JP2012523944A - Imaging system - Google Patents

Abstract

A unified imaging platform is disclosed. The unified imaging platform can be adapted for use with various medical imaging devices. The unified medical imaging platform may include a display, a processor, a data storage device, and one or more external interfaces. The unified imaging platform can be detachably coupled to a medical imaging device such as an endoscope. The unified imaging platform can be coupled to the medical imaging device via a wired link or a wireless link. Using web services, the unified imaging platform can also transfer image data to other devices including at least one of a local desktop computer, a mobile device, and a remote system.

Description

  The present invention relates generally to a portable imaging system, and more specifically, an endoscope having a flexible tube with a distal image sensor, and further having a removable liquid crystal display and wireless data transmission capability. The present invention relates to an imaging system.

(Priority data)
This application claims the benefit of US Provisional Application No. 61 / 170,863, filed Apr. 20, 2009, which is hereby incorporated by reference in its entirety.

  Doctors can use various techniques for use in visualizing and imaging internal organs and systems of the human body. For example, a bronchoscope can be used to visualize the interior of the airway through the nose, mouth or tracheostomy opening. The laryngoscope is intubated to detect the cause of voice problems, to detect the cause of sore throat and ears, to assess dysphagia, and to detect throat narrowing or injury or obstructions in the airways Can be used for treatment. The gastroscope can be used to diagnose causes of unknown anemia, upper gastrointestinal bleeding, persistent dyspepsia, heartburn and chronic acid reflux, persistent vomiting, dysphagia, and swallowing pain. Gastroscopes can also be used to monitor Barrett's esophagus, gastric or duodenal ulcers, and recovery of gastric surgery.

  As another example, otolaryngologists often require endoscopy of the patient's upper respiratory system. One of the most commonly used tools for otolaryngologists to see the upper respiratory system is the endoscope. Similarly, endoscopes are used by surgeons and physicians in many medical fields, such as the lungs and urinary organs, to view human body parts from the inside for examination, diagnosis and treatment. Endoscopes are also used in the gastrointestinal tract. Traditionally, endoscopes were optical instruments. Endoscopes can have rigid or flexible tubes and provide images for visual inspection and photography. Rigid endoscopes are originally hollow, but typically include a series of glass rods that are spaced apart from one another and housed in a tube so that the associated fiber optic beam is incident on the object under examination. Hit. Instead of a series of glass rods, the flexible endoscope includes a small fiber optic glass rod that simply transmits an image from the distal tip to the eyepiece.

  In addition, certain flexible endoscopes include a solid state camera that is placed at the distal end of the flexible endoscope tube instead of a series of optical glass rods contained within the tube. The solid state camera may be a self-scanning solid state imaging device such as a charge coupled device (CCD) or a complementary metal oxide semiconductor (CMOS) sensor. An objective lens or imaging lens can be provided in front of the solid state camera. The lens is arranged to focus the image on the CCD. A preamplifier is coupled to the output of the CCD. For coupling to the remote image processor, a line carrying a signal from the preamplifier extends from the flexible tube to the proximal end of the endoscope. Color image sensors typically utilize one of a variety of means for determining color, such as a color filter array.

  An external light source is typically provided to illuminate the organ or object under examination. The light source typically provides light that is directed through an optical fiber system that extends through the tube.

Endoscopes can also allow biopsy collection and foreign body recovery. The tube can be provided with an additional channel through which a medical instrument or manipulator can be entered.
Initially, the endoscope contained only an eyepiece, from which the physician could see the area to be examined and / or treated. Later systems included video adapters that couple the camera head to the eyepiece. The camera head combined the eyepiece with the video system. The video system was coupled to a monitor. Thus, it is now easier to see the image on the monitor as it is seen from the eyepiece. If the user wants to capture, store, store and edit images and / or video, additional devices such as tape recorders, optical media devices and printers must be obtained. Typically, all of this device is stored on a single cart. The cart typically includes wheels for mobility and is coupled to the endoscope via various cables.

  The camera control unit and accompanying computer and visual screen are bulky and heavy and cannot be easily transported to another location. In addition to size and transport limitations, the cost of currently available systems can be over US $ 10,000 for the camera and camera control unit alone. In addition to the cost of the camera and camera control unit, an endoscope and typically a light source must be purchased.

  Manufacturers endeavor to create a digital archiving platform that integrates a disc burner and hard drive into the endoscopy unit to facilitate integration in the digital era so that test results can be stored directly on removable media. I came. However, these alternatives limit image editing and are not very dynamic. Other manufacturers have endeavored to produce endoscopy units that capture images directly into proprietary computer systems designed for specific functions of capturing and storing video. Although these systems have improved data operability, they can cost over 20,000 US dollars and are therefore not affordable for small or cost-limited clinics.

  Several alternative systems are designed with portable components. These portable component systems are smaller in size than fixed systems, but still require camera control units, monitors, image capture means and light sources in addition to the main components of the camera and endoscope. Although these systems are classified as portable, they are heavy, cumbersome and expensive. Patent Document 1 discloses a hand-held camera that generates a video image of an object, and an object thereof is to provide a camera characterized by an illumination system that can perform high-intensity irradiation without generating excessive heat. U.S. Pat. No. 6,057,077 discloses a fixed lens tube that houses a variety of custom-designed probes, and certain embodiments further require one of several adapters to receive certain probes. In addition, the patent of Patent Document 1 is not easily adapted to a standard fixture of an endoscope eyepiece used in a medical field.

  Patent Document 2 discloses a portable battery-type hand-held endoscope inspection system that is adapted for use compatible with various endoscopes, and is incorporated therein by reference. The endoscopy system includes a portable battery-powered handheld camera unit having a liquid crystal display (LCD). The camera unit is coupled to the endoscope eyepiece. A typical external light source is coupled to the endoscope.

  Further portability, versatility and ergonomic use of the portable, handheld endoscope imaging system, and more specifically an endoscope imaging system having a flexible tube with a distal image sensor Improvement is desired.

US Pat. No. 6,432,046 US Patent Application Publication No. 2007/0276183

An object of the present invention is to provide a portable endoscope imaging system.
Another object is to provide a hand-held endoscopic imaging system.
Another object is to provide an endoscopic imaging system having a flexible tube with a distal image sensor.

Another object is to provide a medical imaging system having a video display unit.
Another object is to provide a detachable video display unit that can be configured to fit a variety of medical imaging tools.

Another object is to provide a detachable video display unit which is a liquid crystal display.
Another object is to provide a medical imaging system having the capability of wireless data transmission.

To provide a point-of-care system that combines portable imaging with web-based image and video storage in a secure HIPAA compliant environment.
These and other objects are achieved by the present invention.

  The present invention provides data acquisition in a novel web application that allows doctors to share patients, synchronize medical records, and send images or videos anytime, anywhere with a secure connection with the referring doctor And storage and management.

  This more general summary of the more important features of the present invention is intended to provide a better understanding of the following detailed description and a better appreciation of its current contribution to the art. . There are, of course, additional features of the invention that will be described in detail hereinafter.

  In this regard, before describing at least one embodiment of the present invention in detail, the present invention is limited in its application to the details and arrangement of components described in the following description or illustrated in the drawings. It should be understood that this is not the case. The invention is capable of other embodiments and of being practiced and carried out in various ways. It should also be understood that the expressions and terms employed herein are illustrative and should not be considered limiting.

  Thus, those skilled in the art will recognize that the concepts underlying the present disclosure can be readily utilized as a basis for designing other structures, methods and systems to serve some purposes of the present invention. I will. For this reason, it is important that equivalent structures are included in the present invention without departing from the spirit and scope of the present invention.

  For a better understanding of the present invention, its operational advantages and specific objectives achieved by its use, reference should be made to the accompanying drawings and descriptive matter illustrating preferred embodiments of the present invention.

1 is a perspective view of a prior art endoscope having a flexible insertion tube and a light source and tubing for suction. FIG. 1 is a perspective view of an embodiment of an endoscopic imaging system having a flexible insertion tube with a distal image sensor and a proximal image processor in accordance with the present disclosure. FIG. FIG. 4 is a perspective view of another embodiment of an endoscopic imaging system having a distal image sensor and a flexible insertion tube with a removable proximal image processor and display according to the present disclosure. FIG. 1 illustrates an exemplary medical imaging system. 1 is a block diagram of an exemplary unified imaging platform according to this disclosure. FIG. 1 is a block diagram of an exemplary endoscopic system having a rigid or flexible image acquisition end and a proximal image sensor. FIG. 1 is a block diagram of an exemplary endoscopic system having a distal image sensor and an electrically coupled display unit. FIG. 1 is a block diagram of an exemplary system having a distal image sensor and a wirelessly coupled display unit. FIG. It is a block diagram of the display unit couple | bonded with an endoscope imaging cart system. FIG. 4 is a block diagram of a display unit coupled with a docking station. 1 is a block diagram of a software system architecture according to this disclosure. FIG. 2 is a block diagram illustrating the integration of an exemplary imaging system and medical information system according to this disclosure. FIG. 2 is an exemplary screenshot of a user interface of a remote imaging system web application. 6 is a flowchart illustrating an example workflow using an imaging system according to the present disclosure. 1 illustrates an exemplary HD camera medical imaging system according to this disclosure. FIG.

  A prior art endoscope is shown in FIG. The endoscope 10 is shown to include a flexible insertion tube 12 and a tubing 14 that transmits light and suction from the light source to the insertion tube 12. The endoscope 10 includes two stack wheels 16 to provide four basic mobilities of the insertion tube 12, such as up and down and left and right, such as used in lung endoscopes and gastroscopes. Endoscopes that have a flexible insertion tube and are designed for use in otolaryngology, urology and gynecology typically have two mobilities, eg, to provide up and down Has one wheel or lever. Additional channels 18 are provided for the entry of medical instruments or manipulators. A connector 20 is provided at the end of the tubing 14. Connector 20 is configured to connect to a remote light source (not shown) and a suction source (not shown), and further includes a connection 22 for coupling to a remote video system (not shown). The distal image sensor 24 and related components are disposed at the distal tip of the flexible insertion tube 12. A wire or line (not shown) extends from the distal image sensor 24 over the length of the flexible insertion tube 12 and continues through the tubing 14 to the connector 20.

  FIG. 2 is a perspective view of an embodiment of an endoscope imaging system 30 according to the present invention. The endoscopic imaging system 30 includes an endoscope 32 having a flexible insertion tube 34 with a distal image sensor 24 and associated components (not shown in FIG. 2) disposed at the distal end of the insertion tube 34. Yes. A wire or line (not shown) extends from the distal image sensor 24 through the entire length of the flexible insertion tube 12 to the proximal end of the endoscope 32.

  A visual screen or video display unit 36 coupled to the endoscope 32 is shown. Video display unit 36 may include a video display such as, for example, a liquid crystal display (LCD), a light emitting diode (LED) display, a plasma display, or the like. The endoscope 32 is illustrated as including a rotating ring 38 that rotates about the longitudinal axis of the endoscope 32. The rotating ring 38 includes a neck 40. The video display unit 36 is shown to include a handle 42 that is rotatably coupled to the neck 40 of the rotating ring 38. As described above, the video display unit 36 is movable with respect to the rotation of the rotary ring 38 with respect to the vertical axis of the endoscope 32 and can be turned with respect to the vertical axis of the handle 42.

  In one embodiment illustrated in FIG. 2, the video display unit 36 is detachable. In particular, FIG. 2 shows that the video display unit 36 is detachable from the endoscope 32. A display holder 44 is coupled to the handle 42. For this reason, like the video display unit 64, the holder 44 can rotate in the same axial direction with respect to the handle portion 42, and can also rotate with respect to the axis of the endoscope 32. The display holder 44 is configured to accommodate a detachable video display 36. In one embodiment, the removable video display unit 36 includes a connector (not shown) disposed at the bottom of the video display unit 36 and a mating connector (not shown) disposed within an internal cavity formed by the holder 44. And the electronic device of the endoscope 32. The video display unit 36 is also expected to include a wireless interface for wireless communication with a corresponding wireless interface coupled to the electronics of the endoscope 32.

  In one embodiment, video display unit 36 includes an analog to digital (A / D) converter having an input that couples to a connector of video display unit 36. The output of the A / D converter is coupled to an image processor that is also located in the video display unit 36. The video display unit 36 further includes a controller coupled to the image processor and the connector of the video display unit 36. Video display unit 36 further includes various memories and various external interfaces coupled to the image processor and controller. Thus, with respect to endoscope 32, the image processor is located proximally.

  The endoscope 32 includes two stack wheels 16 to provide four basic mobilities of the flexible insertion tube 34, such as up, down, left and right. The endoscope 32 further includes a plurality of user input control switches or buttons 50. The switch or button 50 is connected to the connector of the endoscope 32 or the display holder 44 in the case of the detachable video display unit 36. As such, the switch or button 50 may be connected to an internal component of the video display unit 36. The plurality of user input control switches or buttons 50 include a direction button 52, a mode button 54, and a menu button 54. The direction button 52 is preferably a digital joystick that is normally biased so as to be held in a vertical direction at the center and can be swung instantaneously in the front-rear and left-right directions with respect to the center direction. One function of the direction button 53 is to select a digital zoom level for viewing and capturing images. Moving the direction button forward or backward causes a positive or negative corresponding change in the digital zoom level of the image being viewed and the captured still image or movie. In a preferred embodiment, the direction button 52 may be used to select a zoom level with a digital magnification of up to 4 ×. The mode button 54 and the menu button 56 are preferably push buttons and momentary switches.

  The direction button 52 is linked with the on-screen menu presented to the physician using the mode button 54, the menu button 56 and the video display unit 36 under the control of a microprocessor or digital signal processor built in the endoscope 32. And do some additional features. In particular, the physician uses these three buttons to play a video clip or select and view a still image, view the index of the recorded and “thumbnail” image of the still image, fast forward, rewind and Stop playback, select video / still capture image resolution mode from 1, 3 or 6 megapixels, record audio clip, switch image date stamp on and off, enable automatic image stabilization and Disable, adjust the white balance setting of the captured image, switch the image histogram display on and off, select between natural, black and white and sepia image capture, manually adjust the image exposure level, 10 Activates the electronic shutter self-timer for seconds, the screen display To enable / disabling the tray icon, the video output resolution (i.e., 640 × 480 or 320 × 240 pixels) is selected, it is possible such to combine two images taken individually into one.

  Also, the on-screen menu is used to delete images and video clips, to view “slide shows” of previously captured images, and to print images directly to the included PICTBRIDGE® compatible printer. You can also In addition, use the on-screen menu to set the internal date and time, enable / disable audible beeps, set the display flicker frequency to 50 Hz or 60 Hz, direct analog TV output on the high speed I / O data port Set to NTSC or PAL video format, set brightness of video display unit 36, format internal and removable storage media, switch automatic shut-off on and off, change display language on screen Set the operation mode of the USB port to be set (when connected to the personal computer via the high-speed USB port, the display on the screen displays a menu that allows the physician to select the desired connection mode. Or Can such automatically enter) to automatically be connected with detachably disc "mode, or printer mode.

  A high-speed I / O data transfer port (not shown) of the video display unit 36 is digitally transmitted to an external computer such as a personal desktop computer or laptop computer via a conventional universal serial bus (USB) interface. Data can be transferred or analog video output can be output to a conventional video display monitor via a suitable attached AV cable. If the data transfer port is coupled to a PICTBRIDGE (registered trademark) compatible USB printer, a still image captured by the endoscope camera can be directly printed without the need for an intermediary external computer. A power-on switch (not shown) is disposed on the endoscope 32.

  A part of the interior of the endoscope 32 can be accessed by a snap-fit battery door (not shown) that is detachable with the aid of a plurality of gripping ribs, so that the rechargeable battery that drives the endoscope 32 can be removed and replaced. , And a flash memory card for storing the captured moving image and / or still image can be inserted and removed.

  A functional block diagram (not shown) of an embodiment of the present invention includes an endoscope 32 having an image acquisition device that may be, for example, a CCD chip 110. The image acquisition device is connected to the input of a preamplifier that provides an output coupled to the connector card of the holder 44 and the electrical wires extending through the flexible insertion tube 34. The endoscope 32 further includes a fiber light source that extends through the flexible insertion tube 34 to the connector 20. The plurality of user input control switches or buttons 50 each have a circuit that extends to the connector card of the holder 44. Video display unit 36 includes an analog to digital converter coupled to a connector of video display unit 36. An image processor is coupled to the A / D converter. The image processor is also coupled to a controller, various memories, and various optical external interfaces. The controller is also coupled to various memory and optical external interfaces and user input control switches or buttons 50.

  The optical external interface can include a high-speed data transfer port 142, an analog output such as audio S for coupling to an external device, and a removable flash memory. The display unit 36 may be provided with a built-in flash memory.

  Additional internal components of the endoscope system include a battery, a removable flash memory card, a primary printed circuit board, and a secondary printed circuit board. The battery is preferably a conventional lithium ion type battery, which can be removed for charging with a separate charging unit by first removing the battery door from the body or proximal end of the endoscope 32. Alternatively or additionally, a battery charging jack may be provided on the main body to supply an appropriate charging cradle or charging stand and charge the battery on the spot.

  The removable flash memory card preferably comprises an industry standard secure digital (SD) card, a mini SD card with an SD card adapter, or a multimedia card (MMC). The memory card is removable and is held in an attached card slot and can be removed from the camera housing by removing the battery door.

  The primary printed circuit board can include a number of circuitry, including an A / D converter, a digital signal processor or microprocessor, a controller, and a built-in flash memory. The secondary printed circuit board may carry direction buttons, mode buttons, and menu buttons. The secondary printed circuit board may carry a redundant video recording button and a redundant still photo shutter button.

  The main body may further include a small microphone (not shown) that is also coupled to the primary printed circuit board. In conjunction with the on-screen menu function provided via the display and processor, the microphone allows the physician to record a voice clip, such as a voice memo, on a built-in flash memory storage device or a removable flash memory card, The audio clip can be transferred to an external personal computer.

  In another embodiment, the majority of the electronic equipment resides on the body portion or proximal end of the endoscope 32. For example, the A / D converter, the image processor, and the controller are disposed in the main body and coupled to the video display unit 36.

  FIG. 3 shows another embodiment of the endoscope system of the present invention. FIG. 3 shows an endoscopic imaging system 60 that includes an endoscope 32 having a flexible insertion tube 34, with the distal image sensor 24 and associated components (not shown in FIG. 3) being remote from the insertion tube 34. It is arranged at the rear end. A wire or line (not shown) extends from the distal image sensor 24 through the entire length of the flexible insertion tube 12 to the proximal end or body portion of the endoscope 32. A removable visual screen or video display unit 36 is shown coupled to the endoscope 32. The system 60 of FIG. 3 is very similar to the system 30 of FIG. 2 except that the majority of the electronics are located outside the body or proximal end of the endoscope 32. For example, as described with reference to FIG. 2, the majority of electronic components are located in a detachable video display unit 36. A cord 80 extends from the detachable video display unit 46 to a detachable adapter 70. The removable adapter 70 may include a user switch or button 50. Since the adapter 70 is detachable from the endoscope 32 together with the cord 80 and the detachable video unit 36, the adapter 70 can cope with cleaning of the endoscope 32.

  Alternatively, the majority of electronic devices reside in adapter 70. For example, an A / D converter, an image processor, and a controller are disposed on the adapter 70 and coupled to the video display unit 36 via a cord 80.

The biaxial controller 90 provides control of the distal end of the flexible insertion tube 34 as is well known in the art.
In connection with the present invention, it is also conceivable to use transmission software and related applications.

  In some video display unit embodiments, DV quality video compression is performed using MPEG-4 video compression. Still images are compressed using the JPEG compression algorithm. Both of these are industry standard methods of data compression. After use, the image can be transported from a removable flash RAM drive (SD RAM) or sent to another computing device via USB-2. Image viewing can also be performed live on a computing device via USB-2 cable or on a compatible video monitor via AV output. Voice recordings can also be captured when recording for clinical findings.

  FIG. 4 illustrates one embodiment of the present invention. In this embodiment, information is captured via a video capture device 402 such as an endoscope imaging system. This information is uploaded via upload 416 to computer 404 via a wired or wireless connection. For example, upload 416 can be USB, WiFi, Bluetooth, or the like. Computer 404 can import information from multiple video capture devices. Similarly, the computer 404 can import files such as DICOM files (DICOM is a Digital Imaging and Communications in Medicine) for distributing and viewing all types of medical images regardless of their origin. Meaning standard). Storage system 406 communicates with computer 404 via communicator 418. The communicator 418 can be, for example, XMPP (Extensible Messaging and Presence Protocol) or DICOM. In some embodiments, the storage system 406 is web-based, a connection and presence manager, and provides video relays and buffers. The system conveys a pre-recorded video stream in DICOM format and converts live video to a format that runs on various devices. The illustrated exemplary device includes an iPhone® 408, a second computer 410, a web browser 412, and other devices 428. Storage system 406 communicates with iPhone (R) via iPhone (R) communicator 420, which includes, for example, SMS (Short Message Service), e-mail, XMPP, DICOM, and H. H.264 (standard for video compression). The storage system 406 communicates with the second computer via the second computer communicator 422, which can include, for example, email, XMPP, DICOM, and H.264. H.264. The storage system 406 communicates with a web browser via a web browser communicator 424, which can include, for example, email, HTTP, and FLV (flash video). iPhone (R) 408 can include a DICOM viewer. The second computer 410 can include a DICOM viewer and can export the DICOM file to other EMR (Electronic Medical Record) software. The web browser 412 can include an FLV viewer and can be web-based.

  A medical data communication network can be considered. In one embodiment, the network is obtained by connecting a palm-held endoscope imaging system to a personal computer and a portable device. In an alternative embodiment, the network further includes a plurality of medical devices connected to a vast number of medical information transmission systems. Examples of possible medical devices include, but are not limited to, bronchoscopes, laryngoscopes, gastroscopes, and the like.

  The first usage scenario applies to situations where both the sender and the recipient use the sending software application. In this scenario, the data sender is a doctor at the first hospital or care center who evaluates the patient. The data recipient is a doctor in the same first hospital or care center who currently corresponds to the other patient. At least one other doctor is away from the hospital (referred to as “non-hospital doctor”). The data sender starts an examination such as an EGD endoscopy, and selects a data receiver and an out-of-hospital doctor as recipients of related data. Both the data recipient and the out-of-hospital doctor are immediately notified that the test has started. Data recipients and non-hospital doctors can receive live streaming video on their respective data compatible devices (cell phones, PCs, or other devices) and observe ongoing video without having to be present. This feature indicates that the data sender is observing the video being transmitted by the data receiver and the doctor outside the hospital. In addition, data recipients and out-of-hospital physicians can point out areas under evaluation that data senders should better explore and inspect.

  Based on the transmitted video, the data sender can request an opinion from the data receiver and the doctor outside the hospital. Also, if a recipient, such as a data recipient and / or an out-of-hospital doctor, shares a schedule during an examination and / or subsequent procedure, the video can be saved and reviewed at a later date and time.

  The second use case applies to situations where only the sender can use the sending software / application. In this situation, the data sender can be, for example, a rural physician. At the time of use, a doctor who is a data sender performs examination / evaluation using a data transmission compatible examination apparatus. In one possible embodiment, a portable endoscopic camera is adapted for data transmission. The data sender records the inspection / evaluation video on the device. The device components connect to the office computer via a wired or wireless connection such as USB, WiFi, Bluetooth or the like. To this end, the data sender contacts the consulting doctor, provides a password, and sends a text message with a secure link to view the video. The consulting doctor can view the video from any location using a web browser. Furthermore, an instruction regarding how to stop (prohibit) access to the video by clicking on a specific link is sent to the consulting doctor as a text by e-mail.

  The point-of-care system disclosed herein combines portable imaging with web-based image and video storage in a secure HIPAA compliant environment. In some embodiments, the system comprises a camera, a web service, and a desktop application.

  In this embodiment, a high-definition camera equipped with a universal scope coupler, a detachable video display unit such as a liquid crystal display touch screen equipped with a multimedia player, and a USB used for battery charging and data transfer A hand-held portable endoscope imaging system comprising a docking station is disclosed. Additional online data storage and partner sites will be provided. In an online environment, users can upload, store, manage, manipulate and share laboratory findings such as endoscopy. When the disclosed system is used with its desktop companion, data can be shared via automated push-pull of the imaging data stream line workflow.

  Features of the disclosed system include exam filing based on patient demographic data, exam notes, search capabilities, reporting, video editing, video frame-by-frame analysis, and endoscopic images and Can include secure online sharing of video.

  FIG. 5 is a block diagram of an exemplary unified imaging platform according to this disclosure. In particular, the unified imaging platform 500 includes a display 502, one or more processors 504, a network interface 506, a storage device 508, a medical device interface 510, and a user interface 512.

  In operation, digital image data from the medical imaging device is received via the medical device interface 510. The medical device interface 510 forms an interface between the unified imaging platform 500 and a medical imaging device such as an endoscope. The medical device interface can be a wired interface or a wireless interface.

  The digital image data can be processed by one or more of the processors 504 and can be displayed on the display 502 or stored in the storage device 508. The processor 504 may be one or more of a microprocessor, digital signal processor, microcontroller, programmable logic device, or currently known or future developed processor suitable for use with the unified imaging platform 500. Can be included. The display can include LCD displays, LED displays, plasma displays, cathode ray tube (CRT) displays, or currently known displays suitable for use with the unified imaging platform 500 or future developed displays. Storage device 508 is an electronic data storage device (eg, SDRAM, ROM, EEPROM, flash or the like), magnetic data storage device (eg, hard disk drive), optical data storage device (eg, CD or DVD drive). Or a currently known or later developed data storage suitable for use with the unified imaging platform 500 to store at least one of digital images, digital video and related data. it can.

  The unified imaging platform 500 can be controlled by the user via a user interface 512, which can be a switch, button, position sensing device (joystick, mouse, trackball, or the like), touch screen, keyboard, Alternatively, it may include one or more of currently known or later developed user interface elements suitable for use with the unified imaging platform 500.

  The unified imaging platform 500 can communicate with an external network or system via a network interface 506, and the network interface 506 can include a wired or wireless network interface.

  FIG. 6 is a block diagram of an exemplary endoscopic system having a rigid or flexible image acquisition end and a proximal image sensor. In particular, the endoscope system 600 includes a display unit 602, an endoscope 604, a proximal image sensor 606, and a rigid or flexible optical insertion tube 608.

  In operation, light is transmitted from the distal end of the insertion tube 608 to the proximal image sensor 606, where it generates an analog or digital image signal. The proximal image sensor transmits image signals to the endoscope 604 and further to the display unit 602, which can be a unified imaging platform similar to that illustrated in FIG.

  An image generated from the image signal can be viewed on the display unit 602. Images can also be edited, stored, or transmitted to another system by display unit 602. The display unit 602 can be detached from the endoscope 604.

  FIG. 7 is a block diagram of an exemplary endoscopic system having a digital image sensor and a display unit electrically coupled. In particular, the endoscope system 700 includes a display unit 702, an endoscope 704, a flexible insertion tube electrical link 706, and a distal image sensor 708.

  In operation, the distal image sensor 708 generates an analog or digital image signal that is transmitted to the endoscope 704 via the electrical link 706 and further to the display unit 702, which is shown in FIG. A unified imaging platform similar to that shown can be obtained.

  An image generated from the image signal can be viewed on the display unit 702. Images can also be edited, stored, or sent to another system on display unit 702. The display unit 702 can be detached from the endoscope 704.

  FIG. 8 is a block diagram of an exemplary system having a distal image sensor and a wirelessly coupled display unit. In particular, the endoscope system 800 includes a display unit 802, a wireless link 804, an endoscope body 806, a flexible insertion tube electrical link 808, and a distal image sensor 810.

  In operation, the distal image sensor 810 generates an analog or digital image signal that is transmitted to the endoscope body 806 via the electrical link 808 and further to the display unit 802 via the wireless link 804. . Display unit 802 can be a unified imaging platform similar to that shown in FIG.

  An image generated from the image signal can be viewed on the display unit 802. Images can also be edited, stored, or sent to another system on display unit 802. The display unit 802 can be detached from the endoscope body 806.

  FIG. 9 is a block diagram of the display unit coupled to the endoscopic imaging cart system. In particular, the medical imaging system 900 includes a display unit 902 that is coupled to the medical imaging system 904. The display unit 902 can be a unified imaging platform similar to that shown in FIG. The image can be viewed on the display unit 902. Images can also be edited, stored, or sent to another system on display unit 902.

  FIG. 10 is a block diagram of the display unit coupled to the docking station. In particular, the medical imaging system 1000 can include a display unit 1002 coupled to a docking station 1004, which can include a link 1006 with an external system or network.

  In operation, the display unit 1002 can be located at the docking station 1004 for battery charging and / or data transfer. Data transfer between the display unit 1002 and the external system can be performed via the docking station 1004 and the link 1006.

  FIG. 11 illustrates the architecture of the software system. System 110 includes a medical imaging device 1102 (eg, a device similar to that illustrated in FIGS. 6-9). The system also includes a mass storage device 1106. The medical imaging device 1102 and the mass storage device are coupled to the plug-in API 1110 via links 1104 and 1108, respectively. The plug-in API is also coupled to the medical information system 1112 via an HL7 link. A medical information system 1112 is also coupled to the web service API 1116 via an interface 1114 (eg, an XML / REST interface). The system 110 also includes an imaging management station 1118, a portable device 1122, and a remote system 1126, which are coupled to the web service API 1116 via XML / REST interface links 1120, 1124, 1128, respectively. A local cache storage device 1130 is also coupled to the remote system 1126.

  Web service API 1116 is also coupled to web service system 1132 via XML / REST interface link 1134. The web service system is coupled to patient record database 1138 and cloud storage 1140 via interfaces 1136 and 1144, respectively. Cloud storage 1140 is coupled to web service API 1116 via streaming media interface 1142.

  As shown, the system can include a web-based storage system for images and videos, such as endoscopic images and videos. A number of web-based services are available through the REST style interface. All communication between the client and the web server takes place over HTTPS using a 256-bit AES cipher. In one embodiment, three clients are implemented: a web application, an iPhone native application, and a desktop application. The system is highly decoupled and is very flexible using public standards.

  In the exemplary embodiment, the web server consists of a pair of Amazon EC2 instances. In other words, it is a secondary server that can act as a failover server in the unlikely event that the master server instance stops due to acting as the main server and database read slave. Storage of images and videos is handled, for example, by Amazon S3. Amazon EC2 and S3 are high performance, highly scalable, and very secure. It is estimated that approximately 200-300 concurrent users are processed on a single server. Additional users can be supported by adding load balancers and creating additional master-slave server instances. An hourly snapshot of server and database status is stored in Amazon EBS. Data is continuously backed up and new server instances can be immediately brought online. A random backup is selected each week and a full recovery is performed on the new server instance (apart from the production server) to simulate disaster recovery.

  Access to a web service requires a software system account, an authenticated user within that account, and authorization to act as a resource by that user. Authentication and authorization are handled by the server. Each account has its own URL and its own individual database in the system. There may be any number of user accounts within each account. Users can be provided with coarse-grained access control. A user marked “admin” has full control over the account. In order for a user not marked as admin to read, create, update, or delete a patient, file, procedure or other user, permission must be assigned.

  FIG. 12 illustrates integration with EMR. System 1200 includes a medical imaging device 1214 that is coupled to a plug-in API 1216 via a link 1220. The imaging management station 1218 is coupled to a plug-in API 1216 via a link 1222 and is coupled to a web service API 1224 via a link 1226 (eg, XML / REST interface). Plug-in API 1216 is coupled to integration engine 1212 via interface 1228 (eg, HL7). The integration engine 1212 is also coupled to the web service API 1224 via an interface 1230 (eg, an XML / REST interface). Integration engine 1212 is coupled to message transformer 1210, which is coupled to message router 1208 and another message transformer 1206. Message transformer 1206 is coupled to EMR / HIS 1202 via link 1204 (eg, an HL7 interface).

  As shown, the integration engine is used to coordinate traffic between EMR, web services, and applications (and proxies, LCDs). An exemplary integration engine is MirConnect (http://www.mircorp.com/community/overview). In one embodiment, a listener is implemented in Mirth that receives an endoscopic procedure command (ORM) from AllMeds. An exemplary ORM is presented below.

Ｍｉｒｔｈが命令を受信すると、ＲＥＳＴ ＡＰＩを使用してウェブサービスの要求が構成され、ＲＥＳＴ ＡＰＩはさらに我々のデータベースに命令を格納する。ユーザはそのＬＣＤをドッキングステーションにドッキングする。こうして、アプリケーションが上記概説したプロセスを進め、さらに命令ＩＤをプルダウンして、それをＬＣＤの患者フォルダとともに格納する。あるいは、医師はＬＣＤ上で患者チャート番号を入力するだけにして、この初期のドッキングプロセスをスキップしてもよい。医師は次に検査の実施へと進む。ＬＣＤが再びドッキングされると、アプリケーションがｅＧｏからすべてのデータをコピーして、画像および映像データのアップロードを始める。画像または映像がアップロードされたら、アプリケーションは手順ＩＤをローカルに探す。見つからなければ、ウェブサービスに問い合わせて、患者チャート番号（ＬＣＤに入力したもの）および画像の取り込み日と整合する手順を見つけてみる。手順ＩＤが見つかれば、アプリケーションは、画像および映像データを参照するＯＢＸセグメントを含むＯＲＵメッセージを構築する。参照とは画像および映像データに移動させる予め認証済みのＵＲＬである。ＯＲＵがＭｉｒｔｈに送られて、そこで最終的にＥＭＲへと転送される。

When Mirth receives the instruction, the web service request is constructed using the REST API, and the REST API further stores the instruction in our database. The user docks the LCD on the docking station. Thus, the application proceeds with the process outlined above, further pulling down the instruction ID and storing it with the LCD patient folder. Alternatively, the physician may simply enter the patient chart number on the LCD and skip this initial docking process. The doctor then proceeds to perform the test. When the LCD is docked again, the application copies all data from the eGo and begins uploading image and video data. Once the image or video is uploaded, the application looks for the procedure ID locally. If not found, contact the web service to find a procedure that matches the patient chart number (entered on the LCD) and the image capture date. If the procedure ID is found, the application constructs an ORU message that includes an OBX segment that references image and video data. A reference is a pre-authenticated URL that is moved to image and video data. The ORU is sent to Mirth where it is finally transferred to the EMR.

  An exemplary ORU is described below.

このＯＲＵは検査の画像または映像と同数のＯＢＸセグメントを含むことになる。ＡｌｌＭｅｄｓの場合、リンクが外部ドキュメントとして患者記録とともに格納される。ユーザがドキュメントのリンクの１つをクリックすると、デフォルトのウェブブラウザが開いてファイルに移動させる。

This ORU will contain as many OBX segments as the image or video of the examination. For AllMeds, the link is stored with the patient record as an external document. When the user clicks on one of the document links, the default web browser opens and navigates to the file.

  An important consideration in this type of integration is that the EMR must support the processing capabilities of external web links. The link is a direct link with the media data and should be displayed in most browsers. One option is for EMR to launch only the default browser on the system and point it to the file.

  The “shared” feature in links created with web applications and EMR integration procedures both rely on the same signing process to generate secure links to resources. When an authorized user requests a pre-authenticated link, the server generates a digital signature for that link. The pre-authenticated property of the link means that neither the email recipient nor the EMR needs to know the credentials of the user who created the link to access the resource. Link signatures are valid only for specific resources and specific access methods, and are optionally valid for specific periods of time. Unauthorized access is not possible just by someone pointing to a link to a new resource. Also, it is not possible to access resources using unintended methods (e.g. it would be inconvenient if someone could construct an HTTP DELETE request when only data acquisition would have been allowed). Examples of pre-authenticated links are presented below.

図１３はウェブ・アプリケーションのフロントエンドを図示するスクリーンショットである。ある例では、ウェブ・アプリケーションはＭｉｃｒｏｓｏｆｔ Ｓｉｌｖｅｒｌｉｇｈｔ３を使用して構築されて、ＷｉｎｄｏｗｓおよびＭａｃ ＯＳ Ｘ上のＦｉｒｅｆｏｘ、Ｉｎｔｅｒｎｅｔ ＥｘｐｌｏｒｅｒおよびＳａｆａｒｉで動作する。これは患者、画像および映像の管理、映像の編集、セキュアなリンクを介した画像および映像の共有、画像および映像の並列比較、並びにレポート作成のためのユーザフレンドリーなフロントエンドを提供する。

FIG. 13 is a screenshot illustrating the front end of a web application. In one example, a web application is built using Microsoft Silverlight3 and runs on Firefox, Internet Explorer, and Safari on Windows and Mac OS X. It provides a user-friendly front end for patient, image and video management, video editing, image and video sharing via secure links, parallel comparison of images and video, and reporting.

  This application is installed on the user's computer. It runs natively on Windows and Mac OS X. Exemplary tasks include identifying the docking of the LCD unit to the docking station, copying data to and from the LCD unit, web services and communication with medical information systems. One means to allow end users to extend the system is a Python based plug-in system. The application requests the user to log in and also communicates over HTTPS.

  FIG. 14 shows a flowchart of an exemplary workflow in the system, which includes the following steps. Step 1404 where the user performs the inspection, Step 1406 where the user docks the LCD display unit (eg, unified imaging platform) to the docking station, Step where the application software recognizes the LCD and copies all data from the LCD to the PC 1408, the application queries the web service for the patient's schedule and places a folder on the LCD that represents the patient (the folder name is the first letter of the patient's first name and the first four letters of the last name). Step 1412 to release, the LCD is now ready for further inspection. Through the process, the application uploads images and videos to the web service and forwards information 1414 to the integration engine.

It will be appreciated that the steps shown in FIG. 14 may be repeated in whole or in part to complete the intended medical image processing task.
FIG. 15 shows an example of a high-definition camera medical imaging system having a detachable display device. This example includes a camera unit, a video display unit, and a docking station.

  The capabilities and elements of the system disclosed herein include, for example, a built-in image processor, high-definition video and 6 megapixel photographic capabilities, a liquid crystal display visual screen, a touch screen for data entry, and image storage Built-in memory, removable memory for transferring data to various personal computing devices and memory devices, high-speed digital data for viewing live images via conventional monitors or on personal computing devices Transfers and virtual repositories of endoscopic images and videos can be included.

  In relation to image capture, the capabilities and elements of the system include, for example, the ability to capture images such as endoscope images with a handheld device, the ability to obtain high-definition images and video, and a detachable touch screen LCD Display, advanced user interface, portable multimedia player, light source optimization technology, user-specified light balance, manual white balance, and automatic white balance optimized to work with halogen, LED, halide or xenon light sources Can be included.

  In the context of storage devices, system capabilities and elements include, for example, the ability to automatically store high-definition images and video that can be uploaded and stored in a secure data management system, information in secure HL7 format, electronic medical It can include the ability to easily store and transfer records, extract still images from video, trim video, the ability to one-touch download, and parallel comparison of video, photos and CT images.

  In the context of data sharing, the capabilities and elements of the system include, for example, the ability of a physician to share point-of-care image / examination data with a removable LCD monitor, and the physician's normal and abnormal pathology of the patient. Automate data to streamline workflows by eliminating redundant capture, tagging, recording, exporting, and importing tasks that typically accompany video data such as double image comparison, endoscopic data, etc. And web-based storage solutions that allow doctors to send and receive data anytime, anywhere with no restrictions on the size of video files by sending secure links to emails.

  As an example only, the camera unit weighs about 410 grams, is about 16.51 centimeters (6.5 inches) long, has a height of 19.05 centimeters (7.5 inches) without an LCD, and has a height with an LCD. 25.4 centimeters (10 inches), providing 1280 × 720 resolution HD video (MPEG4 compression, AVI format), providing 5 megapixel still images (JPEG format), and CMOS image sensor , Universal C-mount endoscope coupler, HDMI digital video output, composite analog video output, removable and rechargeable lithium-ion battery, hot key for still image / video capture and zoom-in / out, robust And powder-coated magnesium enclosure.

  As an example only, the video display unit weighs about 100 grams and weighs about 9.525 centimeters by 8.255 centimeters by 2.8575 centimeters (3.75 inches by 3.25 inches by 1.125 inches). Yes, an 8.89 cm (3.5 inch) touch screen (measured diagonally), a removable SD card, a multimedia player, and a non-removable and rechargeable lithium-ion battery Prepare.

  As an example only, the docking station is 11.43 centimeters by 5.715 centimeters by 11.43 centimeters (4.5 inches by 2.25 inches by 4.5 inches), with a 50 pin port for the LCD unit and , A charging port for a lithium ion battery, a power supply port (DC5V at 3A), and a USB 2.0 miniport. One embodiment of the docking station implements a mass storage driver (USBSTOR on Windows) for data transfer.

  In order to protect the confidentiality, integrity and availability of data, administrative physical and technical protection in accordance with the HIPAA security standard can be considered. These protections include accommodating servers in physically secure and geographically dispersed data centers, protecting servers with firewalls, and remote connection to servers via encryption means such as 256-bit AES encryption. Secure, provide each user with a unique ID and password needed to access the system, maintain a backup of the system, provide a redundant system for failover, and all access attempts And logging system activity. System design features related to HIPAA compliance rely on EMR and other HIT systems to store file names anonymously and separately from patient data, instead of storing more comprehensive demographic data Storing minimal patient data in a customized web database.

  Further, the server compares the calculated signature with the signature of the inquiry character string. If any part of the request is different from the original, the signature is inconsistent and the request is rejected. The secret code is unique to each account and is known only to the server.

  An optional expiration parameter allows the sender to deny access to the resource after a period of time. This does not prevent the recipient from downloading the resource and obtaining a local copy until its expiration date, but this is not the intended purpose of the expiration parameter. It is assumed that the recipient is a trusted person and that there is no problem with the recipient getting a local copy of the resource. However, when a link is transmitted to an external party, there is a risk that the sender's control may not be achieved for certain security aspects. Links may be stored in plain text on insecure machines, links may be sent and received over insecure channels, and links may be inadvertently sent to the wrong person. The expiry parameter provides a mechanism to limit the amount of time a resource is susceptible to these types of unintended exposures in the user environment. The link stored in the EMR generally does not have an expiration parameter because it is assumed that the communication channel between the application, Mirth, and EMR is secure. Further, it is assumed that the link in the EMR is protected by the security system of the EMR itself.

  An important aspect of the pre-authenticated link is that it does not contain information identifying the patient's identity. However, there is no mechanism in the system to determine if there is patient information embedded in the file pointed to by the link. For example, the patient name may be spoken in the video audio track, or the name and date of birth may be embedded in the CT image. In all cases, it is the user's responsibility to correct any potential confidential information before sending the file or link to the file to another person.

  While the preferred embodiments of the invention have been illustrated in the accompanying drawings and described in the foregoing detailed description, the invention is not limited to the disclosed embodiments and does not depart from the spirit of the invention. It will be understood that numerous reconfigurations, modifications and substitutions of parts and elements can be made. For example, the visual screen on the camera may be a commercially available twin LCD display that has a backlight and a system LSI (Large Scale Integrated Circuit) chip between two LCD screens and can work simultaneously on both sides of the display. In addition, the system may include an audio input to support stroboscopic analysis.

  The system described herein is a flexible and secure system designed to optimize workflow. The workflow and integration scenarios outlined in this document are only representative of possible exemplary scenarios. Possible scenarios include Javascript and HTML that do not require browser plug-ins, a USB interface that inherits the current mass storage driver, and the use of a DICOM wrapper to integrate with PACS. While a few embodiments of the present invention have been described, it will be apparent to those skilled in the art that the foregoing is merely exemplary and not limiting and is provided by way of example only. Numerous modifications and other embodiments are within the scope of those skilled in the art and are considered to be within the scope of the invention and its equivalents. It will be appreciated that variations of the present invention will be readily apparent to those skilled in the art and that the present invention is intended to include alternatives thereof. Further, since numerous modifications will be readily apparent to those skilled in the art, the present invention is not intended to be limited to the exact configuration and operation shown and described, and thus all appropriate modifications and equivalents are also within the scope of the invention. to go into.

Claims (23)

An endoscope,
A body having a proximal end and a distal end;
A flexible insertion tube coupled to the body portion and having a proximal end and a distal end;
A video display unit detachably coupled to the main body through an electromechanical coupling;
An image sensor unit disposed at the distal end of the flexible insertion tube;
An electrical link electrically coupling the image sensor unit to the body portion and extending from the image sensor unit through the flexible insertion tube;
A user interface;
An endoscope comprising: an electrical processor coupled to the electrical link, the user interface, and the video display unit.   The endoscope according to claim 1, wherein the user interface and the image processor are disposed in the main body.   The endoscope according to claim 1, wherein the user interface and the image processor are disposed in the video display unit.   The endoscope according to claim 1, wherein the image sensor unit is at least one of a charge coupled device or a complementary metal oxide semiconductor.   The endoscope according to claim 1, wherein the video display unit is a liquid crystal device.   The endoscope according to claim 1, wherein the user interface is disposed on the video display unit.   The main body includes a biaxial rotatable component for coupling to the video display unit, and the video display unit rotates about the vertical axis of the main body and passes through the video display unit. The endoscope according to claim 1, wherein the endoscope can be rotated around the center.   The image processor and associated components include a memory having software programs for controlling image information received from a distal image sensor unit, information from the user interface, and the video display unit. The endoscope according to Item 1. An endoscope,
A body having a proximal end and a distal end;
A flexible insertion tube having a proximal end and a distal end;
An image sensor unit disposed at a distal end of the flexible insertion tube;
An electrical link extending from the image sensor unit through the flexible insertion tube to an interface section of the body portion;
With a unified imaging platform,
The unified imaging platform is
A video display unit configured to be mechanically and detachably coupled to the main body and configured to be coupled to the main body via a wireless link;
A user interface;
The video display unit, the user interface and the image processor are coupled to the user interface and the video display unit, while maintaining a data link between the unified imaging platform and the main body via the wireless link. An endoscope including an image processing / display / storage device section that is mechanically removable from a main body.   The endoscope according to claim 9, wherein the image sensor unit is a complementary metal oxide semiconductor sensor.   The endoscope according to claim 9, wherein the video display unit is a liquid crystal display device.   The main body includes a two-axis rotatable component for coupling to the video display unit, and the video display unit rotates about a vertical axis of the main body and has a vertical axis passing through the video display unit. The endoscope according to claim 9, wherein the endoscope is capable of rotating about a center.   The unified imaging platform includes a computer readable memory in which a software program is stored, and when the software program is executed by a processor of the unified imaging platform, The endoscope according to claim 9, wherein the endoscope controls image information received from an image sensor unit, information from the user interface, and information transmitted to the video display unit.   The endoscope according to claim 9, wherein an image processor adapter includes the user interface and is coupled to the video display unit via an external code. A unified imaging platform,
A processor configured to process image data received from an image sensor disposed at a distal end of the endoscope insertion tube;
A display device coupled to the processor and configured to display image data;
A storage device coupled to the processor and configured to store image data;
A network interface coupled to the processor and configured to communicate data between the processor and a system external to the unified imaging platform;
A unified imaging platform comprising: a medical device interface configured to wirelessly receive data from a transmitter disposed in a medical imaging device. A medical imaging device,
A distal image sensor coupled to an electrical link disposed on the insertion tube and disposed on a distal end of the insertion tube;
A body interface coupled to a proximal end of the electrical link, disposed on a body portion of a medical imaging device, and configured to wirelessly transmit data received via the electrical link;
And a display unit including a wireless data receiver configured to receive data transmitted by the main body interface. A medical image data processing system, the system comprising:
A medical image processing unit having a processor, a storage device, a display unit and an interface;
A web service system that includes one or more processors, a first storage device and a second storage device and provides a web service interface;
A web service platform provides an interface for receiving medical image data and patient information from the medical image processing unit, storing the medical image data in the first storage device, and the second storage device Is configured to store the patient information,
The medical image data processing system, wherein the web service platform is configured to provide the medical image data to another system via the web service interface.   The web service system is further configured to provide an interface to the medical information system for transferring data between the medical information system and the medical image processing unit via the web service system. The system of claim 17. A computer readable medium storing software program instructions, wherein the software program instructions when executed by a computer,
Receiving medical image data from a medical imaging device;
Storing the medical image data;
Displaying the medical image data on a display device coupled to the computer;
Transferring the medical image data to another system via a web service interface;
A computer readable medium storing software program instructions for performing operations including receiving a test instruction from the other system via the web service interface. A computer readable medium storing software program instructions, wherein when the software program instructions are executed by a processor in a handheld wireless device, the processor
Receiving medical image data generated by the medical imaging device from an external system via a web service interface;
Storing the medical image data;
A computer-readable medium storing software program instructions for causing an operation including displaying the medical image data on a display device coupled to the handheld wireless device.   21. The computer readable medium of claim 20, wherein the operation further comprises receiving the medical image data in real time from the medical imaging device via the web service interface.   21. The operation of claim 20, further comprising notifying the medical imaging device in real time that the handheld wireless device is receiving the medical image data via the web service interface. A computer readable medium as described.   The operation further includes transmitting data in real time from the handheld wireless device to the medical imaging device via the web service interface when performing an examination using the medical imaging device. 21. The computer readable medium of claim 20.

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