CN1738573B - 具有组织曝光控制、分层摄影和动态视野处理的全视域乳房摄影术 - Google Patents
具有组织曝光控制、分层摄影和动态视野处理的全视域乳房摄影术 Download PDFInfo
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Abstract
一个乳房摄影系统,依靠被压迫和固定的乳房的厚度和乳房密度的估计值,使用组织曝光控制器来自动地获取一个或更多技术参数。本系统还使用保持防散射格栅聚焦于X射线源并同时保持X射线接收器视野的分层摄影装置。最后,本系统找到形成在影像中仍包围乳房的缩小的视野的轮廓,并用于进一步处理、传输或归档存储在所述缩小的视野内的数据。
Description
领域
本专利说明书在乳房摄影系统和方法的领域中,尤其适用于大视域,平板,数字X射线接收器。
背景
X射线乳房摄影系统通常使用装配在可旋转的C型臂组件一端的X射线源和位于另一端的影像接收器。在X射线源和影像接收器之间是一个用于压迫和固定乳房的装置。直到最近,影像接收器通常仍是增感屏—胶片盒,其产生一幅与被探测的穿过乳房的X射线相关的影像。用于压迫乳房贴近影像接收器,或覆盖接收器的乳房托盘的装置,通常称作压迫器(paddle),并设有多种尺寸与片盒的尺寸和乳房的尺寸匹配。如此匹配是需要的,因为在一个大乳房上使用小尺寸的压迫器会导致不均匀和不充分的乳房压迫而可能无法得到全部乳房的影像,而在一个小乳房上使用大压迫器会妨碍靠近乳房,为使被置入影像接收器视野的乳房组织的数量最优化,这在压迫循环过程中是重要的。
新型乳房摄影系统现在正在被引入使用数字影像接收器替代增感屏—胶片,并具有许多被广泛认同的优点。现有的这样的系统是来自以Selenia为商品名的受让人。在www.loradmedical.com/selsnia找到的关于其进一步的信息,通过引用包括在本说明书中。Selenia系统使用位于美国特拉华州牛华克市的数字放射成像公司(Digital Radiography Corp.),即该受让人的分公司,生产的数字平板探测器。此板有24x29厘米的视域。乳房摄影系统和方法的各种其它方面在2001年10月19日提出的共同受让的临时专利申请Ser.No.60/350,213和2002年10月17日提出的国际申请No.PCT/US02/33058中描述,通过引用包括在本说明书中。
乳房摄影系统常具有用于部分或完全自动选择X射线曝光的适当技术参数诸如kVp(X射线管的加速势)、mA(X射线管电流)和曝光时间中的一个或多个的装置。当使用胶片-增感屏影像接收器时,这可依靠相对X射线源位于胶片另一端的曝光探测器实现。当这些曝光探测器指示它们已经接收足够数量的X射线时,即停止对乳房的成像曝光。由于种种原因这对用于平板影像接收器被认为是不可行的。因而,一种已知用于数字平板影像接收器的方案是在压迫乳房后,进行一次短暂的,低X射线剂量的预曝光,然后在乳房保持不移动的情况下,使用基于在预曝光中用相同的接收器获取的测量结果的技术参数进行成像曝光。
乳房摄影术的另一个方面是分层摄影影像或分层摄影的方案。按照原理,乳房的平面的分层摄影影像可通过在X射线曝光期间移动X射线源和影像接收器中的至少一个相对于乳房的位置来获取。若X射线源和影像接收器在平行面中沿相反方向,以适当的几何形状移动,乳房中的与影像接收器平行的平面在整个曝光过程中保持在焦点中,而乳房中所有其它平面的影像变模糊并成为最终影像上的背景噪声。一种已知的方案是保持影像接收器固定而在一个适于分层摄影的路径中移动X射线源。该方法的一个问题是这限制了分层摄影影像的视野。另一个问题是这使有效地控制散射辐射的效应变得困难,因为保持通常使用的防散射格栅聚焦于X射线源的聚焦点变得困难。还有另一个问题是这种结构相对于接受器平面的法线只允许相对浅(小)的角度。
使用平板数字影像接收器的乳房摄影术还有另一方面是影像的传递和存储。许多医疗设施具有诸如PACS的影像存储系统,和存在诸如DICOM协议供格式化医学X射线影像用于存储和将来使用。然而,即使不是大部分,在许多实例中,乳房仅占据用平板数字接收器拍摄影像的一部分,以致包围乳房影像的想像矩形小于接收器的视野。已经采取一个方案供用扇型X射线束扫描平板数字影像接收器使用,被认为可从存储的影像消除不包含乳房影像的区域。然而,该方案被认为专供扫描型扇型X射线束使用。
本专利说明书中揭示的系统和方法被设计用于克服已知的先前方案的这些及其它缺点。
发明内容的概述
所揭示的系统和方法的一个目标是通过使用压迫的乳房的厚度和乳房密度估计值,为使用平板、数字X射线接收器的乳房摄影术提供一种特别有效和有益的曝光控制。
另一个目标是改进乳房摄影中的分层摄影,最好是在保留聚焦的防散射格栅的优点的同时避免视野的缩小。
又一个目标是通过选择性使用缩小的有效影像尺寸,改进X射线影像存储和传递的效率,尤其是乳房摄影影像。
附图的简述
图1例示了实施本发明所揭示的较佳实施例的数字乳房摄影系统。
图2是例示了在乳房摄影系统中估计和使用组织曝光控制的过程的流程图。
图3例示了可被用于图4和图1的系统中的聚焦的防散射格栅。
图4例示了乳房摄影中分层摄影的一个方面。
图5例示了选择缩小的尺寸的乳房摄影影像用于存储和传递。
图6例示了涉及选择缩小尺寸的影像用于传递和存储的过程。
较佳实施例的详细描述
参照图1,从共同受让人得到的商品名为Selenia的乳房摄影系统除了这里描述的新颖特征外,还包含一个支架10,支撑可沿支架10向上或向下移动的C形臂12,所选择的高度由操作该系统的医疗专专业人员控制的马达驱动。C形臂12装有位于较上端的X射线管12a和位于较下端的乳房托盘12b。托盘12b包括平板X射线影像接收器12c,被聚焦的防散射格栅12d与托盘隔开(格栅可回缩的故可从托盘12a和接收器12b之间的空间中移去)。C形臂12还装有压迫器12e,位于射线源12a和乳房托盘12b之间,并且是机械控制的可从托盘12b移开使患者的乳房可位于托盘12b和压迫器12e之间,并靠近托盘12b使患者的乳房可被压迫和固定。压迫器12e的移动是机械化的并由医疗专业人员控制。可安装不同尺寸的压迫器12e以适合不同的乳房尺寸的最佳压迫。另外,医疗专业人员可沿托盘12b的宽度移动压迫器12e至某一位置使压迫器12e可与不在托盘12a中心的乳房的位置相匹配,如共同受让人目前提供的Selenia系统中的一样。该系统还包括其它部件,诸如控制台14,包含接口设备诸如键盘14a和轨迹球14b,显示屏14c,和控制及影像处理设备。
为实现组织曝光控制,目前可使用的Selenia乳房摄影系统被修改成包括图2例示的设备和处理步骤。特别是,当医疗专业人员定位,压迫和固定患者的乳房以成像时,压迫器位置编码器20测量压迫器12e相对于托盘12b的位置。被固定的乳房的厚度可转而用其它方法测量或估计。例如,压迫器12e的最终位置可用一些方法测量,如,机械的或光学的或一些其它方法。被固定的乳房的厚度可用许多方法中的任何一种直接测量或估计。计算器22,可通过适当编程处理单元14(图1)实现,在编码器20的输出,或测量乳房厚度的指示器的一些其它装置基础上计算被压迫和固定的乳房的厚度,并为组织曝光控制计算器24提供关于乳房厚度的信息,而计算器24同样可通过这种编程序来实现。
为估计技术参数,计算器24也依靠关于乳房X射线密度的信息。这种信息可来自一个或多个不同的来源。一个例子是手工输入26,如,键盘14a(图1),通过它医疗专业人员可输入代表乳房密度特征的信息。例如,该系统可提供医疗专业人员三个选项-肥胖,中等和稠密-医疗专业人员可基于任何一个或多个因素诸如乳房的体检,来自本次或较早检查的早先的观察,或关于患者的其它信息进行适当的选择。另一个关于乳房密度信息的来源的例子是患者的一侧或双侧乳房早先的X射线影像(观察)。早先的观察可以是任何时间进行的,或是患者的同一次就诊或是早先的就诊。关于密度的信息可由医疗专业人员从早先的观察得到,或可自动得到-通过测量早先X射线影像的总体密度,或许可知晓曾用来摄取它的技术参数。若进行实际测量,来自早先观察的密度信息可通过从测量设备到计算器24的连接被手工或自动地提供至计算器24。另一个密度信息的来源是双重能量装置30,其使用低剂量X射线能量,依次对固定的乳房进行脉冲曝光,每次使用两种不同的能量,在已知的处理中使用在每个能量下用接收器12c(图1)对X射线进行测量,类似于在骨密度测量中所使用的,来估计乳房密度并自动或手工地为计算器24提供此估计值。X射线管12a可用于这样的双重能量处理,使用两个不同的X射线过滤器以适当的不同能量或能量波段反射X射线。还有另一种关于乳房密度信息的来源可以是装置32,测量压迫器12e压迫乳房的力和这个力从开始压迫直到乳房被固定供拍摄所作用的时间,并手动或自动地向计算器24提供这种力/时间的信息。
计算器24可实现为查找表,其条目为许多乳房厚度和乳房密度值的组合中的一个。条目的初始值可由本质上是一个试验-误差过程的实际的测试或另外其它方法估计。计算器24提供其输出到技术参数显示器34,其可以是显示器14c(图1),在其上面医疗专业人员可看到自动估计的参数诸如kV、mAs、滤线器、时间等中的一个或多个。一个输入设备,可以是键盘14a,允许医疗专业人员确认或修改自动估计的参数,且控制器38(其可以是图1的单元14的一个部件)使用得到的最终组织曝光控制技术参数进行一次成像的X射线曝光。
本专利说明书中揭示的示例涉及在确定技术参数和成像前压迫和固定乳房。然而,有在成像前不必压迫乳房的替代的设计;乳房仅需要以某种方式支撑,诸如使用乳房托盘,或可能以某种方式悬置在X射线源和影像接收器之间。在此种情况下,乳房的厚度和密度信息可来自不同的来源,诸如未经压迫的乳房的厚度的测量值或估计值,或将进行成像的乳房部分的厚度和对成像特别重要的部分的厚度的平均值。密度信息可来自医疗专业人员,或来自先前的乳房X射线影像,或一些其它来源。对未经压迫乳房的成像的相同替代方法可使用在下文叙述的两个特征—分层摄影和选择用于传输/或存储的缩小的视像视野(field of view image)—其中替代方法免去了压迫但与下面的描述相符。
这里揭示的乳房摄影系统的另一个特征是既允许大视野又使用聚焦的防散射格栅的分层摄影。如图3例示的,防散射格栅12d是聚焦成允许X射线沿着从X射线源12a的焦点发散的路径40通过,且抑制(分散)沿其它路径运行的(散射的)X射线。如果这种格栅改变其相对于X射线源的方向,它将如人所不希望的抑制本应通过的X射线。若X射线管12e以垂直于其发射的X射线束的方向移动而格栅12d和探测器12c保持固定,就会发生这样的方向改变。另外,这种移动会缩小视野,所以在射线源移动的一个位置投射到接收器的一部分乳房在射线源的另一个位置可能会落到接收器轮廓外。
图4例示了一个克服已知方案的这些不足的结构。在图4中,X射线管12a和防散射格栅12d及接收器12c的组合体作为一个单元旋转,而一个受压迫和固定的乳房保持在它们之间,并处于X射线从管12a发射并投射到接收器12c的路径上。防散射格栅12d保持聚焦于管12a的焦点上,有效视野不随射线源-接收器单元的角度位置改变。在目前提供的Selenia系统中,射线源12a和格栅12d和接收器12c作为一个单元旋转,也与压迫器12c和乳房托盘12b一起,故需进行修正以获得图4的几何图。该修正涉及将受压迫和固定乳房的装置与从管12a,格栅12d和接收器12c的移动中解开。例如,它可通过移去压迫器12e且在压迫器对(paddles)44之间压迫和固定乳房来实现,而压迫器对44恰好位于与管12a旋转中心相应而不随管12a旋转,如图4所示。作为旋转的替代,可相对于被固定在压迫器对44之间的乳房平移管12a或接收器12c中的一个或两者。在这种情况下,聚焦的格栅12d可从接收器12c中解开并被允许对管12a保持聚焦或者可使用不同的非聚焦的或低聚焦的格栅,和/或管12a和/或接收器12c的运动可超越一个更有限的路径。在每个管12相对于乳房的许多不同位置中每个位置拍摄非连续的X射线影像。该影像数据通过使用已知的影像处理方法用于分层摄影。
图4的示例的一个重要的优点是与已知系统比较,它允许在X射线管12a的极度旋转或平移位置之间相对大角度地成像。
这里揭示的乳房摄影系统还具有另外的特征,就是仅传输和存储视野的一部分。具有相对大视野的接收器12c,例如在Selenia系统中使用的(24x29厘米),通常乳房的图像落在一个小于视野的矩形中,如图5所示,其中一个乳房的影像46在一个想像的矩形轮廓48中(缩小的视野),远小于接收器12c的视野50。仅在缩小的视野48之外的视野50的区域可能包含极少或不包含乳房的信息。为节省乳房影像的传输和存储,可使用缩小的视野48中的信息,任何轮廓48以外的信息可被舍弃。如果在轮廓48之外存在任何有意义信息,只有这些信息可被连接到轮廓48内的影像部分的信息。
选择轮廓48的位置和尺寸的一种方法是依靠医疗专业人员选择压迫器12e的尺寸和位置。如前所述,目前提供的Selenia系统既允许医疗专业人员选择压迫器的尺寸,至少是一些压迫器,也可选择压迫器相对于接收器12c的位置,以使正在X射线检查的乳房与在接收器12c上的尺寸和位置匹配。压迫器12e的尺寸和位置可自动确定,并且在将其按照如DICOM标准传输和/或存储和/或为传输或存储而格式化之前,结果常常是有效地修整最终的乳房影像。或者,影像中乳房的尺寸和位置可通过影像分析得到,诸如涉及边界探测的分析,且以这种方式可找到轮廓48的尺寸和位置。又或者,轮廓48的位置和尺寸可由医疗专业人员输入,如,通过键盘14a,基于对显示在显示器14c上的影像的观察。或者,可使用所说各方法的组合,如,基于影像分析和压迫器选择中的一个或两者的自动确认,随后推荐的轮廓48的展示与完整影像一起显示给医疗专业人员,供医疗专业人员确认或修改。
图6例示了一个用来提供缩小视野的影像的结构。一个被并入C形臂或在别处与安装或移动压迫器12e的装置关联的压迫器尺寸和位置的编码器,提供了医疗专业人员已选择的关于压迫器12e的信息,以及关于投射到接收器12c上压迫器的位置的信息。手工输入提供了由医疗专业人员输入的信息,可与编码器52提供的相似、或可以是有关在整个乳房影像中的数个矩形中哪个矩形包围乳房的信息,或在影像上哪个任意矩形包围乳房的信息。影像分析器56提供关于乳房占据的整个影像中的区域的信息。计算器58使用来自单元52,54和57中的一个或多个的信息,以计算仍旧包围乳房的缩小视野的尺寸和位置,计算结果显示在60,如,诸如图5例示影像中的轮廓48,供医疗专业人员确认或修改,如,通过手工输入。此结果在62是一个最终缩小视野的影像,可用于进一步处理,供传输和/或存储。尽管上面已讨论了矩形轮廓48,但实际上轮廓48可具有其它合适的形状。
Claims (6)
1.一种用于患者乳房的X射线摄影系统,包含:
X射线管,平板影像接收器,以及用于压迫和固定患者乳房的装置,所述用于压迫和固定患者乳房的装置包括乳房托盘和压迫器或压迫器对;
组织曝光控制计算器、技术参数显示器、及控制成像曝光的控制器,用于根据所述被压迫和固定的乳房的厚度和密度的信息提供组织曝光技术参数并用于控制所述成像曝光,所述参数用于被压缩和固定的患者乳房的成像的X射线曝光;
所述X射线管和所述影像接收器以及所述乳房托盘和压迫器作为一个单元旋转,或者所述压迫器对从所述X射线管的移动中被解开,并将所述X射线管和接收器之一或两者相对于被压缩的乳房平移,在所述X射线管相对于乳房的多个不同位置中的每一个位置拍摄非连续的X射线影像,并将影像数据结果用于分层摄影。
2.如权利要求1所述的系统,其特征在于,包括能够回缩的防散射格栅,能够从所述乳房托盘和所述影像接收器之间的空间中移去。
3.如权利要求1所述的系统,其特征在于,包括从所述影像接收器解开的防散射格栅,当所述X射线管和所述影像接收器之一或两者相对于乳房移动时,所述格栅保持聚焦在所述X射线管上。
4.如权利要求1所述的系统,其特征在于,包括压迫器位置编码器、受压迫乳房厚度计算器、双重能量装置、测量压迫器压迫乳房的力和这个力从开始压迫直到乳房被固定供拍摄所作用的时间的装置,用于提供有关于所述被压迫和固定的乳房的厚度和密度的信息,并在已编程的组织计算器中使用所述厚度和密度信息以估算所述技术参数。
5.如权利要求1所述的系统,其特征在于,所述X射线管和所述影像接收器围绕患者乳房旋转。
6.如权利要求5所述的系统,其特征在于,包括防散射格栅,和所述影像接收器一起围绕患者乳房旋转。
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US20100135456A1 (en) | 2010-06-03 |
WO2004049949A1 (en) | 2004-06-17 |
US7123684B2 (en) | 2006-10-17 |
US20180177476A1 (en) | 2018-06-28 |
JP4628793B2 (ja) | 2011-02-09 |
CN1738573A (zh) | 2006-02-22 |
US10959694B2 (en) | 2021-03-30 |
US8831171B2 (en) | 2014-09-09 |
US7430272B2 (en) | 2008-09-30 |
US8416915B2 (en) | 2013-04-09 |
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US7760853B2 (en) | 2010-07-20 |
US20110216879A1 (en) | 2011-09-08 |
US20130223591A1 (en) | 2013-08-29 |
JP2006519625A (ja) | 2006-08-31 |
AU2003291189A1 (en) | 2004-06-23 |
EP1569556A4 (en) | 2006-05-03 |
EP1569556B1 (en) | 2012-04-25 |
ATE554707T1 (de) | 2012-05-15 |
US20140376690A1 (en) | 2014-12-25 |
US20090010384A1 (en) | 2009-01-08 |
US7949091B2 (en) | 2011-05-24 |
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