WO2021010934A1

WO2021010934A1 - X-ray diagnostic apparatus based on cone-beam computed tomographic scanner for extremities examination

Info

Publication number: WO2021010934A1
Application number: PCT/UA2020/000066
Authority: WO
Inventors: Sergii MIROSHNYCHENKO; Andrii NEVGASYMYI
Original assignee: Miroshnychenko Sergii; Nevgasymyi Andrii
Priority date: 2019-07-12
Filing date: 2020-07-10
Publication date: 2021-01-21

Abstract

X-RAY DIAGNOSTIC APPARATUS based on cone-beam computed tomographic scanner for extremities examination comprises a vertical pedestal base (1); a vertical ring-like support (2) of opposite a controllable X-ray source (3) and a digital X-ray receiver (4); a swinging movement drive (5) of the support (2); a switch (6) of operation mode 'tomography - fluoroscopy' and back; a reciprocal vertical movement drive (7) of the support (2); a controllable power supply (8); a control unit (9), a sensor (13) of actual position and a presetter (14) of required positions of the support (2). This allows easy insertion of immobilized lying animals into space within the ring-like support (2) and execute a preliminary tomographic examination and a periodic fluoroscopy during surgical operations.

Description

X-RAY DIAGNOSTIC APPARATUS BASED ON

CONE-BEAM COMPUTED TOMOGRAPHIC SCANNER

FOR EXTREMITIES EXAMINATION

Field of the Invention

This invention relates to the structure of X-ray diagnostic apparatuses based on cone-beam computed tomographic scanners for combined (tomographic and fluoroscopic) extremities examination of big animals when are immobilized. Such apparatuses can be used preferably for monitoring of progress and fate of surgical treatment of traumata and diseases of legs of sports horses and bovine animals.

Background Art

Sports horses and pedigree stocks (especially begetters) of bovine animals have appreciated value. Thus owners of such animals are vitally interested in timely diagnostics of their traumata and diseases, which fall on legs up to 80%. Injuries of sports horses’ legs occur especially during contests and trainings.

Up to date such diagnostics is carrying out using traditional fluoroscopes adapted to veterinary needs. However even several radiographs made from a few directions are not enough informative in comparison with series of 2-D (and all the more 3-D) images of slices that can be obtained by computed tomographic scanners.

Therefore such scanners are using quite often in veterinary medicine.

E.g. , the website <http://equine4ddi.com> discloses a robotized computed tomographic scanner for examination of big animals in toto. It comprises - a pedestal base, which must be rigidly fixed onto external basis before operation; a platform that is located on said pedestal base and has a controllable drive of rotation around a vertical axle;

a boom that is mounted on said platform and having a controllable drive of rotation around a horizontal axle;

a controllable rotary support mounted on the boom distal end;

X-ray units, i.e. a controllable X-ray source and a digital X-ray receiver, which are connected kinematically with said support and equipped with own drives of adjusting displacement for the purpose of their permanently opposite position during each diagnostic session;

a power supply of said drives of said X-ray units;

a program-control unit of said drives and said X-ray source;

a data processing unit connected with said digital X-ray receiver output, and cables for connection of said units.

Such apparatus allows effective examination of any body part of any big animal (even giraffes and elephants) in standing position and in lying position when they are immovable. However it is very difficult-to-make, unserviceable, massive and cumbrous. Therefore use of it only for legs examination is unreasonable.

WO 2018106206 discloses a low-size movable X-ray apparatus for computer tomosynthesis for examination of livestock legs. It comprises:

a controllable X-ray emitter equipped with a drive for linear movement during each diagnostic session,

a digital X-ray receiver that is immovably installed in operative position contrariwise the X-ray emitter,

a supporting assembly that is shaped in the form of a rectangular framework having rigidly connected front and rear frames and equipped inside with horizontal guide members, a carriage that translatably supported by said guide members, and a sited onto said carriage rotary holder of said X-ray emitter, at that a lower part of said front frame has a bracket, to which said X-ray receiver is fixed in operative position, at least one off-line power supply,

a control unit and a data processing unit, which have realized together in the form of a personal computer (PC) that is connected with the said X-ray emitter data input through wireless channel, and with a data input and a data output of said X-ray receiver through a bidirectional cable.

This apparatus is easy-to-use for tomographic examination of legs of horses and other livestock in standing position even in field conditions, but unsuitable for tomography and fluoroscopy of legs of immobilized animals in lying position.

The background art includes also relatively low-size simple in structure and widespread X-ray diagnostic apparatuses in the form of so called cone-beam computed tomographic scanners (in abbreviated form CBCT).

Each such scanner has a vertical pedestal base and placed on this base a ringlike support which is kinematically connected to a rotary drive and on which a controllable X-ray source and a X-ray receiver are oppositely fixed [see for example: 1. De Cock J., Mermuys K., Goubau J., Van Petegem S., Houthoofd B., Casselman J.W. Cone-beam computed tomography: a new low dose, high resolution imaging technique of the wrist, presentation of three cases with technique // Skeletal Radiology. 2012, V.41 , pp. 93-96; 2. Ramdhian-Wihlm R., Le Minor J. M., Schmittbuhl M., Jeantroux J., Mac Mahon P., Veillon F., Dosch J.-C., Dietemann J.-L, Bierry G. Cone-beam computed tomography arthrography: an innovative modality for the examination of wrist ligament and cartilage injuries II Skeletal Radiology. 2012, V. 41 , pp. 936-969; 3. US 7224769; 4. US 2013/0243151 A1 ; 5. US 9420977 and many other].

As a rule, openings in said annular supports no exceed size of adult human head. Therefore such tomographs are used usually for examination of cartilages, bones of hands and feet, articulations of extremities, brainpans (including dentitions) and other small parts of people, while they are suitable in principle for tomographic diagnostics of traumata and diseases of legs of horses and other livestock.

For instance, US 2010/0278300 A1 discloses such cone-beam computed tomographic scanner that is used for examination of human hands and legs and is suitable for examination of animals’ legs. It has :

two parallel vertical column bases;

an outer ring-like support of a controllable X-ray source and an inner ring-like support of a digital X-ray receiver, which has arranged concentrically relative to the outer ring-like support, at that these supports are arranged between said column bases and each of theirs has a vertical through gap;

a controllable drives of swinging movement of these supports around vertical geometrical axis;

a synchronizer of said drives of swinging movement that secures diametrical opposition of said X-ray units during each diagnostic session;

a controllable drive of synchronous vertical displacement of said X-ray units along an examined extremity;

a power supplies of said X-ray source and said drives of displacement of both said X-ray units;

a control unit of said X-ray source and said drives;

a data processing unit connected to the X-ray receiver; and

cables for connection of said units.

In initial position the vertical gaps of said X-ray units’ ring-like supports of the known apparatus are oriented uniformly. It allows inserting legs of standing animals into examination zone without lifting.

Unfortunately, use of two separate concentrically arranged massive ring-like supports of the X-ray units and an elaborate hardware-software complex for control of their synchronous movement complicate the known apparatus substantially and make such apparatus too massive and bulky . Moreover, it is unsuitable for examination of legs when an immobilized (particularly narcotized) animal is in lying position.

The website <http://live.russia.tv/index/index/channel_id/3> discloses a more simple floor-standing computed tomographic scanner that is named as ‘Planmed Verity® Extremity Scanner’, meant for extremities examination (especially of human legs in standing position) and is closest constructively to the proposed further apparatus. It has an undetachable during operation housing having a central opening, dimensions of which are sufficient for pass of the biggest human foot, and a horizontally arranged within this housing ring-like rotational support, on which a X-ray source and digital X-ray receiver are fixed oppositely.

This apparatus can be used in principle as a tomographic scanner when said support together with said X-ray units rotates, and as a fluoroscope when said support will be stopped in specified positions relative to an extremity of an examined patient (i.e. a human of an animal).

However, examination of animals’ legs with such apparatus is possible only under condition that own sore leg of each animal should be lifted and then inserted it from above into said opening. It is clear that such active movements of injured or diseased legs are rather complicated (and often are unrealizable). Moreover, this known apparatus is unsuitable for monitoring of progress and fate of legs surgical operations when an immobilized animal lies on a surgical table.

Summary of the Invention

The invention is based on the problem - by way of structure improvement - to create on the basis of a cone-beam computed tomographic scanner such compact and simple in production and sen/ice X-ray diagnostic apparatus for extremities examination, which would be suitable for preoperational tomography and fluoroscopic monitoring of progress and fate of any surgical operation.

This problem has solved in that an X-ray diagnostic apparatus based on cone- beam computed tomographic scanner for extremities examination according to the invention which comprises

a vertical pedestal base;

a vertically oriented ring-like support that is kinematically connected with an upper part of said vertical pedestal base;

a controllable X-ray source and a digital X-ray receiver, which are oppositely fixed onto said ring-like support;

a controllable drive of swinging movement of said ring-like support;

a switch of operation modes‘tomography - fluoroscopy’ and back of said X-ray source and said drive of swinging movement;

a controllable drive of vertical reciprocal adjusting displacement of said ring-like support relative to the said vertical pedestal base;

a controllable power supply of said X-ray source and said drives of swinging and reciprocal displacement of the ring-like support;

a control unit having first and second data inputs, to which a sensor of actual position and presetter of required positions of said ring-like support are connected respectively, third data input, to which said switch of operation modes is connected; and one control output, to which said power supply is connected; and

a data processing unit connected to the digital X-ray receiver output.

Such apparatus is easy-to-produce and serviceable, allows easily insertion of legs of lying immobilized animals into space within said ring-like support of said X-ray units and is suitable for primary tomographic examination and for periodic fluoroscopy during surgical operations. First additional feature consists in that the vertical pedestal base is equipped with means for its horizontal displacement and fixation in operative position. This allows to take into account concrete dimensions and disposition of examined legs and to move the X-ray diagnostic apparatus between several operating rooms or between surgical tables within one operating room.

Second additional feature consists in that the ring-like support is equipped with such drive for its horizontal adjusting movement along own geometrical axis, which is connected to the said controllable power supply. This facilitates examination of practically whole animals’ legs.

Third additional feature consists in that the ring-like support has a gap sufficient for free pass of an examined leg. This facilitates insertion of examined legs into space within said support.

Fourth additional feature consists in that mentioned gap is located in upper part of the ring-like support. This provides above-mentioned insertion by vertical adjusting displacement of said support.

Fifth additional feature consists in that the mentioned gap is located in lateral part of the ring-like support. This provides above-mentioned insertion by horizontal adjusting displacement of said pedestal base.

Brief Description of the Drawings

The invention will now be explained by detailed description of its structure and operation with references to the accompanying drawings, in which:

Fig. 1 shows a X-ray diagnostic apparatus based on a cone-beam computed tomographic scanner for extremities examination (lateral view that supplemented by conditionally showed a switch of operation modes and units meant for power supply, control and data processing);

Fig. 2 shows the same X-ray diagnostic apparatus (frontal view that supplemented also by conditionally showed a switch of operation modes and units meant for power supply, control and data processing);

Fig. 3 shows a block diagram of power supply and control of said apparatus;

Fig. 4 shows the X-ray diagnostic apparatus in operative position.

Best Embodiments of the Invention

The proposed X-ray diagnostic apparatus comprises (see Fig. 1):

a vertical pedestal base 1 that can be as a rule horizontally movable and suitable for fixation in required position;

a vertically oriented ring-like support 2 that kinematically connected with upper part of said vertical pedestal base 1 ;

X-ray units, i.e. a controllable X-ray source 3 and a digital preferably multisensor X-ray receiver 4, which are oppositely fixed onto said ring-like support 2; a controllable drive 5 for swinging movement of the ring-like support 2 (that can be made, e.g., on the basis of a stepping motor and a toothed belt transmission);

a switch 6 of operation modes 'tomography - fluoroscopy’ and back;

a controllable drive 7 of vertical reciprocal adjusting movement of the ring-like support 2 relative to the vertical pedestal base 1 (this drive 7 is symbolically showed by a straight bidirectional arrow);

a controllable power supply 8, to which said X-ray source 3 and said drive 5 of swinging movement and said drive 7 of reciprocating movement of the ring-like support 2 are connected;

a control unit 9 of said power supply 8 that is able to operate in manual and automatic modes, and

a data processing unit 10 that is based usually on a personal computer having respective software and is connected to the output of said X-ray receiver 4.

The vertical pedestal base 1 can be horizontally moving either by manual carrying or by at least three wheels 1 1 , which are mounted in well-known P-shaped holders that are able to turn relative to their vertical axles, at that at least one such wheel 1 1 has a not showed here brake for stopping of the X-ray diagnostic apparatus in required operative position. These P-shaped holders can be kinematically connected either immediately with the vertical pedestal base 1 underside, or with an intermediate supporting carrier.

It is reasonable, if the ring-like support 2 showed on the Fig. 2 has a drive 12 for its horizontal adjusting movement along own geometrical axis and based especially on a stepping motor and a toothed belt transmission. It is obvious that such drive 12 must be connected to the said controllable power supply 8.

It is reasonable, if the ring-like support 2 has a gap ( not designated especially) that is sufficient for free pass of an examined leg. This gap can be located in upper (as i showed as an example) or in lateral part of the ring-like support 2.

Angular size of said gap can be up to 120°, but preferably up to 90°.

Fig. 3 shows that the control unit 9 has first and second data inputs, to which a sensor 13 of actual position and presetter 14 of required positions of said ring-like support 2 are connected, third data input, to which said switch 6 of operation modes is connected; and one control output, to which said power supply 8 is connected.

This power supply 8 ( Fig. 3) serves as a commutator having one starting input, which is connected to the control output of the control unit 9, one power input, which must be connected in operative position to AC network or to an off-line electrical power unit, and four power outputs, which are connected respectively to said X-ray source 3 and to said drives 5, 7 and 12.

The claimed X-ray diagnostic apparatus use as follows. At first it must be prepared for service. For such purpose (see Figs 1 and 2) it is carrying out the following :

(a) the vertical pedestal base 1 is delivered to a table, on which an immobilized (i.e. generally narcotized) animal lies,

(b) the ring-like support 2 is moved as nearer as possible to a selected animal’s leg by horizontal rolling of said pedestal base 1 using wheels 11 and then fixes it in desired position;

(c) the controllable power supply 8 is connected to a source of electric energy;

(d) the selected animal’s leg is inserted into inner space of the ring-like support 2, for this purpose it is provided either

by lifting support 2 by drive 7 (if above-mentioned gap located upwardly), or by preliminary lifting support 2 up to required level and then by additional horizontal rolling of said pedestal base 1 (if above-mentioned gap located on one side);

(e) optionally the ring-like support 2 is displaced by the drive 12 along the selected animal’s leg into specified zone (see Fig. 2).

Switching on of said drives (5), (7) and (12) during preparation phase can be completed using the control unit 9 in manual mode.

Typical example of such actions can be seen on Fig. 4, where two oppositely directed arrows indicating horizontal adjusting reciprocal movements of the ring-like support 2, a bidirectional arrow indicating vertical adjusting reciprocal movements of said support 2, an operating table 15, an immobilized big animal (in particular, horse) 16 that lies on said table 15, and a cable 17 for connection of the data processing unit 10 to the digital X-ray receiver 4 are additionally showed and designated.

At the beginning, a possible trauma or disease of any animal’s legs must be diagnosed (see Fig. 3). For this purpose a veterinary surgeon - sets tomographic operation mode by switch 6 and

specifies initial position and angular range of swinging movement of the ring-like support 2 using the presetter 14.

Then the control unit 9 - examines the sensor 13 about actual position of the ring-like support 2, compares measurement result and datum in order to determine value and mismatch relator,

switches on (through the controllable power supply 8) said drive 5 in start-stop mode in order to put said ring-like support 2 (and, respectively, of said X-ray units 3 and 4) into initial position;

switches on (through the controllable power supply 8) said X-ray source 3 and said drive 5 for impulse or continuous tomographic scanning of an examined leg. As the ring-like support 2 rotates, the data processing unit 10 provides generation and record tomograms on the basis of signals from the digital X-ray receiver 4 and screening of theirs.

If an animal’s leg must be examined for a significant distance, a position of the ring-like support 2 relative to said leg can be at least twice corrected by switching on of the drive 12 in manual or automatic mode.

Fluoroscopy can be realized similarly to tomographic examination with such difference that the ring-like support 2 (and, correspondingly, said X-ray units 3 and 4) displace into required positions by the drive 5 in manual start-stop mode.

Industrial applicability

Industrial applicability of the claimed invention is provided -

- firstly, by possibility of serial production of the proposed X-ray diagnostic apparatuses using available components an materials,

- secondly, by possibility of their introduction into surgical practices of veterinary clinics.

Moreover, such apparatuses can be used for equipping of mobile hospital for the purpose of human extremities examination.

Testing of pilot samples of such apparatus has evidenced its efficiency.

Claims

1. An X-ray diagnostic apparatus based on cone-beam computed tomographic scanner for extremities examination comprising

a vertical pedestal base (1);

a vertically oriented ring-like support (2) that is kinematically connected with an upper part of said vertical pedestal base (1);

a controllable X-ray source (3) and a digital X-ray receiver (4), which are oppositely fixed onto said ring-like support (2);

a controllable drive (5) of swinging movement of said ring-like support (2);

a switch (6) of operation modes 'tomography - fluoroscopy’ and back of said X- ray source (3) and said drive (5) of swinging movement;

a controllable drive (7) of vertical reciprocal adjusting displacement of said ringlike support (2) relative to the said vertical pedestal base (1);

a controllable power supply (8) for powering of said X-ray source (3), said drive (5) of swinging movement and said drive (7) of vertical reciprocal adjusting movement of said ring-like support (2);

a control unit (9) having first and second data inputs, to which a sensor (13) of actual position and presetter (14) of required positions of said ring-like support (2) are connected respectively, third data input, to which said switch (6) of operation modes is connected; and one control output, to which said power supply (8) is connected; and a data processing unit (10) connected to the digital X-ray receiver (4) output.

2. The X-ray diagnostic apparatus according to the claim 1 , in which the vertical pedestal base (1) is equipped with means for its horizontal displacement and for its fixing in operative position.

3. The X-ray diagnostic apparatus according to the claim 1 , in which the ring-like support (2) is equipped with such drive (12) for its horizontal adjusting movement along own geometrical axis, which is connected to the said controllable power supply (8).

4. The X-ray diagnostic apparatus according to the claim 1 , in which the ring-like support (2) has a gap sufficient for free pass of an examined leg.

5. The X-ray diagnostic apparatus according to the claim 3, in which said gap is located in upper part of the ring-like support (2).

6. The X-ray diagnostic apparatus according to the claim 3, in which said gap is located in lateral part of the ring-like support (2).