# US 10,368,946 B2 · Method for determining a target position for a medical procedure

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- Number: US 10,368,946 B2
- Document ID: US10368946B2
- Status: Granted
- Kind: B2
- Application number: 14/112,951
- Filed: 2012-04-13
- Published: 2014-02-20
- Granted: 2019-08-06
- Earliest claimed: 2011-04-20
- Assignees: Siemens Aktiengesellschaft
- Applicants: Rainer Graumann; Gerhard Kleinszig; Martin Ringholz
- Inventors: Rainer Graumann; Gerhard Kleinszig; Martin Ringholz
- Web page: https://patentgrep.com/patent/US10368946B2

## CPC

- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 6/032: {Transmission computed tomography [CT]}
- A61B 6/12: Arrangements for detecting or locating foreign bodies
- A61B 6/4085: {Cone-beams}
- A61B 6/4441: {the rigid structure being a C-arm or U-arm}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/2055: {Optical tracking systems}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- A61B 2090/3983: {Reference marker arrangements for use with image guided surgery}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A method for determining the location, in a coordinate system, of a target position for an invasive medical procedure on a patient. An entry mark that defines the coordinate system and indicates an entry position for the procedure is affixed to the patient. A site marker, which can be identified in a radioscopy image, is fixed in a known relative location in the coordinate system. At least two 2D radioscopy images of the patient, which both depict the respective site marker and the target position, are recorded from different recording directions. The location of the target position in the coordinate system is determined from the representation of the target position and from the representation of the site marker in the 2D radioscopy images and from the relative location of the site marker in the coordinate system.

## Claims

### Claim 1

A method for determining a location of a target position for an invasive medical procedure on a patient in a coordinate system, the method comprising:
recording radioscopy image data of the patient in order to define the target position and an entry position for the procedure, wherein the entry position is on a surface of the patient;
after recording the radioscopy image data of the patient, affixing an entry mark to the patient defining the coordinate system and indicating the entry position for the procedure;
after recording the radioscopy image data of the patient, fixing a site marker to be identified in a radioscopy image in a known relative position in the coordinate system;
after affixing the entry mark to the patient and after fixing the site marker, recording at least two 2D radioscopy images of the patient from mutually different recording directions, each image capturing the site marker and the target position, wherein the different recording directions are substantially orthogonal to each other; and
determining the location of the target position in the coordinate system from a representation of the target position and a representation of the site marker in the 2D radioscopy images and the relative position of the site marker in the coordinate system.

### Claim 2 (depends on 1)

The method according to claim 1, which comprises recording a set of 2D projection images for reconstructing the target position, without recording 3D image data containing the site marker, with a radioscopy device that is fixed in a 3D recording position, wherein the 2D radioscopy images are recorded with the same radioscopy device without changing the 3-D recording position.

### Claim 3 (depends on 2)

The method according to claim 2, which comprises using two images in the set of the 2D projection images as 2D radioscopy images.

### Claim 4 (depends on 1)

The method according to claim 1, which comprises affixing a film on the patient as an entry mark.

### Claim 5 (depends on 1)

The method according to claim 1, wherein:
the coordinate system is associated with a navigation system used to navigate an instrument performing the procedure;
a navigation marker of the navigation system is arranged in a known relative position in respect of the entry mark;
a navigation device detecting the navigation marker is arranged in a known relative position in respect of the instrument, wherein the navigation device is part of the navigation system; and
the site marker is arranged in a known relative position in respect of the navigation device.