KR19980048569A - Remote control devices and systems for tracking and locating photon sources - Google Patents

Abstract

Systems and devices particularly suited to tracking radiopharmaceuticals present in the lymphatic vessels and locating outpost nodules where radiopharmaceuticals are concentrated. Small, long, hand held probes with two manually operated switches are used. In the tracking process, the probe is moved by the wave method where the tube containing the radiopharmaceutical is located and measured by means of a graphic output, preferably a data memory which is accessed circuitry. When approaching the outpost nodal zone, the switch on the probe device is activated by the physician performing the squelch sequence of operations until a zone with a small nodule is found. At this point, long and small probes will point out by approaching outpost nodules containing radiopharmaceuticals. The probe-mounted switch is configured to provide a preset current level on the probe pre-amplifier power supply. This level is detected and identified by the discriminator and an emulating signal is generated.

Sterilizable remote switches provide squelch-dressed level trim.

Description

Remote control devices and systems for tracking and locating photon sources

Assessment of the presence or absence of tumor metastasis or involvement has been a major determinant for achieving effective treatment for cancer patients. In fact, studies have shown that about 30% of patients with newly diagnosed tumors exhibit granular detectable metastases. Of the remaining 70% of patients who appear to be clinically exempt from metastasis, about half are curable with local tumor therapy alone. See Sugar Baker, E. Vizer, Appearance of Metastasis in Human Malignancies, Journal of Cancer Microbiology, 1981 2; 235. Nerby patients will eventually have clinically irrelevant (undetected) microtransitions that will become apparent.

The relationship of the lymphatic lineage in tumor metastasis has been the subject of extensive research and is well established. The lymphatic system is a widely distributed tissue, fluid, and fluid that is involved in the diversity of the correlated functions of the mammalian body, including the circulation and deceleration of tissue fluids formed in capillary foundations, as well as the migration of cell debris by single phagocytes and foreign bodies. It exists as a cell. The lymphatic lineage is importantly involved in the participation of the vascular system in developing the immune response of lymphocytes and cells. Lymph flows within the system as a result of the diversity of perceptual mechanisms of organ and tissue vitality. For some cancers, the metastases resulting from lymphatic drainage will result in the positioning or initial site of neoplastic secretions in any lymph node that typically appears to be a local nodule in the lymphatic drainage of the patient. Certain cancers, such as melanoma, have been observed to show the variability of lymphoid abscesses spreading from different parts of the body. Other cancers, like those experienced in the breast, may be evidence of a more modest nodular relationship. In the thematic forms of cancer disease management, therefore, the aim is to identify the lymph nodes involved. For melanoma, it has been more recent to demonstrate local nodules that follow the assessment of the extent of the lymphatic drainage of patients with drainage or micromigration. In about 20% of the melanoma research procedures, the pre-surgical step, which is usually a tumor of emulsified colloid labeled with technetium 99-m ( ^99m TC), gives the clinician all two-dimensional limited images In situ investigation, and spaced apart therefrom, is seen as performing a gamma camera generated from a lymphatic method, showing the area of radiation in the patient's local lymph nodes. The latter information identifies at least the drainage pathway and the location of the native drainage river. Local nodules are then removed and provided for pathological evaluation.

For cancers such as breast cancer, the locations of lymph node relationships are typically confined in the armpits, internal breasts, and supraclavicular lymph node regions. Among these, the axillary lymph node area is the main site of local metastasis from the malignant tumor of the breast, and about 40% of patients have evidence of spreading to axillary nodules. In early access to the disease, these axillary nodules had been removed as a form of treatment. Currently, however, their positive relationship, or lack thereof, is contrary to treatment and has been diagnosed. In this regard, the combination of presence and the extent of metastasis to the armpits represent the single most important prognostic factor for the management of patients with breast cancer. Cancer, Oncology Principles and Practice, Volume 1, 4th edition, Devita et al., Chapter 40, Harris et al., J. Lippincott, Philadelphia, PA (1993).

Axillary is a triangular region oriented excellently by axillary veins, transverse broad background, and mid-length full-length serrated. With more commonly used diagnostic procedures, virtually all axillary nodules in the axilla, which are assumed to represent the drainage river, are removed during analytical surgery. In general, somewhere between 10 and 30 nodules will of course be eliminated during the dissection process, with ancillary risks. In this regard, these nodules are generally surrounded by the subject and the adipose tissue and their visualization are necessarily limited. Such anatomy will stop the risk of cutting the long chest nerve, the thoracic spinal nerve, the nerve to the main thoracic muscle, or the armpit vein. In some cases morbidity can occur due to local nodule removal and patients are known to frequently discuss sensory palsy in the arm area following the procedure.

Although this form of some underlying axillary nodule dissection has been a traditional approach to nodular metastasis-related decisions, the more recent data, the smaller underlying axillary nodule evaluation procedure, as discussed below, is indicative of patient management, but more limited anatomy and Evaluation information for the staged with resulting trauma can be generated.

Patient care to stage objectives for the case of cutaneous melanoma is highly predicted in determining lymphatic relationships. Many factors are included in the sequelae of the disease, including the demonstration of local nodule metastasis among positions, tumor thicknesses, levels of invasion, shapes of growth, and of particular importance. Some researchers have advised that only resection of clinically verifiable metastatic nodules associated with an injury is desirable, while others have found nodules even though they may appear normal due to the risk of the presence of indiscriminate (clinically small) metastases. Had chosen to be temperate. Practical conversations have been carried out by researchers on whether selective lymph node dissection or cervical lymph gland removal is an appropriate treatment. Selective cervical lymph gland removal has the major advantage of treating nodular metastasis at a relatively early stage in its natural history when tumor burden is low. On the other hand, such an approach would allow the patient to undergo surgery that would otherwise be unnecessary. In particular, if patients exhibit clinical I stage of the disease, nodule is present and there is no benefit and can then be realized from local cervical ablation.

Relatively recently, Morton's lifespan has prayed for a study of procedures designed to demonstrate its lymph nodes in the vicinity of the location of melanoma and in patient lymphatic vessels. The nodules on the most direct drainage pathway will provide the most likely location for premature metastasis and are associated as guard nodes. As such, by performing only a limited anatomy of this nodule and performing histopathological analysis, stepping can be achieved without at least first entry to more radical cervical lymph gland removal. Once the drainage cavity has been demonstrated from injury, internal working mapping of lymphatic vessels on the skin with live dyes is performed, for example, by lymph scintillation in the surgical removal of primary lesions. The live dye is traced by blunt dissection until blue, for example, injected at the location of the disease and reaching the nodule. The nodule is now exclusively blue and easily proved. In this way, the primary drainage lymph nodes of each melanoma are separated and removed. By testing the number of nodules, for example, by rapid free immunohistochemistry, as well as by freezing using general histopathological techniques, only patients with evidence of micrometastasis in sentinel nodules are followed by a lymph node removal procedure. Receive. Morton D., Wen D.-Ar., et al. Technical details of interactive lymphatic mapping for early stages of melanoma, Arc.Surge, 1992: 127,392-399; And Lymphatic scintillation in high-risk melanoma of the aorta: Prediction of drained nodule groups, defining lymphatic channel and nodule nodule positioning. F. Yuren et al., J. Nuclear Medicine 1993; 34; 1435-1440.

Morton's extralife has also been suggested to alleviate axillary lymph node dissection, which is also common in breast cancer stages. Through the use of live dyes specially associated with lymphatic drainage systems from primary breast cancers, smaller underlying watchdog-based procedures may result in proper armpit and local control. With the procedure, blue dyes are generally injected into the lumps of breast and surrounding mammary dysplasia. Following a relatively short interval, the transversal incision is just below the hair retention area of the armpit. Blunt dissection is performed until the catheter leading to lymph bundles or blue stained nodules is demonstrated. Lymphatic conduits with blue color provide a guide pathway leading to the location of the nearest lymph node and such a nodule. This watch nodule is understated and evaluated. The procedure requires talent and considerable surgical experience related to delicate work along the blue conduit (conduit with torn dye may be problematic), but the ability to demonstrate tumor-free lymph node nodules is a risk that the surgeon may undermine underlying anatomy. It may enable patients with accurate staged metastasis-free breast cancer without putting them on burden. The approach could also improve the histology's phasing by enabling pathologists to focus on a smaller number of lymph nodes. Giuliano, A, Lee; Kergan, B.M: The, J.M; And lymphocyte mapping and guarding for cervical breast cancer in Morton, D. Il. Cervical Gland Removal Analysts of Surgery, Vol. 220, no. 391-401, 1994, J. B. Lippincoat.

Lymph node nodules in metastases have also been studied in other different forms of cancer such as colon cancer. This has come through the use of hand operated probes. United States Patent No. 4,782,840, issued by Martin, M. D. and Dr. Stone, of 1988,11,8 entitled How to locate, differentiate, and eliminate neoplastic tumors, shows the approach of nuclear medicine to position colon tumors. Giving. This patent describes a torso with an identified radioisotope associated with a radiation detection probe that the surgeon can use internally to detect positions of radiation. Due to the approach of the detection probes to the identified antibodies, in part due to the unique application of the approximate inverse square method of radio wave propagation, the weak radioactivity radiating from the indescribable positions becomes detectable. This procedure is known as the Riggs Procedure, which is a registered trademark of the Ohio, Dublin and Neoprene companies. The Rix system was discovered to provide unique proof of the lymph nodes involved for staged evaluation. For example, Nieroda, Mr. A. Surg. Gynecol. Obster. See vol. 169 (1), 1989, pp 35-40. The Lyx lymphatic assessment is also subject to the Radiation-Based Laparoscopic Method for Determining Treatment Modality, published November 24, 1995. No. 5,383,456 to M.W.Arnold, M.D. And any smaller invasive procedures may be employed as described by M.O. Thrston, Ph.D.

As a feature of the Rix system, the sites of related lymphoid or neoplastic tumors are performed using a statistical approach. With this approach, the background count ratio of radioactive radiation is developed, for example, in the aorta of the patient, for example during a time interval of 5 seconds. The microprocessor-based control system then calculates a predetermined number of standard deviations of the base coefficient ratios to derive statistically significant values, for example, statistically significant dress radiation coefficient ratio levels. The scoping procedure is referred to by surgeons as a squelch. Operating in relation to the dresshold level, the machine provides an audible instrument to the surgeon indicating that the high probability of tumor involvement is very close to the front window of the handle probe.

Lyx-based machines such as lymphatic vessels I from tumors or injuries, as described in U.S. Patent No. 4,801,803, of Denen et al., Entitled Detection and Localization for Low Energy Radiation Release, issued January 1, 1989. It can be adopted to detect and map emissions. In addition, the Squelch procedure is ever employed to pre-set the machine for positioning and otherwise an undetectable tumor can be used as a guide to the nodule. However, the control and the standard knob probe used with it were initially designed for different types of use to indicate very weak levels of radiation. If performed at this very low level of radioactivity, the labeled antibody is one that performs at the location of an inexplicable (sometimes extremely small) tumor. By contrast, radiopharmaceuticals employed in the lymph node nodules are often relatively high in concentrations. Mechanical components are now required to emphasize techniques for locating local nodules associated with tumors or injuries and distinguishing the nodule from local nodules that group within their field.

It is an object of the present invention to eliminate the improved systems and devices for positioning photon sources that emit from tissues in the body. This system is particularly suitable for tracking radiopharmaceuticals in the lymphatic system's tubes when extending to the nodule in the local nodule group. Such tracking along the tube becomes a practical feature of the system of identifying and measuring the radioactivity from those small vasculature attenuations not by the inverse square law of radio wave propagation. For tracking purposes, the system utilizes visual image reading, which can perform peak information of counting activity through the use of circularly-accessed data memory and image display, although performing on highly random radiation emissions. Two elements operating in the latter cooperation can display a curve flowing from right to left of the coefficient ratio activity; The most recent coefficient ratio data appears on the right edge of the screen and the oldest data disappears from the left edge. In carrying out this, the processing network of the control apparatus employing the present invention is configured for initial storage coefficients or coefficient basis signals for initial short intervals of time for developing initial coefficient ratio increment values. Then these initial increments are averaged using a uniformly metered filter with an impulse response that extends longer than the first intervals and then extends for a second interval of time that is presented to the monitor screen as visible output. This output is updated at the first shorter time intervals. In general, data are provided as a curve that shows the flow to the left that can be observed by a clinician when the handheld probe adopted with the system is operated around the epidermal surface of the patient. In this regard, blunt dissection and the like are not required for the purpose by live dyes and the like, and the range of radioactive emission is sufficient to perform tracking on the skin surface. In a preferred apparatus, a memory accessed by a circuit contributed for the purpose of improving the flowing coefficient ratio data on the image display screen is used.

As radiopharmaceuticals traveling with lymph are collected at wave nodes, they mark a small area in which the photoelectric propagation is defined by the origin of the point so that it follows the approximately inverse square law of radio wave propagation. This is very beneficial for probe use in distinguishing the nodule from other nodules near the tissue or in the area of the lecture. For the first time, nodules are established using injection procedures at the skin surface level. Next, the surgeon makes an incision and through the continued use of the squelch tablet described above, the probe will precisely guide the surgeon three-dimensionally into the nodule. During this procedure, the surgeon's visual attention is desirable, consistently, and tense to see nodular differentiation in the resection. As such, with the device of the present system, a small button-shaped switch is located on the small pro part, one operation of which will result in the execution of the squelch routine. Only when the next dresshold count ratio is reached will the so-called sirens sound output resume. As such, the surgeon moves the small, straight probe until the squelch is performed again until the sound is heard again and disperses. Typically, the movement of the probe is initially transverse around the area of the nodule. Typically, the probe is moved across an area spanning the nodule that begins with a squelched silence, then sound, then silent to the bracket nodule position. Following the incision, this squelch procedure continues as the probe moves through the incision and toward the nodule. The Squelch process results in a siren sound with the probe on a small area and no minor movements will cause an audible signal away from the area, ie the watch nodule will be located when the minimum source of sound is derived. In fact, the straight, cylindrical probe would be directed directly at the nodule to inform the surgeon precisely about its location.

Preferably, a two-handed operation switch is now coupled on a small probe with a diameter corresponding to the major diameter or the diameter of the typically encountered nodules. The second of the switches can be adapted to generate a count ratio output at the display of controller I for verification and recording purposes. This remote switching is achieved without the addition of conductive transmission lines in the cable extending from the control device to the probe. To do this, the probe, which is monitored in control unit I for amplification and through the use of the basic mode discriminator circuit, makes a decision to activate the switch when a signal is generated that competes with an appropriate squelch and / or reset coefficient switch. On the power input to the system, the system imposes a current level. In the former case, the control system emulates a sequence of two signals, one indicating the squelch switch operation and the next continuing to emulate the reset count switch operation. In one state, since the probe tends to draw current for the system when it is initially attached to the control in the on state, the second with the system to prevent the generation of emulating signals for relatively large amplification of the current surge. Level comparator is adopted.

Another feature of the present invention relates to a specialized three-dimensional guided procedure adopted for the purpose of positioning a nodule through injury. A feature of the league control that is not used in the league procedure is that the operator can move the menu arrow up or down to change the value of the last derived squelch dress level within a predetermined interval, for example seven seconds. Allows the user to first activate the squelch switch at the control console from the operating room, following what is operable. The level is developed by keeping the probe in place over the tissue for 5 seconds. With the present system and device, a remote actuator is provided that can be placed in the aseptic chamber of the surgical procedure and, like the switches in the remote console, contain two buttons with up and down designations on them. By pressing one or the other of these switches, the surgeon can quickly change the dresshold level value in small increments, thus allowing three-dimensional guidance to the nodule within shorter time intervals. Receives button-sitting signals, followed by emulation of up or down arrow menu function switches.

Other objects of the invention will be apparent in part and in part in part. The invention thus comprises a system and apparatus having a structure, a combination of elements, and an arrangement of parts, which are illustrated in the following description.

For a complete understanding of the objects and states of the invention, reference will be made to the following detailed description in accordance with the accompanying drawings.

1 is a screen display of a system machine of the present invention,

2 is a side view of a radioactive probe employed with the system of FIG. 1 having a cut away portion to show its internal structure;

3 is a cross-sectional view taken through the 3-3 plane in FIG.

4 is a partial side view showing a collimator adopted with the probe of FIG. 2 having a cut out portion to show an internal structure;

5A and 5B are combinations as sorted to provide a block circuit representation of circuits employing the probe and control device shown in FIG.

6 is a scan range to modulus ratio density curve showing a system of the present invention and a squelch based guidance technique employed;

7 is an electrical schematic diagram of a circuit employed in the radiation probe of FIG. 2 for the purpose of generating current level signals;

8 is a block diagram representation of a circuit functioning as generation signals that emulate a reset coefficient and a squelch switch function of the control device shown in FIG.

9 is a pulse output diagram illustrating the operation of the circuit of FIG. 8;

FIG. 10 is a state diagram illustrating the operation of the classifier circuit shown in block form in FIG. 8;

11 is a semi-primitive flow chart employed in the development of the circuit shown in FIG. 8;

12 is a related data for analyzing the flowchart of FIG. 11;

FIG. 13 is a reduced flowchart developed in connection with FIGS. 11 and 12;

14 is an allocation map,

15 is a stimulus table according to FIGS. 13 and 14;

16 is an output table for the variable Q1,

17 is an output table developed for the reset coefficient variable;

18 is an output table developed for the variable Q0,

19 is an output table developed for a variable background;

20-20D are combinations, such as those classified to provide an electrical schematic of the circuit shown in FIG. 8,

FIG. 21 is an electrical schematic diagram of a circuit adopted with the squelch arrangement shown in FIG.

FIG. 22 is an electrical schematic diagram showing parts shown in block diagram form illustrating the remote squelch logic function shown in FIG. 5B; FIG.

23A and 23B are extended logic switches for performing the circuit of FIG. 22 and Boolean logic functions for normal switch operation;

24 is a perspective view of a tube used in evaluating radiation of radioactivity from a lymphatic vessel,

25 is a chart showing normalized coefficients for distance from radio wave propagation by first force and by inverse square method;

FIG. 26 is a sketch adopted in analyzing the falling effect of moving the crystal detector from a tube carrying a radiation source;

FIG. 27 shows a theoretical examination in which the crystal detector surface is shifted transversely a distance from the center of the radiation tube I at varying heights.

28 shows the compression of plots taken by experiments in which the crystal detector was moved vertically and transversely relative to the radioactivity contained in the plastic tube,

29 is an enlarged view of the visually possible output shown in FIG. 1;

30 is a schematic diagram illustrating performance of a moving average filtering function;

31 is a schematic diagram of a memory adoption that may be used to generate the visible output of FIG. 29;

32 is a schematic diagram illustrating a circuit memory arrangement provided in lieu of what has been described in connection with FIG. 31;

33 is a view showing the front of the upper right hand limb showing the location of melanoma, lymphatic tube I, wave nodule, clavicle, and clavicle nodule on the skin,

FIG. 34 shows the anterior midsection of the lower limbs showing lymphatic drainage from the melanoma on the skin towards the local external groin nodules;

35 is a naked posterior view of the numb without upper head limbs showing the mesothelial melanoma and bibranched lymphatic vessel I drainage located in the middle,

36 is a view of the nucleus without upper head and limb from the rear side showing melanoma on the skin with branched lymph nodes related to paired watch nodules;

37A is a view of the nucleus without upper head limb from the previous aspect illustrating lymphatic I drainage from mammary tumors

37B is a sectional view of the breast described in FIG. 37A showing a tumor relationship.

The present invention actually has two aspects. One of these aspects relates to the observation and mapping of lymphatic vessels draining from the location of neoplastic tumors, such as melanoma or breast tumors against wave lymph node nodules. Another aspect involves the detection and isolation of the nodule once its local location is in place. In general, phenomena associated with radio wave propagation or photon emission are slightly different considering the radioactivity emitted from the lymphatic tube, as opposed to radioactivity emitted from small sources such as lymph nodes. The lymphatic tube will appear to be a source generating roughly characteristic R- ¹ functions. Lymph node nodules occur with a range of characteristic R- ² functions to indicate point sources. The equipment used to carry out the diagnosis is, as far as possible, the adaptation of equipment to which a radioimmune-guided surgical system (RIX) has been adopted or used above the tumor locations, for example in the colon area. The Rix procedure typically employs radiolabeled positioning to specifically bind markers associated with or generated with neoplastic tissue. Such localization includes substances that preferentially concentrate at tumor locations by binding to neoplastic tissue or neoplastic tumors associated with or generated by a marker (eg, cancer cell or cancer product). Since the positioning is injected into the patient's bloodstream, the equipment with the rigs must inevitably work with radionuclide concentrations at radiographic background levels and at tumor locations. However, for the present procedure, such positionings are not adopted and radiopharmaceuticals are used in connection with the carrier. For example, emulsified colloids labeled ^99m TC may be used, indicating a relatively low cost, readily available, approved pharmaceutical product. Another advantage associated with its use is its short half-life (6 hours) and virtually disappears from the patient's body within about 3 days after injection. It shows higher energy (140 Kev) than the material in which the Rix system was adopted, but this is not an important characteristic, and lower energy radionuclides have been successfully used.

The Rix system is provided with a cadmium zinc telluride detector or probe for detecting hand radiation which supports a crystal of sufficient surface area to detect the small levels of radiation involved in the procedure. Such detection probes are described, for example, in US Pat. No. 5,070,878 to Denen, issued on December 10, 1991 and commonly assigned. The probe uses a suitable surface area of cadmium zinc telluride crystals, which is currently noted, is installed forward-looking in the tubular probe body, and is laterally oriented at 30 degrees to facilitate handling in and around ambient light in the abdominal cavity. Have a slope. As the probe is held by the surgeon, the widget is moved along the unfolded tissue at its end. During this test operation, since radioactivity is sealed, it is first evaluated for appropriate energy levels and then statistically as a factor of coefficients. If a statistically significant modulus ratio is encountered, the probe is operated in the audible or sound mode specified as a sounding siren to alert the surgeon. Careful statistical analysis of the counting ratio is generally based on the number of standard deviations above the base counting ratio. The basic counting ratio is developed, for example, by holding the crystal plane of the probe relative to the region of the heart to generate an average counting ratio during the interval of 5 seconds and then during that interval. Next, the software algorithm of the associated controller, depending on its mode of operation, will set the presence of the tumor, for example, at a level of three standard deviations (three sigma) above the fundamental coefficient ratio. This algorithm is published, for example, on December 26, 1989 by Ramsey and Duston, entitled Gamma Radiation Detector with Enhanced Signal Processing, and is commonly disclosed in US Pat. No. 4,889,991, which is hereby incorporated by reference. have.

In preparation for the RIX procedure, the technique of the present invention is the injection of a radiopharmaceutical locally near the housewife rather than intravenous. The result is a small normal background but high concentrations in the lymphatic vessels or tubes and their nodules. Relatively high concentrations result in high counting ratios and smaller diameter detectors can be used.

1 shows a system 10 in which nodule proofing techniques can be personalized. System 10, now configured for use in connection with the identification of frequency lymph nodes, has a conventional control, indicated at 12. Apparatus 12 is, for example, issued on January 1, 1989, and is commonly assigned and referred to herein by Denin, Dunton, and Ramsey, for detectors and positioning for low energy radiation emissions, United States of America. Patent No. 4,801,803. Extending from the coupling or connector 14 on the front of the device 12 provides grounding to the handheld probe 20 by virtue of its power source, crystal detector bias signal, return line, and its connection at the coupling or connector 22. Providing a flexible connector or cable 18. Such connectors can be provided as D Series model EGG connectors marketed by Remo USA company of Santa Rosa, Central America. The probe 20 is configured to hold a cadmium zinc telluride detector crystal substantially the same as discussed above with respect to US Pat. No. 5,070,878, but with a smaller diameter and a longitudinal extension of about 6 inches (15.24 cm). Located above the housing 24 of the probe 20 are two sealed piezoelectric switches 26 and 27, preferably located directly back in the middle of the probe. These switches may be actuated by a clinician or surgeon for the purpose of performing either of the two functions associated with the control device 12.

The control device 12 is also represented by a keyboard 36 coupled with the console 34 by a cable 38, and a monitor 40, 32 having a display device 42 and a conventional computer console 34. Combined with a serial port showing that a conventional personal computer (PC) combined with a serial communication cable 30 is connected to the input / output card installed. The display device 42 is shown to display the dynamic image output represented by 44.

Also coupled to the control console 12 by a cable 46 is a passively controllable, indicated as 48 and appears to have a housing 50 and two sealed piezoelectric button switches 52 and 53. Dress hold (Squelch background) adjuster. A witness is placed on the housing 50, as seen at 54 and 55, respectively, in the form of an up arrow in conjunction with the switch 52 and in the form of a down arrow in conjunction with the switch 53. The device 48 may be employed in the mode of operation of the system 10 to find the precise location of the wave lymph node nodules in the drainage cavity or local nodule site.

Returning to the control device or control device 12, the front face 16 is a chain of relatively large LCD readout or display 60, a double colored LED readout 62, and finger-operated switches, generally indicated at 64. Seems to have This switch array 64 or keyboard allows the microprocessor drive control device 12 to communicate with the practitioner in a directed or user friendly manner. In addition to the conventional on and off switches indicated by 66 and 67, respectively, the switches installed in the front face 16 are such function selection switches, sound switch 69, such as counting mode switch 68, For the adjustment in the switch counting modes indicated by the reset count switch 70, the statistical significance level referenced by the term squelch or the range switch 71, the calibration switch 72, and 73 and 74, respectively. Up and down incremental switches. Of the switch array 64, the reset coefficient switch 70 and the squelch switch 71 are twisted to the opposite side on the probe 20, like the switches 26 and 27, to a certain extent. In this regard, one of the switches such as 26 performs the function of the reset count switch 70 when actuated. The function is to derive a count value of preset interval, e.g. 5 seconds or more. Another one of the switches 27 on the probe 20 performs an emulated switching sequence of the squelch switch 71 initially followed by the operation of the reset coefficient switch 70. This allows the system 10 to reset the dresshold above that ratio with a fundamental ratio and single switch operation.

In a similar manner, the switches 52 and 53 of the device 48 act to reverse the respective upper and lower switches 73 and 74 on the console device 12. Sealable piezoelectric switches are employed with the device 48 to allow them to be positioned during surgery at the operating room. In this regard, the sealed switches 53 and 54 can be properly disinfected by an autoclave. In its normal operation, when the controller 12 is in the entered squelch mode by actuating the switch 71, the squelch coefficient ratio dresshold level is incrementally upwards and actuates the switch 74 by actuating the switch 73. By incrementing the value can be adjusted incrementally downward. The upper end of this manual adjustment range is inherently limited to reduce the chance of inadvertently setting the squelch background dresshold to make the system inoperable. The maximum manual adjustment range is about three times the square root of the two second equivalent of the last five second standard squelch operation. The minimum value squelch background obtainable using the down arrow switch 74 is equivalent to 25 coefficients at 5-second intervals.

2, the probe device 20 is shown in more detail. As noted above, the probe 20 is smaller in size than a conventional Rix probe and does not incline at its forward end. This straighter, thinner structure makes it easier to detect and locate or pinpoint watch nodules. The device 20 necessarily uses a cadmium zinc telluride crystal of smaller diameter, for example 7 mm, to provide a front-view surface area of about 38.48 mm 2. This smaller surface area practically remains in scope for immediate application, for example ^{99 m} TC, in view of the higher concentration of the system and the radionuclide employed. The housing or gripping portion 80 of the probe is formed of stainless steel of the general structure of a hollow cylinder. The front cap or cover 82 is mounted on the body position 80. The cap 82 is configured to have a front view window 84 of smaller thickness. Immediately located near the crystal holding parts of the probe 20 in its cap 82 is a small circuit board that forms a detector device with crystals and has a preamplification function and a bias to the detector crystal. The cable 18 which appears to be connected to the probe 20 of the Remo connector 18 provides the recorded detector bias, ground, preamplifier output signals and preamplifier power supply, some leads from the cable 18 shown at 90. . Power lead 90 is tapped by switches 26 and 27. The switches 26 and 27 are of piezoelectric variety which generate a voltage when actuated. In order to ensure their integrity to their operating environment (surgery and gas disinfection), the switches are mounted in the housing 80 to ensure their sealing against fluid and gas leakage, preferably in the switch position. Windows installed with reduced wall thickness allow fixing on piezoelectric switches to perform their operation. Flexible aluminum dome structures are also available for such switching. The same arrangement can be provided for the device 48 to protect the integrity of the circuitry in the switches, for example, during sterilization and during the use of the device in the operating room. Such switch components are available, for example, from Wilson-Hud Corporation of Wausau, Wisconsin.

3, a cross-sectional view of the front portion of the probe 20 is shown. The figure is arranged symmetrically about the probe axis 92 or in the orientation in which the components of the probe are arranged longitudinally. Although straight or non-tilted deformation of the probe device 20 represents a preferred embodiment for immediate purposes, the axis may be tilted to remain perpendicular to the window 84 and the detector surface immediately below it. The front portion of the housing 80 appears to narrow at 94 to provide a cylindrical receiving surface for the cap 82. In addition, the annular end surface of the housing 80 acts to provide alignment and contact support for the generally cylindrically formed slug or crystal mount 98. Mount 98, formed of lead, has a cylindrical rear portion 100 that is slidably accommodated within the inner surface of the housing 80. This cylindrical support portion 100 terminates at an annular shoulder 102 which abuts against the distal face 96 of the housing 80. The crystal mount 98 thus installed is stored in place, for example with an electrically conductive epoxy cement. A passageway or aperture 104 is formed through the mount 98 so as to extend into the cavity 106 formed therein. Intersecting holes 108 are also formed in the retainer 98 to equalize the gas pressure in the probe 20, and an annular groove 110 is formed in front of the hole 108. Centrally located within the cavity 106 is a generally cylindrical cadmium telluride crystal detector 112, with the front face 107 in a plane perpendicular to the axis 92 being cushion-shaped to avoid motion noise. It is installed in. With the device shown, since it is perpendicular to the plane of the front face 107 of the crystal, the probe axis 92 also becomes the detector axis. In general, cadmium telluride crystals have microphone-like (piezoelectric) effects and are very fragile, requiring installation attention. CdTe crystals are alloyed and are still referred to as cadmium telluride or CdTe crystals for this purpose. Preferred cadmium telluride crystals are formed as CdTe materials alloyed with zinc and are generally represented by the formula: Cd _1-X Zn _X Te. The ratio of the Cd and Zn components of the crystals can be varied to provide an effective ratio selected to suit the specific needs of the user. However, although a lower limit or limit was determined for the proportion of zinc where x equals about 0, 2, a corresponding high limit or limit where x equals 0.8 has been determined. Alloyed crystals are commercially available, for example, from Central America 92067, San Diego, Digirad, and PA 16056, Schönberg, eV.

Returning to FIG. 3, the passage 104 appears to contain a teflon insulated polytuned 114 that acts to convey the specified bias signal and these charge signals generated from the crystal device. In order to provide a cushion period of the crystal 112, an electrically insulating layer of the cup-shaped structure shown by 116 is employed. Cup-shaped layer 116 may be formed of silicon, generally referred to as silicone rubber, which is an elastomer in which the C rings of polymerized hydrocarbons are replaced with Si-O rings. It is, for example, sold under the trademark silicone. The front facing surface 118 of layer 116 is coated with an additional amount of silicon material, as in layer 120, and the shape of the multiple bath 122 of lead 114 is above this layer 120. Spreads through the disk-shaped array. Also located on the front face 118 of the bottom of the cavity 106 is an electrically conductive cushion layer 124, the bottom face being positioned on the strands at 122. Preferably, the cushion layer 124 is installed as carbon-filled non-woven teflon cloth to the extent that it creates an effective conductor. In general, the material is a carbon containing elongated, highly crystalline, unsintered polytetrafluoroethylene sold under the Gore-Tex trademark. With such a device, the bias can be used on the rear face of the crystal 112 without the generation of a metal-to-crystal induced noise crystal 112 and, as noted above, installed as a standard lix device, i.e. Typically it has a smaller surface area than that selected corresponding to the normal diameter or raw size of the enclosed lymph node. In addition, in order to accommodate the higher energy radionuclides enclosed with the nodule tracking and differentiation procedures, the crystal 112 is thicker, for example as opposed to the 1.5 mm thickness of the detector in the Rix probe. A crystal 112 of 2.0 mm is made. As in installing the Rix probe, the sides of the crystal 112 are slightly spaced from the corresponding sides of the cup-shaped layer 116. This provides the shape of the gap 126. The gap 126 acts to aid in the avoidance of noise induced by the bubbling beam. A small amount of silicon having layer 120 may penetrate gap 126 with a beneficial effect.

5A and 5B, a block circuit representation of a circuit in which system 10 is employed is shown. This figure should be considered for accessibility in a manner labeled on it. In FIG. 5A, the cadmium cellulide crystal 112 appears to have one side coupled to ground through line 160, while the opposite, blasted side is lines 162 and 164 on the bias filter indicated by block 166. Combined via). Input to filter 166 is indicated by line 168 as the number is applied through the cable as described in 18, indicated in the figure. The bias input appears to come from the multi-output power source shown in FIG. 5B at block 170, as indicated by line 170. These various outputs are generally indicated by arrows 172 as shown in the latter figure.

Microprocessor network 226 also generates an analog signal at DAC224, as indicated by line 234, as indicated by line 228. This information is transferred to a pulse ratio amplifier network, represented by block 236. The output of the non-amplifier function 236 may be provided behind the control device 12, as indicated by line 238. The circuit represented by block 236 may also be employed to generate a calibration pulse to test downstream components of the system.

The signals in line 210 are also directed to the pulse acquisition function, indicated by block 250, as indicated by line 248. Network 250, when activated by the microprocessor function, functions to obtain the highest pulse amplification value seen in line 210. Periodically, this information is sent to microprocessor function 226 as indicated by line 252. Indicating the shape of the peak detector, the network 250 is sometimes referred to as a snapshot circuit.

With the device shown, the probe device derives the count outputs according to the photon emissions facing in the crystal 112. These counting output signals will have amplification corresponding to the energy of the photons. Signals can also indicate pseudo phenomena, such as spacecraft. Thus, the energy or amplification of the counting power is evaluated in the energy window network 216 shown in FIG. 5B. Lower dress comparator 220 emits a pulse with a fixed duration, indicated as L, in line 260 when the signal exhibits an amplitude equal to or greater than the dress hold value. The dresshold value is determined from line 232 as described above. Correspondingly, the count from line 222 such that a pulse with a fixed duration, denoted by H, can be emitted at line 262 when the count output signal exhibits an amplitude having a value greater than or equal to the maximum determined from line 230. The output signal will be evaluated by the limit comparator 218. These outputs from lines 260 and 262 are then input to an asynchronous, sequential, fundamental mode discriminator circuit, represented by block 264. The circuit as in 264 is sequential in nature but not synchronized with the clock signal. For example, a circuit such as (264) is applied for photon emission using an energy window network, filed by co-pending Olson on October 26, 1994, and subsequently combined with a co-assigned US patent application 08 / 329,505 basic mode identification circuit. Validation of Photon Emission Based Signals Using an Energy Window Network in Conjunction with a Fundamental Mode Discriminator Circuit. The identifier 264 has a function of generating a photon event output or a count related signal having a finite pulse shape at line 266 when a count output signal occurs at line 210. The count output signal here represents the emission of photons valid in terms of the energy range associated with it. These pulses in line 266 are then counted by a counter, represented by block 268, and the count data evaluated by the input network described above, as represented by line 270, is then used for the microprocessor network for statistical analysis. Is passed to 226. The counter network 268 may be implemented in software as disclosed in US Pat. No. 4,889,991, referenced above. The microprocessor network 226 runs under a variety of tasks determined by the user's input to the function switch 64 on the controller 12. In general, it serves to provide output to two output components, one of which is the type of voice generated from the speaker and the other of which is the visual type that visually outputs to the display 60. In general, the siren type signal divided according to the predetermined frequency cotton is input to the volume control function shown in block 274.

There, a volume adjustment signal is provided to the audio amplifying circuit of block 278 as indicated by line 276. The circuit 278 is connected to the speaker 28 as shown by reference numeral 280 and induced. The frequency output to the speaker 282 by the mentioned siren device increases from 20 Hz to 1200 Hz exponentialal change when the average coefficient ratio determined by the system 10 exceeds a predetermined dress level. The siren mode is accessed by the user from the control unit 12 by continuously operating the squelch switch 71 and resetting the counting switch 70 to operate the switch 27 on the probe 20. For distinguishing sentinel nodes, this siren mode feature performs a skeletal process by allowing the surgeon to move the probe 20 and actuate the switching 27 and repeat until the range of movement becomes small.

In this regard, the final sound source is effective to the extent that the axis 92 of the probe 20 is located at the sentinel node and responds to the peak coefficient ratio. Execution siren mode is described in the referenced US Pat. No. 4,889,991 to Ramsey and Thurston.

In the RIGS process, according to the continuous operation of the switches 70 and 71, the counting output of the probe 20 continues for a period of 5 seconds to set the base counting ratio.

At that time, the program of the microprocessor network 226 sets a predetermined dress count ratio exceeding the base count ratio. As a result, the audio output from the speaker 282 is effective only after reaching the predetermined counting ratio level.

Thus, by performing this process, for example, it performs a move when the output extends near the squelch around the sentinel node and silences the low frequency output. The sentinel node is located in the transverse or depth direction. This is because the probe 20 moves to a large amount of tissue in which the sentinel node is located. In the latter statement, from the node performing the radiation source, the radiation useful for counting increases in accordance with the inverse scatter law of radiation propagation when the detector 112 of the probe 20 approaches the sentinel node.

The same result can be obtained in another mode of operation and the operator incrementally trims the dresshold to a higher dresshold rate value from the manually operated device 48 by pressing the switch button 52. This eliminates the need for a basal ratio factor for 5 seconds provided that the siren mode of operation is provided.

This technique of establishing a nodule by developing a decreasing squelch defined range of scans can be graphically depicted. Referring to FIG. 6, the count ratio densities during scanning over the local nodule cavity containing the nodule are plotted against the distance the probe is used to scan over the area.

The control system implemented in the console 12, as used by the Rix surgical system, is characterized in that the surgical system is not used and the previously existing squelch dresshold values can be arranged upwards or downwards in the coefficient ratio value. Although no conventional Rix surgical procedure has been employed, the feature can be used for the purpose of rapidly incrementally increasing the Squelch dresshold coefficient by increment.

The counting ratio developed from the microprocessor network 226 is also a serial port 292, as indicated by the double arrow 290 in the general purpose computer 32 for the purpose of mapping its lymphatic tube, which also has radioactivity radiating fluid towards the nodule. And from cable 30. For such purposes, the injury does not need to be placed in the tube and the basal counts can be visually identified on the display 42 of the monitor 40 as the probe 20 is moved around the epidermis.

The microprocessor network 226 performs in conventional fashion with a work / output network, as indicated by block 296 and bidirectional arrows 298. This input / output port function provides proper scanning of the keyboard or switches 64 as indicated by arrow 300. These switch inputs or function inputs are simulated by the probe handheld switch as indicated by the regeneration of probe switch logic output lines 200 and 202 directed to block 296. The output port also drives the display, also indicated by arrow 302.

Arranging device 48 is shown in FIG. 5B in the form of a block having the same proof number. In addition, the cable 46 coupled into the console 12 is represented as a four line array. These input lines will have a + 12V, ground, downshift switch enable signal from switch 52, and downshift switch enable signal from switch 53.

In FIG. 7, a circuit through which current level signals can be transmitted from switch 26 or switch 27 along the power line of cable 18 is indicated generally at 330. Two such circuits 33 are mounted in the probe 20 for this embodiment. One such circuit provides a current level prayed to result in a derivative of the actuation of the reset coefficient switch 70, with the second current level generated by the same circuit being followed by the actuation of the reset coefficient switch 70. This will result in an imitation of the squelch switch 71 operation, the mode adopted to establish the nodule of the distribution of local nodules.

8 shows a block circuit representation of a circuit for developing signals that mimic the specified reset coefficients and squelch switch functions. The circuit 350 monitors the current flow in the probe current function 182 of the control device 12. In this regard, the above-described lines 196 and 198 are regenerated by monitoring the induced voltage in the resistor R7 in the power supply lines 185-186. Lines 196 and 198 extend to the differential amplification function indicated at block 352. The amplified output is provided to the filtering of the network shown at block 356, as shown at line 354. In this function shown in block 356, the RC circuit representing a relatively long time constant causes current to flow for the preamplification function in response to a pulse signal representing the switching input. It is used to remove the current.

In addition, the function at block 356 represents an RC filter that blocks noise generated by bumping the piezoelectric crystal in the probe 20.

Without such interruption, the comparator level of circuit 350 may not play a role. From the filter function at block 356, the voltage base pulses are provided to three comparison stages, represented by levels 1-3. It is also indicated by blocks 360-362, respectively. In this regard, line 358 addresses level 1 comparator 360, while level 2 comparator 361 is simultaneously addressed from lines 358, 364, 366. Level 3 comparator 362 is addressed from lines 358 and 364. The dress hold input to comparator function circuit 360 is indicated by line 368. This dresshold has a sufficient pulse and low level line 370 it is indicated by L to indicate the output of the switch 26 indicating the reset coefficient input. In a similar manner, the dresshold input for that level comparator 361 is indicated at line 372.

This upper limit is selected as the high level provided in line 368, as set in line 372. As a result, the comparator 361 is responsive to generate a pulse by the squelch switch 27 operation and not by the operation of the switch 26. At least as there is a voltage pulse of this upper limit amplification, the output appears as H, like line 374. That is, the level 1 comparator provides the L output by the operation of the switch 26 as well as the presence of the operation of the switch 27. Level 3 comparator 362 receives an upper limit input as indicated by line 376, which is much higher than that indicated by line 372. The function of the comparator 362 is approached to the control unit 12 when the control unit is on and provided for a rapid current rush to the probe 20.

The output of the comparator stage is indicated by line 378 and is intended to perform an inhibit function. The level 1 and level 2 comparator outputs are input to the identifier as indicated by block 380. Comparator 380 responds with an L signal at line 370 because it occurs not only by the signal received at line 374 in response to the operation of switch 27, but also by the operation of switches 26 and 27. The circuit then determines whether the switches 26 and 27 operate and provide an output on line 384 with switch 27 in operation and an output of line 382 with switch 26 in operation. Decide Preferably, the comparator 380 is asynchronous, continuous, and basic mode identification circuit. This circuit is continuous but not synchronized as a clock signal. These circuits are, of course, formed of a circuit having a level input and an unlocked memory element in its basic mode. They are known, for example, as type 4 circuits in the 1975 edition of Englewood Cliffs, an introduction to NJ's computer logic. The circuit of block 380 is an embodiment based on the Mealy model. Here the output is shifted to a state as mentioned in FIG. Because of this variant base model, the output of lines 382 and 384 is of short duration. Thus, the output at lines 382 and 384 becomes a pulse stretching function as indicated by blocks 386 and 384. Therefore, the stretched pulse is a monostable R.C.block 386, which is input to the logical OR circuit as indicated by reference 392.

This provides the output at line 200 described above that emulates the operation of reset count switch 70. The pulse stretching output of the monostable block 388 is shown in line 202 described above. This provides an initial emulation of the operation of the squelch switch 71 in line 202. In addition, the output at line 202 is provided via line 394 to the input of monostable multivibration labeled monostable. Device 396 blocks the delay and the output is provided in monostable multivibration, denoted as monostable 2400. The device denoted by reference numeral 400 generates the same pulse width as that generated at line 390 and provides it to OR circuit 392 via line 402. By this arrangement, the control circuit 12 responds to the operation of the switches 70 and 71, causes the system to enter the siren mode, and performs the base count for a period of time. For example, a statistical count ratio dress hold is set for 5 seconds more than the coefficient indicated by the base coefficient.

Returning to the level 3 comparator function at block 362, a predetermined period of time selected to occur throughout the high amplification pulse is received after a specified very high amplification pulse is received, well above the limit set by the level 2 comparator function at block 361. While a stop signal is provided at line 378.

9, a signal or pulse output diagram illustrating the performance of circuit 350 is described. In the figure, the pulse output at line 382 in communication with the operation of the reset count switch 26 is indicated at 410. The corresponding pulse directed from line 200 in controller 12 is represented as pulse 412 which has received pulse extension function 386.

As noted above, a significant advantage of the device is the utilization of a switching function with the probe 20 but without the addition of further wire strands in the probe cable 18. This allows for the maximum amount of flexibility in the component.

The asynchronous, sequential, basic mode classifier circuit described with respect to block 380 in FIG. 8 may be described according to the state diagram. For this particular application, this circuit was designed with four states of ad, but one such state for this circuit is never entered or utilized in the wiring diagram to follow. Such a wiring diagram is provided in FIG. 10 with three steady state ac and adopts the predicate L for displaying a signal at line 370 and H for displaying a signal at line 374. When these signals are present they are represented by a logic value of 1, and when these signals are not present, they are represented by a logic value of zero. It can be recalled that while the signal L is generated by the operation of the reset count switch 26 or the squelch switch 27, the H signal is formed only in response to the squelch switch 27 mounted on the probe. As defined by the state diagram, two mealy outputs will only be present during some state transition. In FIG. 10 the fourth steady state ac is indicated by circles denoted by 430-432, respectively. The idle state a of the circle 430 is the absence of a pulse signal from either the comparator 360 or 361 The condition indicates that a condition is obtained, and the stop state is maintained when there is no signal as indicated by the transition loop 434. However, when a pulse is initiated, for example, as induced in lower dress comparator 360, the transition transitions to state b, represented by circle 431, as indicated by arrow 436. Condition whether it continues or recurs Maintains state b as indicated by transition loop 438. However, if a pulse output from comparator 360 is provided without a signal output from level 2 comparator 361, the transition indicated by arrow 440 occurs at the end of the pulse with the corresponding output 1,0 of the identification circuit. . In that case this condition is as shown by arrow 440. It can be represented as The circuit then returns to stable state a, represented by circle 430 and the output transition 0,0. Transition occurs for condition LH / 00 as indicated by arrow 442 where the signal under evaluation is crossing both lower dress comparator 360 and limit comparator 361. As indicated by transition loop 444, the resulting stable state c follows.

Since the pulses under evaluation will represent the falling edge, each state And The states that indicate the transitional loops 446 and 448 for are preset. However, the state With the presence of, the turning point indicated by the turning contact arc 450 is then And state a enters as indicated by circle 430.

The state diagram of FIG. 10 shows another possible logical event and result. For example, a condition associated with state a If there is, it transitions to state c as indicated by arrow 452. Similarly, condition LH / 00 appearing in state a transitions to state c as indicated by arrow 454. As described above, the execution of the identification circuit 380 may take various forms according to a designer's request. For example, it can be implemented by combining with an electrically programmable logic device (EPLD), such as the EPM 5130 type commercialized by San Jose's Altera company. Alternatively, simpler circuits may be employed by using conventional semiconductor logic devices.

11 through 19 show a more detailed analysis of the circuit constructed in conjunction with the comparator 380. The construction of the circuit begins with the initial occurrence of a modified primitive flow chart that describes the conditions and potential conditions. In FIG. 11, the column heading of the chart is indicated by 0110 of low dressing condition L and 0011 of corresponding high dressing condition H. In FIG. In assigning rows for each condition, a Gray code assignment format is provided so that only one variable can change at a time. In the row of the chart of FIG. 11, state designators a-d are displayed. According to the system, this use of the chart is only allowed up to row d. In the chart, the state or row display is indicated by the column indication as one of a-d, and the resulting output of 00.10 or 01 is displayed after the slash mark (/) for each cell of the chart. The steady state is indicated by a column or state indicator surrounded by circles, and the transition is shown by a small arrow. In this chart, a steady state a with output 00 is shown to exist for LH condition 00. The LH transition to 10 causes a temporary random state b / 00 and then descends to row b leading to a stable b state with a continuous 00 output. The next LH transition to 00 shifts to the left, resulting in an unstable state a / 10, in which case the transition output returns to a stable state a / 00 as indicated by the vertical arrow. If the H variable is transitioned to 1 and becomes LH condition 11, then an unstable state c with one zero with output c / 00 occurs and then a transition to stable state c with 00 output occurs in row c as shown. . The LH transition to condition 01 causes an unstable d state with a 00 output and immediately changes to a stable state d with a 00 output. Similarly, the LH transition from 11 to 10 results in an unstable state d with a 00 output followed by a stable state d with a 00 output as shown in row d. Note that there are three steady states in row d of the flowchart. In addition, row d shows an unstable state with 01 output and row a shows an unstable state with 00 output.

Referring to FIG. 12, an application table is described for the modified one flow chart of FIG. 11. This application table is adopted to determine if there are any rows that can be deleted without affecting the results required in the rows of the one flowchart. The evaluation result indicates whether there are two rows in which the output for each column is the same and are compatible with each other. This application table indicates that only rows c and d can merge together. From this result, technicians can generally generate a merge diagram, but this merger is not necessary for immediate development. Thus, a reduced flow chart as shown in FIG. 13 can be made by deleting row d and filling empty cells with c / 00 from FIG. This degree of merging shows that steady state a with output 00 for LH condition 00 and steady state b for corresponding LH condition 10 are regenerated. In the case where LH becomes 00, this causes unstable state a with output 10 to transition back to stable state a.

Following the construction of this reduced flowchart, it is necessary to construct an assignment map to which measurement variables are assigned to arbitrary states a, b and c. You can define the variables Q0 and Q1 with the map. However, choosing a variable assignment for a map is not obvious. In general, depending on the designer's experience, one or more assignments are determined carefully. Fig. 14 shows the assignment of variables Q0 and Q1 with respect to states a, b, and c, where the lower right column of the map means don't care where any content can be displayed, but the Allocation is not self-explanatory. Excitation tables as shown in FIG. 15 may be constructed from the reduced flowchart of FIG. 13 and the allocation map of FIG. 14. The excitation table shows the excitation state and the output state as a function of the total state. Each column of the table of FIG. 15 is associated with a single input state, denoted LH, and each row of the table corresponds to a single second state q1, q0. As before, the stable state is indicated by enclosing the corresponding excited state in a circle. The states in the table are arranged in order of Q1 and Q0. It should be noted that the variable Q0 is only equal to q0 after the transition has occurred and the same criteria apply between Q1 and q1. In addition, in Fig. 15, a temporary assignment 10 is provided at a position where arbitrary contents can be displayed. This assignment is chosen to prevent it from locking into one particular state or any other abnormal state. Such assignment makes the resulting circuit predictable. Therefore, by allocating the output according to the above-described method, it is possible to prevent a momentary change in the output when the circuit is in an unstable state. The information from FIG. 15 can be converted to a Karnaugh map. In connection with FIG. 16, variable Q1 is shown graphically. From this table, the Boolean logic equation can be written as: Q1 = H + (L * q1). Similarly, a reset count or count output variable is shown graphically in FIG. 17. The Boolean logic equation for this variable is written as: . 18 shows a plot for the Q0 variable. The Boolean logic equation for this variable is: . Finally, a plot of the squelch or background variable is shown in FIG. 18. The Boolean logic equation for this variable is: BKgnd = q1 . In the above formula, the variables q0 and q1 represent the delayed variables Q0 and Q1, respectively.

20A-D, the circuit of FIG. 8 is shown as an electrical wiring diagram. These figures should take into account the mutual relationship as indicated in the figure. Common reference numerals have been used for appropriate portions between FIGS. 8 and 20.

20A illustrates an amplifier and filter as described above in blocks 352 and 356. Lines 196 and 198 are connected via resistor R7 described above and have resistors R10 and R11, respectively, to each negative and positive input terminal of differential amplifier 460. Connected. Lines 196 and 198 are set to have resistors R10-R13 with amplifier 460 to provide a voltage division of the incoming DC signal and a gain of about 2.5. Device 460 may be provided, for example, of type TL072 and directs output to line 462. The benefit of this circuit setup is that the normal 12 volt common mode voltage present at lines 196 and 198 is approximately 9, which is the voltage the device can accept at the two input terminals of device 460. Can be reduced by volts. Since the direct current component of the input signal at lines 196 and 198 represents the current draw of the current in the preamplification stage in the probe 20, RC comprising a capacitor C1 and a resistor R14. The network 464 is provided to filter the direct current component using a very long time constant, for example about 4.7 seconds. This long time constant prevents undershoot phenomena, which can be adversely affected in the comparison stage. Another RC circuit 466 having a resistor R15 and a capacitor C2 is cascaded with the RC circuit 464. The network 466 exhibits a very short time constant of, for example, about 0.01 seconds and the high frequency side of the switch may occur when the cadmium telluride crystal 112 in the probe 20 is impacted by a collision or the like. It acts to filter spurious high frequency signals. This piezoelectric nature allows such spurious signals to be encountered frequently, and in the absence of the spurious signals it is possible to trigger downstream circuitry. Network 466 also provides advantageous filtering for external noise.

The output line 462 from the network 466 leads to the positive input terminal of a conventional non-inverting amplification step that includes an amplifier 468. Device 468, also of type TL072, is set to have resistors R16 and R17 to provide a gain of 28 on the output line 470 and to generate a negative pulse when the probe switch 26 or 27 is actuated. Generate.

20B, line 470 reappears to deliver this negative pulse signal to level 1 comparator stage 360 and level 2 q comparator stage 361. In this regard, line 470 connects coupling capacitor C5 to the negative input terminal side of comparator 472. The comparator is of type LM311 capable, sends an output to line 370, and is set to have a power decoupling capacitor C6, C7. It also includes a feedback path with resistors R16 and R17 coupled to the positive input terminal, thereby providing hysteresis specification for circuit 360. Pull-up resistor R18 is connected between output line 370 and Vcc. The threshold limit response for this comparator 360 is induced by fixed resistors R19-R21 connected to input line 470 via line 476. In this regard, resistors R19 and R20 are connected between + 12V and ground. As an alternative setting, resistor R22 can be replaced in place of resistors R19 and R20 in combination with a manually adjustable potentiometer 478. Resistor R21 functions to connect the voltage of the same bias from resistors R19 and R20 to the negative terminal of comparator 472. The time constant is obviously derived from coupling capacitor C5 and resistor R21. As a result, the inverted signal at line 370 is the positive signal labeled L. At the same time, the signal at line 470 is communicated to comparator 361 via lines 480 and 482. Stage 361 includes a comparator 484 set to have capacitors C10 and C11 and hysteresis resistors R23 and R24 in the feedback path 486. A pullup resistor R25 is connected between its output line 374 and Vcc. As before, the negative input pulse from line 470 is delivered through capacitor C9 to the negative input terminal of device 484. The dresshold level or maximum value of the stage 361 is determined by resistors R26-R28 as previously, or by resistor R28 acting in conjunction with the fixed resistor R29 and the manually adjustable potentiometer 488. All. As before, resistors R26 and R27 are connected between + 12V and ground and the same is true when resistor R29 and potentiometer 488 are employed.

L and H outputs at each of lines 370 and 374 are passed to comparator circuit 380. Circuit 380 is set up to execute the Boolean logic described in conjunction with the four equations described above. In this regard, by connecting line 370 to the input terminal of inverter 492 via line 494. This occurs at line 490. In response, Are made at lines 496 and 498 from lines 374 connected to the input terminals of inverter 500. Not only is the output at line 506 of NAND gate 508 but also from line 498 Variable Q1, which is the output of the OR gate 504 that accepts the variable, is made in line 502. At this time, the input terminal of the NAND gate 508 accepts the L variable from the line 370 as well as the output of the line 502 through the line 510. This Q1 variable at line 502 is inverted at inverter 512 and is variable at line 514. To provide. The variable is made as the output of the NAND gate 518 at line 516, and the input of the NAND gate is at line 498. Created in Variables and Lines (514) L variable from input and line 370.

Delays occur between lines 514 and 516 due to the short output duration of the signal at lines 514 and 516, for example, due to the mealy transitional output. do. In this regard, an RC network 520 consisting of resistor R30 and capacitor C12 is provided to line 514, and a delayed signal on that line is inverted in inverter 522 to signal Q1d to line 524. ). Similarly, an RC network 526 consisting of resistor R31 and capacitor C13 is provided on line 516. The delayed signal is inverted at inverter 528 to provide signal Q0d to line 530. In the elements of the preceding circuit 380, the inverters 492, 500, 512, 522, and 528 may be provided as 74HC14 types, and the NAND gates 508 and 518 may be provided. 74HC10 type. Selecting the 74HC14 type schmitt-trigger inverter at 522 and 528 has the advantage of reproducing fast rise and fall times in lines 524 and 530. .

Referring to FIG. 20C, line 530 reappears to transmit signal Q0d to one input terminal of NAND gate 532 whose output is line 382 described above. Along with the signal on line 530, the remaining input of device 532 is Is indicated. This provides the reset coefficient (RES.CT) output as described in conjunction with the Boolean equations made in the table of FIG. Correspondingly, NAND device 534 is shown to provide an output at line 384, where the output is a signal displayed at the input terminal of the NAND device. Represents the operation of the squelch switch from the switch 27 in response to the application of. Devices 532 and 534 may be provided in a 74HC20 type.

The output at line 382, which occurs in accordance with the operation of switching 26, is coupled to block 386 as MONOSTABLE R.C. and is delivered to a trigger input terminal of a monostable device 540 as described above. Device 540 may be provided as a timing device of type 1CM7556 that operates in conjunction with an internally formed dresshold. In this regard, the device is set such that its trigger terminal is connected to the output line 382, while the dresshold terminal is connected to an RC network consisting of a capacitor C14 and a resistor R32 connected between Vcc and ground. . Device 540 has a discharge term (discharge termianl) to discharge function with respect to the RC network consisting of resistor (R32) and capacitor (C14) via line (542) comprising resistor (R33) and blocking diode (D5). It is connected to have. Upon receiving a trigger pulse from line 382, the previously discharged capacitor C14 is charged through resistor R32 to generate a pulse having a fixed duration of, for example, about 100ms, on line 390. . The pulse is transmitted to the base terminal of the NPN transistor 546 through a resistive OR gate formed of resistors R34 and R35. The transistor 546 is wired via a reset coefficient switch in the control device 12, and since the emitter of the transistor is grounded, the transistor 546 performs its function by pulling it down. The switching signal of line 390 is present at Vcc which causes device 546 to operate, while the corresponding resistance R35 and voltage at line 402 are zero.

Monostable stage 388 includes device 548 having the same structure as device 540. For example, a squelch signal at line 384 is input to the trigger input terminal of device 548 and its dresshold terminal is coupled to an RC circuit that includes capacitor C15 and resistor R36. This RC circuit is connected to the dresshold terminal of device 548 and discharged from line 550 coupled with resistor R37 and diode D6. The resulting output is provided to line 552 as a pulse having a predetermined fixed duration of, for example, about 100 ms, which is passed through base resistor R38 to the base of NPN transistor 554. At this time, the open collector of the transistor is connected via a squelch switching device of the control device 12. In this regard, the collector of device 554 is connected to line 202 and the emitter is grounded.

Line 552 is also connected by line 556 to monostable circuit 396 that couples the same device 558 as device 540. Note that the duration of the output pulse generated by Monostable No. 1 396 is about twice that of circuits 386 and 388. The pulse signal from line 552 passes through capacitor C16 along line 556 to the trigger input of device 558. Line 556 is connected to Vcc through pull-up resistor R39 to which protection diode D7 is connected. As a result, the device 558 begins to operate at the falling edge of the pulse transmitted from the line 556 according to the method described at 418 with respect to FIG. 9. Stage 396 functions to provide a pulse delay between the generation of the squelch emulating signal at line 552 and the generation of the reset coefficient emulating signal at line 402. Thus, the dresshold terminal of the device 558 is connected to an RC network comprising a resistor R40 and a capacitor C17. This Rc circuit comprises a line 560, a resistor R41, a diode D8 and is selectively discharged by a network connected to the discharge terminal of the device 558.

The output of the stage 396 is delivered to line 398, which in turn passes through capacitor C18 to the corresponding trigger terminal of device 562 of monostable stage 400. As before, line 398 is fixed relative to Vcc through pull-up resistor R42 to which protection diode D9 is normally connected. Thus, device 562 begins to operate at the falling edge of the signal at line 398. The device 562 is identical to the device 540, with its dress terminal connected to an RC circuit comprising a capacitor C19 and a resistor R43. The RC circuit is discharged from the discharge terminal of the device 562 connected through the line 564, the resistor R44, and the diode D10 as before. The induced output of the stage 400 is the pulse described in conjunction with FIG. 8 at 420, the output being delivered to the transistor 546 via an OR resistor R35 and by the stage 396 at line 200. Provide a coefficient reset emulating pulse that lags behind the squelch emulsifying pulse in line 202 by a determined interval.

20D, level 3 comparison stage 362 is disclosed in greater detail. Stage 362 includes a comparator 570, the negative input terminal of the comparator being coupled to receive a negative signal at line 480 via capacitor C20. As before, device 570 may be LM311 and provides an output to line 572. A regeneration feedback path comprising a line 574 with resistors R45 and R46 is connected to line 572. Additionally, device 570 is set to have a power decoupling capacitor C21. As before, the dresshold of stage 362 is derived from a splitting circuit comprising resistors R49 and R48 coupled between resistor R49 and + 12V and ground. The values of these resistors are chosen to provide a relatively high maximum, and the purpose of this circuit is to provide a short circuit under the ingress of large amounts of probe current, a phenomenon that can occur when the probe 20 is first plugged into the console 12. It is to suppress the operation of the stabilizer. Output line 572 is pulled up to Vcc via resistor R50 and is inverter at inverter 576. Here, the output of the inverter is delivered to the trigger terminal of the pulse defining monostable device 450 via line 578. The device 580 may be an initial type ICM7556 and provides an output to line 582 with a duration determined by an RC circuit comprising a capacitor C22 and a resistor R51. This RC circuit is connected to the dresshold terminal of the device 580 and selectively discharged from the discharge terminal in combination with the line 582, the resistor R52, and the diode D11. The output at line 582 is inverted at inverter 584 and provides a pulse output to line 378, which line 378 is a device (as shown in each line 586-589 in FIG. 20C). Applied simultaneously to the reset terminals of 540, 548, 558, and 562 Pass the signal.

Using the probe 20, for example, in positioning a sentinel node within a group of local nodules in the armpit, for example, 10-30 lymph nodes are located and only one of them is radiopharmaceutical. The switch 27 mounted on the probe is very valuable to a surgeon who is interested and focused on the tissue containing and the incision. In general, the radiation count rate emanating from these outpost nodules will inherently be higher than that measured in the duct to which the radiopharmaceutical has traveled. Once a high active area is found, the system reads the base count rate at selected intervals of, for example, 5 seconds, by a switch 27 that continuously operates to perform the squelch process. At the end of this sampling interval, the system sets a threshold that is above the base coefficient, which is already selected statistically significant. As described in connection with FIG. 6, the scanning procedure begins with a squelch procedure for normal tissue several inches away from the high modulus active area caused by the nodule. This process provides maximum sensitivity. The probe 20 then moves slowly across the area containing the nodules. The positions representing the beginning and end of the sound include the location of the outpost I nodules in one dimension. The probe 20 then scans along a path perpendicular to the first scan path. The area where the sound starts and ends is displayed. This includes the location of the outpost I nodules along the second direction. Outpost I nodules will be near the midpoint of this sound region. In order to increase the accuracy of the positioning, the probe moves to the edge of the sound region and undergoes a squelch process. If the scanning process is repeated, the sound range will be narrower. Again, the location of the outpost I nodules will be near the center of the sound region. Since the inverse square law of radiation propagation is obtained for sources such as those contained within the outpost I nodules, this squelch process for guidance can also be done in three dimensions. For example, two can be done transversely until axis 92 points directly to the nodule and can be done towards the nodule along axis 92 until window 84 is essentially adjacent to the outpost I nodules. Such nodules can then be dissected for pathological evaluation. It can be observed that the reduced anterior surface area of the crystal 112 is about the same as the size and / or diameter of a typical lymph node. Because of the cylindrical shape of the probe 20, the axial direction of the probe relative to the outpost I nodules becomes more apparent to the surgeon.

As described above with respect to FIG. 1, another method of performing this three-dimensional guidance procedure with the probe 20 is a threshold timing type ranging devic 48. In combination with the use of switches 52 and 53. Surgeons working within the sterile area of the operating room with the device 48 instead of the actuation switch 27 can increase the squelch dresshold level by pressing the switch 52. Such level can be reduced by pressing switch 53. As used in conjunction with the probe 20, through the use of a piezoelectric switch, the dresshold adjustment device 48 can be sterile, making it suitable for use in sterile areas as described above. By pressing either switch 52 or 53 one can induce a control input to the console 12 that conforms to the operation of the initial squelch switch 71 and then switch 73 after operation of the switch 71. ) Or (74) is followed by an appropriate operation. The control system of the console 12 responds by increasing the squelch dress level by an amount related to the last typical squelch level that occurred as provided from the switch 27 on the probe 20. In general, the increased increment is a value that coincides with the interval of the base squedch count rate. However, the upward increase is limited so that when the maximum is reached, the surgeon needs to perform the usual squelch operation with the switch 27 by restarting the incrementation process in a new range. By pressing the switch portion 52 or 53, the increment can be performed as a series of increments that occur at a faster rate than once per second.

The dress-hold trip device I 48 shown in FIG. 1 includes two piezoelectric switches coupled to the switches 26 and 27 of the probe 20. Additionally, the housing or enclosure 50 includes two identical circuits, one of which is indicated by reference numeral 590 in FIG. 21. Referring to FIG. 21, a piezoelectric element, such as at 332 in FIG. 7, is provided for circuit 590 at 592. The element 592 is connected to the line 594 ground and is connected to the line 596 and the resistor r60. Register R60 is connected to negative terminal of operational amplifier 600 via line 598. Element 600 may be provided, for example, type LMC6062. Resistor R60 is connected in series with element 592 and helps to prevent the device from going down. In this regard, if any one of (51, 52) occurs, such as a sudden operation occurs, it is preferable that the component 48 is dropped to prevent voltage surges caused by it. In a similar configuration, zener diode D15 may be installed in line 602 between line 598 and ground line line 604. Device D15 operates to clamp the input voltage so that it does not exceed 9 volts and diode drop does not proceed negatively.

A resistor R61, which must be located in line 606 between lines 598 and 604, is installed in parallel with the piezoelectric element 592.

The resistor R61 is chosen to have a relatively high resistance value, for example 200 megaohms. In addition, resistor R62 in line 608, which includes an N-channel MOSFET device Q1 and a gate coupled via line 610 to line 612 at the output of amplifier 600, is coupled to line 598; Installed between lines 604.

Element 600 is configured as a comparator, and the positive terminal is connected at line 614 with a voltage divider in line 616 including resistors R63 and R64. Line 616 is in turn connected with line 618 at position intermediate voltage divider R65 and R66. Line 618 extends from line 612 at + 12V at the output terminal of device 600 and at line 620.

Capacitor C25 is connected for filtering between line 620 and ground. As a result, resistor R67 is provided at the output terminal of element 600 in line 612. The resistor group including the resistors R63 to R66 is divided and supplied to the positive input terminal of the amplifier 600 below 12V voltage. In addition, the ratio of these resistances is selected so that a regenerative feedback with hysteresis is provided to avoid switch induction chatter or the like. In general, the output of element 600 in a stationary state becomes a 12V power supply supported via line 610 at the gate of transistor Q1. This is to hold the element Q1 in the inductive state and to ground below the resistor R62, which in turn flows any charge that may be present in the system. Similarly, a large value resistor R61 will flow the charge at a slow rate. From the latter point of view, the piezoelectric switching field 592 by this structure will be composed of a capacitor, or distributed capacitance in the circuit 590 will appear.

From the latter point of view, the piezoelectric switching element 592 by this structure will be composed of a capacitor, or distributed capacitance in the circuit 590 will appear. In the switching operation, the piezoelectric element 592 exhibits a fast pulse charge build-up that allows current to flow through the resistor R62 as well as the term R61. The corresponding voltage causes the switch device coupled to element 592 to go down to a predetermined voltage level maintained while being pressed to compress the crystal.

Since the discharge occurs not only through the diode D15 but also through the large resistor R61, there is a limit section of the available voltage. The voltage at line 598 causes the dresshold that occurs at line 614 relative to device 600 to be exceeded, and the output at line 612 supplies the gate voltage to transistor Q1 at line 610. It will be removed in turn for removal. Resistor R62 is essentially an open circuit and a stop value appears at output line 612 when the switch associated with element 592 is pressed. Elimination of the depressurization of the switch associated with element 592 causes the voltage drop at line 598 to cause a 12V re hold at line 612 and corresponding gating of transistor Q1. Thus, the resistor R62 is reinserted to quickly discharge the charge started from the capacitance coupled with the element 592.

Referring to FIG. 22, circuitry that supplements the remote Squelch I trim logic associated with FIG. 5B and block 320 is shown in detail. The circuit 320 has the same network indicated by reference numerals 624 and 625 in connection with the input processing from each of the switches 52 and 53. Thus, one of the circuits is shown in detail, while the first and second parts are shown in block diagrams. The output of circuit 320 shown at lines 322 to 324 of FIG. 5B is provided to an open collector NPN transistor shown at Q2-Q4. Transistors Q2-Q4 are connected across the low effective corresponding outputs of each of the switch-down switches 73 and 74 of the console 12. Similarly, transistor Q3 is connected across the output of squelch I switch 71 of console 12.

In the structure of the shut-off switch 52 coupled to the network 624, it is coupled to the line 612 in FIG. 21, and the input from the cable 46 is connected to a capacitor C26 and a resistor (c) providing filtering function. Line 626 to reach the RC network comprising R67. Here, the time constant of the network 628 is selected to remove the rapid variation in the voltage signal present in the line 626 where the noise occurs. The filtered output from the network 628 is provided to the level converter network indicated at 632, which includes a type 4049 level converter and an inverter 634 in line 630.

Element 634 converts the 12 volt level on line 630 to a 5 volt level on output line 636. This signal at line 636 improves to provide sensitive variation through Schmidt invert 638. The output of element 638 in line 640 forms a pulse having a period corresponding to the length of time when the surgeon pressed the switch 52. The signal at line 640 consists of a variable overswitch and is coupled to line 642.

It has a slash mark as long as there is a negative effective value change in the signal at line 642. This signal is connected to the trigger input of timing element 646 via capacitor C27 and line 644. Device 646 is of type ICM7556 described in connection with FIGS. 20C and 20D. Line 644 is connected to Vcc via a resistor 68 connected to diode D16.

The dress terminal input of the device 646 is connected to an R-C network 648 including a capacitance C28 and a resistor R69. The network 648 is selectively discharged from the discharge terminal of the device 646 in combination with the line 650, resistor R70, diode D17. Thus constructed, element 646 is part of the network shown at 654 having a squelch button closure signal generation function as shown at 654. The output of element 646 is in line 652. Line 652 moves the specified parameter to the squelch button closure along line 656. Line 656, comprised of resistors R71 and R72, is associated with the OR function and is connected through the line 656 and the base of transistor Q3. Thus, depending on the presence of the squelch button closure signal at line 654, transistor Q3 is turned on to attempt to operate the squelch switch 71.

The signal on line 652 is connected to the trigger input of type ICM7556 element 662 via capacitor C29 and line 658. Line 658 is connected to Vcc via a resistor R71 connected to diode D18. As described above, the dresshold terminal of the element 662 is connected to the RC network indicated by reference numeral 664, and consists of a capacitor C30 and a resistor R72. Network 664 is selectively discharged from the discharge terminal of element 662 from line 666 coupled with resistor R75 and diode D19. The output of element 662 is line 668 and the Q terminal. The device 662 and the network of components associated with it represent the function of reference number 670 specified by a variable expressed in delay. This delay is located between the termination of the variable called squelch button closure and the performance of the operation of the shutoff switch 73.

The signal at line 668 is associated with the close closure function represented at network 672.

Here, the signal at line 668 is connected to capacitor 31 and line 674 via a trigger input of type ICM7556 timing element 676. As described above, the dresshold terminal of element 676 is coupled with the RC network indicated by reference numeral 678, which consists of capacitor C32 and resistor R76. Network 678 is selectively discharged from the discharge terminal of device 676 shown in line 680, which is coupled to resistor R77 and diode D20. The output of the Q terminal of element 676 is represented by a variable up closure and represented by line 682 in the network represented by reference numeral 684 leading to a function variable up arrow button closure. exist.

Referring to FIG. 23A, the timing diagram shows the variable function associated with the network 624 corresponding to the operation of the switch button 52 of the element 48. As shown in FIG. For clarity, the variables in this figure are represented by Boolean algebra 1, 0 or true, false, configuration, etc., as in Figure 23B, where the actual signal level is ignored. The recess switch variable is shown here in pulse form 686. The value is true for a period corresponding to the pressing operation of the switch 52. In Fig. 23A, a short pressing or a middle wrinkle of the switch is shown. FIG. 23B shows the same variables with respect to expansion closure of switch 52, as shown in pulse form 688. FIG. In FIG. 23A, the squelch button closure variable is represented by Boolean logic as the corresponding value at 690.

This variable is initiated as represented by the variant arc 692 according to the variation or rising edge of the variable 686. The closing period is long enough to allow the microprocessor network 226 (FIG. 5B) to recognize the switch closing operation. It is known that the variable period is about 100 milliseconds. The logic indicated at 690 must be performed at transistor Q3 from line 656. Following the end of this variable, a delay is applied, as indicated by reference number 694. The transition ike 696 shows that the variable at 669 is initiated with a variation or falling edge of the variable 690. The delay function 694 stops the microprocessor network 226 from recognizing the series of closing operations of the first switch function represented by the switch 71 following the operation of the overturn switch 73. In general, this delay is known to have a duration of about 200 milliseconds. As variable 669 transitions from logic 1 to logic 0 as shown in transition arc 698, the closed closed variable 700 is true. This closed variable has a period of about 100 milliseconds, which is sufficient time for the microprocessor network 226 to recognize the switching condition. As shown in the ike 702, as the close variable 700 transitions to a logical reference, the up button or switch closed variable becomes logical or true as in reference 704. This logic condition for a short period of time of the switch variable 686, which turns on the transistor Q2, has a period of time beginning at the close variable 700 and ending as shown in the variant arc 706.

Looking at the long term of the switch switch variable at 668 as shown in FIG. 23B, the logic provided for the extended period of the shut button closure variable has been developed. As indicated by transition ike 708, the squelch button closure variable, indicated by reference numeral 710, begins upon the start of variable 688. As discussed above, this variable 710 continues for a period of 100 milliseconds, such as in transition arc 712, which transitions to logic zero. At that time, a transition of the delay variable to logic 1 or the true value occurs as represented by 714. As mentioned above, the delay continues for 200 milliseconds, and at the end of that period, variable 714 transitions from logical true or one to logical zero. At that time, as in reference numeral 718, the closed-closed variable is changed to TRUE or 1. This variation lasts about 100 milliseconds and will transition to the logical zero state shown in the falling transition 720. The button closure variable is logically true or changed to 1 with the start of variable 718 as shown in arc 722. This variable true condition, as with reference 724, however, does not change with the variation of variable 718 to logical 0 condition, as with falling edge 720. The TRUE or 1 condition 724 continues until the transition of the SWITCH variable 688 from the TRUE or TRUE condition to a logic 0 in the reference 726. The up button closed logic true condition is transitioned to logic 0 in accordance with the operation at variable 688 as with reference 728.

Referring again to FIG. 22, the implementation of a button closure variable generation, such as at 704 or 724, is shown in relation to network 684. The network 684 is a basic mode circuit that includes an AND function implemented by the NOR gate 730 and low true for the input. As in reference numeral 730, the AND function is performed by combining the OR function transferred to the NOR gate 732. Here, the input is high level true and the output is low level true.

At functions 730 and 732, it can be seen that line 682 that performs the close variable relates to one input. The output of function 732 is in line 734 additionally connected to the inverting input for AND function 730 via line 736 in the Pitback configuration. The output of AND function 730 is provided to the inverting input of OR function element 732 via line 738. Depending on the configuration shown, for a short period of switching operation, the close block variable will be true through line 682 for the OR function 732 appearing at the output at line 734. This same output is provided on a true condition with respect to AND function element 730. The output of AND function element 730 at line 738 becomes a logic zero condition, resulting in the elimination of the logic engagement condition at line 682 as in Figure 23A at transition arc 706. The condition at is effectively a logical zero condition. During the logic engagement condition at line 734, the low signal is invertered by Schmitt inverter 740. In addition, the output at line 742 extends through the base resistor R79 to the base of transistor Q2 to turn it on. Thus, when the variable output at line 734 is logic 0, transistor Q2 is turned off.

Considering the extension of the push switch 52 again, Fig. 23B shows that the Boolean algebra 688 is true for an extended period of time. This means that the overswitch signal on line 642 provides a true input to AND function 730. When the boolean of the close closed variable is true at reference numeral 718 in FIG. 23B, there is a true value at line 734 at the output of OR function element 732. The true condition from line 736 to AND function element 730 is that the feedback provides an output that is true at line 738 and that the switch signal at line 642 is AND-function 730 true or logic. As long as 1 is provided, the latching condition continues to occur. When the operator removes the pressing pressure of the switch 52, the output at line 734 then changes to a logic low level or zero condition to turn off transistor Q2.

The network 625 performed in connection with the down direction switch 53 is configured in the same manner as the network 624. In this respect, the configuration is the same as that of the network 624. In this regard, the network is shown to have input from circuitry associated with switch 53 in line 744. This input is filtered and its voltage level is converted in the manner provided in association with the function 632 as in block 746. The resulting output of the converter is shown at line 748 and takes over the downswitch variable via line 750 with the down button closure function shown at block 752. The function of block 752 is referred to in FIGS. 23A and 23B and is a down-directional equivalent network, such as at 684. The downswitch signal at 748 is related to the squelch button closure function as at block 754. This function is performed in the same manner as the network 654 which provides a squelch button closure period to the output of the line function 756 connected to the OR function resistor R72 and transistor Q3 via line 758. This same output is associated with the same delay function as in block 760. This function provides a delay between the operation of the Squelch I switch function and the down switch closure operation and corresponds to the network 670. This internal switch operation delay maintains the same down-closure function as the close-closure operation of network 672 described above, as shown in line 762 and network 764. This down closure output is shown in line 766 extending to the down direction button closure function shown in block 752, which corresponds to network 684. The output of function 752 is shown in line 768 which provides a forward bias to transistor Q4 through resistor R80.

Another aspect of the invention involves the use of an objective system 10 to observe or record the pathway of a lymphatic vessel from a tumor or leision to a sentinel node. The use of such a system 10 derives fundamentally from the determination that the inverse square law of radiation propagation does not hold where radiation is from restrictions of tubes such as blood vessels or lymphatic vessels. In particular, under such circumstances, the attenuation of radiation is at inverse first power.

This is associated with a graphical display embodiment, such as in FIG. 1, for example, where a lymphatic that moves 99 m Tc is mapped using a probe. Inverse first power attenuation, representing the force per length of the tube, is shown in FIG. 24.

In the analysis associated with Fig. 24, it is considered in the intuitive analysis of the Gaussian law. That is, if a source composed of radioactive elements is surrounded by a virtual surface or there are no media absorbing radiation, then all radiation will be emitted through the surface, regardless of the size or shape of the surface. Considering a long cylindrical tube as in reference 780 with an activity concentration of NnCi / m1, radiation attenuation in the tube is ignored if the radius r of the tube 780 is less than half the length of the measured radiation. If the directions of the individual photons are random, the radiation concentration at the radius R from the center of the tube 780 is not a function of either the position around the tube and the position along the tube. The radiation passing through the surface of the tube 780 will pass out through a concentric shell of radius R, as shown at 782. The following equation is expressed per unit length of the tube 780.

(1) Size per unit length of tube 780 = πr²

(2) Area per unit length of track shell (782) = 2πR

(3) the number of photons through unit length or cross section = πr²N · 37 · K,

Here, K is the number of photons per disintegration 125I and 37 is the number of disintegration 125I per nanocury.

(4) Number of photons per unit area of shell 782 =

From the above equation, there is no squared term in the daemon of equation (4).

If a detector having a front face area A is located at a distance R, then A is much less than 2πR, then the number of photons in one second detected for the 125 I source described above is to be. here, Is the detection efficiency.

As indicated by reference numeral 784 in FIG. 24, the actual front surface area is reduced because of the rectangular detector disposed relatively close to the cylinder 780 or tube. In Fig. 24, the area is projected onto the cylinder track shell. As such a geometry, the number of photons detected per second is calculated as follows.

(6) A = 1W

(7) A = 21tanθ

(8) photon / second detection

here,

(10) Photon / Dec Detection = 37KNr²Qη

The advantages arising from the primary power reduction of radiation apparent in the mapping of radiopharmaceuticals moving in the lymphatics are shown in FIG. Here, the curve 786 is related to the ratio of rationalized coefficients having an arbitrary distance, such as millimeters.

Along with curve 786 is shown a curve 788 representing the known inverse squeer law of attenuation. It can be observed that the curve 788 has fallen very quickly and sharply to a lower value.

Compared with each other, it is shown that the inverse primary power relationship of the curve 786 representing the coefficient ratio from the cylinder or tube I 78 gradually decreases in proportion to the distance. In conclusion, the mapping approach for tracking radiopharmaceuticals as they move from disorders or tumors to outpost nodules becomes a real diagnostic modality.

In order to perform this mapping method, the probe 20 is moved along the epidermis or skin as the probe axis 92 which is maintained perpendicular to the skin surface. An important feature of developing a dynamic configuration or graphic presentation in which the tube is positioned is the development of sharp radiant coefficient peaks when the axis 92 of the probe 20 is arranged in a tube, ie with a radius R configuration. Where these sharp peaks are dynamically formed, the therapist can easily identify the lymphatic vessel position. When the probe 20 is used in the mentioned method, the probe axis 92 is initially oriented in such a way as to define the scanning surface in the region adjacent to the skin where the lymphatic vessel is located. At that time, the probe 20 moves outward or in the opposite direction and returns while maintaining the front of the detector in parallel with the scanning surface.

Referring to FIG. 26, peak development for this test or injection is shown. In the figure, detector surface 784 is initially positioned as in FIG. 24. However, the detector surface is moved laterally at the height of the radius R as shown in the figure, i.e., a distance away from the center of the tube 780.

Considering the projection of the radiation from the center of the tube 780, the left end of the detector is located in the transverse direction, which is the distance XW / 2 in scanning from the right angle of the (784 ') angle Q1, while their relative to the corresponding projection angle Q1 Opposite side is transverse position Located at the point.

The geometry of this array is:

= Projection of the width W on the cylinder with radius R.

Photons detected per second

Wherein said induction formula is constructed on a theoretical basis for carrying out the total activity of 5.39 micro curie. Referring to Fig. 27, this configuration is shown well. In the figure, the theoretical detector surface depends on the position of the tube, and the above-described procedure involving regions 872,874 is performed as the tube is defined by peak graphic observation. In reference numerals 900 and 9220 two cross-sectional areas are shown along the groin. As noted above, as peaks are observed in the graphic readout 44, remnant, or small, ink spots on the tombs are displayed on the seedlings as the radiopharmaceutical moving tubes are mapped or irradiated. The tube 898 is shown to pass through the saphenous vein 904 where the inguinal ligament 908 is observed. The outpost nodules from which the tube 898 extends are shown as nodules 912 in the area indicated by the inguinal node indicated by the area 910.

As with outpost nodules, there will be a shift in the actual concentration of radiopharmaceutical indicated at 912. The reading 44 will also use the secondary features of the rapid increase in counting ratio activity and the detection and removal processes as evidence. Squenching or basal count ratio will be performed around the active area. This is accomplished by the operation button switch 27 or by performing the process of the operation switch 71 following the operation of the switch 70 on the console 12.

As mentioned above, a period of five seconds is taken up by the system in accordance with this operation. By setting the basal coefficient ratio, the performer performs an initial bracket across the high active area that indicates the location of outpost nodule I 912. Such cross sections are shown at 916 and 918 in the figures. Using the process as described in FIG. 6 above, the outbreak nodule 912 is easily bracketed onto the epidermis of the patient, where a cut has been made, the process being cut off of the nodules I 912 along the X-axis, for example. Continuing with the use of a switch 52 which increases the coefficient ratio dress hold as the movement of the probe 20 using the voice or siren output bracket position.

The doctor is convinced that the system is responding properly because the tip and the distinction of the probe 20 can be heard even in very small movements. As described above, there are limitations in systems that represent the dresshold coefficient ratio, for example, using the switch 52 of the element 48. When the limit of the system is reached, another sketching process is required, for example through the operation of the switch 27 on the probe.

In FIG. 35, skin melanoma 922 is shown in the middle of the upper back 920 of the patient. In some cases, the practitioner will find that the radiopharmaceutical drainage extends into secondary lymph node basins or zones 924 and 926 associated with the right and left ribs. The radiopharmaceutical is injected into the quadrant at the location of the lesion 922 which results in a high counting ratio active zone represented by the border 928 of the lobe. When allowing a suitable time path for the movement of the radiopharmaceutical along the lymphatic tube leading to the outpost nodules, the probe 20 abuts and encloses from the active zone boundary 928, for example along a circular trajectory represented by a dotted line 930. Move to the area. For example, assuming two outpost nodes 932 and 934 appear, the peak output signal will appear on the dislay 44 when the lymphatic tube 936 appears and additionally the lymphatic tube 938 appears. . Thus, each tube 936,938 is drawn and examined in this manner. For example, for the tube 936, a traverse scan is made as indicated by the area indicated by line 940. The tube 936 is drawn, for example, by traversing using the probe 20 from the zone indicated by 20a to the zone indicated by 20b while observing the reader 44. The probes at 20a and 20b are oriented slightly with respect to the desired traverse orientation in which the detector axis 92 is perpendicular to the injection surface of the patient's epidermis. This is explained more clearly. Since the tube 796 is drawn by traverse in addition to being observed as a peak in the display 44, in particular, the area in which the outpost nodules 932 are located will be measured due to an increase in the counting ratio activity. At that time, the probe 20 is positioned around the increased active zone and the process of establishing the skeletal or basal count ratio is, for example, permutated to operate the switch 27 or the switches 70 and 71. Is performed by. For example, the location for such a fundamental coefficient ratio dress measurement is indicated by x at 942. Along this modulus dress hold development, the highly active zone is traversed, preferably in two traverse directions, which are represented by lines 944 and 946. Next, the bracketing process is performed as described with respect to FIG. 6 until the probe 20 is placed directly on the outpost 932. In this connection, a small incision is made and the bracketing process is carried out as described above, for example using the switch 52 of the device 48, whereby the front of the probe 20 is adjacent to the outpost 932 (92). ) Continue until the axis is pointed directly at nodule I. Outpost nodules 932 are removed for evaluation of the presence of metastases.

In a similar manner, a tube 938 extending into the nodular basin of the armpit is drawn and examined. For example, as before, one or more traverses are made as indicated by line 948 and probe 20 moves from zone 20a to zone 20b at 948. Reaching the zone of the outpost nodules 934, an increase in counting ratio activity appears on the display 44 and the process is changed to a squelch or dresshold based guiding process. The dresshold basal counting ratio or squelching process is performed in an area adjacent to the increased counting active area above the outpost nodule 734, for example in the area indicated by x at 950. After the basic counting ratio is made through the operation of the switch 27 of the probe 20 or the sequential operation of the switch 71 and the switch 70 in the console 12, the bracket process is performed as described in FIG. Preferably, the traverse on the high active zone is as shown by dashed lines 952,954. Outpost until the axis of the probe 20 directly points out, by using the switch 52 or by raising the fundamental modulus of the dresshold during such traverse through the squelch process using the switch 27. The nodule 934 is bracketed. A small incision is made and the bracket process through the incision continues until only a slight movement of the probe 20 is required to perform the bracket procedure. At this time, the front face of the probe 20 will be adjacent to the nodule 934 and the axis of the detector will point it directly at 92. Outpost nodules 934 are removed for evaluation of the presence of metastases. Thus, the diagnostic process is minimal and the axillary nodules in the non-affected areas, as in 956, are not disturbed.

In FIG. 36, skin melanoma or lesion 962 is shown on the upper back 960 of the patient. The figure shows that the lymphatic vessels are associated with lesions 962 that diverge from 964 to 966,968 and encounter two outpost nodules 970,972, respectively. As before, the practitioner will be able to visually identify the lesion where the radiopharmaceutical is injected by quadrant to create a boundary of relatively high counting ratio activity, indicated at 974. Depending on the time interval between which radiopharmaceuticals are allowed to travel along tube 964, injection of, for example, an annulus around the tumor tissue and border 974 site and dotted circles 976 appear. This process, along with the peak detection reading, allows the location of the lymphatic tube I 974 to move the radiopharmaceutical. Thus, for example, traverse is performed along the zones 978,980 and 982 in the manner described so far with respect to FIGS. 33-36.

For example, a traverse scan is made as indicated by the area indicated by line 982. Two peaks are observed in the display 44. It is necessary to use the collimator 140 described in FIG. 4 for the difference between these peaks and indicated with the same reference in association with the probe 20. When reaching the zone in which the outpost nodules 970,972 are located, the process of squelching around the increased active zone, for example at x, shown by 984, for example by actuating the switch 27 of the probe 20 This is done. Using the collimator 140, it can be made in the area above the nodules 970, 972, and the basal count ratio adjustment process can be performed using, for example, the device 48 and its switch 542. When nodules 970, 972 are bracketed, the collimator shields the detector of probe 20 from excessive radiation effects, a small incision is made, and nodules 970, 972 are removed for evaluation of the presence of metastases.

The method of the present invention can also be applied for locating outpost nodules associated with breast cancer. In this 37A, the breast region 990 is shown. The tumor 992 is located inside the breast 990. Referring to FIG. 37B, the tumor 992 is shown in cross section, the pectoral muscle 994 next to the rib 996, and the artery 998, the intercostal muscle 1000 and the blood vessel 1002 are located inward. Tumor 992 is located within chest tissue 1004 associated with vascular system 1006. By injecting a radiopharmaceutical into the root of the tumor 992, the procedure described above in connection with melanoma on the skin is performed to locate the outpost nodules. In this way, the practitioner can have a lymphatic tube that extends to the outpost nodules toward the armpits. Returning to FIG. 37A, the lymphatic tube 1008 can be tracked in this manner by moving the probe 20 transversely while observing the counting ratio of the peaks of the reader 44. Typical traverses of such a tube 1008 region are indicated by dashed lines 1010, 1012 and 1014. Outpost nodules 1016 may be present, for example, within the nodules of the armpit zone. Lower clavicle nodules appear in lateral groups 1020 adjacent to 1018 and axillary vein 1022. Likewise, while the tube 1008 is drawn, the counting ratio activity is increased, and the process of establishing a squelch or basal counting ratio is indicated by the switch 27 of the probe 20 at the boundary of that activity, e. Is carried out by operation. After making the basal counting ratio, the increased active area on the outpost 1016 is traversed along the area indicated, for example, by dotted lines 1025 and 1026. The probe that was initially at 20a for the (1025) region passes through the outpost 1016 and the traverse endpoint of the probe is (20b). The bracketing procedure is performed until the anterior nodules 1016 have been identified on the epidermis. A small incision is made, for example a bracket procedure is performed using the device 48 and the switch 52. Alternatively, the resquelching process may be performed using the switch 27. Nodules 970 and 972 are removed for evaluation of the presence of cancer.

It is clear that the method of the present invention can minimize the hassle of patients and practitioners as compared to surgical methods of removing lymph nodes of all areas of the armpit. Modifications may be made without departing from the spirit and scope of the invention, and the specification is intended to illustrate the invention and should not be construed as limiting the invention.

Claims (24)

Responsive to the output signal of the detector in the presence of a housing, a crystal detector that is located within the housing and provides an output signal of a corresponding detector in response to the emission impinging thereon; An amplifier stage attached to the detector in the housing, one or more piezoelectric switches installed in the housing operative to induce a switch voltage signal, in response to the switch voltage signal imposing a current signal of a predetermined amplitude on the applied power supply; A hand operated probe comprising a current induction circuit having an output coupled with the applied power supply; At least one function selection switch for inducing a function input signal, a power supply network for inducing the applied power supply, an input network for accepting and evaluating the count output signal for inducing a coefficient related signal, a detectable output signal An output device responsive to the applied output signal, a processor responsive to the function input signal and the coefficient related output signal for inducing the corresponding output signal, and a current level of the applied power supply for providing a corresponding monitor output signal. A level comparator circuit responsive to said monitor output signal with a monitoring amplifier stage responsive to and a current signal validating said processor induction of said detectable output signal and inducing an emulating signal corresponding to said functional input. Circle from the probe comprising a In the control device; And A long flexible connector device coupled between the probe and the control device for coupling the input network and the output line and for transporting the applied power supply from the power supply network to the amplifier stage of the probe, A system for detecting and locating photon emitters emitted from tissue in the human body, The system of claim 1, wherein the current induction circuit is a voltage comparator having an input signal responsive to the switch voltage signal. The method according to claim 1, The monitoring amplifier stage of the control device includes an amplifier responsive to the current level to provide the monitor output signal as a monitor voltage signal of a given level; The level comparator circuit includes a pulse shaping network for responsive to the monitor voltage signal and inducing the emulating signal when the given level provides a comparator output signal above a predetermined threshold level. System. The method according to claim 3, The processor is responsive to the function input signal for deriving a basis coefficient for a predetermined basis coefficient interval and by counting the coefficient related signal to increase the basis coefficient by a statistical value deriving a coefficient threshold level; The output device is configured to generate an ear detectable output signal. The method according to claim 1, The hand operated probe comprises: first and second piezoelectric switches operative to induce first and second switch voltage signals; A current induction circuitry responsive to said first and second switch voltage signals imposing first and second current signals of a first and second predetermined amplitude on said applied power supply, The control device comprises: first and second function selection switches for inducing first and second function input signals; A monitoring amplifier stage providing a first monitor output signal in response to the first current signal and a second monitor output signal in response to the second current signal; When the output signal of the first monitor circuit exhibits an amplitude value above the dresshold value, and when the output signal of the second monitor circuit exhibits an amplitude value above the dresshold value, the first comparator with L, and the second monitor circuit A level comparator circuit comprising a second comparator having an output signal, H, when the output signal of? Represents an amplitude value above the upper value; Generating the output signal of the first identification device corresponding to the operation of the first piezoelectric switch and the output signal of the second identification device corresponding to the operation of the second piezoelectric switch; A sensitive identification circuit; The second identification device responsive to an output signal of the first identification device inducing a first emulating signal corresponding to the first functional input signal and inducing a second emulating signal corresponding to the second functional input signal And an emulator network responsive to the output signal of the system. The circuit according to claim 5, wherein the identification device circuit has three stable states a, b and c, and has no special output condition in the stable state, and from state a to state b when there is the output signal L without the output signal H. When the transition of the identification device circuit occurs without a special output condition, and the output signal L is terminated during the b state without the output signal H, the first identification device provides the output signal from the b state. A system characterized by an asynchronous, basic mode discriminator circuit in which a transition occurs. The circuit according to claim 6, wherein, when in the stable state b, the discriminating device circuit responds to the output signal L and the output signal H to cause a transition to the stable state c without a special output condition, wherein the output signal L and And at the end of H, provide the second discriminator output signal in response to a transition from state c to state a. The said discrimination apparatus circuit of Claim 5 responds to the said output signal L and the said output signal H when it is in the stable state b, and makes the transition to the said stable state c without a special output condition, and to the said stable state c. And when present, stays in the state c in response to the termination of the output signal L. The said discrimination apparatus circuit of Claim 5 responds to the said output signal L and the said output signal H when it is in the stable state b, and makes the transition to the said stable state c without a special output condition, and to the said stable state c. And stays in said state c in response to the termination of said output signal H when present. The said discrimination apparatus circuit is a state in which when it is in the said stable state a, it responds to the said output signal H without the said output signal L, and produces the transition to the said stable state c without a special output condition. system. The system according to claim 5, wherein the discriminator circuit is in response to the output signal L and the output signal H when in the stable state a to cause a transition to the stable state c without a special output condition. . A hand operated probe having a housing, a crystal detector positioned within said housing having an outwardly facing surface and providing a corresponding counting output signal in response to said photon emission; A control network including an input network for receiving and evaluating an energy level of the coefficient output signal for inducing a coefficient related signal, and a processing network for compressing the coefficient related signal in a predetermined time interval to derive a sequence of coefficient ratio values; And A display device for providing a graphical output representative of said coefficient ratio value as an amplitude over time corresponding to the movement of said probe in a wave path moving along said tube in response to said coefficient ratio value, And a radiopharmaceutical system utilizing photon emission applied to the tissue for movement of the lymph along the lymphatic tube towards the outpost lymph node. 13. The processing network of claim 12, wherein the processing network of the control device first compresses the coefficient related signal during a first time interval to provide a first coefficient ratio increase value and the first coefficient ratio increase value is greater than the first time interval. And provide the count ratio value that compresses over a time period to drive the graphical output. The system of claim 13, wherein the processing network updates the count ratio value in successive periods corresponding to the first time period. 15. The system of claim 14, wherein each of said updated coefficient ratio values is represented by cotton on said display device continuously during said first time period. 13. The system of claim 12, wherein said processing network consists of a single weight transfer filter. The housing, a crystal detector positioned forward in a housing having an outwardly facing surface supported perpendicular to the direction axis in response to the emission impinging upon it, the crystal detector positioned forward and inducing a counting output signal at the output line I An amplifier attached to the detector in the housing responsive to the output signal of the detector in the presence of a power supply, one or more piezoelectric switches installed in the housing operative to generate a switch voltage signal, of a predetermined amplitude in the applied power supply A hand operated probe comprising a current induction circuit device in response to the switch voltage signal imposing a current signal and having an output coupled with the applied power supply; Count switch dress hold Input switch for inducing input signal, power supply network for inducing the applied power supply, input network for accepting and evaluating the coefficient output signal for inducing coefficient related signal, ear detectable output signal A first output device responsive to a first applied output signal generating a second output device responsive to a count ratio value providing a graphical output indicating a coefficient ratio value and amplitude over time, the coefficient ratio input signal and the coefficient associated Selectively inducing a coefficient ratio dresshold based on the first output signal in response to an output signal, and inducing a coefficient related signal in response to the coefficient related output signal and compressing the coefficient related signal in a predetermined time interval. Produces permutation of coefficient ratio values for application to first output device And a monitoring amplifier stage responsive to the current level of said applied power supply for providing a monitor output signal, and said current application signal validating the response of said processor and inducing an emulating signal corresponding to said coefficient ratio input signal. And a control device remotely located from the probe comprising a level comparator circuit responsive to the corresponding monitor output signal; And A long flexible connector device coupled between the probe and the control device for coupling the input network and the output line and for transporting the applied power supply from the power supply network to the amplifier stage of the probe, And a radiopharmaceutical system utilizing photon emission applied to the tissue for the movement of the lymph along the lymphatic tube towards the outpost lymph node. The method according to claim 17, The monitoring amplifier stage of the control device includes an amplifier responsive to the current level to provide the monitor output signal as a monitor voltage signal of a given level; The level comparator circuit includes a pulse shaping network for responsive to the monitor voltage signal and inducing the emulating signal when the given level provides a comparator output signal above a predetermined threshold level. System. 19. The apparatus of claim 18, wherein the processor is further configured to derive a basis coefficient for a predetermined basis coefficient interval and by counting the coefficient related signal to increase the basis coefficient by a statistical value deriving a coefficient dress level. Responsive to a signal and derive the first output signal when a subsequent coefficient related signal exceeds the dress level. 18. The method of claim 17, wherein the processing network of the control device first compresses the coefficient related signal for the first time interval to provide a first coefficient ratio value and compresses the first coefficient ratio value for a second time interval greater than the first time interval. And provide the count ratio value that derives the graphical output. 21. The system of claim 20, wherein the processing network updates the count ratio value in successive periods corresponding to the first time period. 21. The system of claim 20, wherein each updated count ratio value is represented as cotton on the display device continuously during the first time period. A housing, a crystal detector positioned forward in a housing that provides an output signal of the detector in response to an emission impinging thereon and has an outwardly facing surface supported perpendicular to the direction axis; A hand operated probe in response to providing a corresponding count output signal; Inducing a corresponding coefficient ratio value in response to the coefficient ratio output signal, compressing the coefficient output signal into a squelch interval and deriving an initial squelch dresshold coefficient ratio value, and then the derived coefficient ratio value is the squelch dresshold. A control device for inducing an ear-detectable output signal when the count ratio value is exceeded, the controller adapted to respond to a dresshold trim for changing an initial value of the squelch dress count factor value and then a changed value; And A squelch trim device capable of being remotely located from the control device and in signal exchange communication with the control device including one or more switches that are manually operated to induce the dresshold trim signal; And a radiopharmaceutical system utilizing photon emission applied to tumor tissue to travel with the lymph along the lymphatic vessel towards the outpost lymph node. 24. The system of claim 23, wherein the rotary actuator is a shaft encoder.