# US 9,433,383 B2 · Image-guided therapy of a tissue

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- Number: US 9,433,383 B2
- Document ID: US9433383B2
- Status: Granted
- Kind: B2
- Application number: 14/661,138
- Filed: 2015-03-18
- Published: 2015-09-24
- Granted: 2016-09-06
- Earliest claimed: 2014-03-18
- Assignees: Monteris Medical Corporation
- Applicants: Monteris Medical Corporation
- Inventors: Eric Andrews; Mark Grant; Brooke Ren; Richard Tyc
- Web page: https://patentgrep.com/patent/US9433383B2

## CPC

- A61B 90/14: Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
- A61B 5/0042: {for the brain}
- A61B 5/015: {By temperature mapping of body part}
- A61B 5/055: involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
- A61B 5/4839: {combined with drug delivery}
- A61B 5/702: {Posture restraints}
- A61B 5/742: {using visual displays (displays for heart-related electrical signals, e.g. ECG, A61B5/339)}
- A61B 5/748: {Selection of a region of interest, e.g. using a graphics tablet}
- A61B 6/032: {Transmission computed tomography [CT]}
- A61B 6/04: Positioning of patients; Tiltable beds or the like
- A61B 6/0421: {with immobilising means}
- A61B 6/0492: {using markers or indicia for aiding patient positioning}
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/1703: {using imaging means, e.g. by X-rays}
- A61B 17/1739: {specially adapted for particular parts of the body}
- A61B 17/3403: {Needle locating or guiding means}
- A61B 18/04: by heating (by applying electromagnetic radiation A61B18/18)
- A61B 18/1477: {Needle-like probes}
- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61B 18/22: the beam being directed along or through a flexible conduit, e.g. an optical fibre; {Couplings or} hand-pieces therefor
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- A61B 34/20: Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B 90/11: with guides for needles or instruments, e.g. arcuate slides or ball joints
- A61B 90/37: {Surgical systems with images on a monitor during operation}
- A61B 90/50: Supports for surgical instruments, e.g. articulated arms
- A61F 5/37: Restraining devices for the body or for body parts; Restraining shirts
- A61F 5/3707: {for the head (cervical supports A61F5/055; splints A61F5/05883)}
- A61N 5/062: {Photodynamic therapy, i.e. excitation of an agent}
- A61N 7/02: Localised ultrasound hyperthermia
- A61N 7/022: {intracavitary}
- A61B 5/0035: {adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography}
- A61B 5/01: Measuring temperature of body parts {; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue} (clinical contact thermometers G01K13/20)
- A61B 2018/00011: {with fluids}
- A61B 2018/00321: {Head or parts thereof}
- A61B 2018/00446: {Brain}
- A61B 2018/00791: {Temperature}
- A61B 2018/0293: {using an instrument interstitially inserted into the body, e.g. needle}
- A61B 2018/1869: {with an instrument interstitially inserted into the body, e.g. needles}
- A61B 2018/20361: {with redirecting based on sensed condition, e.g. tissue analysis or tissue movement}
- A61B 2034/107: {Visualisation of planned trajectories or target regions}
- A61B 2034/2051: {Electromagnetic tracking systems}
- A61B 2034/2065: {Tracking using image or pattern recognition}
- A61B 2090/103: {Cranial plugs for access to brain}
- A61B 2090/374: {NMR or MRI}
- A61B 2090/3954: {magnetic, e.g. NMR or MRI}
- A61B 2576/026: for the brain
- A61N 5/1048: {Monitoring, verifying, controlling systems and methods}
- A61N 2005/1051: {using an active marker}
- A61N 2005/1055: {using magnetic resonance imaging [MRI]}
- A61N 2005/1097: {Means for immobilizing the patient}
- A61N 2007/003: {Destruction of nerve tissue}
- A61N 2007/0047: {interstitial}
- A61N 2007/025: {interstitial}
- G16H 30/40: for processing medical images, e.g. editing
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

In one aspect, the present disclosure relates to a head fixation apparatus including a number of support posts, and a curved ring portion including a number of connectors configured to adjustably and releasably mount support posts on the lower ring portion, such that the support posts are selectively mounted to a subset of the connectors in a customized arrangement for a patient. The apparatus may include a ring mount configured for fixation to a platform, including a curved channel substantially matching a curvature of the curved ring portion, and a mount locking mechanism for locking the curved ring portion within the channel of the ring mount. The curved ring portion may be configured to rotate within the channel of the ring mount while the ring mount is fixed to the platform, an angular head position of the patient being selectably adjustable while the patient is laying on the platform.

## Claims

### Claim 1

A head fixation apparatus comprising:
a plurality of support posts for supporting a head of a patient;
a curved ring portion including a lower ring portion, the curved ring portion comprising a plurality of connectors configured to adjustably and releasably mount the plurality of support posts on the lower ring portion, such that the plurality of support posts are selectively mounted to a subset of the plurality of connectors in a customized arrangement for the patient;
a ring mount configured for fixation to a platform, wherein the ring mount comprises a curved channel substantially matching a curvature of the curved ring portion; and
a mount locking mechanism for locking the curved ring portion mounted within the channel of the ring mount;
wherein,
the curved ring portion is configured to rotate within the channel of the ring mount while the ring mount is fixed to the platform, an angular head position of the patient being selectably adjustable while the patient is laying on the platform, and
the mount locking mechanism is configured to lockably engage the curved ring portion within the channel of the ring mount upon positioning of the angular head position of the patient.

### Claim 2 (depends on 1)

The head fixation apparatus of claim 1, wherein the curved ring portion and the ring mount channel are semicircular.

### Claim 3 (depends on 1)

The head fixation apparatus of claim 1 wherein the curved ring portion further comprises an upper ring portion including an upper locking mechanism, and
wherein the curved ring portion comprises a lower locking mechanism configured to mate with the upper locking mechanism such that the upper ring portion and the lower ring portion are adapted to encircle the head of the patient.

### Claim 4 (depends on 3)

The head fixation apparatus of claim 3, wherein the upper ring portion comprises a nose indent in which a nose of the patient aligns when the head of the patient is positioned in the head fixation apparatus.

### Claim 5 (depends on 3)

The head fixation apparatus of claim 3, wherein the lower locking mechanism is configured to engage with the upper locking mechanism at two or more mating positions to form a head fixation ring, and
wherein an interior area of the head fixation ring is adjustable.

### Claim 6 (depends on 5)

The head fixation apparatus of claim 5, wherein one of the upper locking mechanism and the lower locking mechanism comprises a plurality of openings, and the other of the upper locking mechanism and the lower locking mechanism comprises a set screw.

### Claim 7 (depends on 5)

The head fixation apparatus of claim 5, wherein one of the upper locking mechanism and the lower locking mechanism comprises a plurality of indents, and the other of the upper locking mechanism and the lower locking mechanism comprises a spring-loaded plunger.

### Claim 8 (depends on 3)

The head fixation apparatus of claim 3, further comprising:
at least one additional upper ring portion, wherein one of the upper ring portion and the additional upper ring portion is selected based on a size of the head of the patient.

### Claim 9 (depends on 3)

The head fixation system of claim 3, wherein the upper ring portion comprises a plurality of upper support posts, wherein each of the plurality of upper support posts comprises a respective fixation mechanism configured to fix a position of the head of the patient.

### Claim 10 (depends on 1)

The head fixation apparatus of claim 1, wherein each of the plurality of support posts includes at least one connection point that releasably connects to a respective fixation mechanism that fixes a position of the head of the patient.

### Claim 11 (depends on 10)

The head fixation apparatus of claim 10, wherein the respective fixation mechanism is one of a conforming abutment and a fixation pin.

### Claim 12 (depends on 10)

The head fixation apparatus of claim 10, wherein each of the plurality of support posts includes a plurality of connection points, and
wherein positioning of the respective fixation mechanism upon the respective support post is adjustable.

### Claim 13 (depends on 12)

The head fixation apparatus of claim 12, wherein the plurality of connection points are positioned upon each of the plurality of support posts in an arrangement providing at least one of a plurality of linear connection options and a plurality of radial connection options for connecting the respective fixation mechanism to the respective support post.

### Claim 14 (depends on 1)

The head fixation apparatus of claim 1, wherein the mount locking mechanism comprises a clamp, and
wherein the angular head position is continuously adjustable by rotating the curved ring portion within the channel to a desired angular head position.

### Claim 15 (depends on 1)

The head fixation apparatus of claim 1, wherein the curved ring portion comprises a plurality of mating features for mating with the mount locking mechanism.

### Claim 16

A head fixation system for immobilizing a head of a patient, comprising:
a plurality of support posts, wherein each of the plurality of support posts includes a plurality of connection points for releasable connection of a respective fixation mechanism to fix a position of the head of the patient, such that positioning of the respective fixation mechanism upon the respective support post is adjustable; and
a curved ring portion including a lower ring portion, the curved ring portion comprising a plurality of connectors configured to adjustably and releasably mount the plurality of support posts on the lower ring portion, such that the plurality of support posts are selectively mounted to a subset of the plurality of connectors in a customized arrangement for a patient,
wherein the plurality of support posts are selectively positioned in a plurality of support post mounting slots arranged radially along the lower ring portion, to support the head of the patient.

### Claim 17 (depends on 16)

The head fixation system of claim 16, further comprising:
a ring mount configured for fixation to a platform, wherein the ring mount comprises a curved channel substantially matching a curvature of the curved ring portion; and
a mount locking mechanism for locking the curved ring portion within the channel of the ring mount,
wherein the curved ring portion is configured to rotate within the channel of the ring mount while the ring mount is fixed to the platform, an angular head position of the patient being selectably adjustable while the patient is laying on the platform, and
wherein the mount locking mechanism is configured to lockably engage the curved ring portion within the channel of the ring mount upon positioning of the angular head position of the patient.

### Claim 18 (depends on 17)

The head fixation system of claim 17, wherein the curved ring portion includes an upper ring portion configured to releasably mate with the lower ring portion to encircle the head of the patient, and
wherein at least one of the lower ring portion and the upper ring portion comprises at least one fiducial marker, such that, upon positioning the angular head position of the patient and lockably engaging the curved ring portion with the mount locking mechanism, the at least one fiducial marker identifies the angular head position within the channel of the ring mount.

### Claim 19 (depends on 18)

The head fixation system of claim 18, further comprising:
a memory having instructions stored thereon, wherein the instructions, when executed, cause a processor to:
identify, within one or more images, the at least one fiducial marker, and calculate, based upon a position of the at least one fiducial marker, an angle of rotation of the head fixation system.

### Claim 20 (depends on 19)

The head fixation system of claim 19, wherein the one or more images comprise magnetic resonance (MR) images.

### Claim 21 (depends on 19)

The head fixation system of claim 19, wherein the instructions, when executed, cause the processor to present a model on a graphical user interface, based upon the calculated angle of rotation of a patient positioning relative to a neurosurgical apparatus.