PROBE FOR DETERMINING MAGNETIC MARKER LOCATIONS
A probe including a first sensor having a first magnetometer and a first accelerometer and a second sensor having a second magnetometer and a second accelerometer is configured for determining the distance and direction to a marker. The marker may be magnetic and may be surgically inserted into a patient's body to mark a specific location. The probe may be used to locate the marker, thus identifying the location. The probe may include a microprocessor that receives an output from the first sensor and an output from the second sensor and determines the distance and direction to the marker.
This application is a continuation of U.S. application Ser. No. 14/832,528, filed Aug. 21, 2015, which claims the priority benefit under 35 U.S.C. § 119(e) of U.S. Provisional Application No. 62/041132, filed on Aug. 24, 2014, and titled “MAGNETIC MARKER, SCANNING DEVICE, AND METHODS OF PERFORMING SURGERY USING THE SAME,” which is hereby incorporated by reference in its entirety.
BACKGROUNDMarking potentially cancerous tissue for subsequent surgical removal, such as marking a lesion in breast tissue for later removal in a lumpectomy procedure, remains a big challenge for the health care system. It is desirable to place tissue markers at locations of interest in patients, sometimes deep within a patient's tissue, that are both small and easily detectable by some type of external scanning device. In addition, any markers that are placed in the body should have a minimal or no MRI image footprint that may obscure anatomical features (e.g., tumors) that may be located in the imaged area. Another important consideration is the complexity of inserting such markers, which vary in size and detection range, so as to minimize pain and discomfort during the procedure.
SUMMARYThe systems, methods, and devices described herein each have several aspects, no single one of which is solely responsible for its desirable attributes. Without limiting the scope of this disclosure, several non-limiting features will now be discussed briefly.
In one aspect, a probe for detecting a magnetic marker includes a first sensor, including a first magnetometer and a first accelerometer located in a handheld housing, a second sensor, including a second magnetometer and a second accelerometer, the second sensor located in the housing and separated from the first sensor, and a processor located in the housing and electrically connected to the first sensor and the second sensor, the processor configured to receive an output from the first sensor and an output from the second sensor and determine a distance and direction between one of the first sensor and the second sensor and a magnetic marker.
In some embodiments, the first and the second magnetometers are configured to detect the field strength of the magnetic field of a magnetic maker within a range measured from each of the first and second magnetometers. The first and second sensors may be separated by a distance greater than the range. In some embodiments, the distance separating the first and second sensors is at least twice the range of the first and second magnetometers, such that the field strength of the magnetic field of a magnetic marker can only be substantially detected by either the first magnetometer or the second magnetometer.
In some embodiments, the processor is configured to determine the distance between one of the first sensor and the second sensor and a magnetic marker by calculating a difference between the output of the first sensor and the output of the second sensor. The difference may represent the field strength of the magnetic marker.
In some embodiments, the probe also includes a memory configured to store a lookup table containing data relating the magnetic field strength of a magnetic marker to a distance from the magnetic marker.
In some embodiments, the housing of the probe is configured as a wand and includes a base, wherein the first sensor is located in the base, an extension member extending from the base, the extension member defining the distance between the first and second sensors, and a tip, wherein the second sensor is located in the tip, and wherein the processor determines the distance and direction between the tip and the magnetic marker.
In another aspect, a method for determining the distance and direction between a probe and a magnetic marker includes providing a probe which includes a first sensor, having a first magnetometer and a first accelerometer, and a second sensor, having a second magnetometer a second accelerometer, the probe configured to determine the position in three-dimensional space of a magnetic marker, balancing the probe while away from the magnetic marker, moving the balanced probe so that the magnetic marker is within a range of the magnetic marker, and determining the distance and direction between the probe and the magnetic marker by comparing an output of the first sensor with an output of the second sensor.
In some embodiments, balancing the probe includes compensating for a gain and an offset in the output of the first magnetometer and the output of the second magnetometer, wherein the gain and the offset are caused by hard and soft iron effects. In some embodiments, the output of each of the first and second magnetometers comprises X, Y, and Z, values, and balancing the probe further includes rotating the probe through 360 degrees around each of three orthogonal axes. In some embodiments, balancing also includes, for each of the first and second magnetometers, recording the minimum and maximum X, Y, and Z values output during the rotation, calculating a length between the minimum and maximum values for each of X, Y, and Z, calculating a gain factor by dividing the length for each of X, Y, and Z by the average length of the X, Y, and Z for both magnetometers, and calculating an offset value for each of X, Y, and Z by, for each of X, Y, and Z, adding half the length of X, Y, and Z, to the minimum value for X, Y, and Z. In some embodiments, the method includes adjusting raw output data into balanced output data by subtracting the offset value and then multiplying the result by the gain factor for each of X, Y, and Z.
In some embodiments of the method, the output of the first sensor comprises first magnetometer output data and first accelerometer output data, and the output of the second sensor comprises second magnetometer output data and second accelerometer output data, and wherein determining the distance and direction between the probe and the magnetic marker further includes calculating a difference between the first magnetometer output data and the second magnetometer output data to determine distance between the probe and the magnetic marker, and determining the orientation of the probe using one of the first accelerometer data or the second accelerometer data.
The features of this disclosure will become more fully apparent from the following description and appended claims, taken in conjunction with the following figures.
As will be described more fully herein, the marker 110 may be surgically inserted into a patient's body 101 to mark the location of tissue, for example, potentially cancerous breast tissue (or any other tissue), for removal. In some embodiments, the marker 110 is inserted into the body via a natural opening or a surgical opening. The probe 150 may then be used to determine the location of the marker 110 within the patient's body 101. In the embodiment of
In this embodiment, the marker 110 comprises a magnet, such as a magnet with a bio-compatible coating/layer surrounding the magnet or simply a magnet. In some embodiments, the marker 110 is a micro magnet that has a strong magnetic field relative to its size. For example, the magnet may be a neodymium rare earth magnet, or may comprise other magnetic materials such as ferrite, samarium cobalt, yttrium cobalt, and combinations thereof. Various other types of magnets can be used in conjunction with the probe 150. In some embodiments, the probe 150 must be balanced with reference to the specific characteristics of the particular magnet. In some embodiments, the marker 110 has a magnetic field strength in the range of between about 1,000 to about 20,000 Gauss. A magnetic field strength of approximately 5,000 Gauss may be preferred in some applications. These field strength ranges are provided for example only—other field strengths may be used. The example magnetic field strength calculations herein are presented in units of Gauss, although units of Tesla may also be used in some embodiments. The conversion factor is 1 Tesla equals 10,000 Gauss.
The marker 110 can comprise various geometric shapes, such as spheres, rods, rings, discs, cylinders, and blocks, among others. In one embodiment, the marker 110 is configured as a micro rod having a diameter from about 0.2 mm to about 2.0 mm, with about 0.75 mm to about 1.5 mm being preferred in some applications. A marker 110 configured as a micro rod may have a length of about 1 mm to about 3 mm, with about 2 mm being preferred in some applications. These size ranges are provided as examples; other size ranges and shapes of the marker 110 may also be used with the system 100. In some embodiments, the marker 110 is configured to be as small as possible, for ease of insertion into the patient's body 101 and precision of marking, while still having a magnetic field strength sufficiently strong to be detected by the probe 150 external to the patient's body 101.
In
In some embodiments, the marker 110 is gold coated. A gold coating may increase the biocompatibility of the marker 110. In some embodiments, the coating may be omitted.
In some embodiments, the marker 110 includes an anti-migration device. The anti-migration device may be configured to ensure that the marker 110 remains in the position in which it is placed. For example, the anti-migration device could include a hook or anchor, such as is described in U.S. Pat. No. 8,939,153, issued on Jan. 27, 2015, and entitled “Transponder Strings,” which is hereby incorporated by reference in its entirety and for all purposes. In some embodiments, a collagen plug or sleeve may encapsulate, or partially encapsulate, the marker 110. The collagen plug or sleeve may resist migration of the marker 110 after the marker 110 is implanted into the patient's body.
In use, one or more markers 110 may be loaded into a syringe that can penetrate mammalian tissue to a depth of about 0.5 mm to about 300 millimeters depending on the type of tissue and the depth of the tissue to be marked. The system 100 may have particularly beneficial application in marking breast tumors, which can range in depth from between about 0.1 mm to about 75 mm or more, although, the system 100 is not limited to this application. Using the syringe, the markers 110 may be inserted into or near the tumorous tissue to be marked using ultrasound, CAT scanning or MRI real time imaging. This allows the markers 110 to be accurately placed, as the medical professional inserting the markers 110 is able to see the location of the tumor and marker 110 in real time. However, placement of the markers 110 often occurs hours, days, or weeks prior to the subsequent surgical procedure wherein the markers 110 are located and the surrounding tissue is examined (and possibly biopsied in the case of a tumor). During surgical removal of the tumorous tissue it is generally not possible to use ultrasound, CAT scanning or MRI imaging in the operating room. Thus, use of the probe 150 is desirable as it is allows the location of the tumorous tissue to be accurately determined by detecting the location of the marker 110.
In some embodiments, the marker 110 can be injected along with a conventional non-magnetic marker. In some cases where the marker 110 is injected along with a conventional non-magnetic marker, the marker 110 can be connected to a suture, such as 2-0 proline with the suture extending to the skin surface and then covered with a sterile dressing. If the biopsy is found to be negative, the doctor could remove the suture and marker 110, leaving behind the conventional marker. This would allow use of the marker 110 for all or most biopsies, knowing that the magnet could be removed if a surgical excision is not required based on a negative biopsy result. Similarly, in some embodiments, the marker 110 could be implanted connected to a suture as described above, but the suture could extend to another marker 110 or RFID that is left subcutaneously. If the biopsy is negative, the two magnets could be easily removed together, because embodiments of the present system could be used to locate the subcutaneous marker 110.
In some embodiments, multiple magnetic markers and/or other tags may be included in a string of markers, such as connected via a suture, with one of the markers near the lesion of interest and one near the skin surface so it may be more easily located, possibly with one or more markers in between. For example, magnetic markers may be included in the various configurations of markers disclosed in U.S. Pat. No. 8,939,153, issued on Jan. 27, 2015, and entitled “Transponder Strings,” which is hereby incorporated by reference in its entirety and for all purposes. For example, any of the transponders mentioned in that patent may be replaced with a magnetic marker and located using the probe 150 discussed herein.
In some embodiments, the marker 110 is attached to an RFID or light based chip (such as a Pharmaseq) so that the marker 110 is essentially labeled with a serial number. This may be useful for differentiating between multiple markers 110.
The probe 150 will be described in greater detail below. However, in general, the probe 150 may include at least some of the following features: a battery, a microprocessor, wireless communications capability, and at least two magnetometers/accelerometers, a reference magnetometer/accelerometer and a sensing magnetometer/accelerometer. As used herein, a pair of magnetometer/accelerometer sensors, whether both sensors are on a single chip or multiple chips (e.g., an EEPROM, FPGA, ASIC, or other chip), may be referred to as a “sensor pair,” such as a “base sensor pair” and a “tip sensor pair.” In a preferred embodiment, the probe 150 is configured to determine the location in three-dimensional space of the marker 110 with a resolution of about 0.1 mm, although a more or less precise resolution is possible and may be suitable depending on the particular application. The probe 150 may further be configured to detect markers 110 within a range of up to 12 inches or more.
In one embodiment, the tip sensor pair 151 is positioned in the sensing tip 164 of the probe 150 and the base sensor pair is positioned outside of the range 153 of the tip sensing pair 151. In one embodiment, the distance to the marker 110 may be determined by taking the difference of the magnetic field measured by the tip sensor pair and the magnetic field measured by the base sensor pair. This difference represents the magnetic field strength of the marker 110 and is proportional to a distance of the probe 150 the marker 110. The accelerometer data from either the tip sensor pair or base sensor pair may then be used to determine the orientation of the probe 150 itself and the direction to the marker 110. This process, only briefly summarized here, will be presented in greater detail below.
In some embodiments, analysis and determination of the distance and direction to the magnetic marker 110 may be executed by the probe 150 itself, for example, in a microprocessor. In some embodiments, the data obtained from the probe 150 (e.g., the sensing and base sensor pairs) may be relayed to an external device 170 and analyzed there. The distance and direction to the marker 110 may be displayed on the probe 150 itself and/or a display 171 of the external device 170. The external device 170 may be a computer, tablet, smartphone, or similar device. The external device may include a display 171 and one or more inputs 173, such as a keyboard, mouse, touchscreen, or the like. In some embodiments, the probe 150 can be used as an input device for the external device. For example, by selecting an appropriate input button 154 on the probe 150, the probe may operate as a 3D mouse for manipulating content on the display 171 of the external device. The external device 170 may further include one or more processors, memories, or storage devices. In the system 100, the probe 150 and the external device 170 may be connected via a link 181 so as to communicate with each other. The link 181 may be wired or wireless, for example through a Bluetooth or Wi-Fi connection, and may further be direct, with no intermediate device, or indirect, with communication routed through one or more additional devices. In some embodiments of the system 100, the external device 170 may be omitted.
The system 100 may allow for marking of tumors previously inaccessible to surgeons, such as brain tumors because of the small size of the injection needle that may be used to insert the small micro-magnets and the long range 153 in which the probe 150 can locate marker 110. For example, the range 153 of the probe may be 6 inches or more (for example, the radius of the range 153 is 6 inches or more), such as up to 12 inches or more in some embodiments. This may not be possible with RFID markers due to the size and strength limitations thereof. Other applications of the system 100 include, but are not limited to, locating endotracheal tubes, catheters, magnetic contrast agents, magnetic tumor antibody agents, surgical sponges, and instruments, such as by attaching magnetic markers to these objects.
Example Probe Components and FunctionsIn the example of
In some embodiments, the housing 160 may have an overall length of approximately 220 mm, an overall width of approximately 25 mm, and an overall height of approximately 15 mm, although these dimensions are provided as examples only, and the size of the housing is not intended to be limited thereto.
In this example, the internal components of the probe 150 include a tip sensor pair 151, a base sensor pair 152, one or more input buttons 154, a display 155, a buzzer or speaker 156, a microprocessor 157, an RF (wireless) module 158, and a battery 159. In other embodiments, a probe may include any portion of these components and/or additional components.
As used herein, the terms “accelerometer-magnetometer” or “sensor pair” may refer to a dual three-axis accelerometer and three-axis magnetometer paired together on a single chip or on separate chips adjacent one another. For example, each accelerometer-magnetometer or sensor pair may be a LSM303D available from STMicroelectronics of Geneva, Switzerland. The product sheet for this accelerometer-magnetometer is available at http://www.st.com/st-web-ui/static/active/en/resource/technical/document/datasheet/DM00057547.pdf, and is hereby incorporated by reference in its entirety. A combination magnetometer-accelerometer pair, packaged in a single chip may be preferred in some embodiments of the probe 150 as it will tend to reduce the distance and placement error between the individual magnetometer and accelerometer sensors. However, this is not required in all embodiments of the probe 150 and discrete accelerometers and magnetometers may be used. As noted above, a sensor pair includes a magnetometer sensor and an accelerometer sensor. A magnetometer sensor measures magnetic field strength and typically provides a three component data output representing the three-orthogonal components of the magnetic field (itself a vector, with direction and magnitude). An accelerometer sensor measures not only the acceleration of the sensor, but also the sensor's orientation to earth's gravity. The accelerometer typically similarly provides a three component data output representing the acceleration of the sensor.
In the example of
In one embodiment, the distance D between the tip sensor pair 151 and the base sensor pair 152 may be configured to be at least twice the radius R. This configuration reduces the likelihood of a marker 110 being sensed by both the tip sensor pair 151 and the base sensor pair 152. However, this need not be the case in all embodiments. In another embodiment, the distance D is at least as large as the radius R. In some embodiments, the distance D may be approximately 500 mm to approximately 50 mm or less. In some embodiments the radius R may be approximately 250 mm to 1 mm. These ranges are provided only by way of example, and are not intended to be limiting of this disclosure. In some embodiments, as the radius R of the range 153 is decreased, the resolution or precision of the probe 150 increases because the incremental scale of the magnetometer in a sensor pair is divided over a shorter distance. For example, the LSM303D chip referenced above outputs raw magnetometer data on a 16-bit binary scale. When the radius R of range 153 is divided into the chips binary scale, a shorter radius R produces a higher resolution because each bit represents a smaller incremental distance.
In one embodiment, the tip sensor pair 151 and the base sensor pair 152 are aligned with each other so that the three-axes (as shown in
The tip sensor pair 151 and the base sensor pair 152 are each electrically connected to the microprocessor 157, such that the microprocessor 157 receives the data output from each. The microprocessor 157 may be a ATmega16U4/ATmega32U4 available from Atmel. The data sheet for this microprocessor is available at http://www.atmel.com/Images/Atmel-7766-8-bit-AVR-ATmega16U4-32U4_Datasheet.pdf and incorporated herein by reference. Other microprocessors may be used. In general, the microprocessor 157 analyzes the output data from the tip sensor pair 151 and the base sensor pair 152 to determine the distance and direction to the marker 110. Accordingly, the microprocessor 157 may be configured with instructions for making this determination. The process by which the microprocessor 157 determines the distance and direction to the magnetic marker 110 will be described in greater detail below. In some embodiments, the probe 150 may include more than one microprocessor 157.
In the example of
In the example of
In the illustrated embodiment, the probe 150 includes a buzzer or speaker 156 connected to the microprocessor 157. The buzzer or speaker 156 provides another mechanism by which the probe 150 can communicate information regarding the location of the marker 110 to the user. For example, the microprocessor 157 may be configured with instructions that cause the speaker 156 to emit a tone indicative of the position of the marker 110 relative to the probe 150. In one embodiment, the frequency (pitch) of the tone may indicate the distance to the marker 110 and a warble (or small undulation in the frequency) in the tone may indicate the orientation of the probe 150 relative to the marker 110. For example, a user may move the probe 150 relative to the patient's body 101 while listening to the tone emitted by the speaker 156. As the frequency of the tone increases, for example, the user will understand the probe is being moved closer to the marker 110. The user may also adjust the orientation of the probe 150 so as to remove the warble from the tone. When the user finds a probe orientation that removes the warble from the tone, this indicates that the probe 150 is pointed at the marker 110. Other audible methods for communicating the location of the marker 110 are possible. Moreover, the buzzer or speaker 156 may be configured to vibrate to provide a haptic feedback to the user regarding the position of the marker 110. In some embodiments, the buzzer or speaker 156 may be omitted.
In the example, a battery 159 is included to power the components of the probe 150. In some embodiments the battery may be rechargeable, and the probe 150 may include a recharging port. In some embodiments, the battery 159 may be omitted, and the probe 150 may include a wired connection to a power source. For example, the probe 150 may be powered via USB connection to the external device 170.
In some embodiments, the internal components of the probe 150 may be assembled onto a single printed circuit board (PCB) that is configured to fit within the housing 160. However, in other embodiments the components may be separate or assembled onto more than one PCBs.
While many embodiments of the probe 150 are described herein as including two sensor pairs (each including a magnetometer and accelerometer), in some embodiments the probe 150 includes only a single accelerometer along with two magnetometers (spaced in the same manners as discussed herein with reference to spacing of the sensing and tip sensor pairs). For example, in one embodiment the probe 150 may include base sensor pair 152 (having a magnetometer and accelerometer as discussed herein) and only a magnetometer (without an associated accelerometer) near the sensing tip 164 of the probe 150; or alternatively may include tip sensor pair 151 (having a magnetometer and accelerometer as discussed herein) and only a magnetometer (without an associated accelerometer) in the base 161 of the probe 150. In another embodiment, the probe 150 may include magnetometers at each of the sensing tip 164 and base 161 of the probe (e.g., spaced in a similar manner as discussed herein with reference to spacing of base and tip sensor pairs) and a single accelerometer (e.g., on a separate chip) placed at any location within the probe 150. In some embodiments, the probe 150 may not include an accelerometer and instead include a base and tip magnetometer and provide the functionality and features associated with the magnetometers. Any probe embodiments disclosed herein may be adjusted to include any of these different combinations of accelerometer and/or magnetometer sensors. Such adjustments to the use of magnetometer sensor pairs are applicable to the removable and/or disposable sensing tips also, such as those discussed with reference to
Depending on the implementation (e.g., the sensing member size) and ongoing development of sensors of smaller sizes, the sensor pairs may be of varying sizes. For example, in one embodiment each sensor pair is 3 mm×3 mm×1 mm (plus a circuit board thickness) in size. In other embodiments, the sensor pairs may be larger or smaller. For example, each sensor pair may be sized to fit within a sensing member having a diameter that is approximately 1 mm or less. The tip sensor pair 151c is positioned at the distal end of the sensing member 163c that may be inserted into tissue. The base sensor pair 152c can be positioned in the base 161c or in the proximal end of the sensing member 163c opposite the tip sensor pair 151c. In some embodiments, the probe 150c, with the sensing member 163c configured as a needle, is used to probe within the patient's body 101, for example, by inserting the sensing member 163c at least partially into the patient's tissue while gripping the probe base 161c. In the example of
In another embodiment, the sensing member 163d may communicate directly to the external device 170, such as a smart phone or tablet. In this embodiment, the external device 170 may include the logic (e.g., hardware, firmware, and/or software) for performing the various functions discussed herein with reference to the microprocessor 157, such as receiving raw data from the two sensor pairs of the sensing member 163d and performing the necessary calculations and processing of the data to balance the sensor pairs and provide measurement information based on the received sensor data. In this embodiment, the removable and/or disposable sensing member 163d may communication wirelessly with the external device 170 (e.g., via a WiFi, RF, or Bluetooth signal) and/or may be wired to the external device 170 (e.g., via a port on the proximal end of the sensing member 163d). Thus, in one embodiment, the user can download an application on a mobile device that communicates wirelessly with the sensing member 163d. In one embodiment, various kits of components, such as a kit including multiple sensing members 163d (perhaps of different sizes and/or sensitivities, or each of a same size sensitivity) could be manufactured/shipped to users so that multiple sensing members 163d are readily available for use. Another kit may include a single base and multiple sensing members.
The components of the various embodiments of the probe 150 discussed herein may be arranged in any other configurations between multiple devices.
Example Balancing of Sensor PairsThe ellipsoids 251, 252 in
Differences in the output value set for each of the magnetometers may be largely or entirely caused by “hard iron” and “soft iron” interference. “Hard iron” interference is caused by magnetic fields generated by permanently magnetized ferromagnetic components of the probe 150 itself, for example, a permanent magnetic field generated by the buzzer or speaker 156, other components of the probe 150, or other magnetic fields in the area where the probe 150 is used. Because the magnetometers and the other components of the probe 150 are in fixed positions with respect to each other, the hard iron interference manifest itself as an additive magnetic field vector when measured in the magnetometer reference frame. That is, the hard iron interference induces a constant offset in the x, y, and z output data from each magnetometer, regardless of the orientation of the magnetometer. This offset results in the shifting of the ellipsoids 251, 252 discussed above. In some embodiments, the components of the probe 150 which may tend to produce hard iron interference are positioned within the probe housing 160 away from the tip sensor pair 151 and the base sensor pair 152, thus minimizing the hard iron interference.
“Soft iron” interference is caused by the induction of temporary magnetic fields into normally unmagnetized ferromagnetic components of the probe 150, such as the battery 159, by the Earth's geomagnetic field. Soft iron interference therefore depends on the orientation of the probe 150 relative to the Earth's geomagnetic field. Soft iron interference, therefore may add to or subtract from the x, y, and z output of a magnetometer depending on the magnetometer's orientation. This manifests itself in the irregular shape of the ellipsoid 251, 252, as compared with a sphere. In some embodiments, the components of the probe 150 which may tend to produce soft iron interference are positioned within the probe housing 160 away from the tip sensor pair 151 and the base sensor pair 152, thus minimizing the hard iron interference.
The method 500 begins with an unbalanced set of magnetometers in a probe 150. In this embodiment, the probe 150 is balanced away from (out of range of) any markers 110. At block 505, the probe 150 is rotated through 360 degrees around each of three orthogonal axes and the minimum and maximum x, y, and z output values are recorded. For example, the probe 150 is rotated 360 degrees in each of the pitch, roll, and yaw directions. As the probe 150 rotates, the magnetometer of each of the tip sensor pair 151 and the base sensor pair 152 outputs a substantially real time stream of x, y, and z values. For each of the tip sensor pair 151 and base sensor pair 152, the maximum and minimum values for each of the x, y, and z values are stored. In some embodiments, the maximum and minimum values are stored in a memory associated with the microprocessor 157, such as a solid state storage device.
For example, in some embodiments, the microprocessor 157 stores the first x output value it receives from the magnetometer of the tip sensor pair 151. The microprocessor 157 then checks each successive x output value against the stored value and replaces the stored value if the successive x value is higher. After one complete rotation of the probe 150, the maximum x value will be stored. This process can be similarly repeated for determining the minimum x value (by checking each successive x value against the stored value and replacing the stored value if the successive value is lower).
In some embodiments, the probe 150 may be rotated through greater than or less than 360 degrees around the three orthogonal axes. In some embodiments, the three axes are not necessarily orthogonal. However, rotating for at least a full 360 degrees around each of the three orthogonal axes will likely increase the accuracy of balancing.
Sample minimum and maximum x, y, and z values for each of the tip sensor pair 151 and the base sensor pair 152 are shown in the table of
Next, at block 510, the individual length between the maximum and minimum x, y, and z values is determined. This length is representative of the length of the three semi-principal axes of the ellipsoids 251, 252. As shown in
At block 515, a gain factor for each of the x, y, and z directions of each sensor pair 151, 152 is calculated by dividing the individual length of each of the x, y and z directions by the average length of the x, y, and z directions. The average length of the x, y, and z directions is calculated by dividing the sum of the individual x, y, and z lengths of both magnetometers by six. The resulting gain factors calculated from the sample data of
At block 520, an offset value is calculated for each of the x, y, and z directions of each sensor pair 151, 152 by adding the average of the maximum and minimum values to the minimum values. Calculated offset values using the sample data of
At block 525, the raw output data from the magnetometers of the tip sensor pair 151 and base sensor pair 152 is balanced by subtracting each of the corresponding offset values from the corresponding raw output data and then multiplying by the corresponding gain value.
The method 900 begins with a balanced probe 150 and at least one marker 110 implanted into the tissue of a patient. At block 905, the probe 150, and specifically the tip sensor pair 151, is brought within range of the marker 110 (for example, as illustrated in
At block 910, the base sensor pair's 152 magnetometer data is subtracted from the tip sensor pair's 151 magnetometer data. This difference is representative of the magnetic field strength of the marker 110. Block 910 is shown conceptually in
In the example of
The magnetic field of the marker 110, measured at the tip sensor pair 151 is a vector quantity with length and direction. After taking the difference described above, the probe 150 will have resulting x, y, and z values representing the component parts of that vector. The magnitude of the magnetic field strength bx, then, can be calculated using the Pythagorean Theorem, for example, to calculate a major axis length of the ellipsoid.
In some embodiments, the calculated differential represents raw magnetometer output data that needs to be converted into a magnetic field strength value with units of Gauss. For example, the magnetometer raw output data of an LSM303D chip is firmware selectable, and the magnetometer selected allows for different full-scale output sensitivity. The LSM303D allows for selection of ±2/±4/±8/±12 gauss, dynamically selectable magnetic full-scale output over a signed-16 bit number, from −32768 to +32767. The example data presented in
The magnitude bx of the marker's 110 magnetic field measured at the tip sensor pair 151 may be determined using the Pythagorean Theorem, as shown in the third column of the bottom table of
In some embodiments, the determined magnitude bx of the magnetic field of the marker 110 may be adjusted as shown in the column titled “Zero Adjust.” The zero adjust is used to compensate for any changes in the magnetic field around the probe, not caused by the marker 110, since the time when the probe 150 was balanced. For example, the Earth's geomagnetic field changes slowly over time. While the balancing process described above calibrates the base sensor pair 152 and the tip sensor pair 151 to account for the Earth's geomagnetic field at the time the probe 150 is balanced, the zero adjust may further compensate for changes in the Earth's geomagnetic field since balancing. The zero adjust may also compensate for other magnetic field changes not caused by the Earth's magnetic field. This zero adjust value modifies the output of the probe 150 due to minor changes in the environment and orientation of the probe. It is not a fixed value, but a user selectable minor offset correction. In the example of
Returning to the method 900 of
At block 915, the distance to the marker 110 is retrieved from a lookup table (an example of which is shown in
The lookup table can be created either experimentally or mathematically. For example, field strength to distance calibration may be performed by placing the micro magnet to be used under the sensing probe tip to record the value of the closest distance or strongest field strength measurement, this will be the first point, then moving the micro magnet to any known measured distance (e.g. 20 mm, 25.4 mm, 50.8 mm) and recording the value as the second point. Since the magnetic field strength falls off roughly exponentially over the distance, multiple calibration points will add to the accuracy.
Another method for calibrating the second point (with a built in reference) is to move the micro magnet along the side of the probe between the sensing probe tip sensor and the reference sensor. Since these two sensors are always at a fix distance in relationship to each other, a lowest field strength differential value displayed will be at the midpoint between these two sensors (where their magnitudes cancel each out), this low point value is at the distance which will always be ½ the distance between the two sensors.
Another method for calibrating the distance to field strength is to use an automated process, including use of the equation below to setup a look-up table for distance verses field strength. For a cylindrical marker 110 with a radius of R and Length L, the magnitude of the magnetic field Bx at the centerline of the marker 110 a distance X from the marker 110 can be calculated with following formula (where Br is the residual induction of the material):
Using Equation 1, a lookup table can be populated for a marker 110 with a known size (R and L) and a known residual induction (Br). In general the residual induction Br is a known value which can be obtained from the manufacturer of the magnet. For example, the table can be populated by calculating Bx at incremental distances X. The example lookup table in
Alternatively, at block 920 the distance to the marker 110 can be calculated directly by solving Equation 1 for X, given the Bx value determined at block 910. This, however, may be computationally difficult for the microprocessor 157.
Equation 1 is specific to rod shaped magnets; however, similar equations are known in the art for magnets of other shapes, for example, spherical, cuboid, or other three dimensionally shaped magnets. Markers 110 with different shapes may be used by substituting an appropriate and corresponding equation for Equation 1.
A magnetometer sensor will measure the earth's magnetic field to determine North, East, South & West (NESW) orientation when held in the same orientation plane as when it was calibrated. But if the magnetometer sensor moves through pitch, roll or yaw, then heading information calculated for NESW will not be correct. To cancel the effects of the pitch, roll and yaw, an accelerometer is used.
As noted above, an accelerometer (measures acceleration of the sensor) but it also measures the sensors orientation to earth's gravity which at 9.8 m/s2 is used to determine UP and DOWN orientation. Thus, one or both of the accelerometers in the base and/or tip sensor pairs may be used at block 925 to determine orientation data of the probe 150.
If the probe 150 is not accelerating, both the tip sensor pair 151 and the base sensor pair 152 will output x, y, and z accelerometer data representative of a vector pointing in the direction of gravity. Thus, the accelerometer output provides a determination of an orientation of the probe 150 relative to the direction of gravity. By calculating the yaw, pitch, and roll of the probe 150 (with reference to gravity for a non-accelerating probe 150), the probe 150 can determine the specific orientation of the probe 150 with reference to gravity, which can then be used in to adjust the magnetometer data output to display a direction component output by the probe 150. In one embodiment, the yaw, pitch, and roll of the probe 150 are determined mathematically using the formulas shown in
At block 930 of
In the example of
In one example, when no marker 110 is within the range 153 of the probe 150, and if, for example, the range 153 is 50 mm, the display should indicate that the distance to the marker 110 is greater than 50.0 mm, XX distance, or otherwise indicate that no marker 110 is within range. However, continuing this example, if the probe 150 has not been zero adjusted, the probe 150 may display fluctuating values indicating that a marker is approximately 40-50 mm from the probe 150, even though no marker 110 is within range. This may be because the probe 150 is detecting small changes in the magnetic field that are different than those present at the time or location of balancing. After selecting the zero adjust function, the probe 150 will correctly indicate that no marker 110 is within range.
In some embodiments, the probe 150 includes a manual zero adjust function where the operator can select when to perform the zero adjust function. In some embodiments, the probe 150 may be configured with an automatic zero adjust function, wherein the microprocessor is configured with instructions that execute the zero adjust function based on continuing population of all the points on the balanced spheres 351, 352.
In some embodiments, the zero adjust values can be stored during the balancing of the probe 150, but this would require rotating the probe 150 one hundred and eighty times changing the side movement in one degree increments of orientation on each rotation for a total of 64800 degrees of rotation to cover every possible point on the spheres 351, 352.
At block 1415, real time raw data is received from the accelerometer and magnetometer of each of the tip sensor pair 151 and the base sensor pair 152. At block 1420, the raw data is balanced using the calculated gain and offsets determined at block 1405. At block 1425 the magnetometer readings from the base sensor pair 152 are subtracted from the magnetometer readings from the tip sensor pair 151, and at block 1430 this difference is converted to the actual distance of the marker 110 from the probe 150. At block 1435, the accelerometer data is calculated to determine the orientation and movement of the probe 150.
In some embodiments, the movement of the probe 150 in the magnetic field is used to determine the direction to the marker 110 from the probe. For example, the probe 150 may provide feedback regarding direction in a manner similar to a metal detector. The probe 150 may measure and display the distance to the marker and/or may produce an output tone indicative of the field strength as the probe 150 is moved toward and away from the marker 110. As in metal detecting, the user may move the probe 150 direction feedback in order to mentally determine the direction to the marker 110. As presented above, in reference to
In some embodiments, to get an absolute measured location without any movement of the probe 150 may use at least two magnetometer sensors located at the tip of the probe 150 which then would triangulate the location of the marker 110. For example, with two magnetometers positioned at the tip of the probe 150 and separated by a distance, each magnetometer can be used to calculate respective (and slightly different in most positions) distances to the marker 110 according to the methods described herein. Then, because the distance between the two magnetometers at the tip of the probe 150 is known, the location of the marker 110 can be triangulated.
At block 1440, the resulting location of the marker 110 is communicated to the user. For example, the location data may be provided on the probe itself, or may be sent to an external device 170, such as a smart phone or tablet with a compatible operating system such as Android, Apple OS, or Microsoft Windows. The wireless device can display the location and distance of the probe sensing tip to the micro magnets enabling the surgeon to determine the best path to tumor and tissue marker removal to minimize discomfort and scarring to the patient. As noted above, the probe 150 and/or the wireless device can also have an audio cue as to the distance to the tissue marker and as the probe gets closer the audio pitch can change accordingly so that the surgeon can have both visual and audio feedback as to where to operate on the patient.
Example User InterfacesAlso shown in
In addition to marking potential breast cancer lesions as discussed throughout this disclosure, the system discussed herein may be utilized in a wide number of applications. For example, the system could be used to mark lung nodules, lymph nodes, parathyroid nodules, thyroid nodules, or GI lesions. For example, a gastroenterologist might mark one or more biopsied colonic polyps that are biopsied during a colonoscopy. A pulmonologist might mark one or more lung or bronchial lesions found during a bronchoscopy. A radiologist might mark one or more axillary lymph nodes in a patient with breast cancer. This would facilitate removal of cancerous lesions by a surgeon later.
Even when a lesion is not marked pre-operatively, a surgeon that removes abnormal tissue might mark one or more parts of the surgical specimen in order to direct the pathologist's attention to the proper location. For example, when a mastectomy is performed, a pathologist cannot microscopically examine the entire breast. If a surgeon or radiologist marks the suspicious areas of the specimen based on visual, palpable, or imaging-based guidance, this can facilitate more accurate pathological examination.
Other uses may include locating surgical instruments and sponges used in the operating room and locating magnetic antibody and targeted molecular probes that can attach to cancer cells.
In some embodiments, the probe 150 can be attached to an endoscopic or laparoscopic instrument. In some embodiments, the probe 150 itself may be as simple as a magnet on the tip of a wire or other probe, in which case the system can be used to show the proximity between the magnet at the probe tip relative to an implanted magnet. In that case, the detector could remain external to the patient but would indicate by audio tone or display the relative proximity or location of the probe tip magnet to an implanted magnet. The display could show the relative location of the two or more magnets as the probe is moved (like following the path of a plane vs. a fixed object on a radar screen).
The system also has application outside of the medical field, such as locating pipes that are submerged in the ground, such as irrigation pipes; locating construction materials within walls, such as wall stud locations; and locating various drilling and mining equipment pipes where location relative to the Earth's magnetic field is important. Similar to the medical embodiments discussed above, magnetic markers may be placed in such locations of interest and then located using a probe with both a base sensor pair and a tip sensor pair.
Example Computer ArchitectureAs noted above, the probe 150 and/or the external device 170 may include various computing components, which may perform some or all of the functions discussed herein. While the probe 150 typically includes fewer components than the external device 170 to maintain a smaller size, it may include any of the components and/or functionalities discussed below with reference to the device 170.
The device 170 may include, for example, a single computing device, a computer server, or a combination of one or more computing devices and/or computer servers. Depending on the embodiment, the components illustrated in the device 170 may be distributed amongst multiple devices, such as via a local area or other network connection. In other embodiments the device 170 may include fewer and/or additional components than are discussed below.
The various devices disclosed herein, including the probe 150 and the external device 170, may be in communication via a network, which may include any combination of communication networks, such as one or more of the Internet, LANs, WANs, MANs, etc., for example.
The device 170 includes one or more central processing units (“CPU”), which may each include one or more conventional or proprietary microprocessor(s). The device 170 may further include one or more memories/storage, such as random access memory (“RAM”), for temporary storage of information, read only memory (“ROM”) for permanent storage of information, and/or a mass storage device, such as a hard drive, diskette, or optical media storage device. The memory/storage may store software code, or instructions, for execution by the processor in order to cause the computing device to perform certain operations, such as described herein.
The methods described herein may be executed on the computing devices in response to execution of software instructions or other executable code read from a tangible computer readable medium. A computer readable medium is a data storage device that can store data that is readable by a computer system. Examples of computer readable mediums include read-only memory, random-access memory, other volatile or non-volatile memory devices, CD-ROMs, magnetic tape, flash drives, and optical data storage devices.
The various illustrative logical blocks, modules, and algorithm steps described in connection with the embodiments disclosed herein, especially those disclosed with reference to the microprocessor 157 and the probe 150 can be implemented as electronic hardware, such as a digital signal processor (DSP), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. Such processes may be embodied directly in hardware, in a software module executed by a processor, or in a combination of the two. A software module can reside in RAM memory, flash memory, ROM memory, EPROM memory, EEPROM memory, registers, hard disk, a removable disk, a CD-ROM, or any other form of computer-readable storage medium known in the art. An exemplary storage medium can be coupled to the processor such that the processor can read information from, and write information to, the storage medium. In the alternative, the storage medium can be integral to the processor.
The exemplary device 170 may include one or more input devices and interfaces, such as a keyboard, trackball, mouse, drawing tablet, joystick, game controller, touchscreen (e.g., capacitive or resistive touchscreen), touchpad, accelerometer, and/or printer, for example. The computing device 170 may also include one or more displays (also referred to herein as a display screen), which may also be one of the I/O devices in the case of a touchscreen, for example. Display devices may include LCD, OLED, or other thin screen display surfaces, a monitor, television, projector, or any other device that visually depicts user interfaces and data to viewers. The device 170 may also include one or more multimedia devices, such as camera, speakers, video cards, graphics accelerators, and microphones, for example.
The device 170 may also include one or more modules. In general, the word “module,” as used herein, refers to logic embodied in hardware or firmware, or to a collection of software instructions, possibly having entry and exit points, written in any programming language, such as, for example, Java, Python, Perl, Lua, C, C++, C#, etc. A software module may be compiled and linked into an executable program, installed in a dynamic link library, or may be written in an interpreted programming language such as, for example, BASIC, Perl, or Python. It will be appreciated that software modules may be callable from other modules or from themselves, and/or may be invoked in response to detected events or interrupts. Software modules configured for execution on computing devices may be provided on a computer readable medium, such as a compact disc, digital video disc, flash drive, or any other tangible medium. Such software code may be stored, partially or fully, on a memory device of the executing computing device, such as the device 170, for execution by the computing device. It will be further appreciated that hardware modules may be comprised of connected logic units, such as gates and flip-flops, and/or may be comprised of programmable units, such as programmable gate arrays or processors.
Variations to the Disclosed EmbodimentsConditional language, such as, among others, “can,” “could,” “might,” or “may,” unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements and/or steps. Thus, such conditional language is not generally intended to imply that features, elements and/or steps are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without user input or prompting, whether these features, elements and/or steps are included or are to be performed in any particular embodiment.
It should be emphasized that many variations and modifications may be made to the above-described embodiments, the elements of which are to be understood as being among other acceptable examples. All such modifications and variations are intended to be included herein within the scope of this disclosure. The foregoing description details certain embodiments of the invention. It will be appreciated, however, that no matter how detailed the foregoing appears in text, the invention can be practiced in many ways. As is also stated above, it should be noted that the use of particular terminology when describing certain features or aspects of the invention should not be taken to imply that the terminology is being re-defined herein to be restricted to including any specific characteristics of the features or aspects of the invention with which that terminology is associated. The scope of the invention should therefore be construed in accordance with the appended claims and any equivalents thereof.
Claims
1. A method for determining a distance and direction between a probe and a magnetic marker implanted in a patient, the method comprising:
- providing the probe, wherein the probe comprises a first sensor including a first magnetometer and a first accelerometer, and a second sensor including a second magnetometer and a second accelerometer, wherein the probe is configured to determine a position, in three-dimensional space, of the magnetic marker;
- balancing the probe while away from the magnetic marker;
- moving the balanced probe so that the magnetic marker is within range of the first magnetometer;
- determining the distance and direction between the probe and the magnetic marker by comparing an output of the first sensor with an output of the second sensor;
- aligning the probe with the magnetic marker based on the determined distance and direction between the probe and the magnetic marker; and
- inserting a portion of the aligned probe into an incision in the patient and directing the probe toward the magnetic marker.
2. The method of claim 1, further comprising continuously indicating the alignment of the probe with the magnetic marker through visual or audio feedback.
3. A probe for detecting a magnetic marker, the probe comprising:
- a first sensor including a first magnetometer and a first accelerometer located in a handheld housing;
- a second sensor including a second magnetometer and a second accelerometer, the second sensor located in the housing and separated from the first sensor; and
- a processor located in the housing and electrically connected to the first sensor and the second sensor, the processor configured to receive an output from the first sensor and an output from the second sensor and determine a distance and direction between one of the first sensor and the second sensor and a magnetic marker.
4. The probe of claim 3, wherein each of the first and the second magnetometers are configured to detect the field strength of the magnetic field of a magnetic maker within a range measured from each of the first and second magnetometers, and wherein the first and second sensors are separated by a distance greater than the range.
5. The probe of claim 4, wherein the distance separating the first and second sensors is at least twice the range of the first and second magnetometers, such that the field strength of the magnetic field of a magnetic marker can only be substantially detected by either the first magnetometer or the second magnetometer.
6. The probe of claim 4, wherein the processor is configured to determine the distance between one of the first sensor and the second sensor and a magnetic marker by calculating a difference between the output of the first sensor and the output of the second sensor.
7. The probe of claim 6, wherein the difference represents the field strength of the magnetic marker.
8. The probe of claim 7, further comprising a memory configured to store a lookup table containing data relating the magnetic field strength of a magnetic marker to a distance from the magnetic marker.
9. The probe of claim 3, wherein the handheld housing is configured as a wand comprising:
- a base, wherein the first sensor is located in the base;
- an extension member extending from the base, the extension member defining the distance; and
- a tip, wherein the second sensor is located in the tip, and wherein the processor determines the distance and direction between the tip and a magnetic marker.
10. The probe of claim 1, wherein the first and second sensors are located with a sensing portion which is configured to be removable from the housing.
11. The probe of claim 10, wherein the sensing portion is disposable.
Type: Application
Filed: Jan 28, 2019
Publication Date: May 23, 2019
Inventors: Kevin J. Derichs (Buda, TX), Robert J. Petcavich (The Woodlands, TX), Murray A. Reicher (Rancho Santa Fe, CA)
Application Number: 16/259,742