Abstract: A surgical navigation system has a computer with a memory and display connected to a surgical instrument or pointer and position tracking system, so that the location and orientation of the pointer are tracked in real time and conveyed to the computer. The computer memory is loaded with data from an MRI, CT, or other volumetric scan of a patient, and this data is utilized to dynamically display 3-dimensional perspective images in real time of the patient's anatomy from the viewpoint of the pointer. The images are segmented and displayed in color to highlight selected anatomical features and to allow the viewer to see beyond obscuring surfaces and structures. The displayed image tracks the movement of the instrument during surgical procedures. The instrument may include an imaging device such as an endoscope or ultrasound transducer, and the system displays also the image for this device from the same viewpoint, and enables the two images to be fused so that a combined image is displayed.

Abstract: A marking apparatus includes a rigid cannula having a peripheral wall forming a lumen that carries an imaging marker, a proximal end coupled to a handle, a lateral opening in the peripheral wall that is open to the lumen, and a closed-off distal portion having a ramp adjacent the lumen. The closed-off distal portion extends distally from the ramp to terminate at a tissue piercing pointed tip. The ramp of the rigid cannula is curved to transition from the peripheral wall of the rigid cannula to the lateral opening of the rigid cannula. The ramp of the rigid cannula is adapted to engage the distal end of the stylet as the stylet is advanced through the lumen of the rigid cannula to guide the distal end of the stylet to a position to substantially close off the lateral opening of the rigid cannula having the tissue piercing tip.

Abstract: An array for use with a surgical navigation system is provided. The array comprises a frame and first, second and third markers attached to the frame. The first, second and third markers are detectable by a tracking system used in image guided surgery, and the first marker is movable relative to the frame. In one embodiment, at least one marker slides along the frame from a first position where it is held in place to a second position where it is also held in place. In another embodiment, one or more of the markers is removed from the frame at a first position and reattached to the frame at a second position. In still another embodiment, a portion of the frame itself moves with the movable marker.

Abstract: A surgical navigation system for tracking a procedure relative to a patient is disclosed. The system can track a portion of the patient, an instrument, both, and both or either relative to image data, a coordinate system, an atlas, a morphed atlas, or combinations thereof. The system can include a minimally or non-invasive dynamic reference frame and/or fiducial marker, sensor tipped instruments, and isolator circuits.

Abstract: The present application relates to a tool for detecting planes which are defined by anatomical landmarks, comprising a first and a second level abutment area for placing onto a body structure, wherein the first and second abutment areas have a predetermined position relative to each other, and comprising a tool marker device which has a stationary position relative to the first and second abutment areas.

Abstract: A method and system for producing tomosynthetic images of a patient's breast. An x-ray source that delivers x-rays through a breast immobilized and compressed between a compression paddle and a breast platform and form an image at a digital x-ray receptor panel. Multiple x-ray images are taken as the x-ray source and the receptor move relative to the immobilized breast. In one preferred embodiment, the x-ray source travels from ?15° to +15°. The source can travel in an arc around the breast while the receptor travels linearly while remaining parallel and at the same distance from the breast platform. The sets of x-ray image data taken at different angles are combined to form tomosynthetic images that can be viewed in different formats, alone or as an adjunct to conventional mammograms.

Abstract: A method of defining a biological target for treatment in which image detectable markers are placed at and correlated to the location or locations of tissue biopsy. By obtaining pathological analysis of the biopsy tissue specimens and correlating the analysis to the corresponding marker locations, the definitive pathological analysis of the target tissue at the marker locations can be correlated to corresponding locations on a functional image of the target tissue. The correlation of the marker locations and pathology to the corresponding locations on a functional image can then be used to prescribe and apply modulated therapy to the target tissue.

Abstract: A method and apparatus for cross checking points palpated with a localization device. Points corresponding to the palpated points are obtained from a preoperative image of an object such as an X-Ray of a tibia bone. During a surgical procedure, the accuracy of palpated points are determined based on the palpated points and corresponding points obtained from the preoperative image. If a palpated point is inaccurate, an indicator is generated to indicate the inaccuracy of the palpated point.

Abstract: Embodiments include a fiducial deployment system and method for use thereof. A fiducial may include one or more protuberances configured to engage one or more slots in a needle of the system. The needle may be configured to deliver a plurality of fiducials to a target location in serial fashion, one at a time. In certain embodiments, echogenic placement of fiducials may present certain advantages.

Abstract: A localization mechanism, or fixture, is used in conjunction with a breast coil for breast compression and for guiding a core biopsy instrument during prone stereotactic biopsy procedures in both open and closed Magnetic Resonance Imaging (MRI) machines. The localization fixture includes a fiducial marker and three-dimensional Cartesian positionable guide for supporting and orienting an MRI-compatible biopsy instrument with detachable probe/thumb wheel probe to the biopsy site of suspicious tissues or lesions.

Abstract: Devices and methods for providing in vivo performance measurements of an orthopedic implant involve an orthopedic implant having at least two radiopaque markers associated with a movable portion of the implant. The markers are positioned at known locations and in a first known and predetermined relationship to each other. The markers provide visible references upon application of a medical imaging technique to show the relative position of the markers according to a second, changed relationship to each other after implantation of the orthopedic implant. At least one measurement of performance of the implant can be determined from the first and second relationships of the markers.

Abstract: An inventive medical imaging marker includes a base (2) composed of a non-imageable material, three spherical members (10, 11, 12) provided in a predetermined positional relationship in the base (2) and each composed of an imageable material, and auxiliary marker members (20, 21, 22) provided in the base (2) and composed of the imageable material. The auxiliary marker members (20, 21, 22) respectively have linear portions (20L, 21L, 22L) which are disposed parallel to straight lines extending through center points of the three spherical members (10, 11, 12) and each have a predetermined length sufficient to serve as a mark. The center points of the three spherical members (10, 11, 12) can be correctly identified in a captured image with reference to the linear portions (20L, 21L, 22L) of the auxiliary marker members (20, 21, 22) of the inventive medical imaging marker. Thus, reference axes can be correctly defined in the image.

Abstract: An access port for subcutaneous implantation is disclosed. Such an access port may comprise a body for capturing a septum for repeatedly inserting a needle therethrough into a cavity defined within the body. Further, the access port may include at least one feature structured and configured for identification of the access port subsequent to subcutaneous implantation. Methods of identifying a subcutaneously implanted access port are also disclosed. For example, a subcutaneously implanted access port may be provided and at least one feature of the subcutaneously implanted access port may be perceived. Further, the subcutaneously implanted access port may be identified in response to perceiving the at least one feature. In one embodiment, an identification feature is included on a molded insert that is incorporated into the access port so as to be visible after implantation via x-ray imaging technology.

Abstract: A surgical navigation system for navigating a region of a patient includes a non-invasive dynamic reference frame and/or fiducial marker, sensor tipped instruments, and isolator circuits. The dynamic reference frame may be repeatably placed on the patient in a precise location for guiding the instruments. The instruments may be precisely guided by positioning sensors near moveable portions of the instruments. Electrical sources may be electrically isolated from the patient.

Abstract: A system and method for providing computer assistance for performing a medical procedure provides a graphical user interface to guide and/or assist a user, for example a surgeon, performing the medical procedure, whether surgical or non-surgical. The computer-assisted system comprises a software application that may be used for a medical procedure.

Abstract: A method for planning minimally invasive direct coronary artery bypass (MIDCAB) for a patient includes obtaining acquisition data from a medical imaging system, and generating a 3D model of the coronary arteries and one or more cardiac chambers of interest. One or more anatomical landmarks are identified on the 3D model, and saved views of the 3D model are registered on an interventional system. One or more of the registered saved views are visualized with the interventional system.

Abstract: A device and method for automatically verifying, calibrating and surveying a navigable surgical instrument, wherein by means of a scanning device, the geometry of the instrument, in particular the shape of the functional elements (e.g., tips) and their spatial position with respect to an attachable reference system, are detected. By means of a data processing unit, a three-dimensional model of the instrument is calculated from the detected information concerning the geometry of the instrument including the reference system, wherein verification, calibration or surveying is performed with the aid of the ascertained information concerning the geometry of the instrument.

Abstract: Devices and processes for use in computer aided or computer navigated surgery include one or more fault interfaces interposed between an indicium and an item to be used during surgery such as a body part, tool, implant, trial or other structure or component. After the indicia have been registered into the system and surgery begun, it is sometimes the case that indicia can be inadvertently moved or dislodged in position and/or orientation relative to the body part. Fault interfaces according to various embodiments are designed to fail first, so that the indicia can be repositioned relative to the item without the need to reregister the indicia into the system relative to the item. The fault interfaces preferably include structure that allows the indicium to be repositioned relative to the item so that it does not need to be reregistered into the system. Frame attachments which can by easily manufactured at relatively low cost, are disposable, and which are manufactured for single use are disclosed.

Abstract: A system for constructing image slices through a selected object, the system comprising an identifiable fiducial reference in a fixed position relative to the selected object, wherein the fiducial reference comprises at least two identifiable reference markers. A source of radiation is provided for irradiating the selected object and the fiducial reference to form a projected image of the selected object and the fiducial reference which is recorded by a recording medium.

Abstract: A computed tomography unit and a method are disclosed, for a computed tomography unit having at least one marking device for the positionally accurate marking of an intervention position by way of a laser beam on an object to be examined. The at least one marking device is assigned to a rotary frame of the computed tomography unit and is arranged directly in a recording plane of a recording system. As such, a positionally accurate marking of an intervention position with the aid of simple devices/methods is possible without a large numerical outlay, particularly even during operation of the computed tomography unit, that is say during a rotational movement of the rotary frame.

Abstract: Cavity and sentinel lymph node marking 412 devices, marker delivery devices, and methods are disclosed. More particularly, upon insertion into a body, the cavity marking device and method enable one to determine the center, orientation, and periphery of the cavity by radiographic, mammography, echogenic, or other noninvasive imaging techniques. A composition and method are disclosed for locating the sentinel lymph node in a mammalian body to determine if cancerous cells have spread thereto. The composition is preferably a fluid composition consisting of a carrier fluid and some type of contrast agent; alternatively, the contrast agent may itself be a fluid and therefore not need a separate carrier fluid. This composition is capable of (1) deposition in or around a lesion and migration to and accumulation in the associated sentinel node, and (2) remote detection via any number of noninvasive techniques.

Abstract: Doppler radar sensor (3) is used for generating a reference or target signal (SR, ST), which can be used for positioning of measuring sensors (2) for acquiring a vital parameter of a subject (5). With the invention a simple and reliable technique for positioning sensors (2) is provided. Furthermore a simple and reliable technique for reproducing the position of sensors (2) is provided.

Abstract: Image data can be obtained with an imaging device. A location of the imaging device relative to a subject can be determined. A location of an instrument can be tracked relative to the subject using two or more tracking systems operating with different tracking modalities. Also, the tracked location of the instrument can be illustrated relative to the image data.

Abstract: The invention provides materials, devices and methods for marking biopsy sites for a limited time. The biopsy-marking materials are ultrasound-detectable bio-resorbable powders, with powder particles typically between about 20 microns and about 800 microns in maximum dimension, more preferably between about 300 microns and about 500 microns. The powders may be formed of polymeric materials containing cavities sized between about 10 microns and about 500 microns, and may also contain binding agents, anesthetic agents, hemostatic agents, and radiopaque markers. Devices for delivering the powders include tubes configured to contain the powders and to fit within a biopsy cannula, the powders being ejected by action of a syringe. Systems may include a tube containing powder, and a syringe containing sterile saline. The tube may be configured to fit within a biopsy cannula such as a Mammotome® or SenoCor 360™ cannula.

Abstract: A marking device for identifying a subcutaneous biopsy cavity having a first nonabsorbable marker element detectable by a first imaging modality and a second nonabsorbable marker element detectable by a second imaging modality but not detectable by the first imaging modality.

Abstract: This document discusses, among other things, a fiducial marker assembly that includes an internally engagable base. The base is sized and shaped to be mounted flush to or recessed from an outer surface of a patient's skull, thereby reducing or avoiding patient discomfort. The fiducial marker assembly includes an imagable locator and a registration receptacle. A base insertion instrument is engaged to the base to attach the base to the patient's skull. In one example the base includes a faceted head, permitting a socket-like device to screw or unscrew the base into or out of the skull. In another example, the base includes at least one step or slot for engaging an insertion or extraction tool.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined imagable fiducial locator and divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example is reflective such that it is locatable by a remote detector of an optical positioning system. A generally cylindrical (e.g., faceted cylindrical) columnar locator permits easy application of reflective tape. Other examples discusses a unitary fiducial marker with multiple divots and a swiveling and/or tilted fiducial marker divot, each of which allows manipulation of a positioning wand into a remote camera's field of view. Another example includes at least one reflector that can be aimed. A further example discusses an imagable fiducial marker carrier that is attachable to a single location on a patient's skull to reduce trauma.

Abstract: A system and method for positioning a device at a desired location in a tubular organ such as an artery. A three-dimensional reconstruction of the organ is obtained, and the desired location is marked in the reconstruction. The device is inserted into the organ and an image is obtained of the device and organ. The reconstruction with the marked location is projected onto a plane from the perspective of the image and the projection and image are superimposed. If the device is not at the desired location, the device is repositioned in the organ and an additional image of the device is obtained. The reconstruction is then projected onto a plane from the perspective of the additional image and the additional image and the projection are superimposed. This process is repeated, as required, until the device is in the desired location.

Abstract: The invention is directed to an anchor marker that is secured to adjacent tissue in order to prevent or minimize displacement of the marker and a method of delivering such a marker to a patient's body cavity such as a cavity in a patient's breast after a biopsy or lumpectomy. The anchor marker has an anchor element and a marker element which is secured to the anchor element. The anchor element penetrates into surrounding tissue and secures the marker from movement. The marker element is remotely imagable by ultrasound, x-ray, MRI and the like and preferably has incorporated imagable material to facilitate such imaging.

Abstract: Determining impingement between first and second bodies by determining a spatial relationship between surface points of the first body and markers of a first reference element; determining a spatial relationship between surface points of the second body and markers of a second reference element; displacing the first and second bodies relative to the other body; determining 3D coordinates of the respective pluralities of markers; and using at least (1) the 3D coordinates of the respective pluralities of markers of the reference elements, (2) the determined relationship between surface points of the first body and markers of the first reference elements, and (3) the determined relationship between surface points of the second body and markers of the second reference elements, to determine whether a surface point of one of the first and second bodies coincides with a surface point of the other body.

Abstract: A guide is disclosed for use in performing spinal surgery to prepare across a spinal disc and adjacent vertebrae an implantation space. The guide is associated with a computer controlled surgical navigation system employing an energy-detecting array to track positions of the guide in three dimensional space relative to a known reference point. The guide comprises a body for providing protected access to prepare across the spinal disc and into the adjacent vertebrae the implantation space. The body has a passage adapted to receive a bone removal device for forming the implantation space through the body. At least one electrically energizable energy emitter array is attached to the body for use in identifying the location of the guide relative to the adjacent vertebrae. A system and method for using the guide in spinal surgery are also disclosed.

Abstract: A device and a method are provided for spatially locating and tracking an object, such as medical instruments, a patient and/or part of a patient's body using a camera array having at least two cameras, and for mutually assigning the spatial position of the object and an acquired, stored data set. Trackable markings are recorded via the camera array, the markings are extracted from the recordings, and a location of the markings is monitored, wherein the spatial position of the object is based on the location of the markings. Further, video recordings of a surface of the object are produced via the camera array and, with computer assistance, surface portions of the object are identified and correlated with corresponding surface portions in the stored data set, wherein the spatial position of the object is assigned to that of the data set.

Abstract: Markers that are visible under magnetic resonance imaging (MRI) and fluoroscopy and related medical devices are disclosed.

Abstract: The present invention relates to a method and a device for correcting motion in imaging during a medical intervention, by which method a 3D tomographic image of a target area for the intervention is first recorded while there are one or more medical instruments in the target area that will remain there during the intervention. During the intervention 2D fluoroscopic images of the target area are recorded and registered with the 3D image. The registration is therein adjusted for each 2D fluoroscopic image in realtime based in each case on the one or more instruments. The 2D fluoroscopic images are then in each case visualized with representations, concurring in terms of perspective, of the 3D image. Virtually error-free overlaying of the 3D image with in each case one 2D fluoroscopic image can be implemented using the present method and associated device.

Abstract: A system and method for non-invasive and continuous measurement of cardiac chamber volume and derivative parameters including stroke volume, cardiac output and ejection fraction comprising an ultrawideband radar system having a trans-mitting and receiving antenna for applying ultrawideband radio signals to a target area of a subject's anatomy wherein the receiving antenna collects and transmits signal returns from the target area which are then delivered to a data processing unit, such as an integrated processor or PDA, having software and hardware used to process the signal returns to produce a value for cardiac stroke volume and changes in cardiac stroke volume supporting multiple diagnostic requirements for emergency response and medical personnel whether located in the battlefield, at a disaster site or at a hospital or other treatment facility.

Abstract: A method includes receiving during a first time interval image data associated with an image of a dynamic body. The image data includes an indication of the positions of a first marker and a second marker on a garment coupled to the dynamic body. The first marker and second marker are each coupled to the garment at a first and second locations, respectively. A distance is determined between the position of the first marker and the second marker. During a second time interval after the first time interval, data associated with a position of a first and second localization element that are each coupled to the garment is received. A distance between the first and second localization elements is determined. A difference is calculated between the distance between the first marker and the second marker and the distance between the first localization element and the second localization element.

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 present disclosure relates to systems, methods, and tools for tool tracking using image-derived data from one or more tool-located reference features. A method includes: capturing a first image of a tool that includes multiple features that define a first marker, where at least one of the features of the first marker includes an identification feature; determining a position for the first marker by processing the first image; determining an identification for the first marker by using the at least one identification feature by processing the first image; and determining a tool state for the tool by using the position and the identification of the first marker.

Abstract: There is provided a device for generating a frame of reference and tracking the position and orientation of a tool in computer-assisted image guided surgery or therapy system. A first curvature sensor including fiducial markers is provided for positioning on a patient prior to volumetric imaging, and sensing the patient's body position during surgery. A second curvature sensor is coupled to the first curvature sensor at one end and to a tool at the other end to inform the computer-assisted image guided surgery or therapy system of the position and orientation of the tool with respect to the patient's body. A system is provided that incorporates curvature sensors, a garment for sensing the body position of a person, and a method for registering a patient's body to a volumetric image data set in preparation for computer-assisted surgery or other therapeutic interventions. This system can be adapted for remote applications as well.

Abstract: An orthopaedic prosthesis includes a curved outer surface configured to abut a patient's bone when the orthopaedic prosthesis is implanted therein. The outer surface may or may not be electrically conductive. A channel is defined in the outer surface and extends from a rim of the outer surface to a location on the outer surface. One or more electrical conductors is positioned in the channel and extends outwardly from the channel at the rim of the outer surface. A switch is positioned at the first location and is configured to establish an electrical connection between the electrical conductor and the outer surface and/or another electrical conductor when the first location of the outer surface contacts the patient's bone. The switch may be embodied as an end of the electrical conductor or a more complex switch such as a push-button type switch.

Abstract: A navigation system or combination of navigation systems can be used to provide two or more types of navigation or modalities of navigation to navigate a single instrument. The single instrument can be positioned within the patient and tracked. For example, both an Electromagnetic (EM) and Electropotential (EP) navigation system can be used to navigate an instrument within a patient.

Abstract: An auxiliary device for establishing a mechanical connection between a medical implant and a tissue part of a patient, a medical implant for use with such an auxiliary device, and a method for establishing such a mechanical connection. To establish a mechanical connection between a medical implant and a tissue part of a patient in a particularly simple manner, an auxiliary device for establishing a mechanical connection between a medical implant and a tissue part of the patient is provided. A securing element establishes a releasable mechanical connection between the auxiliary device and the tissue part. A marking element is configured to allow its position to be determined with the aid of a contactless locating method. A guide body is connected to the securing element and designed to guide the medical implant to the connection site on the tissue part.

Abstract: Methods for staining a selected tissue with a dye, stain or pigment that is attuned to absorb the energy from a radiant energy source are disclosed. The stain enhances absorption of incoming radiant energy, which results in increased destruction of stained tissues and decreased destruction of underlying tissues. This method provides clinicians with the ability to selectively mark a tissue for destruction, while leaving wanted tissues generally intact. Optionally, a radiant energy opaque substance that can be applied adjacent the stained treatment area to protect against incidental exposure to untargeted tissue. Also optionally, an oxidizing substance may be applied with the stain to further enhance the effect of this method. Wavelengths of radiant energy to which tissue is normally transparent may be utilized by applying appropriate stains to targeted tissue, thereby allowing targeted tissue to even be destroyed when it lies beneath untargeted tissue.

Abstract: The invention relates to a localization system that can particularly be used to localize an interventional instrument (2) in the body of a patient (1). The localization system comprises an electromagnetic wave source (10) which splits an electromagnetic signal into components propagating along a probe path (20) and a reference path, respectively. Said probe path (20) comprises a signal outlet (22) for emitting the signal at the point to be located and at least one detector (23) for picking up the emitted signal. A correlator (40) is used to determine the correlation between the signal components that propagated along the probe path (20) and the reference path (30), respectively. Knowing the length of the reference path, the unknown distance between the signal outlet (22) and the detector (23) in the probe path (20) can be estimated based on the correlation information.

Abstract: A bone marker for use in image guided surgery comprises a support having an anchor mechanism for anchoring the support in a bone. The marker includes at least one reference member which can be detected by an image guided system and which is attached to the support. The support has at least one limb which is resiliently deformable.

Abstract: An imaging system of an object in an imaged subject is provided. The imaging system includes an image detector and a guidewire in support of a pair of markers. The imaging system also includes a controller in communication with the image detector. The controller includes a processor in communication to execute a series of programmable instructions stored in a memory, the programmable instructions including acquiring a plurality of acquired images, detecting a position of the pair of markers, calculating a first mathematical representation of an alignment of the guidewire between the markers and a second mathematical representation of an alignment of the guidewire not between the markers, and registering the first and second mathematical representations of the guidewire extending through the object relative to more than one of the acquired images so as to locate the object in at least one of the acquired images.

Abstract: A system is provided for marking on a recording medium (36), such as a label, the location of imaged tissue with respect to an exposed surface of the tissue (34). Tissue is imaged by a microscope (11) capable of imaging sections of the tissue below the exposed tissue surface through optics. A ring (32) applied to the surface of the tissue stabilizes the tissue to the optics and localizes a portion of the tissue surface through an aperture in the ring. An actuator (38) is connected to both the ring and the microscope for moving the ring to adjust the position of the tissue with respect to the optics, thereby allowing an operator of the system to survey different images of tissue sections with the microscope.

Abstract: A target motion simulator system for use in verifying target tracking with a radiation therapy device. The system comprises a radiation detection target coupled to a first motion actuator simulating a first motion of a first tissue and a fiducial coupled to a second motion actuator simulating a second motion of a second tissue offset from the first tissue, a component of the first motion being asynchronous with the second motion. A synthetic physiological signal generator is synchronized with the component of the first motion, wherein an output signal from the generator, in combination with a sensed position of the fiducial, may be used by the radiation therapy device in tracking the target.

Abstract: This document discusses, among other things, fiducial marker devices, tools, and methods. One example illustrates a combined imagable fiducial locator and divot for receiving a positioning wand of an image-guided surgical (IGS) workstation. A further example is reflective such that it is locatable by a remote detector of an optical positioning system. A generally cylindrical (e.g., faceted cylindrical) columnar locator permits easy application of reflective tape. Other examples discusses a unitary fiducial marker with multiple divots and a swiveling and/or tilted fiducial marker divot, each of which allows manipulation of a positioning wand into a remote camera's field of view. Another example includes at least one reflector that can be aimed. A further example discusses an imagable fiducial marker carrier that is attachable to a single location on a patient's skull to reduce trauma.

Abstract: There is provided a method for intra-operatively presenting an approximate model of an anatomical structure by collecting a cloud of small surfaces. The cloud of small surfaces is gathered with a registration pointer having an adapted tip capable of making contact with the surface of an anatomical structure and registering the normal at the point of contact.