Abstract: A system and methods for adaptive placement of a treatment element include a placement device (134), and a localization system (120) configured to track progress of the placement device such that a position of a treatment element (146, 132) placed by or to be placed by the placement device is stored in memory. A computer system (142) includes a program (104) implemented in computer readable storage media and configured to compute an effect of the treatment element at the position and determine whether a dosage amount has been achieved by the treatment element for treatment of an organ.

Abstract: Systems and methods for registering, verifying, dynamically referencing, and navigating an anatomical region of interest of a patient are provided. In one embodiment, the anatomical region of interest is imaged using an imaging device such as, for example, an x-ray device. A tracked registration device may then be removably inserted following a path within the anatomical region and the position of the registration device may be sampled by a tracking device as the registration device is moved within the anatomical region through the catheter. The sampled position data is registered to the image data to register the path to the anatomical region of interest. The same or a similar device may be used to dynamically reference the movements affecting the anatomical region and modify the registration in real time. The registration may also be verified.

Abstract: The invention provides a method and system for method of determining the shape of a flexible endoscope. The invention may include registering image-space coordinates of a path of a flexible endoscope within the anatomy of a patient to patient-space coordinates of the path of the flexible endoscope within the anatomy of the patient. In some embodiments, the image space coordinates of the path of the flexible endoscope may be predicted coordinates such as, for example, a calculated centerline through a conduit-like organ, or a calculated “most likely path” of the flexible endoscope within the anatomy of the patient. In other embodiments, the path of the flexible endoscope may be an actual path determined using intra-operative images of the patient's anatomy with the flexible endoscope inserted therein. The registered instrument may then be navigated to one or more items of interest for performance of the endoscopic medical procedure.

Abstract: The invention provides a method and system for performing an image-guided endoscopic medical procedure. The invention may include registering image-space coordinates of a path of a medical instrument within the anatomy of a patient to patient-space coordinates of the path of the medical instrument within the anatomy of the patient. In some embodiments, the image space coordinates of the path of the medical instrument may be predicted coordinates such as, for example, a calculated centerline through a conduit-like organ, or a calculated “most likely path” of the medical instrument within the anatomy of the patient. In other embodiments, the path of the medical instrument may be an actual path determined using intra-operative images of the patient's anatomy with the medical instrument inserted therein. The registered instrument may then be navigated to one or more items of interest for performance of the endoscopic medical procedure.

Abstract: Systems and methods for registering, verifying, dynamically referencing, and navigating an anatomical region of interest of a patient are provided. In one embodiment, the anatomical region of interest is imaged using an imaging device such as, for example, an x-ray device. A tracked registration device may then be removably inserted following a path within the anatomical region and the position of the registration device may be sampled by a tracking device as the registration device is moved within the anatomical region through the catheter. The sampled position data is registered to the image data to register the path to the anatomical region of interest. The same or a similar device may be used to dynamically reference the movements affecting the anatomical region and modify the registration in real time. The registration may also be verified.

Abstract: The invention provides a method for adjusting the calibration of a tracked ultrasound device using the measured difference between two sets of fiducial markings in two relative positions of a tracker and an scan head of the device. The invention also provides a trackable ultrasound device that enables repeatable attachment of a tracker to a scan head, thus preserving an initial calibration between the tracker and the scan head. Furthermore, the invention provides a calibration jig that can be used to repeatably attach a tracker to an ultrasound scan head or to measure the difference between two relative positions of a tracker and a scan head.

Abstract: The invention provides systems, methods, and instrumentation for aiding the performance of an image guided procedure of the anatomy of a patient such as, for example, the prostate. The invention includes a plurality of lumens therein and a balloon portion or other fixating portion. In some embodiments, the catheter includes a lumen for introducing a contrast agent visible to an imaging modality external to the anatomy of the patient. Image space data of the catheter within the anatomy of the patient may be obtained using the imaging modality. The catheter also includes at least a lumen for inserting a registration device for obtaining patient space data regarding the anatomy of the patient. Other lumens and/or other elements visible to the imaging modality may be used. The image space data may be registered to the patient space data for use during an image guided procedure to the anatomy of the patient.

Abstract: A method, apparatus and system for fusing real-time ultrasound images with pre-acquired medical images are described.

Abstract: The invention provides an image-guided medical instrument that utilizes a tracking device to track the location of at least a portion of the instrument on at least one image of a patient's anatomy. The instrument may include a handle having an operating element, an elongated flexible body member connected to the handle, wherein the body member includes a lumen, a transmission element housed within the lumen of the body member, and a treatment apparatus connected to end of the transmission element, wherein actuation of the operating element actuates the treatment apparatus via the transmission element. The body member also includes at least one sensor element that is utilized by the tracking device to determine position information regarding the treatment apparatus that is used to display the location of the treatment apparatus on the at least one image of the patient's anatomy.

Abstract: Systems and methods for assisting/performing image-guided transjugular intrahepatic portosystemic shunt (TIPS) procedures in a portion of an anatomy of a patient include a guide needle portion having a hollow tube with a bend toward its distal tip, and a puncture needle portion that includes at least one position indicating element at its tip. The puncture needle is slidably mounted within the hollow tube of the guide needle such that a distal tip of the puncture needle can be extended from an opening in the distal tip of the guide needle and used to place a shunt between the portal and hepatic veins of a patient. The position indicating element of the puncture needle is used to produce a display of the puncture needle relative to a target vessel, including a projected path of the puncture needle that can be adjusted to accurately locate a shunt.

Abstract: The invention provides methods and apparatus for navigating a medical instrument to a target in the lung. In one embodiment, the invention includes inserting a bronchoscope into the lung, inserting a catheter into the lung through the working channel of the bronchoscope, inserting a tracked navigation instrument wire into the lung through the catheter, navigating the tracked navigation instrument through the lung to the target, advancing the catheter over the tracked navigation instrument to the target, removing the tracked navigation instrument from the catheter, and inserting a medical instrument into the catheter, thus bringing the medical instrument in proximity to the target.

Abstract: A system and methods for adaptive placement of a treatment element include a placement device (134), and a localization system (120) configured to track progress of the placement device such that a position of a treatment element (146, 132) placed by or to be placed by the placement device is stored in memory. A computer system (142) includes a program (104) implemented in computer readable storage media and configured to compute an effect of the treatment element at the position and determine whether a dosage amount has been achieved by the treatment element for treatment of an organ.

Abstract: Systems and methods for obtaining position sensor space data regarding an endovascular prosthesis within an anatomical region of a patient include at least one position indicating element which is movable within an endovascular prosthesis is tracked by a tracking system. A guidance portion of the endovascular prosthesis constrains movement of position indicating elements within the endovascular prosthesis.

Abstract: An apparatus having an insertable portion for holding a position sensor is disclosed. The position sensor can transmit a signal indicative of its position with respect to a field generator. The insertable portion of the catheter has fiducial markings that are detectable by an imaging modality when the insertable portion is inserted into the anatomical body. The fiducial markings are asymmetrical about at least a first axis of the insertable portion. After the insertable portion has been inserted into the anatomical body, the fiducial markings can be detected to facilitate registration of the position sensor held in the insertable portion to the anatomical body. The apparatus also has a fixing mechanism for releasably fixing the insertable portion to the anatomical body. The non-symmetrical fiducial markings facilitate unambiguous registration of the insertable portion to the anatomical body.

Abstract: Devices and methods for registering, dynamically referencing, and navigating an anatomical region of interest of a patient are provided using a tracked Kirschner wire (K-wire), where the K-wire includes a position-indicating element.

Abstract: The invention provides a system and method for testing and correcting the accuracy of a tracking device in a volume using an accuracy device. The invention may include placing a rigid object into an experimental volume and sampling position and orientation information regarding one or more position indicating elements at known positions relative to a frame of reference of the tracking device. The position and orientation information may then be compared to known baseline position and orientation information. If a difference between the experimental position and orientation information and the baseline position and orientation information exceeds a predetermined threshold, a correction map enabling adjustment of the tracking device to correct for the distortion in the experimental volume may be generated, and the tracking device may be adjusted accordingly.

Abstract: The invention provides systems and methods for assisting/performing image-guided transjugular intrahepatic portosystemic shunt (TIPS) procedures in a portion of an anatomy of a patient, including a guide needle portion comprising a hollow tube having a bend toward its distal tip and a puncture needle portion that includes at least one position indicating element at its tip. The puncture needle is slidably mounted within the hollow tube of the guide needle such that a distal tip of the puncture needle can be extended from an opening in the distal tip of the guide needle and used to place a shunt between the portal and hepatic veins of a patient. The position indicating element of the puncture needle is used to produce a display of the puncture needle relative to a target vessel, including a projected path of the puncture needle that can be adjusted to accurately locate a shunt.

Abstract: The invention comprises an integrated skin-mountable multifunction device for use with a computer assisted or image guided surgical system and methods of using the same, wherein the multifunction device includes a patient mountable portion that has at least one position indicating element and at least one imageable pattern whose geometry is known in a coordinate system of the at least one position indicating element, wherein the imageable pattern is visible on an imaging modality. The multifunction device may also include a monitoring device capable of measuring a physiological parameter of a patient for use in gating image or position signals or for other purposes.

Abstract: The invention provides systems and methods for providing access to a target site. Example systems may include a needle, a grid to guide the needle, a plate with an aperture, a member coupled to the plate and including a semispherical surface, and a hub slideably coupled to the plate by a guide. The system may also include a needle coupled to the hub, the needle including a magnetically trackable sensor positioned in a tip of the needle. The semispherical surface can be positioned against skin of a body and the hub slid relative to the plate along the guide to insert the needle through the aperture in the plate into the body until the tip reaches a target site. The hub can be locked by a lock mechanism when the tip of the needle reaches the target site, and an action performed on the target site through the needle.

Abstract: The invention provides systems and methods for aligning or guiding instruments during image-guided interventions. A volumetric medical scan (image data) of a patient may first be registered to patient space data regarding the patient obtained using a tracking device. An ultrasound simulator fitted with position indicating elements whose location is tracked by the tracking device is introduced to the surface of the anatomy of the patient and used to determine an imaginary ultrasound scan plane for the ultrasound simulator. This scan plane is used to reformat the image data so that the image data can be displayed to a user in a manner analogous to a handheld ultrasound transducer by re-slicing the image data according to the location and orientation of the ultrasound simulator. The location of an instrument fitted with position indicating elements tracked by the tracking device may be projected onto the re-sliced scan data.