JP2015178010A - 乳房針生検システム及び使用方法 - Google Patents
乳房針生検システム及び使用方法 Download PDFInfo
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- 238000013188 needle biopsy Methods 0.000 title claims abstract description 63
- 210000000481 breast Anatomy 0.000 title claims abstract description 44
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
- A61B90/17—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins for soft tissue, e.g. breast-holding devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/04—Positioning of patients; Tiltable beds or the like
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/0233—Pointed or sharp biopsy instruments
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus for radiation diagnosis, e.g. combined with radiation therapy equipment
- A61B6/50—Clinical applications
- A61B6/502—Clinical applications involving diagnosis of breast, i.e. mammography
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A61B2017/3409—Needle locating or guiding means using mechanical guide means including needle or instrument drives
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- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
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- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/25—User interfaces for surgical systems
Abstract
【解決手段】X線システムに取り付ける針生検組立体10である。生検針は検出器及びX線源のうちの少なくとも1つに対して傾斜され、生検手術中に、生検装置による干渉を伴わずにX線撮像を行い得る。定位生検装置を、直立であれ傾斜であれ、乳房X線撮像システム、トモシンセシスシステム、及び、乳房X線撮像システム/トモシンセシスシステムの組み合わせを非限定的に含む、如何なるX線システムにも連結し得る。システムは、標的視覚化及び標的局所化の一方又は両方のために、如何なる画像捕捉モード(即ち、偵察、二次元乳房X線撮像、三次元再構築容積)の使用をも柔軟に支持する。そのような構成を備えることで、様々な異なるX線撮像プラットフォームとの使用のために、改良された患者適用範囲を有する。
【選択図】図1
Description
biopsy)を含む様々な方法で、細胞又は組織を回収し得る。最も侵襲的な手術である観血手術は、関心領域の視覚化中にワイヤを乳房内に配置する放射線医によって行われるのが一般的であり、その場合、ワイヤは切除されるべき関心領域内に延びる。次に、患者は手術に移され、関心領域を位置決めするワイヤを使用して、組織が回収(retrieve)される。
visibility)をもたらす能力である。その優れたコントラスト可視性の故に、標準的なX線マンモグラフィ、定位装置、又は、超音波を使用しても可視的でなく、MRIを使用してさえも可視的でない病理が、トモシンセシス画像上に見られることが予期される。
2 X線撮像組立体
2a X線管
2b 乳房トレイ
2c X線画像受容器
2d 集束散乱防止グリッド
2e 圧縮パドル
4 獲得ワークステーション(AWS)
4a キーボード
4b トラックボール
4c ディスプレイスクリーン
10 針生検組立体
11 針支持体
12 角度支持アーム
13 ホルスタ
15 生検装置
17 固定支持アーム
19 案内モジュール
21 支持ブラケット
23a ハンドル
23b ハンドル
25 制御モジュール
27 ボタン
28 ディスプレイ
30 X線検出器
31 コネクタ
32 管ヘッド
33a 指動輪ノブ
33b 指動輪ノブ
35 ホルスタ取付部
36 取付け機構
41 角軌道
50 標的領域
50a 連結機構
50b 連結機構
62A 圧縮パドル
62B 圧縮パドル
62C 圧縮パドル
64a スロット
64b スロット
66 開口
68 部分
80 病巣
91 ステップ
92 ステップ
93 ステップ
94 ステップ
95 ステップ
96 ステップ
110 標的化工具
120 画像源セレクタ
130 画像ビューセレクタ
150 画像窓
200 横方向生検アーム
210 ホルスタ取付板
220 指動輪
Claims (12)
- − 一端にX線源を含み他端にX線検出器を含むCアームと、
− 概ね前記X線源と前記X線検出器との間で前記Cアームに解放可能に連結される針生検組立体とを含み、
前記X線源は、トモシンセシス撮像のために前記X線検出器に対する角軌道に沿って回転するように構成され、
前記針生検組立体は、
− 固定支持アームと、
− 前記X線検出器の平面から偏心した角度で前記固定支持アームに連結される角度支持アームと、
− 該角度支持アームに連結される生検装置とを含み、該生検装置は、針を含み、該針は、前記X線検出器の前記平面から偏心した角度で位置付けられる、
直立X線撮像及び生検システム。 - ホルスタ取付部を更に含み、該ホルスタ取付部は、前記ホルスタ取付部に連結される前記生検装置を標的場所に位置付けるために前記角度支持アームに移動可能に連結される、請求項1に記載の直立X線撮像及び生検システム。
- 前記針生検組立体の前記固定支持アームと支持構造との間に連結される案内モジュールを更に含み、該案内モジュールは、前記標的場所の座標を決定し、前記決定される座標への前記ホルスタ取付部及び連結される生検装置の自動化された動作を制御する、請求項2に記載の直立X線撮像及び生検システム。
- 前記標的場所の前記座標は、前記X線撮像システムによって獲得されるX線画像データを用いて決定される、請求項1乃至3のうちのいずれか1項に記載の直立X線撮像及び生検システム。
- 前記X線画像データは、偵察画像、乳房X線写真、定位画像、トモシンセシス投射画像のような、二次元画像データを含む、請求項4に記載の直立X線撮像及び生検システム。
- 前記X線画像データは、定位容積データ及びトモシンセシス再構築データのような、三次元画像データを含む、請求項4に記載の直立X線撮像及び生検システム。
- 前記X線画像データは、二次元画像データ及び三次元画像データの組み合わせを含む、請求項4に記載の直立X線撮像及び生検システム。
- 前記固定支持アームと前記角度支持アームとの間の前記角度を調節するための調節機構を更に含む、請求項1乃至7のうちのいずれか1項に記載の直立X線撮像及び生検システム。
- 横方向生検の間に生検針を支持するために、前記組立体に連結される横方向生検アームを更に含む、請求項1乃至8のうちのいずれか1項に記載の直立X線撮像及び生検システム。
- 当該直立X線撮像及び生検システムによって捕捉されるトモシンセシス画像を検討するために当該直立X線撮像及び生検システムに連結される獲得ワークステーションを更に含み、該獲得ワークステーションは、当該直立X線撮像及び生検システムの生検モードと関連付けられるユーザーインターフェースを有し、該ユーザーインターフェースは、生検中に病巣を視覚化すること及び標的化することのうちの少なくとも一方における使用のために画像データを選択するための機構を有する、請求項1乃至9のうちのいずれか1項に記載の直立X線撮像及び生検システム。
- 一端にX線源を含み他端にX線検出器を含むCアームを有する種類の直立X線撮像及び生検システムのための針生検組立体であって、
前記X線源は、トモシンセシス撮像のために前記X線検出器に対する角軌道に沿って回転するように構成され、当該針生検組立体は、概ね前記X線源と前記X線検出器との間で前記Cアームに解放可能に連結され、前記針生検組立体は、
固定支持アームと、
前記X線検出器の平面から偏心した角度で前記固定支持アームに連結される角度支持アームと、
該角度支持アームに連結される生検装置とを含み、該生検装置は、針を含み、該針は、前記X線検出器の前記平面から偏心した角度で位置付けられる、
針生検組立体。 - 直立X線撮像及び生検システムを用いて乳房生検を行う方法であって、
前記直立X線撮像及び生検システムは、
一端にX線源を有し他端にX線検出器を有するCアームと、
概ね前記X線源と前記X線検出器との間で前記Cアームに解放可能に連結される針生検組立体とを含み、
前記X線源は、トモシンセシス撮像のために前記X線検出器に対する角軌道に沿って回転するように構成され、
前記針生検組立体は、固定支持アームと、前記X線検出器の平面から偏心した角度で前記固定支持アームに連結される角度支持アームと、該角度支持アームに連結される生検装置とを有し、該生検装置は、針を含み、該針は、前記X線検出器の前記平面から偏心した角度で位置付けられ、
当該方法は、
生検されるべき乳房を圧縮するステップと、
前記乳房内の病巣を視覚化するステップと、
前記病巣の座標を決定することを含む、前記視覚化される病巣を標的化するステップと、
前記X線検出器の平面から偏心した角度で前記生検装置の針を前記標的化される病巣に向かって前進させるステップと、
前記病巣を切除するステップとを含む、
方法。
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US20200205928A1 (en) | 2020-07-02 |
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