EP4346608A1 - Système et procédé d'imagerie par rayons x - Google Patents

Système et procédé d'imagerie par rayons x

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Publication number
EP4346608A1
EP4346608A1 EP22743623.5A EP22743623A EP4346608A1 EP 4346608 A1 EP4346608 A1 EP 4346608A1 EP 22743623 A EP22743623 A EP 22743623A EP 4346608 A1 EP4346608 A1 EP 4346608A1
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EP
European Patent Office
Prior art keywords
ray
voi
detector
image
reconstruction
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
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EP22743623.5A
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German (de)
English (en)
Inventor
Ying Zhao
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Sail Sv LLC
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Sail Sv LLC
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Publication date
Application filed by Sail Sv LLC filed Critical Sail Sv LLC
Publication of EP4346608A1 publication Critical patent/EP4346608A1/fr
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5205—Devices using data or image processing specially adapted for radiation diagnosis involving processing of raw data to produce diagnostic data
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/02—Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computerised tomographs
    • A61B6/032—Transmission computed tomography [CT]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/42—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis
    • A61B6/4208—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector
    • A61B6/4241—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment with arrangements for detecting radiation specially adapted for radiation diagnosis characterised by using a particular type of detector using energy resolving detectors, e.g. photon counting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/48—Diagnostic techniques
    • A61B6/481—Diagnostic techniques involving the use of contrast agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/48—Diagnostic techniques
    • A61B6/482—Diagnostic techniques involving multiple energy imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5258—Devices using data or image processing specially adapted for radiation diagnosis involving detection or reduction of artifacts or noise
    • A61B6/5282—Devices using data or image processing specially adapted for radiation diagnosis involving detection or reduction of artifacts or noise due to scatter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
    • A61B6/02—Devices for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computerised tomographs
    • A61B6/037—Emission tomography

Definitions

  • This application is related to X-ray imaging systems and related technology for Medical and non-Medical Applications such as diagnosis, monitoring, surveillance, image guidance, identification and characterization in medicine, drug discovery and life science research, non-destructive testing (NDT), field inspection, characterization of minerals and security, digital content for entertainment, commerce, social media and marketing, input data for AI based analysis,
  • a system which allow integration of at least two modalities or more modalities or an All-in-one x-ray system of prior art typically is a C ARM or tomosynthesis system of CBCT, to combine with General X-ray System and typically is only used in the setting of intervention guidance. Complete replacement of CT and densitometer has not been achieved with these all-in-one system. Discrepancies between modalities may have contributed to high radiological error and limitation in the use of AI due to lack of standard and or integrated imaging method and apparatus.
  • AI analysis typically are using images with SPR much higher than 10% or at least 5%. As a result, the accuracy and precision is limited in scope and or may generate false negative or false positive in medicine and or inconsistencies within and across varies modalities, x-ray imaging systems by the same and or different x-ray system manufacturers
  • image acquisition and reconstructions in a CT system is generally an enclosed system for example, only detectors assembled in the imaging gantry when measured together, are programed to reconstruct.
  • the measurements from prior measurements generally are using the same set of detectors.
  • a preexisting measurement result which are in a separate system are used to analyze the Region of Interest.
  • This type of reconstructed is suitable for a closed system, such as a traditional CT or tomosynthesis system.
  • AI used with x ray imaging system does not use density and other physical properties such as movement, fluidic dynamics, concentration changes within a spatial constraint or energy disturbed properties , such as energy sensitivity, chemical properties and elasticity as data input in a training material or detection information.
  • qCT provides better bone density measurement however, the radiation level is much higher than that of conventional bone densitometer such as Dexa using linear x ray detectors.
  • Reconstruction of CT typically use sinogram and assuming rotation more than 10 or 15 degree and or 60 degree which increases the complexity of imaging systems, typically require complex iteration methods
  • Tomographic imaging system such as traditional CT and or traditional Tomosynthesis system are typically bulky and hard to transport
  • a reference sensor is needed to measure and estimate x ray input intensity of VOI imaging, which makes it complex
  • PCT Applications including International Patent Application Nos. PCT/US2019/044226, PCT/US2019/014391 and PCT/US2019/022820 and PCT/US2020/062426.
  • PCT/US2019/044226 International Patent Application Nos.
  • PCT/US2019/014391 International Patent Application Nos.
  • PCT/US2019/022820 PCT/US2020/062426.
  • One or more configurations from aforementioned PCTs and their improved versions and configurations are used in the present closure.
  • a x-ray imaging system comprising from front to back, source, detector, optionally a sample holder, and or scatter removal devices such as beam blocker array or beam selector, single, or double or triple detectors or more are used which stack together or measure the same VOI from different angles, or spatial location relative to at least one voxel within VOI
  • elements and aspects of aforementioned PCTs may be combined here with new content as a complete system or sub modules in a kit or software modules of a complete software application.
  • Such element or kit component in hardware and or software may be combined with any x ray imaging system to improve speed, resolution, foot print, diagnostic value, save time and reduce radiation level and artifacts in imaging and quantitative measurements and for be used by AI to train or analyze to diagnose, monitor, track, inspect, 3D render and test in medical, non medical, security and research applications.
  • improved reconstruction methods for quantitative 3D imaging is based on using simplified system matrix and datasets of little scatter interference in fast and low radiation tomographic image acquisition and reconstruction some using time continuity and spatial continuity.
  • This method may enable potential fast adoption of x ray imaging systems with capabilities for tomographic imaging, scatter removal and or spectral imaging to for example material decompose and separating substance images.
  • Rapid and low cost payment and transaction methods for X ray Imaging Procedures and purchase of equipment or kits may involve the use of digital bank and or digital wallet, some deposited with cryptocurrency are used for payment and reimbursement transactions involved in subscription and or pay per procedure
  • At least one thin beam projected through the VOI where density measurement is to be done for the tissue, or substance or component of interest.
  • the projected region on the detector is approximately at least one pixel or more.
  • Two or multiple beams which are distributed or have distance apart from each other may be used to illuminate the VOI, all at the same time or at different time points.
  • Each beam may be generated by the field of view of a collimator.
  • multiple beam or structural illumination of thin beams may be generated by a collimator placed between patient of the source, which has one or more x ray transmission regions, distributed across from the x ray beam cross section. Dual or multiple energy measurements may be derived.
  • Inverse functional response equation system look up may be used to derive the attenuation value of the component or substance.
  • the thickness may be calculated or measured by x ray at different angles of projections.
  • the final calculation of density is derived from attenuation value at dual or multiple energies and corresponding density value of each component or substance. For example, if a VOI or the component of interest or a tissue volume is relatively homogeneous, such as LI of lumbar spine, the average value of the density derived from all beams may be calculated.
  • the density may be derived from tomography measurement.
  • Bone densitometer using the x ray tomography method with low radiation level and low resolution, for example, 0.5 cm as the resolution desired in the z direction, or a dimension which may be smaller than thickness of bone in the z direction, for example, parallel to the center axis.
  • the area of interest is restricted in the xy direction, for example a 1cm or size of xy dimension of lumbar spine or smaller are used as the dimension of xy cone beam diameter or slight bigger or slight smaller, approximately 40 projections, each are 0.5cm apart from the most adjacent point, the entire area of travel may be less than approximately 20 cm 2
  • the total data points in area of travel to be at least equal or less than 5 x 8 data points.
  • the distance between data points to be approximately the desired resolution in the z direction.
  • the angle of a x ray emitting position to the isocenter of the region of interest compared to the original center axis and or relative position of the x ray emitting position to the isocenter of the region of interest may be less than 10 or 11 degrees. In some cases, it may be less than 5 degrees.
  • less than 20 or less than 10 or less than 40 projections of a region of interest such as lumbar spine, with x ray beam diameter to be approximately the same or less than that of lumbar spine, may be sufficient for accurate density measurement.
  • the number of projections or Number of x ray emitting positions relative to the VOI are approximately quantatitatively related to the value of thickness of the Volume of Interest Tv and or Cz which is the dimensions of the component of interest along the third axis, or in some cases, number of of projections and or x ray emitting positions relative to the VOI is directly proportional to Tv divided by Cz, or approximately equal to thickness of VOI divided by Cz/2 with Cz or Cz/2 being the distance between x ray emitting positions where x ray measurements are taken.
  • less than 10 projection images are taken or less than 20 projections or less than 30 or 40 projections may be taken at various x ray emitting positions.
  • x ray radiation locations where the measurements are taken are less than 2 cm 2 or less than 4 cm 2 or less than 5 cm 2 or less than 6 cm 2 or less than 10 cm 2
  • x ray emitting locations for each projection is traveling in less than the total thickness along the Z or third access which is Cz cm 3
  • the region of interest of lumbar spine may identified by taking a full view x ray first.
  • the tomography x ray source position and its volume integral through the Volume of Interest may be saved in a table or database.
  • Reconstruction involves a step to look up the system matrix of each projection from the table and or derive on the fly based on the projection geometry.
  • similar method may be used for assessing density of component or composite matter, if the mass or dimension of the matter may be estimated. Restricted xy direction ROI and step size is estimated to be smaller than the dimension in the z direction or third axis perpendicular to the detector coordinates and or third axis of the matter and or the material.
  • the density of the matter may be derived. If the voxel situated within the component or the matter is derived and the density is approximately the value of expected of the matter, and in the spatial location of the matter, then not only the density may be used for accurate determination of the density of the matter, or the material or the component of interest, it may also be used to identify the matter, or the material or the component.
  • the thickness of the component may be derived as well if it is not known already along the third axis in some cases.
  • the thickness of the material may be derived by adding the dimensions of voxels sharing similar density values along the dimension in the z direction or third axis and or dimension of the VOI to derive the true thickness of the matter or substance.
  • the interface region of the two materials or two tissues may be resolved by increasing the resolution of CT measurement to have fine definition along the z.
  • a method where with low radiation, higher speed, low resolution tomography of selected regions may be used to achieve similar or better results.
  • low resolution image or low resolution tomography of selected regions of one or more within a region of interest, or the entire region of interest combined with density measurement, and or spectral imaging method to derive high resolution measurement at the region where two materials meet, for example between bone and soft tissue.
  • Low resolution typically for example, is described as having lesser resolution than a typical CT along the third axis, or third dimension,
  • the material decomposition is done in 2D configuration without tomographic reconstruction, or in line projection in one pixel or small number of pixel to allow the attenuation value of one component or composite material or a material to be derived on a pixel basis, , or the total attenuation value or radiographic density of the material or the component or the composite material or substance may be derived then the thickness of the material, or the component or the composite material may be derived based on the density and or optical and or radiographic density measurement from the low resolution tomographic imaging method.
  • segmentation is performed based on the material decomposition results, as one or more substances may exist in one segment and or such a segment may be comprised of combination of substances, in some cases, with an approximate ratio between the substances, and or with a range of ratios between two or more substances.
  • substance 1: substance : 2 0.5 to 1
  • substance 1: substance 2 : substance 3 0.5 to 1: 1.2 to 3 meaning substance 1 to substance 2 ratio is between 0.5 to 1 and substance 2 to substance 3 ratio is between 1.2 to 3.
  • thickness measurement of a particular material may be derived from density measurement from a tomographic method combined with at least a dual or multiple energy measurements and material decomposition method.
  • Segmentation or separation of tissues may be derived with low resolution low projection tomography with less radiation and faster speed to achieve equivalent or better result than high resolution CT or tomography method.
  • segmentation is done after image reconstruction of the entire VOI.
  • the segmentation may be done on a normalized pixel basis.
  • the entire VOI does not need to be reconstructed, only selected region can be reconstructed and in some cases, reconstructed fully to enable segmentation.
  • Spatial position of the segmented tissue or thickness of segmented sections along a beam path, for examples if there are more than one sections of the same tissues along the beam path, can be derived after tomographic reconstruction.
  • Density measurements and or relative density information may be measured in qCT or densitometer using linear detectors such as in DXA.
  • the exact density of the substance and composite substances and or tissue may not be accurately measured due to 1) thickness variation of the VOI along each beam path, which affects the radiodensity or optical density derived from the measurements.
  • qCT has high noise and or scatter interference therefore absolute and or density value is typically not easily derived from the CT measurements although variation and change of the density may be derived over time.
  • typically linear detector based measurements are believed not to be as accurate as qCT.
  • both modalities are slow.
  • the absolute density values can therefore be obtained.
  • method using tomographic imaging method in the present disclosure and or in the aforementioned PCTs are more accurate than or at least equivalent traditional CT.
  • the density values derived may be more accurate than prior CT and DXA methods.
  • segmentation and or separation of bone or soft tissue or calcification regions, or microcalcification regions, and or separation of implant or catheters and or foreign objects or surgical probes, biopsy probes and surgical tools, from the background, in a beam path, or 2D image measured by a 2D detector as well in space, such as multiple dimension or approximately complete tomography, in 3D may be achieved by using number of projections in the range of less than between 1/100* to 1/1000* projection measurements and or less than 1/1000* or less than 1/100* or less than 1/50*, or 1/40*, or 1/30*, or 1/20*, or 1/10 th or less than 1/5* or anything in between those levels, compared to the projections numbers of a typical CT for similar or equivalent or better results in resolving regions with two or more matters or for separating different tissues or components or materials at the interface regions.
  • the number of projections may be dependent upon or quantitatively related to the size of the material or the size of component along the z, Cz, and or the desired resolution to achieve desired density measurements along the third dimension of the VOI, which is typically parallel the center axis between the x ray source and the detector.
  • the segmentation and or material decomposition may be done on a normalized pixel by pixel basis.
  • the density derived for a small dimension or volume can be interpolated or applied to the rest of the approximately same substance, or material or composites.
  • the exposure level below detector saturation level may not be sufficient to quantitatively or effectively measure a thickness sample. For example, not enough photons are emitted to reach the detector to describe variability of different thick samples.
  • the establishment of energy response function system by using interpolation plot may require data points to be measured at the thickness similar to the VOI. At least one or at least two or more data points measured at thickness level of the known substances or combination of known substance similar to the thickness of the VOI.
  • the thickness of the VOI is measured by the user, or by a sensor and or given and or predetermined.
  • the inversion of the energy response function from spectral measurements which has a dependence of thickness value of VOI and energy response function system established for the approximate thickness level and or within a certain thickness level of VOI.
  • the inversion generates at least one image of at least one substance within VOI.
  • a phantom comprised of similar materials with regions of varied densities of each material and or combination of materials or substances, in some cases, with varied feature sizes, are placed in the illumination beam path of VOI between the source and the detector.
  • the separation of tissues may be performed using inverse energy response function system, the separation of material in phantom may serve as a quality verification tool to ensure that the proper separation has been completed given that the density and material composition in the phantom is known.
  • the attenuation value of the phantom material and or each substances separated from the background can be subtracted from the material decomposed image to give rise to the measurement or data containing only relevant information to VOI.
  • Variation of the present value and to the value measured some other time may be compared to monitor changes in VOI.
  • Energy response function system established by the interpolated plot based on data points generated by measurements, image processed data and or reconstructed data of the phantom within a volumetric unit can be used to derive the approximate density value and or linear attenuation coefficient and or the relative density value of voxels within VOI using inversion of the energy response function system.
  • the input intensity of the x ray source may be adjusted to be small enough to avoid saturation, but if there is a thick VOI, the signal measured may not be accurate enough due to photon starvation or quantum photon randomness. Multiple exposures may be done to increase exposure level to collect enough photons for better representation of the imaged results. The resultant measurements can be stacked together.
  • the projection measurements or its derivatives such as primary images or scatter images or derived attenuation values may be added together, and in some cases, averaged to generate an image with average value of at least two images, which can be used down the line for one or more of the following methods: the resultant image is to be analyzed and or processed such as primary images after scatter removal and or to be used as the source of data for reconstruction.
  • image settings which generates X ray input can be set at approximately just below those which generates x ray measurement level at approximately just below the saturation level of the detector, without the VOI in between the x ray detector and source.
  • x ray imaging setting to generate x ray input can be set so that the x ray irradiated can be used to generate image intensity less than the saturation level.
  • the exposure level will need to be at a level which sufficiently produce primary x rays so that the input x ray radiation entering the VOI, cause two major photon events, 1) scatter x ray, 2) Primary x ray will produce sufficient primary x rays to be measured on the detector so that there basically is no photon starvation, but also enough photons are collected to describe the accurate attenuation value of VOI.
  • 32 bit or more dynamic range may be sufficient in which exposure level of the one frame radiation level at the same or below the detector saturation level may be sufficient to produce primary x ray signals coming out of VOI to have sufficient information for quantity analysis for AI, or density measurement and other statistically meaningful data.
  • One method is to take a number of measurements of the sample, each with increasing exposure time, measure primary x ray signal and scatter signal
  • x ray sources with settings of varied intensity or a field emitter based x ray source may be used to modulate x ray intensity for two or more selected regions of interest, based on the thickness of the region. Each region may be illuminated with modulated intensity at different times.
  • the appropriate radiation level is selected for calculation of input primary which produces enough photons to pass through VOI and to generate detected signals higher than the noise level of the detector and producing consistent output signals for the same VOI.
  • the input x ray radiation may needed to be much higher than the saturation level of the detector if the imaged subject is thick.
  • the amount of radiation or input x ray intensity may be adjusted based on thickness measurement, for example by an optical sensor and or a first x ray image of the region of interest.
  • an interpolated plot inverse response function system as established may be used for multiple energy or dual energy for material decomposition
  • distributed rare substances, or at least one additional substance may be differentiated based on material decomposition of at least two substances using at least two energies. This may be done by identifying collocated regions of the same substances, extract data from the collocated regions to characterize the additional substance.
  • Attenuation value pertaining to the additional substance within the approximately same volumetric unit may be extracted without using a third energy if 3D tomography measurements may be used to assess the density or attenuation value of the voxel containing only of the additional substance, for example, by subtracting the values ( in density, attenuation value and or linear attenuation coefficient ) contributed by material decomposed substances from the total density value and or linear attenuation coefficient and or the attenuation value.
  • the density information of at least one of the substances have been measured and or given. Therefore number of energy levels used to interrogate the voxel or volumetric unit containing two or more substances can be one level or two levels less than number of substances.
  • Fig. 1 Illustrates the use of a Gap strip gsl and gs 2, in a tomography system for covering up the track of the mover. It generally comprised of soft material.
  • a conveyer belt like mechanism cycles the cover so that there is limited or none wrinkled look, but at the same time be able to cover the entire opening and the part or most or complete part of the track where the payload and translation stage moves hardware such as a x ray tube, collimator and sensors are moved to and from below the structure.
  • the opening faces the user
  • Fig. 2 Flow diagram of imaging reconstruction for mapping of 3D and or spatial distribution of a substance in a volume of interest in an object.
  • Fig. 3 is a configuration of the imaging device in the present disclosure or one possible orientation of the imaging device relative to the room or the user/patient
  • x ray tomography device or x ray imaging device means to rotate or reorientate, for example with a motorized arm or with a ceiling connector.
  • Various fixtures such as for support of skull, head may be inserted in the middle.
  • fixtures for support for mammography may be inserted in the middle.
  • X-ray tube and detector may be placed close together with the pillar or the supporting arm as in Fig 2 may be adjustable in height.
  • a rail may be installed on the ceiling and a motor and a x ray tube assembly may be attached.
  • ceiling attachment may be connected to the pillar through a motorized arm to move or orient the a portion of or the whole structure.
  • At least one detector can be either in the lower gantry, and at least one source in the upper gantry or at least one detector in upper gantry and source in lower gantry respectively. And in this configuration, can be rotated accordingly.
  • Accessory hardware mechanical means or fixture many be used to stalized or attach the system to the ceiling and or side wall of a room or ceiling or internal side of a mobile device ceiling or side walls for imaging applications
  • the pillar is on the ground, the source and or detector are moved up and down.
  • Fig. 4 One configuration of placement of Beam blocker array plate 100 sandwiched in between two detectors, detector 22 and detector 29 in an X-ray Imaging Device of the present disclosure.
  • Antiscatter grid Grid 1 may be movable, may be optional, it may be placed between the patient and beam blocker array 100 or between the patient and the x ray source.
  • Antiscatter Gridl may be placed between detector 29 and the object 2.
  • the antiscatter grid Grid 1 is placed between the patient and the x ray source or between the patient and the beam blocker array. Measurement of patient table or object support table and the cover surface is taken into account and calculated in calibration and or in imaging procedures.
  • Data and measurement effects of the table and object support table and or the cover surface for the detector gantry can be removed in image processing.
  • Fig. 5 In one configuration, in the image acquisition and reconstruction method for multiple dimensional and 3D imaging, only selected regions in an xy full view is selected for tomographic image acquisition and reconstruction.
  • Z coordinate of 2A a portion of the complete z coordinate display, for example, with annotation, or digital density information, or z coordinate digital reading, or presentation of identified material, or varied visual presentation in color or gradient of color, or selective digital display of analysis results, extracted point to 7D data or image presentation or selection of region of interest for selective reconstruction and or User Interface presentation.
  • Time tracked information display may be displayed based on selected axis or plane or 3D element of interest or may be displayed based on selected component or substance. With at least a lower resolution background information displayed or reconstructed selectively or displayed.
  • Selecting of a point or a region of VOI can be done by a computer input device, a joy stick or mouse, or touch pad, or via text through user interface. Or by filter process for density and other parameters available for each voxel and or component of interest or composite material or a micro or macro environment for processing or reconstruction or analysis and or presentation
  • x ray images can be reconstructed in 7 dimensions, the 7 th dimension being time.
  • the number of projections measured from varied xray emitting position relative to ROI and or step size between relative x ray emitting positions relative to VOI can be related quantitatively to the resolution of reconstructed 3D image along the approximately third dimension.
  • the third dimension can be approximately perpendicular to the detector plane and or virtual plane for projection images, transposed from the xy plane where the measurement of detector takes place.
  • a minimized step size of approximately Xc to provide projection measurements of VOI to achieve approximately resolution Xc along the z.
  • the movement is only less than 2 degrees or 1 degree or 5 degrees or less than 3cm squared or less than 5 cm squared or 9cm squared or 25 cm squared in a 2D dimension or 1cm cubed or 2cm cubed in order to approximately reconstruct the 3D image of the VOI and or anything in between.
  • detectors and or x ray tubes or x ray sources may be used to collect data, reconstruct and interrogate voxels within volume of interest to generate additional parameters or data for characterization, or quantification, or identification and or later for presentation.
  • the total distance traveled may be the same as the total thickness of the ROI to be resolved, or the total distance traveled by the source or the ROI may be the same as the total thickness of component or individual substances or unknown regions to be resolved.
  • the thickness measurement may be defined as the thickness along the axis which is parallel to the center axis connecting the x ray source emitting position and the detector.
  • such a multiple dimensional measurement system may be used for material decomposition to separate at least one substance and or for density measurements, with spatial resolution and or with time resolution.
  • spectral imaging may be used for improved material decomposition and or better and or more accurate density measurements, this may be achieved by using dual or multiple energy x ray imaging combined with tomographic imaging described.
  • such an apparatus and method of measurements and tomographic imaging system may be combined with another imaging system configuration, for example, existing system configurations such as a ceiling mounted x ray system and or O-arm or O ring and or helical imaging geometry, to provide ease of access to a part or the entire VOI or field of view or a varied orientation of imaging source and detector pair, and better visibility and or flexibility of spatial configuration to provide better imaging angle.
  • Measurements or datapoints from any x ray position may be used in tomographic reconstruction and or spectral imaging for improved material decomposition and or better density measurements.
  • the degrees described here is the total angle describing the relative movement of x ray emitting position to the ROI, for example, the center axis connecting a x ray source emitting position to the detector, for example relative to the center of the ROI, or passing through the center of ROI, relative to the center axis of ROI which is perpendicular to the detector.
  • the emitting position may move, for example linearly or rotate or both.
  • the distance between each projection may be Xc, if Xc is approximately resolution desired by the imaging, and the total projection number is approximately equivalent to thickness divided by Xc in order to reconstruct a 3D image which has approximately Xc resolution along the Z or the third axis perpendicular to an 2D projection image or virtual image plane or the detector plane.
  • the following methods may be used to modulate the position of the x ray radiation for one or more x ray measurement or x ray projections.
  • the source has a number of stationary emitting positions
  • the emitting position may be moved by electromagnetic means
  • the emitting position or the x ray tube may be moved by a mover, energy driven.
  • the emitting position of x ray source may be moved by at least one electrostatic means
  • the emitting position of x ray radiation may be moved by at least one electron beam deflector or electron beam steerer
  • the emitting position of x ray radiation may be moved by at least one x ray beam steerer
  • the emitting position of x ray radiation may be adjusted by electronic means such as in a field emitter x ray source, by turning on and off regions of field emitters, to adjust for the position of the x ray emission.
  • Optical or laser or ultrasound energy based electron beam or x ray beam steerer Optical or laser or ultrasound energy based electron beam or x ray beam steerer.
  • the emitting position may be moved by combining at least two of the above methods.
  • Combining two methods or using two movers or steerers may remove constraints of each method or moving or steering device which may impact image quality or stability of image acquisition system. For example, To allow the area of x ray irradiation to be expanded or reduced to adjusted in a larger range at the same time, allow precision to be achieved regarding x ray emission spatial position. Or such combinations may allow stability and improve image quality by continuous operation at one setting of one device while using another device to accommodate and achieve the desired setting of image acquisition.
  • such combination may allow the adjustment of field of view while image acquisition to be more flexible and finer tuned.
  • One mover may provide image acquisition at larger than Xc distance between x ray irradiation positions, but a second mover or steerer may adjust the x ray irradiation position at the position needed to achieve the desired Xc for a selected region of VOI, therefore reduce number of total projections
  • the method of having x ray radiation from more than two positions may be accomplished by
  • a mover such as an mechanical mover to move the x ray source or the anode target or the electron beam emitting location, while using electron beam deflector to move the electron beam
  • the electron deflector may keep the electron beam at one position while the mover moves the x ray source or at least anode target at approximately acceleration or velocity. So that the x ray radiation may be made to be emitting from approximately one or more emitting position.
  • x ray may be irradiation from one spatial position relative to the VOI, as the x ray tube moves with a mover, the electron beam steerer may be able to keep the x ray irradiating from the said position as the x ray tube moves.
  • the result may be that the x ray may be irradiated from the said position longer and have longer exposure time as x ray tube or the anode moves, and or as the cathode moves.
  • the x ray emitting position relative to the VOI may be adjusted for increasing or decreasing exposure time or x ray irradiation time at the said position by at least combination of two movers, or combination of at least two different movers and or electron beam steerers.
  • the x ray emitting position may be tuned by an electron beam steerer or x ray beam steerer.
  • other Scatter removal methods may be used to remove scatter other than beam absorber particle or beam selector methods.
  • the same or a different deflector or a electron beam deflector or a mover or x ray beam steer, or a mover may be able to move to approximately the desired spatial position relative to the VOI, or at least closer to the said location.
  • limiting spatial position where the x ray irradiation position may be at, a second mover, or electron steer or x ray steer may be used to move to the additional positions.
  • a mechanical mover can only move in 33 or 44 um intervals instead of 40 um
  • the x ray steerer or the electron beam steerer may be able to adjust the position to 40um step size as desired by the application.
  • a deflector may be used to steer the electron beam so that the x ray beam irradiation may be able to stay at the said position.
  • the second steering or moving system or method may allow for precise adjustment of x ray emission location and or precise adjustment of exposure time at the said location or overall exposure time.
  • x ray may be continuous irradiated
  • the electron beam steerer may steer the x ray irradiation or electron beam to a different location such as an x ray attenuator so that the VOI is not irradiated even if the x ray generator is on and continue to generate electron beams.
  • a different location such as an x ray attenuator
  • X ray steerer or electron beam steerer or mover may allow the adjustment of on and off illumination on the VOI as x ray beam or electron beam continues to emit. This allows adjustment of the precise dosage level or exposure level on the VOI separated from the x ray emission or electron emission state, thereby allow the flexibility, and fine tuning of the device previously not possible.
  • x ray emission may be always on or electron beam generation may be on continuously while x ray tube is in motion and as soon as the x ray tube is in position or close to the position desired, the x ray beam generated irradiates the VOI.
  • VOI is being selectively illuminated from a desired spatial position or spatial positions using combination of methods as the x ray emission or electron beam emission continuously to be on.
  • the least total number of projections and or the least number of x ray emitting positions are quantitative related to at least H max and or Xc , in some cases,
  • Hmax / Xc where Xc is approximately resolution desired in the z direction or along the thickness direction, or the third dimension perpendicular to approximately the projection measurement plane on the detector and or reconstruction projection image plane or virtual projection image plane, where Hmax the thickness or maximum thickness of VOI in the field of view or VOI.
  • the position between x ray irradiation position relative to VOI can be adjusted to generate 3D reconstructed models with approximately the resolution desired in the third axis.
  • x ray optics and other means blocking a certain portion of x ray passing the VOI or the x ray exiting VOI , reaching the detector or when x ray is collected by the regions in between x ray detector cells and or the projection lands in regions of x ray pixel which the signal sensitivity is significant different or less than the active region of the x ray cell, such as middle of the cell.
  • Image data required for multiple dimensional and or tomographic image reconstruction using the aforementioned method may be lost due to for example, geometry configuration for image measurements, therefore, additional projections from the same or different spatial location, of approximately the same or similar regions of VOI, may be measured additionally to establish additional linear equations or additional measurements and or additional datapoints to make up for the data lost in order for an image reconstruction or a complete 3D or spectral imaging processing for VOI. .
  • detector or detectors may be moved or the VOI may be moved relative to the x ray source, so that previous missing data from the projection path signal not detector or omitted in reconstruction algorithms may be made up.
  • the beam blocker array may be moved to at least one different position or x ray imaging geometry configuration may be varied in order to provide the measurements to replace the missing data.
  • spectral measurements improve material decomposition and or 3D reconstruction by providing improved estimate of the density of at least one substance in the VOI.
  • Scatter is removed in the projected image by using spatial domain scatter removal method by using Beam Stopper arrays ( or beam blocker arrays) or beam selector arrays, both may be movable and or both may be sandwiched in between two detectors to achieve Scatter to primary ration at less than 1% or less than 5%.
  • Low scatter projection primary measurements of VOI are needed in some instances to measure density and other quantifiable properties of VOI and the substances within.
  • two or more detectors and corresponding x ray emitting positions or x ray tubes may be used, either the set of detector and x ray emitting positions may move independently with each other, or the set of x ray detector and x ray tube are moving relatively different from the other sets. Due to the projection geometry calculation and spatial matrix setup, measurements from the set of detector and source are merged with that of the others and reconstruction is based on the data measurement from a variety of settings for spectral measurements, tomography measurements, and image processing of VOI may be performed on the combined measurement dataset collocated on a pixel by pixel basis and or voxel by voxel basis.
  • correlating the measurements from two or more detectors on pixels by pixel basis based on voxel spatial location in the VOI relative to the x ray emitting position and detector pixel locations receiving the projected signal from the voxel, derived from spatial system matrix, reconstruction algorithms may be based on the data derived or measurements from two or more detectors, moved by the same or different movers, or emitting position steered by different means.
  • a spectral imaging of a ROI selected from a object, due to the 3D tomography may be guided by the calculation of projected geometry based on the x ray tomographic image, to align the x ray emitting position at the center axis of detector and cone beam to be directly above the ROI.
  • the reconstruction algorithms of the spectral measurements if it is desired to be multiple dimensional use measurements for the ROI from the 3D tomographic measurements of the prior measurements, in the reconstruction algorithms and method as part of the data input, for either deterministic method or analytical method.
  • spectral measurements of an object which guides the alignment of subsequent x ray emitting position and detector alignment for the measurements used to reconstruct a 3D image may be used in the 3D reconstruction.
  • 3D measurements of one or more ROI regions of an object as well as background image of the object in one or more ROIs may be used as a geometric and spatial reference for derivation of positioning of a selected internal VOI.
  • characteristics of fluidic dynamics or cardiac movement may be derived in a 3D reconstruction assisted with measurements of the region around it but custom image acquisition and reconstruction of internal VOI relative to the background or a reference ROI may save time in image acquisition and reconstruction and reduce radiation exposure.
  • the present measurements and system configuration described in this disclosure and aforementioned PCTs allow for the incorporation of system configurations of multiple hardware which may be the same or different from each other in terms of a number critical parameters such as pixel size, image acquisition speed, spectral sensitivity and measurements from one or multiple set of hardware and mix match of detectors and x ray sources.
  • a different or the same x ray source may travel in the same 2d area for example, the first positions of the first x ray source traveled, but in smaller step size, and the first position where the first x ray source travel may not be revisited again as the measurements have already been done.
  • the total x ray beam emitting area or volume and x ray emitting positions may be a combination of step sizes, distances between projection emitting locations.
  • the x ray emitting sequence may be implemented to be one acquisition process, so all combination of step sizes are traveled and emitted from or different step sizes can be implemented separately.
  • reconstruction there maybe two image acquisition process in sequence, one is from the first process and the other is from the image acquired for the second x ray source.
  • the measured data from both detectors are used to reconstruct a multiple dimensional or 3D image if necessary. Due to motion artifacts of the object, there may be slight aberrations and artifacts but some of measurements may be useful. Motion artifacts can be removed using post processing methods. Selected regions where the measurements from both detectors are combined to perform reconstruct motion artifacts corrected and processed image may be used.
  • the image reconstruction may be done separately as well and to compare and evaluate ROI from both type of constructions may bring insight to ROI.
  • the method is to minimize measurement, for example, in number of measurements, such as minimize the number of projected path in ROI, minimize each beam size, or total field of view of the projection volume, and as well as number of images projections taken, which can be down to one or two projection image, and minimize number of emitting positions, for example, in some cases, only one emitting position is sufficient, and the utilization of structured illumination, x ray thin beam with distributed locations and or only one x ray thin beam measurements needed to track a component or substance measurement in 6D spatial volume.
  • One Configuration of 3D reconstruction may include the following:
  • bone registration data or tissue surface data is used for determination marker spatial relationship relative to a substance or component of interest.
  • tissue surface data is used as a reference point for navigation purposes.
  • the distance and relative position between the tissue of interest or clot and or catheter probe may be determined by specific spatial dimension and orientation distance between those points and at least one point on another component.
  • the direct link between these points simplifies the navigation process as without reconstruction, knowing the approximate volume distribution and reconstruction of the component is sufficient to orient the components relative to each other. Or such reconstruction may be done once for one component and such dimensions are preexisting. As long as the relationship between dimensions or spatial distribution between the two components can be correslated to these selected points, it is sufficient to track these positions and approximate the component orientation due to preexisting data of the component, instead of the reconstruct the entire component.
  • Each point described may be one voxel, or it could be grouped voxel or it could be a number of voxels with a distributed spatial pattern, and such a point could be a column of voxels from the top layer of vol to the bottom layer, or it could be embedded within the VOI.
  • such a method may be used reduce speed by reducing image acquisition time and or time required for reconstruction.
  • surface points may be determined from the reconstructed image.
  • An approximately volumetric distribution in any approximate shape may be used. And any point in the volume of interest of the component may be used as a reference or any point with a relative fixed spatial position to the volume of interest of component may be used.
  • distinct road map may be derived based on the relative relationship between the catheter probe, center of vessel, and the diameter of the vessel may be used to calculate possible path to determine if the diameter is sufficient for the catheter to pass through.
  • 3 D reconstruction is based on selective detector regions.
  • 3D reconstruction is based on distributed small regions S of VOI projection measurement regions on the detector.
  • such a region S may be created by a collimator, with holes, where the x ray beam can pass through, such a collimator can be placed between the x ray tube and the patient or between the patient and the detector.
  • Such a region S may be selected from the total projection image, either randomly or by a criteria. At least two of such regions can be reconstructed sequentially or parallel, to build a time dependent 3D image. At least one voxel column may be projected on to the the detector or at least measurement on one pixel in the S region can be used for 3D reconstruction.
  • the benefit of such a method is to be able to select and choose each beam path or each detector region using digital program , without having to have a preset path. Therefore the size of voxel cylinder and its spatial location may be adjusted continuously throughout the monitoring and tracking process. This leaves flexibility and speed and accuracy.
  • At least one portion and or at least one component or one part of the catheter is comprising microstructure, of microstructure, and in some examples of certain frequency. Varied portion or various component of the catheter may be differentiated by the frequency of the microstructure in x ray measurements from other portions of the VOI. Such microstructure may serve as a marker or barcode for a portion of, or a component of or the whole selected VOI. .
  • the benefit of such a design is for rapid identification of spatial location and or orientation of the catheter or a portion of the catheter relative to other markers and or other portion of the catheter and or compared to the background and or relative to a selected VOI and subregion of VOI.
  • the rapid identification of the portion of the catheter may allow selective reconstruction of at least one column of selected VOI or catheter to be reconstructed, instead of reconstruction of the entire FOV with the projection image of VOI. This may also allow optimization of selection to ensure faster position and feedback and steering and or navigation of the catheter and or at least one portion of the catheter.
  • At least one portion of the beam blocker may comprised of microstructure of certain frequency.
  • a microstructure may be a bar bode or marker for a particular beam blocker to differentiate it from the others and or simply to position such beam blocker relative to the background or a marker within the FOV and or VOI.
  • At least one or more portion of beam blocker comprising microstructure of certain frequency, the x ray tube and detector may be positioned or aligned spatially using at least one or more such beam blocker.
  • Each beam blocker may be the same or different from each other.
  • the size of beam blocker may be from sub millimeter to 10 cm in diameter. In some cases, it can be sphere shaped to ensure consistent measurements as x ray emitting moves relative to the VOI and beam blocker array.
  • Fourier Transform is used to extract frequency element of x ray measurement for identification and separation.
  • Beam blocker mage or beam absorber particle image and projection measurement of beam blocker or beam absorber can be identified and or replaced and or manipulated in the frequency domain.
  • 3D reconstruction can use at least one partition method for reconstruction.
  • 3D reconstruction can use at least one partition method for reconstruction and such partition can be iterative.
  • first image is reconstructed as a complete image for tracking.
  • the present disclosure presents a method where without the first image, the VOI and internal components are diagnosed and tracked without having to wait for high resolution image from the beginning. Sequential or 3D images of VOL or selected regions of VOI taken at different time may be used to reconstruct a high resolution 3D image of VOI. of the same VOI,
  • Reconstruction from distributed location of the detector or low resolution 3D image may be taken as the first 3D image.
  • At least one additional 3D image of the same or different resolution is reconstructed at a different time, At least two 3D image acquired or reconstructed at different or the same time, may provide higher resolution 3D image for the VOI and at the same time provide tracking information of a selected VOI region or a component inside.
  • Such selection of distrubted region or field of view may be done digitally or using a hardware such as a collimator.
  • low resolution CT perfusion images may be used to reconstruct a high resolution CTA image by combining voxel information from sequential CT images.
  • the benefit of doing so for example is to speed up time to treatment by combining at least two procedures into one. For example, CTP with CTA so that time to skin puncture or time to recanalization may be minimized and the operation time can be minimized.
  • the size of small voxel column can be as small as 1 x 1, and the total number of partition can be 64 x 64.
  • the small voxel column can be 2 x 2 x 64, or 2 x 1 x 64, the number of partitioned voxel column therefore 1024.
  • partition can be looped at least two times or be iterative, for example a secondary column partition of 2 x 2 x 64 may be used to partition each 16 x 16 x 64, and 16 of l6 x l6 x 64 partition may be combined to a final 64 x 64 x 64 volume.
  • the benefit of the looped or iterative approach is that the user or the digital program can determine if a certain sub column needs to be reconstructed, or prioritized so that the speed of reconstruction is faster for some regions than others based on the requirement of the user, or the application. Criterial can be set ahead of time for making decisions during the reconstruction process or during the image acquisition process.
  • partition process may be utilized to reduce system matrix for faster calculation and improvement of calculation condition.
  • the partitioned volumes may be reconstructed from measurements at different times or at the same image acquisition session.
  • the volume of predicable change may be marked as different at each time interval, the rest may be resolved or resolved with highest resolution over time.
  • the guidance is optimization of both image acquisition and reconstruction and radiation level of the same or different tissue.
  • Non Contrast CT is possible prior to CTP, significant amount of image acquisition and reconstruction may be eliminated as it would be clear where the LVO might be, regions outside of the LVO may be spared from high resolution imaging and regions close to LVO may be reconstructed with higher resolution.
  • Predetermined x ray emitting position for each projection image and combine all of the positions to give rise to high resolution image of the VOL Selective reconstruction or image acquisition at certain set of position to determine dynamic characteristics of one or two component, for example, the catheter movement or addition of a component such as insertion of catheter or addition of contrast agents.
  • Determine the volume distribution where the dynamic state may take place or modification may take place prior to imaging for example, estimate the density or possible changes or spatial location of such volume distribution over time, and predetermine x ray imaging emitting positions prior to image acquisition and reconstruction region. Or certain information and decision are derived in real time by a preset criterial or with AI.
  • the volume regions of VOI which are static over a period of time during dynamic changes of one or more regions of the VOI, or one or more component, the x ray tube imaging position for each projection may be planned so that the total area and or the total projection and or the distance between adjacent positions may be used to reconstruct a higher resolution 3D image.
  • the reconstructed images can be two low resolution x ray image sufficient describing the VOI and a high resolution x ray from the total x ray emitting position.
  • the low resolution may be used for tracking and the high resolution may be used for characteristics of static region.
  • the location of x ray emitting positions for each reconstruction and the time window where the projection image from these x ray emitting positions can be used can be optimized for accuracy and precision.
  • Spatial distribution of selected VOI region for reconstruction and or for image acquisition can be determined prior to image acquisition or during the image acquisition.
  • the FOV can be determined by selected volume of reconstruction and or in presentation or display.
  • This method typically can be used in surgical planning.
  • One configuration of 3D reconstruction may use at least one low resolution 3D reconstruction method
  • One configuration for 3D reconstruction is the following:
  • L p/2 or p/3 or p/4 or . p/1
  • the distance between most adjacent projection position or emission position of x ray source for low resolution Xi reconstruction is therefore 4Xc.
  • Such low resolution 3D reconstruction may take place at least once prior to the final 3D reconstruction at Xc with P layers.
  • Such a low resolution 3D reconstruction may be iterative at least once prior to the final 3D reconstruction at Xc with P layers.
  • the adjustment or location or movement of the emission position and projection image x ray emission position for the complete 3D reconstruction may be preplanned.
  • the spatial location of the x ray emitting position where a projection image originated may be in the same or similar plane or may in the plane approximately parallel to the traveling area of the x ray emitting position of low resolution 3D reconstruction, or such traveling spatial location is in close proximity with each other, the traveling path of the x ray source emitting location for 3D reconstruction for at least low and high resolution 3D reconstruction may be combined.
  • the reason for recombined spatial locations of x ray emitting location may be to shorten traveling time for x ray emitting position if the x ray emitting position to be moved. Another reason could be to limit the number of new unknown voxels outside of VOI to be measured, for example in the region next to VOI, but not within VOI, voxels adjacent or right next to the VOI, may be on the same projection path which include voxels from VOI.
  • the projection images of the x ray source or x ray emitting positions for high resolution 3D reconstruction are in the same approximate regions of the detector or having similar or approximately same projection volume from x ray emitting positions of projection images used for in low resolution 3D of the VOI.
  • the Xc can be approximately less than one pixel on the detector or more than one pixel, the distance between x ray emitting positions to allow reconstruction for both low resolution or high resolution 3D reconstruction may be less one pixel or to multiples of Xc.
  • Xc may be in the dimensions of multiples whole integers of a pixel , or may be in the dimensions of less than one pixel, or may be any where between one pixel to multiple integers multiples of one pixel or Xc may be in between integer multiples of a pixel.
  • the x ray projection source position may be selected from the total emitting positions based on low resolution or high resolution 3D reconstruction.
  • the projection sequence of x ray emitting positions or the x ray emitting position movement sequence or movement pattern or spatial travel distance may be designed to minimize total x ray acquisition time or x ray electromagnetic steering time or the time required for mover to move the x ray source.
  • x ray source or x ray emitting position may be of varied intervals, but may have complete set of x ray emitting positions for projections to be collected for 3D reconstruction.
  • the x ray emitting position may be set with Xc/2 intervals, so that there may be addition projections to be used to for example:
  • Additional projection or linear equations may be used in cases, where there is missing data to be collected for example, if beam blocker blocks a number of primary x rays, additional projections than P or approximately minimal projection numbers and at least minimal number of projection x ray emitting locations may be taken.
  • Total set of x ray emitting positions for both low resolution and high resolutions and any other additional projection emitting positions may travel through the most efficient or optimized travel path.
  • 3D reconstruction or image processing relevant methods may select a number of projections from selected positions at a time from the total collected projection image or from the projection images from the complete set of x ray emitting positions.
  • the resolution desired in the z direction is Xc
  • Xc the resolution desired in the z direction
  • the resolved scaled Voxel, Vsc have dimension along z in the dimension of Xa x Xb x Xc x Sc , where Xa, is the resolution along the x axis, Xb, y axis and Xc, z axis.
  • the highest number of Sc is the numbers of units of Xc along the z direction, or P.
  • Sc may be between 2 and p.
  • Dimensions of Xc could be between greater than 0 , less than 1 pixel to multiples of pixels, and everything in between.
  • Resolving voxel reading Vsc comprising Xc x Sc x Xa x Xb will reduce number of unknowns in the volume of interest and provide more linear equations for the same VOI.
  • Resolved voxel value may provide constraints or optimized conditions for resolving voxels with resolution of Xc along.
  • the additional introduced unknowns outside of the VOI may be sufficiently small that extended region of detectors outside of the first projection detecting region is also small such that only small number of pixels in the extended regions of detector are to be read beyond the first detector region measuring the projection image of VOI.
  • the number of voxels outside of VOI may be very limited in quantity due to the fact that as the x ray source moves to new locations for x ray projection, or x ray projections taken from new x ray emitting positions, for example, such positions are at least Xc apart. If such a Xc is in the dimension of one pixel. Projections taken of VOI at a new location which is Xc apart from its ajacent x ray emitting position, the newly introduced unknow voxels in the region outside of VOI may now be in the new projection path where at least one voxel from VOI is involved.
  • the detector region which collects measurements of such new projection line collect signals which are lands on just a fraction of Xc within a pixel or a fraction of pixel offset from the projection of the most adjacent projection from the most adjacent x ray emitting position. And when total number of projections, at least P number are measured, instead of square root of P , or a calculated number relating to P in one dimension to up to six dimensions in P, only one or two or a few extra pixels are extended along at least one axises. As a result, sometimes, the new ly introduced unknown voxels are very limited in numbers, may be ignored. In this case, projection emitting positions for calculation, image processing and or 3D reconstruction in low resolution or high resolution, may be placed in only partially overlapping regions or may not overlap at all.
  • the extension of the measurement region of detector during projection acquisition while the x ray emitting position changes may be at least one or more pixels.
  • the extension could at least one pixel row and additional one pixel column in the opposite direction of x ray emitting position as compared to the emitting position before.
  • the x ray emitting position is in a xy area region centered in the center axis of the cone beam whose projection image is approximately center of all projection images.
  • the dimension of one side of a pixel on the detector is less than half size of the Xc in dimension.
  • at least two or more pixels are read and their signals are processed, such as averaged to obtain the appropriate measurement, corresponding to a projection path landing on a region of size .
  • the VOI is partitioned into more than 2 smaller regions, for example a 256 x 256 x 256 VOI, partitioned small region unit may be 4 x 4 x 256 ( x, y, z respectively) the reconstruction of smaller regions from measurements of corresponding detector region which are on the projection path of voxels within the selected volume or region of VOI, may be parallel processed after the projection images of VOI has been acquired for 3D reconstructions. In this case, approximately 4096 units of 4 x 4 x 256 columns are reconstructed.
  • the attenuation value of each voxel can be between 0 and 1. And additional constraints and optimization condition may be applied.
  • the density of a tissue at one voxel location may be similar to those in the regions around it.
  • At least one pixel within ROI or within selected region containing substance of interest dual or multiple energy measurement, determine attenuation value, provisional density value, iterative algorithms as in reconstruction to determine the thickness and therefore density of the substance of interest.
  • 3D reconstruction starts with the provisional thickness value and density of the substance of interest. And perform iterative algorithms as in CT or iterative process in other modalities, until the simulated value on each pixel converge with that of the measured value.
  • two or more such pixel positions may be selected to increase number of projection measurement locations, for example, such pixel positions may be spatially distributed throughout the ROI, or may be aggregated in a region selected by the user or determined by the spatial location and or spatial distribution of the substance of interest, or substances of interest.
  • dual energy or multiple energy measurements may be done in the selected pixels.
  • a ID line measurements or 2D measurements may be done at one energy, and a second or third energy or more energy measurements may be done at the selected pixel regions.
  • the ID or 2D measurements or 2D image may be done to provide a spatial reference.
  • two or more ID and or 2D and or 2D images of the first energy measurements may be done of the selected region of ROI at the same time, but distributed from each other.
  • Reconstruction or material decomposition may be done in distributed fashion throughout the ROI in a parallel fashion. First for derivation of first set of density value and thickness value of two or more selected regions. Until eventually all of the pixels are derived. There is not interpolation but rather providing of provisional density value of each substance in the regions immediately adjacent to the regions measured by the pixels of whose value the material decomposition and or reconstruction image processing have been performed on for substances of interest.
  • Line or volume integral method may be used for reconstruction.
  • volume integral method 3D poly tope that arises from intersecting a pyramidal cone-beam with voxels in VOI.
  • the polytope may be subdivided into a set of subvoxels, so the proportion or the percentage value of a particular voxel in the beam path can be derived, a weight factor may be used.
  • the volume of polytope does not pass the center of voxel, it is a 0, if it passes, it can be assigned a 1 value.
  • a look up table may be established for varied dimensions of region of interest, varied dimensions of voxels and or varied location of x ray emitting positions, and or varied x ray emitting positions of first positions as well as second positions to speed up the reconstruction method.
  • combination of look up table and on the fly calculations may be performed to optimize speed.
  • 3D Reconstruction In one configuration, 3D Reconstruction In one configuration, a Look-Up Table-Based Ray Integration Framework may be used for reconstruction
  • the x ray measurement is set at low exposure level for the estimated body size, the measurement may be repeated at least one or more times.
  • step 3 may be omitted.
  • the measurements may be averaged, for example or added together, or stacked.
  • the measurements may be averaged, for example, to reduce noise, such as random noise.
  • the measurements may be stacked, for example, to avoid photon starvation
  • the measurements may be averaged and stacked with two or more exposure levels.
  • the measurement is set to be 50% equal or less than the minimum required exposure for the estimated or approximate thickness. based on the thickness of the sample, look up in a table or database, volume integral, or x ray beam volume intersection with the voxel of specified dimensions, the said dimensions are the resolution desired.
  • the detector plane relative to the x ray tube is different than the data stored in the table or database, derive a virtual plane of the detector based on the relative x ray detector location, relative to the x ray source, compared to that stored in the database, while all the other parameters values stay the same.
  • Reconstruction of 3D images may be achieved by area-based ray integration using summed area tables and regression models.
  • number 3 and 4 or number 4 may be used in single energy x ray or single energy x ray 2D or spectral 2D or tomosynthesis imaging method to configure the exposure level needed for an imaging procedure from one x ray source radiation position.
  • such exposure setting may be done in real time.
  • such a setting may be used for in the entire image acquisition process needed for a tomographic reconstruction of VOI within FOV.
  • 6D is defined as x, y, z, pitch, yaw, roll.
  • 3D is defined as x, y, z.
  • the segmentation is based on density, or density range. For example, in brain imaging, white matter and grey matter separation is based on density difference.
  • the separation of white matter and grey matter may be based on dual energy or multiple energy decomposition.
  • the segmentation may be based on the ratio of at least one substance to another or more substances, , for example, the protein to lipid ration, in white matter compared to that grey matter, may be different.
  • Such ratio of substances could be substances located in one location comprising one or more voxels or a volume of interest.
  • material decomposition using spectral imaging may be used, such as using a look up table and or inverse energy function response function, and or thickness, the separated substances or the image of each substance may be displayed, certain markers, such as white matter hyperintensity, may be more visible now that the two materials, grey matter and white matter are separated and or the lipid and protein are separated. The white matter hyperintensity may appear more in one substance, such as lipid than protein, therefore more visible.
  • Micro calcification in one configuration, may be separated by using dual or multiple energies.
  • Microcalcification in one configuration, may be separated from lipid or protein component or white matter or grey matter as a distributed rare component, DRC, as defined in the aforementioned PCTs.
  • DRC distributed rare component
  • Such method of segmentation or evaluation of ratios of substances may be used to identify a substance, or diagnose or track or characterize a material or a substance of interest.
  • the spatial location of measurements and energy level may be predetermined. For example, if it is a catheter or a portion of catheter. Its total spatial volume and distribution is well characterized. For the selected ROI within the catheter, a number of measurements maybe close to each other or distributed from each other may be used to spatially position the component or a portion of catheter, The rest of catheter spatial distribution may be derived through simulation.
  • a selected roi involving estimated spatial distribution of the substance may be illuminated and measured, such as a blood vessel, with contrast agents.
  • the concentration of the contrast agents may change over time. Since the tissue external to the blood vessel either stays static or monitored due to material decomposition, and tracking as described in 1), the spatial orientation and the location of blood vessel may be derived due to tissue around it, thereful the concentration of the contrast within the blood vessel may be drived especially if the thickness of blood vessel and attenuation value of the contrast agents measured by each normalized pixel are known.
  • the object or ROI has moved in the 6D space.
  • the central axis has shifted or iso center of ROI has moved.
  • ROI may not have moved, at least one substance has moved and number of projections is the thickness of substance divided by the resolution desired.
  • a high resolution 3 D may be needed to be performed for the region.
  • the 6d spatial distribution of such a substance or substances may stay the same while the interface region with substances of the interest and substances of interest may vary, therefore 3D reconstruction or material decomposition processing may be performed for such a substance or substances.
  • the number of projections may be much less than total thickness of the object in the region of ROI / Xc, but rather the unknown region contains approximately the interface regions of substances of interest with the background or rest of object and what is internal to substances of interest.
  • the total number of projections needed is therefore approximately thickness of unknown region divided by Xc, Xc being the resolution desired in the z axis perpendicular to the detector.
  • the orientation of the substance or the component may be determined.
  • one source may generate one or at least two projection path, received by the same detector or a different detector measurements on each detector, may give rise to determination of the substance position.
  • At least two source or two emitting position - detector pair, each generating at least one projection thin path may also work.
  • Attenuation value of each material is decomposed and at least one substance is separated from the rest.
  • the attenuation value of any tissue or composite tissue other than bone may be separated out, therefore may be accounted for as at least one known segment in the projection path.
  • Thickness of bone / Xc if there are only dual energy is performed. However if there are three components or substances in the projection path, the amount of measurements is therefore approximately ( 3 x thickness / bone /Xc).
  • the substance of interest is thicker than the rest of other tissues, then the total amount of emitting position may be determined by the total thickness of the ROI.
  • reconstruction may also be done, for example using a selected energy for a portion of first positions or a projection images, so that the portion of projected images may be approximately sufficient to resolve unknowns in the corresponding tissue or substance which responses distinctly for the x ray attenuation than the rest of substance in the ROI. And a second level for another tissue, for another portion of first positions or another portion of projected images. And son.
  • the total number of projection image stays the same but the energy level is adjusted during 3D image acquisition.
  • reconstruction of at least a portion of VOI is based on measurements on the area of the detector immediately below VOI on the projection path or each measurement of segmented columns of VOI or of VOI for reconstruction is the detector region approximately below segmented column or VOI, variation of the center of said detector region is less than 0.5mm or less than 1mm, less than 5mm or less than 1cm or less than 2cm, or less than 5cm, or less than 10cm deviated than an original detector region or the original detector position for the measurement of the same VOI or each segmented VOI.
  • the reconstruction of any selected column such as lx 2 x height of the sample or lxl x height of the sample, the detector region collecting projection imaging for any one voxel is substantially different in spatial position during image acquisition for 3D reconstruction, is substantially different for the measurement of any one voxel , therefore for smaller volume of interest compared to a larger volume of interest or larger subject, the amount of radiation is typically larger than what is necessary in prior art configuration, or the total number of detector cells or pixels required to track and measure for 3D reconstruction are much larger in number, or the amount of unknowns which needs to be resolved for accurate and essentially 3D reconstruction of selected VOI are typically much more, therefore may take longer and cause ill condition more likely to occur.
  • filters such as aluminum, copper and tin filters may be placed, between the x ray source and the patient, for example, placed in collimator and used selectively for reducing beam hardening effect and/or dose and and/or to optimize image quality at the interface between tissue and air.
  • filters may be used for adjusting the energy level of the x ray emitting source to optimize the imaging result for a particular substance, substance composite and molecular complexes or one or more coded aperture, or filter which transmissive of a range of energy levels peaking at k-edge of one or more substances in VOI.
  • computation for image processing including the complete tasks or some of the tasks in preprocessing such as remove dark noise, flat field, gain, pixel consistency, dead pixel mapping, spurious noise filtering, normalization, scatter removal, material decomposition, attenuation value derivation for each substance or composite substances, 2D or 3D or multiple dimension, or up to 6D plus time, 7D reconstruction, post processing, such as removing geometric artifacts, segmentation, quantitative analysis of the data, AI assisted diagnostics, or any AI assisted reconstruction, tracking, monitoring, presentation, texture map, density information, parallel computing, cuda, annotation, or other CT or spectral imaging typical image processing methods and noise and artifacts removal methods, may take placed locally at the detector location, or take place at the microprocessor integrated with the hardware controller, or may take place at a desk top computer or a server, with a graphic microprocessor, GPU or parallel computing device, or being transferred via wired and wireless communication protocol, through one or more wireless or wired networks, such as cellular network , or satellite, or dedicated network
  • a microprocessor at the location of image acquisition or image data source or image processing site may digitally determine or a user using such a microprocessor may determine and send command digitally to a digital program or software to set conditions to separate different tasks and in some cases, categorizes the tasks.
  • a portion or complete of tasks are transferred out of the original data site to a remote location for image processing, but patient private information may not be transferred except information about the computing or processing tasks and relevant data needed for image data processing.
  • such tasks may be tagged, or labeled or marked with identifier or identifiers which are different than patient Id or sensitive data from the patient. From example, the location of the x ray device where the imaging acquisition is taken, and or tagged with time the images are taken, and or based on. The identification of the data set is given by the time of which such data is set, therefore no patient sensitive information may be transferred off site or away from the image acquisition location, only tasks to be completed.
  • Such tasks may be sent out when, for example, during an imaged guiding intervention procedure or during diagnostic and or during patient monitoring, or during pre surgical planning and during surgeries or clinical studies or post procedure analysis and processing.
  • Communication of such tasks intranet or external via internet or other digital network may or may not be encrypted.
  • the usage of the server, and computation access and or data and computation complexity level may be subscribed or based on per use case.
  • a computation server may be installed within a hospital to serve multiple image acquisition systems, and or multiple image processing applications, stored in a location different from the image acquisition system such server may be subscribed or purchased.
  • Computation may be for application other than medical purposes.
  • payment transaction may be based on a database kept either on the image acquisition system, or controller or at the server used for computation side.
  • the database keeps track of and stores metered information regarding the amount of computing done for each imaging data source location, for example, each computing task is associated with a facility via an identifier which server provider may provide computing service to.
  • Computing service may be provided from outside of the hospital network, payment transaction may be performed based on usage tracked or metered by the server where the computer service is performed, or by the local computer to the image acquisition system.
  • Such metered information stored on the server or the image acquisition or image processing data side may be communicated electronically periodically to payment processing server, where the amount is of payment is calculated based on the usage.
  • a subscription fee may be associated and charged periodically through the payment system involving user interface, payment transaction, encryption, confirmation and communications involved in similar digital banking transactions.
  • Meta file for each image may contain image identifier, may contain configuration of system matrix, time label, DICOM tag, or reference to a 3D or spectral image reconstruction or meter which may indicate the count of the images, taken of the same object or ROI.
  • a tally of or count of the number of an imaging procedure of each category of imaging modalities are recorded in the portal a user and or administrator and or maintenance staff or tech support can access.
  • imaging modalities such as spectral imaging, tomography, general X ray or densitometer
  • tally can be included in user information or user portal and or log file and can be retrieved and displayed in either admin panel in the software and or send through an intranet or internet or hospital communication channel to a server either for storage and record keeping and or for confirmation of service rendered and business intelligence analysis, and or sent to a customer site as an electronic invoice or directly feed into a communication method used by a customer such as hospital, clinics and imaging centers.
  • one method to determine and or approximate minimum exposure needed for quantitative imaging and / or material decomposition includes one or more of the following methods:
  • Measure the material decomposed image for each substance if the primary image of the measured value or a image with has 1% or less SPR or 5% or less SPR or 10 % or less is approximately equivalent to the simulated or calculated projection image or value on each pixel based on an analytical algorithms and/or based on Monte Carlo simulation, of the substance or composite tissue, the minimum exposure under which the measurement is done is sufficient.
  • a database may be established either by direct measurements and or interpolation of various samples of thickness and or components, for each organ, or region of organ or tissue or tissue composite. Or such minimum exposure value may be obtained from an existing database.
  • the measure value may be x ray measurements, a primary x ray image with less than 1% of SPR or less than 5% of SPR or less than 10% SPR.
  • automated exposure control is generally based on the previous measurements. However the level of radiographic exposure is determined based on the present day diagnostic levels with antiscatter grid.
  • Automatic Exposure Control may be set by using an established database, depending on the region of ROI or type of ROI and dimension of the ROI, the automatic exposure is set.
  • An sensor such as Time of flight sensor may be used to measure such dimensions or cameras.
  • X ray measurements of the same or approximately same ROI in some case, with image processing, such as noise removal, and other image processing techniques and / or scatter removed to be of less than 1% SPR or less than 5% of SPR or less than 10% of SPR may be used as a reference to determine the exposure level, for example, by simulation or calculation, where such exposure level will generate approximately a minimum pixel value of measurements of ROI, normalized and or with scatter removal, is 5% or 1% or 1% to 10% of the saturation level of the detector.
  • Time of flight sensor may be used to generate height map or thickness measurement of an area selected from a 2D image generated by a 2D camera.
  • the height information or thickness of the selected region digital or visually, such as a height map or 3D surface view generated based on the height measurement or grey scale image of time of flight sensor may be displayed or layed on top of the 2D image, for example, layered over the region of interest from 2D. This may be used to replace a 3D camera with accurate measurement of 3D, as it is less expensive and may be more accurate in some cases of measurement.
  • Sensor such as time of flight sensor may be used to measure the thickness therefore the number of projections needed for 3d tomography.
  • an x ray image based on selected region of interest may be displayed in the camera view.
  • the images of different modality may be displayed separately or colocated.
  • Computer may indicate region of interest with a selection indicator, such as a box which shows the selected region on the camera image, and at the same top, the height map or grey scale image or key measurements of height map or thickness information or 3D surface model or measurements are displayed in a separate display region or on top of the camera image or image of the selected region in the camera capture image is replaced by the gray scale image or height map or thickness measurement or 3D information.
  • the computer control may toggle back and forth between images captured by different modalities, camera, time of flight sensor, or x ray or other modalities such as optical imaging method or MRI or ultrasoound, for the region of interest.
  • the background image could be image captured by any modality such as the camera or time of flight sensor or x ray image.
  • the x-ray imaging is taken with the following steps, some steps are optional
  • the user selects the region of interest using user interface offered such as on a computer and or a joystick or a computer input device or a handswitch
  • Selected region can be converted into 2D or multiple dimension coordinates, for example in a system matrix
  • the ToF sensor or non radiation sensor such as optical sensor is programmed to perform measurement of this region specified by these coordinates.
  • this heightmap image is displayed like another layer over first image and we place this heightmap image over the previously selected region of interest.
  • the height map image displaces the region of interest in the 2D image or the height map may be converted into a grey scale image, or a 3D surface model of the region of interest or there is an indicator on the 2D camera image or numerical display on the computer user interface at least the maximum and or minimum of thickness of VOI within field of view selected for ROI, or thickness range of the VOI
  • the user may select the region of interest based on the first x ray image or the computer program may select the ROI based on at least one or a set of criteria.
  • Exposure settings may be adjusted, or exposure time may be adjusted or the number of images may be set , in some cases based on the first x-ray image so that additional images are taken to provide the data and information the application needs.
  • the exposure adjustment is not needed as the exposure is set based on the measurement of the time of light sensor.
  • each plate one or more beam particle absorbing regions which attenuates x ray beams, in some cases, approximately 100%
  • the corresponding projection measurement of VOI, acquired by the detector there may be at least two positions for the same beam absorption particle array (also called “beam blocker “ array).
  • a position A and position B for the same beam absorption particle array for the same x ray emitting position or x ray source position.
  • the x ray shadow area of projection measurement while the beam absorbing particles at position A on the detector may be replaced by the measurement or essentially primary x ray measurement of same detector region of a different projection while the shadow of the beam absorbing particles are at the position B location and the x ray source location or x ray emitting point location are at the same spatial location relative to the VOI and detector. And reverse may be done for shadow regions of beam absorber particle array.
  • the resultant projection measurement at position A or Position B may be called “missing data gap replaced modified projection or primary image measurement” or simply modified projection or primary measurement at Position A or at Position B
  • the modified projection measurements at position A and position B may be added together on a pixel by pixel basis - each derived or measured value of each pixel location on the detector are added together, the total measured value can be directly used for presentation and or display, or the averaged value, in this case, total value on each pixel divided by two, may be used for further analysis or for the presentation of the generated image value.
  • more than two positions such as 3 or more beam particle array positions may be used if multiple frames or multiple exposures or measurements are needed for the application, for example in reducing time for image processing and or reducing possibly total numbers of projections to be made or generated or measured.
  • position A and B or C, or more are not overlapping. Therefore the missing gap is different in each position.
  • the beam particle absorber plate may be placed at position A, position B and Position C for each frame of projection measurement.
  • the total stacked images or total averaged image will therefore have regions from data derived from two projection exposures, therefore only missing 1/3 of the total data compared to regions outside of beam particle absorber shadow areas on the detector for position A, B and C. the benefit of additional spatial locations is so that the measurement exposure time or sampling time can be increased for the missing data regions.
  • the number of projection measurements at position A, or B or C etc can be the same or varied depends on the requirement. However, it is preferred that equal number of projections at each position at taken to avoid photon starvation or improve data quality due to quantum photon randomness.
  • one configuration includes the following one or more steps.
  • Step a • Take the first image for position A of the beam blocker positions at one x ray emitting position p in six dimensions, and a particular position in six dimensions for detector D and particular location in six dimensions for beam blocker plate B
  • One configuration for the shadow finding or location of all scatter signal region method is one or more of the following:
  • One configuration Using known geometry, spatial position in up to 6D or 7D x ray tube or emitting position, known position of detector, beam blocker array, spatial position and spatial distribution of each beam blocker, locate the simulated shadow region on the detector of each beam blocker at least one pixel, which has a beam path directly traced back to the x ray emitting position, with the beam blocker / beam absorber particle in the beam path.
  • one configuration o Using circle finders or shape finder algorithms to find predicable shape or pattern of the shadow on the detector
  • Another configuration for the shadow finding method is o Find regions which have signal levels below a certain threshold or within a certain range, with one or two or more pixels, or pixel region which approximate or slightly smaller than of predicated beam blocker or beam blocker shadow dimensions, which may have approximately lowest level signal compared to the surrounding the detector region, within field of view illuminated by the x-ray beam or selected by a beam restricting device between the x ray source and detector. o
  • One configuration for the shadow finding method is o Find regions which have signal levels below a certain threshold or within a certain range, with one or two or more pixels, or pixel region which approximate or slightly smaller than of predicated beam blocker or beam blocker shadow dimensions, which may have approximately lowest level signal compared to the surrounding the detector region, within field of view illuminated by the x-ray beam or selected by a beam restricting device between the x ray source and detector.
  • the verification of the accuracy of shadow region of the beam blocker may be performed, as the spacing between the shadow regions have predicable range based on the beam blocker array design.
  • Step b some of the steps and configurations are optional
  • imaged subject is placed between the source and detector
  • One configuration includes one or more the following configurations or steps:
  • a test has been performed, that the shadow regions identified to have predictable approximate spacing between the shadow areas if more than one shadow areas are found.
  • the location X is determined prior to the imaging of the subject.
  • the position of shadow areas are determined from image in the location X area.
  • shadow area of the rest of beam blocker are determined based on the shift from Step a image of the same shadow areas and or relative spatial positions to the shadow areas within location X, where X is identified as a portion of the complete beam blocker shadow position and has a relative specific spatial relationship to the rest of the shadow positions for the approximate x ray emitting position and or approximate beam blocker array position.
  • the determination of the shadow areas could also be determined through calculation of x ray emitting position, relative to the shadow area, thereby determine the beam blocker position corresponding to the shadow region, or what is called, reference beam blocker or reference beam blockers if there are more than one beam blockers and their corresponding reference shadow areas are measured and calculated.
  • the location of beam blocker corresponding to the shadow area can always be determined, and as the location of other beam blockers are fixed to the reference beam blockers.
  • computer software determines the field of view of the detector which is used to image the subject for example, the edge of the image may be determined, such as due to detector measurement, beyond a threshold, that is outside of the field of view.
  • high resolution scatter image can be derived from scatter interpolation.
  • scatter Interpolation • Interpolate selected data point or data points in the shadow area, for example, approximately center region of the shadow area to derive high resolution scatter image
  • the following process may happen a) repeat 1-9 or b) assume that position A and position B of beam blocker are assumed to be the same interpolate using the same position a and position b beam blocker position, but adjust the center position of the beam shadow for interpolation based on the position of the x ray emitting position; or c) assume that position A and position B of beam blocker are assumed to be the same interpolate using the same position a and position b beam blocker position, but do not adjust the center position of the beam shadow for interpolation based on the position of the x ray emitting position as x ray emitting position is very close to the one before, the center of beam blocker shadow therefore has little change, position change can be negligible; or d) using the method in c) for a number of x ray emitting positions, but adjust the center of beam blocker shadow area based on x ray emitting positions
  • a x ray image of the beam blocker at Position A may be taken prior to the subject being placed between the source and detector. And beam blocker shadow regions of position A of beam blockers are determined, separately. And center pixel or center region of the shadow areas are determined and used as the data point for interpolation to derive high resolution scatter image at position A In one configuration, same process is repeated for Position B or at other position of the beam blocker array.
  • the shadow area of beam blocker at position A may be shifted and determined in the system matrix based on the geometry of the x ray tube and detector.
  • an optical sensor is placed near the actuator of the beam blocker to measure the location of the beam blocker.
  • a laser and laser measurement device is used to sense the actuator location.
  • an LED and a wide angle lens are used to sense the location of the actuator.
  • an led or retroreflector of led is placed on the side of actuator at a fixed location, as the actuator moves, the emitted or reflected light is captured by a wide angle negative lens or fish eye lens combined with or not combined with a waveguide.
  • the location of collected signal spatially can be corelated with the location of the actuator. The precise location of the beam blocker plate can therefore determined.
  • the side of the detector may be attached to a light source or a retroreflector and the a sensor placed directly in the line of sight or optics are placed in the line of sight steer the light emitted from the light source to the sensor.
  • optical based sensors may be used to detect the precise location of the detector and or the actuators attached to the beam blocker plate or the beam blocker plate.
  • a sensor which signal gets interrupted when the actuators of detector and or beam blocker plate moves pass the sensor where the sensor ‘s placement is precisely at a known position. If the sensor sensing occurs with predicted timing or steps of movement of actuator, then it is verified that
  • Light bars or light indicators may be placed or embedded on the x ray system, or integrated as part of the system for example at the top enclosure end in the middle, or on the control panel or at the base, behind the logo to light up the logo at the exterior.
  • the color can be one or more colors selected from the color chart. For example, green may be used for eco or less radiation, or branding, or blue for cooling effect, or pink may be used for girl, lady.
  • the indicator can be one color or it can alternate and change to different colors based on the customer, for example, blue for boy, pink for a patient who is a girl etc. to make the machine more appealing by soothing the patient or calming or other therapeutic or meditating or mood adjusting for the patient. Or it can be multicolored for example, when spectral x ray is administered, designated color may be used to symbolize different wavelength.
  • LED may be used for the light indicator.
  • Other light sources may be used alternatively.
  • light bar can be placed in the middle or edge of top enclosure.
  • Light bar can be used to enclose the control panel on the system or any where on the machine for aesthetic reasons or mood adjustment or informative purposes.
  • Images obtained by conventional general x ray imaging method, with 2D detector, combined with for example, an antiscatter grid, may require radiation exposure for example at 30m As to 40mAs, a typical setting for chest imaging, to achieve visualization presentation, familiar to users such a radiologist.
  • the presentation of the image at a low exposure level may be visually difficult for a user to see.
  • exposure may be increased for better visualization after image processing and or reconstruction.
  • increasing exposure for example by exposure time, or increase current or both, may saturate the detector, therefore affect the accuracy of the quantitative measurements, or affect the repeatability or post measurement image processing, for AI or density measurement.
  • a high dynamic range reference detector may be used to overcome such situation.
  • two or more images such as the primary images with less than 1% scatter to primary ration or less than 5% or less than 10% of scatter to primary ratio, separate exposures of the same ROI may be used and/ or combined.
  • the x ray radiation level reaching the ROI and / or exposure level may be below the saturation level of the detector.
  • the total added exposure level may be less than or substantially less than that of conventional x ray or radiographic image needed for a visual diagnosis by a user or AI diagnosis, for example, from 2/3 to 1/10*, ( two thirds to one tenth) or 2/3 rd to 1/1000, or 8/10 ( eight 10 th ) to 1/1000.000 of the radiation level of a conventional x ray image.
  • a first pulse may be a full view image and second or third pulse of a different energy level may illuminate smaller region of interest or may be lower resolution such as using a distributed illumination or structured illumination.
  • Distributed illumination or structure illumination of x ray thin beams may be achieved by a conventional x ray tube, for example, using a collimator or a variable target or a MAD filter or beam chopper or a filter, or a digital controlled field emitter x ray source with adjustable Field of View, or a monochromatic x ray source, for example, a monochromatic x ray radiation derived from a filter or generated by fluorescent x ray from a second target or x ray radiation from synchrotron radiation.
  • a multiplication factor of more than 1 may be applied to the measured value and or intensity value and or Hounsfield value, so that total intensity value of each pixel is higher for visualization, however, AI, density and or post processing or image analysis take into account such a factor or omit such a factor for accurate image analysis, as such a multiplication factor is used for visualization purpose, for example, so that the intensity level is pleasing or is at the level which is familiar with that of a user, such as an radiologist.
  • each separated substance Hounsfield value may be multiplied by a factor, for multiple components or multiple substances in a ROI, Hounsfield value of each substance or each component may be multiplied by a same or different factor and / or adjusted quantitatively on a pixel basis, and or on a detection region basis and or on at least one measurement of one or multiple pixels at least one time, for alternative presentation and/or alternative visualization.
  • an image of 2D may be presented with improved visual diagnostic value and /or human user friendliness, at the same time, allowing lower radiation exposure to the subject or ROI.
  • MFP multiplication factor presentation
  • MFP method may be used in point, or ID x ray measurements with radiation reduction to less than 2/3 to less than 1/10,000,000 of conventional radiographic and CT imaging level.
  • MFP method may be used in timed measurements, such as dynamic measurements with tracking or monitoring or fluidic dynamic methods.
  • Multiplication factor presentation or MFP may be combined with the use of various color which is either true to the nature color of the substance or a color selected to distinctly represent at least one substance or one ROI, different from the measured color value such as grey scale or RBG value.
  • Blood vessel space which is mapped out by the first multi dimensional reconstruction using contrast agents which is a substance differentiable by spectral imaging, may be used to derive concentration of contrast agents in the blood vessel over time as a constraint in a 3D reconstruction. Illustrated in Fig. 2 , one example of using such a reconstruction process is the following:
  • Display is controlled (g)to present images of blood vessel separately or against a reference or background.
  • datasets without contrast may not be acquired prior to datasets with contrast agents
  • contrast agent concentration presentation is amplified, in intensity presentation of selected color to indicate a clear blood vessel image.
  • contrast agents may be proposed to be reduced.
  • the x ray measurement is not uniform, there are highly saturated region due to absorption of bone, or other super absorber, such as a metal, as a result, if there is contrast agent spatially distributed in the projection path of a thick bone, the measurement contrast agent or the Prescence or quantification of contrast agents are interfered.
  • the scatter is removed to less than SPR ⁇ 1% or less than 5% for example, as the contrast agent is reduced, for example, at least to ,50% , ⁇ 75% , or ⁇ 90% , or ⁇ 99 % , or ⁇ 99.5%, the precise attenuation value or optical density due to contrast agents are measured, in a spectral measurements, or single energy point, ID or 2D, or in multiple dimensional imaging conditions.
  • Microbubbles generated by ultrasound for example may be used in void imaging by x ray tomography or spectral imaging. Inter lumen mixing may be characterized using this technique. microbubble disruption at high ultrasound pressure was harnessed as a technique for injecting a negative indicator by creating a microbubble void within a microbubble-filled vessel.
  • a long burst of 5000 cycles at 2 MHz and a peak-negative pressure of 1.3 MPa was transmitted from the single-element unfocussed transducer to destroy the microbubbles within the intersection volume between the ultrasound field and the vessel lumen
  • Microbubble contrast agent In one configuration,
  • decafluorobutane microbubbles were prepared by the dissolution of l,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine (DPPC),
  • microbubble solution generated was sized and counted according to Sennoga et al.
  • microbubbles were diluted in outgassed water (Mulvana et al. 2012) to a concentration of 2 x 10 5 microbubbles/mL.
  • microbubble disruption at high ultrasound pressure was harnessed as a technique for injecting a negative indicator by creating a microbubble void within a microbubble-filled vessel.
  • a long burst of 5000 cycles at 2 MHz and a peak-negative pressure of 1.3 MPa was transmitted from the single-element unfocussed transducer to destroy the microbubbles within the intersection volume between the ultrasound field and the vessel lumen. This level of ultrasound transmission is well within the Food and Drug Administration (FDA) safety limit (FDA 2008).
  • FDA Food and Drug Administration
  • Missing data may be due to grid space between active pixel area in a detector in some cases, interpolation may be used to fill up the missing data gap. In some cases, additional images may be need to be taken to fill in the data gap. For example by moving the x ray emitting position in the same area the first positions of the radiation emitting positions, only in positions different from the first positions, or second positions where the emitting positions may be center at regions in between the first positions.
  • one or more markers which may be placed in one or more distributed location, may attenuates x ray differently than the background, in some cases, perturb x ray distinctly and or differently than the rest of VOI, achieved through distribution through space, atomic z and or density, may be used to characterize relative distance and or 2D - 6D position of anatomic markers in VOI.
  • a marker may be used to collocate the patient anatomic markers as the patient moves, for example, when patient rotates in order to improve accessibility for procedures or reduce radiation exposure or for better visibility, for example, reduce number of tissue types in an VOI.
  • the marker may be measured by x ray and or may be sensitive to optical measurements, such as it has reflective surface, and can be measured by an one or more optical sensors placed externally to the patient.
  • One or more optical sensors may be placed on the patient, which may capture retroflectors or LED positioned in the line of the sight of the sensor to precisely position the patient 6D location.
  • Such a device may be used to collocate multiple measurements where the VOI may be rotated and or there may be motion by VOI which affects x ray measurements and artifacts may be generated.
  • the system substantially unifies the coordinate systems of the patient, optical position sensing device and or imaging systems
  • representation of point measurements such as material decomposed measurements to represent individual substances, or composite substances, may be displayed against a 2D or 3D background, based on the spatial location of the ROI illuminated which result in the point or ID or structural illuminated projection measurements.
  • Such spatial location may be derived from the determination of the movement of x ray source, or x ray emitting position, and /or focal spot size, field of view, relative to the ROI, and / or relative to the detector.
  • Such spatial positioning of ROI illuminated region may be determined by measurements prior to the subject or ROI placed in between the source and the detector.
  • x ray tomography systems such as conventional CT is bulky, therefore difficult to be moved around due to its dimensions.
  • the tomography system described is compact, small enough to fit through a standard room door.
  • the source emitting position mover or the beam steering device may be permanently mounted with the source or detachable.
  • Various sources may be placed in the same mounting location. Such sources may be detached prior to moving to avoid major impact. And such a source or sources may be kept in a case during transportation.
  • the navigation, and drivable device and transport device is detachable. Thereby can standalone and used to transport other tomography system.
  • such a device is detached from the x ray system, as the mobile portion comprising the drive device, or the transport device and the navigation device is not permanently installed to save space. In some cases, part of which are connected permanently.
  • Tomography system may be equipped with a pulling electric motor, which is driven by a user pressing a button or using a control stick.
  • Such a tomography system may be collapsible into a more compact form for easy and safe transportation to avoid damages and causing damages to the surroundings during transportation.
  • a mobile X-ray tomography apparatus capable of taking 2D and or spectral imaging and measurements, for imaging guidance, point of care diagnosis, diagnosis, 3d fluoro, comprising an apparatus body comprising one or more of the following items: x ray generator, computer acquisition, processing and viewing device, an X-ray source or an x ray source mount where an x ray source may be detached or attached and an X-ray detector mounted thereon or an detector mount where x ray detector may be detached and reattached upon reaching the destination, associated power supplier, controllers, said apparatus body may be connected to a mobile body comprising one or more of a drive device and a transport device;
  • the mobile body may be permanently attached to the apparatus body or may be detachable.
  • Computer for image acquisition and or a display system may be part of the apparatus.
  • the mobile body has container location which has one or more slots for the detector or detectors, and container location for the x ray source or x ray sources.
  • One or more element of the mobile body in some instances are permanently connected to the apparatus body, for example the transport device.
  • an instruction receiving device is connected through a physical connector to the apparatus body, is detachable, the instruction receiving device being configured to receive an instruction configured to be entered therein as an input, and configured to instruct the mobile body to transport the apparatus body to reach a designated position; a navigation device removably mounted on the apparatus body, to which the instruction receiving device sends the instruction, the navigation device including a detection device comprising an optical detection and distance-measuring sensor, the optical detection and distance-measuring sensor being mounted so as to face a region in front of the apparatus body in a direction of travel thereof, the optical detection and distance-measuring sensor being configured to emit a series of coded laser pulses at intervals of a predetermined angle in a plane in space so as to detect, in real time, the environment of the mobile X-ray examination apparatus, wherein said navigation device is configured to create an environment map of an environment of the mobile X-ray e amination apparatus, and to determine a current position of the apparatus body according to a detected environment profile information;
  • a portable tomography system with an ambulance, as a portable CT.
  • a portable CT may be battery operated or may be powered by the electrical vehicle or the engine.
  • the exterior of the CT should be connected via mechanical method and or hardware.
  • Locking mechanisms to lock the wheels of the x ray system and or the x ray source and related hardware and or the mover for the x ray source in place.
  • a stationary x ray system may be installed inside the vehicle, as a part of the construction, for example to the ceiling and to the floor of the vehicle. And there may be support connections to connect the structural support of the x ray system to either the floor and or at least one side of the vehicle.
  • the x ray source may be attached to a robotic arm which may have one or more joints, which allow flexibility in direction as well as flexibility in distance and movement in dimensions the movement may be manually controlled or motorized.
  • electromagnetic steerer may move the x ray emitting position for tomography and or a mover to move in at least one axis of 6D dimension for, for example, tomography and or increase field of view of the tomography, for example to perform tomography in two ROI which may be separate from each other spatially in the xy plane parallel to the detector.
  • such an x ray system inside an ambulance can be a whole body tomography system.
  • the field of view may be adjusted by collimator, MAD filter and or adjusted internally by the field emitter x ray source where the angle of emission is adjusted to fullfill the demand of field of view.
  • the field emitter source may also be adjusted to emit structural illumination such as only a certain regions of emitter is emitted, thereby generating a narrow beam.
  • Sequential generation of narrow beam or simultaneous narrow beam distributed from each other may be generated to measure a VOI to track or interrogate, for example, with multiple energy x ray.
  • the focal spot size may be adjusted by the x ray source for example field emitter x ray source depends on the application demand and resolution demand in xy or multiple dimensions.
  • Beam particle stopper plate may be moved for spectral imaging or tomography or may stay stationary.
  • the data gap may be interpolated from adjacent regions, for example, for visual presentation purpose, and or when accuracy requirements or precision requirements are not very high but in general to make up for the data gap due to beam particle stoppers, the beam particle stopper may be moved, and or imaging in other energy level while the beam particle stoppers are in a position different from those which caused the said data gap, and or as the x ray emitting position moves, the region of ROI, which are illuminated by the primary blocked by the said beam particle stopper position to cause said data gap, may not be in the same position relative to the emitting position of the source, therefore the primary x ray from the emitting position may pass through the said ROI region and reaching the detector instead of blocked by the x ray emitting position.
  • reconstruction of adjusted resolution may be done on one tissue and a different type of reconstruction such as a different resolution may be done on a different tissue. For example, if a tumor is estimated to be embedded only in selected one or more tissues, only high resolution 2D or 3D images need to be reconstructed for those tissue only.
  • the other tissues may be estimated by the nature of slow variation or AI method to derive the three dimensional and or spectral data.
  • additional measurements or projections may be performed to interrogated the selected tissues.
  • measurement of one or more relevant substance or component or ROI in varied settings of resolution in spectral or spatial domain, or in the time domain may be done in order to derive information may be used to derive information which reveal negative presence or absence of a certain substance or component or a tissue or a marker.
  • Reconstruction may be based on system matrix or a non system matrix approach in which each voxel is tracked and labeled based on each projection line and its attenuation value may be derived.
  • prior trajectory geometry are designed either to accommodate multiple applications by different users, therefore providing flexibility of multiple degrees and multiple coordinates. And the user may put in any projection geometry using the software.
  • the example are use of various applications of tomosynthesis of large angles.
  • the system matrix set up here are simplified and specific for one system, therefore providing only limited number of degree of freedoms for the specific application only.
  • Additional coordinate or coordinates may be added for example to represent x ray detector and or x ray source rotation. These coordinates may be needed because of the alignment of the source and or detector may not be deviated from the theoretical position where the program or the user sets at, the user can either align the hardware perfectly or use digital method to track the rotation and or misalignment of the detector and the emitting position.
  • the data is then used in calculation of preprocessing, or post processing to correlate data, or to make image processing and or in reconstruction algorithms.
  • a virtual detector position, relative to the x ray emitting position may be generated in which the x ray detection plane is perpendicular to the center axis of the cone beam or center axis of a set of distributed thin beam. And the measurements may be converted to the measurements at a translational and or a rotation placement , which is where the actual detector is placed at to illustrates the actual geometry.
  • the virtual detector position relative to the actual detector position is determined by a number of means, including sensors, such as time of flight sensors, or cameras or at least point detectors and or x ray exposures and or x ray exposure plus reference objects with which measurements may give rise to the accurate determination of virtual detector spatial position information.
  • sensors such as time of flight sensors, or cameras or at least point detectors and or x ray exposures and or x ray exposure plus reference objects with which measurements may give rise to the accurate determination of virtual detector spatial position information.
  • the algorithms may make use of a measurement such as white field measurement and or during measurement of a subject, with or without a reference marker or reference object to determine quality of cone beam as well as its position in 6D.
  • measurements may vary, depends on the x ray source, due to the variation of spectral or multiple x ray radiation characteristics and or source design.
  • the differences may be characterized prior to the measurements of the ROI so that the differences may be accounted for in each reconstruction or spectral imaging calculation. This may be done by deduction based on characterized beam behavior and measurement at a specific location of the cone beam
  • the thickness and density can be estimated for each tissue
  • the thickness of ROI may be derived.
  • the thickness of the ROI may be used such that in the material decomposition method, where on inverse energy function system using interpolated plot is established via the data points derived from measurement of known samples with known density with similar thickness range of the ROI. For example, if the thickness is 5cm, a number of known samples with similar density as with thickness varies for example from 2 - 5 cm, may be measured individually and or in a composite material similar to the ROI, to establish an interpolated plot at dual or multiple energies. And given the thickness of ROI at 5cm, such a plot is used to be accurately deduce the attenuation value of each of decomposed material within the ROI. If a large pool of measured value is obtained. Based on the thickness of ROI, an interpolated plot or energy response function system may be generated specifically for the thickness range, in order to derive more accurate or precise results of material decomposition for the ROI.
  • Integrated audio and or camera/video may assist patient positioning within the x ray system for imaging, or may assist user such as medical tech and patient communication while the patient and medical tech are not in the same room. And or in situations where remote monitoring and imaging are required from a location adjacent to room housing the imaging system or from a room remote from the room housing the imaging system. For example, in consideration of social distancing or when the patient is highly contagious, limited contact or no direct contact is needed during the imaging procedure. Speaker and audio system as well as camera system and visual system may be used at the patient side.
  • speaker, audio, camera and visual system may be used the user side, which may be in a different room.
  • a imaging system comprising:
  • a table may be placed on top of the gantry b
  • a gantry A containing detector or detectors for receiving radiation may be used as a surface and structure for patient.
  • a gantry A containing the x ray radiation source is above said table;
  • a side gantry C containing structural support, for example, on the side of table, for supporting the radiation source and or connecting the radiation source with Gantry A where the detectors are.
  • One configuration of the build of the system is to leave a gap between the support pillar and base gantry.
  • having a connecting bridge to allow electric wiring and control of the stage from the pillar at the same time, allowing a patient table, such as a surgical table or patient bed to be placed directly below the x ray source and base gantry without having to move the patient off the table.
  • One configuration is to have the base gantry directly connected to the support pillar so that the patient can be load onto the patient table above the base gantry where the detectors and assemblies are held.
  • Gantry A, B , or C may be integrated.
  • A optionally a display screen mounted within said system so that it can be viewed by said patient; the display screen may display images of the patient or optical camera images of the patient and or images of the user controlling the x ray imaging system, or phycian.
  • At least one camera may be mounted on gantry C or Gantry B for visualization of the patient.
  • Camera can be controlled by a controller at the side of gantry via a microprocessor or at a desk top display side or at the user side remotely.
  • an audio speaker provided with said system, for example, via connection with a controller or a computing system, such that sound emanating therefrom may be heard by said patient;
  • a media player connected communicably to said video screen by a first channel and to said audio speaker by a second channel; wherein said first channel comprises further a standard interface mounted on said gantry A, or B or C and interposed between said media player and said video screen; and wherein a patient may listen to the sound from the audio speaker and optionally view said video screen while undergoing said imaging or before imaging procedure or after imaging procedure
  • the patient may have a microphone on site, which integrated with a microprocessor via communication channel and digitized audio be streamed through a network through an software or digital method, and displayed on a media player in a remote location.
  • a microphone on site integrated with a microprocessor via communication channel and digitized audio be streamed through a network through an software or digital method, and displayed on a media player in a remote location.
  • User, the physician or the imaging tech may have the same set of set up, audio speaker, microphone, and in some instances visual display to visualize the patient and patient position on the x ray table.
  • the audio speaker may also be used for audio alerts such as radiation active and any error conditions.
  • the video camera may be used to assist in alignment of x-ray tube over the subject and region of interest, by the user.
  • the audio and or video system may also allows for remote monitoring or positioning of the patient by verbal and visual presentation and communication between the patient and the user such as a x ray tech or a surgeon.
  • Time of flight Method is used
  • time of flight sensor, and or x ray source may remove the separate primary with scatter to less than 5% or less than 1%, combined with n to n6 matrix method described in the aforementioned PCTs and one configuration one configuration, it allows for quantitative 3D and or spectral imaging in a short time.
  • time of flight method may be combined with and/ or utilized in single energy imaging, spectral imaging, tomosynthesis, with multiple source, or multiple location of the source spanning in a range greater than 5 degrees, or 10 degrees, or 5cm or 10 cm for sparse reconstruction or combined with conventional CT and or helical or any other trajectories which allows for a complete reconstruction
  • amount of exposure may not be enough due to a single pulse, for example, when in the ps or faster range.
  • Measurement of two or more pulses from the same emitting position and/or travel in the same projection path through VOI may be combined to give a total primary x ray measurement which may be characterized using spectral, tomosynthesis and CT and multiple dimensional imaging apparatus and method.
  • characterization of ROI and or components internal to ROI in space and / or in time and or in spectral domain may all be achieved.
  • Scattered x ray signals which has a time delay would be separated out in the time domain from primary x ray.
  • an x ray pulse is emitted from time of flight x ray source, illuminating ROI or a portion of ROI, the corresponding detector is synchronized to capture and separate primary x ray and scatter x ray.
  • the scatter x ray is not measured, only primary x ray is measured by timing the measurement capturing time window of the detector. Any x ray signal outside of the time of arrival for the primary x ray is not processed selectively.
  • the primary measurement from two or more pulses are combined to produce primary x ray measurement for further processing.
  • a time of detector may be used to capture x ray signals from multiple emitting positions at the same time. For example, if each x ray emitting position illuminates the ROI at the same time, however from different emitting positions,
  • Thickness measured by an external sensor or estimated by x ray measurement, or estimated by the user select a size based on visually assessed approximate value.
  • AI may be used to determine or a database may be used to store information on the type and estimated amount of substance or substances ROI may have, from optical measurements, or x ray measurements, exposure level may be approximated based on such values or information. And the thickness or proportion of each substance or composite substances within the ROI may be estimated, for example using material decomposition, such as dual energy or multiple energy x ray measurements. Exposure levels on the subsequent measurements on the same ROI or selected region or regions of ROI for either material decomposition or multiple dimensional measurements or tracking or monitoring may be approximated.
  • the x ray imaging system may be used to guide Robotics
  • surgical guidance of robots may be accomplished by X ray measurements combined with optical based motion tracking to better locate surgical tools.
  • Tracking with a motion tracking device couple to the imaging device, a position and orientation of surgical instrument.
  • Optical based motion tracking may deploy distance to 6D tracking by deploy one or more optical sensor assembly, including a retroflector.
  • the optical sensor assembly may have a negative lens or fish eye lens and waveguide and 2D sensor down stream from the waveguide.
  • the negative lens and the waveguide and the sensor assembly may be monolithic.
  • optical sensor assembly may be mounted to a movable device, which can be tracked by optical means by the following method: two or more LED emitters may be used external to the movable device, optical sensing assembly may be mounted on the movable device.
  • x ray imaging data indicates the position and orientation of the end effector of the robotic arm.
  • X ray measurements may be combined with inertia based surgical tracking.
  • X ray system may be combined with one or more 6D optical input device, for tracking of surgical instrument in minimum invasive intervention procedures.
  • the system is designed to display medical device
  • the system comprises a virtual window system that creates a visual coherency between the image of the patient and his or her anatomy and the patient by aligning the image of the patient anatomy on the display to the patient and presenting the image to the user that feels as if the user is looking directly into the patient through the display.
  • the invention is designed to also display medical devices, such as a minimally invasive tool.
  • the system substantially unifies the coordinate systems of the patient, the medical device, the display, and the physician's hands.
  • the invention creates a visual coherency between the motion of the medical device in the image and the motion of the physician's hands manipulating the device. This method also creates a visual coherency between the motion of the image in the display and of that display.
  • the system includes the capability to display an image of a patient anatomy on a moveable display, said system comprising: a display screen configured to be moved and aligned with target regions on an exterior of a patient's body; a processor configured to receive data representing the patient's anatomy relative to the movement of an intervention or biopsy device such as a catheter or a portion of a catheter or implant for intervention procedures and data representing a position of the display screen in real time, wherein the processor is configured to deliver to the display screen a real-time image representing the catheter or a portion of catheter or an implant navigating in the patient anatomy in accordance with a first spatial relationship between a position of the intervention device and its navigation path in patient and a position of the display screen in real time, the image being updated in real time in response to movement of the display screen in accordance with the first spatial relationship; and means on the display screen allowing a user to establish a second spatial relationship between the position of catheter which is trackable by the x ray imaging device in 6D relative to the patient's anatomy, the position of
  • the display may be a virtual reality display.
  • the surgical tools connected to a surgical effector or a catheter with one or more portion of it having 6D attenuation variations so that it or a portion of it can be tracked in 6d by x ray imaging.
  • a first control signal is generated to control an intervention device.
  • the first control signal is send to or a microprocessor or send to a microprocessor and or directly to a user or be connected to an intervention device or robotics arm.
  • a first valve in the robotic surgical instrument or the intervention device is opened to flow a first fluid over a surgical site.
  • the valve may control the fluid to be delivered through a lumen of a catheter. The opening is at the tip of intervention device.
  • a system for use in treating a carotid artery can include the following components: an arterial access device adapted to be introduced into a common carotid artery the arterial access device having a lumen that extends from a distal opening at a distal region of the arterial access device to a proximal opening at a proximal region of the arterial access device, the lumen configured for receiving retrograde blood flow through the distal opening from the common carotid artery; and a shunt having an internal shunt lumen fluidly connected to the lumen of the arterial access device at a location between the distal and proximal openings of the arterial access device.
  • the internal shunt lumen can provide a pathway for blood to flow out of the internal lumen of the arterial access device at a location between the distal and proximal openings of the arterial access device; and said first occlusive member can be located on said catheter.
  • One configuration further includes methods and systems for establishing retrograde carotid arterial blood flow, systems for cleaning and vacuum system of debris from intervention operations, and a method for positioning a bifurcated graft across a distended region of a main vessel adjacent a bifurcation of the main vessel into an ipsilateral vessel and a contralateral vessel.
  • the method can include the following steps: introducing a catheter pre-packaged with a bifurcated graft therein into the ipsilateral vessel and then into the main vessel to a point beyond the distended region, the bifurcated graft having a tubular main portion branching into two tubular extensions at a bifurcation point, namely, an ipsilateral extension and a contralateral extension; deploying the bifurcated graft from within the catheter so that the tubular main portion contacts the walls of the main vessel at a point beyond the distended region and the tubular extensions are located within the distended region and pointing toward respective ipsilateral and contralateral vessels; delivering a flexible guidewire through the ipsilateral vessel and ipsilateral extension and causing it to deflect around the bifurcation point into the contralateral extension and then into contralateral vessel; deploying a tubular contralateral graft through the contralateral vessel using the flexible guidewire; engaging a first end of the contralateral graft with the contralateral extension; engaging a second end of
  • the step of deploying the contralateral graft can include: a. using the flexible guidewire as a locator within the contralateral extension of the bifurcated graft to deliver a stiff guidewire into the contralateral extension from the contralateral vessel; and b. passing the contralateral graft over the stiff guidewire into the contralateral extension.
  • a bifurcated graft assembly for bridging a distended region of a main vessel adjacent a bifurcation of the main vessel into two branching vessels can include the following: a. a bifurcated graft having a tubular main portion branching into two tubular extensions at a bifurcation point, the bifurcated graft including a bifurcated graft body reinforced with a plurality of separate and spaced apart wires in the main portion and tubular extensions each of which has a generally closed sinusoidal shape, at least one wire at the ends of each of the tubular extensions is self-expanding, a first wire being located adjacent to the end of the main portion of the bifurcated graft body such that alternate apices of the first wire projects beyond at least part of the end; and b.
  • tubular graft sized to connect between one of the tubular extensions of the bifurcated graft and the respective branching vessel, the tubular graft having a graft body reinforced with wires, wherein a wire in a first end of the tubular graft is balloon-expandable, the first end of the tubular graft being overlapped within and being capable of outward expansion into frictional engagement with the end of the tubular extension to form the graft assembly.
  • a prosthetic mitral valve assembly can include a radially-expandable stent including a lower portion sized for deployment between leaflets of a native mitral valve and an upper portion having a flared end.
  • the upper portion is sized for deployment within the annulus of the mitral valve and the flared end is configured to extend above the annulus.
  • the stent is formed with a substantially D-shape cross-section for conforming to the native mitral valve.
  • the D-shape cross-section includes a substantially straight portion for extending along an anterior side of the native mitral valve and a substantially curved portion for extending along a posterior side of the native mitral valve.
  • the assembly can further include a valve portion formed of pericardial tissue and mounted within an interior portion of the stent for occluding blood flow in one direction.
  • An active annuloplasty ring holder can have a template that can be folded or pivoted to the side allowing the template to align longitudinally with the handle and enter the patient's chest through a small incision.
  • the holder may include a mechanism to remotely detach sutures fastening the ring to the holder, thereby detaching the ring while avoiding the risk associated with introducing a scalpel into the operating field.
  • a detachment mechanism may include a movable pin actuated by a pull wire that releases a plurality of holding sutures, or a hot wire, knives, or pull wire that severs the sutures.
  • the holder may have a built-in light source for better visualization of the ring inside the heart.
  • the holder may also have an optical mechanisms of visualizing the inside of the heart from the proximal end of the handle.
  • One or more components or portion of the above described minimum invasive devices containing one or multiple regions may be made of materials with the same or varied attenuation properties, so that the movement and process of procedure may be controlled with visual and measurement based feedback related to the artery and other parts of body.
  • Visual and x-ray measurement based feedback system disclosed herein may be used for the following non-limiting examples and any other medical device, such as surgical devices described herein:
  • a catheter-based material removal device includes an elongated tube having a distal material removal tip thereon.
  • the material removal tip includes a one- or two-piece housing affixed to the tube, and a rotating member therein.
  • the rotating member includes a screw thread for coarsely chopping material received within the housing and an outwardly projecting flange for finely chopping the material.
  • the housing includes at least one shearing member located axially adjacent the outwardly projecting flange.
  • the shearing member has a relatively small circumferential size and a shearing edge that removes any material buildup on the axially- facing surface of the flange.
  • Two shearing members may be provided, one each on both the proximal and distal sides of the flange. There may be three flanges restrained within a groove formed with the housing.
  • a multiple lumen access device can be used for providing a single entry port into the human body for selectively introducing medical implements therethrough and for providing simultaneous auxiliary access into the body.
  • the multiple lumen access device includes a multi-lumen sheath which may have an outer tube and structure defining a device lumen located therein.
  • the inner structure may be an inner wall or inner tube.
  • the outer tube and inner structure are located so as to define at least one auxiliary lumen.
  • Some embodiments include flexible inner walls which can be flexed between relaxed and expanded/contracted positions wherein the relative cross-sectional areas of the device lumen and auxiliary lumens are varied.
  • the access device further includes a valve which provides sealing of the device lumen. The valve may be provided in a lumen junction housing or separate from the housing either permanently or removably connected with the device lumen.
  • a system can sense a characteristic of fluid flowing to or from the body of a human or a conduit having a first end adapted to be outside the body, a second end adapted to be received within the body, and a flow passage through which fluid can flow between the first and second ends.
  • There may be a probe including a sensor for sensing a characteristic of the fluid or a liquid dispensing device in the lumen of the flow passage having an internal lumen which fit into the flow passage and be reasonably sized so that one or more contrast agents may be released into the flow passage.
  • the direction of the flow and speed may be tracked by taking measurements at one or more time interval.
  • second or third contrast agents may be administered in order to track sequence and directions and speed of the flow.
  • the probe is mounted on the conduit with the sensor in the flow passage.
  • the sensor is isolated from the fluid flowing in the flow passage.
  • 64 x 64 approximately describes the xy plane in which the ROI is enclosed in, in some cases are parallel to the detector; z is the thickness along the center axis, may be perpendicular to the detector plane, in this example, may be approximately 64, total number of variables may be 262144 variables needs to be resolved. For example, resolve approximately 4096 linear equations involving 262144 variables. In 3D volume of VOI projected image, as the x ray emitting position moves relative to the object or the detector, additional unknown voxels may be added to the total number of unknow voxels need to be resolved.
  • the total unknown linear equation at each projecting involving voxels in the ROI may still be m x n
  • additional pixels on the detectors used to make the measurements of projected image may be c 2 + (m+n) c.
  • x ray emitting position moves not all of such pixels are used in measurements or in the solving of linear equations.
  • additional pixels are to be used on the detector for the measurement of projected image involving voxels inside of the ROI, therefore the measurements from such pixels are used for in the solving of the linear equations.
  • Xa, or Xb or Xc may not be equivalent in dimensions, nor Xa, or Xb or Xc may not be the same size as the pixel pitch of the detector. Or the top layer closest to the source or the x ray emitting position may not be the middle point between the emitting position and the detector. The number of unknown voxels therefore may be adjusted accordingly.
  • each voxel of ROI illuminated by X ray and projected onto the detector is correlated with at least one pixel on the detector as x ray source moves, or relative position of the object and source changes, the correlation is tracked and new measurements are performed.
  • Each voxel in ROI contributes to the projection image or measurements on the detector. Such process may be tracked by labeling both the voxel as well the detector pixels.
  • Projected measurements or projection images may be related weighted voxel attenuation density.
  • Projected geometry of an x-ray system representing approximately three degrees of freedom in a system matrix disclosed herein may be sufficient for multiple dimension reconstruction or 3D reconstruction.
  • Projection geometry of a system matrix designed for tomographic reconstruction comprising additional coordinates or vectors formed to represent additional degrees of freedoms to describe relative spatial position and movement of one or more components.
  • 3D reconstruction by solving linear equations may take a long time.
  • Simultaneous Algebraic Reconstruction Technique it may still take a long time.
  • simultaneous updating method, SIRT may take long time.
  • Methods to improve the speed of reconstruction may include one or more of the following methods
  • texture mapping hardware such as 2-D texture mapping hardware with microprocessors
  • texture mapping hardware such as 2D texture mapping hardware, and /or extend the precision of a given frame buffer using color channels, or using methods to increase the resolution of the framebuffer.
  • Randomized iterative method for solving a consistent system of linear equations may be used to improve the speed of reconstruction using Algebraic methods.
  • Reconstruction with fast speed may be achieved using the above methods with minimally a general purpose CPU or with GPU.
  • One method of tomographic reconstruction may use the method of solving many simultaneous linear equations.
  • One equation can be written for each measurement.
  • a particular sample in a particle profile is the sum of a particular group of pixels in the image to calculate unknown variables (the image pixel values), there must be independent equations, and there therefore m x n measurements or n squared measurements.
  • the final image has reduced noise and artifacts. Since the ROI is dramatically reduced, therefore it is possible for using n 2 matrix or n 6 matrix where the emitting position moves in at least 2 axis of the 6D space for illuminate the VOI.
  • volume of interest is fairly restricted, therefore suitable for the reconstruction.
  • the method of tomographic reconstruction may use iterative techniques to calculate the final image in small steps.
  • this method Algebraic Reconstruction Technique (ART)
  • SIRT Simultaneous Iterative Reconstruction Technique
  • ILST Iterative Least Squares Technique
  • An iterative procedure is then used to gradually change the image array to correspond to the profiles.
  • An iteration cycle consists of looping through each of the measured data points. For each measured value, the following question is asked: how can the pixel values in the array be changed to make them consistent with this particular measurement ? In other words, the measured sample is compared with the sum of the image pixels along the ray pointing to the sample. If the ray sum is lower than the measured sample, all the pixels along the ray are increased in value. Likewise, if the ray sum is higher than the measured sample, all of the pixel values along the ray are decreased.
  • Another configuration reconstruction method may be used is an example of DSP, such as filtered backprojection.
  • An individual sample is backprojected by setting all the image pixels along the ray pointing to the sample to the same value.
  • a backprojection is formed by smearing each view back through the image in the direction it was originally acquired.
  • the final backprojected image is then taken as the sum of all the backprojected views
  • Filtered backprojection may be used as a technique to correct the blurring encountered in simple backprojection.
  • each view is filtered before the backprojection to counteract the blurring PSF. That is, each of the one-dimensional views is convolved with a one dimensional filter kernel to create a set of filtered views. These filtered views are then backprojected to provide the reconstructed image, a close approximation to the "correct" image.
  • One reconstruction method may be a Fourier reconstruction.
  • tomographic reconstruction involves the relationship between a two-dimensional image and its set of one-dimensional views.
  • the problem can be examined in the frequency domain.
  • Fourier domain reconstruction is the following, In the spatial domain, each view is found by integrating the image along rays at a particular angle. In the frequency domain, the image spectrum is represented in this illustration by a two-dimensional grid.
  • Fourier reconstruction of a tomographic image may require three steps. First, the one dimensional FFT is taken of each view. Second, these view spectra are used to calculate the two-dimensional frequency spectrum of the image, as outlined by the Fourier slice theorem. Since the view spectra are arranged radially, and the correct image spectrum is arranged rectangularly, an interpolation routine is needed to make the conversion. Third, the inverse FFT is taken of the image spectrum to obtain the reconstructed image.
  • an apparatus comprising: processing circuitry configured to obtain projection data representing an intensity of radiation having illuminated VOI and exited out of VOI of an object detected at a plurality of detectors or the ratio of such intensity over the radiation entering VOI, in some cases, derived from the ratio of from radiation detected in the first detectors and radiation detected at a reference detector, generating the first data sets and a second dataset.
  • First data sets comprising data generated by at least one detector
  • At least a second data set comprise data generated by the same first detectors or a second detectors
  • the projection data may be from a different radiation emitting position, or different energy level, different exposure or different system configuration.
  • more data set comprising data generated by the same first detectors, or the same second detectors or additional detectors.
  • a second radiation source may be a first radiation source, or the same radiation source which may have different emitting position or different emitting positions, and or different focal spot size and or different field of view due to an field of view or beam restricting device, such as MADs , referred to as m
  • Multiple aperture devices sequential binary filters that can provide a wide range of fluence patterns, may be placed between the source and the object, and adjusted dynamically with relatively small motions to select VOI, some of which may be off axis. or collimators.
  • the second radiation source may be a different radiation source than the first radiation source but travel in the same area of the first emitting positions of the first radiation source where the radiation emitted may be of a different focal size, and or different energy level and or speed of pulse generation.
  • the plurality of detectors and or x ray sources includes the first detectors may have a different detector configuration than the second detectors, or 3 rd or more detectors, wherein the respective detector configurations of the first detectors and second detectors, third or more detectors are respectively determined by a detector type
  • Each dataset of the plurality of datasets may corresponds to approximately the same or similar system matrix equation or a different system matrix equation representing respective projection geometries corresponding to the plurality of datasets, and the image is reconstructed using one of the following methods, using
  • the same system matrix for a plurality of datasets comprising data with scatter to primary ration less than 1% or less than 5%, for example, by either low scatter VOI, or using time of flight primary measurement by removal of scatter in the time domain, or scatter removal method comprising primary x ray image derived from subtraction of high resolution scatter derived from interpolation of low resolution scatter image, using ART or its derivative algorithms to reconstruct, in some cases, iterative methods are used as well.
  • Subproblem Same system matrix for a plurality of datasets, at least one modified-dual variable and using a splitting based subproblem method. Subproblem may be performed on the datasets separated by time of data generation.
  • Use of at least one more addition dataset may be extended using the same method.
  • the controller is further configured to determine from a defined geometry using a first system matrix comprising at least one coordinate with at least three degrees of freedom.
  • the controller is further configured to execute a material decomposition to generate a spatial distribution and position model for at least one material . wherein the controller is further configured to generate a material decomposition model based on 2D dual energy or multiple energy material decomposed measurements of the VOI from x- ray emitted at one or both of the first or second emitting positions.
  • the method further comprising a second data set including measurements of a reference detector.
  • the system wherein the reference detector is placed in an x-ray beam path.
  • the first data set and the second dataset are used to train AI algorithms for reconstruction and determining said VOI for data acquisition.
  • the method wherein an x-ray exposure level is approximated by an automatic exposure method and apparatus, the time of flight detector, and/or a reference detector
  • each system matrix has at least one vector 3 coordinates, each coordinate with three degrees of freedom.
  • a density information of at least one substance of interest or composite substance of interest is derived from the at least one 2D projected image of the VOI, or at least one 2D projection measurement at selected pixels at one or dual or multiple energy levels on a normalized pixel basis.
  • a radiation diagnosis apparatus comprising: reconstructing circuitry configured to reconstruct three-dimensional substance distribution, substance such as contrast agent or microcalcification or a portion of or a whole part of an implant or surgical tool or a catheter tip, distributed rare components in a time series from a group of acquired 2D images and or point to ID measurements acquired in presence of the substance by at least one imaging system from directions in a range that makes it possible to reconstruct three-dimensional images of a ROI of an object, or determine relative spatial position in 6D to a reference ROI or a component internal or external to the object by performing a reconstruction process that is based on at least on one of the following method
  • the material decomposition may involve establishment of an energy response function system with an interpolation step where spectral measurement of known materials with various combination of density and thickness are correlated, and interpolate to form a plot to include a total number of variables in density and thickness possible.
  • the total possible number of variables in each substance which may be limited by the total number of dynamic range allowed by the detector pixel for representing each substance and or composite material with two or more substances.
  • Spectral imaging using photon counting detectors and or energy sensitive detectors in comes cases, combined with a broadband source, may be used for material decomposition during 3D reconstruction
  • Spectral imaging using tunable wavelength plus detector may be used for material decomposition to be combined with 3D reconstruction
  • Spectral imaging using k-edge methods may be used with 3D reconstruction.
  • spatial continuity or temporal continuity of the density of the substance is used as a constraint condition for reconstruction.
  • An image processing apparatus comprising:
  • At least one acquisition unit configured to image a Volume of Interest of an object and reconstruct three-dimensional data and or 3D image; an image formation unit configured to form a first image and a second image according to a first image generation condition and a second image generation condition, based on the acquired data; a generating unit configured to generate positional and distance relationship information expressing a positional relationship between the first image and the second image, based on the acquired data; a controller configured to cause a display to display information expressing the positional and distance relationship, based on the positional relationship information ⁇
  • a x ray imaging apparatus comprising: setting circuitry configured to obtain position information with respect to a landmark of an object in a first image generated by performing a first image acquisition on the VOI in an object and to set an imaging condition or an imaging setting to be used during a second imaging acquisition by using the obtained position information, the position information being determined on a basis of at least first image and expressed in an image taking system used during the first image; and image generating circuitry configured to generate a second image by performing the second measurements based on the imaging condition.
  • Exact Volume Integration Method may be used.
  • the intersected volume aij may be computed as the following, a voxel, vj , is projected to a (flat) detector to find detector cells that interact with the voxel.
  • a pyramid- like shape of a beam can be designed with four-planes that connect the x-ray source to the four-edges of the cell.
  • the intersected volume between the voxel and the beam is equal to the volume of the voxel clipped by the four-planes.
  • We used the Sutherland-Hodgman clipping algorithm [6] which works by extending each plane of the convex shape of the beam in turn and selecting only vertices from the subject polygon, vj , that are on the visible side.
  • aij would be counting the number of sub- voxels of known volume within the intersected volume.
  • the approach is inspired by an approximation of the area underneath a curve, also known as a Riemann sum where the area is divided into a number of rectangles (or trapezoids) and approximated by the sum of all the rectangles.
  • a voxel, vj is first divided into N 3 of sub-voxels whose side length is 1/N of the voxel’s side. Then, the intersected volume is approximated by counting the number of sub- voxels whose central points are inside the beam.
  • Figure 2(a) shows a brief explanation of this approach with the case that N is 4 (in 2D for simplicity).
  • the volume is approximated by 6 ⁇ d where 6 is the number of rectangles whose central points (red dots) lie inside of the beam (green area) and d is the area of a small rectangle.
  • Recursive sub-division approach In this approach, instead of having a fixed number of sub- voxels per voxel as in the Riemann sum approach, we recursively divide it into N sub-voxels when the current cube is intersecting with the beam. Suppose that each time a voxel is divided into N sub- voxels.
  • Each sub- voxel will be evaluated if it intersects with a beam or not. If it intersects, the sub- voxel will be divided into another N sub-voxels. This process will be recursively enacted until a pre-defined number of sub-divisions has been reached. The final volume is computes by counting the number of the smallest size of sub-voxels that pass the intersection test. This process is described in Figure 2(b) for the 2D case when N is 2 and there are two sub-divisions.
  • the volume is approximated as 9 ⁇ d where 9 is the number of rectangles at the finest levels that are determined as the one having overlap region between the beam (green area) and tangent circle to the rectangle, and d is area of a rectangle at the finest level.
  • intersection test is performed by setting the criterion of non- intersection cases. There are four cases when a voxel (or a sub-voxel) does not overlap with a beam, designed by four planes with inward direction of normal vector.
  • du (dd ) is negative distance and its magnitude is larger than the half side of the cube, the beam is passing below (above) of the cube.
  • dl (dr ) is negative distance and its magnitude is larger than the half side of the cube, the beam is passing right (left) of the cube.
  • dx is a signed distance from the center of the sub-voxel to a plane, x, and the subscripts ⁇ u, d, l, r ⁇ are short-hand for the location of a plane as ⁇ up, down, left, right ⁇ . If any geometry configuration between a sub- voxel and a beam violates one of the non-overlap criteria, we perform another sub-division for the (sub-)voxel or count the voxel as part of the intersected volume, if it reaches the pre defined number of sub-divisions.
  • a cell sensitivity kernel may be described by a zero mean Gaussian distribution.
  • the variance of the cell sensitivity kernel is determined to have the side length of a cell as its FWHM.
  • the density value at each sub-voxel is obtained by using (tri-) linear interpolation and the projected values are scattered over nearby cells according to their sensitivities.
  • the voxel can be considered relatively uniform in its density distribution.
  • the density value of the subunit may be interpolated into its surrounding subunits.
  • Another configuration of a 3D reconstruction based on volume integration method may include the following
  • each ray beam radiated from the x ray source may be be collected on a corresponding pixel on the detector after passing through a number of voxels of a VOI in between the source and the detector the said voxels may be identified based on its relative geometric position to the source, to the pixel on the detector pixel Dxy.
  • there are a number of subunits for example, 1000 subunits are used to represent substantially a portion or the complete volume of a voxel Vox ijk.
  • a reference point in the subunits such as a center point of the subunit, it is determined from the line connecting the source to reference point of the subunit, an intersection with the detector plane.
  • the intersection point may be on the said pixel location, and the subunit is counted as 1, or if the said line lands on the border of the pixel location or it may be outside of the said pixel area, the subunit is then counted as 0.
  • Dxy the total number of “1” s will be used to determine the portion of the said Voxelijk in the ray beam path which projects on to the pixel Dxy.
  • the subunits of each Voxel in the VOI are evaluated based the ray beam radiating from the source, and its corresponding detector pixel or pixel region is identified.
  • the ray beam tracing the pixel or pixel region back to the source may comprise a number of such projecting lines connecting source, subunit in a voxel and the pixel or the pixel region.
  • Each subunit therefore its corresponding pixel on the detector is tracked and counted, until the entire VOI has been evaluated.
  • a cell sensitivity kernel described by a zero mean Gaussian distribution For example, the variance of the cell sensitivity kernel can be determined to have the side length of a cell as its FWHM.
  • the results may be used to establish the linear equations to resolve for the unknow voxel values.
  • Such sparse matrix may be converted into a lesser sparse matrix for faster computation and data processing.
  • the algebraic techniques assume a discretized problem, and solve the reconstruction problem in a completely different way.
  • the reconstruction problem is represented by a system of linear equations.
  • the variables (unknowns) are the pixels of the reconstruction area, and the right hand side of the equations is the projection data.
  • the linear system can be written more succinctly as
  • T may be the transpose operator, x and b are column vectors. All pixels of the reconstruction area may be listed in a single column vector x, and all data points of the projections are a single column vector b.
  • m x n matrix A specifies what the relation between the scanned object and the projections is. In other words, it is the mathematical representation of the scanner with which the projections were taken. Each row of the matrix (each equation) may describes a single projection ray, since it exactly describes the list of pixels that are hit by that ray. Each ray will only meet a very small percentage of the pixels, since it crosses the reconstruction area in a straight line. Hence, the matrix A may be sparse (a large percentage of its elements is zero).
  • the algebraic reconstruction problem may be solved using iterative techniques. These may start from a certain initial guess of the solution, and then repeatedly apply an update step, till the solution is “good enough” according to some criterion. Most, but not all, of these iterative methods (mathematically) converge to a solution. Examples of iterative algorithms are SIRT and PD ART.
  • Ax b, where x represents the image, b represents the projections, and A represents the scanning process
  • the SIRT algorithm is one of many methods for doing that.
  • A represents the action of the scanner, may also be known as the forward projection.
  • Each row of A contains the coefficients of an equation that corresponds to a single ray. It describes how the pixels are combined into ray sums.
  • the transposed matrix, A T back projects the projection images onto the reconstruction area. Given a ray sum, it describes which pixels are hit by that ray.
  • the current reconstruction x ® is forward projected: Ax ® .
  • the correction factor is then added to the current reconstruction, and the whole process is repeated from step 1.
  • Example below is an implementation, if matrix A is known.
  • R sparse(l : rows, 1 : rows, 1 ./ sum(A'));
  • ROI may be divided into multiple sections, such as subsets of total volume, and parallel computed.
  • a solution may use attenuation value derived for each tissue or each substance or two or more composite substances, and or density values, and or thickness values derived by x ray measurements, such as single energy, or spectral measurements, or a different sensor or predetermined value, or a preexisting database or looked up in a database or an inverse energy response equation system.
  • low Radiation Tracking Method to track using ultra low radiation method and volume integral method includes at least some of the following Scatter removal using interpolation method can provide high resolution scatter image and high resolution primary image, often needed in diagnostic settings. However, such image processing for high resolution imaging may come at a cost of time required for tracking high speed event.
  • scatter removal is achieved by combining scatter removal method to achieve SPR ⁇ 1% and SPR ⁇ 5% and SPR ⁇ 10% with a antiscatter grid. Such a combination may decrease the exposure required even more high resolution primary x ray imaging with scatter removal to less than 1% SPR or SPR with that of image acquired without scatter removal or with an antiscatter grid in real time.
  • Such a antiscatter grid may move or shaken during image acquisition
  • detector 29 may not optional
  • Table 1 a sample holder or patient table may be placed between the patient and the detector assembly
  • the beam blocker array 100 may be placed between the source 12 and the patient 2.
  • a antiscatter grid, Grid 1 may be placed between detector 22 and patient.
  • Antiscatter grid Gridl may be optional.
  • the tracking method may be done by using a point, linear detector or 2D detector combined with a full view detector which is capable of high resolution primary imaging with SPR less than 1% or less than 5% or less than 10%, or such detector may be combined with a antiscatter grid to provide tracking capabilities without image processing based scatter removal. Both scatter removal and real time imaging without scatter removal may be used in one imaging procedure.
  • Tomographic imaging may be acquired prior to the tracking or monitoring procedure, or it may done prior to the imaging procedure.
  • the SPR is relatively low or may be less than 1%, such a detector may be used in between the VOI and the full view detector or behind the full view detector.
  • low resolution fluoroscope may be used to provide a full view, and positioning of the VOI relative to the source and the full view detector. Intermittently, a high resolution primary image may be derived, with the scatter removal method.
  • 3D fluoro where the 3D images are reconstructed continuously, and sometimes with a time interval and displayed intermittently. Contrast agents injected with for example certain flow rate, are used with system to provide capabilities such as CT angiogram using the present disclosure.
  • tracking of distances between different tissues of various density such as nerve tissues and blood vessels can be achieved with or with out contrast label using tomographic imaging and or spectral imaging to material decompose based on density difference and derive spatial distribution and distances and dimensions between different tissue types, for diagnosis and tracking.
  • Warning or alert signals may be given when a probe or surgical tool or catheter tip is too close to the nerve or blood vessels or other type of tissues for safety and surgical guidance purpose.
  • volume integral method can be used to trace a series of voxels and subunits in a ray corresponding to a detector pixel or a pixel region.
  • measurements of a series of voxels which known spatial positions may lead to the derivation of exact position of the VOI in 6D space. Such measurements may be gated.
  • volume integral and the position of the x ray source and a known position of VOI is determined.
  • Simulation of projection image, with VOI with known composition, and known x ray source location and detector location may be performed. If the measured data at a number of positions are a match with the simulated data in the corresponding positions for the VOI, then the spatial location of the VOI can be determined.
  • VOI spatial position of an VOI
  • VOI in terms of its material composition and dimensions
  • one or more materials or component with a certain spatial distribution inside the VOI moves, such as a catheter or a RF ablation transducer probe, and or if there is a change in spatial distribution, and such change can be monitored over time, such as contrast labeled blood flow, in and near heart valve, the dynamic movement and orientation of said component, said material may be monitored with fast frame rate with high resolution primary image.
  • material decomposition using measured data at distributed locations can be used to precisely determine the position and distribution of a substance or component.
  • measurements outside of the field of view of the substance or the said component may be used to position VOI.
  • the tracking measurement is done with the large detectors, but the precise position of the catheter or the implant may be done with a second detector, such as a small 2D detectors, in some cases, may be capable of 3D imaging or a linear detectors in some cases, measuring only primary images, a motor may move the detector to track the movement of the catheter.
  • a 3D imaging may be performed on the small detector or the linear detector which may comprise of multiple row detector cells, precisely track the catheter but at the same time,
  • interpolation of measured dual energy detector data to establish a plot at dual and multiple energies and using inverse look up of the established energy response function system has been used in densitometry, but limited to only small samples. As the material or VOI gets thicker, significant amount of primary x ray may be lost due to the generation of scatter. The plot established by the multiple energy measurement and inverse energy response function is therefore not useful or accurate anymore in some cases. Due to this reason, such a method has not found its way to clinics.
  • such a method may be improved by establishing the energy response function at measurement data points where the thickness of the VOI is relatively close to each other. For example, within um, or within 1mm, or within 1 cm or within single digit cm or within 10cm or with 15cm. if a number of data points of certain thickness range are used to establish the energy response function system, then the material decomposition method may be more accurate. For example, such an improved method may be used for densitometer of thick samples.
  • K edge measurements for example, by using a kedge filter, and spectral imaging with point to 2D detectors or one or more multiple energy photon sensitive detectors may also be used here.
  • cone beam CT with antiscatter grid and scatter removal device such as beam stop array have been done before, however, due to the mechanical limitation and spatial limitation and performance limitation such implementation in clinics are limited.
  • tomography may not even needed during the procedure.
  • surgery may be planned with precision with a roadmap predeterimined to optimize speed and reduce safety risk by spatial positioning of surgical tools in is designed to avoid or be too close to regions where sensitive tissues such as nerve
  • simulated projection image of the VOI at various source and detector location may be compared with 2D, ID or point measured data to determine the orientation and spatial location of VOI or component or substance internal to the VOI.
  • Each of the hardware component or imaging processing involved may be optional depends on the application requirement. catheter may be tracked with high speed during a surgery.
  • Antiscatter grid may be optional, however the use of it may improve SNR. And in addition it allows real time 2D imaging with sufficient scatter removal for visual guidance. Combination of antiscatter grid and beam stop array plate, enable even lower radiation than either one of the method. As the imaging procedure is relatively long, such reduction on a repeated basis is therefore useful in drastic reduction of radiation overall.
  • a computer-supported method for reconstructing an image of a three- dimensional subject surface comprising the steps of: supplying at least two line illumination of a position with reflected object on the surface of a three-dimensional subject, capture reflected optical signal in at least two sensors, connected to an evaluation controller or computer.
  • said projections being offset from each other by difference angles in space; in said evaluation computer allocating to each of said surface elements a position designation designating a position of the sensor surface element in the illuminated surface of the object, and in each illumination, a sensor element data value; and in said evaluation computer, allocating binary volume data values, dependent on the respective position designations and data values of a plurality of said elements on the sensor, each is spatially sensitive, for a plurality of positions on the surface of the object having respective positions in space, for generating a three-dimensional image of said subject from a totality of said volume elements.
  • 3D reconstruction method For a set of voxels in the ROI or VOI in a particular beam path, there may be parameter or parameters and criterium or criteria set to determine or define which voxel or voxel in a particular spatial location which the beam path may touch up or passing through is considered to be in the beam path or not or if the beam pass through the voxel. For example, one criterium may be whether the beamlet of certain size, pass through the center of the voxel.
  • one configuration is to limit number of projections acquired.
  • a computer-supported method for reconstructing an image of a three- dimensional subject comprising the steps of: supplying at least two axis 2-dimensional projections of a three-dimensional subject, onto a projection surface composed of surface elements, to an evaluation computer, each projection being offset from each other by difference angles in a rotational plane or translational plane ; in said evaluation computer allocating to each of said surface elements a position designation designating a position of the surface element in the projection surface, and in each projection, a surface data value; and in said evaluation computer, allocating binary volume data values, dependent on the respective position designations and surface data values of a plurality of said surface elements, for a plurality of volume elements having respective positions in space, for generating a three-dimensional image of said subject from a totality of said volume elements.
  • each step size can be approximately equivalent to or quantitatively related to the resolution desired for the axis parallel to the center axis describing the shortest distance from the detector to the x-ray source.
  • a method as itemed wherein the step of supplying at least three two-dimensional projections to said evaluation computer comprises supplying said at least three two-dimensional projections with said difference angles being less than 2° or less than 3 degrees or less than 5 degrees, or less than 10 degrees or less than 15 degrees.
  • the antiscatter grid may be used with spatial domain based scatter removal method to achieve removal of scatter to less than 1% of primary or less than 5% of the primary, at the same time, may allow for higher primary x ray dynamic range or Signal to noise ratio for the signals collected by the x ray detector.
  • thickness of lead strip may be adjusted or grid comprising of two or more substances with varied atomic z number. In some case, such is not needed as the beam particle absorber array plate is also used.
  • x ray source 12, subject 2 or the ROI , beam particle absorber array plate 100, with a number of beam attenuating particles distributed in the beam path, to block primary x ray from reaching the detector in distributed spatial locations, antiscatter grid, Grid 1, detector 22.
  • scatter removal is achieved by combining scatter removal method to achieve SPR ⁇ 1% and SPR ⁇ 5% and SPR ⁇ 10% with a antiscatter grid.
  • Such a combination may decrease the exposure required even more high resolution primary x ray imaging with scatter removal to less than 1% SPR or SPR with that of image acquired without scatter removal or with an antiscatter grid in real time.
  • Such a antiscatter grid may move or shaken during image acquisition
  • Beam blocker array plate 100 sandwiched in between two detectors, detector 22 and detector 29,
  • detector 29 may not optional
  • Table 1 a sample holder or patient table may be placed between the patient and the detector assembly
  • the beam blocker array 100 may be placed between the source 12 and the patient 2.
  • a antiscatter grid, Grid 1 may be placed between detector 22 and patient.
  • a Gridl may be placed between detector 29 and the patient.
  • Antiscatter grid Gridl may be optional.
  • the antiscatter grid, or bucky grid may be movable during the exposure.
  • the beam particle absorber array plate 100 or beam blocker array plate 100 is movable by an actuator.
  • filters are added down stream of x ray source but upstream of the ROI.
  • detector 22 is a dual detector assembly of dual energy x ray layer.
  • detector 22 is a dual detector assembly, with a beam selector layer 16, sandwiched in the middle of the two detectors.
  • detector 22 is a dual detector assembly, with a beam particle absorber plate 100 , sandwiched in the middle of the two detectors.
  • Antiscatter grid 900 may be placed between the beam absorber array plate 100 and the detector or antiscatter grid 900 may be placed in upstream of the beam absorber array plate but down stream from the ROI.
  • Antiscatter grid may be placed upstream of the front detector of a dual detector assembly.
  • the antiscatter grid may be moved during the 3D image acquisition to ensure alignment of the source with the antiscatter grid for optimized scatter removal.
  • a sample table for holding the ROI or the subject for example, x ray transparent patient table, may be used between ROI and the rest of hardware, such as beam particle absorber plate 100, and or the antiscatter grid, and the detector or detectors.
  • post imaging processing include removing noise, scatter, gain correction, dark current and other typical post imaging processing method to ensure accuracy of the quantitative data, based on Lambert-Beer Law
  • the attenuation value of antiscatter grid given the measured x ray signal on the detector can be calculated based on the thickness of the grid and attenuation value and or coefficient of various substances which make up the grid
  • the adjusted x ray signal level (for example, intensity or the radiographic density, or optical density) which is the x ray signal level exiting out of the ROI but before entering the antiscatter grid, can therefore be derived.
  • the x ray signal entering the sample holder can be calculated from x ray signal level or derived optical density measurement of the x ray exiting out of the sample holder, and known thickness and known attenuation value or optical density or linear attenuation coefficient of the sample holder, where the input x ray is the x ray signal entering the sample holder and out put the x ray signal coming out the sample holder
  • the resultant value can thereby be used for image processing analysis using material decomposition
  • a number of beam particle absorbers may be distributed or interspersed within the antiscatter grid in a x y plane parallel to the detector.
  • a device may be used upstream of the detector or detects or detector assemblies. This may be useful for tracking applications especially for when the resolution of the images are not critical.
  • the missing data gap generated by the attenuation of the beam particle absorbers are not critical in determining the spatial location and or position of a catheter or an implant.
  • the missing data gap may be filled by interpolation from the pixel value of adjacent regions to allow visually pleasing presentation to the viewer.
  • Methods may be used here on low SPR images, or material decomposed images or SPR ⁇ 1% or ⁇ 2%, or ⁇ 3% or ⁇ 4% or ⁇ 5% images, of single energy, dual energy or multiple energy, or spectral images to increase exposure or increase times of exposure so that there is sufficient exposure totaled for the measurement to derive attenuation density or optical density or radiolographic density or density of the substance or composite substances.
  • Exposure may be repeated or time of exposure may be adjusted provide enough photons for attenuation density or optical density or radiographic density or density or thickness measurements, through single energy, spectral imaging, material decomposition and tomography methods in x ray.
  • sensitivity of x ray measurements and accuracy of x ray measurements may be affected by the noise of the detector.
  • the noise of the detector For example, at extreme low level of exposure, for example, 1/30* of the general x ray measurement setting used by a typical radiographic system or fluoroscope today, there may be enough photons to reach detector to provide sufficient measurements for derivation of the attenuation values, or optical density or radiolographic density or density or mass attenuation coefficient may be able to derived from a measurement.
  • the detector has high noise level, due to for example, dark current, or white noise or other issues, the exposure may be increased so that the captured signal is sufficient above the noise level to provide accurate measurements.
  • the detector such as cooled detector have low noise level, in addition to sensitivity level, photocounting detector, much lower radiation exposure may be sufficient to provide sufficient measurements for density or optical density or mass coefficient measurements.
  • X ray radiation profile over a field of view may be characterized, by one or multiple detectors.
  • a reference detector may be used in the beam path, for example, down stream from the source and upstream of VOI, may be used to monitor dynamically or in real time the x ray emitted intensity coming out the x ray tube, such as the anode target.
  • additional changes may contribute to the measured value of a specific pixel, for example, the position of the x ray emitting position in 6D.
  • the value measured by the pixel is affected by the location of the x ray emitting position, such as in a cone beam, with a field of view large enough that the further away the pixel is from the pixel or pixel region where the center axis of x ray cone beam, the more variation there may be, compared to the pixel region right next to or directly measuring the center axis projection line from the source.
  • the level variance may be different for each wavelength or energy level of the x ray.
  • the resultant variance of signal level on each pixel of the detector due to its related position to the projected beam path it measures relative to the x ray emitting position in 6D space, and / or relative position to the center axis of the x ray beam may be taken into account.
  • the characterization of such variance may be done at a time separate from the actual measurement of VOI.
  • Such variance level may be taken into account prior to image processing, analysis, spectral image using energy sensitive detectors or spectral imaging using monochromatic source or spectral imaging using inverse energy response function system method, densitometry, spectroscopy and /or multiple dimension reconstruction.
  • images or measurements may be taken at various x ray emitting positions prior to and after taking images of VOI.
  • x ray radiation input characterization is characterized at each location of x ray emitting position relative to the detector.
  • Spectral fluoroscope is not widely adopted due to the fact in the past, the spectral images using large flat panel detectors have scatter therefore affecting accuracy and complete material decomposition. And antiscatter grid is still used in single energy fluoroscope systems.
  • Fluoroscope with radiation exposure of less than half of the current clinical setting per image captured while maintaining sufficient resolution or equivalent resolution and or provide comparable clinical value or image guidance has not been typically possible.
  • x ray system with spectral imaging capability for example, with dual or multiple energy sensitive detector systems, or with inverse energy response function system method for material decomposition, with a SPR approximately ⁇ 1% or less than 5%, or less than 4%, or less than 3% or less than 2% and, in some instances with tomography capability may be used in a fluoroscope format, with radiation shields, in some instances, optically see through with human eyes and other related hardware used similar to fluoroscope system.
  • Single Energy or Spectral Fluoroscope or x ray imaging may to track or intervention guide or monitor for example, post treatment and post op condition
  • radiation exposure level can be carefully and precisely controller to be less than 1/30*, or less than 1/20* or less than 1/25*, or less than 15* or less than 10* of present fluoroscopy procedures, or less than 1/5* or less than l/3 rd or less than 1 ⁇ 2 of the current exposure level using scatter removal method to reach ⁇ 1% SPR or less than 4% SPR, or less than 5% SPR, in some instance, using material decomposition method to separate tissue, contrast agents, implant, catheter and surgical tools and or probes, or diseased tissues.
  • Radiation exposure level may be reduced to less than 1/30*, or less than 1/20* or less than 1/25*, or less than 15* or less than 1/10* , or less than 1/5*, or less than 1/4* or less than l/3 rd or less than 1 ⁇ 2 or less than 70% or less than 60% or less than 80% or less than 90% of present fluoroscopy procedures using scatter removal method to reach ⁇ 1% SPR or less than 4% SPR, or less than 5% SPR.
  • Such reduction may be implemented per image captured. Such reduction in radiation may be for the same resolution and or for the same ROI or VOI.
  • Ultralow radiation tomographic fluoroscope or spectral tomography fluoroscope may be reconstructed based on using such low radiation settings for each 2D, ID or point measurements taken.
  • tomosynthesis methods may be based on images measured with ultralow radiation settings as described.
  • ultralow radiation exposure based x ray measurements may be used in tomography, or tomosynthesis or any geometric trajectory used in x ray imaging to reduce radiation exposure in each point, ID or 2D measurement and therefore dramatically reduce total radiation exposure in a specific imaging method, for example, digital tomosynthesis in mammography, or in O ring imaging method, or in helical imaging method.
  • the tomography methods and apparatus of using n or n 2 to n 6 CT method by using a xy mover of the x ray emitting position, for example, adding an electromagnetic steerer, or a mechanical mover, or adding scatter removal apparatus, such as beam selector, or beam particle absorber, array or beam stopper array, or Beam Stopper array, with or without a moving mechanism or moving apparatus.
  • scatter removal apparatus such as beam selector, or beam particle absorber, array or beam stopper array, or Beam Stopper array, with or without a moving mechanism or moving apparatus.
  • Beam Stopper array or beam particle absorber array may be placed in between the patient or ROI and the detector and movable with a mover, such as a motorized actuator.
  • 2D images of the ROI, and material decomposed ROI, and or 3D images of the ROI may be displayed at different times or simultaneously on one or multiple displays. And selected slices of sagittal, coronal, axial view of ROI, may be displayed separately or simultaneously.
  • one or more selected substance or components such as tissues or catheters or implant, or blood vessels, or nerve tissue or simulated substance image, derived from sparse measurements or point, or ID measurements may be selectively presented using various presentation method, such as intensity adjustment, or color representation, displayed against other substances or the rest of ROI. Resolution or intensity relativity or color choices may be related or independently selected and used.
  • continuous mode at, for example at 0- 10mA images at single energy, dual energy or triple energy or multiple energy are taken, for example, at less thanlms or less than 5ms or less than 10ms or less than 20 ms to provide enough exposure for scatter removal or material decomposition method.
  • the fluoroscope settings can be adjusted to reduce exposure and increase speed of user feedback: for example, if exposure level setting is at 100mA fluoroscope pulsed level, less than 1ms or less than 2ms or less than 3ms or less than 4ms or less than 5ms or less than 10ms or less than 15ms or less than 20ms or less than 25 ms or less than 30 ms or less than 50 ms or less than 100ms or less than 150ms or less than 200ms or at a fraction of exposure setting for a typical fluoroscopy pulsed measurements.
  • At least one or more or one or more set of initial measurements may be done, such as each measurement at each energy is done at exposure level similar or slightly less than that of typical clinical exposure level, however, subsequently, additional measurements for tracking or for additional measurements at different geometry or x ray emitting positions of the same ROI, may be done at lower exposure level, such that sufficient photons reaches detector to measure and derive attenuation value and or density of each tissue, or imaging and presentation of images with ⁇ 1% SPR or ⁇ 5% SPR.
  • the intensity level of lower exposure level measurements may be adjusted , for example, multiple by a factor, to achieve the intensity level familiar to the user such as radiologists or for other VR applications for the same ROI.
  • the goal of going through the method, measuring both at high exposure level and lower exposure level may be to ensure that intensity presentation is not misleading or arbitrary.
  • Such method is to ensure accuracy and consistency of the measurement or intensity presentation which is familiar to radiologists without creating artifacts which may be misleading in fluoroscope tracking and visualization and diagnostic applications.
  • the exposure level of each projection image used for tomography reconstruction and or material decomposition can be anywhere between l/30 th to 90% of a typical CT or tomosynthesis or spectral imaging setting for each projection image or measurement.
  • there may be one or more projection image or one or more set of projection images done at one or multiple energies at one x ray emitting position may be done at the level sufficient for photon collection for scatter separation and or material decomposition to derive accurate and consistent attenuation value or density of each tissue and or produce images of ⁇ 1% SPR or ⁇ 5% SPR.
  • the setting of current and exposure time may be similar to a typical CT or tomosynthesis projection image setting, or at a level approximately equivalent or below the saturation level of the detector.
  • user or computer program may determine the appropriate exposure level for sufficient signal display presentation based on one or more images done.
  • minimum exposure level may be determined based on the first x ray measurement so that enough exposure is provided for measurements so that the exposure level is sufficient for material decomposition, or scatter removal to derive the accurate attenuation value or density of substances in the ROI.
  • Such minimum exposure level may be preselected.
  • the quantitative factor relating the two exposure levels may be derived.
  • a criterium or a preset criteria may be used to determine the quantitative factor.
  • a preset value for the quantitative factor may be used.
  • measurements may be repeated at approximately minimal exposure level or a low exposure level in between the minimum exposure level and a typical exposure setting acceptable to the user.
  • the quantitative factor may be used to in multiplication to bring the intensity level to one that is desired by the user.
  • the total images are then combined together to provide images to be presented at an intensity level qualitative similar to those familiar with CT or tomosynthesis projection images or fluoroscopy images.
  • Each separated tissue may be displayed by multiplying with an adjustable factor which is the quantitative factor determine relating the difference in exposure level between typical clinical setting and visualization measurements and the lowered exposure measurements.
  • an adjustable factor which is the quantitative factor determine relating the difference in exposure level between typical clinical setting and visualization measurements and the lowered exposure measurements.
  • Such a presentation may reduce any artifact may rise due to multiplication, as the reference level of presentation intensity has been measured and used here to do the presentation and the multiplification factor are consistent or intensity level is consistent and or the qualitative presentation are deemed suitable in all calculations, reconstructions, image processing of projection measurements and their presentations. Artifacts, misleading information quantitative or qualitative, or visual misrepresentation may then be avoided.
  • x ray detector may be timed to collect exposure as soon as the x ray emitting position is at a spatial location to image ROI, for example, when the mover moves the x ray source emitting position or electromagnetic steerer steers the x ray emitting position to a position preferred by the user and digital program, generally such a movement is for multiple dimensional reconstruction, or in movement of x ray source and or detector to position to image an ROI within its field of view.
  • the detector may be timed to stop collecting exposure at a time set by the user or the digital program.
  • the mover may move the x ray emitting position to a different location, after dwelling at the spatial location for a period of time, which may be preset or determined in real time,
  • the movement of the x ray emitting position signals to the detector to stop acquiring images.
  • the detector is signaled in real time by the user and digital program after a period of time collecting the signal to stop until the x ray emitting position reaches its new location. A second exposure may be acquired.
  • the source and detector distance may be variable, for example, approximately at 45cm distance or approximately less than 36 cm distance, or great than 45 cm to up to 1.6meters.
  • the source and detector distance may be fixed.
  • Fiduciary markers may be used in the same way as in fluoroscope of prior art or may be omitted.
  • such a system may be with or without wheels for portability within operating room or within a clinic or within a hospital.
  • the x ray system may be designed or configured to meet the requirements of system, performance and fda or other regulatory agency in the US or outside US.
  • the emitting source attached to the mover or the x ray emitting device steered by a steerer, with or with out x ray optics or optics for manipulating x ray radiation may be moved independently by one moving device, the same moving device may move the detector or multiple detectors, in some instances, attached to the scatter removal apparatus, one movement.
  • a C arm may have a motion system attached to a gantry or supporting apparatus which holds both the x ray source and detector in relatively fixed position.
  • the detector or detectors related or attached modules may move independently from the x ray source and related modules, as in a design where the source is moved by a mover, which is attached to a gantry.
  • the detector or the detector assembly or detector related modules such as scatter removal apparatus may be moved by a different mover, which is attached to the same gantry or a different gantry.
  • the total angle of movement for the line passing through x ray emitting position connecting to the center of ROI, and reaching detector may be in less than five degrees, or less than four degrees, compared to its original location, for a complete tomography reconstruction.
  • the total angle of movement for the line passing through x ray emitting position connecting to the center of ROI, and reaching detector may be in less than 15 degrees, or less than 14 degrees, or less than 13 degrees, or less than 12 degrees or less than 11 degrees, or less than ten degrees, or less than 9 degrees, or less than 8 degrees, or less than 7 degrees, or less than 6 degrees or less than 5 degrees, or less than 4 degrees or less than 3 degrees, or less than 2 degrees, compared to its original location, for a complete tomography reconstruction.
  • the degree total angle of x ray emitting position to the center of ROI may increase as the distance between the source and detector decrease for the same thickness of ROI.
  • the missing data of one image at the shadowed area of the beam absorbing particles may be filled in from the projection measurements without beam absorbing particles blocking the primary x ray.
  • one image may have different intensity than the other, or different x ray input intensity and or output intensity than the other at the shadowed area, sometimes, it is not a direct replacement or filling in of the data on the same detector positions of first image in the shadow area with that of projection measurements from the second measurements in the same regions.
  • a direct replacement would result in uneven regions of intensity representing replacement data.
  • one or more of following methods may be used.
  • comparison of regions of measurements between two images derive the ratio of intensity between two images.
  • adjust intensity of replacement data from one image to match that of the image with the shadowed regions replace, for example by multiplication of an factor which is approximately the intensity ratio between the two images.
  • the modified two images may be combined to have a better display image.
  • material decompose into each tissue displays, at least one tissue from each image with the shadowed region. Since the material decomposed tissue attention value is approximately the same for the same ROI, and its representation would then be the same for the data derived from either images with different beam absorbing shadow area. The shadow area of one image may then be replaced by the value of same pixel location of the other image.
  • each projection image involving VOI by using a measured white image at the same x ray emitting position and similar configurations and image setting without the imaged subject in some cases, reconfigure or readjust the primary image derived from white image intensity based on the variation of the primary image outside the projected area containing VOI information so that the intensity of adjusted primary image from the white image is similar in intensity as the input primary x ray intensity for the projection image of the VOI.
  • Derive the attenuation value of the VOI for example using formular based on on murphy’s law. Replace missing data from shadow regions of one image comprised of attenuation values with image of attenuation due to the same VOI but with different shadow regions due to varied beam blocker array positions.
  • White Image Intensity Adjustment and or VOI imaging with different beam blocker array position may include some or all of the steps below for image processing involved in scatter removal and or spectral imaging and or tomographic imaging.
  • Position A and Position B - look for area not in the shadow - primary image of the white image
  • the difference is more than 0.05% or more than 0.01% of the total, or between 0.00001% to 0.01%, or any variation value of significance which can impact the consistency and or determined intensity level of an image in visualization
  • image processing and tomographic reconstruction and or spectral imaging the pixel values of image for VOI and or within field of view can to be adjusted.
  • -Same x ray emitting position can be able to adjust intensity of images based on the average pixel value of the selected region.
  • remove data acquired in the shadow regions, or label as null use images from the same x ray emitting position, but different beam blocker position, or images from a different x ray emitting position, having the x ray projected illumination passing through voxel regions which has been in the beam illumination path blocked by beam blocker array at the position A. of any of the positions to measured sufficient times for resolving each voxel or voxel regions or voxel volumes.
  • a different energy image of the same voxel regions may be used to derive voxel value or attenuation value or intensity value.
  • a reference white image intensity level is set where all the other white images are adjusted to have approximately the same value of intensity.
  • a reference imaged subject image - typically a primary image, is used for comparison of regions or average pixel value of a region in two images
  • such regions are the entire image or a region or a portion of the detector region within a field of view.
  • the ratios between adjacent pixels or pixels in certain proximity are calculated, compared to each other within one image and the relational information between pixels of a selected region or multiple regions are compared to those of a second image, those with minimized variations are selected for intensity comparison and calculation of pixels or pixel regions in the selected regions.
  • certain regions of imaged areas have large variations from one exposure to the next, and certain regions may not have any significant variations or have small variation due to the fact that they are body parts or regions of imaged subject are approximately the same or relatively similar between the two or more frames or exposures.
  • Such regions can be selected to do intensity comparison.
  • regions external to the VOI may be used as intensity comparisons
  • the x ray intensity or variation between exposure is carefully modulated and is known
  • material decomposed data of a marker for example one or two marker with defined density and or defined dimensions and or defined x ray attenuation value in one or more pixels or one or more normalized pixels can be used to assess variation in intensity level of pixels or pixel regions in relatively the same or approximately spatial locations.
  • the marker can be an internal marker, such as a selected region of bone, or it can an external marker, for example a reference marker with x ray measurement value and or attenuation value or properties to be differentiable, for example a metal, and or bone like material.
  • a reference sensor placed between the x ray source and the patient may be used for measure x ray input intensity or intensity level variation between images taken at various positions of x ray emission and or beam blocker array position.
  • Imaged subject image or VOI image adjustment of intensity level of primary x ray image of VOI , for varied x ray emitting position within a certain region or volume and or rotational angle in pitch, yaw and roll.
  • Image taken within the similar condition for example, with the same xray emitting position or similar x ray emitting positions, however different beam blocker array positions can be adjusted as described above using either a portion, or selected region and or the entire primary x ray image comparison , for example, measured pixel value, or normalized pixel value.
  • a portion of, or selection region or regions of, or the entire Scatter image such as average pixel value calculated, can be used to compare from one image to another, for example, with the same image settings of kv, ma and ms.
  • a reference image can be selected to compare to, and the rest of images can be adjusted.
  • the adjustment is using the first image or first scatter image or primary image can be used as the reference for the image, or scatter image, or primary image.
  • the scatter image intensity level difference can be calculated based on those from two most adjacent x ray emitting positions or among those whose x ray emitting positions are close and generating approximately the same scatter image if given the same x ray input radiation.
  • the adjustment level for primary x ray compared to the reference x ray image can be cumulative and or multipliable over a number of positions, especially if x ray radiation from those positions generates scatter x ray image which are not approximately the same anymore.
  • the same method may be used for adjusting image intensity of the original image or replacement projection data to ensure relative attenuation level and or intensity level of the transmitted signal on the detector on a pixel by pixel or pixel region by pixel region basis.
  • Attenuation can there be approximately derived based on Wc and measured value, as, if there is a variation between the input for the white image and input for the VOI image, the variation is the same for all projection measurements, the reconstruction results can be valid approximately, but could be provide voxel values which when compared to actual voxel value, there is a factor which is consistent in all projection paths, but since all voxels have the same difference factor, the relative attenuation values between voxels are approximately the same compared to those generated by the actual white image or actual x ray input intensity value is known and used for attenuation value calculation.
  • System matrix or line or volume integral for scatter removal to identify the pixel or pixel region in the end point of the beam path, along the thickest part of the beam particle absorber, as it is estimated that it contains only scatter only signals.
  • the pixel value can be interpolated. However average value of the pixel region may be applied to the pixel region that is more than just a pixel in the center of the beam path.
  • the pixel region may be comprised of two or more pixels, but no more than the shadow of the beam particle absorber plate, ideally with the beam path of estimated pixel region where the corresponding beam path from the source is blocked by the beam particle stopper due to the thickness of beam absorber particles is high enough so that the estimated b primary x ray blocked is more than 99% or 99.9% or 99.99% or better of the intensity of the beam reaching the beam particle stopper along the said beam path
  • position A for both energies, high energy level, for example, 250kV, 150 KV - 250kV, or 100 KV to 150 Kev, separately at low energy level, for example, 65-100 Kv, 20kvto 65kv - remove scatter at a different position of beam particle absorber array plate, for example, position B for both energies, high energy level, for example, 150 KeV, or between 100 KeV and 150 Kev, separately at low energy level, for example, 65-100 Kev
  • the different positions of the beam particle stopper array plate result in for example, non overlapping shadow regions on the detector.
  • Optional A calculate the radiographic density for each of the four images the equation or calculate the ratio between output intensity Io and input intensity I t on a pixel by pixel basis.
  • Io is the measured output image, or I t is input intensity, sometimes, it may be the measured pixel value in the same pixel location in the white image at the same exposure setting may be used when the x ray source radiation level is quantitively relatable or similar or the same between exposures.
  • the alternative method to derive I t is to use the reference photodiode or detector to derive from measured intensity and location of the reference detector, the estimated pixel value of each pixel on the detector used to measure VOI.
  • a background pixel value of at least one pixel which directly measures the input intensity without the VOI in between may be measured on the same detector but away from the x ray beam path illuminate VOI.
  • the variation in the array image data or its derivation due to the contribution of the input intensity is removed.
  • Pixel values in the regions corresponding to the shadow area of beam attenuation by each of the beam particle absorber on the beam particle absorber arrays location of the radiographic density image array resulted from position A is then replaced by a radiographic density image array of the same exposure and in some instance of the same VOI, but with the beam particle array plate or each of beam particle absorber at a position B.
  • Position B is different than position A in that the shadow area of beam particle absorber array plate produced by each beam particle absorber may not overlap with that of each beam particle absorber at Position B.
  • Option B - use the data from dual energy or spectral images to material decompose, derive image for each substance, such as a bone image and a soft tissue image, each with an image at position A and an image at Position B. Since the material decomposed image is the essentially radiographic density image of individual tissues at position A and position B, the shadow area can then be replaced by the corresponding regions.
  • Either radiographic density or the ratio of output to input intensity on a pixel by pixel basis may be used in multiple dimensional image reconstruction as the input projection value.
  • the simulated value or derivation of simulated value may be expressed in approximately the same format so that the difference between the two may be calculated directly without variation in values contributed by varied input intensity, which may be produced by separate exposures along the same beam path.
  • measured intensity values by the detector may be used as the projection data directly in scatter removal, material decomposition, spectral imaging, multiple dimensional imaging, tomosynthesis, and 3D tomography and other image processing procedures and methods.
  • missing data from the shadow area may be set as missing, or no linear equations were established during reconstruction, therefore the linear equations do not exist for those data points.
  • addition projections may be needed at additional x ray emitting positions, for example, additional projections when x ray emitting position is at a position where its projection path through one or more voxels that is the in the projection path of the missing primary x rays due to beam particle absorber elements. Additional such projections may pass through other voxels until each of the voxels in the missing projection path is illuminated by at least one different x ray beam path in a different exposure. This combines with projection image set which are estimated enough to resolve all of the voxels in the VOI if the beam particle absorbers are not blocking primary beams to cause missing data in reconstruction.
  • the missing data from the shadow area may be set as missing, or no linear equations were established involving the unknown voxels in the beam path passing through the attenuation elements of beam particle absorber plate.
  • X ray emitting position may be moved further away from the area of x ray emitting position which result in the first set of projection images captured. The first set is captured so that if there was no missing data due to the attenuating elements from the beam particle absorber plate, the image set is sufficient for a complete reconstruction of 3D image of the VOI.
  • the second x ray emitting positions may be an area of x ray emitting positions, each emitting position generates x ray radiation which passing through the voxels of VOI which are in the path of primary x rays blocked during the capture of first set of projection image.
  • the primary x rays emitted from the x ray source in the second positions, blocked by the attenuation elements of the beam particle stopper array plate may pass through voxels or voxel positions in VOI which are different than the voxels or voxel positions of VOI which are in the beam path of primary x ray emitted from the x ray source in the first x ray emitting positions, attenuated completed by the beam particle absorber array plate.
  • Either x ray source moves away from the first positions to a location constraints by said conditions of primary x ray path.
  • a second x ray source may be used the number of projection image in the image set generated by x ray moving in the second positions, or a x ray source array set which second positions are locations of each array element which generates x ray. Number of second positions is determined by the size of voxel layer along the z direction which perpendicular to detector and the source movement plane. In some cases, the number of second set of projection images may be as many as that of first image set or significantly less base on the distance and angle between the first positions and second positions.
  • the second source, or source array or the source illuminating in second position may have a collimator placed downstream from the second source but upstream of VOI.
  • the collimator may have distributed transmissive regions to allow primary x rays to illuminate regions, or VOI slices or voxels which are in the paths of primary x rays blocked in the acquisition of the first set of images.
  • Such primary x rays transmitted from collimator may not be blocked by the attenuating elements of beam particle stopper array plate before reaching the detector if the transmitted beam is small in cross sections, it is therefore possible that there is not a high SPR value in the second imaging positions, therefore scatter removal may not be needed before the capture projection image data or their derivation may be used for imaging processing, and or image reconstruction.
  • the images generated by the second set of emission positions by a second source may be same or may of different energies or of varied frequencies, or different phase, or different exposure settings or radiated with characteristics of varied values in x ray imaging parameters, than that of the first image sets.
  • the image capture by the same detector or different detector corresponding to each of the source may take place in the same time domain or approximately at the same time.
  • the continuous mode only emit small amount of current, for example, at 10mA
  • the source may be in a continuous mode as the x ray emitting position changes from one position to another.
  • the detector is synchronized with the location of x ray emitting position being at the preferred location where image is to be taken for image reconstruction and or image processing so that x ray detector starts to collect the image or exposure signal at the preferred location. After enough exposure signal is collected at the preferred location, x ray detector either deactivated or timed to take an image at a later time. X ray radiation is either off for a small period of time or continuous until the detector is ready to take another image again.
  • the total amount of radiation exposure needed may be 10m As, therefore the x ray emission may be set to be continuous and the detector activates and be set to collect exposure in a period of one second until 10m As signal is collected, then the detector is off, until the x ray emission position is moved to a new location for another image, at which time, the detector is on again to initiate the signal collection process, therefore may be synchronized with the location or spatial location of the x ray emitting position.
  • the projection image may be related using a method describing the geometry of projection image as the x ray emitting position moves relative to the ROI, and the pixel position on the detector each beam of the projection measurement may be accounted for by an angle from the vertical axis of x ray radiation source, and / or the projected location corresponding to the beam line. If the x ray emitting position moves in a xy grid area, then the grid may be described by xy coordinates of each point on the grid area compared to a reference location. Each beam line is tracked by a number which may also have an x y coordinates to indicate its spatial position to the center line of the x ray tube.
  • At least one tensor may be used to relate a projection beam to its corresponding position in the detector and at least one additional projection beam of the x ray source or x ray beam generated from the x ray emitting position to its corresponding pixel or pixel positions on the detector.
  • At least one vector may be used to describe the beam affected area on the ROI and /or the imaged object.
  • At least one matrix may be used to describe each voxel in the ROI and its projection path involving other voxels and resultant projection measurements on its corresponding pixel or pixel region on the detector or detectors.
  • a sub matrix may be used to describe a subset of linear equations for solving a subset number of variables.
  • Kaczmarz method may be used for reconstruction. Various modifications or derivatives of this method may be used to improve the speed of reconstruction or of the convergence of solutions.
  • each equation of the linear system can be interpreted as a hyperplane, and the solution of the consistent system can be interpreted as the point of intersection of these hyperplanes.
  • the search for an approximate solution by the Kaczmarz algorithm is carried out in the directions perpendicular to these hyperplanes.
  • a randomized version of this algorithm may be used, and estimates its rate of convergence may be estimated.
  • the block Kaczmarz modification was developed with the study of the convergence of the random projection algorithms. From the geometric point of view, the projection may be not made onto the hyperplane, but on intersection of several hyperplanes.
  • the block algorithm implementation is related with the least squares solution of an underdetermined system of linear algebraic equations in each iteration. This problem may be solved using the MoorenPenrose pseudo-inverse. This is equivalent to solving a system of equations with a generalized arrowhead matrix
  • kaczmarz may be used in which a modified Kaczmarz algorithm for solving systems of linear equations in a distributed environment, i.e. the equations within the system are distributed over multiple nodes within a network.
  • randomized coordinate descent for solving the full-rank overdetermined linear least-squares may be used.
  • a first CD coordinate descent
  • Kaczmarz on the resulting consistent system
  • enhancement of the Kaczmarz algorithm with projection adjustment may be used.
  • relaxed greedy randomized Kaczmarz methods for solving large sparse linear systems may be used.
  • an Iterative Hard Thresholding Algorithm based on Sparse Randomized Kaczmarz Method for Compressed Sensing may be used.
  • one randomized iterative method for solving a consistent system of linear equations may be used.
  • the iterative method for solving a consistent system of linear equations may include the randomized Kaczmarz algorithm, randomized coordinate descent, randomized Gaussian descent and randomized Newton method. Block versions or versions with importance sampling of all these methods may be used.
  • the method is shown to enjoy exponential rate decay (in expectation) - also known as linear convergence, under very mild conditions on the way randomness enters the algorithm.
  • Another row projection method for solving structured linear systems on parallel computer for image reconstruction is cimmino’s method, which may also be used.
  • ECOI Embedded Component of Interest
  • ECOI such as Microcalcification, Blood Vessel, Nerve or Cation++ rich or Negative Contrast Labeled Regions, Contrast Labeled Regions, Plaster Cast, and or identifiable region which can be separated from the rest of the background from an x ray measurement, diseased region, a tissue and or a region of tissue or object, a region of composite material or absence of an component of interest
  • the microcalcification represents any of the above material and substance.
  • a embedded component or material or substance such as microcalcification imaging method 3D imaging reconstruction system which include tomosynthetic image reconstruction system and method and or inverse geometry scanning imaging method and or 3D imaging method described in the disclosure and aforementioned PCTs and other 3D or tomographic imaging method comprising the steps of:
  • the acquisition may be selectively, the approximately the selected regions which may contribute to the potential microcalcification projection image regions are illuminated and or are prioritized in reconstruction.
  • microcalcium regions contained in the respective reconstructed image and electronically marking microcalcium voxels respectively associated with said microcalcium regions;
  • noise-filtered 2D projection images by subjecting the microcalcification pixels of the 2D projection images to adaptive noise filtering, wherein no noise filtering or noise filtering leading to a noise reduction that is reduced relative to remaining image regions is implemented;
  • the voxels or regions or slice which containing microcalcifications may be material separated to provide information of proportion of substances and materials relative to each other or each of other materials or the background substances.
  • Structural illumination comprising two or more x ray illumination beams with defined field of view can be performed. If there are distributed regions of macrocalcification or x ray beam with restricted field of view by electronic control, such as in a field emitter x ray source or by collimator or MAD filter is used to illuminate only microcalcification voxels.
  • multiple dimensional image acquisition and or multiple dimensional or 3D reconstruction may be performed on a VOI directly with or without at least one single energy projection measurement.
  • selected reconstruction and image processing with varied parameters may be performed to further zoom in the details of microcalcification and or its surrounding volumes or regions. For example, higher resolution reconstruction, and or dual or multiple energy imaging to separate substances and derive relative quantitative relationship in terms of amount or density concentration in one or multiple volume of interests.
  • nose filters or adaptive noise filters or edge filters may be performed after forward projection to the microcalcification region while no filtering or no noise filtering leading to a noise reduction that is reduced relative to remaining image regions is implemented.
  • image processing may be performed such as Denoise, gain, dead pixel, pixel consistency and normalization.
  • the measurement of reference sensor may be performed to derive input intensity of x ray measurements.
  • dual energy or multiple energy 2D measurements may be used to identify provisional region of microcalcification prior to a 3D reconstruction.
  • Provisional Region of ECOI may be selected which can be designated as may containing calcification may be 3D reconstructed selectively using regions of projection images or measurements containing projection images of provision regions of ECOI.
  • dual energy and multiple energy 3D reconstruction and measurements of the provisional region of ECOI may be performed to provide quantitative analysis of the Provision Region of ECOI.
  • inverse energy response function system may be used, where depending on the thickness of the VOI, and thickness of components as part of VOI, materials and substances are separated in 2D as well as within each volumetric unit of interest with the imaged subject.
  • methods concerning identification, quantification and multiple dimension from 2D - 7D ( xyz, pitch yaw and roll and time) reconstruction of VOI comprising Metal or Synthetic Material Configurations for Imaging Metal and or other absorbing material in catheter or an implant which comprising one or more substances overlapping each other, such as sheath or lumen
  • a method for determining a three-dimensional reconstruction of an examination object include steps of:
  • Scatter can be removed if SPR is significant to SPR ⁇ 1%, or SPR ⁇ 5% or 5%-10% using stationary and or movable beam selector, beam absorber particle arrays or beam blocker arrays and time of flight source and detector and or primary modulator based scatter removal methods.
  • TOMOGRAPHIC IMAGING using the present disclosure and aforementioned PCTs, tomosynthesis and inverse scanning geometry fluoroscope and other tomographic imaging methods from point to 3D images or measurements of the VOI containing the metal part.
  • dual energy or multiple energy 2D and or 3D imaging are performed to Identify the region of measurements which containing the metal in the projection images.
  • the identification and characterization of metal location and spatial distribution is through dual or multiple energy imaging involving DRC, distributed random components, where such components are displayed and located in the material separated image of substance such as soft tissue, lean tissue or fat, where the image is slow varying except due to presence of metal, or other synthetic or foreign objects within VOI
  • DRC dual or multiple energy imaging involving DRC, distributed random components, where such components are displayed and located in the material separated image of substance such as soft tissue, lean tissue or fat, where the image is slow varying except due to presence of metal, or other synthetic or foreign objects within VOI
  • the volume of the metal region and or spatial distribution of the metal can be derived.
  • mapping the provisional metal are into the original projection images to create a plurality of corresponding provisional metal area; if the are multiple metal area or multiple layers of metal or other absorbing material, based on preexisting data, approximately determine the edge zones of each material or substance Determining a provisional three-dimensional reconstruction of the examination object based on a plurality of two-dimensional original projection images of the examination object, approximate density or volume of metal or substance and related information to forward project and approximate relative spatial position and or distribution in the projected image and or in the 3D reconstructed image;
  • determining modified projection images and compared to the original projection images if a threshold target or approximate variance value has been reached, store the 3D volumetric data and proceed to the next stage for data presentation or processing relevant to the current method and application. If not, proceed to the following steps:
  • the projection image containing the metal portion in the VOI can then be presented against the background and or imaged processed and or positioned against the background and or markers such as anatomic markers and or external markers, and or labeled.
  • the following steps may be used to reconstruct VOI containing metal volume, it may include iterative steps or the iterative steps may be omitted depends on the results of the first reconstruction, -Determining a provisional three-dimensional reconstruction of the examination object based on a plurality of two-dimensional original projection images of the examination object, approximately determine the approximate density or volume of metal or substance and related information;
  • -Segmenting or material separate the provisional three-dimensional reconstruction and in some cases with dual or more energy measurements and material decomposition to determine a provisional metal volume and its spatial distribution and position in multiple dimensional space; mapping the provisional metal volume into the original projection images to create a plurality of corresponding provisional metal volume;
  • Dual or more energy CT may be performed at each source and corresponding detector position, and material decomposition may be performed and correct for each projection line geometry corresponding to a pixel or a pixel region.
  • the value of modification may be limited to one or more voxels instead of all the voxels in the beam path where the variance above the threshold is detected. If there is high frequency voxel values or voxels with values significantly different from its surrounding areas, when slowing variance values are expected or predetermined relative values are expected, the voxel regions where such signal exists may be replaced with values interpolated from its surrounding regions or simulated values, and forward projection is performed again to assess the variance value from the modified projection and the original measured value or data derived from the original projection value.
  • the original volume and or the original spatial distribution of metal attained from the first reconstruction may be sufficiently close to the actual data that there is no need for reconstruction for areas other than selected regions.
  • the regions with high variance such as above threshold values may be derived from its adjacent neighbors where such variance values are relatively small.
  • Such interpolation can occur in both metal and non metal area. Forward projection and or summation of attenuation values can be used to reevaluate the modified reconstructed value and or projected image to until such variance is minimized below threshold
  • Such a method can be used on metal, or microcalcification or any tissue or non tissue component or substances.
  • VOI VOI
  • a component in VOI such as metal or an object differentiable by x-ray measurements, without knowing the density and or dimension and or the spatial distribution of of such component, in a human body or an imaged subject:
  • using dual energy or multiple energy to separate background materials such as using dual energy to separate bone and soft tissue.
  • the part of the metal exist in the VOI will show up in bone image, and as well as soft tissue image.
  • the edge of metal or the metal portion will therefore have a sharp and distinct measurement from its adjacent materials, therefore can be identified.
  • edge zone In one configuration, single energy imaging is sufficient to identify the edge zone In one configuration, three dimensional tomography identify the edge zone as well
  • identification of the metal at distributed locations using spectral imaging using x ray spectral thin beams and or using 2D spectral imaging In one configuration, determine approximate density value
  • edge zones of the provisional metal areas in the original projection images In one configuration, defining edge zones of the provisional metal areas in the original projection images; selecting edge points from the edge zones; in one configuration, Determining a provisional three-dimensional reconstruction of the examination object based on a plurality of two-dimensional original projection images of the examination object, the approximate metal density and volume and spatial position in the projected image; in one configuration, Segmenting the provisional three-dimensional reconstruction to determine a provisional metal volume; mapping the provisional metal volume into the original projection images to create a plurality of corresponding provisional metal areas; in one configuration, determine the spatial position of the metal volume related to other anatomic markers
  • determining modified projection images by modifying data values of the original projection images assigned to locations in the provisional metal areas as a function of data values of the selected edge points; calculating differential images based on the original projection images and the corresponding modified projection images; segmenting the differential images to determine definitive metal areas; subtracting the definitive metal areas from the differential images; and determining the three-dimensional reconstruction by adding the subtracted differential images to the corresponding modified projection images.
  • Method for generating or quantify metal based on reconstructed density values
  • the voxel value are verified and corrected if it is different from its adjacent voxels.
  • Projection image and reconstruction of a metallic area in the VOI and in turn the metal volume in the tomographic data set is identified by means of segmentation and or material separation based on density value or a range of density value or radiographic density value and or voxel value for each voxel.
  • each projection image either has low SPR level and or Scatter is removed using beam blocker, beam selector, time of flight x ray source and or detector.
  • Preplanning after 3D image acquisition and reconstruction of the original volume, or VOI for the surgery which can be called first tomographic image.
  • Live measurements of VOI for example, the probe and implant in point to 2D and reconstructed 3D to 7D image provides the feedback of alignment and misalignment of the measurement relative to the anatomic marker and reference marker
  • Navigation guidance of the catheter and surgical tool or biopsy probe and or radiotherapy orientation is adjusted in ID to 6D to improve alignment.
  • the final alignment is when the probe or implant is precisely placed in the preplanned volume, and in some cases, relative to anatomic or reference marker.
  • the analysis of post alignment physiological characteristics is performed such as blood flow direction and or other physiological state are measured to verify results.
  • Specific tests and verification methods used in real time post surgery may be developed and utilized to verify the final position prior to the end of intervention and treatment.
  • In spine treatment may be the alignment angle between different bone types and or bone structures.
  • nerve and or blood vessel distribution are mapped relative to anatomic markers either as part of navigation path, or as a part to be kept at a distance larger than a threshold set by the user and or a digital program.
  • an alarm or sound may be generated to alert the operator and physicians when the distance is assessed to be shorter than a threshold value.
  • 3D reconstruction algorithms there typically iterative method and correction method to ensure the fidelity of the reconstructed image.
  • no iterative method is needed after the first reconstruction or limited number of iteration may be performed.
  • the error of voxel value detected can either be automatically corrected based on a set of criteria, for example, reconstruction in the approximate region which is critical and or important for the intervention or treatment, for example, where the movement of the catheter tip and or the region of pathology or treatment would be, two or more reconstruction algorithms may be used. If there are inconsistencies between the resultant reconstruction value, if it is critical for guidance, such values are compared to the adjacent or voxel values in proximity, if they are quite different, an interpolated value from the voxel values for voxel in proximity of the voxel in question can be generated.
  • the resultant voxel value reconstructed from the live measurement may be generated compared to the voxel value from a measurement before the image guidance, such as during surgical planning and can be replaced with a value closer to the correct value based on prior measurements and or prior reconstructed value.
  • reconstruction can be approximately minimized to regions of variable which is relatively critical for assessing the 7d or 6d spatial location of the catheter relative to the object and or anatomic markers, as the value of rest of the object can be obtained from the either prior measurements during surgical planning and or during the surgical guidance.
  • the guidance system may contain at least one computer, display or hand or foot pedal or switch.
  • the time interval between approximately at least one or more of the following methods during one procedure can be used : complete 3D imaging and or sometimes spectral imaging and or spectral 3D and or limited region 3D, and or 2D imaging and or ID imaging and or point imaging and or structural illuminated imaging of VOI can be adjusted
  • the time interval between approximately at least one or more of the following methods during one procedure can be selected and used complete 3D imaging and or sometimes spectral imaging and or spectral 3D and or limited region 3D, and or 2D imaging and or ID imaging and or point imaging and or structural illuminated imaging of VOI can be adjusted
  • an image acquisition system and or a reconstruction algorithms and or image processing method or algorithms may be stored and integrated together in at least one computer. Images stored in the computer can be image processed and reconstructed.
  • programs and or algorithms for image processing such as scatter removal, and or relative image intensity assessment from one exposure to the next, and pixel value and relevant data adjustment based on factors such as relative image intensities and relative x ray input intensity, can be a separate program, its function can be performed in one computer, near the image acquisition system, or in the remote operator’s room, or in cloud and or in a remote server.
  • the reconstruction algorithms can also be store in the same or a different location such as cloud or a separate computer and remote server.
  • imaging processing and or image reconstruction and or image analysis software such as material separation and segmentation may be performed in the same location or in cloud or on block chain and or in a remote server.
  • the image processing can be done parallel, for example all in cloud and or in local computer and or remote server, or there may be redundant image processing running parallel and or in series so is reconstruction in a separate software, to ensure accuracy and verification and speed.
  • a certain portion of the images may be processed in one location and the rest of images may be processed in another location, the combined results are used together for prognosis, diagnosis, surgical guidance, post - monitoring and surveying.
  • Raw images without scatter removal acquired may be export out of the local position and reconstructed in locations and servers and computer different than the computer used for image acquisition.
  • Both raw images and or the image processed images such as generated scatter and or primary images and or the final beam blocker shadow swapped images and or image averaging processed images can be exported out of the imaging system a user may use the imaging processing and reconstruction tools on the local computer and or within the facility, or a different imaging processing and or reconstruction algorithms can be used for image processing such as scatter removal, intensity adjustment, pixel value adjustment, averaging, stacking of signals and material decomposition, segmentation, and reconstruction.
  • such images and or image processed results and or reconstructed images may be analyzed further for surgical planning using a software.
  • a software may image process the data files, or images acquired, and or image processed images in one or more stages of image processing, and or reconstructed image.
  • the analysis such as for neurosurgery or implant or for spine or cardiovascular surgeries, may include function and features such as measurement tool, additional annotation of anatomic markers, surgery mapping and reconciliation of surgical planning and live and or real time surgery guidance images.
  • the images have less scatter to primary ratio, such as less than 1% or less than 5% or between 1-5% or between 0-10%
  • information such as precise spatial distribution, and or dimensions and or density improve over CT or 2D fluoro to be achieve precision of guidance in space as good as 1% or as good as up to 5%, or as good as up to 10% and or anything in between.
  • Dimensions, relative spatial position and identification of various parts of the same tissue for example, from reference markers and or anatomic markers or temporal markers may be achieved with higher accuracy, to 1% and or up to 5% and or up to 10% may be achieved, or achieved in shorter time frame than before when CT, or c arm, or cone beam CT and or digital tomosynthesis or 2D fluoro are used.
  • the images are display in a grey scale designated by the range of density or voxel value generated in the 3D image reconstructed.
  • Relative ratio of voxel value within VOI can be less than 1 or equal to 1 if the highest voxel value is set to 1.
  • the reconstructed 3D image to absolute density information may require establishment of a database using known materials similar to actual material and or using actual material which has a quantitative relationship with known material in physical characteristics and or in x ray measurement based quantitative value at single or multiple energies in one or multiple dimensional images or measurements, which may vary with thickness.
  • This provides the basis for correlating measurements and or reconstructed value of voxel in VOI at varied thickness to actual density values or attenuation values using tomographic imaging and or spectral imaging and or spectral CT of VOI the present disclosure and or prior PCTs and or all of chao’s disclosure.
  • a quantitative relationship of the detector used for measurement of the unknow or VOI of the image object may be established with a highly repeatable and accurate reference sensor.
  • the reference sensor may server as the standard by which each detectors can be measured against and or quantitatively related to and the measurement of the standard established the reference for properties which can be measured with varied thickness, material, density and dynamic characteristics and relative substance ratio and or segmentation, and or material decomposition and or point to 7D distribution and characterization.
  • all images are labeled with relevant information in dicom file or meta file to be used as a reference and or for image processing and or for reconstruction.
  • Such image files may be stored in local drives of the image acquisition system and or a server linked to image acquisition system or transported out to a pac system and or to a database with or with our pac infrastructure for digital storage.
  • Such images may be time stamped
  • a set of data file relating an imaging procedure including images and or related data files and or patient information, and or facility or image acquisition information and or software name and version for generating image processed images and or reconstructed images and or AI software may be stored locally in one or more computer or servers for storage and or for accessing by radiologist or programs for further analysis.
  • Analysis of at least one or more images, locally and or in a separate location and or server by radiologist, surgeons and or AI algorithms and in sequence and or in time in imaging procedures and in some cases, against surgical planning data and algorithms, may used for improve surgical planning algorithms and or to improve AI algorithms and for optimizing and or improve operating time and or patient outcome.
  • At least a portion of the image data or a set of image data in an image procedure and or in a number of imaging procedures over time for example for the same patient and or for two or more or a set of patients to draw conclusions about the patient condition, and or to provide statistically meaningful data and or quantitative information and or qualitative information to generate new results and or facts regarding the patient and or for a least two or more patients.
  • Blockchain may be used to link with at least one image of the entire study series, or a portion of or over a long period of time to monitor variations and changes for clinical significance.
  • the number of x ray emitting positions and or number of projections may be quantitatively related to the dimension of the implant or a portion of the implant.
  • the number of x ray emitting position and or number of projections may be quantitatively related to the approximate dimension of the implant oriented in the VOI approximately vertical to the detector, and or related to the approximate dimension of at least one internal object or at last one reference marker with specified dimension and with a relative spatial distribution and or relationship to the implant.
  • images or data files from other modalities such as MRI, optical imaging, electromechanical or electrochemical or invitro pathology analysis and or biopsied sample characterizing a region of VOI and derived data and facts can be combined with one or more images and or data files obtained using x ray measurements, for example, those generates or raw images obtained with scatter to primary ratio less than 1% or less than 5% or less than 10% for surgical/ intervention and treatment planning, prognosis, diagnosis, post intervention monitoring, surveillance.
  • Alignment and reconciliation of real time intervention probes and tools with existing planned surgical map, in some cases, angiograms can be achieved faster and more accurate using the 2D or material decomposed or spectral imaging combined with CT or 3D imaging and or fluoroscope and or 3D fluoro, CT perfusion, multiple phase CT using the present disclosure and or disclosed methods and apparatus in the aforementioned PCTs and chao’s disclosure.
  • the user can select resolution from the software interface which is suitable for different parameter configuration of 3D imaging throughout the intervention procedure and or different parameter configurations, such as varied or a selected resolution for different procedures, exposure setting, mA and or imaging and or x ray filter for varied imaged subject and or for tracking or monitoring and or identifying of at least one object which can be placed internal to the imaged subject, such as surgical tools, or implant and or parts used in energy based surgeries.
  • resolution can be adjusted, For example from single digital um to cm as the resolution.
  • both in intervention and or treatment planning and or navigation planning and post monitoring, the dimension of the implant and or intervention volume within VOI and or dimension of a part , or a portion of intervention device, such as surgical probe, and or biopsy probe and tool tips, may be quantitatively related to the resolution of the 3D image, for example, determines the number of x ray emitting positions and or number of projection images need to be taken for an approximately complete 3D image.
  • the interval between 3D fluoro or 3D image generation may be adjusted.
  • the interval may be a fixed number or generation of 3D images and display is continuous.
  • the interval between 3D images can be longer such as during one stage of intervention navigation, and in other stage such as during energy treatment or during ablation, the interval can be shortened.
  • spectral imaging in 2D and 3D may be used during the treatment, and may be applied during a specific stage of the intervention.
  • the user or operator of the x ray system may adjust such parameter using software by entering information prior to the intervention.
  • the operator may use a switch or physical switch or software input to trigger 3D image generation during the intervention
  • only a selected component is tracked and displayed over existing background and or a portion of images acquired and reconstructed earlier.
  • use of AI is applied for image processing for diagnosis, prognosis and post op monitoring and surgical planning and or for reconstruction, and or for inspection, identification and quantification
  • an AI method includes: A storage unit for storing the trained model,
  • a processing unit that performs detection and or tracking processing based on the learned model
  • the trained model is
  • the processing unit is in one configuration, by performing the detection and or tracking process on the detection and or tracking measurements captured so that the volume of interest is within the angle of view, the detection information indicating the distribution in the space domain, density, movement, fluidic dynamics, chemistry properties, energy disturbed properties, elasticity, identification, determination, characterization of the VOI and substances within it and or the object is output, and the detection information is used as the detection image.
  • An information processing system characterized by being displayed on a display unit in a superimposed manner.
  • the information processing system is an annotation. For example, by giving a flag to a pixel determined as a pixel belong to a characterized region part of VOI in the learning image.
  • a detection process of receiving an input of the detection image to the neural network and detecting an object is performed, and detection information indicating the distribution in the space domain, density, movement, fluidic dynamics, chemistry properties, energy disturbed properties, elasticity within at least one Volume Of Interest (VOI) of the object, in the detection image is superimposed on the detection image and displayed on the display unit.
  • VOA Volume Of Interest
  • the neural network is a
  • An input layer for inputting data is an input layer for inputting data
  • An intermediate layer that performs arithmetic processing on data input through the input layer
  • an output layer that outputs data based on the calculation result output from the intermediate layer
  • Equipped with The trained model is
  • a learned model which is learned so as to output the distribution in the space domain, density, movement, fluidic dynamics, chemistry properties, energy disturbed properties, elasticity within Volume Of Interest (VOI) of the object in the learning image.

Abstract

L'amélioration des procédés de reconstruction pour une imagerie quantitative en trois dimensions (3D) est basée sur l'utilisation d'une matrice de système simplifiée et d'ensembles de données de faible interférence de diffusion dans l'acquisition et la reconstruction d'image tomographique rapide et/ou à faible rayonnement, certains utilisant la continuité temporelle et la continuité spatiale. L'invention concerne un procédé qui intègre l'imagerie tomographique, l'élimination de diffusion et/ou l'imagerie spectrale. La reconstruction à l'aide de mesures spectrales peut permettre de séparer chaque substance du reste. Et une reconstruction 3D à haute résolution peut s'effectuer sur seulement une substance sélectionnée, par exemple, le reste de la région d'intérêt (ROI), ou d'autres tissus ou composants peuvent être calculés comme une valeur d'atténuation connue à partir du traitement d'image de décomposition de la matière. L'invention vise à proposer une imagerie par rayons X quantitative en deux dimensions (2D) et en trois dimensions (3D) à très faible rayonnement, avec moins de 1 % de SPR, ou moins de 5 % de SPR, avec, par exemple, une réduction de 10 % à plus de 99 % de la dose de rayonnement, mais offrant une visibilité d'image similaire ou équivalente ou meilleure que les images radiographiques générales classiques, avec une grille anti-diffusion comme dispositif d'élimination de diffusion ou en utilisant un logiciel ou une combinaison des deux. Ceci peut être obtenu en multipliant l'intensité de chaque pixel par un facteur ou en ajustant le niveau d'intensité de chaque pixel par un facteur quantitatif. Les ajustements peuvent être dépendants des pixels ou indépendants les uns des autres.
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