EP4719202A1 - Visual roi setting and positioning system and method - Google Patents

Abstract

A computer-implemented method for selecting a region of a patient body for long length imaging begins with displaying an unobstructed video of the patient on a digital display screen. The operator views the display screen and uses a graphical user interface to select upper and lower bounds on the digital display screen to define the region of interest of the patient body. The upper and lower bounds appear on a portion of the digital display screen external to the display of the patient body.

Description

VISUAL ROI SETTING AND POSITIONING SYSTEM AND METHOD

BACKGROUND OF THE INVENTION

[0001] The subject matter disclosed herein relates to digital radiographic (DR) imaging systems and methods. In particular, to a camera enabled system and method for selecting regions of interest on a patient to be imaged.

[0002] In daily radiographic imaging practice, long length imaging (LLI) for full-spine and foil-leg is a special case. It requires taking several images in quick succession, which are then stitched together by algorithmic computer calculation. Accurate positioning of the exposure range on the patient’s anatomy is key for diagnosis, but it has always been a challenge for radiology technicians as they need to manually point the x-ray tube assembly toward the patient and mark the top and bottom locations of the region of interest. /Additionally, the slight movement of the patient during the entire process can also affect the result. Frequently the technicians have to walk in and out of a lead-lined x-ray room to reposition the patient when patient movement is observed. This process requires the radiology technicians to consume excess time prior to a radiographic LLI exam.

[0003] One disadvantage of the prior ait methods is that it requires radiologytechnicians to position the patient, set the exposure range on the anatomy, adjust the exposure parameters, etc. Additionally, the patient may unconsciously move their body, which can deviate from the initial set position and therefore disturb positioning the region of interest of the patient anatomy for diagnostic purposes.

[0004] Another disadvantage of the prior art solutions is that most of tire time, the radiology technicians choose to use the maximum collimation width by default (i.e., the width of the digital detector positioned in the bucky), which results in the patient receiving more x-ray dose than necessary. Previously developed methods have provided a way, via a still image camera or a video camera, to view a digital display showing live images of patients in a lead-lined x-ray room directly from a control console outside the x-ray room and to remotely adjust the exposure region on the patient anatomy for a LLI exam, eliminating the need to go back and forth into the x-ray room. See, for example, U.S. Pat. No. 10,098,598, identified above.

[0005] The discussion above is merely provided for general background information and is not intended to be used as an aid in determining the scope of the claimed subject matter.

BRIEF DESCRIPTION OF THE INVENTION

[0006] A computer-implemented method for selecting a region of a patient body for long length imaging begins with displaying an unobstructed video of the patient on a digital display screen. The operator views the display screen and uses a graphical user interface to select upper and lower bounds on the digital display screen to define the region of interest of the patient body. The upper and lower bounds appear on a portion of the digital display screen external to the display of the patient body.

[0007] In one embodiment, a computer-implemented method for selecting a region of a patient body for long length imaging comprises displaying an unobstructed video of the patient on a first portion of a digital display screen. The operator views the display screen and selects upper and lower bounds on the digital display screen to define the region of interest of the patient body. The upper and lower bounds appear on a portion of the digital display screen external to the display of the patient body. A graphical user interface (GUI) facilitates the selection of the upper and lower bounds.

[0008] In one embodiment, a digital radiographic imaging system for selecting a region of a patient body for long length imaging includes a video camera and a display screen for displaying an image of the patient captured by the video camera on a portion of the display screen . An x-ray source and a digital radiographic detector for capturing images of the patient exposed by the x-ray source are positioned according to regions of the patient selected by an operator. A graphical user interface (GUI) on the digital display screen is operable for the regions of the patient to be selected by moving upper and lower bounds on the digital display screen so as to define the region of interest of the patient body. The upper and lower bounds are configured to appear on a portion of the digital display screen external to the patient display.

[0009] To simplify the radiographic imaging setup process before acquiring a LLI exposure, improve exam efficiency, and minimize the unnecessary X-ray dose received by patients during exposure, a virtual positioning-assisted long length imaging system is created. This system allows the radiologist to virtually position the desired vertical exposure range directly at the control console display screen and set the width of the collimator according to the patient's body size as seen on the display.

[0010] To begin, the patient is positioned in the x-ray room ’such as on a bed with a DR detector beneath or behind the patient, or the patient, may be standing adjacent to a wall bucky which holds the DR detector. Using a still or video camera, the radiographic imaging system displays the real-time image of the patient on a control console display screen located outside the x-ray room. The display screen also visually displays the upper/lower boundary controls and left/right boundary controls of the exposure range via a graphical user interface to enable an operator to select a region of interest of the patient’s anatomy for a LLI exam. In addition, the radiology technician or operator can choose to adjust other imaging parameters at the control console such as object to detector distance (OID), kV and mAs power/energy levels, and to apply other adjustments to the radiographic imaging system. The system is programmed to calculate and acquire the number of images required to capture the region of interest.

[0011] In one embodiment, the imaging system includes a remote-control module in the control console that allow's the operator to adjust the upper and lower bounds of the exposure region of interest on the patient anatomy for long length imaging, and provides a real-time video display of the patient, allowing the radiology technician or operator to observe the patient's movement on the video, to determine the best timing to start exposures, and to determine if there is significant patient motion before or during the exposures. [0012] The summary descriptions above are not meant to describe individual separate embodiments whose elements are not interchangeable. In fact, many of the elements described as related to a particular embodiment can be used together with, and possibly interchanged with, elements of other described embodiments. Many changes and modifications may be made within the scope of the present invention.

[0013] This brief description of the invention is intended only to provide a brief overview of subject matter disclosed herein according to one or more illustrative embodiments, and does not serve as a guide to interpreting the claims or to define or limit the scope of the invention, which is defined only by the appended claims. This brief description is provided to introduce an illustrative selection of concepts in a simplified form that are further described below in the detailed description. This brief description is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter. The claimed subject matter is not limited to implementations that solve any or all disadvantages noted in the background.

BRIEF DESCRIPTION OF THE DRAWINGS

[0014] So that the manner in which the features of the invention can be understood , a detailed description of the invention may be had by reference to certain embodiments, some of which are illustrated in the accompanying drawings. It is to be noted, however, that the drawings illustrate only certain embodiments of this invention and are therefore not to be considered limiting of its scope, for the scope of the invention encompasses other equally effective embodiments. The drawings below are intended to be drawn neither to any precise scale with respect to relative size, angular relationship, relative position, or timing relationship, nor to any combinational relationship with respect to interchangeability, substitution, or representation of a required implementation, emphasis generally being placed upon illustrating the features of certain embodiments of the invention. In the drawings, like numerals are used to indicate like parts throughout the various views. Thus, for further understanding of the invention, reference can be made to the following detailed description, read in connection with the drawings in which: [0015] FIG. 1 is a live camera view of the patient from the operator console with width (w) and height (h) adjustments provided by the GUI for LLI exposures;

[0016] FIG. 2 is a live camera view as in FIG. 1 with height and width adjustments using the GUI;

[0017] FIG. 3 shows a live camera view as in FIG. 1 with patient movement data;

[0018] FIG. 4A and FIG. 4B are schematic representations of FIG. 1 and FIG. 2; and

[0019] FIG. 5 is a schematic diagram that shows an exemplary arrangement of a radiographic imaging system that can be used for long length imaging.

DETAILED DESCRIPTION OF THE INVENTION

[0020] This application claims priority to U.S. Patent Application Serial No. 63/505,745, filed June 2, 2023, in the name of Tao et al., and entitled VISUAL ROI SETTING AND POSITIONING SYSTEM AND METHOD, which is hereby incorporated by reference herein in its entirety.

[0021] This application is related in certain respects to U.S. Patent No. 10,098,598, filed August 25, 2016, in the name of Lee et al., and entitled X-RAY IMAGING APPARATUS AND METHOD FOR CONTROLLING THE SAME, which is incorporated herein by reference in its entirety.

[0022] FIG. 1 shows a digital display screen 100, having a graphical user interface (GUI), of an operator control console including adjustment tools to allow the operator to selectively adjust the width and height of an exposure region on a patient P from the console while viewing the patient in real time, thus selecting a desired exposure region of the patient anatomy. In this embodiment, the patient P is in a standing position on a patient support S in front of a vertically movable wall bucky that holds a DR detector. The icons along the horizontal lines 101 indicated by the h (height) arrows and the icons along the vertical borders 103 indicated by the w (width) arrows are slider-type controls that can be adjusted by a technician or operator using a mouse, i.e., known as “dragging” the icons to a desired position. Adjustments as between FIG. 1 and FIG. 2 illustrate a selected narrowing of the exposure width 105 and a selected extending of the height 107, thus achieving an operator desired exposure region of interest defined by the selected width 105 and selected height 107. In response to the selected exposure width 105, the radiographic imaging system 10 (FIG. 5) will electromechanically set the collimator width so that an emitted x-raybeam exposes the selected narrowed-vvidth region of interest 105 on the patient as illustrated in FIG. 2. In response to the selection of the exposure height 107, the imaging system automatically calculates, in the example of FIG. 2, that three vertical images are required to capture the desired height of the region of interest. The three required vertical images are illustrated by the horizontal demarcation lines 109 which divide the vertical height 107 into three vertical sections. These three images of the patient P will be digitally sti tched together to form the long length image of the region of interest of the patient anatomy. As shown in FIG. 2, this region of interest extends from about the patient P’s midsection down to about the patient P’s ankles. The horizontal lines 101, while defining the operator selected upper and lower bounds 107 of an exposure region of interest on patient P, do not extend across the video image portion on the display 100. Similarly, the vertical borders 103, while defining the width of an exposure region of interest 105 on patient. P, also do not appear in the video image portion of the display 100.

[0023] Using such a DR imaging system may be illustrated by a set of steps performed by an operator of the system. Initially, patient identification information and exam information may be input to the control console computer system. The tube head and DR detector are center aligned, whether the detector is placed in a wall bucky, in a horizontal table, or in an inclined patient bed. The patient is then positioned in front of the wall bucky, or on the table or bed. In the patient figures described herein, during the various steps in the preparation process, the patient view is displayed and visible to the operator at the control console,

[0024] The camera module of the radiographic imaging system may capture real-time video of the patient, and the system displays the video on the control console digital display screen outside of the x-ray room. The GUI may be initialized to display default upper/lower and left/right bounds of the exposure range on the control console display screen together with the real-time patient video. The default left/right bounds may be programmed to not allow a width to be selected beyond a maximum width, to match the width of the DR detector positioned behind the patient. The operator may selectively adjust the left/right bounds by any amount so long as the bounds do not extend beyond a left/right edge of the DR detector. The maximum width is automatically limited to protect the patient from unmercenary radiation. These adjustments are made by the operator while observing the real-time patient video on the control console’s digital display screen.

[0025] The operator may also adjust the upper/lower bounds on the control console’s digital display screen in a similar fashion. However, the upper and lower bounds are not as constrained as the left/right bounds, as the radiographic imaging system will automatically move the DR detector vertically, as well as the x-ray source, to capture regions of i nterest in the patient anatomy during acquisition of the long length image of the patient. The control console software automatically and dynamically calculates the number of images required in the LL1 exam based on the GUI-selected upper/lower bounds. The number of required images may vary depending on the operator’s adjustment of the upper/lower bounds. The position of each image, relative to the patient body, is dynamically displayed on the control console’s digital display, as described herein.

[0026] The operator may then make other adjustments and inputs as necessary, such as adjusting the object to detector distance (OID), which is the distance from the center of the anatomical region of interest to the DR detector. The radiographic imaging system updates and records the settings. If the operator is not satisfied with any image settings, the operator may re-initialize the system and readjust the width and height bounds. When completed, the radiographic imaging system hardware mechanically moves the x-ray source in the tube head and the DR detector to a first position for imaging, which first and subsequent positions are calculated by the console computer system based on the selected operator settings. The operator may then activate an exposure button to initiate the x-ray exposures. The radiographic imaging system captures a first radiographic image and automatically moves the x-ray tube and the DR detector to a second position for imaging the patient. This process continues until all required radiographic images are captured. The captured images may be processed by the control console’s computer software, and a single-composite long length image is generated by programmably stitching together each of the captured DR images. The stitching algorithm is not described in detail herein as such algorithms are well known. The stitched long length image may then be presented to the operator for approval and for delivery.

[0027] With reference to FIG. 3, there is depicted exemplary unintended lateral patient movement (di splacement) after final adjustments of the width bounds and uppcr/lower bounds of the region of interest. The contours of the patient displacement are highlighted as black outlines in the small slit figure on the left in FIG. 3, having a width 301 which width corresponds to an amount of unintended movement by the patient P. The magnitude of the displacement is also highlighted by the same magnitude of width 303 overlaid on the video image in the center, as indicated by the arrows. The direction of the movement is highlighted in this figure by the arrows, to give an overview/magnitude of the patient displacement.

[0028] By being able to monitor and notice patient displacements in real time, the operator may decide to act by pausing, resetting or ignoring the small amount of movement. Such contour displacement can be computed by one of many methods that will allow quantifying gross motions. A process for monitoring patient movement may include any one or more of the following steps: computing image differences from original images, edge images, Laplacians, from a base image frame; computing the magnitude of displacement relative to key dominant directions (as illustrated In the center in FIG. 3 as an example); and filtering the magnitude of displacement with respect to a minimum threshold so that only significant movement (e.g. > 2 cm) may be presented to the user.

[0029] The magnitude and direction triggering the GUI as shown in FIG. 3 can be operator configurable, in part also to suppress any vibration motions such as during the movement of the tube-head (and hence the camera attached to it) when moving to different set points during a LLI exam. Smart filtering of camera motion and image correction may be included as part of the programming model to account for perspective image distortions.

[0030] As noted, the LLI adjustment offers significant benefits from a workflow perspective. Not only can the operator perform the adjustments of the exposure range on the anatomy from the console, but also, the operator can view the patient at all times. While other solutions in the prior art offer a camera view of the patient from the console, when it comes to adjusting the exposure range, the field of view of the camera is obstructed by graphic overlays. The user interface described herein, in some embodiments, differs from the prior art in that the patient is clearly visible at all times and any adjustment interface does not obstruct this view. This is critical as it allows the operator to provide feedback to the patient in the event of patient motion while also making adjustments as needed. Having this continuous real-time view and comparing it to the original field of acquisition, the operator can monitor for any motions by the patient.

[0031] With reference to FIGS. 4A-B, there is illustrated the operation of one embodiment as demonstrated in FIGs. 1-2 using schematic drawings. FIGs. 4A and 4B show the digital display screen 100 having a graphical user interface (GUI) including adjustment tools to allow the operator to selectively adjust the width w and height h of an exposure region on a patient P from the control console while viewing the patient P in real time. The height of the exposure window is controlled by upper and lower icons h that are movable vertically by the operator using a mouse to drag the h icons higher or lower on the display screen. The horizontal lines 101 move together with the position of the height icons h and do not extend over the portion of the display screen where the patient P image appears, but serves to control the region of interest of the patient P that is exposed for radiographic imaging. Similarly, the width of the exposure window is controlled by left and right icons w that are movable horizontally by the operator using a mouse to drag the w icons to the left or to the right on the display screen 100. The vertical borders 103 move together with the position of the width icons w and limit the display of the patient region of interest to the region that is exposed for radiographic imaging. Adjustments as between FIG. 4A and FIG. 4B illustrate a selected narrowing of the exposure width 105 and a selected extending of the height 107, thus defining an operator selected region of interest delineated by the width 105 and height 107. In response to the exposure width 105, the imaging system will electromechanically set the collimator width so that the emitted x-ray beam exposes the selected narrowed region of interest 105 on the patient P as illustrated in FIG. 4B. In response to the selection of the exposure height 107, the imaging system automatically calculates that three vertical images are required to capture the desired height. This is illustrated by the two hyphenated horizontal lines in FIG. 4B which divide the vertical height 107 into three vertical sections. Thus, three images of the patient will be stitched together to form the long length image of the selected region of interest of the patient anatomy. As shown in FIG. 4B, this region of interest extends from about the patient’s midsection down to about the patient’s ankles. None of the horizontal lines of the GUI extend into the video image of the patient P, and there are no vertical lines of the GUI that extend into the video image of the patient P.

[0032] FIG. 5 is a schematic diagram of an exemplary radiographic imaging system 10, which may be used to perform a LLI exam as described herein. In one embodiment, a patient P is disposed on a table, bed or other support platform S, which may also be a platform that supports a patient who is standing, as described herein. An x-ray source is disposed in a tube head 14 with a motorized x-ray collimator 26 which forms and directs an x-ray beam toward a DR detector 16, with the emitted x- ray radiation represented by a central ray 18. Central ray 18 is preferably orthogonal to the planar incident surface of detector 16. A DR detector translation apparatus 20 driven by actuator 22 under control of processor 41, provides electromechanical motion to suitably position the DR detector 16 to receive the incident x-ray beam that passes through the patient anatomy of interest, as described herein. In one embodiment, the DR detector 16 may be positioned in a w'all bucky behind the patient P and moved vertically during a series of radiographic image captures as described herein. DR detector 16 is in wired or wireless communication with a central processor 41 in the computer system of control console 40. Image-bearing data from DR detector 16 may be sent to the control console 40 to be processed. The image data can then be rendered on the control console’s digital display screen 100. The image data can also be transmitted to one or more networked processors 42 for further processing and storage. Processor 41 includes memory 44 for storing acquisition parameters and acquired image data. Memory’ 44 also includes control console programming and software modules for controlling the camera 30, the collimator 26, the GUI as described herein, operation and movements of the DR detector 16 and the tube head 14 including timing and activation of the x-ray source therein.

[0033] A number of sensors in the radiographic imaging system 10 provide information that may be needed to support automated positioning of imaging components such as the tube head 14 and DR detector 16. For example, an inclinometer 28 can be used to sense the relative inclination angle of detector 16. A video camera 30, attached to the tube head 14, can be used to transmit live video images of the patient P to be displayed on the control console digital screen 100 for viewing by the operator O. Video images can be used by processor 41 programming to calculate positioning information for the tube head 14 and DR detector 16 to capture two or more sequential images to be combined for LLI capture. An actuator 32 provides angular- and/or x-axis and y-axis translational movement of the tube head 14 in the plane of detector 16 (as shown by conventional x, y, and z axes in FIG. 5) under control of processor 41 for guiding the path of the x-ray beam from the x-ray source to the DR detector 16 as selected by the operator O as described herein.

[0034] The processor 41 controls one or more actuators to automatically position the tube head 14 and DR detector 16. After the radiographic imaging system’s configuration is aligned according to the operator selected adjustments, the subsequent images can be captured during an imaging exam. The first and subsequent images can be combined using a stitching algorithm to form a long length image.

[0035] According to an alternate embodiment of the present disclosure, an operator interface on display 100 can provide text, graphical, or audible instructions to guide manual adjustment of source and detector position. The operator interface can also provide data for technique settings and other information for use by the operator O in configuring the imaging apparatus for obtaining consistent imaging results for subsequent images, based on stored configuration parameter data from previous images. Feedback from sensor detection can help to guide operator adjustment, indicating that dimensional or angular positioning does not match that used for previous exams and suggesting remedial modification, for example.

[0036 ] As will be appreciated by one skilled in the art, aspects of the present invention may be embodied as a system, method, or computer program product. Accordingly, aspects of the present invention may take the form of an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, micro-code, etc.), or an embodiment combining software and hardware aspects that may all generally be referred to herein as a “service,” “circuit,” “circuitry,” “module,” and/or “system.” Furthermore, aspects of the present invention may take the form of a computer program product embodied in one or more computer readable medium(s) having computer readable program code embodied thereon.

[0037] Any combination of one or more computer readable medium(s) may be utilized. The computer readable medium may be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any suitable combination of the foregoing. More specific examples (a non -exhaustive list) of the computer readable storage medium would include the following: an electrical connection having one or more wires, a portable computer diskette, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory⁷ (EPROM or Flash memory), an optical fiber, a portable compact disc readonly memory' (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing. In the context of this document, a computer readable storage medium may be any tangible medium that can contain, or store a program for use by or in connection with an instruction execution system, apparatus, or device.

[0038] Program code and/or executable instructions embodied on a computer readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF, etc., or any suitable combination of the foregoing.

[0039] Computer program code for carrying out operations for aspects of the present invention may be written in any combination of one or more programming languages, including an object oriented programming language such as C++ or the like and conventional procedural programming languages, such as the “C” programming language or similar programming languages. The program code may execute entirely on the user's computer (device), partly on the user’s computer, as a stand-alone software package, partly on the user’s computer and partly on a remote computer or entirely on the remote computer or server. In the latter scenario, the remote computer may be connected to the user's computer through any type of network, including a local area network (LAN) or a wide area network (WAN), or the connection may be made to an external computer.

[0040] This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to practice the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal language of the claims.

Claims

CLAIMS:

1. A computer-implemented method for selecting a region of a patient body for long length imaging using a digital radiography system, the method comprising: displaying an unobstructed video of the patient on a first portion of a digital display screen; and selecting upper and lower bounds using a graphical user interface (GUI) on the digital display screen to define the region of interest of the patient body, wherein the upper and lower bounds appear on a second portion of the digital display screen external to the first portion of the digital display screen.

2. The method of claim 1, further comprising selecting left and right bounds using the GUI on the digital display screen to define the region of interest of the patient body, wherein the left and right bounds do not appear in the first portion of the digital display screen.

3. The method of claim 2, further comprising detecting sideways patient motion and displaying a portion of a width of the patient on the display screen corresponding to an amount of the detected sideways patient motion.

4. The method of claim 3, further comprising showing the patient motion as an edge outline in a sideways direction of the patient motion on the display screen.

5. The method of claim 4, wherein the magnitude and direction of the edge outline is quantified by one of width or color.

6. The method of claim 5, wherein the patient motion is displayed using an indicator either within the first portion of the digital display or external to the first portion of the digital display.

7. The method of claim 5, further comprising activating a visual or audible alarm when detecting patient motion greater than a preset threshold.

8. A digital radiographic imaging system for selecting a region of a patient body for long length imaging, the system comprising: a video camera and a display screen for displaying an image of the patient captured by the video camera on a first portion of the display screen; an x-ray source and a digital radiographic detector for capturing images of the patient exposed by the x-ray source; and a graphical user interface (GUI) on the digital display screen operable to select upper and lower bounds on the digital display screen to define a region of interest of the patient body, wherein the upper and lower bounds are configured to appear on a second portion of the digital display screen external to the first portion of the digital display screen.

9. The system of claim 8, wherein the graphical user interface is operable to select left and right bounds on the digital display screen to define a region of interest of the patient body, wherein the left and right bounds do not appear in the first portion of the digital display screen.

10. The system of claim 9, wherein the system is configured to detect sideways patient motion and to display on the digital display screen a portion of a width of the patient corresponding to an amount of the detected sideways patient motion.

11. The system of claim 10, wherein the system is configured to display the patient motion as an edge outline in a sideways direction of patient motion on the display screen.

12. The method of claim 11 , wherein the patient motion is displayed using an indicator either within the first portion of the digital display or external to the first portion of the digital display.

13. The system of claim 5, further comprising a visual or audible alarm responsive to detecting patient motion greater than a preset threshold.