# US 2013/0158346 A1 · Catheterscope 3D Guidance and Interface System > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2013/0158346 A1 - Document ID: US20130158346A1 - Status: Published application - Kind: A1 - Application number: 13/742,889 - Filed: 2013-01-16 - Published: 2013-06-20 - Earliest claimed: 2003-12-12 - Assignees: University of Washington - Inventors: Timothy D. SOPER; Robb W. GLENNY; Eric J. SEIBEL - Web page: https://patentgrep.com/patent/US20130158346A1 ## CPC - A61B 1/005: Flexible endoscopes - A61B 1/000096: {using artificial intelligence} - A61B 1/00016: {using wireless means} - A61B 1/00045: {Display arrangement} - A61B 1/00097: {Sensors} - A61B 1/00172: {with means for scanning} - A61B 1/07: using light-conductive means, e.g. optical fibres - A61B 1/2676: {Bronchoscopes} - 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 5/062: {using magnetic field} - A61B 5/065: {Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe} - A61B 5/066: {Superposing sensor position on an image of the patient, e.g. obtained by ultrasound or x-ray imaging} - A61B 5/08: Measuring devices for evaluating the respiratory organs - A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis - A61B 5/0816: {Measuring devices for examining respiratory frequency (measuring frequency of electric signals G01R23/00)} - A61B 5/7285: {for synchronizing or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal} - A61B 6/541: {involving acquisition triggered by a physiological signal} - A61B 2034/2051: {Electromagnetic tracking systems} - A61B 2090/3762: {using computed tomography systems [CT]} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Visual-assisted guidance of an ultra-thin flexible endoscope to a predetermined region of interest within a lung during a bronchoscopy procedure. The region may be an opacity-identified by non-invasive imaging methods, such as high-resolution computed tomography (HRCT) or as a malignant lung mass that was diagnosed in a previous examination. An embedded position sensor on the flexible endoscope indicates the position of the distal tip of the probe in a Cartesian coordinate system during the procedure. A visual display is continually updated, showing the present position and orientation of the marker in a 3-D graphical airway model generated from image reconstruction. The visual display also includes windows depicting a virtual fly-through perspective and real-time video images acquired at the head of the endoscope, which can be stored as data, with an audio or textual account. ## Claims ### Claim at position 1 -10. (canceled) ### Claim 11 A system for visually guiding a flexible endoscope through linked passages within a body, comprising: a sensor that produces an output signal indicating coordinates that define a three-dimensional disposition of a distal end of the flexible endoscope; a processor configured to determine positions of branching points of a three-dimensional model of linked passages and to provide indicators that indicate positions of branching points on the three dimensional model; and a display for displaying a view from within the linked passages as the flexible endoscope is advanced therethrough, to enable the flexible endoscope to be visually guided and tracked along a path through the linked passages, wherein the output signal indicates coordinates that define a disposition of the distal end of the flexible endoscope relative to the three-dimensional model as the flexible endoscope is advanced and wherein the display to shows a current position of the endoscope relative to the three-dimensional model of the linked passages. ### Claim 12 (depends on 11) The system of claim 11, wherein the processor and display are configured for a user to identify bifurcations of the three-dimensional model based on the view from within the passage in order to confirm alignment of the disposition of the distal end with the three-dimensional model. ### Claim 13 (depends on 11) The system of claim 11, wherein the processor and the display are configured to provide said three-dimensional model on said display to enable determining at least an initial path along which to advance the flexible endoscope through the three-dimensional model of the linked passages. ### Claim 14 (depends on 11) The system of claim 11, wherein the three-dimensional model is derived from an image of a portion of a body in which the linked passages are disposed, the model providing an indication of an orientation and a disposition of the linked passages relative to a specific anatomical feature. ### Claim 15 (depends on 11) The system of claim 11, further comprising a signal source, the signal source comprising an electromagnetic field source, and wherein the signal source and sensor together comprise at least five coils configured to sense at least a three-dimensional position of a distal portion of the flexible endoscope relative to the electromagnetic field source. ### Claim 16 (depends on 15) The system of claim 15, wherein the sensor comprises at least one coil configured to sense both a three-dimensional position and an orientation of the distal portion of the flexible endoscope. ### Claim 17 (depends on 11) The system of claim 11, further comprising a body function sensor configured to be disposed adjacent to one of a sternum, a thorax, and a mouth of a patient, to monitor at least one of breathing, a chest orientation, and a deformation of airways of a patient, for at least one of updating the three-dimensional model in regard to changes caused by at least one body function, and gating a determination of a disposition of the distal end of the flexible endoscope in regard to the at least one body function. ### Claim 18 (depends on 11) The system of claim 11, wherein the flexible endoscope includes a vibrating optical fiber that scans a region adjacent to the distal end of the flexible endoscope, producing a signal that is used to drive the display. ### Claim 19 A method for guiding a flexible endoscope through linked passages within a body, the method comprising: creating a three-dimensional model of the linked passages; using the flexible endoscope for imaging a region of the linked passages that is adjacent to the distal end of the flexible endoscope, to display an image of the region; producing an output signal at the end of a flexible endoscope, the output signal indicating coordinates that define a disposition of the distal end of the flexible endoscope relative to the three-dimensional model as the flexible endoscope is advanced; and advancing the distal end of the flexible endoscope through the linked passages along a path determined at least in part by the image of the region and the output signal. ### Claim 20 (depends on 9) The method of claim 9, wherein the processor and display are configured for a physician to identify bifurcations of the three-dimensional model based on the image of the region in order to confirm alignment of the disposition of the distal end with the three-dimensional model. ### Claim 21 (depends on 19) The method of claim 19, wherein the step of providing the external tracking signal comprises the step of transmitting an electromagnetic signal that penetrates the patient's body, the electromagnetic signal providing a three-dimensional reference for determining the position of the distal end of the flexible endoscope relative to the linked passages, as indicated by the output signal. ### Claim 22 (depends on 19) The method of claim 19, wherein the step of tracking further comprises the step of determining a position of the distal end of the flexible endoscope relative to the linked passages using the three-dimensional reference provided by the electromagnetic signal. ### Claim 23 (depends on 19) The method of claim 19, further comprising the step of providing a three-dimensional model of the linked passages for use in tracking the disposition of the distal end of the flexible endoscope. ### Claim 24 (depends on 23) The method of claim 23, wherein the step of providing the three-dimensional model comprises the steps of: (a) non-invasively imaging the patient's body where the linked passages are disposed; and (b) producing the three-dimensional model from the image of linked passages within the patient's body. ### Claim 25 (depends on 24) The method of claim 24, wherein the step of advancing comprises the steps of: (a) establishing an arbitrary reference point relative to the three-dimensional model for use in determining the path through the linked passages; (b) with regard to the arbitrary reference point, establishing three-dimensional model frame coordinates for bifurcations in the linked passages and the desired location; and (c) determining at least a portion of the path through the linked passages to the desired location, by reference to the three-dimensional model frame coordinates and by visually detecting each bifurcation as the distal end of the flexible endoscope is advanced through the linked passages. ### Claim 26 (depends on 25) The method of claim 25, wherein the step of advancing further comprises the steps of: (a) displaying a graphic image of the three-dimensional model; and (b) indicating a position of the distal end of the flexible endoscope on the graphic image, where the position is determined from the output signal. ### Claim 27 (depends on 25) The method of claim 25, wherein the step of advancing further comprises the steps of: (a) plotting the path of the distal end of the flexible endoscope as a virtual fly-through of the three-dimensional model before advancing the flexible endoscope through the linked passages; and (b) resolving a direction to take at each bifurcation of the linked passages in the graphic image that is displayed in real-time as the flexible endoscope is advanced through the linked passages, using the model and through direct comparison of the path that was plotted with the position of the distal end of the flexible endoscope indicated on the graphic image.