Abstract: Presented is a preoperatively designed guidance tool for intraoperative use during bone or joint surgery wherein the guidance tool is specific to the anatomy of the patient being treated. The guidance tool comprises a body portion, a mating surface provided on the body portion for positioning the guidance tool on a corresponding registration surface of a patient's anatomy. The guidance tool further comprises at least one guide mechanism provided on the body portion for guiding a medical instrument at one or more preoperatively defined trajectories relative to a patient's anatomy. In the event of misalignment, the at least one guide mechanism is adjustable to alter the one or more preoperatively defined trajectories if necessary during intraoperative use. Also presented is a preoperative process for designing the guidance tool.

Abstract: Radiosurgical treatments of tissues of the heart mitigate arrhythmias and treat other tumerous and non-tumerous disease using an implanted fiducial positioned in or near the heart using cardiac catheterization techniques. The fiducials may be implanted after diagnostic and planning images of the target tissues have been acquired. Fiducial implantation may take place the day of a scheduled radiosurgical treatment. Techniques to accommodate post-planning fiducial implantation may include registration of the implanted fiducial location with the treatment plan, and active fiducials may limit collateral imaging radiation exposure while enhancing tracking accuracy.

Abstract: A navigation system includes a display monitor, a CPU, and a camera, wherein the camera is mounted to a back side of the display monitor to form a monitor unit. One or more reference units are placed on a body while acquiring an image data set, and are tracked during a surgical operation by the monitor unit to register and correlate a position of a visual image of an exterior surface of the body with the image data set including information concerning internal structures of the body. The image data set is displayed on the display monitor superimposed in registration over the visible image of the exterior of the body with an angle of view and aperture in accordance with the actual position of the camera, whereby the display monitor displays the internal structures corresponding to the line-of-sight of the camera and the observer.

Abstract: Integrated surgical systems and methods for using same are provided that can receive scanned images and produce a three dimensional model from the images. Based at least in part on the three dimensional model, a processor generates code defining an optimized tool path, which is sent to a surgical machining system that can machine the desired portion of the patient. In one exemplary aspect, the integrated system operates in a clearly defined and pre-programmed manner with no necessity for in-situ sensory or guidance feedback.

Abstract: A surgical instrument comprises a first member including an inner surface that defines a cavity and an outer surface configured to space tissue. The first member includes a first locking surface. A second member is configured for disposal within the cavity and extends between a first end configured to penetrate tissue and a second end configured to generate a signal representative of a position of the second member. The second member includes a second locking surface. The members are disposable between a first orientation such that the locking surfaces are engaged to resist relative axial translation of the members and a second orientation such that the locking surfaces are disengaged and the second member is axially translatable relative to the first member. Systems and methods are disclosed.

Abstract: A computer navigation system may be used with the robot to guide movement of a cutting tool. A robot may perform cutting and/or implant placement operations on a portion of a patient. A robot may have computer controls that could be utilized to form the cuts without using guide members.

Abstract: A trackable medical instrument for use in a computer assisted image guided surgery system having a digitizer for tracking the position of the instrument in three dimensional space and a display providing an indication of the position of the instrument with respect to images of a body part taken preoperatively, wherein the instrument comprises a tracking array located distally of a rotatable, axially fixed drive handle.

Abstract: A mapping system (200) including: (a) at least one external marker (210,212,214,216) adapted for positioning outside a target (520) to define a target context; (b) at least one target marker (230) adapted for positioning with the target; (c) a data acquisition tool (221) configured to provide position coordinates for at least one data point (220) at the target (520); and (d) a registration module (300) adapted to output position coordinates of said at least one data point relative to at least a portion of the target context.

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: A medical robotic system has a joint coupled to medical device or a slave manipulator or robotic arm adapted to hold and/or move the medical device for performing a medical procedure, and a control system for controlling movement of the joint according to user manipulation of a master manipulator. The control system includes at least one joint controller having a sliding mode control for reducing stick-slip behavior on its controlled joint during fine motions of the joint. The sliding mode control computes a distance to a sliding surface, computes a reaching law gain, and processes the distance and reaching law gain to generate a sliding mode control action that is in absolute value less that a maximum desired feedback control action. The sliding mode control action is then further processed to generate a feedback torque command for the joint motor.

Abstract: An OCT probe for imaging patient tissue may include an actuation system arranged to displace an optical fiber within a cannula. The actuation system may include a driver actuatable to displace a portion of the optical fiber, with the driver acting in an angled direction relative to the axis of the cannula. The actuation system also may include a pivot feature operably engaged with the optical fiber in a manner permitting the optical fiber to pivot on the pivot feature when the driver actuates to displace the portion of the optical fiber.

Abstract: An OCT probe includes a cannula and includes a selectively displaceable light-carrying optical fiber disposed within the cannula. The optical fiber may be arranged to emit light from a distal end thereof. A flexor may be bent to divide the flexor into a first segment and a second segment extending along a lumen of the cannula. The first segment may be coupled to the optical fiber. A driver may be configured to push or pull the second segment in the axial direction to elastically bow the second segment and laterally displace the optical fiber to perform an OCT scan.

Abstract: An image-guided system and method for performing needle biopsy on a moving lung nodule of a body is provided. CT images of the lung nodule are obtained to generate a motion model, based on which an optimal needle advancing path is determined. The motion of the lung nodule and the motion of a fiducial marker attached to the body are correlated. The motion of the fiducial marker is tracked and monitored by a camera to determine a position of the lung nodule based on the correlation. A time for advancing the needle is determined based on a motion attribute of the reference. The needle is advanced by a robotic needle manipulator at the predetermined time along the path to accomplish the needle placement.

Abstract: A method of assessing stenosis severity for a patient includes obtaining patient information relevant to assessing severity of a stenosis, including anatomical imaging data of the patient. Based on the anatomical imaging data, the existence of any lesions of concerns may be identified. A three dimensional image can be generated of any irregular shaped lesion of concern and a surrounding area from the patient anatomical imaging data. A plurality of comparative two dimensional lesion specific models may be created that have conditions that correspond to the three dimensional model. The comparative two dimensional models may represent vessels having regular shaped lesions with each of the comparative two dimensional models represents a different stenosis severity. The three dimensional model can then be mapped to one of the plurality of comparative two dimensional models. After this mapping, a diagnosis of whether the patient has coronary artery disease may be made.

Abstract: The present invention relates to a data processing method of determining at least one operating parameter of a medical imaging device, the method being executed by a computer and comprising the following steps: a) acquiring entity geometry data comprising entity geometry information describing a geometry of a corporeal entity to be considered in a medical procedure; b) acquiring imaging device operability data comprising imaging device operability information describing a mode of operation of the medical imaging device; c) determining, based on the entity geometry data and the imaging device operability data, operating parameter data comprising operating parameter information describing a value of at least one operating parameter of the medical imaging device.

Abstract: Integrated surgical systems and methods for using same are provided that can receive scanned images and produce a three dimensional model from the images. Based at least in pan on the three dimensional model, a processor generates code defining an optimized tool path, which is sent to a surgical machining system that can machine the desired portion of the patient. In one exemplary aspect, the integrated system operates in a clearly defined and pre-programmed manner with no necessity for in-situ sensory or guidance feedback.

Abstract: An optical potentiometer includes a metal pipe having one end closed, a metal pipe that has a relationship of a nested structure with respect to the metal pipe and guides the metal pipe movably in a longitudinal direction, a light source and an optical fiber which supply light into the metal pipe, and an optical power meter that detects a change in the amount of reflected light from inside the metal pipe. The metal pipe has a slit along the longitudinal direction. The optical power meter detects a change in the amount of reflected light from inside the metal pipe caused by a change in the opening amount of the slit caused in accordance with the movement of the metal pipe in the longitudinal direction.

Abstract: A supporting apparatus used for medical treatment includes a support arm in which a leading end side is coupled to a supporting unit supporting an endoscope, and a moving arm that is coupled to a base end side of the support arm, the moving arm moving the supporting unit and supporting the supporting unit in a moved position of the supporting unit. The support arm includes a leading-end-side coupling unit that is turnably coupled to the supporting unit, a base-end-side coupling unit that is disposed in coaxial with the leading-end-side coupling unit and turnably coupled to the moving arm, and an offset unit laterally offset with respect to an axis line R passing through the leading-end-side and the base-end-side coupling units. The offset unit is freely rotatable about the axis line R with respect to the supporting unit and the moving arm.

Abstract: Apparatus and methods are described including, while an endoluminal data-acquisition device is being moved through a subject's lumen, acquiring a plurality of endoluminal data points of the lumen using the endoluminal data-acquisition device. It is determined that respective endoluminal data points correspond to respective locations along the lumen. A display is driven to display at least some of the plurality of endoluminal data points in a stack. While a second endoluminal device is inside the lumen, a current location of at least a portion of the second endoluminal device with respect to the lumen is determined. In response thereto, an image of the second endoluminal device is displayed within the stack, at a location within the stack corresponding to the current location of the second endoluminal device. Other applications are also described.

Abstract: A system is provided to align a surgical guide instrument over a burr hole in a patient's body. Adjustments of a surgical instrument can be made in x, y, z, and angular directions using the system. An instrument guide unit can include an instrument guide for guiding a surgical instrument into the body of a patient and a base unit operative to be secured to the body near an area in which surgery is to occur. The base unit is coupled to the instrument guide. An adjustment mechanism, coupled to the base unit and the instrument guide, is operative to adjust the instrument guide in lateral directions with respect the surface of the area.

Abstract: Tree structures corresponding to a first linear structure and a second linear structure are constructed from medical image data including the first linear structure and the second linear structure, each repeatedly branching from an origin and extending in directions away from the origin in such a manner to become wider. Each of a first root node corresponding to a root node in the first tree structure and a second root node corresponding to a root node in the second tree structure is connected to each node, based on the characteristic that each of the first and second linear structures repeatedly branches from the origin and extends in directions away from the origin in such a manner to become wider, by using, with respect to each node, a cost function that weights a cost representing a probability of connection of each of a plurality of edges connectable to each node.

Abstract: A method and apparatus for allowing determination of patient position change relative to an imaging device and/or allowing digital subtraction in an operative position. The system can include devices for determining a position of a patient at various times and comparing the various positions of the patient. Further, a digital subtraction may be performed if the patient change is not above a threshold value and/or if motion correction can occur.

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

Abstract: A system and method for localizing a catheter is provided. Distance values are determined between a plurality of reference electrodes and a catheter electrode. At least two circles are identified based on the distance values. The catheter electrode is located at a position where the at least two circles substantially coincide or within a minimum distance between the at least two circles. A transformation is applied to the at least two circles to express the at least two circles in a global coordinate system. An image is displayed as a function of the catheter electrode position.

Abstract: The present invention provides methods and compositions for modulating x-ray attenuation, where the x-ray attenuation compound can comprise a molecule having at least two conformational states, a first k-edge atom attached to the molecule at a first position, and a second k-edge atom attached to the molecule at a second position, where the molecule changes from a first conformational state to a second conformational state in response to an external stimulus. Additionally, a first interatom distance between the first k-edge atom and the second k-edge atom in the first conformational state can be within a first harmonic error of 0 to about 0.2, and a second interatom distance between the first k-edge atom and the second k-edge atom in the second conformational state can be within a second harmonic error of about 0.8 to 1.0.

Abstract: The invention provides a non-invasive system and method for treatment of the heart. In a first aspect, a method for treatment of an anatomical site related to arrhythmogenesis of a heart of a patient comprises creating a target shape encompassing the anatomical site, directing particle beam radiation or x-ray radiation from outside the patient toward the target shape wherein one or more doses of radiation ablates the target shape and disregarding at least one orientation of cardiac motion while creating the target shape or directing the particle beam or both.

Abstract: A system and apparatus allows the tracking of a selected body portion, instrument, or both. A tracking device can be interconnected to a body portion at a mounting site. A procedure can be performed at a location remote from the mounting site of the tracking device. The tracking device can be interconnected with the body in a low invasive manner.

Abstract: The present invention provides a surgical tracking system for assisting an operator to perform a laparoscopic surgery of a human body, said surgical tracking system comprising: a. at least one endoscope adapted to acquire real-time images of a surgical environment within said human body; b. a maneuvering subsystem adapted to control the spatial position of said endoscope during said laparoscopic surgery; and, c. a tracking subsystem in communication with said maneuvering subsystem, adapted to control the maneuvering system so as to direct and modify the spatial position of said endoscope to a region of interest.

Abstract: A trajectory guide for providing access to a target site of a living subject along a desired path comprises a baseplate including a clamp lock, a guide member at least partially contained within the baseplate and having a channel therein, a plurality of adjustable legs each including a first end and a second end, wherein the first end is coupled to the baseplate, and a leg lock coupled to each adjustable leg and moveable between an unlocked position and a locked position in order to set a desired length of the adjustable leg, wherein the adjustable legs and the guide member are structured to be adjusted to provide an infinite number of trajectories in three-dimensional space extending through the channel in the guide member toward a target.

Abstract: A model-based method is described which defines a rigid transformation between two co-ordinate systems that reduces the accuracy requirements on the quality of the data-set (including, but not restricted to, the error in the acquisition process, and the number and spread of the points) measured in one of the two co-ordinate systems by identifying a set of remote correspondences that are used to bind the convergence process. The method can be used in minimal-access orthopaedic surgery to improve the accuracy of limb registration. Specific instances include femoral registration, by estimating the functional center of the hip joint in both co-ordinate systems to be co-registered, and tibial registration, using the ankle center as a distant set of paired correspondences. Accuracy can be measured in a variety of ways, including, but not restricted to, evaluating the mis-alignment between the two co-registered objects.

Abstract: A fiducial marker system (210a-c) comprises a first unit and a second unit. The first unit is patient affixable and comprises a partly spherical inner surface having a first center point that is adapted to receive a touch probe measurement head for measuring the spatial position of the center point. The second unit is releasably attachable to an outer surface of the first unit, and has a second center point, wherein the first center point and the second center point are substantially identical when the second unit is attached to the first unit. For stereotactic therapy, a patient is imaged with the first and second unit assembled. Then the second unit is detached. A stereotactic frame (300) is attached to the first units via arms. Thus frameless imaging is provided in a frame based stereotactic surgery system with high precision. Repeated assembly of the frame (300) to the first units, remaining in the patient, provides advantageous fractionized stereotactic radiotherapy.

Abstract: A method and system for identifying a portion of an image data is disclosed. The image data can include image data of an anatomy, such as a brain of a patient. The identified portion can be used for planning a procedure. The identified portions can include anatomical landmarks that can be used to determine anatomical targets of the patient. The plan can include a path or trajectory to reach the anatomical target.

Abstract: A device for registering in a medical navigation system a position and/or orientation of a patient's pelvis includes a pelvic registration frame. A plurality of positioning elements are arranged on the pelvic registration frame so as to define a plane, wherein the plurality of positioning elements are movable with respect to each other to enable placement of the positioning elements at defined pelvic points of the patient's pelvis. At least one position transmitter is arranged in an unambiguously defined position and/or orientation relative to the frame.

Abstract: A navigation system for use during a surgical procedure is provided. The navigation system is configured to use electromagnetic tracking data produced by electromagnetic tracking devices and 2D image data produced by a fluoroscope to intra-operatively register 2D images of a patient to a pre-operative 3D image of the patient. In some implementations, a surgeon may be able to perform an interventional or surgical procedure guided by the navigation system.

Abstract: A method generates a three dimensional (3D) model of a tubular organ having an occluded segment. The occluded segment adjoins a proximal segment at a proximal end thereof, and a distal segment at a distal end thereof. The procedures included injecting a first dye injection into the tubular organ, the first dye approaching a first end of the occluded segment. Multiple first-injection two-dimensional (2D) images of the tubular organ are acquired, each acquired from a different perspective, the first-injection 2D images further acquired with a respective organ timing signal reading. A second dye is injected into the tubular organ, the second dye approaching a second end of the occluded segment. Multiple second-injection 2D images are acquired of the tubular organ, each acquired from a different perspective, the second-injection 2D images further acquired with a respective organ timing signal reading.

Abstract: A reference frame is described for use in a radiographic procedure. The reference frame is positionable relative to a joint or bone to be imaged, and is radio-transparent. The frame has embedded or affixed thereto a plurality of computer recognizable radio opaque markers. A method of obtaining three dimensional images of bones and joints using the frame is described.

Abstract: The system comprises at least three anchors (2,2?,2?) intended to be attached to the patient and equipped with markers (5,5?,5?), an insertion guide device (6) with an insertion guide (7) intended to be attached to said anchors (2,2?,2?), an external calibration device (8) with at least three calibration markers (10,10?,10?) corresponding to said markers (5,5?,5?) and a planning and imaging software. The planning and imaging software is used to determine the position of a target point in the patient with respect to the markers (5,5?,5?), the calibration device is used to calibrate and orient the insertion guide (7) of the insertion guide device (6) mounted on said calibration markers (10,10?,10?) using the determination of the software before the insertion guide device is mounted on said markers (5,5?,5?) attached to the patient.

Abstract: A method is disclosed for assisting in determination of the suitability of a patient for a scan of the heart of the patient using an X-ray computer tomograph. In at least one embodiment of the method, a) an electrocardiogram of the patient is recorded; b) the electrocardiogram is evaluated by predicting the occurrence time of at least the immediately following R wave on the basis of at least four immediately consecutive R waves of the electrocardiogram which were measured last, and comparing this with the actual measured occurrence time of the next R wave; and c) wherein the quality of the prediction is visualized qualitatively. Further, in at least one embodiment, a device is disclosed including an ECG instrument and a computation device for carrying out the method. At least one embodiment of the invention furthermore relates to a method and a device for scanning the heart of a patient on the basis of a prediction of R waves.

Abstract: The present invention relates to a system for positioning with respect to a patient's body an observation and/or intervention device having a portion penetrating into the patient's body comprising a base laid on the patient's body; a means for supporting the device formed of a first portion movably assembled on the base according to a connection with one degree of freedom, and of a second portion movably assembled on the first portion according to a connection with one degree of freedom and connected to the device; and means for actuating the first portion with respect to the base, and the second portion with respect to the first portion, in which the base surrounds at a distance at least partially the device, said device being detachably connected to the second portion to enable removal of the positioning system while leaving in place the device.

Abstract: A radiation imaging system includes a radiation imaging cassette and a console device. A communication mode between the cassette and the console device is switchable between a wired mode and a wireless mode. Due to shortage of a battery of the cassette, the communication mode is switched to the wired mode to start charging the battery and send image data from the cassette to the console device through a cable. The console device has first and second judging sections. The first judging section judges whether or not a charge level of the battery exceeds a predetermined threshold value. The second judging section judges whether or not radiography is in progress. If it is judged that the charge level of the battery exceeds the predetermined threshold value and the radiography is not in progress, a window that indicates permission for switching to the wireless mode is displayed on a monitor.

Abstract: The invention relates to a method and a device for making correction information for correcting a guidance direction of an instrument. Based on a current position of the tip of the instrument and the current guidance direction of the instrument and the position of a target point in an object, a first straight line indicating the current guidance direction and a second straight line defined by the tip of the instrument and the target point in the object are determined. The second straight line intersects the first straight line and indicates the desired guidance direction. Based on the position of the first and second straight lines relative to one another, a digital item of correction information is specified, wherein the correction image has a correction diagram located in a plane in the perspective of the current guidance direction of the instrument.

Abstract: A method for imaging objects is disclosed. In at least one embodiment, the method includes using a first and a second imaging method which differ at least in regard to the spatial resolution or sensitivity. Furthermore, in at least one embodiment, the method includes generating an overview image at least by the first or the second imaging method; simultaneously planning the measurement of the first and the second imaging method on the basis of the overview image; and simultaneously conducting the planned measurements of the first and the second imaging method. A device which conducts at least one embodiment of the method is also disclosed.

Abstract: A head fixation assembly includes a head fixation frame, a plurality of upper head fixation members, a plurality of lower head fixation members, and at least one drive mechanism. The head fixation frame includes a pair of upwardly extending spaced-apart arms defining a free space therebetween. At least one upper head fixation member extends from each of the respective arms of the head fixation frame, with each upper head fixation member adjustable relative to the head fixation frame and adapted to engage a patient's head within the free space of the head fixation frame. The lower head fixation members extend from the head fixation frame between the pair of arms, with each member adjustable relative to the head fixation frame and adapted to engage an underside of the patient's head within the free space of the head fixation frame.

Abstract: A needle-coupled parallel mechanism is provided. The needle-coupled parallel mechanism is structurally improved so as to have a broad working area and a high precision. The needle-coupled parallel mechanism comprises a fixedly positioned frame, a main shaft, three first links, three second links, and a needle. The main shaft is arranged so as to be movable relative to the frame. One end of each of the first links is connected to the frame between both ends of the main shaft and the other end thereof is connected to one end of the main shaft. One end of each of the second links is connected to the frame between both ends of the main shaft and the other end thereof is connected to the other end of the main shaft. The needle is linearly movably coupled to the main shaft to perform a predetermined operation on a target object. Each of the first links and the second links has at least three joints selected from a prismatic joint, a 1-axis revolute joint, a 2-axis revolute joint and a spherical joint.

Abstract: An embodiment of an imaging system of an imaged subject is provided. The imaging system comprises a controller, and an imaging system and a display in communication with the controller. The imaging system can include an imaging probe having a marker representative of a unique identifier. The display can be illustrative of the imaged data acquired with the imaging probe in combination with a graphic representation of an imaging plane vector representative of a general direction of a field of view (FOV) of image acquisition of the imaging probe traveling through the imaged subject.

Abstract: A robotically controlled guide instrument system, comprising an elongate flexible guide instrument; a drive assembly coupled to a proximal portion of the guide instrument and configured to maneuver a distal portion of the guide instrument; a master controller including a user interface that may be manipulated to actuate the drive assembly and thereby maneuver the distal portion the guide instrument; and a closure device detachably coupled to a delivery member carried by the guide instrument, the guide instrument maneuverable to position the closure device proximate an opening of a left atrial appendage of a person's heart such that the prosthesis may be detached from the delivery member and implanted to substantially close off the left atrial appendage.

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 system for monitoring a position of a medical instrument with respect to a patient's body, including a medical instrument, a reference mount attachable to the patient's body for movement with the patient's body, and an electromagnetic unit for association with the reference mount and the medical instrument for monitoring movement of the medical instrument relative to the reference mount. The electromagnetic unit includes a first member attachable to the patient's body and a second member attachable to the medical instrument. The first and second members communicate by electromagnetic radiation.

Abstract: A method and apparatus to perform a procedure that can include a processor assisted surgical procedure. During the procedure patient space and image space can be registered to allow for tracking of various tracking sensors. A dynamic reference frame can be used to maintain localization of the patient space with the image space. The dynamic reference frame can be fixedly interconnected with a bone portion of the anatomy.

Abstract: A trackable medical instrument for use in a computer assisted image guided medical and surgical navigation systems that generate images during medical and surgical procedures, includes a guide member having an emitter array for being tracked by the system and a drive shaft contained within the guide member having a proximal and a distal end, the drive shaft being rotatable within the guide member while being fixable axially inside the guide member, the proximal end of the drive shaft having a first connector for interchangeably receiving at least one drive source, and the distal end having a second connector for interchangeably receiving at least one instrument tip.