# US 12,178,666 B2 · Fiducial marker > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,178,666 B2 - Document ID: US12178666B2 - Status: Granted - Kind: B2 - Application number: 17/585,629 - Filed: 2022-01-27 - Published: 2022-05-12 - Granted: 2024-12-31 - Earliest claimed: 2019-07-29 - Assignees: Augmedics Ltd. - Applicants: Augmedics Ltd. - Inventors: Stuart Wolf; Nissan Elimelech - Web page: https://patentgrep.com/patent/US12178666B2 ## CPC - A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers} - A61B 90/361: {Image-producing devices, e.g. surgical cameras} - A61B 90/57: Accessory clamps - G02B 27/017: {Head mounted} - A61B 2017/0092: {for X-rays} - A61B 2090/365: {augmented reality, i.e. correlating a live optical image with another image} - A61B 2090/372: {Details of monitor hardware} - A61B 2090/3916: {Bone tissue} - A61B 2090/3966: {Radiopaque markers visible in an X-ray image} - A61B 2090/3983: {Reference marker arrangements for use with image guided surgery} - A61B 2090/3991: {having specific anchoring means to fixate the marker to the tissue, e.g. hooks} - A61B 2090/502: {Headgear, e.g. helmet, spectacles} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G02B: OPTICAL ELEMENTS, SYSTEMS OR APPARATUS ## Abstract A medical marking device, consisting of a radiotransparent plate having a first plurality of radiopaque elements embedded therein in a first predefined pattern and a second plurality of optical reflectors positioned on a surface in proximity to the plate in a second predefined pattern. The device also includes a sigmoid mounting arm having a first end connected to the radiotransparent plate and a second end containing one or more fastening receptacles. ## Claims ### Claim 1 A method, comprising: rigidly attaching a retaining structure to a bone of a patient; connecting a first end of a sigmoid mounting arm to the retaining structure, the sigmoid mounting arm having a second end fixedly connected to a plate that has a first plurality of optical reflectors positioned in a first predefined pattern on a surface thereof; optically scanning the first plurality of optical reflectors so as to form a first optical scan; disconnecting the first end of the sigmoid mounting arm from the retaining structure and connecting a patient marker, having a second plurality of optical reflectors in a second predefined pattern, to the retaining structure; optically scanning the second plurality of optical reflectors so as to form a second optical scan; and causing one or more computer processors to: derive from the first and the second optical scans a correction vector indicative of a difference between a location and an orientation of the plate and a location and an orientation of the patient marker; and in response to the correction vector, register a frame of reference of the patient with a frame of reference of the patient marker. ### Claim 2 (depends on 1) The method according to claim 1 and comprising: mounting a head-mounted display, having a camera configured to acquire the first and second optical scans, on a head of an operator of an augmented reality system; acquiring the first optical scan with the camera while the operator and the camera are in respective first locations; and acquiring the second optical scan with the camera while the operator and the camera are in respective second locations, different from the respective first locations. ### Claim 3 (depends on 2) The method according to claim 2, further comprising causing the one or more computer processors to: determine a local fiducial marker vector relating a location of the plate to a region of the retaining structure from the first optical scan, and determine a local patient marker vector relating a location of the patient marker to the region of the retaining structure. ### Claim 4 (depends on 3) The method according to claim 3, further comprising forming the correction vector as a sum of the local fiducial marker vector and the local patient marker vector. ### Claim 5 (depends on 3) The method according to claim 3, wherein the region of the retaining structure comprises a surface of the retaining structure, and wherein connecting the first end of the sigmoid mounting arm to the retaining structure comprises mounting the first end on the surface, and wherein connecting the patient marker to the retaining structure comprises connecting the patient marker to the surface. ### Claim 6 (depends on 1) The method according to claim 1, wherein connecting the patient marker to the retaining structure comprises attaching the patient marker to the retaining structure in a selected one of a plurality of different discrete orientations. ### Claim 7 (depends on 1) The method according to claim 1, wherein the retaining structure comprises at least one of a pin rigidly inserted into the bone of the patient or a clamp rigidly attached to the bone of the patient. ### Claim 8 A computer-implemented method for performing an augmented reality procedure on a patient, wherein an operator of the procedure wears a head-mounted display and rigidly attaches a retaining structure to a bone of the patient, attaches a fiducial marker to the retaining structure, then detaches the fiducial marker from the retaining structure and attaches a patient marker to the retaining structure, the method comprising; accessing a computerized tomography scan of the attached fiducial marker; storing an image of the computerized tomography scan in a memory; analyzing the stored image so as to determine a registration of a frame of reference of the fiducial marker with a frame of reference of an anatomy of the patient; acquiring an image of the patient marker while the patient marker is attached to the retaining structure that is rigidly attached to the bone of the patient; and using the registration and the acquired image to align images projected on the head-mounted display with the anatomy of the patient as seen from a point of view of the operator of the procedure. ### Claim 9 (depends on 8) The method according to claim 8, wherein using the acquired image comprises analyzing the acquired image to determine a location and an orientation of the operator with respect to the patient marker. ### Claim 10 (depends on 8) The method according to claim 8 and comprising using the acquired image to form a registration between a patient marker frame of reference and a frame of reference of the anatomy of the patient. ### Claim 11 (depends on 8) The method according to claim 8, wherein attaching the patient marker to the retaining structure comprises attaching the patient marker to the retaining structure in a selected one of a plurality of different discrete orientations. ### Claim 12 (depends on 8) The method according to claim 8, wherein the fiducial marker is attached to the retaining structure by a sigmoid mounting arm. ### Claim 13 (depends on 8) The method according to claim 8, wherein the fiducial marker comprises a plurality of optical reflectors in a first predefined pattern, and the method further comprises optically scanning the plurality of optical reflectors while the patient marker is attached to the retaining structure that is rigidly attached to the bone of the patient. ### Claim 14 (depends on 8) The method according to claim 8, wherein the retaining structure comprises at least one of a pin rigidly inserted into the bone of the patient or a clamp rigidly attached to the bone of the patient.