WO2010064049A1 - Repère radiographique - Google Patents

Repère radiographique Download PDF

Info

Publication number
WO2010064049A1
WO2010064049A1 PCT/GB2009/051650 GB2009051650W WO2010064049A1 WO 2010064049 A1 WO2010064049 A1 WO 2010064049A1 GB 2009051650 W GB2009051650 W GB 2009051650W WO 2010064049 A1 WO2010064049 A1 WO 2010064049A1
Authority
WO
WIPO (PCT)
Prior art keywords
marker
patient
strip
adhesive
fold
Prior art date
Application number
PCT/GB2009/051650
Other languages
English (en)
Inventor
David Brettle
Andrew Forbes
Andrew Spragg
Original Assignee
The Leeds Teaching Hospitals Nhs Trust
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The Leeds Teaching Hospitals Nhs Trust filed Critical The Leeds Teaching Hospitals Nhs Trust
Priority to GB1109049.5A priority Critical patent/GB2477687B/en
Publication of WO2010064049A1 publication Critical patent/WO2010064049A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment

Definitions

  • the present invention relates to a marker and in particular to a marker which can be imaged using x-rays to determine the magnification of an x-ray image.
  • the x-ray image of the body part is usual subject to a degree of magnification so that the size of the body part in the image is greater than, or lesser than, the actual size of the body part.
  • the size of the image of the disk only accurately determines the magnification of the image at the height position of the disk on the patient's skin and not the actually magnification below the patient's skin for the anatomical feature of interest.
  • a first aspect of the invention provides a marker for determining the magnification of an X-ray image comprising: a circular member of a material imageable by x-rays; and a support for holding the circular member away from the surface of a patient.
  • the support can be releasably attachable to the patient adjacent a body part to be imaged using x-rays.
  • the support holds the x-ray imageable circular marker away from the patient, it prevents the marker obscuring the x-ray image of the body part. Further as the support can be releasably attached to the body part it is possible to position the marker at a preferred position relative to the body part so that the magnification of the x-ray image at that preferred position can be accurately determined. Hence, the size of the patient's body part at the preferred position can be more accurately determined.
  • the support can bear an adhesive by which the marker can be releasably attached to the body part.
  • the support can bear a single patch or portion of adhesive or can bear multiple portions or patches of adhesive.
  • the adhesive can be releasably attached to skin, and more preferably human skin.
  • the marker can include a mechanism by which the marker can be releasably attached to the patient.
  • the mechanism can be a mechanical mechanism.
  • the mechanism can be in the form of a clip or a press or push fit mechanism.
  • the mechanism can be a suction device, such as a suction cup or similar.
  • the mechanism can be a strap or straps.
  • the mechanism can be calipers or similar.
  • the mechanism can be attached to the support part of the marker.
  • the support part of the marker can be movable relative to the mechanism. This can allow the position of the marker to be adjusted.
  • the circular member can have any form with a circular perimeter.
  • the circular member can be a disc.
  • the circular member is a ring or loop as they are light weight and easier for the support to hold.
  • the circular member can have an outer diameter of between approximately 10mm and 50mm.
  • the outer diameter is between about 20mm and 40mm and more preferably the outer diameter is approximately 25mm or 30mm.
  • the circular member can be of a material which is substantially x-ray opaque.
  • the material can be or include a metal.
  • the material can be an alloy or substantially pure metal.
  • the material can be stainless steel, steel, zinc or lead or an alloy or compound including any of these materials.
  • the circular member can be made of sufficient material that the circular member is sufficiently non-transmissive to x-rays that the circular member will be discernable in an x-ray captured under typical x-ray imaging conditions
  • the support can include at least one portion extending from the circular member and by which the marker can be attached to the patient.
  • the at least one portion can extend from a side of the circular member.
  • the marker can have a generally 'L' shape.
  • a body of the support can bear the circular member and a foot part of the support can be releasably attachable to the patient.
  • the support can include a first portion extending from a first side of the circular member.
  • a second portion can extend from a second opposed side of the circular member.
  • a one of or each of the first and second portions can bear an adhesive.
  • the support can be in the form of a strip of material.
  • the strip of material can be a length of medical or surgical tape.
  • At least a portion of the support can be flexible so that the portion of the support can conform to the shape of the patient's body part to which the marker is to be attached.
  • the material is preferably sufficiently rigid to support the member away from the patient's body part.
  • the support may include a flexible portion or portions which can conform to the shape of the patient's body part and another portion or portions which are less flexible and which bear the marker.
  • the strip of material can include at least one fold.
  • the strip of material can include a plurality of folds.
  • the or each fold can define a patient engaging portion, or portions, of the marker and a marker portion, or portions, which bear the circular member.
  • the plurality of folds can have senses of folding which cause the strip to be foldable in a generally zig-zag or concertina form.
  • the strip of material can include three folds.
  • a first fold can be located toward a first end of the strip of material.
  • a second fold can be located at the centre of the strip of material.
  • a third fold can be located toward a second end of the strip of material. The first and third fold can have the same sense of folding and the second fold can have an opposite sense of folding.
  • the marker can include adhesive on a first patient engaging surface of a portion of the strip of material between the first fold and the first end.
  • the marker can include adhesive on a second patient engaging surface of a portion of the strip between the third fold and the second end.
  • the marker can further include a fastener for holding a first central portion of the strip between the first fold and the second fold and a second central portion of the strip between the second fold and the third fold together.
  • the circular marker can be borne by the first central portion or the second central portion.
  • the fastener can be a permanent fastener or a releasable fastener.
  • the fastener can be a mechanical fastener, such as a push fit, press fit, snap fit or hook and eye type fastener.
  • the fastener can comprise an adhesive material borne by the first central portion or second central portion so as to allow the first central portion and second central portions to be secured together.
  • the fastener further can comprise a raised member which stands proud of the surface of the strip and in registration with the adhesive.
  • the raised member can be substantially as thick as the thickness of the circular member. A free end of the raised member can bear the adhesive.
  • the marker can further comprise a backing cover removable from the marker to allow the marker to be releasably attached to the patient.
  • the backing cover covers the adhesive material of the marker and is removable to expose the adhesive material.
  • a second aspect of the invention provides a method for determining the magnification of an x-ray image of a body part of a patient, comprising: releasably attaching a marker including a circular member of material imageable by x-rays to an outer surface of the patient adjacent the body part and with the circular member standing away from the surface of the patient; capturing an x-ray image including at least a part of the body part of the patient and the circular member; determining the size of the largest dimension of the image of the member in the captured x-ray image; and using the determined size of the largest dimension to calculate the magnification of the x-ray image.
  • the whole of the circular member is imaged.
  • the method can further comprise releasably attaching the circular member using an adhesive.
  • the circular member can be releasably attached to the skin of the patient.
  • the method can further comprise retrieving a marker from a dispenser storing a plurality of markers.
  • the method can further comprise removing a backing cover from an adhesive part of the marker prior to releasably attaching the marker to the patient.
  • Figure 1 shows a perspective view of a first embodiment of an x-ray marker according to the invention
  • Figure 2 shows a schematic partial cross sectional view of the marker of Figure 1 attached to a patient's limb in use
  • Figure 3 shows a perspective view of a second embodiment of an x-ray marker according to the invention
  • Figure 4 shows a side view of the marker of Figure 3 with a cover
  • Figure 5 shows a schematic side view of a dispenser holding a plurality of markers as shown in Figure 4
  • Figure 6 is a perspective view of the marker of Figure 3 during a stage of assembly prior to use
  • Figure 7 shows a schematic perspective view of the marker of Figure 3 attached to a patient's knee during use
  • Figure 8 shows a third embodiment of a marker according to the invention.
  • the marker 100 can be used to determined the magnification of an x-ray image of a patient's body part, e.g. a leg.
  • a patient's body part e.g. a leg.
  • the marker can be used in connection with any body part for which it is useful to be able accurately to determine the degree of magnification of the x-ray image.
  • the marker includes a circular member 110 in the form of a circular ring or loop.
  • the ring 110 is made of a material which is sufficiently opaque to x-rays that an image of the ring will be discernable in an x-ray image.
  • the ring can be made of a number of materials, including stainless steel, steel, lead, an alloy, solder or a zinc based material. The material is chosen to make the ring light while also ensuring that it will be clearly imaged under typical x-ray imaging conditions.
  • the ring 110 can be made from a loop of wire in which the wire itself has a circular cross-section. A circular cross-section eliminates a possible penumbra effect which can occur when x-rays pass through the edges of a material.
  • the ring 110 is circular and has a diameter of approximately 25mm. It will be appreciated that rings of other dimensions can be used. However, a 25mm ring can be preferred as image processing algorithms already exist to identify images of 25mm diameter discs in x-ray images and therefore a 25mm diameter ring will allow images to be generated which can be processed using various existing algorithms and software routines.
  • the marker 100 also includes a support 120 in the form of a strip of adhesive tape.
  • the support 120 acts to hold the ring 110 generally erect and away from the surface of the patient's limb when the marker is attached to a patient in use, as will be described in greater detail below. Holding the marker away form the patient's limb helps to prevent the image of the marker obscuring any of the anatomy of the patient which is being imaged.
  • the tape 120 can be a specially designed and fabricated product or can be a conventional medical tape as currently used and available, e.g. a micropore tape, a duopore tape, a claripore tape or a transpore tape.
  • the width of the tape is much less than the length of the tape so that the tape only covers a small portion of the diameter of the ring.
  • the length of the tape is chosen to be sufficient to allow sufficient adherence of the tape to the patient so as to prevent easy dislodgement of the marker when in position. This will also depend on the strength of the adhesive present on the underside of the tape and the weight of the ring 110.
  • Figure 2 illustrates use of the marker 100 during the capture of an x-ray image of a patient's body part.
  • an x-ray camera 210 acts as a source of x- rays 212 which pass through a patient's body part, e.g. thigh 214, and are captured by x- ray detector 216.
  • X-ray detector 216 may be a digital device or an analogue device, such as a conventional x-ray film in a cassette.
  • the x-rays 212 from the x-ray camera 210 diverge as they travel between the camera and x-ray imaging device 216.
  • the degree of magnification of the patient's body part varies from the upper surface of the body part 218 (closer to the x-ray source) to the lower part of the body part 220 (further from the x-ray source).
  • the marker 100 of the present invention allows a more accurate determination of the magnification of the x-ray image at a preferred position within the patient's body part.
  • the marker 100 may be attached adjacent to a patient's knee and at a particular "height" position (in the anterior-posterior direction) so that the surgeon can more accurately size an orthopaedic implant to use in an arthroplasty procedure to be carried out on the knee.
  • the marker 100 has been attached to the skin at the side of the patient's leg with the ring 110 standing generally erect and away from the surface of the patient's leg and at a height corresponding generally to a plane represented by dashed line 222.
  • the tape 120 is flexible and so can conform to the local curved shape of the patient's leg and allows ring 110 to stand away from the patient's leg and therefore the captured image of the ring will not obstruct or obscure any of the patient's anatomy in the captured image of the leg.
  • a magnification factor for the x-ray image can be determined by comparison with the actual size of the largest dimension of the ring, which is known (2.5cm). Further, as the ring is a circle, no matter what angle relative to the plane of the circle the x-ray image is captured at, the largest dimension of the captured image of the ring (which will vary from a straight line, through ovals to a circle) will always correspond to the diameter of the circle. Therefore, even if the ring is not perfectly parallel to the imaging plane of the x- ray detector 216, it will always be possible to determine the magnification factor from the captured image of the ring.
  • the marker includes a circular ring or loop 310 of a substantially x-ray opaque material, similar to loop 110 of the first embodiment 100.
  • the circular loop 310 is mounted on a support 320 in the form of a substrate 320 made of a flexible plastics material.
  • the strip of plastics material has first 322, second 324 and third 326 fold lines.
  • a first end of the substrate and the first fold line 322 define a first portion 328 of the substrate 320 which bears a first patch 330 of adhesive.
  • the first fold line 322 and second fold line 324 define a second portion 332 of the substrate.
  • the second fold line 324 and third fold line 326 define a third portion 334 of the substrate to which the ring 310 is attached.
  • a portion of double sided sticky tape 336 is provided on the third portion of the substrate and toward the centre of ring 310.
  • the third fold line 326 and second end of the substrate define a fourth portion 338 of the substrate on which a second patch of adhesive 340 is provided.
  • the first and second fold lines have the same sense of folding which is opposed to the sense of folding of the second fold line 324 so that the substrate naturally has a slightly zig zag or concertina form, which facilitates assembly of the marker prior to use.
  • the marker can also include a cover 342 in the form of a releasable cover or backing strip which is mounted on and attached to the marker by the action of adhesive patches 330, 336 and 340.
  • the cover strip facilitates easy use and handling of the marker prior to its assembly for attachment to a patient.
  • Figure 5 shows a schematic side view of a dispenser 400 holding a plurality of separate makers 401, 402, 403 (and as represented by dashed lines within the dispenser).
  • the dispenser 400 is generally in the form of a rectangular box having a similar length and width as the marker and cover assembly and having sufficient depth to hold a usefully large number of markers, e.g. several tens.
  • a cut away lower corner 410 of the housing of the dispenser includes a flap portion 412 extending from a base of the housing of the dispenser.
  • a radiologist simply grips and pulls on a one of the exposed marker/cover assemblies to remove it from the housing and the remaining markers are gravity fed to replace the removed one.
  • the marker/cover assembly can be provided joined together in a continuous strip, which can be in a roll, in which the cover and substrate are each provided as part of a continuous roll of material.
  • the individual markers are defined by perforations across the width of the stip so that an end most marker/cover assembly can be removed from the free end of the roll by simply tearing off the marker and cover from the roll of marker/cover assemblies.
  • the radiographer removes a marker and cover assembly from the housing 400 and removes the backing strip 342 to expose the adhesive parts of the marker.
  • the folds 322, 324, 326 are arranged to give the marker a slight zig zag or concertina shape, hi order to assemble the marker for use, the second 332 and third 334 portions of the substrate are folded toward each other, as illustrated by arrows 350, 352, about fold line 324 as illustrated in Figure 6.
  • Adhesive patch 336 is contacted with the mating surface of second portion 332 and holds the second and third portions together so that the marker has a generally "T" shape.
  • Patch 336 extends slightly from the surface of the third portion 334 so as to compensate for the finite thickness of loop 310 of radio opaque material when in the form of a wire.
  • loop 310 maybe printed on substrate 320 and therefore have negligible thickness.
  • the first and fourth portions of the support can be pushed outward about respective fold lines 322 and 326 if required.
  • Figure 7 shows the marker 300 attached adjacent the knee 500 of a patient's leg 502.
  • the marker 300 is attached to the patient's skin with the first portion 328 and fourth portion 338 of the substrate flexing to match the local curvature of the patient's leg.
  • the marker 300 is attached with the ring 310 at a height corresponding generally to the part of the anatomy which the surgeon wants to image and accurately determine the size of.
  • the ring 310 stands erect and away from the surface of the patient's skin and does not obstruct the anatomy to be imaged.
  • parts 338 and 328 of the support can flex to match the local curvature of the surface of the patient's leg, this tends to allow the part of the support bearing ring 310 to stand generally perpendicular to the part of the leg to which it is attached rather than being inclined as tends to be the case if the support parts 338, 328 can not flex or bend to match the curvature of the surface of the body part.
  • the marker can be attached before or after the patient is positioned on the x-ray imaging equipment. An x-ray image of the patient's knee and the marker is then captured, ensuring that the whole of the ring 310 is imaged.
  • the plane of the ring 310 should be generally parallel to the imaging plane of the x-ray detection device 216.
  • the marker can be removed and replaced on the patient's joint in a different position, if it is necessary to capture x-rays from different directions.
  • the adhesive used on the marker is preferably a reusable adhesive.
  • the adhesive should be sufficient to allow the marker to be robustly attached to the patient's skin, or to a covering or outer garment of the patient, so as to allow the marker to be self-supporting, but while also allowing the marker to be removed without hurting or harming the patient.
  • the x-ray image can then be processed as normal and the size of the image of the ring can be measured either using automated image processing techniques or manually, for example using a ruler or a template. By comparing the measured size of the ring in the image with the known diameter of the ring, the magnification factor for the x-ray image can be accurately determined.
  • Figure 8 shows a perspective view of a third embodiment of the marker 600.
  • Marker 600 includes a circular ring 610 of substantially x-ray opaque material similar to that used in the other embodiments.
  • the support 620 is in the form of a strip of flexible plastics material having a single fold 622 which defines a patient engaging portion 624 and a ring bearing portion 626.
  • a patch of adhesive material 628 is provided on a skin engaging side of the first portion 624.
  • the marker has a generally L shaped configuration and similarly to the second embodiment can be provided in a generally flat initial configuration with a cover which is removed prior to attachment of the marker to the skin of a patient.
  • a circular ring or loop has been used, it will be apparent that a circular disc, or any other form having a circular perimeter can be used.
  • ring 310 could be replaced by a disc of substantially x-ray opaque material deposited by printing, e.g. a lead based ink or paint.
  • a ring or loop it can be beneficial to use a ring or loop as that reduces the weight and therefore the strength of the support structure and/or adhesive used to attach the marker to the patient.
  • the marker can be attached directly to the patient's skin but could also be attached to a cover or clothing of the patient provided that does not move relative to the patient during imaging.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Pathology (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Optics & Photonics (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • Apparatus For Radiation Diagnosis (AREA)

Abstract

La présente invention concerne un repère pour utilisation dans la détermination du grossissement d’une image radiographique et un procédé associé. Le repère comprend un élément circulaire d’un matériau pouvant être soumis à imagerie par radiographie et un support pour maintenir l’élément circulaire à l’écart de la surface d’un patient. Le support soutient un adhésif par lequel le repère peut être fixé de manière réversible au patient à proximité d’une partie du corps à soumettre à imagerie en utilisant des rayons X. Une image radiographique de la partie du corps du patient et de l’élément circulaire est acquise. La taille de la plus grande dimension de l’image du membre dans l’image radiographique acquise est déterminée et utilisée pour calculer le grossissement de l’image radiographique.
PCT/GB2009/051650 2008-12-04 2009-12-04 Repère radiographique WO2010064049A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB1109049.5A GB2477687B (en) 2008-12-04 2009-12-04 X-ray marker

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0822155.8 2008-12-04
GBGB0822155.8A GB0822155D0 (en) 2008-12-04 2008-12-04 Marker

Publications (1)

Publication Number Publication Date
WO2010064049A1 true WO2010064049A1 (fr) 2010-06-10

Family

ID=40289493

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2009/051650 WO2010064049A1 (fr) 2008-12-04 2009-12-04 Repère radiographique

Country Status (2)

Country Link
GB (2) GB0822155D0 (fr)
WO (1) WO2010064049A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2015157418A3 (fr) * 2014-04-08 2016-06-02 Sizer Llc Dispositif de mesure de la taille de vaisseaux sanguins
US9375167B2 (en) 2012-03-22 2016-06-28 Sizer Llc Blood vessel sizing device
US9408586B2 (en) 2012-03-22 2016-08-09 Sizer Llc Blood vessel sizing device
US10143533B2 (en) 2016-10-06 2018-12-04 Sizer Llc Blood vessel sizing device
US11419523B2 (en) 2012-03-22 2022-08-23 Sizer Llc Blood vessel sizing device and method for sizing blood vessel

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3836776A (en) * 1973-03-01 1974-09-17 E Gullekson Three dimensional x-ray opaque foreign body marker device
US5193106A (en) * 1990-08-28 1993-03-09 Desena Danforth X-ray identification marker
US5216700A (en) * 1992-02-18 1993-06-01 George Cherian Tape having graduated scale providing location indicia during x-ray processes
US5232452A (en) * 1991-12-13 1993-08-03 Beekley Corporation Radiology marker system and dispenser
US20040086082A1 (en) * 2002-11-05 2004-05-06 Eastman Kodak Company Method for automatically producing true size radiographic image

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3836776A (en) * 1973-03-01 1974-09-17 E Gullekson Three dimensional x-ray opaque foreign body marker device
US5193106A (en) * 1990-08-28 1993-03-09 Desena Danforth X-ray identification marker
US5232452A (en) * 1991-12-13 1993-08-03 Beekley Corporation Radiology marker system and dispenser
US5216700A (en) * 1992-02-18 1993-06-01 George Cherian Tape having graduated scale providing location indicia during x-ray processes
US20040086082A1 (en) * 2002-11-05 2004-05-06 Eastman Kodak Company Method for automatically producing true size radiographic image

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9375167B2 (en) 2012-03-22 2016-06-28 Sizer Llc Blood vessel sizing device
US9408586B2 (en) 2012-03-22 2016-08-09 Sizer Llc Blood vessel sizing device
US10244966B2 (en) 2012-03-22 2019-04-02 Sizer Lllc Blood vessel sizing device
US10314519B2 (en) 2012-03-22 2019-06-11 Sizer Llc Blood vessel sizing device
US11419523B2 (en) 2012-03-22 2022-08-23 Sizer Llc Blood vessel sizing device and method for sizing blood vessel
WO2015157418A3 (fr) * 2014-04-08 2016-06-02 Sizer Llc Dispositif de mesure de la taille de vaisseaux sanguins
EP3245951A1 (fr) * 2014-04-08 2017-11-22 Sizer LLC Dispositif de mesure de la taille de vaisseaux sanguins
US10143533B2 (en) 2016-10-06 2018-12-04 Sizer Llc Blood vessel sizing device

Also Published As

Publication number Publication date
GB0822155D0 (en) 2009-01-14
GB2477687B (en) 2013-04-10
GB2477687A (en) 2011-08-10
GB201109049D0 (en) 2011-07-13

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