CN100553564C - Be used to form the apparatus and method of the cone beam volume calculation machine x-ray tomography breast image of patient's breast - Google Patents
Be used to form the apparatus and method of the cone beam volume calculation machine x-ray tomography breast image of patient's breast Download PDFInfo
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- CN100553564C CN100553564C CNB2007101849896A CN200710184989A CN100553564C CN 100553564 C CN100553564 C CN 100553564C CN B2007101849896 A CNB2007101849896 A CN B2007101849896A CN 200710184989 A CN200710184989 A CN 200710184989A CN 100553564 C CN100553564 C CN 100553564C
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Abstract
Volume tomography X mammography is undertaken by stand frame (206), and cone beam radiation source (210) and thin film detector (208) are installed on this stand frame.Patient (P) lies on the platen (202) of human engineering design, and this platen (202) porose (204) stretches out thereby allow a breast (B) to pass this hole, and like this, stand frame (206) is around this breast.The stand frame is rotatable, and like this, radiation source (210) and detector (208) move around breast (B) along circuit orbit.In addition, this stand frame (206) can for example add the track of one or more lines, perhaps spiral path to be different from the given geometric figure motion of simple circular track along circle.
Description
The application is Chinese patent application a 00817349.4 (PCT application number: PCT/US00/30239; International filing date: on November 2nd, 2000; Denomination of invention: the dividing an application apparatus and method that are used to form the cone beam volume calculation machine x-ray tomography breast image of patient's breast).
The reference of related application
The application requires the priority of the U.S. Provisional Application No.60/166223 of application on November 18th, 1999.
Technical field
The present invention relates to a kind of apparatus and method of cone beam volume calculation machine x-ray tomography breast image of the patient's of being used to form breast.
Background technology
Breast carcinoma is a very big health problem.In the U.S., diagnose out every year to surpass 180000 new case, and nearly have that 45000 women die from this disease.
The clinical purpose of breast imaging is to detect it when the tumor material is as far as possible little, and preferably diameter is less than 10mm.According to reports, the survival rate of women after 16 years of utilizing mammography to detect the invasive breast carcinoma of 1-10mm is 93%.
Common screened film mammography (mammography) is the most effective current breast carcinoma earlier detection instrument.But, mammography is relatively low for the susceptiveness that detects less breast carcinoma (less than several millimeters).The wholesomeness of mammography and positive predicted value are still restricted, because optimum and presentation malignant change will overlap.In the breast cancer detection of mammography susceptiveness and wholesomeness limited be that all types of projection imaging methods all have this problem (projection imaging only can have 10% Contrast Detection ability) because its Contrast Detection ability is lower.Common mammography differentiates that the susceptiveness of the malignant tumor that is in clinical preceding period can be subjected to the very big influence of breast soft tissue on every side naturally.It is less that calcification detects the influence that is subjected to surrounding tissue.The detection (representative detects most of tumor of the patient of cancer) of the breast material that do not have corresponding calcification is subjected to the very big influence of the essence figure of mammography.Therefore, because the contrast resolution is lower, common mammography can not directly detect several millimeters tumor usually.Common mammography needs very high resolution (50-100 μ m/ pixel) to come imaging is carried out in small calcification, so that compensate its lower contrast resolution.Mammography can not be determined at the very start to the cancer of 30%-35%.In addition, not all breast carcinoma that detects by mammography can enough early be found so that treat.Under the best circumstances, common mammography can make mortality rate reduce 50%.This is very big progress, but is also having sizable room for improvement aspect the earlier detection of breast carcinoma.
The relatively low wholesomeness of mammography causes will carrying out biopsy for uncertain case, and this bioptic shortcoming to be cost higher and make patient's anxiety.Therefore need breast lesion characteristic more accurately, so that reduce biopsy rate and bioptic positive error rate.
Breast carcinoma has the multiple radiology or the biological characteristics that can be used to carry out imaging.At first, carcinoma has the X ray linear attenuation coefficient different with surrounding tissue, as shown in Figure 1.The second, carcinoma is compared with the benign tumor of not growing much higher volume growth speed.The 3rd, the figure of carcinoma can be opened with carcinoid graphics distinction.The 4th, after phlebography agent injection, benign tumor can not demonstrate contrast and strengthen.The 5th, be formed with neovascularity and can be expressed as cancer.Common mammography mainly relies on first characteristic, and part utilizes the 3rd characteristic to carry out breast cancer detection.Because mammography is a bidimensional quiescent imaging method, it can not provide any information about feature 2,4 or 5.
At present, the radioassay of breast carcinoma is not only very important for the earlier detection of disease, and also very important for the process and the monitoring of treatment.Up to now, common screened film mammography be used for breast carcinoma earlier detection have cost-efficient instrument most.But, the wholesomeness of mammography and positive predicted value are still restricted, because optimum and presentation malignant change will overlap and the Contrast Detection ability is lower, all types of projection imaging methods all have this problem.Projection imaging only can have 10% Contrast Detection ability.Therefore, in uncertain case, need biopsy usually, although this biopsy cost is higher and make patient's anxiety.Therefore, need breast lesion characteristic more accurately, so that reduce biopsy rate.
In nearly ten years, the MRI of breast is after differentiating mammography and/or supercritical ultrasonics technology especially aspect the uncertain case after the breast surgical operation and obtaining certain effect aspect many focuses of detection breast carcinoma.But, incorporate MR into obstruction that common clinical practice also is subjected to a plurality of restrictions, this restriction comprises that long sweep time and higher MR detect cost.In addition, a lot of patients can not carry out MR, because MR contraindication (for example aneurysm clamp, pacemaker) or serious claustrophobia.
The breast lesion characteristic that MR detected is based on the different speeds of growth optimum and malignant change.Constant trading off between space in MR and the interim resolution makes it be difficult to obtain to improve the required spatial resolution of pathological changes characteristic.
Comprise that the standard fan beam computed tomography (CT) of spiral CT is considered to be used for a kind of potential instrument of breast lesion characteristic.Most of existing work are based on the common or spiral method of the scanner that utilizes the whole health of scanning.But, this method has a plurality of shortcomings, comprises remarkable increase radiating irradiation because standard CT can not to be used for only be target with the breast, like this, most of X ray is wasted in the scanning of whole health.This causes the spatial resolution (1.0lp/mm usually) in the relatively low plane, even lower flat resolution (being less than or equal to 0.5lp/mm) along direction perpendicular to section, and prolonged the volume scan time, because spiral CT scans whole volume blocks ofly, therefore whole breast scanning will spend 120 seconds.For up-to-date multi-ring spiral CT, 1mm/ section and 12cm scope will spend 15-30 second.
The resolution of ultrasound wave aspect expression pathological changes local edge and discriminating microcalciffcation is lower.Ultrasound wave also depends on operator very much.
In addition, for common mammography, extruding can improve this low contrast power of test greatly.But, even this extruding is harmless for patient, patient also can feel ill.
The method and system that the cone beam tomography X reproduces is as described in the WO99/01066.But, above-mentioned problem about mammography does not solve.
Summary of the invention
As previously mentioned, this area needs a kind of mammography imaging system and method, and this system and method has overcome the restriction of above-mentioned ordinary skill.
Therefore, main purpose of the present invention provides a kind of three-dimensional Mammography law technology that can clinical use, so that accurately detect breast carcinoma.
Another object of the present invention provides a kind of Mammography law technology, this Mammography law technology can only provide three-dimensional accurately breast analysis explanation by single quick volume scan, this three-dimensional breast analysis explanation has very high homogeneous space resolution and lesion locations, and common mammography only provides the bidimensional projected image.
Another object of the present invention provides a kind of imaging technique, so that by x-ray tomography mammary neoplasms is separated with object in other adjacent plane, thereby eliminates the overlapping situation and removes overlaying structure.
Another object of the present invention is that breast cancer detection is had than the higher contrast resolution of common mammography and enough spatial resolution.
Another object of the present invention is to improve greatly than low contrast resolution by comparing with common mammography, thereby improves the power of test to the breast carcinoma (tumor) of several millimeters sizes.
Another object of the present invention provides and makes the volume of being concerned about (VOI) have high-resolution target imaging reproduction mode, and with common mammography mutually specific energy represent the three-dimensional character of mammary neoplasms better.
Another object of the present invention provides a kind of three-dimensional x-ray tomography reproducing technology, so that detect the X ray linear attenuation coefficient of carcinoma and the difference of surrounding tissue.(the X ray linear attenuation coefficient of carcinoma is different with surrounding tissue.)
Another object of the present invention is to compare with common mammography, can accurately represent the border figure of mammary neoplasms, so that represent the characteristic (the border figure of carcinoma can differentiate with carcinoid border figure) of mammary neoplasms better.
Another object of the present invention is to compare with common mammography, by can measuring lesion volume variation in the short period of time more accurately, thereby improves the wholesomeness (carcinoma has the volume growth speed more faster than benign tumor) of breast cancer detection.
Another object of the present invention provides a kind of Mammography law technology, this technology can adopt iodine contrast vein (IV) to inject to improve and detect, and represents the characteristic (benign tumor has different contrast growth rate with malignant tumor) of mammary neoplasms better with growth rate by energy assess lesion vascularity
Another object of the present invention provides a kind of Mammography law technology, and this technology can adopt iodine contrast vein (IV) to inject, so that assess the angiogenesis of mammary neoplasms in the Noninvasive mode.
Another object of the present invention is to make patient more comfortable by reducing required breast compression amount.
Another object of the present invention is to adopt volume growth measuring technique based on the CBVCTM image (just growing and bear growth), so that definite mammary neoplasms pernicious and monitor the effect (this method also can be used for other malignant tumor, for example pulmonary carcinoma) of breast cancer treatment.
Another object of the present invention is to utilize the X ray that the X ray more used than common mammography can be higher can carry out breast imaging, so that improve penetrance, improve picture quality and reduce patient's radiation dose.
Another object of the present invention is to carry out multiresolution volume x-ray tomography by same group of projected image to reproduce, so that improve the power of test of microcalciffcation and breast carcinoma (tumor), represents the characteristic of mammary neoplasms better, thereby reduces patient's gross accumulation dosage.
Another object of the present invention is the computer-aided diagnosis technology of utilizing based on the CBVCTM image, so that improve the characteristic that power of test is also represented breast carcinoma (tumor) better.
Another object of the present invention is to improve the susceptiveness of breast cancer detection, thus by detect common mammography non-detectable less breast carcinoma further reduce the mortality rate of breast carcinoma.
Another object of the present invention improves the wholesomeness of mammography, and reduces biopsy rate greatly.
Another object of the present invention is to make picture quality be enough to be used in the Mammography of fine and close breast.
Another object of the present invention is to be convenient to by 3D rendering guided biopsy process.
Another object of the present invention is accurately to assess the canceration degree, so that carry out preoperative plan better, during especially limited excision, and more radiotherapy treatment planning is carried out on the highland, can also monitor the therapeutic effect of breast carcinoma simultaneously more accurately.
In order to realize above-mentioned and other purpose, the invention provides a kind of device of cone beam Volume CT breast image of the patient's of being used to form breast, this device comprises: the stand frame; At least one motor is used to make this stand frame motion; Radiation source, this radiation source is installed on the stand frame, so that move with this stand frame; Area detector, this area detector is installed on the stand frame, so that move with this stand frame, this area detector is arranged in the radiation channel; And supporting member, patient rests on this supporting member when gathering the breast projected image; It is characterized in that: this radiation source is the cone beam radiation source; This at least one motor makes this stand frame motion with specified data acquisition geometry figure; This device is gathered patient's cone beam Volume CT breast projected image, and this supporting member supports patient in such a way, that is, make breast be arranged between this radiation source and this area detector; This supporting member comprises a platen, and patient lies on this platen when gathering cone beam Volume CT breast projected image; This device also comprises at least one computer system, and this computer system is used to control the volume scan of breast, and the cone beam volume that carries out breast reproduces and graphical analysis; This at least one motor makes this stand frame motion, like this, rotate synchronously to be formed for the data acquisition geometric figure of cone beam volume calculation machine tomography X around the axis that passes breast by making radiation source and detector rings, thereby carry out the volume scan of breast, this volume scan causes producing picture signal; Distribute with the three-dimensional attenuation coefficient that produces breast by picture signal being carried out the reproduction of cone beam volume calculation machine tomography X, thereby described at least one computer system forms three-dimensional cone beam Volume CT image by picture signal; This platen has a breast hole at least; And this device also comprises contrast medium injector, and this contrast medium injector is by described at least one computer system control, so that injection of contrast medium; 3-D view comprises a plurality of planes, and by at least one computer system, the mammary neoplasms in a described plane is separated with other object in described planar adjacent plane by the tomography X method.
The present invention relates to a kind of system and method, this system and method comprises the cone beam volume x-ray tomography reproducing technology of the flat-panel detector that adopts latest developments, so that obtain cone beam volume calculation machine x-ray tomography mammography (CBVCTM).By cone beam geometric figure and flat-panel detector, can constitute cone beam volume calculation machine x-ray tomography mammography (CBVCTM) imaging system, and can obtain three-dimensional (3D) reproduction of breast by single quick volume scan based on flat board.Compare with common mammography, can be by x-ray tomography the object of being concerned about (for example pathological changes) be separated with object (for example other pathological changes or calcification) in the adjacent plane based on the CBVCTM system of flat board.This 3D x-ray tomography reproduces has eliminated the pathological changes overlapping, provides complete, real breast analysis 3D to show.Be 1.0lp/mm with flat resolution with the section intrinsic resolution be that the existing computed tomography (CT) of 0.5lp/mm is compared, CBVCTM reproduces can be had along the 2.0lp/mm of whole three coordinate axess or better homogeneous space resolution (or more generally being to be better than 1lp/mm).The invention still further relates to a kind of amplification mode that utilizes flat-panel detector, make volume of interest (VOI) have the reproduction of ultrahigh resolution, so that reach the resolution of 5.0lp/mm.Therefore, the comparison and detection ability of CBVCTM can be than common mammography well a lot of doubly (tomography imaging can have 0.1% Contrast Detection ability).
Can adopt various scan geometry figures.According to the size of breast, both can consider to adopt circular scan, also can consider to adopt round ledger line (CPL) scanning.But, also can adopt other geometric figure, for example spiral type.
The present invention can detect breast carcinoma better, represents the characteristic of pathological changes better, and can represent before the operation more accurately and postoperative breast profile information, thereby reduces negative biopsy rate.
The present invention has tangible clinical effectiveness in breast cancer detection, diagnosis and therapeutic effect assessment.Because good low contrast power of test and higher homogenizing resolution, the present invention has significantly improved the accuracy that breast lesion detects, thereby has reduced biopsy rate greatly.The potential clinical application of this method is carrying out imaging by the uncertain pathological changes of mammography, fine and close breast and operation rear udder attachment by mammography being carried out imaging.At present, major part is all carried out biopsy by the uncertain pathological changes of mammography, so that make a definite diagnosis.Know that also mammography is limited for the patient's that fine and close breast is arranged effect, need carry out other imaging or biopsy usually.The formation method that employing has many planes and a volume data acquisition capacity can improve to be represented the characteristic of the pathological changes in the dense breast tissue.Higher spatial resolution makes CBVCTM can improve the difference of reproduction figure and postoperative version.
The present invention is by amplifying the specific region in less pathological changes or the tumor, thereby very high-resolution tomography image is provided.Can represent the characteristic of breast lesion more accurately to the detailed diagnostics of the specific region in the pathological changes, the specific region in this pathological changes is (intraductal) zone, extension in microcalciffcation, necrosis and bladder and the pipe for example.Adopt contrast material and dynamic imaging that additional temporary information will be provided, this temporary information can improve wholesomeness and reduce biopsy rate with morphological characteristic.
Tumor-blood-vessel growth is an independently breast carcinoma omen sign.Usually, angiogenesis is definite by the microvessel density in the assessment pathology sample.But, research worker also detects between contrast enhancing and the microvessel density good mutual relation.In the formation method that very high space and interim resolution are arranged, use contrast agent that a kind of noninvasive method of assessing tumor-blood-vessel growth can be provided.In addition, the collection of 3D volume data can be carried out multiple plane imaging, and the preceding plan that can undergo surgery better, especially when carrying out limited excision.
Generally speaking, the introducing of CBVCTM has been represented the pathological changes characteristic of the uncertain pathological changes of mammography better with the probability that is used for obtaining very high spatial resolution tomography image, so that reduce biopsy rate.It also has improves the advantage preceding and that plan the operation back of performing the operation.
CBVCTM can provide about the information of front with reference to the described characteristic 1-5 of prior art, so that raising lesion detection and characteristic are represented.
In a preferred embodiment, patient lays with face downward and has on patient's platen of human engineering, and this platen has one or two breast hole.The stand that x-ray source and flat-panel detector are housed rotates below this platen, so that breast or two breast are carried out imaging.The advantage that two breast holes are arranged is the geometric figure relation that can store between the breast.In an optional embodiment, before patient stood in stand, this stand had belt, so that make patient static.
A version of the present invention has adopted the volume of being concerned about (VOI) to have the reproduction mode of ultrahigh resolution, so that focus on suspicious lesions.Ultrahigh resolution VOI reproduction mode is similar to the mammography of amplification.
CBVCTM also provides very high-resolution tomography image by the specific region in less pathological changes or the tumor is amplified.(being zone, extension in microcalciffcation, necrosis and bladder and the pipe) detailed diagnostics to specific region in the pathological changes can be represented the characteristic of breast lesion more accurately.
CBVCTM can provide a kind of noninvasive method of assessing tumor-blood-vessel growth.Nearest work shows that tumor-blood-vessel growth is an independently breast carcinoma omen sign.At present, determine angiogenesis by the microvessel density in the assessment pathology sample.But, research worker finds between contrast enhancing and the microvessel density good mutual relation is arranged.In the formation method that very high space and interim resolution are arranged, adopt contrast agent, a kind of noninvasive method of assessing tumor-blood-vessel growth can be provided.
By the present invention, CBVCTM scanning can be finished fast, and several groups of scannings can carry out continuously, so that carry out dynamic contrast research and angiogenesis is studied.
Description of drawings
Introduce the preferred embodiments of the present invention below with reference to the accompanying drawings in detail, in the accompanying drawing:
Fig. 1 has represented the linear attenuation coefficient of various tissues, and this tissue can be found in the breast of health or pathological changes;
Fig. 2 A-2C represents the sketch map according to the cone beam Volume CT mammography scanner of preferred embodiment;
Fig. 2 D has represented a kind of version of the scanner of Fig. 2 A-2C;
Fig. 2 E has represented another version of the scanner of Fig. 2 A-2C;
Fig. 2 F has represented another version (the type moves up and down patient's platen, rather than stand) of the scanner of Fig. 2 A-2C;
Fig. 3 has represented to be used for the block diagram of circuit of the scanner of Fig. 2 A-2F;
Fig. 4 has represented the scan geometry figure that can adopt in the scanner of Fig. 2 A-2F;
Fig. 5 A and 5B have represented to be used to gather reconnaissance image (scout image), so that carry out the device of scatter correction;
Fig. 6 A-6C has represented to be used for the dynamic collimation device sketch map of the scanner of Fig. 2 A-2F; And
Fig. 7 A-7G has represented the operating procedure of the device of Fig. 2 A-2F.
The specific embodiment
Introduce the preferred embodiments of the present invention and optional embodiment below with reference to the accompanying drawings in detail, in the accompanying drawing, identical reference number is represented identical parts.
The restriction of common mammography will be resolved by the cone beam Volume CT reproducing technology that adopts flat-panel detector.By cone beam geometric figure and flat-panel detector, cone beam volumetric computed x-ray tomography mammography (CBVCTM) imaging system based on flat board can constitute shown in Fig. 2 A-2F, and by once fast the volume scan three-dimensional (3D) that can obtain breast reproduce figure.Compare with common mammography, can be by x-ray tomography the object of being concerned about (for example pathological changes) be separated with other object (for example other pathological changes or calcification) in the adjacent plane based on the CBVCTM system of flat board.This 3D x-ray tomography reproduction method has been eliminated the pathological changes overlapping, and complete, correct 3D breast analysis explanation is provided.Is that the common computer x-ray tomography (CT) of 0.5lp/mm is compared with the section intrinsic resolution for～1.0lp/mm and whole flat resolution, and CBVCTM reproduction method has 2.0lp/mm or better homogeneous space resolution.According to the size and the inherent detector resolution of x-ray focus, has very high-resolution reproduction with volume (VOI) formation that obtains 5.0lp/mm or higher resolution, can make to be concerned about by the zoom pattern that adopts flat-panel detector.
CBVCTM based on FPD can set up by slip ring.Slip ring is can stride across the rotation interface to transmit electricity or signal, perhaps transmits the electromechanical device of electricity and signal.The Fabricast company limited of the South El Monte that a source of slip ring can be U.S. California.
The schematic construction of CBVCTM scanner is shown in Fig. 2 A-2F.This CBVCTM scanner has the patient table plate structure of human engineering and is particularly suited for the scan geometry figure of target imaging.
In scanner 200, patient P crouches on the platen 202 of human engineering form, and like this, breast B to be scanned hangs down in the breast keeper 205 by the hole on the platen 202 204.The breast keeper 205 that will be described in detail below makes breast B form cylindricality, so that scan, this flat pattern than common for most patient is more comfortable.
Below platen 202, stand 206 is supporting detector 208 and X-ray tube 210, and it is respectively in the both sides of this breast keeper 205.Stand rotates by motor 212, thereby can be around the axis A rotation through breast keeper 205, like this, when X-ray tube when track O moves, breast B is stayed in the passage by the cone beam C of X-ray tube 210 emissions.This stand also can move by motor 214, thereby moves up and down along vertical channel V.Perhaps, platen 202 can move up and down along vertical channel V.When needing, detector 208 can be by motor 216 towards axis A motion or leave axis A motion, thereby change amplification coefficient.
For the geometry repeatability that guarantees breast imaging and the correct imaging of thoracic wall, breast keeper 205 is harder relatively, and is made by the material with low X ray decay.This breast keeper as shown is the part of platen 202, but it also can be made into the part of stand 206.This breast keeper 205 is pulled out thoracic wall with breast, so that guarantee the correct imaging of thoracic wall, and this breast keeper 205 applies less, reproducible pressure, so that make breast form cylindrical shape.In the breast keeper, cushion can be arranged, to guarantee patient comfort.Then, can push nipple to thoracic wall with piston 218, so that make Z direction scope reduce several centimetres.This piston promotes to have reduced the required bevel angle of X ray wire harness.Therefore, promote by piston, and the scanning of most of breast (breast height＜10cm) can only realize by the circular scan pattern, and for bigger breast, required projection line number can reduce.In addition, piston promotes also will improve the uniformity of breast thickness.
Perhaps, when standing, patient scans.Shown in Fig. 2 E, in this scanning system 200 ', breast keeper 205 is by support 222 supportings, so that the patient's that supporting is stood breast.Perhaps, two breast keepers 205 can be arranged on support 222.A breast moves in the image field and also at first scans.And then make another breast move to into the line scanning of going forward side by side in the image field.Perhaps, two breast can scan with two breast keepers.The stand 206 that is supporting detector 208 and X-ray tube 210 can rotate around horizontal axis A ', rather than the vertical axis A of Fig. 2 A-2C.In others, system 200 ' can be similar to system shown in Fig. 2 A-2C.
Fig. 3 has represented the circuit of scanner 200.Computer 302 on the stand 206 links to each other with host computer system 306 by the slip ring 304 on the bar of stand 206.Computer 302 on the stand 206 also is communicated with detector 208, and simultaneously two computers 302 and 306 is communicated with various other devices on stand 206, as hereinafter described.Computer 306 also is communicated with user's control and drawing user interface 308.
In the computer 302 on stand 206, CPU 310 is communicated with detector 208 by digital frame receptor 312 and flat panel controller 314.CPU 310 also is communicated with storage buffer 316, disk memory 318 and real non-destructive image compression module 320, and by this compression module 320, and CPU 310 is communicated with CBVCTM data transmitting module 322 on the stand 206.These CPU 310 two devices in addition direct and on the stand are communicated with, i.e. stand controller 324 and X ray controller 326.This X ray controller 326 can be controlled length, time of exposure and the exposed pulse number of exposed pulse.In addition, (dynamically) change in real time of this X ray controller 326 is from once projecting to the x-ray bombardment level of another time projection, so that obtain best x-ray dose efficient under the situation of the quality that does not reduce reproduced image.
In host computer system 306, host CPU 328 is communicated with data transmitting module 322, both can directly be communicated with, and also can pass through real time imaging decompression module 330.This CPU 328 also reproduces with storage buffer 332, disk memory 334 and parallel accelerogram picture and processing module 336 is communicated with.By image output device 338, this CPU 328 is communicated with interface 308.CPU 310 and 328 communicates with each other by slip ring 304.Also have, although the not expression in Fig. 3 for simplification, all between the parts on the stand 206 and host computer system 306 are communicated with is all undertaken by slip ring 304.
CPU328 with parallel accelerogram picture reproduction and processing module 336 can realize from same one group of projected image that the volume x-ray tomography of multiresolution reproduces, so that improve the power of test of microcalciffcation and breast carcinoma (tumor), the characteristic of representing mammary neoplasms better, therefore and reduce patient's gross accumulation dosage.CPU 328 can also be used for the computer-aided diagnosis technology based on the CBVCTM image, so that improve power of test and represent the characteristic of breast carcinoma better.
When the focus of x-ray source and detector in the cone beam scanning process is single circle (the cone beam geometric figure of Dan Yuan), will obtain one group of incomplete data for projection.Fuzzy region appears in this data for projection not exclusively will cause inevitably in the plane of leaving the center z-plane, and causes along the resolution loss of z direction.By adopting, because the reconstruction error size that the imperfection of data for projection causes increases with bevel angle based on the geometric Feldkamp algorithm of single conical wire harness.Computer simulation show, for mammography imaging and average breast size (highly being 10cm or littler), reconstruction error less relatively (＜5%), and can observe and do not have the striped product.Improved Feldkamp algorithm is used for less and average breast size (highly＜10cm), and the cone beam track of circle ledger line (CPL) and its corresponding filtered back-projection algorithm are used for big breast (highly＞10cm).In fact this method has solved the incomplete problem of data for projection that is obtained by the conical wire harness geometric figure of list that is used for mammography scanning.Suitable improved Feldkamp algorithm is by Hu, and (SPIE 1994 for " a kind of new cone beam is reproduced algorithm and the application on circular trace thereof " of H.; 2163:223-234) as can be known.The appropriate algorithm that is used for the circle ledger line is by Hu, H. " adopting circle ledger line cone beam mammography that vertical unconfined object is carried out zone reproduction accurately " (Proc.SPIE, Vol.3032, pp.441-444,1997) with by Hu, " the improved cone beam that is used for circular trace is reproduced algorithm " H. (Scanning1996,18:572-581) as can be known.When we adopted circle to add trajectory, we need change the algorithm of Hu or develop a kind of new algorithm.
Circular scan can realize with following method by the CBVCTM scanner: 1) make patient's breast B be positioned at the hole 204 of patient's platen 202 that light pressure breast keeper 205 is arranged, so that make this breast form the shape of similar cylindricality; 2) make 206 rotations of this stand, so that obtain one group through 180 ° of circular projections that add bevel angle, perhaps pass through the circular projection of N * 360 °, wherein N is positive integer (1,2,3).CPL scanning can utilize the spiroid scanner with slip ring and realize by following three steps: 1) make patient's breast B be positioned at the hole 204 of patient's platen 202 that light pressure breast keeper 205 is arranged, so that make this breast form the shape of similar cylindricality; 2) make this stand 206 rotations, so that obtain one group of circular projection; And 3) in case finish circular projection, control stand 206 also makes it to move downward and rotates (perhaps, patient's platen 202 can move upward, x-ray source 210 and detector 208 are rotated together), and only when the anglec of rotation is 0 ° and 180 °, carry out projection, obtain two line projections so that whenever revolve to turn around.Should be known in needs a plurality of line projections, so that reproduce the breast of relatively large size.Fig. 4 has represented circuit orbit C1 and C2 and the position L1, L2, L3, L4, L5, L6, L7 and the L8 that carry out line projection in once possible scanning process.
Also have, add in the cone beam angle sweep at 180 degree, the total angle that stand rotates on track C1 or C2 is the size that 180 degree add the cone beam angle, and this cone beam angle is represented with θ in Fig. 2 B.In 360 degree scannings or N * 360 degree scannings, stand is around track C1 or the C2 suitable number of times that moves.
Fig. 7 A-7G has represented the example of above-mentioned steps.Fig. 7 A has represented to have the human engineering platen 202 in breast hole 204.In Fig. 7 B and 7C, patient P is passed the mode of stretching out in hole 204 with a breast B and is lain on the platen 202.In Fig. 7 D, the breast keeper 205 that two halves 205a and 205b are arranged is around breast B, and piston 218 places below the breast B.In Fig. 7 E, the two halves 205a of breast keeper 205 and 205b and piston 218 are squeezed into breast B desirable cylindrical shape together.In Fig. 7 F, the stand 206 that detector 208 and X-ray tube 210 are housed is arranged in breast B position on every side.In Fig. 7 G, stand 206 rotations, breast B is by the imaging by the cone beam C of X-ray tube 210 emissions.
Fig. 8 a shows traditional mastography principle of (comprising digital mastography) (current state of this area).The photography of X line breast is a kind of projection imaging technology, it adopts x-ray source 802 and area detector 810 to come three-dimensional body (breast) is carried out imaging, this object comprises a plurality of fragments 804,806,808, and wherein each fragment includes different information, for example the tumor in fragment 806 816.This x-ray source to detector 812, makes structure overlapping and cover little tumor all information projections in the Different Plane of breast.This is the main limitation that comprises the mastography of digital mastography.Fig. 8 b shows the principle of cone beam Volume CT breast imaging.Cone beam Volume CT breast imaging comprises cone beam x-ray source and area detector.In data acquisition, x-ray source 210 and detector 208 rotate around breast, to obtain one group of two-dimensional projection's image, are used for direct cone beam and reproduce.The picture matrix that reproduces shows by fragment ground of 823 1 fragments of monitor (824,804-828,808), and it is overlapping and detect little tumor 816 to have eliminated structure.
Fig. 9 A shows the bioptic principle of cone beam CT image guiding.Biopsy rifle 902 when in place, obtains a two-dimensional projection 906, at injury of breast 904 places shown in Fig. 9 B.Then, the projection image that has biopsy rifle 902 in place that is obtained combines with the 3-d reproduction image that does not have the breast B of biopsy rifle in place, shown in Fig. 9 C, to show the spatial relationship between biopsy rifle and the described damage, be used for the real-time image guiding of biopsy procedure.
Also have based on the cone beam track of circle and filter back projection's cone beam of CPL track and reproduce algorithm.Example as previously mentioned.This algorithm can not only pass through the computer efficient calculation, and can also handle vertical truncated projection problem.
It is different with common mammography that (common mammography need be carried out intensive breast compression, so that obtain suitable picture quality (to this, a lot of patient's complaints are than pain)), CBVCTM does not need to carry out intensive breast compression, but forms cylindrical shape to improve the geometric figure reproducibility of 3D breast imaging.Because not strong extruding is compared with common mammography, the maximum ga(u)ge of the breast of employing CBVCTM can be bigger.In order in common mammography, to obtain maximum target contrast, need to adopt low-down kVp, so that the acquisition scope is the effective energy of 17-23keV, shown in the attenuation curve of Fig. 1.And the breast of this mean size that is suitable for compressing most adopts so low kVp breast that be not suitable for compressing, greater density.Use so low effective energy (17-23keV) will be not enough to penetrate not compression breast in CBVCTM scanning.In addition, can see that CBVCTM has much wide work capacity zone from following table 1.Therefore, bigger leeway next trade off (seeing Table 1) is arranged between contrast, dosage and x-ray system energy output.In single pass, we need hundreds of time very short irradiation.In the CBVCTM imaging, select best kVp scope and anode filtering combination, so that obtain optimal dose efficient.Computer simulation show, for the not compression breast of mean size, best effective energy scope is 33-40keV.
Table 1: the calculating target contrast of breast carcinoma
In projection imaging and CBVCTM imaging
At first, volume scan speed will be subjected to the largest frames speed restriction of real-time FPD.The frame speed of available real-time FPD is 60-120 frame/second at present.But, dull and stereotyped research worker prophesy, frame speed in the future can reach 120 frame/seconds (1K * 1K pixel/frame) and be 480 frame/seconds (256 * 1K pixel/frame) when reducing vertical sense wire.When the frame speed when being increased to 480 frames/second of detector in future, the volume scan time of breast will foreshorten to 1-2 second according to required resolution, and/or number of projections can increase to improve picture quality.CBVCTM scanner based on FPD has tangible technological progress, because the cone beam reproduction algorithm that has adopted flat-panel detector, slip ring and can cause forming accurate reproduction.
Three types electronic imaging area detector is arranged: fluorescent screen-CCD area detector (FS-CCD), image intensifier-CCD (II-CCD) detector and flat-panel detector (FPD).The contrast of these three kinds big area detectors is shown in following table 2.As shown in table 2, the FS-CCD detector only has 5% to 10% DQE.This causes image noise on equivalent radiation dose basis obviously greater than the noise by modern Spiral CT scan instrument gained image.Image intensifier can obtain 50% or higher DQE in the diagnosing radiation scope, thereby compares with volume imagery system based on FS-CCD, can provide much better low contrast resolution on the basis that equates radiation dose.
The comparison of three kinds of zones of different detectors of table 2
| ECTORE | DQE | Distortion | Dynamic range | Spatial resolution (MM) | Possible frame speed (unit) | Dazzle light |
| CCD | 5-10％ | Do not have | 2000-4000 ∶1 | 0.5 | 60(512×512×12bits) | Do not have |
| D | 50-80％ | ' S ' ﹠ pincushion | 2000-4000 ∶1 | 0.25-0.5 | 60(512×512×12bits) | Have |
| FPD | 50-80％ | Do not have | ＞30000 ∶1 | 0.05-0.25 | 60(512×512×16bits) | Do not have |
But, based on the system of II-CCD some shortcoming is arranged, for example: size is huge, and this is not suitable for mammography; Limited (the 1000-3000: 1) of dynamic range; Geometrical distortion (pincushion and S-distortion) and the light of dazzling is arranged, this has limited the further raising of low contrast and spatial resolution.Therefore, FPD is preferred.This FPD can be thin film transistor (TFT) array FPD, and this thin film transistor (TFT) array FPD both can obtain static number image (radiographic images), also can obtain dynamic image (gathering in real time).Another preferred detection device is that resolution is better than any area detector that 1lp/mm and picking rate are higher than 5 frame per seconds, and this area detector can obtain static number image and dynamic image.
Development and optimization X ray scatter control and the technology that reduces are very big challenges for CBVCTM, because compare with fan beam CT, CBVCTM is subjected to the influence of scattering more.Do not having under the situation of Best available control technology, scattering can reduce the CBVCTM picture contrast.Scattering can be offset by the mixed method of utilizing the control scattering of air gap technology and utilize the actual software alignment technique to detect scattering.A calibration that the main distinction is the X ray wire harness between fan beam slice CT and CBVCTM.Utilizing very narrow slit to calibrate in fan beam CT makes the scattering and the ratio (SPR) of principal ray be decreased to 0.2 or littler.On the other hand, only by the air gap technology, adopt big taper to calibrate the breast that will cause for mean size at the cone beam geometric figure that is used for mammography, average SPR will reach 1.In order to reduce patient dose, do not adopt anti-scatter grid for the breast of mean size.Utilize the software alignment technique come correct detection to scattering and the SPR of population mean is reduced to 0.2 or littler.Convolutional filtering (convolution filtering) technology and the scattering that is detected by FPD will be used to assess scatter distributions, then it be deducted from total projection.A kind of known convolutional filtering technology is by Love, L.A. and Kruger, " utilizing the scattering assessment that is used for digital radiography system of convolutional filtering " (Med.Phys.1987 of R.A.; 14 (2): 178-185) as can be known, this convolutional filtering technology is used for the imaging system based on image intensifier, and analysis will produce 6.6% average percentage error with different clinical applications for difference.This is equivalent to coefficient 14 and reduces SPR.Compare with the system based on II, for the system based on FPD, even can obtain better scatter correction result, because do not dazzle light component, and in the system based on II, this dazzles light component is more significant component.Based on former research and preliminary result, should be known in that the average SPR in each cone beam projection can be decreased to 0.2.This is to utilize the obtainable equivalent SPR of blended scatter correction techniques (software is proofreaied and correct and added air gap) in the fan beam slice CT.This is analyzed and preliminary result demonstration, reduces and alignment technique by above-mentioned X ray scattering, can provide the low contrast resolution that is enough to fully be used for breast cancer detection based on the CBVCTM system of FPD.
Preferred embodiment has made up the air gap technology with anti-scatter grid and has been used for the software alignment technique of residual scatter.The air gap technology of 10-15cm is to prevent to arrive detector and make average SPR be decreased to effective ways less than 1 than the scattering radiation of wide-angle.In the CBVCT system, center of rotation to the distance of detector can be 20cm.Adopt this geometric figure, air gap reaches average SPR less than 1 greater than 15cm.
Residual scatter in projected image is removed according to the convolutional filtering method, so that the residual scatter that is evaluated in each projected image distributes.In the convolutional filtering method, residual scatter is modeled as low pass, the space filtering type in the total projection (scattering adds principal view).After the residual scatter in having assessed each projection, deduct the residual scatter radiation again, distribute thereby obtain principal view, so that reproduce.This technology can make SPR effectively reduce to 0.2 or littler from 1.0.
Common convolutional filtering method need be in two X ray projections of each projected angle, so that accurately assess residual scatter: one has wire harness and stops array (stop array), so that calculate two proportionality coefficients, and another does not have wire harness to stop array.This is also unrealistic, because will obviously increase the dosage of patient in CBVCTM.In order to overcome these difficulties, preferred embodiment adopts reconnaissance image, so that to each patient " in real time " assessment scatter distributions.Before beginning scanning, obtain to scout projected image, as among the standard fan beam CT.In general, reconnaissance image is used for the location, and the body size of being measured is used for regulating in real time the degree of illumination of X ray, and reduces patient dose and (resemble " the Smart Scan in the GE spiral CT
TM").Before obtaining reconnaissance image, shown in Fig. 5 A and 5B, the square matrix 504 of little plumbous ball bearing 506 is arranged between X ray aligner 502 and the breast B.Principal view and sample scatter distributions all stop array by this spongy lead bundle and are assessed by reconnaissance image.The master image of this assessment is used to scout purpose.And can be identified for assessing the proportionality coefficient of scatter distributions and at the convolution kernel function of sample angular position.Utilize convolution kernel function evaluation scatter distributions then, and from the projection that detects, deduct this scatter distributions in the respective angles position.For radiation dose and the calculated load that reduces patient, only gather minimum required reconnaissance image.Only needing one or two reconnaissance image, is cylindrical shape because push rear udder attachment, and when convolutional filtering was used for different analysis, the degree of accuracy of this method was not the definite form that depends on very much the convolution kernel function, as long as its size is enough big.
Index kernel function (exponential kernel) is used to assess residual scatter, because 2D index kernel function is an optimal form.Same 2D index kernel function is used for all projections, because after extruding, breast is a cylindrical shape, and scatter distributions changes with the angle position hardly.
Can be used to improve other method to the detection of mammary neoplasms in the present invention and be the reproduction mode that the volume of being concerned about (VOI) has ultrahigh resolution, this mode class is similar to the mammography of amplification.This method can focus on suspicious pathological changes.
Known have amplification mode in the flat-panel detector technology.The Varian Imaging Products of Mountain View that a source of such flat-panel detector is U.S. California.The flat-panel detector for example amplification mode of Varian flat-panel detector is used to gather the data for projection that is used for superelevation VOI reproduction.In this amplification mode, detector can pass through the randomized block of the 4lp/mm resolution of pick off with speed acquisition 768 * 960 pixels of 30 frame/seconds.The pixel size of detector is 127 μ m.Adopt the bifocus X-ray tube, the focus of this X-ray tube is 0.1 and 0.3mm.Ultrahigh resolution VOI can adopt the focus of 0.3mm, and like this, this focal spot size is not the limiting factor of the spatial resolution of VOI pattern.Therefore, the FOV of amplification mode (field of vision) is 9.75 * 12.2cm.In order to reduce unnecessary radiation to patient, in the VOI gatherer process, aligner with radiation limitations in ROI (zone of care).Need fillet calibration (～2cm is wide).When breast diameter during greater than 12.2cm, the data for projection of gathering in superelevation VOI pattern is intercepted along horizontal direction.When data not being carried out under the pretreated situation being reproduced by the data of intercepting, some striped products will be arranged.The commonsense method of handling the data for projection that is intercepted is before filtering a cosine wave to be added in this data for projection.Fortunately, at this moment, the complete information outside VOI in the zone is by formerly more low-resolution scan and obtain.This information can be used in the data for projection that adding intercepts, and finishes VOI again and reproduces.Computer simulation show, such algorithm have been eliminated the reproduction product that causes owing to data intercept in VOI.This method should be better than commonsense method.Can also know that ultrahigh resolution VOI reproducing technology can provide the resolution of 5lp/mm by suitable increase x-ray dose.Above-mentioned VOI technology can be used to detect other cancer, for example pulmonary carcinoma.
Another purposes of CBVCTM is the detection volume growth.A kind of known markers of malignant tumor is the quick growth of tumor.Because carcinoid feature is not grow, therefore, whether monitoring tumor size growth change speed can be differentiated that this tumor is whether pernicious and need to remove immediately.Accurately the assessment tumor size speed of growth can be used to estimate the doubling time of tumor, and helps very much the doctor to make diagnosis and treatment decision.
The volume of being concerned about is scanned, and obtain 3D reproduction matrix.Then, adopt automatic detection algorithm to detect tumor, and on all detected tumors, carry out 3D and cut apart.After finishing 3D and cutting apart, each tumor size is determined by calculating all voxels that are defined as belonging to this tumor in this cutting procedure.A kind of known software bag of carrying out this function is " ANALYZE " 3D software for display bag with 3D segmentation software.Volume growth can be determined by carrying out this identical process at different time and volume being compared.
Volume growth measure the growth of obvious diameter group measure sensitiveer because volume changes as the cubical function of diameter.The ratio that the ratio of mammary neoplasms volume changes than this diameter of tumor changes bigger.Therefore, compare, can determine the variation of mammary neoplasms based on the volume growth measuring technique of CBVCTM more accurately with the common mammography that when changing greatly, only can assess vary in diameter.
Fig. 6 A-6C has represented a kind of dynamic calibrator 601, and this dynamic calibrator 601 can be used for the CBVCTM among aforementioned any one embodiment.This dynamic calibrator can be used in and reduces the unwanted radiation of patient, gathers the conventional data for projection that is used for conventional CBVCTM reproduction simultaneously and/or is used for the superelevation spatial resolution projection that VOI reproduces.This dynamic calibrator 601 comprises an aligner body 603, and this aligner body 603 is plumbous or other suitable material, and a hole 605 is arranged therein, so that receive only the suitable part 607 by the X ray of x-ray source 210 emissions.Aligner body 603 can form with any desired manner, but is that two plumbous thin slices 611 of a and two plumbous thin slices 609 that spacing distance is b form by spacing distance preferably.Like this, this hole 605 is a rectangular shape, is of a size of a * b.Motor 613,615 makes this aligner body 603 along two movement in vertical direction, and (u0 v0) locates so that make hole 605 be centered in the corresponding coordinate in center with the volume be concerned about.By aligner 601, reproduce and/or the ultrahigh resolution collection for conventional CBVCTM, X ray only shines ROI, and can obtain conventional CBVCTM reproduced image and/or ultrahigh resolution reproduced image.The spacing that this motor 613,615 is also controlled between every pair of thin slice, like this, a and b also can change.
Following table 3 has been represented the comparison of spiral CT, MRI and CBVCTM, supposes the 12cm of target is partly scanned.Compare with other method, CBVCTM can have more high-resolution and shorter sweep time.
The comparison of table 3 spiral CT, MRI and CBVCTM
| Method | Second volume scan time | X and y resolution mm | Z resolution mm |
| Spiral CT | 15-120 | 0.5 | 1.0 |
| MRI | 30-400 | 0.7 | 0.7 |
| CBVCTM | 2.4-9.6 | 0.1-0.25 | 0.1-0.25 |
Experimental result shows, is the reproduction voxel of 0.36mm for equivalent radiation dose and the size of 240mRad, utilizes the detectable minimum carcinoma diameter of CBVCTM imaging to be 1mm, and minimum calcification diameter is 0.2mm.This result shows that for the breast of mean size, the accumulated dose level is less than the dosage (supposing that each breast needs two views) of single shielding mammography inspection, and the CBVCTM imaging can detect the calcification of several millimeters carcinoma and 0.2mm.By such radiation dose level and such power of test, being benefited of patient-dangerous ratio can be above 800: 1.
Although describe preferred embodiment and version above in detail, seen those skilled in the art of this description readily appreciate that, within the scope of the invention other embodiment can be arranged.For example, X ray can not be adopted in radiation.Also have, can adopt as authorizing the U.S. Patent No. 5999587 described image analysis technologies of Ning etc.Therefore, the present invention can only be limited by attached claim.
Claims (1)
1. device that is used to form the cone beam Volume CT breast image of patient's breast, this device comprises:
The stand frame;
At least one motor is used to make this stand frame motion;
Radiation source, this radiation source is installed on the stand frame, so that move with this stand frame;
Area detector, this area detector is installed on the stand frame, so that move with this stand frame, this area detector is arranged in the radiation channel; And
Supporting member, patient rests on this supporting member when gathering the breast projected image;
It is characterized in that:
This radiation source is the cone beam radiation source;
This at least one motor makes this stand frame motion with specified data acquisition geometry figure;
This device is gathered patient's cone beam Volume CT breast projected image, and this supporting member supports patient in such a way, that is, make breast be arranged between this radiation source and this area detector;
This supporting member comprises a platen, and patient lies on this platen when gathering cone beam Volume CT breast projected image;
This device also comprises at least one computer system, and this computer system is used to control the volume scan of breast, and the cone beam volume that carries out breast reproduces and graphical analysis;
This at least one motor makes this stand frame motion, like this, rotate synchronously to be formed for the data acquisition geometric figure of cone beam volume calculation machine tomography X around the axis that passes breast by making radiation source and detector rings, thereby carry out the volume scan of breast, this volume scan causes producing picture signal;
Distribute with the three-dimensional attenuation coefficient that produces breast by picture signal being carried out the reproduction of cone beam volume calculation machine tomography X, thereby described at least one computer system forms three-dimensional cone beam Volume CT image by picture signal;
This platen has a breast hole at least; And
This device also comprises contrast medium injector, and this contrast medium injector is by described at least one computer system control, so that injection of contrast medium;
3-D view comprises a plurality of planes, and by at least one computer system, the mammary neoplasms in a described plane is separated with other object in described planar adjacent plane by the tomography X method.
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| CN103976738A (en) * | 2014-06-03 | 2014-08-13 | 续哲莉 | Clinical application of mammary gland MRI combined with Mimics software for measuring size of breast |
| JP6611428B2 (en) | 2014-12-09 | 2019-11-27 | キヤノン株式会社 | Mammography system |
| CN104983440B (en) * | 2015-07-24 | 2018-03-09 | 江苏摩科特医疗科技有限公司 | The special CT devices of new breast and its control method based on Pulsed Xray source |
| CN107714041A (en) * | 2016-08-11 | 2018-02-23 | 丁长青 | A kind of device that positioning scanning is assisted for the small lesion examining of magnetic resonance limbs |
| CN110680373A (en) * | 2019-10-29 | 2020-01-14 | 金阿水 | CT system special for breast examination and method for scanning breast by using CT system |
| CN112686877B (en) * | 2021-01-05 | 2022-11-11 | 同济大学 | Binocular camera-based three-dimensional house damage model construction and measurement method and system |
| CN116509433A (en) * | 2023-07-04 | 2023-08-01 | 有方（合肥）医疗科技有限公司 | Scanning bed, positioning method, breast imaging CT device and imaging method |
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| US4015836A (en) * | 1975-07-31 | 1977-04-05 | General Electric Company | Mammography table |
| US5949811A (en) * | 1996-10-08 | 1999-09-07 | Hitachi Medical Corporation | X-ray apparatus |
| EP0948930A1 (en) * | 1998-04-06 | 1999-10-13 | Picker International, Inc. | Acquiring volumetric image data |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4015836A (en) * | 1975-07-31 | 1977-04-05 | General Electric Company | Mammography table |
| US5949811A (en) * | 1996-10-08 | 1999-09-07 | Hitachi Medical Corporation | X-ray apparatus |
| EP0948930A1 (en) * | 1998-04-06 | 1999-10-13 | Picker International, Inc. | Acquiring volumetric image data |
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