JP2001521772A - Multispectral / hyperspectral medical instruments - Google Patents

Abstract

(57) Abstract: A first stage optical system responsive to a tissue surface of a patient, a spectrum separator optically responsive to the first stage optical system and having a control input, and an optical system An image forming sensor having a responsive and image data output, and a diagnostic processor having an image acquisition interface having an input responsive to the image forming sensor and a filter control interface having a control output provided to a control input of the spectral separator. Medical instrument.

Description

DETAILED DESCRIPTION OF THE INVENTION

FIELD OF THE INVENTION The present invention relates to surgical and diagnostic instruments for performing general purpose, real-time imaging during surgical procedures, procedures, and other medical evaluations. BACKGROUND OF THE INVENTION Tunable acousto-optic filter (AOTF), tunable liquid crystal filter (LCTF)
Alternatively, a spectral image forming apparatus using a dispersion diffraction grating is known. Such devices have been used for microscopy and remote sensing. SUMMARY OF THE INVENTION The present invention generally provides a medical instrument that includes an optical system responsive to a tissue surface of a patient, a spectral separator optically responsive to the optical system, and an imaging sensor optically responsive to the spectral separator. Features. The instrument also includes a diagnostic processor having an image acquisition interface responsive to the image forming sensor and a filter control interface responsive to the spectral separator.

[0002] The spectral separator may be a tunable filter, such as a tunable liquid crystal filter, and the imaging sensor may be a two-dimensional imaging array, such as a charge-coupled device. The optics may include a macro lens, an adjustable lens, or a probe including an imaging fiber optic cable, and a cradle for positioning the optics relative to the patient may be connected to the optics. The control interface is operable to adjust the filter at least 20 times to obtain hyperspectral data for redisplay in real time. The medical instrument can perform a diagnostic process on an image acquired only under visible light.

A diagnostic processor may include a general-purpose processing module and a diagnostic protocol module, each of which may include a filter transfer function and an image processing protocol. The general-purpose processing module sequentially applies the filter transfer function to the light collected from the patient for the filter, and obtains from the image forming sensor a number of images of the collected light each obtained after one filter transfer function is applied. And operating to process the acquired image according to an image processing protocol to obtain a processed display image. The general-purpose processor may be a real-time processor that operates to produce a processed display image within a period of time comparable to human visual afterimages. The processor can also operate to acquire images at a slower rate, depending on the number of wavelengths and the complexity of the diagnostic processing protocol. The processor and filter can operate in the visible, infrared, and ultraviolet regions.

An instrument according to the present invention may be used by a surgeon or physician to diagnose a medical condition or to perform a surgical procedure based on real-time images obtained during a surgical procedure, during a clinical procedure, or during the course of another medical evaluation. It is beneficial in that it can allow you to make a policy. Thus, the physician can obtain significantly more information about the condition of the patient than could be assembled by providing an interactive interface. Such additional information may allow a given surgical procedure to be performed more accurately and may lead to better surgical results. It may also enhance the accuracy and results of other types of medical evaluations and procedures.

The versatility of the instrument can also help surgeons generate enormous amounts of medical information in time-critical surgical settings. For example, when a patient undergoes a relatively simple operation, a surgeon may discover a tumor or other internal condition during that time. With the instrument according to the present invention, the surgeon can spend a small amount of extra time on an anesthetized patient and can determine the nature and extent of the tumor. This is especially beneficial in large surgeries, where long surgical times impose a potential risk of morbidity and mortality. Because the procedure is quick and non-invasive, patients are at little risk of extra risk. The benefits of rapid diagnosis and evaluation are significant.

[0006] The instrument according to the present invention can also provide a wide range of diagnostic capabilities, allowing physicians to enhance their techniques in substantially different areas without investing a large number of instruments. To be able to Thus, the physician can enhance or update the instrument by the addition of software modules that are specifically targeted to a particular tissue, sub-organization, or some symptom of the disease state. This allows a single basic instrument to be configured for a variety of different types of treatment and priced according to the type of treatment provided by the instrument. For example, a general purpose instrument used by a general surgeon may include a package of diagnostic protocols that allow for the diagnosis of various situations that a general surgeon may encounter, while the specialist may be able to identify specific symptoms in the brain. A neurosurgeon's module may be added to allow detection of Electronic and optical improvements are also provided to update, specialize or improve instrument performance. Such improvements may include processing modules, memory boards, lenses, etc. DETAILED DESCRIPTION Figure 1 of the embodiment, the instrument 10 according to the present invention includes an image formation module 12 placed on the surgical platform 14. In this embodiment, the surgeon can direct the image forming unit 12 toward the patient 20 by operating the control device 16 that adjusts the posture of the image forming unit via the positioning mechanism 18.

In FIG. 2, an alternative embodiment 22 of the present invention is a fiber optic cable 2
6 includes a probe 24 for a rigid or flexible endoscope, thoracoscopy, laparoscopic or vascular microscope connected to the imaging station 30 via 6. The surgeon can operate the probe within the patient with minimally invasive surgical procedures, obtain images from one part of the patient, and display the images on the display 28. Medical means 32, such as a laser, may also be provided via the probe. For example, after diagnosing a particular condition, a physician can initiate laser ablation therapy to treat the condition.

Referring to FIG. 3, a medical instrument 34 according to the present invention includes an optical acquisition system 36 and a diagnostic processor 38. The optical acquisition system 36 includes a first stage image forming optics 40, a tunable liquid crystal filter (LCTF) 42, a second stage optics 44, and an image forming element 46. The first stage optics receives the light collected from the patient and focuses this light on the surface of the LCTF. The first stage optical system is a macroscopic instrument (
In the case of FIG. 1), a simple or composite macro lens may be used. In a probe-based instrument (FIG. 2), the first stage optics can include imaging optics within the probe, such as a probe for an endoscope, laparoscope, thoracoscopy or vascular microscope. The first stage lens is also adjustable, allowing the physician to scan a wider area of tissue before looking up a particular area.

The LCTF 42 is a programmable filter that removes all but the wavelength region of interest from light collected from the patient. The second stage optics 44 receives the remaining light from the LCTF and focuses this light on the image sensor 46. The image sensor is a charge coupled device (CC) that sends an image signal to the diagnostic processor 38.
D) A two-dimensional array sensor, such as an array, is preferred, but not required.

The diagnostic processor 38 includes an image acquisition interface 50 having an input responsive to the output of the image sensor 46 and an output provided to a general purpose operating module 54. The general purpose operating module includes routines for processing images and operating and controlling various parts of the system. This module has a control output provided to a first control interface 52, which has an output provided to the LCTF 42. The generic operating module also includes a number of diagnostic protocol modules 56A,
6B,..., 56N and has an output provided to the video display 12. The diagnostic processor may include special purpose hardware, general purpose hardware including special purpose software, or a combination of these hardware. The diagnostic processor also includes an input device 58 connected to the general purpose operating module. The storage device 60 and the printer are also connected to the general purpose operating module.

In operation, referring to FIGS. 3 and 4, a surgeon using an instrument selects a diagnostic protocol module using the instrument's input device (step 100). Each diagnostic protocol module is adapted to detect a particular property of the surface of one or more types of tissue. For example, the surgeon selects a module that emphasizes the sharpness of the cancerous tissue. The surgeon then directs the camera to the area in question and begins examining said area under ambient light or with the aid of an auxiliary light source that can be filtered to emphasize certain characteristics of the emitted light. I do.

The diagnostic processor 38 obtains a series of filter transfer functions and an image processing protocol from the selected diagnostic protocol module 56,
Respond to surgeon input. The diagnostic processor provides the transfer function for filtering to the LCTF 42 via the filter control interface 52 (step 102),
It then instructs the image acquisition interface 50 to acquire and store the resulting filtered image from the image sensor 46 (
Step 104). The general purpose operating module 54 repeats these filtering and acquisition steps one or more times depending on the number of filter transfer functions stored in the selected diagnostic protocol module (step 106). The transfer function for filtering may represent bandpass, multiple bandpass, or other filter characteristics.

[0013] Once the image acquisition interface 50 has stored images for all image planes specified by the diagnostic protocol selected by the surgeon, the interface 50 implements the image processing protocol from the selected diagnostic protocol module 56N. Based on this, processing of these image planes is started (step 10).
8). The operations of the process are combined, such as comparing the relative amplitudes of the collected light of different wavelengths, adding the amplitudes of the collected light of different wavelengths, or calculating other combinations of signals corresponding to the acquired surface. It may include general image processing of the image. Processing operations may also include more complex multivariate statistical techniques (eg, chemometrics) for calculating the image. The calculated image is displayed on the display 12. This image can also be stored in the storage device 60 or the printer 62
To print out.

[0014] Processing operations can also be based on a diagnostic knowledge base. This database can include data resulting from a comparison between the optical diagnosis and the actual diagnosis. Each instrument can also continually update its database as it is used to make a diagnosis, thereby ensuring its diagnostic capabilities are expanded.

To provide real-time or near real-time images to the surgeon, the instrument repeatedly acquires surfaces and processes these surfaces to produce an image that is displayed to the surgeon. This allows the surgeon to move the instrument or see a moving organ such as a beating heart. This constant acquisition and processing continues until the surgeon turns off the instrument (step 110) or selects a different imaging mode (step 112). Preferably, the diagnostic processor 38 has sufficient processing power to update the screen at the video rate (ie, about 30 frames / second) in this manner. However, video rates as low as a few frames per second work well, and rates as low as 1 frame per minute are suitable for many purposes. In slower instruments, cardiac gating is used to eliminate motion artifacts due to breathing or heartbeat.
For example, a general lock-in method such as the above-mentioned method or another tracking method can be used. The frame rate also varies depending on the number of wavelengths and the complexity of the diagnostic procedure.

The instrument may be a multispectral, hyperspectral, or ultraspectral.
It is desirable to be able to operate in an image forming mode. The multispectral mode involves image processing that is obtained from a relatively small number of spectral image planes (two to about twenty wavelengths). Hyperspectral and ultraspectral imaging modes include at least 20 image planes and can produce more accurate and informative results. Ultraspectral mode includes hundreds of wavelengths and can even generate more information about the patient.
Hyperspectral and ultraspectral imaging involves the selection of specific wavelength bands for discrimination of specific medical conditions, and also allows the instrument to scan multiple health conditions simultaneously.

It is also conceivable to enable both types of instrument to operate in connection with an excitation source such as an ultraviolet lamp, an infrared source or other spectral irradiation means or a laser to enhance the image received. Such excitation is not required, but allows for the examination of different optical phenomena and provides more diagnostic information. In the diagnostic procedure, both modes of radiation and reflection can be combined simultaneously or sequentially. The relative use of different emission or reflection measurement methods involved in the same diagnostic procedure can be achieved by modulating different excitation sources. The meter can also generate light from a bioluminescent source introduced to the patient.

The instrument according to the invention can also be operated to process images from image planes obtained at wavelengths outside the visible range. In certain embodiments, the instrument is sensitive in the visible and near infrared. It is also conceivable to include far-infrared radiation to allow the instrument to detect the inherent rotation mode of the molecule.

One example of operation is a diagnostic protocol module that examines about 550 first wavelengths and about 575 second wavelengths associated with oxyhemoglobin and deoxyhemoglobin to determine blood oxygen saturation. Includes use. Regarding the relationship between these wavelengths, see H.S. F. Van, B. Faget, W.C. B. Sanders' Memoglobin:
Molecular Genetics and Clinical Characteristics "(1986). Another case is B
. "Human colorectal cancer displays an abnormal Fourier transform spectrum" by Rigas et al. (Proceedings of the National Academ
y of Science, pp 8140-8144, 1987), including the use of diagnostic protocol modules to examine the Fourier transform infrared spectra of the colon and rectum.

The surgical and medical applications of the instrument according to the present invention include, but are not limited to, the viability of the tissue (ie, whether the tissue is dead or living tissue, and Determination of whether it is expected to be present), detection of tissue ischemia (eg, in the heart, or legs after gunshot wounds), discrimination between normal and malignant cells and tissues (eg, tumor Depiction of dysplasia and precaucerous tissue), detection of metastases, discrimination between infected and normal (but inflamed) tissue (eg, degree of aortic root infection), quantification of pathogens And identification (eg,
Bacterial counts of burn wounds) and other pathological conditions. Applications may also include tissue, blood chemistry and blood flow (including oxyhemoglobin and deoxygenated hemoglobin, myoglobin deoxymyoglobin, cytochrome, pH, glucose, calcium and other elements, alone or in combination with biological compounds) . The instrument can be applied to animals by a veterinarian and to dental applications such as periodontal disease by a dentist.

The present invention has been described with reference to several specific embodiments. However, many modifications that are deemed to fall within the scope of the invention will be apparent to those skilled in the art.
Therefore, the scope of the present invention shall be limited only by the appended claims.
Furthermore, the claims should not be interpreted as limiting the scope of the particular claims.

[Brief description of the drawings]

FIG. 1 is a perspective view of a visual instrument according to the present invention.

FIG. 2 is a perspective view of an instrument based on a rigid or flexible probe according to the present invention.

FIG. 3 is a block diagram of the instrument of FIG. 1;

FIG. 4 is a flowchart showing the operation of the system of FIG. 1;

[Procedure amendment]

[Submission date] January 22, 2001 (2001.1.22)

[Procedure amendment 1]

[Document name to be amended] Drawing

[Correction target item name] Figure 3

[Correction method] Change

[Correction contents]

[Procedure amendment 2]

[Document name to be amended] Drawing

[Correction target item name] Fig. 4

[Correction method] Change

[Correction contents]

──────────────────────────────────────────────────続 き Continuation of front page (81) Designated country EP (AT, BE, CH, CY, DE, DK, ES, FI, FR, GB, GR, IE, IT, LU, MC, NL, PT, SE ), OA (BF, BJ, CF, CG, CI, CM, GA, GN, GW, ML, MR, NE, SN, TD, TG), AP (GH, GM, KE, LS, MW, SD, SZ, UG, ZW), EA (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), AL, AM, AT, AU, AZ, BA, BB, BG, BR, BY, CA, CH, CN, CU, CZ, DE, DK, EE, ES, FI, GB, GE, GH, GM, HR, HU, ID, IL, IS, JP, KE, KG, KP , KR, KZ, LC, LK, LR, LS, LT, LU, LV, MD, MG, MK, MN, MW, MX, NO, NZ, PL, PT, RO, RU, SD, SE, SG, SI, SK, SL, TJ, TM, TR, TT, UA, UG, UZ, VN, YU, ZW Lane 18420 (72) Inventor Freeman, Jenny E, Lion Road, Chestnut Hill, Massachusetts, United States 02167 27F Term (Reference) 4C061 CC07 FF47 HH51 HH60 LL03 NN01 NN05 NN07 NN10 QQ02 QQ03 QQ04 QQ07 RR04 RR12 RR14 WW WW17 YY03 YY04

Claims (22)

[Claims] A first stage optics responsive to a tissue surface of a patient; a spectrum separator optically responsive to the first stage optics and having a control input; An image forming sensor responsive to the image forming sensor and having an image data output; an image acquisition interface having an input responsive to the image forming sensor; and a filter control interface having a control output applied to a control input of the spectral separator. A medical instrument comprising: a diagnostic processor; 2. The medical instrument of claim 1, wherein said spectral separator is a tunable filter. 3. The medical instrument of claim 2, wherein said spectral separator is a tunable liquid crystal filter. 4. The medical instrument according to claim 1, wherein said image forming sensor is a two-dimensional image forming array. 5. The image forming sensor according to claim 1, wherein said image forming sensor comprises a charge coupled device.
The medical instrument as described. 6. The medical instrument of claim 1, wherein said image forming sensor comprises an infrared sensitive focal plane array. 7. The medical instrument of claim 1, wherein the diagnostic processor includes a general-purpose processing module and a plurality of diagnostic protocol modules. 8. The medical instrument according to claim 1, wherein said first stage optical system is a macro lens. 9. The medical instrument of claim 1, wherein the first stage optical system is an adjustable lens. 10. The medical instrument of claim 9, further comprising a cradle connected with respect to the first stage optics for positioning the first stage optics with respect to a patient. 11. The medical instrument of claim 1, wherein the first stage optics comprises a probe including a fiber optic imaging cable. 12. The medical instrument of claim 1, further comprising a surgical instrument attached to said probe. 13. The medical instrument of claim 1, wherein the control interface is operable to adjust the filter at least 20 times to acquire and redisplay hyperspectral data in real time. 14. The general-purpose processing module, wherein the diagnostic processor includes a general-purpose processing module and a plurality of diagnostic protocol modules, each of the diagnostic protocol modules includes a plurality of filter transfer functions and an image processing protocol. Operates to instruct the filter to sequentially apply a filter transfer function to the light collected from the patient, and wherein the general purpose processing module is configured to generate the collected light obtained after one of the filter transfer functions is applied. The general-purpose processing module is operative to obtain a plurality of images from the image forming sensor, and the general-purpose processing module is operative to process the obtained images according to an image processing protocol to obtain a processed display image. Medical instruments. 15. The medical instrument of claim 14, wherein the general-purpose processor is a real-time processor operable to generate a processed display image within a period of about human visual afterglow. 16. The medical instrument of claim 14, wherein the general-purpose processor is a real-time processor operable to generate a processed display image within about one minute. 17. The medical instrument of claim 16, wherein the general purpose processor is operative to acquire images at a slower rate, depending on the number of wavelengths and the complexity of the diagnostic protocol. 18. The diagnostic processor includes a general-purpose processing module and a diagnostic protocol module, wherein the diagnostic protocol module includes a plurality of filter transfer functions and an image processing protocol for detecting one or more symptoms. The general-purpose processing module is operative to instruct a filter to sequentially apply the filter transfer function to light collected from a patient, the general-purpose processing modules each obtaining after one of the filter transfer functions has been applied. Operable to obtain a plurality of images of collected collected light from the image forming sensor; and the general-purpose processing module operates to process the obtained images according to an image processing protocol to obtain a processed display image. The medical instrument according to claim 1. 19. The medical instrument of claim 1, wherein the diagnostic processor includes a real-time processor operable to generate a processed display image within a period of time after human visual persistence. 20. The medical instrument of claim 1, wherein the diagnostic processor is operative to perform diagnostic processing on an image acquired from a light source including visible light. 21. The medical instrument according to claim 1, wherein the filter and the sensor are operable in a visible region and a far-infrared region. 22. The medical instrument of claim 1, wherein said filter and sensor are operable in the ultraviolet, visible, and infrared regions.