fiducial. This corrected emplacement is then used to produce an image for display. Systems and devices for carrying out the presented methods are also described.

Abstract: A dilation catheter device and system for dilating an opening in a paranasal sinus and/or other passageways within the ear, nose or throat is disclosed. A dilation catheter device and system is constructed in a manner that facilitates ease of use by the operator and, in at least some cases, allows the dilation procedure to be performed by a single operator. Additionally, the dilation catheter device and system may be useable in conjunction with an endoscope and/or a fluoroscope to provide for easy manipulation and positioning of the devices and real time visualization of the entire procedure or selected portions thereof. In some embodiments, shaft markers are disposed on a shaft of the dilation catheter and have a light color to contrast with a dark color of the dilation catheter shaft. The high contrast between the markers and catheter shaft allows for easy viewing of the markers in low light and operation conditions.

Abstract: The invention includes a method and system for intra-operative navigation of a joint replacement operation, without recourse to pre-operative imagery of pre-operative computerized simulations. Trackable markers and a locating system are employed to track first and second bones. A computer receives positional information regarding the trackable markers and calculates (predicts) at least one suggested combination of components of a modular implant system to produce a desired post-operative skeletal relationship.

Abstract: A method and apparatus for lesion or organ definition for the purpose of radiation treatment planning localization and treatment position verification. The apparatus uses a combination of an ultrasound imaging system and a diagnostic imaging system to acquire localization ultrasound images referenced in the coordinate space of the diagnostic imaging system through the use of a position sensing system. The method compares the location of the lesion in the localization ultrasound images with the position of the lesion in ultrasound images taken while the patient lies on the treatment table of a therapy treatment unit, suggests corrective measures to place the lesion in its intended treatment position and executes the correction upon confirmation from qualified personnel.

Abstract: Described are computer-based surgical methods and apparatuses for a self-detecting kinematic assembly. The self-detecting kinematic clamp assembly detects and indicates a degradation in pose. The self-detecting kinematic clamp assembly includes a tracking element for tracking a pose of the kinematic clamp assembly. The self-detecting kinematic clamp assembly includes a base portion comprising a fixation device that is attachable to a rigid body, and a top portion connected to the tracking element, the top portion being removably connected to the base portion. The self-detecting kinematic clamp assembly includes a detection mechanism, the detection mechanism including three or more contact points between the base potion and top portion and a mechanism that detects movement between one or more of the three or more contact points.

Abstract: A method and system to assist in a planning and navigation of procedure. Generally, the system allows for image acquisition of a selected area of the anatomy. The images may then be used to mark various points to determine true anatomical definitions and planes. The definitions may assist in positioning a prosthesis.

Abstract: A system includes a component that updates a registration between an image space coordinate system and an interventional space coordinate system based on interventional device position information within a patient obtained from intermediate image data indicative of the interventional device location and a position sensor (160) that is located on an interventional device (156) within the patient.

Abstract: Laparoscopic ultrasound has seen increased use as a surgical aide in general, gynecological, and urological procedures. The application of real-time three-dimensional (RT3D) ultrasound to these laparoscopic procedures may increase information available to the surgeon and serve as an additional intraoperative guidance tool. The integration of RT3D with recent advances in robotic surgery can also increase automation and ease of use. In one non-limiting exemplary implementation, a 1 cm diameter probe for RT3D has been used laparoscopically for in vivo imaging of a canine. The probe, which operates at 5 MHz, was used to image the spleen, liver, and gall bladder as well as to guide surgical instruments. Furthermore, the 3D measurement system of the volumetric scanner used with this probe was tested as a guidance mechanism for a robotic linear motion system in order to simulate the feasibility of RT3D/robotic surgery integration.

Abstract: A system for selectively triggering an energy activated therapy agent. The system includes a member to which a device for emitting energy is attached. One or more navigation markers are also attached to the member. The position of the navigation markers is tracked to provide an indication of the position of the energy emitting device relative to the target tissue. When the energy emitting device is adjacent the target tissue, it is actuated.

Abstract: Generally, systems, methods, and apparatus related to the use of a dynamic imaging modality in an image guided intervention are disclosed herein. More specifically, the use of such modalities in sealing a bodily opening, such as those that may be formed during an invasive medical procedure are disclosed herein. In some embodiments, a method includes viewing a representation of an instrument within a body of a patient, adjusting a position of the instrument based on the viewing such that a portion of the instrument is at a location within the body of the patient, and delivering a sealant via the instrument to the location within the body of the patient. The sealant is configured to seal an opening in the body part.

Abstract: A method for providing measuring data for the precise local positioning of an ablation catheter comprises the recording of electrophysiological potential curves in a plurality of positions of the ablation catheter with regard to a potential measurement on a reference catheter. An x-ray image is recorded in each of the positions and the position of the ablation catheter in each instance on the x-ray image is characterized by a marker. The electrophysiological potential curves are coupled in a data-related manner with the markers. When a marker on the screen displaying the x-ray image is clicked on, the associated electrophysiological potential curves appear highlighted on another screen, if necessary in color or with increased brightness. Conversely, the x-ray image with the marker is queried, i.e. displayed and the marker highlighted when the potential curve is activated on a screen displaying the potential curve.

Abstract: An inventive medical imaging marker includes two plate members (2a, 2b) of an imageable material, which respectively includes: two flat major surfaces (4a, 4b) located symmetrically about an intersection (7) of two orthogonal straight lines (5, 6); and two pairs of side surfaces (8a, 9a; 8b, 9b) disposed perpendicularly to the respective major surfaces (4a, 4b) with their boundary edges (5a, 6a; 5b, 6b) defined by at least parts of the straight lines (5, 6). With the use of the marker, an image can be easily and accurately correlated with an actual entity.

Abstract: In a method for operation of an imaging medical apparatus, a recumbent board supporting an examination subject is positioned in the scan region of the medical-technical apparatus, an exposure of both a section of the recumbent board and of a part of the tissue of the examination subject to be examined in the scan region is generated, the acquired real position of the section of the recumbent board is compared with an expected position of the recumbent board by image evaluation of the exposure generated with the medical-technical apparatus, and the exposure generated with the medical-technical apparatus of the examined tissue is corrected using the expected-real comparison of the position of the recumbent board.

Abstract: Digital x-ray images taken before a surgical procedure by a fluoroscopic C-arm imager are displayed by a computer and overlaid with graphical representations of instruments being used in the operating room. The graphical representations are updated in real-time to correspond to movement of the instruments in the operating room. A number of different techniques are described that aid the physician in planning and carrying out the surgical procedure.

Abstract: A targeting system, which provides an adjustable optical assembly, for use with imaging systems having a penetrating beam source, a penetrating beam receiver. The optical assembly has a targeting marker in the path of a penetrating beam emitted by the source. The targeting marker is at least partially opaque to the penetrating beam emitted by the source, and the targeting marker indicates a targeting point on a target axis. The optical assembly further includes a sensible targeting beam device that is capable of providing a sensible targeting beam coaxial and collinear with the target axis. In addition, there is provide a method of aligning the targeting system, such as the system described above, and a method of targeting an area of interest. One advantage of the system and method is that it requires only a two point alignment.

Abstract: An apparatus and a method for guiding the placement of an object to a desired location based on an image generated by an image intensifier where the apparatus includes a first coupling mechanism that is configured to be releaseably attachable to one of the transmitter and receiver of the image intensifier and a second coupling mechanism that is coupled to the first coupling mechanism and includes an object holding mechanism, the object holding mechanism is configured to releaseably hold the object and where at least a portion of the second coupling mechanism is visible in the image generated by the image intensifier when the apparatus is attached to the image intensifier.

Abstract: A tracking system is provided for tracking an objects. A first and a second trackable member each have an inertial sensor unit producing at least orientation-based data. A processing unit receives the orientation-based data from the trackable members. The processing unit has an orientation calculator calculating an orientation of the second trackable member with respect to the first trackable member from the orientation-based data of both said trackable members, whereby the processing unit calculates an orientation of the objects. A method is also provided.

Abstract: A marker device that aids in the subsequent identification of a particular area is equipped with an anchoring device that prevents migration once placed in the tissue of that particular area. The device may include a chemical agent or drug that adds a therapeutic function to the marker device.

Abstract: The present application relates to a system for navigation-assisted shoulder operations in which the humeral component is partially replaced with a prosthesis, comprising: a first tracking unit which is configured to be fastened to a section of a bone which is to be removed during the operation; a detection unit which is configured to detect landmarks on the bone; a second tracking unit which is configured to be attached to another section of the same bone; a camera unit which simultaneously detects the first and second tracking unit, in order to determine their respective location; and a computational unit which is connected to the camera unit and is configured to: determine a first relative location of the landmarks relative to the first tracking unit from data acquired by means of the detection unit; and calculate a second relative location of the landmarks relative to the second tracking unit on the basis of the first relative location; such that additional navigated treatment apparatuses can be exac