# US 10,765,308 B2 · Method and apparatus for tracking in a medical procedure

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- Number: US 10,765,308 B2
- Document ID: US10765308B2
- Status: Granted
- Kind: B2
- Application number: 15/287,896
- Filed: 2016-10-07
- Published: 2017-01-26
- Granted: 2020-09-08
- Earliest claimed: 2009-06-29
- Assignees: Koninklijke Philips N.V.
- Applicants: Koninklijke Philips N.V.
- Inventors: Joerg Sabczynski; Heinrich Schulz
- Web page: https://patentgrep.com/patent/US10765308B2

## CPC

- A61B 1/05: characterised by the image sensor, e.g. camera, being in the distal end portion
- A61B 5/06: Devices, other than using radiation, for detecting or locating foreign bodies {; Determining position of diagnostic devices within or on the body of the patient}
- A61B 5/067: {using accelerometers or gyroscopes}
- A61B 6/5247: {combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound}
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 90/36: {Image-producing devices or illumination devices not otherwise provided for}
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 1/2676: {Bronchoscopes}
- A61B 5/0013: {Medical image data (A61B1/00011, A61B6/56, A61B8/56 take precedence)}
- A61B 6/4441: {the rigid structure being a C-arm or U-arm}
- A61B 8/12: in body cavities or body tracts, e.g. by using catheters
- A61B 2034/2048: {using an accelerometer or inertia sensor}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- A61B 2562/0219: Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A tracking system for a target anatomy of a patient can include a medical device having a body (281) having a distal end (290) and at least one channel (292) formed therein, where the body is adapted for insertion through an anatomy (105) to reach a target area (430); an accelerometer (185) connected to the body and positioned in proximity to the distal end; an imaging device (295) operably coupled with the body; and a light source (297) operably coupled with the body, where the accelerometer is in communication with a remote processor (120) for transmitting acceleration data thereto, where the imaging device is in communication with the remote processor for transmitting real-time images thereto, and where an orientation of the medical device and calibration of direction with respect to the anatomy is determined by the processor based on the acceleration data.

## Claims

### Claim 1

A tracking system for use in a medical procedure, comprising
an endoscope including:
a body having a distal end and at least one channel formed therein, the body being adapted for insertion through a patient anatomy of a patient to reach a target region;
an accelerometer connected to the body through the at least one channel and positioned in proximity to the distal end and configure to obtain acceleration data while being moved through the patient anatomy towards the target region;
an imaging device connected to the body and configured to obtain a real-time image of the patient anatomy; and
a light source connected to the body; and
a remote processor configured to receive the acceleration data from the accelerometer, to determine an orientation of the endoscope with respect to the patient anatomy based on the acceleration data;
to determine a first bifurcation in bifurcated bronchi of the patient anatomy using the real-time image to determine directions at the first bifurcation of the patient anatomy, to compare the determined directions at the first bifurcation with an expected direction into the bifurcated bronchi at the first bifurcation based on the acceleration data from the accelerometer and an assumed patient orientation, to determine a deviation between the determined directions and the expected direction, and to correct the assumed patient orientation by the deviation to generate a first corrected assumed patient orientation.

### Claim 2 (depends on 1)

The tracking system of claim 1, wherein the remote processor is further configured to determine directions into bifurcated bronchi of the patient anatomy at a second bifurcation of the patient anatomy, to compare the determined directions at the second bifurcation with an expected direction into the bifurcated bronchi at the second bifurcation based on the acceleration data from the accelerometer and the first corrected assumed patient orientation, to determine another deviation between the determined directions at the second bifurcation and the expected direction at the second bifurcation, and to correct the first corrected assumed patient orientation by the another deviation to generate a subsequent corrected assumed patient orientation.

### Claim 3 (depends on 1)

The tracking system of claim 1, wherein the remote processor is further configured to receive at least one of a pre-interventional computed tomography, magnetic resonance imaging or ultrasound scan and corresponding path planning data to the target region.

### Claim 4 (depends on 1)

The tracking system of claim 1 further comprising a display operably coupled to the remote processor for displaying directions determined from the first corrected assumed patient orientation.

### Claim 5 (depends on 1)

The tracking system of claim 1, wherein the remote processor is further configured to relate the real-time image of the patient anatomy to an image of the endoscope obtained by an external imaging modality.

### Claim 6 (depends on 5)

The tracking system of claim 5, further comprising a display operably coupled to the remote processor for simultaneously displaying the real-time image of the patient anatomy and the image of the endoscope.

### Claim 7 (depends on 1)

The tracking system of claim 1, wherein the accelerometer is removable from the at least one channel formed in the body of the endoscope, enabling the at least one channel to be utilized as a working channel or a suction channel after reaching the target region.

### Claim 8 (depends on 5)

The tracking system of claim 5, wherein the external imaging modality comprises one of MRI, ultrasound, X-ray or CT imaging.

### Claim 9 (depends on 5)

The tracking system of claim 5, further comprising a display operably coupled to the remote processor for displaying the real-time image of the patient anatomy, wherein the remote processor is further configured to automatically rotate the real-time image of the patient anatomy to depict an up-direction based on the orientation data from the accelerometer.

### Claim 10

A tracking system for use in a medical procedure, comprising:
an endoscope comprising:
a body having a distal end and a plurality of channels formed therein, the body being configured to insert through a patient anatomy of a patient to reach a target region;
an accelerometer in a first channel of the plurality of channels in the body positioned in proximity to the distal end and configured to obtain acceleration data while being moved through the patient anatomy towards the target region; and
an imaging device in a second channel of the plurality of channels in the body and configured to obtain real-time images of the patient anatomy; and
a processor and a non-transitory memory storing code that, when executed by the processor, causes the processor to perform a process comprising:
receiving the acceleration data from the accelerometer and image data corresponding to the real-time images from the imaging device;
determining an orientation of the endoscope with respect to the patient anatomy based on the acceleration data;
determining a first bifurcation in bifurcated bronchi of the patient anatomy using the image data;
determining a direction at the first bifurcation of the patient anatomy;
comparing the determined direction at the first bifurcation with an expected direction into the bifurcated bronchi at the first bifurcation based on the acceleration data and an assumed patient orientation;
determining a deviation between the determined direction and the expected direction; and
correcting the assumed patient orientation by the deviation to generate a first corrected assumed patient orientation.