RU52320U1 - DEVICE FOR REGISTRATION OF CYTOLOGICAL STUDIES - Google Patents

Abstract

The utility model relates to medicine and can be used in a clinic for cytological studies. A device for recording cytological studies contains the studied material 1, a specialized microscope 2 with a reference radiation source 3 and connected to the microscope 2 through an optical channel through an optical adapter 4 with a digital camera 5, which has the ability to synchronize operation from the console 6, and change under the influence of the positioning mechanism 7 the observation angle and the output of the digital camera 5 and the input to the control computer 9 and directly to the color image input module 10, electrically connected through the interface 8 with displaying the current results of the survey in real time on the monitor 11. The color image input module 10 is mounted directly on a common bus 12 of the control computer on which the color image processing processor 13 is also installed, the common bus 12 receives and transmits operation control commands to all units of the device according to the algorithms laid down in the software package 14, and through the remote consultation module 15 connected to the common bus 12, they interact with the remote workstation 16 of the consultant, where a similar (or part of it) software package 17 has become available. The data on the results of the studies are displayed on the second monitor 18 connected to the host computer 9 by one of the inputs and outputs and to obtain a hard copy the data is printed on a color printer 19 connected to the host computer 9 by one of the inputs and outputs.

Description

The utility model relates to medicine and can be used in a clinic for cytological studies.

Cytological studies are a highly specialized type of laboratory analysis. Cytological examination is one of the main methods of morphological analysis of cellular and non-cellular biological material. It consists in a qualitative or quantitative assessment of the characteristics of the morphological structure of cellular elements in a cytological preparation (smear) in order to establish a diagnosis of a benign or malignant tumor and non-tumor lesions. In cytology, as in no other type of laboratory research, the subjective factor dominates and at the same time, the conclusion of the cytologist often serves as the basis for the diagnosis.

Modern technologies for cytological diagnostics include improving cytological diagnostics through the use of well-known devices based on high-tech microscopes or automatic devices, standardizing the preparation of drugs for research based on the use of modern cytocentrifuges, the proper execution of drug preparation procedures, and the use of high-quality reagents for fixing and staining smears. [1] Quality assurance of clinical cytological studies should include an examination of the quality of instruments recommended for use in cytological studies (microscopes, automatic analyzers), an examination of the quality of reagents, setting standards for the implementation of all stages of cytological studies, and setting standards for the training of qualified specialists. Ensuring the quality of clinical cytological studies at the level of a healthcare institution includes equipping workstations with the recommended types of devices, standardizing all stages of the cytological examination, and theoretical and practical training of specialists in accordance with the industry standard. Of paramount importance is the training and experience of doctors involved in cytological diagnostics.

To improve professional skills, it is necessary, in this type of laboratory diagnostics, first of all to develop a device for teleconsultation systems, teleconferences, and to widely use professionally trained

image archives, promote the publication of cytological atlases and manuals. To reduce subjectivity, it is necessary to carry out programs of internal laboratory monitoring and external assessment of the quality of cytological studies, apply forms of a standardized cytological conclusion, etc. Given the importance of the cytological conclusion, it is necessary to analyze and widely use the available technologies of intraoperative cytodiagnostics, biopsy of internal organs under the control of ultrasound, x-ray and other diagnostic methods, to contribute to the development of objective quantitative methods for assessing the parameters of cells and investigated tissues.

Cytological studies are currently a generally accepted technology of morphological diagnosis, based on the study and assessment of cellular material (exfoliative, puncture, biopsy and surgical) obtained in various ways (including endoscopic) from a pathological focus. Accordingly, they conduct research on fluids, smears, scrapings, punctures and fingerprints obtained from various organs or neoplasms. Cytological analysis allows you to evaluate the nature and severity of proliferation of the epithelium, highlighting the group of dysplasia, and on this basis to form a group of "high risk". Registration and cytological conclusions can be carried out using a computer program using a formalized response according to WHO morphological classification codes.

In addition, cytological diagnostics by video images transmitted over communication lines is actively practiced. So, for example, the medical sanitary unit of the medical medical center No. 1 AMO ZIL, the Department of Clinical Laboratory Diagnostics of the Russian Academy of Medical and Medical Sciences, Moscow, Municipal Hospital No. 1, Tula, carried out studies on the possibilities of cytological diagnostics using images entered into a computer and analysis of the results of consultations conducted on a clinical material in static telepathology mode. [2]

The material was provided by cytological studies in 62 patients; smears from the cervix (32 observations), punctate of the mammary gland and discharge from the nipple (17), punctate of the thyroid gland (8), effusion fluid (3), and macrotum were studied (2). Images were entered into a computer using a video camera connected to a microscope; consultations were carried out using computer micrographs transmitted by e-mail. Video images (from 8 to 25 in one observation)

accompanied by brief clinical data. The results were compared with standard microscopy of cytological preparations and histological examination.

Complete coincidence of results was observed in 54 (87.1%) patients. The discrepancies were not "fatal" in nature, that is, they did not significantly affect treatment tactics. In three observations, they were associated with the wrong choice of the field of view. So, in two patients, sections of reactive cylindrical ethelium were predominantly selected for transmission, which did not allow the diagnosis to be formulated in the affirmative form. Histological examination - intraepithelial cancer and severe cervical dysplasia. A punctate from the mammary gland transmitted video images of dense structures from the ductal epithelium, in connection with which an assumption was made about fibroadenoma. Microscopy of the corresponding cytological preparations gave the conclusion - possibly fibrocystic disease, the diagnosis was histologically confirmed. In two cases, discrepancies were associated with poor quality of the preparation and images (thyroid puncture, mammary puncture). Difficulties in interpretation occurred in 2 cases, however, they were also noted during microscopy of the corresponding preparations (histologically-papillary thyroid cancer, breast fibroadenoma). It is interesting to note that in some patients, the correct diagnosis was established in video form in a confident form by video images, presumably by standard microscopy. Such conclusions have occurred with follicular and follicular-papillary thyroid cancer, effusion with the presence of cancer elements, breast fibroadenoma.

Thus, it is advisable to carry out the technology of the experiment of cytological diagnostics and consultation using the images entered into the computer. To improve the quality of consultations, it is important that the consultant obtain the most complete picture of the cellular composition of the smear. The minimum number of "pictures" is 5, the optimal is 6-7. It is advisable to introduce one or two images of the field of view with a lens x 10, two or four - x 40-60; You can enter one or two images with a magnification of x 100.

Diagnosis of images entered into a personal computer with a microscope is technologically feasible.

To effectively solve this problem, it is necessary to ensure high-quality input of the studied images into computers and their high-quality display on the monitor.

The known device allows to solve the aforementioned problem with different efficiency.

The closest is a device for recording cytological studies, taken as a prototype, including a microscope, an operator console, the studied material, the microscope output and the input of a digital camera optically connected by an optical adapter and the output of a digital camera electrically connected through an input interface, and the input to a control computer with the display of the results on the monitor and color printer [3].

The prototype of the device has a number of positive properties, however, there are some disadvantages:

- a strictly selected CCD matrix with specified characteristics is installed in the device and there is no possibility of replacing it with a new one with higher characteristics;

- there is no possibility of remote data reading;

- the possibility of conducting remote consultations is not provided;

- the database work program does not provide for connection to the Clinic information system;

- there is no possibility of receiving stereo images;

- there is no hardware processing of the current image and simultaneous display of information on two monitors (on one - the current, on the other from the database archive or transmitted by the consultant).

The utility model is based on the task of developing and manufacturing an automated workstation for a doctor to work with cytological images with the possibility of obtaining high-quality cytological images and the possibility of conducting remote consultations by:

- connection to a microscope of a special optical adapter and docking with a CCD matrix;

- implementation of input into the host computer of images from the microscope in two modes (in real time with low resolution, with reflection on the monitor also in real time and in photographic mode with programmable high resolution);

- display simultaneously on two monitors of two images;

- the possibility of real-time hardware processing of the current image;

- remote synchronization of the photographic input mode to the control computer;

- the ability to maintain a database of cards of the studied patients, received images and protocols of conclusions;

- the ability to conduct remote consultations with the recording of the session;

- the ability to receive stereo images due to the impact on the CCD matrix by the positioning mechanism;

- obtaining a hard copy of the research on paper with the printing of images and examination protocols.

This object is achieved by the fact that in the device for recording cytological studies, including a microscope, an operator’s console, the studied material, the microscope output and the input of a digital camera optically connected by an optical adapter and the digital camera’s output is electrically connected through an input interface, the input to the control computer with the display of the results on a monitor and a color printer, according to a utility model, the optical adapter is made in the form of a system of focused m I’m waiting for five lenses with the possibility of matching the optical output of the microscope with the geometric dimensions of the CCD of the digital camera’s matrix, and the operator’s panel and the host computer are equipped with infrared sensors, respectively, for synchronizing recordings to the host computer of the selected image, while one of the inputs and outputs of the host computer is connected to the monitor displays the information of the current study in real time and improves the focusing of the received images from a digital camera, and the other input the control computer's progress through a common bus is connected to a second monitor to display the results of the study and the results of remote consultation.

Technologically, the device would be equipped with a color image processor, with the ability to convert input color images in real time according to a given algorithm.

Structurally, the managing computer was equipped with a module for conducting remote consultations connected via communication channels with the automated workplace of a consultant.

For a better understanding of the design of the device, it is illustrated in the drawing, where

Figure 1 is a block diagram of a device indicating the positions and names of nodes;

Figure 2 is a block diagram of a device indicating the positions.

Figure 3 is a structural diagram of an optical adapter in the form of a system of five lenses focused between each other with the possibility of matching the optical output of the microscope with the geometric dimensions of the CCD matrix of a digital camera.

A device for recording cytological studies contains the studied material 1, a specialized microscope 2 with a reference radiation source 3 and connected to the microscope 2 through an optical channel through an optical adapter 4 with a digital camera 5 or similar means based on a replaceable CCD matrix (not shown conventionally in the drawing), with the ability to synchronize operation from the remote control 6, and under the influence of the positioning mechanism 7 to change the viewing angle and the digital camera output electrically connected through interface 8 that 5 and the entrance to the control computer 9 and directly to the module 10 input color images with the display of the current results of the survey in real time on the monitor 11, the module 10 input color images is installed directly on a common bus 12 of the control computer on which the color processing processor 13 is also installed , the common bus 12 receives and transmits operation control commands to all device units according to the algorithms embedded in the software package 14, and through the remote consultation module 15 connected to the general The bus 12 interacts with the remote workstation 16 of the consultant, where a similar (or part of) software complex 17 is installed. Data on the results of the studies are displayed on the second monitor 18 connected to the control computer 9 using one of the inputs and outputs and to obtain a hard copy data is printed on a color printer 19 connected to the host computer 9 through one of the inputs / outputs.

For technological studies, the operator’s console 6, digital apparatus 5, and host computer 9 are equipped with infrared (IR) sensors made in the form of an IR receiver 20, an IR receiver 21, and an IR transmitter 22.

A device for recording cytological studies through the communication line 23 and the workplace 16 of the consultant associated with the host computer 9.

To obtain a high-quality image, both high-resolution household digital cameras from 5 megapixels and higher can be used, as well as interchangeable CCD sensor modules, for example, Omni Vision Technologies [4]. The first construct requires the use of a more complex optical adapter, which solves the problems of docking the optical output of the microscope and the input of a digital camera.

To implement the work of figure 3, the optical adapter 4 is made in the form of a system of five lenses focused on each other 24, 25, 26, 27, 28 with the possibility of matching the optical output of the microscope 2 with the geometric dimensions of the CCD of the digital camera 5. Lenses 24, 25, 26 , 27, 28 form a three-component optical system: lenses 24. 25 are made in the form of an image transfer lens, lens 26 is made in the form of an optical team, and lenses 27, 28 are made in the form of a main power lens.

An example of a specific implementation is shown in figure 1.

The design of the optical adapter is based on two prerequisites: matching the microscope image field with the matrix of the digital camera from the requirements for fitting the image field into the rectangular dimensions of the CCD, matching and optical conjugation of the aperture diaphragm of the microscope and the aperture diaphragm of the digital camera lens.

The optical system has the following technical characteristics: focal length: 19.52 mm; relative aperture: 1/18; field of view (angular): 23.64 degrees; front focal length: - 28.49mm; working segment: - 25 mm.

The versatility of optical compatibility is that it does not require the creation of a specialized digital camera, but a household digital camera with the required technical characteristics is used. Given the fact that technological progress offers more and more opportunities to use CCD matrices with high resolution, the second constructive implementation of receiving images from a microscope is also relevant. For its implementation, a specialized kit is used, for example, an image sensor (CameraChip family) from OmniVision Technologies, type OV 3620 or with higher characteristics, with the possibility of replacing the CCD by an array and an irreplaceable input interface to the host computer via USB-2 channel. Connection to the control computer is carried out in both cases via the video input channel 8 by a television signal to the color image input module 10 and then for display in real time is transmitted to the monitor 11, and for transferring the captured images (via the sync command) via the USB-2 channel on one of the inputs of the host computer 9. In the host computer on a common bus 12, a processor 13 for processing color images is installed, which allows processing the images obtained, for example, various filtering, between frame processing with weighted accumulation, preliminary processing of two frames with positioning bias to obtain a stereoscopic effect, etc.

When turning on the host computer 9, the software complex 14, loading the operation algorithm by the operator’s commands, synchronizes the operation of the entire device, allowing remote consultations to be organized with the consultant's workstation 16 through the remote consult module 15, due to the presence of a similar software complex 17 or part of its modules on it. The device can be equipped with a positioning mechanism 7, which is a stepping mechanical motor, controlled by commands from one of the input-output of the control computer 9, the commands of the software package. The positioning mechanism 7 solves the problem of shifting the CCD of the matrix or digital camera 5 in order to obtain an image of the material under study at different viewing angles.

This problem can be solved by using focused lenses 24, 25, 26, 27, 28 (due to changes in their design) in the optical adapter 4, but this will ultimately lead to a decrease in the resolution of the device. For ease of operation, the device has an operator panel 6, which allows you to implement the function of inputting images into the control computer 9 by supplying a synchronization signal to infrared (IR) sensors made in the form of an IR transmitter 22 to one of the inputs of the control computer 9 to the input of the IR receiver 21 and digital camera input IR receiver 20. Monitor 18 is connected to one of the inputs and outputs of the control computer and is designed to display the results of the study. The printer 19 is connected to one of the inputs and outputs of the control computer and is designed to obtain the results of the study in printed form, with the ability to print both text information and print images.

A device for recording cytological studies through a communication line 23 is provided with at least one workplace of a consultant 16 connected via a communication line with a control computer 9 and made in the form of either a similar device or simply a personal computer with a part of a software package installed on it.

Communication line 23 is one of the varieties of network solutions, either local, departmental, regional, or simply Internet technology.

The block diagram of the device of figure 1. It works as follows. The test material 1 is mounted in front of the microscope 2 on a stage and illuminated with a reference radiation source 3 in a selected light range. Using the optical adapter 4, a part of the light flux is transmitted to the input of the digital camera 5, which transmits the received data through the input interface to the control machine 8

images through the color image input module 10 installed in the control computer 9 on the common bus 12 are transferred directly to the monitor 11 and at the same time, by the command from the operator panel 6, the selected current image is fixed in the digital camera 5 and then transmitted via one input interface 8 from the inputs and outputs of the host computer 9 via the USB port. The obtained high-quality images (one or several, depending on the research methodology) to the color image processing processor 13 where, according to the selected algorithm and in accordance with the commands from the software package 14, the processing of the received images takes place and their subsequent delivery through the common bus 12 to the monitor 18 and printer 19. If there is a need for remote consultation on command from the software package 14, the image under investigation through module 15 for conducting remote consultations with installed in the host computer 9 on a common bus 12 are transferred to the remote workplace of the consultant 16, which includes at least a software package 17 or part of it that allows you to process the transmitted images and generate consulting opinions. The generated consulting conclusions are returned via communication lines 23 and the remote consultation module 15 to the host computer 9, where the session of the consultation is recorded using the commands of the software package.

The device for recording cytological studies is designed to fully automate the processes of inputting, storing, processing and documenting the results of cytological studies of patients, including computer registration and processing of cytological images.

Key features of the device:

- Creation and maintenance of a unified database of electronic cytological maps, patient examination protocols and cytological images (static and dynamic);

- input in real time into a personal computer of cytological images directly from laboratory microscopes;

- storing in the database for each patient the required number of cytological images, which makes it possible to observe the patient's condition for a long time by comparing images taken at different times;

- various processing of cytological images (changes in brightness, contrast and scale, linear and volumetric measurements, construction and analysis of histograms, filtering, inter-frame processing, etc.);

- documentation of research results in the form of various conclusions and standardized protocols (including calculation of various clinical parameters) on a printing device (inkjet printer) with the issuance of high-quality hard copies of cytological images;

- maintaining registration logs and statistics, the ability to obtain various statistical data for the required period of time (for example, by the number of examined patients, organs, revealed pathologies, medical load, etc.).

Using the proposed device will solve the following problems:

- increase the validity of medical decisions made and ensure greater continuity of treatment and diagnostic assistance provided to patients by creating and maintaining an archive of research results and providing the possibility of operational work with the archive to specialist doctors;

- increases the flow of patient care by about 20-40% due to the refusal to keep register books, the mechanical writing of cytological conclusions and protocols, as well as due to the semi-automatic work with the database;

- significantly reduces the time (about two orders of magnitude) for the compilation of various statistical reports on studies conducted for any period of time;

- provides the ability to quickly transfer cytological images over the network to other departments of the clinic;

- provides the opportunity for electronic consultations with other medical institutions.

The device operates under Windows XP (ME, 2000) with the following minimum characteristics of a host computer:

- RAM not less than 512 MB;

- processor class Intel Pentium-1800 and higher;

- the volume of the hard disk is at least 60 GB.

- database server -InterBase 5.0 or MS SQL Server 2000. Software package 14 consists of the following interacting components:

- subsystems for maintaining a database of medical information: medical records of patients, research protocols and images;

- subsystems for inputting cytological images into a PC in real time;

- subsystems of telemedicine consultations and their recording;

- correction subsystems of built-in dictionaries;

- subsystems for processing and issuing statistical information. Functions and capabilities of the software package can be changed at the request of the Customer.

The general strategy for working with the device is as follows:

- check the current time and date on the host computer, if necessary, make appropriate adjustments using Windows commands;

- download the software package;

- using the search system to determine whether an electronic card has been previously entered into the patient or if a new one is required;

- after filling out (or making changes) the card, it is necessary to proceed to filling out the research protocol, while filling in the columns of the card or protocol is done in semi-automatic mode using a system of contextual dictionaries (the so-called "tokens");

- then, if necessary, enter the required number of images on the selected patient for this patient’s study, and record the desired images in an archive (database), with the current time and date being attached to each image;

- after recording the image in the archive, create a comment for him in which to mark in abbreviated form those or other signs of the organs under investigation or a brief diagnosis;

- if necessary, perform processing by filters, scaling, changing the dynamic range or make measurements of selected objects in the studied image;

- if necessary, conduct remote counseling;

- if necessary, make a hard copy of the images and research protocol on the printer using the print project;

- with all actions, the exit from this or that working window is carried out by pressing the left Mouse button while the cursor is on the <Exit> key.

Industrial applicability of the device for recording cytological studies is expected in the CIS.

Information sources:

1. The concept of development of the clinical laboratory diagnostics service in the Russian Federation www.medinform.biz, 07/13/2005, pp. 1-16

2. T.V. Dzhangirova, I.P. Shabalova, O.D. Solomentseva. Cytological diagnostics by video images. MSCh No. 1 AMO ZIL, Department of Clinical Laboratory Diagnostics RMAPO, Moscow, Municipal Hospital No. 1, Tula, http://www.zilhospital.ru/newscito l.htm (5Kb) 07/13/2005, p.1-3

3. Bulletin of infectology and parasitology. The system for obtaining and archiving digital images based on the Leica DM 4000B microscope, //www.infectology.ru/microscopy/. 07/13/2005, p.1-3

4. Image Sensors (CammeraChip Family) OmniVision Technologies. ODO “Premier Electric” //premier-elektric./com/ 07/26/2005. p.1-2

Claims (3)

1. A device for recording cytological studies, including a microscope, an operator’s console, the studied material, the microscope output and the input of a digital camera optically connected by an optical adapter and the digital camera’s output electrically connected through an input interface, and the control computer is input to the control computer with the results obtained displayed on a monitor and a color printer, characterized in that the optical adapter is made in the form of a system of five lenses focused among themselves with the possibility of matching The optical output of the microscope with the geometric dimensions of the CCD of the digital camera’s matrix, and the operator’s console and the host computer are equipped with infrared sensors, respectively, for synchronizing recordings to the host computer of the selected image, while one of the inputs and outputs of the host computer is connected to the monitor for displaying information from the current study in real time and improving the focusing of the received images from a digital camera, and the other input-output of the control computer via a common bus is connected with second monitor to display the results of research and remote consultation results. 2. The device according to claim 1, characterized in that it is equipped with a color image processing processor, with the ability to convert input color images in real time according to a predetermined algorithm. 3. The device according to any one of paragraphs.1 and 2, characterized in that the control computer is equipped with a module for conducting remote consultations connected via communication channels with an automated workstation of a consultant.