Patent Description:
Percutaneous interventional procedures involve a positioning of a plurality of elongated instruments (e.g., needles or electrodes) within a patient according to a treatment plan. Examples of such percutaneous interventional procedures include, but are not limited to, transperineal prostate brachytherapy or biopsy, lumbar spine radiofrequency or microwave ablation, facet joint injections and irreversible electroporation with multiple electrodes.

Most of the percutaneous interventional procedures are very challenging because such elongated instruments need to be positioned at a certain accuracy according to the treatment plan. More particularly, the main challenges of percutaneous interventional procedures are related to long procedures times, overuse of both contrast media and imaging radiation (e.g., X-ray) and difficulty in integrating and reproducing very complex multiple-instrument treatment plans into the intraoperative clinical situation.

One solution for an accurate positioning of elongated instruments according to a treatment plan during a percutaneous interventional procedure is the use of a stereotactic interventional navigations systems. Generally, availability of a preoperative treatment plan and its registration with current surgical site is a great advantage of stereotactic interventional navigation systems, and several clinical sites have successfully introduced stereotactic interventional navigation systems for complex multiple needle procedures into their every-day practice. However, these stereotactic interventional navigation systems are usually cumbersome to use and may require remarkable changes into existing clinical workflows, especially because of their strong dependency on general anesthesia. More particularly, stereotactic interventional navigation systems for multiple-instrument percutaneous needle interventions may be difficult to setup and integrate into existing clinical workflows, especially when usage of general anesthesia is imposed, and may be costly because of expensive tracking technologies incorporated into the systems.

Another solution for an accurate positioning of elongated instruments according to a treatment plan during a percutaneous interventional procedure is the use of a generic rigid templates with multiple through guiding holes. Generally, generic rigid templates have been successfully deployed in percutaneous interventional procedures, such as, for example, transperineal prostate interventions including brachytherapy, biopsy, and electroporation. While generic rigid templates are considered to be less expensive than stereotactic interventional navigation systems but sufficiently robust for percutaneous interventional procedures, there are several main limitations of generic rigid needle templates for percutaneous interventional procedures. One such limitations is a large and bulky design of rigid templates due to their generic nature (rigid templates need to cover relatively large surgical access areas and provide enough flexibility in selection of needle entry points). Another limitation is a specificity of a generic rigid template to particular application(s) (e.g., generic rigid templates specifically designed for transperineal prostate interventions) whereby such templates have guide holes of a certain diameter, non-configurable needle orientation angles, and even but non-configurable spacing between holes. The result is non-configurable spacing in the template may enforce undesirable needle entry points. Yet another limitation is an inflexibility of generic rigid templates in terms of workflow because generic rigid templates need to be deployed before the image acquisition and planning of instrument trajectories is constrained by the evenly spaced through guide holes on the generic rigid template.

<CIT> addresses the challenges of stereotactic interventional navigations systems and generic rigid templates by providing a method of utilizing preprocedure scans of a patient's anatomy to identify targets and critical structures as a basis for generating a virtual template containing one or more guide elements and manufacturing a physical template as a replication of the virtual template.

The invention of the present disclosure address the challenges of stereotactic interventional navigations systems and generic rigid templates by providing a plan-specific instrument template for percutaneous interventions involving a plurality of elongated intervention instrument (e.g., needles or electrodes). A plan-specific instrument template of the present disclosure is designed from a preoperative or an intraoperative imaging of a guide base fixed relative to a patient for supporting a development of a treatment plan for the patient, and may be preoperatively or intraoperatively generated using an additive manufacturing process or a subtractive manufacturing process. No methods are claimed.

One embodiment of the present disclosure is a plan-specific instrument template system employing an intervention guide base, and an instrument guide design controller for controlling a designing of a plan-specific instrument template including a platform and one or more instrument guides extending through the platform for guiding one or more intervention instruments during an percutaneous intervention.

In operation, the controller generates and positions a generic instrument template relative to an image segmentation of the intervention guide base, the generic instrument template being a geometric representation of the plan-specific instrument template including reconfiguration of the one tube guide or each instrument guide of the generic instrument template having a generic location and a generic orientation of a generic configuration relative to the platform of the generic instrument template.

In accordance with a treatment plan associated with the percutaneous intervention, the controller further controls a relocation, a reorientation and/or a reconfiguration of the one tube guide or each instrument guide of the generic instrument template relative to the guide surface of the generic instrument template.

A second embodiment of the present disclosure is a instrument guide design controller for controlling a designing of a plan-specific instrument template including a platform and one or more instrument guides extending through the platform for guiding one or more intervention instruments during an percutaneous intervention.

The instrument guide design controller employs a generic instrument template generator configured to generate and position the generic instrument template relative to the image segmentation of the intervention guide base, the generic instrument template being a geometric representation of the plan-specific instrument template including reconfiguration of the one tube guide or each instrument guide of the generic instrument template having a generic location and a generic orientation of a generic configuration relative to the platform of the generic instrument template.

The instrument guide design controller further employs a plan-specific instrument template designer configured to control the relocation, the reorientation and/or the reconfiguration of the one tube guide or each instrument guide of the generic instrument template relative to the platform of the generic instrument template in accordance with the treatment plan associated with the percutaneous intervention.

A third embodiment of the present disclosure is an instrument guide design method for designing a plan-specific instrument template including a platform and one or more instrument guides extending through the platform for guiding one or more intervention instruments during an percutaneous intervention.

The instrument guide design method involves the instrument guide design controller generating and positioning the generic instrument template relative to the image segmentation of the intervention guide base, the generic instrument template being a geometric representation of the plan-specific instrument template including reconfiguration of the one tube guide or each instrument guide of the generic instrument template having a generic location and a generic orientation of a generic configuration relative to the platform of the generic instrument template.

The instrument guide design method further involves the instrument guide design controller controlling the relocation, the reorientation and/or the reconfiguration of the one tube guide or each instrument guide of the generic instrument template relative to the platform of the generic instrument template in accordance with a treatment plan associated with the percutaneous intervention.

For purposes of describing and claiming the inventions of the present disclosure:.

The foregoing embodiments and other embodiments of the inventions of the present disclosure as well as various structures and advantages of the inventions of the present disclosure will become further apparent from the following detailed description of various embodiments of the inventions of the present disclosure read in conjunction with the accompanying drawings. The detailed description and drawings are merely illustrative of the inventions of the present disclosure rather than limiting, the scope of the inventions of the present disclosure being defined by the appended claims solely.

To facilitate an understanding of the invention of the present disclosure, the following description of <FIG> teaches basic inventive principles of a planning phase and an intervention phase of a percutaneous intervention in accordance with the present disclosure. From this description, those having ordinary skill in the art will appreciate how to apply the inventive principles of the present disclosure of additional embodiments of a percutaneous intervention in accordance with the inventive principles of the present disclosure.

Referring to <FIG>, a planning phase of a percutaneous intervention in accordance with the present disclosure involves an imaging of an intervention guide base <NUM> relative to an anatomical object <NUM> that is the subject of the percutaneous intervention. In practice, the imaging may be executed by an imaging modality as known in the art of the present disclosure (e.g., computed-tomography ("CT"), cone-beam CT, magnetic resonance imaging, ultrasound, positron emission tomography and single-photon emission computed tomography).

Subsequent to the imaging of an intervention guide base <NUM> relative to an anatomical object <NUM>, the intervention guide base <NUM> is image segmented whereby a generic instrument template <NUM> is generated in the form of a computer mesh positioned onto the segmented intervention guide base <NUM>. Generic instrument template <NUM> includes a platform <NUM> positionable onto segmented intervention guide base <NUM>. Generic instrument template <NUM> further includes instrument guides <NUM> extending through platform with each instrument guide <NUM> having a generic location, a generic orientation and a generic configuration (i.e., shape and dimensions) relative to platform <NUM>. More particularly, the location, the orientation and the configuration of each instrument guide <NUM> are unrelated to the subject percutaneous intervention.

Subsequent to the generating and the positioning of generic instrument template <NUM>, an treatment plan is developed to delineate within the image of an instrument trajectory of one or more intervention instruments (e.g., needle(s) and/or electrode(s)) sequentially through generic instrument template <NUM> and intervention guide base <NUM> to a target location within anatomical object <NUM>. For example, as shown in <FIG>, two (<NUM>) instrument trajectory <NUM> are delineated through generic instrument template <NUM> and intervention guide base <NUM> to two (<NUM>) respective target locations 11a and 11b within anatomical object <NUM>.

For each delineated instrument trajectory <NUM>, the present disclosure provides for a relocation and/or a reorientation of an instrument guide <NUM> relative to platform <NUM> to correspond to the delineated instrument trajectory. For example, as shown in <FIG>, instrument guide 32a may be laterally shifted to a location corresponding to delineated instrument trajectory 50a, and instrument guide 32e may be laterally shifted to a location and tilted to an orientation corresponding to delineated instrument trajectory 50b.

Also, for each delineated instrument trajectory <NUM>, the present disclosure provides for a reconfiguration of a shape and/or dimensions of an instrument guide <NUM> relative to platform <NUM> to correspond to the delineated instrument trajectory. For example, a length and a diameter of a particular one of instrument guides <NUM> may be adjusted to account for a length and diameter of a particular intervention instrument through that particular one of the instrument guides <NUM> along the corresponding delineated instrument trajectory and to thereby guide the user not only in terms of a location and an orientation of the trajectory but also in terms of insertion depth. For example, for a shallow target location, an instrument guide may be lengthened and/or narrowed thus limiting the depth of the intervention instrument into the anatomical space, and for a deeper target location, an instrument guide may be shortened and/or widened thus increasing the depth of the intervention instrument into the anatomical space. Alternatively, an intervention instrument may be marked for depth insertion.

The present disclosure further provides for a manufacturing of a plan-specific instrument template based on each relocation, each reorientation and/or each reconfiguration of an instrument guide <NUM> relative to platform <NUM> to correspond to a delineated instrument trajectory <NUM>, and a removal of any unused instrument guide <NUM> from platform <NUM>. For example, as shown in <FIG>, a manufactured plan-specific instrument template <NUM> includes an instrument guide 42a located and oriented relative to a platform <NUM> in accordance with the relocation of instrument guide 32a relative to platform <NUM>, and further includes an instrument guide 42b located and oriented relative to platform <NUM> in accordance with the relocation, the reorientation and the reconfiguration of instrument guide 32e relative to platform <NUM> as well as a lengthening of instrument guide 32e.

Referring to <FIG>, an intervention phase of the percutaneous intervention in accordance with the present disclosure involves a positioning of plan-specific instrument template <NUM> onto intervention guide base <NUM>, which is positioned relative to anatomical object <NUM> as in the planning phase of the percutaneous intervention. Subsequent to the positioning of plan-specific instrument template <NUM> onto intervention guide base <NUM>, an intervention instrument 51a may be inserted sequentially through instrument guide 42a and intervention guide base <NUM> to target location 11a within anatomical object <NUM> and an intervention instrument 51b may be inserted sequentially through instrument guide 42b and intervention guide base <NUM> to target location 11b within anatomical object <NUM>. In practice, such insertion of intervention instruments <NUM> may be monitored via an imaging of intervention instruments <NUM> as known in the art of the present disclosure (e.g., computed-tomography ("CT"), cone-beam CT, magnetic resonance imaging, ultrasound, positron emission tomography or single-photon emission computed tomography) and/or a tracking of intervention instruments <NUM> as known in the art of the present disclosure (e.g., electromagnetic tracking, optical tracking, optical shape sensing or marker-based tracking). Also in practice, as previously described, each instrument guide may be lengthened or shortened in the planning phase to thereby regulate an insertion depth of a corresponding intervention instrument.

Referring to <FIG>, in practice, intervention guide base <NUM> may have a material composition and a geometric configuration suitable for one or more particular types of percutaneous interventions. Also in practice, intervention guide base <NUM> may be attached to, mounted onto or otherwise affixed to a patient body during the planning phase and the intervention phase of a percutaneous intervention of the present disclosure.

In one embodiment as shown in <FIG>, an intervention guide base <NUM> employs a frame <NUM> having an instrument passage <NUM> with frame <NUM> further having a degree of flexibility to comply with a shape of the patient body. Frame <NUM> contains a set of uniquely spaced attachment pins <NUM> located on the top surface to enable easier assembly of intervention guide base to plan-specific instrument template <NUM>. A lower surface of frame <NUM> contains a self-adhesive tape (not shown), such as, for example hypoallergenic tapes used in urology or under electrocardiography electrodes as known in the art of the present disclosure. Optionally, to enable accurate segmentation of intervention guide base <NUM> within volumetric images, frame <NUM> may incorporate a set of internal radiopaque markers or other material distinguishable from human tissue attenuation coefficient.

Furthermore, a self-adhesive base may be reinforced with an attachment belt that surrounds patient body as known in the art of the present disclosure. Such a belt may also allow for dynamic placement of multiple instrument guide bases for different parts of the procedure, and may also allow to quickly clip on and off different instrument guide bases in case of occurrence of intraoperative changes.

Referring to <FIG>, in practice, generic instrument template <NUM> is a computer mesh geometrically representative of a plan-specific instrument template for one or more particular types of percutaneous interventions.

In one embodiment as shown in <FIG>, a generic instrument template <NUM> includes a platform <NUM> in the form of a generic 3D triangular mesh with a set of generic located and orientated, evenly spaced models of instrument guides <NUM> on platform <NUM>. This generic mesh is a geometric representation of a plan-specific instrument template <NUM> (<FIG>) that is deformable based in information from both volumetric images and an treatment plan as previously described in the present disclosure.

Further, a lower surface of platform <NUM> contains a set of holes (not shown) that matches unique configuration defined by pins located on the upper surface of instrument guide base <NUM> (<FIG>). Other possible attachment mechanisms, such as self-adhesive tape, are also possible.

Referring to <FIG>, in practice, a deformed generic instrument template <NUM> is inputted an additive manufacturing system (e.g., a 3D printer) or a subtractive manufacturing system to thereby manufacture plan-specific instrument template <NUM>.

In one embodiment as shown in <FIG>, a deformed generic instrument template <NUM> is stored in a file format usable by additive manufacturing systems or subtractive manufacturing systems (e.g., STL file format, OBJ file format or. VRML file format) whereby the file format serves to manufacture plan-specific instrument template <NUM>.

While instrument guides <NUM> are shown having tubular segments extending from platform <NUM>, in practice instrument guides may totally be integrated into platform <NUM> without any extending tubular segments.

Furthermore in practice, instrument guides <NUM> may be made from a flexible material, whereby a user may adjust a location, an orientation and/or a configuration of instrument guides <NUM> as needed. Also, instrument guides <NUM> may be a combination of both rigid material and flexible material whereby a user may slightly adjust a location, an orientation and/or a configuration of instrument guides <NUM> if needed within a specific range.

Also in practice, a multi-material instrument guide <NUM> may be manufactured to gauge depth of the insertion of intervention instrument relative to the target location. For example, with a semi-flexible instrument guide <NUM>, the material may compress to indicate a proximity to the target location. Additionally, 0nstrument guides <NUM> may also be printed with fixed motion ball joints to regulate motion in one or more planes (e.g., only allowing for 'x' degree motion in certain planes).

Referring to <FIG>, plan-specific instrument template <NUM> typically will be preoperatively designed and manufactured during the planning phase. Nonetheless in practice, plan-specific instrument template <NUM> may be preoperatively designed during the planning phase and intraoperatively manufactured during the intervention phase. Issues associated with an intraoperative manufacture of the plan-specific instrument template <NUM> the intervention phase include (<NUM>) speed of manufacturing, (<NUM>) biocompatibility and (<NUM>) post-production disinfection.

For example, a high speed additive manufacturing process or a high speed subtractive manufacturing process as known in the art of the present disclosure may be used to comply with a time-constraint of the percutaneous intervention (e.g., several minutes). Further, while plan-specific instrument template <NUM> will typically have limited contact with the patient body and very short exposure time, plan-specific instrument template <NUM> should have a material composition according to medial regulatory standards (e.g., PolyJet photopolymer MED610). Finally, intervention guide base <NUM> may be disinfected before the percutaneous intervention during the manufacturing process plan-specific instrument template <NUM> using steam autoclaves or plazma sterilization or with ethyl alcohol (<NUM>%) as disinfectant.

To further understand the embodiments of <FIG>, <FIG> illustrate an exemplary percutaneous intervention of a spine <NUM> of a patient incorporating an intervention guide base <NUM>, generic instrument template <NUM> and plan-specific instrument template <NUM>.

<FIG> illustrates an image segmented intervention guide base <NUM> flexibly and adhesively attached to a patient body <NUM> whereby an treatment plan of two (<NUM>) instrument path 150a to target locations within spine <NUM> to thereby facilitate a deforming of instrument guides <NUM> of generic instrument template <NUM> in accordance with the treatment plan.

<FIG> illustrates a manufacture of plan-specific intervention template <NUM> prior to an attachment of plan-specific intervention template <NUM> to intervention guide base <NUM>.

<FIG> illustrates a mounting of plan-specific intervention guider <NUM> onto intervention guide base <NUM> whereby intervention instruments <NUM> may be accurately guided to the target locations in spine <NUM>.

To facilitate a further understanding of the invention of the present disclosure, the following description of <FIG> and <FIG> teaches basic inventive principles of an instrument guide design controller of the present disclosure and an instrument guide design method of the present disclosure. From this description, those having ordinary skill in the art will appreciate how to apply the inventive principles of the present disclosure for making and using additional embodiments of instrument guide design controllers of the present disclosure and instrument guide design controller of the present disclosure.

Referring to <FIG>, an instrument guide design controller <NUM> of the present disclosure inputs an intervention guide base image file <NUM> including data of an imaging of an intervention guide base of the present disclosure (e.g., intervention guide base <NUM> shown in <FIG>) relative to an anatomical object that is a subject of a percutaneous intervention, and further inputs (or alternatively stores) a generic instrument template file <NUM> including data for a generation of a generic instrument template of the present disclosure (e.g., generic instrument template <NUM> shown in <FIG>). From the inputs, instrument guide design controller <NUM> outputs a plan-specific instrument template file <NUM> including data for an additive manufacturing or a subtractive manufacturing of a plan-specific instrument template of the present disclosure (e.g., plan-specific instrument template <NUM> shown in <FIG>).

Generally, instrument guide design controller <NUM> is configured to (a) segment an intervention guide base of the present disclosure from pre-operative volumetric images or intra-operative volumetric images, (b) define, via a generic instrument template of the present disclosure, an treatment plan that contains a plurality of instrument trajectories/paths, and (c) design of a plan-specific instrument template of the present disclosure.

During the segmentation process, instrument guide design controller <NUM> automatically segments an intervention guide base of the present disclosure from the volumetric images using one of the methods known in art of the present disclosure (e.g., thresholding, level set, or active contours segmentation algorithms), or via a manual segmentation by delineation of the intervention guide base.

Defining the treatment plan includes interventional instrument trajectories/paths identified by a user of instrument guide design controller <NUM> via a graphical user interface on the volumetric images (e.g., CT, CBCT, MRI, PET-CT, etc.) Examples of intervention instruments suitable for the treatment planning include but are not limited to, radiofrequency instruments, microwave or electroporation electrodes, facet joint injection needles, biopsy needles, local ablation applicators, endoscopes, intraoperative imaging modalities (e.g., ultrasound transducers), treatment applicators and pedicle screws. An instrument path is defined as a point-to-point needle access path to percutaneously reach the clinical site, and an instrument path consists of a target location and a skin-entry point. Preferably, trajectories are defined manually by the user of instrument guide design controller <NUM>, but other automatic methods that incorporates both the position of the instrument guide base and the anatomical knowledge of the surgical site may be applied as known in the art of the present disclosure.

The design of the plan-specific instrument template is derived from a deformation of the generic instrument template in accordance with the treatment plan as previously described in the present disclosure.

In one embodiment, instrument guide design controller <NUM> executes a flowchart <NUM> representative of an instrument guide design method of the present disclosure as shown in <FIG>. While flowchart <NUM> will be described in connection with an exemplary percutaneous intervention of a spine of a patient incorporating an intervention guide base <NUM>, generic instrument template <NUM> and plan-specific instrument template <NUM> of <FIG>, those having ordinary skill in the art will appreciate how to apply flowchart <NUM> to any embodiments of an intervention guide base, a generic instrument template and a plan-specific instrument template of the present disclosure.

Referring to <FIG>, prior to image acquisition, a stage S102 of flowchart <NUM> involving a physician/clinician attaching a self-adhesive instrument guide base 120a above the surgical site. In practice, the physician/clinician determining a right position of instrument guide base 120a above the surgical site may require previous diagnostic scan(s) or usage of metallic wires previously attached around the surgical site. For this example, the surgical site is a level in the vertebral column in which pedicle screws will be implanted. In one embodiment, instrument guide base 120a is used in the areas of a patient body that are not susceptible to respiratory motion and soft-tissue deformation. Because of any degree of rigidity of instrument guide base <NUM>, respiratory motion could significantly influence the instrument positioning accuracy of plan-specific instrument template <NUM> due to organ motion. In another embodiment, a coupling or a registering of instrument guide base <NUM> with real-time imaging modalities may enhance the capabilities of the plan-specific instrument template <NUM> in dynamic motion of the patient body.

Upon the placement of instrument guide base <NUM>, a volumetric image dataset is acquired and transferred as file <NUM> to instrument guide design controller <NUM> (<FIG>). <FIG> illustrates an exemplary imaging <NUM> of instrument guide base <NUM> relative to a spine 111a.

Still referring to <FIG>, a stage S104 of flowchart <NUM> encompasses instrument guide design controller <NUM> generating a model 120b of an instrument guide base 120a via image segmentation as shown in <FIG>. More particularly, during the image segmentation, voxels belonging to a specific objects are grouped and labelled using an arbitrary scalar value. Usage of a building material of instrument guide base 120a with unique attenuation coefficient compared to human tissue could simplify the process After segmentation, stage S140 further encompasses instrument guide design controller 60a generating generic instrument template <NUM> as shown in <FIG> using methods known in art of the present disclosure (e.g., Delaunay triangulation). As a post-processing step, generic instrument template <NUM> may be simplified and cleaned using a decimation method.

Still referring to <FIG>, a stage S106 of flowchart <NUM> encompasses instrument guide design controller <NUM> facilitating a defined treatment plan containing single or plural instrument trajectories (e.g., instrument trajectories <NUM> shown in <FIG>). In one embodiment, instrument trajectories are defined manually by the physician/clinician. Alternatively, in another embodiment, automatic methods that incorporate both the position of the model 120b of an instrument guide base 120a and the anatomical knowledge of the surgical site may be used by instrument guide design controller <NUM> to define the instrument trajectories.

Still referring to <FIG>, a stage S108 of <NUM> encompasses instrument guide design controller <NUM> designing 3D model 140a of plan-specific multiple needle template <NUM> based on the model 120b of an instrument guide base 120a, the generic instrument template <NUM> and the treatment plan containing desired instrument trajectories.

In one embodiment, generic instrument template <NUM> is introduced by instrument guide design controller 60to elastic deformation using one of the deformable models algorithms known in the art of the present disclosure that are successfully applied in non-rigid image registration, finite element analysis and other simulations (e.g., deformable surfaces or level set). During the elastic deformation, internal deformation energy may expand the generic mesh under constrains imposed by upper surface of the model 120b of an instrument guide base 120a and attachment pins. In a simplified version, the upper surface of the model 120b of an instrument guide base 120a will define the lower surface of generic instrument template <NUM> whereby the lower surface of generic instrument template <NUM> will be expanded in the direction opposite to the patient body to reach a certain thickness (e.g. <NUM>). Attachment pins on model 120b will generate its counterparts - attachment holes - on the lower surface of generic instrument template <NUM>. Positions of through holes for needles (entry points) are defined as an intersection between instrument trajectory and an upper surface of generic instrument template <NUM>. Diameters of through holes of the instrument guides are defined by the known diameter of the instrument (known a priori from internal database). A length of an instrument guide is defined by subtracting length of a vector defined by target and entry point on the upper surface of generic instrument template <NUM> from the instrument length (known a priori from internal database). Orientation of the instrument guides are calculated from instrument orientation angles derived from the treatment plan.

Upon termination of flowchart <NUM>, plan-specific instrument template file <NUM> enables an additive manufacturing or subtractive manufacturing of plan-specific instrument template <NUM>.

To facilitate a further understanding of the invention of the present disclosure, the following description of <FIG> teaches basic inventive principles of an instrument guide design system of the present disclosure. From this description, those having ordinary skill in the art will appreciate how to apply the inventive principles of the present disclosure for making and using additional embodiments of instrument guide design systems of the present disclosure.

Referring to <FIG>, an instrument guide design controller <NUM> of the present disclosure is installed within an application server <NUM> accessible by a plurality of clients (e.g., a client <NUM> and a client <NUM> as shown) and/or is installed within a workstation <NUM> employing a monitor <NUM>, a keyboard <NUM> and a computer <NUM>.

In operation, instrument guide design controller <NUM> inputs instrument guide base image file <NUM> (<FIG>) from one or more imaging systems <NUM> (e.g., MRI imaging systems <NUM>-<NUM>) to output plan-specific instrument template file <NUM> (<FIG>), which is communicated by controller <NUM> to one or more manufacturing sources <NUM> including, but not limited to, an additive manufacturing systems <NUM> (e.g., a 3D printer) and a subtractive manufacturing system <NUM> (e.g., a CNC machine).

In practice, instrument guide design controller <NUM> may be implemented as hardware/circuity/software/firmware.

In one embodiment as shown in <FIG>, an instrument guide design controller <NUM> includes a processor <NUM>, a memory <NUM>, a user interface <NUM>, a network interface <NUM>, and a storage <NUM> interconnected via one or more system bus(es) <NUM>. In practice, the actual organization of the components <NUM>-<NUM> of controller 160a may be more complex than illustrated.

The processor <NUM> may be any hardware device capable of executing instructions stored in memory or storage or otherwise processing data. As such, the processor <NUM> may include a microprocessor, field programmable gate array (FPGA), application-specific integrated circuit (ASIC), or other similar devices.

The memory <NUM> may include various memories such as, for example L1, L2, or L3 cache or system memory. As such, the memory <NUM> may include static random access memory (SRAM), dynamic RAM (DRAM), flash memory, read only memory (ROM), or other similar memory devices.

The user interface <NUM> may include one or more devices for enabling communication with a user such as an administrator. For example, the user interface <NUM> may include a display, a mouse, and a keyboard for receiving user commands. In some embodiments, the user interface <NUM> may include a command line interface or graphical user interface that may be presented to a remote terminal via the network interface <NUM>.

The network interface <NUM> may include one or more devices for enabling communication with other hardware devices. For example, the network interface <NUM> may include a network interface card (NIC) configured to communicate according to the Ethernet protocol. Additionally, the network interface <NUM> may implement a TCP/IP stack for communication according to the TCP/IP protocols. Various alternative or additional hardware or configurations for the network interface will be apparent.

The storage <NUM> may include one or more machine-readable storage media such as read-only memory (ROM), random-access memory (RAM), magnetic disk storage media, optical storage media, flash-memory devices, or similar storage media. In various embodiments, the storage <NUM> may store instructions for execution by the processor <NUM> or data upon with the processor <NUM> may operate. For example, the storage <NUM> store a base operating system (not shown) for controlling various basic operations of the hardware.

More particular to the present disclosure, storage <NUM> further stores control modules <NUM>.

A first control module <NUM> is a generic instrument template generator 167a for executing an image segmentation of an instrument guide base of the present disclosure and a mesh generation of a generic instrument template of the present disclosure (e.g., stage S104 of flowchart <NUM> shown in <FIG>).

A second control module <NUM> is a treatment planner 167b for executing a delineation of instrument trajectories (e.g., a stage S106 of flowchart <NUM> shown in <FIG>).

A third control module <NUM> is a plan-specific instrument template designer 167c for executing a deformation the mesh generation of the generic instrument template of the present disclosure in accordance with the treatment plan to thereby design a plan-specific instrument template of the present disclosure (e.g., a stage S106 of flowchart <NUM> shown in <FIG>).

Referring to <FIG>, while instrument guide base <NUM> of the present disclosure is important for the planning phase of a percutaneous intervention of the present disclosure, alternative devices may be substituted for instrument guide base <NUM> during the intervention phase of the percutaneous intervention of the present disclosure.

For example, <FIG> illustrates a bottom view of a large ultrasound array <NUM> having an instrument through hole <NUM> as known in the art of the present disclosure, and <FIG> illustrates a mounting of a plan-specific instrument template <NUM> onto a top surface of large ultrasound array <NUM> whereby instrument trajectories extend through the through hole <NUM> large ultrasound array <NUM>. This exemplary embodiment provides for a real-time guidance and safe means for instrument insertion, especially when clinical site is under respiratory motion.

Referring to <FIG>, those having ordinary skill in the art of the present disclosure will appreciate numerous benefits of the invention of the present disclosure including, but not limited to, a configurable instrument guide supporting a more accurate intervention instrument insertion into a surgical site as compared to non-configurable instrument guides as known in the art of the present disclosure.

Further, as one having ordinary skill in the art will appreciate in view of the teachings provided herein, structures, elements, components, etc. described in the present disclosure/specification and/or depicted in the Figures may be implemented in various combinations of hardware and software, and provide functions which may be combined in a single element or multiple elements. For example, the functions of the various structures, elements, components, etc. shown/illustrated/depicted in the Figures can be provided through the use of dedicated hardware as well as hardware capable of executing software in association with appropriate software for added functionality. When provided by a processor, the functions can be provided by a single dedicated processor, by a single shared processor, or by a plurality of individual processors, some of which can be shared and/or multiplexed. Moreover, explicit use of the term "processor" or "controller" should not be construed to refer exclusively to hardware capable of executing software, and can implicitly include, without limitation, digital signal processor ("DSP") hardware, memory (e.g., read only memory ("ROM") for storing software, random access memory ("RAM"), non-volatile storage, etc.) and virtually any means and/or machine (including hardware, software, firmware, combinations thereof, etc.) which is capable of (and/or configurable) to perform and/or control a process. Similarly, one having ordinary skill in the art should appreciate in view of the teachings provided herein that any flow charts, flow diagrams and the like can represent various processes which can be substantially represented in computer readable storage media and so executed by a computer, processor or other device with processing capabilities, whether or not such computer or processor is explicitly shown.

Having described preferred and exemplary embodiments of the invention of the present disclosure (which embodiments are intended to be illustrative and not limiting), it is noted that modifications and variations can be made by persons skilled in the art in light of the teachings provided herein, including the.

It is therefore to be understood that changes can be made in/to the preferred and exemplary embodiments of the present disclosure which are within the scope of the embodiments disclosed herein.

Claim 1:
An instrument guide design controller (<NUM>) for controlling a designing of a plan-specific instrument template (<NUM>), the plan-specific instrument template (<NUM>) including a platform and at least one planned instrument guide extending through the platform for guiding instruments during a percutaneous intervention, the instrument guide design controller (<NUM>) comprising:
a generic instrument template generator (167a) configured to generate and position a generic instrument template (<NUM>) relative to a model generated via an image segmentation of an intervention guide base (<NUM>),
wherein the generic instrument template (<NUM>) includes a platform and at least one generic instrument guide, and
wherein the at least one generic instrument guide has a generic location and a generic orientation of a generic configuration relative to the platform of the generic instrument template; and
a plan-specific instrument template designer (167c) configured to control at least one of a relocation, a reorientation and a reconfiguration of at least one generic instrument guide of the generic instrument template (<NUM>) relative to the platform of the generic instrument template (<NUM>) to execute a deformation of the generic instrument template (<NUM>) and thereby design the plan-specific instrument template (<NUM>) in accordance with a treatment plan associated with the percutaneous intervention,
wherein the generic instrument template is a geometric representation of the plan-specific instrument template.