# US 12,599,437 B2 · Pre-procedure planning, intra-procedure guidance for biopsy, and ablation of tumors with and without cone-beam computed tomography or fluoroscopic imaging

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- Number: US 12,599,437 B2
- Document ID: US12599437B2
- Status: Granted
- Kind: B2
- Application number: 17/955,224
- Filed: 2022-09-28
- Published: 2023-04-27
- Granted: 2026-04-14
- Earliest claimed: 2021-10-21
- Assignees: Covidien LP
- Applicants: Covidien LP
- Inventors: William J. Dickhans; Oren P. Weingarten; Evgeni Kopel; Avital Zik; Ariel Birenbaum
- Web page: https://patentgrep.com/patent/US12599437B2

## CPC

- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/25: {User interfaces for surgical systems}
- A61B 34/30: Surgical robots
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 2018/00541: {Lung or bronchi}
- A61B 2018/00577: {Ablation}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/2046: {Tracking techniques}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2061: {using shape-sensors, e.g. fiber shape sensors with Bragg gratings}
- A61B 2034/2072: {Reference field transducer attached to an instrument or patient}
- A61B 2034/301: {for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes}
- A61B 2090/376: {using X-rays, e.g. fluoroscopy}
- A61B 2090/3764: {with a rotating C-arm having a cone beam emitting source}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A system and method for navigation of a luminal network including receiving a computed tomography (CT) image data set, generating a three-dimensional (3D) model, displaying the 3D model in a user-interface on a display operatively connected to the computing device, and receiving an indication of a location of a tumor in the CT image data set. The system and method further including displaying the location of the tumor in the 3D model, receiving an indication of a margin around the tumor to achieve a desired therapy, generating a pathway to the tumor for navigation of a catheter, receiving a location of a sensor associated with a navigation catheter and registering the CT image data set with a luminal network of a patient, displaying the location of the sensor within the 3D model that substantially corresponds to the location of the sensor within the luminal network of the patient.

## Claims

### Claim 1

A system for planning and navigation of a luminal network, comprising:
a computing device including a memory and a processor, the memory storing one or more applications that when executed by the processor execute the steps of:
receiving a computed tomography (CT) image data set;
generating a three-dimensional (3D) model;
causing display of the 3D model in a user-interface on a display operatively connected to the computing device;
receiving an indication of a location of a tumor in the CT image data set;
causing display of the location of the tumor in the 3D model;
receiving an indication of a margin around the tumor to achieve a desired therapy;
reducing the displayed 3D model to an airway generation level wherein the generation level is a selected number of generations beyond an identified point in an airway;
generating a pathway plan to the tumor for navigation of a catheter;
receiving a location of a sensor associated with a navigation catheter and registering the CT image data set with a luminal network of a patient;
causing display of the location of the sensor within the reduced 3D model that substantially corresponds to the location of the sensor within the luminal network of the patient;
causing the display of, following the pathway plan, the navigation of the navigation catheter to the tumor;
receiving an intraprocedural image data set;
updating a relative position of the tumor and the navigation catheter in the reduced 3D model based on the intraprocedural image data set;
displaying in the reduced 3D model the navigation catheter advanced into the tumor;
receiving a second intraprocedural image data set depicting the navigation catheter with respect to the tumor;
receiving an indication that an ablation catheter has been advanced through the navigation catheter; and
initiating ablation of the tumor.

### Claim 2 (depends on 1)

The system of claim 1, wherein the margin is automatically generated.

### Claim 3 (depends on 1)

The system of claim 1, further comprising determining a location of an access point on a wall of the luminal network to access the tumor, wherein the tumor is located beyond an airway wall.

### Claim 4 (depends on 3)

The system of claim 3, further comprising causing display of the access point on the user-interface at a location in the reduced 3D model.

### Claim 5 (depends on 1)

The system of claim 1, further comprising receiving an indication that the ablation catheter is properly placed in the tumor.

### Claim 6 (depends on 5)

The system of claim 5, further comprising causing display of a third intraprocedural image data set during the ablation of the tumor, wherein the intraprocedural image data set depicts a progression of the ablation.

### Claim 7 (depends on 6)

The system of claim 6, wherein the first, second, and third intraprocedural image data sets are fluoroscopic images or cone beam CT images.

### Claim 8 (depends on 7)

The system of claim 7, wherein the pathway plan is registered to the second or third intraprocedural image data sets.

### Claim 9 (depends on 8)

The system of claim 8, further comprising causing;
display of at least a portion of the pathway plan, an access point, the tumor, or the margin on the second or third intraprocedural image data set;
display of an ablation zone on the third intraprocedural image data set; and
receiving an instruction to adjust the ablation zone before initiating the ablation.

### Claim 10 (depends on 1)

The system of claim 1, further comprising, receiving an indication of critical structures in the 3D model, wherein the critical structures are overlaid on the first or second intraprocedural image data set.

### Claim 11 (depends on 1)

The system of claim 1, wherein during the first or second intraprocedural image data set acquisition certain frames of the image data set are skipped to reduce a radiation dose of the imaging.

### Claim 12 (depends on 1)

The system of claim 1, further comprising receiving an indication of critical structures or key structures and a minimum distance to maintain from the critical structures or key structures.

### Claim 13

A system for planning and navigation of a luminal network comprising:
a navigation catheter configured for insertion into a luminal network of a patient;
a sensor associated with the catheter for detecting a position of the navigation catheter within the luminal network of the patient;
an ablation catheter configured for receipt into the navigation catheter; and
a computing device including a memory and a processor, the memory storing one or more applications that when executed by a processor:
causes display of a 3D model of the luminal network of a patient, the 3D model including airways and blood vessels of the luminal network, a pathway through the luminal network, a tumor including a margin, and where the tumor is located beyond an airway wall an access point, and a position of the catheter within the luminal network of the patient based on the detected position of the sensor;
reduces the 3D model to an airway generation level wherein the generation level is a selected number of generations beyond an identified point in an airway;
receives intraprocedural images; and
overlays at least a portion of the reduced 3D model onto the intraprocedural images.

### Claim 14 (depends on 13)

The system of claim 13, wherein the intraprocedural images are caused to display on a user-interface as the ablation catheter is inserted into the tumor.

### Claim 15 (depends on 14)

The system of claim 14, wherein prior to insertion of the ablation catheter an ablation zone, determined prior to a therapy procedure, is displayed on the intraprocedural images and the ablation zone may be adjusted prior to initiation of the ablation.

### Claim 16

A method comprising:
receiving a computed tomography (CT) image data set;
generating a three-dimensional (3D) model:
causing to display the 3D model in a user-interface on a display operatively connected to a computing device;
receiving an indication of a location of a tumor in the CT image data set;
causing display of the location of the tumor in the 3D model;
reducing the 3D model to an airway generation level wherein the generation level is a selected number of generations beyond an identified point in an airway;
receiving an indication of a margin around the tumor to achieve a desired therapy;
generating a pathway plan to the tumor for navigation of a catheter;
receiving a location of a sensor associated with a navigation catheter and registering the CT image data set with a luminal network of a patient;
causing to display the location of the sensor within the reduced 3D model that substantially corresponds to the location of the sensor within the luminal network of the patient;
causing to display, following the pathway plan, the navigation of the navigation catheter to tumor;
receiving an intraprocedural image data set;
updating a relative position of the tumor and the navigation catheter in the reduced 3D model based on the intraprocedural image data set;
causing to display in the reduced 3D model the navigation catheter advanced into the tumor;
receiving a second intraprocedural image data set depicting the navigation catheter with respect to the tumor;
receiving an indication that an ablation catheter has been advanced through the navigation catheter; and
initiating ablation of the tumor.

### Claim 17 (depends on 16)

The method of claim 16, further comprising determining a location of an access point on a wall of the luminal network to access the tumor, wherein the tumor is located beyond an airway wall.

### Claim 18 (depends on 1)

The system of claim 1, wherein the identified point in the airway is the trachea.

### Claim 19 (depends on 13)

The system of claim 13, wherein the identified point in the airway is the trachea.

### Claim 20 (depends on 15)

The system of claim 15, wherein the identified point in the airway is the trachea.