WO2016051005A1 - Mécanisme électromécanique permettant de localiser des lésions non palpables sur des mammographies - Google Patents

Mécanisme électromécanique permettant de localiser des lésions non palpables sur des mammographies Download PDF

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Publication number
WO2016051005A1
WO2016051005A1 PCT/ES2015/070714 ES2015070714W WO2016051005A1 WO 2016051005 A1 WO2016051005 A1 WO 2016051005A1 ES 2015070714 W ES2015070714 W ES 2015070714W WO 2016051005 A1 WO2016051005 A1 WO 2016051005A1
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WO
WIPO (PCT)
Prior art keywords
locator
lesion
mammograms
electromechanical
fenestrated
Prior art date
Application number
PCT/ES2015/070714
Other languages
English (en)
Spanish (es)
Inventor
Cecilia Elisabet GARCÍA CENA
Basil Mohammed AL-HADITHI
Antonio MARTÍN GONZÁLEZ
Original Assignee
Fundacion Para La Investigacion Biomedica Del Hospital 12 De Octubre
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 Fundacion Para La Investigacion Biomedica Del Hospital 12 De Octubre filed Critical Fundacion Para La Investigacion Biomedica Del Hospital 12 De Octubre
Publication of WO2016051005A1 publication Critical patent/WO2016051005A1/fr

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Classifications

    • 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
    • A61B6/12—Arrangements for detecting or locating foreign bodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3403—Needle locating or guiding means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser

Definitions

  • the present invention relates to a locator mechanism of non-palpable lesions on mammography.
  • the object of the invention is to establish a correlation of a lesion obtained by a digital image of a mammogram with the region to be examined, by means of a mechanism capable of moving to a previously determined point of interest, automatically, the marking of said point it will be done with a pointing indicator; Once the point is located, the corresponding radiological procedure will be performed and the mechanism will return to the starting position, to the position (0,0).
  • the final effect of the invention is developed to serve as a positioning instrument.
  • the first registered patent of a fenestrated compression plate and positioning mechanism dates from March 1981, which is registered under joint patent number US4259585.
  • the first registered patent dates from September 1987, with patent number US4691333, multi-hole compressor adaptable to the image and grating system using a grid and strap and the second of July 1990, a multi-hole compression plate adaptable to a mammography body, with patent number US4943986.
  • radio-transparent multi-grid compressors have been developed in a tennis racket arrangement.
  • the US4259585 patent presents a locating mechanism consisting of two components.
  • the locator itself located at the exit of the X-ray beam by means of a mechanical anchor, consists of a sliding system with two degrees of freedom being able to move in the plane (x, y).
  • the slider displaces from its ends, two metal rods coinciding 90 °, which, in the light of the collimator of the mammograph itself, mark the point on the lesion to be marked in the form of coordinate axes. This point is projected through the window of the fenestrated compressor.
  • alphanumeric characters are engraved on the edge of the window of the same to facilitate the location.
  • Patents US0053201 1 1A and US006507748B2 describe a locating mechanism also consisting of two components, locator and compressor fenestrated with alphanumeric characters, also located at the exit of the X-ray beam, by means of a mechanical anchor, consists of a flat gear system, for move a carrier head of a laser device in both coordinate axes, said device is fed from the mechanism itself.
  • the actuation of the mechanism for its movement through the plane (x, y) is carried out manually, just like the laser drive, which once positioned at the point of interest, is projected through the window of the Fenestrated compressor.
  • US4691333 describes a direct use device, main feature is that when performing the radiological technique of location, we only need one component, it is a radiopaque multi-perforating grid, adaptable to a chassis-holder system used in analogue mammograms, in which the processing of the image was obtained by chemical procedures and more recently by digital technology CR (Computer Radiography), the patient was placed on the multi-drilling grid and in turn on the chassis holder, through the holes of said compressor the point of interest is located, thus being able to perform the radiological procedure of location of the lesion.
  • CR Computer Radiography
  • US4943986 describes another device for direct use with multi-hole compressor, improved, and its location is on the body of the mammograph like the rest of compressors.
  • the location of the lesion is done analogously to the previous one, matching the lesion between any of the holes of the same, this can be used in both analog and digital mammographers, the disadvantage of this type of devices is in the difficulty in making coinciding the lesion between a hole and not between the opening of the hole and especially when the approach is by posterior route, the location procedure is laborious.
  • the electromechanical locator mechanism with two degrees of freedom from non-palpable lesions in a mammogram of the invention, is intended for use in a digital mammograph. Said mechanism would be placed at the exit of the beam of the equipment by means of a mechanical anchor of easy assembly-disassembly since we will only use it to signal the injury.
  • the mechanism can be adapted to any mammogram through the groove of a protective visor, located on both sides of the collimator window, or by means of an adapter on it.
  • the mechanism is constituted by a base, on which two linear precision guides for medical applications will be fixed, on its lateral face and a bridge on it that will be fixed another guide with similar characteristics bearing the indicator indicator, both will move in a way automatic in any direction of the plane, by means of the actuation of two servo motors of direct current, controlled by a control unit, this will be connected to a digital image display station, to a computer from where the exact coordinates will be sent, so this would be done at through a computer application.
  • the drive components, the servomotors will be located in the mechanism itself, the control unit and the power supply in the vicinity thereof, both will adopt a special general connection diagram.
  • the electromechanical locator mechanism is accompanied for the realization of the radiological procedure of a fenestrated compression plate, as described above, not object of the invention since any of the existing patented ones can be used, with the exception that it should be placed on the edge Outside the window of the same, a mark will indicate the point for the calibration of the electromechanical mechanism locator.
  • the locator calibration will consist of moving the locator pointer to the position (0,0) of the fenestrated compression plate.
  • One aspect to take into account with respect to calibration is the degree of compression of the breast, since this is variable according to its characteristics, so once the breast is compressed, the object in this case the Fenestrated compression plate window is enlarged in the FD / FO ratio, (FD detector focus distance) and (FO object focus distance), displacing (+ X or -X) and (+ Y or -Y) the starting point (0,0) of the locator in the image, with respect to (0,0) of the patient's breast.
  • This has its importance in the calibration itself and therefore in the precision of the mechanism when locating the lesion in the image and its correlation with the region to be examined.
  • This mechanism helps in the following radiological procedures: Pre-surgical Location for Biopsy of non-palpable lesion with needle-harpoon system and fenestrated compression plate; With the locator mechanism, the coordinates of the point chosen by the radiologist where the harpoon will be placed at the point of injury will be determined. Another application will be the location of non-palpable lesions, for its marking by means of a marker clip prior to subsequent treatment. In the location and marking of the x-ray of the surgical piece secondary to the surgery of the lesions included therein by means of a needle to facilitate its identification by the pathologist in the macroscopic study.
  • the pathologist does not identify the lesion in the macro and / or microscopic study, by locating and marking the lesion by means of a needle.
  • the pieces are radiographed after fixation in formalin. Given the difficulty of locating the lesion / lesions, in this case, the locator mechanism would be performed immediately.
  • Another application for this device is the location of lesions in the mammography image and its correlation with the region itself to be examined that will help us to locate these lesions in other stereotactic equipment to perform biopsies by procedures stereotaxics, since mammography can be performed and the exact point of interest on the patient can be marked on the patient, thus facilitating the location of lesions of interest in the most complex cases.
  • the described locator is designed for use in digital mammography and serves as a positioning instrument, matching the correlation between a lesion obtained in mammography and the patient's own breast, precisely, by interconnecting the elements corresponding to an application computing, a control unit, a linear actuator and two direct current servomotors.
  • the electromechanical locator mechanism can be mounted on any digital mammograph, on the groove of the protective visor or by means of a small adapter on the base of it. Given the characteristics of the preliminary design (dimensions, size, physical characteristics) it is a simple mechanism, easy assembly / disassembly and simple calibration.
  • Figure 1 It shows a perspective view of the electromechanical locator mechanism, which shows the output of the X-ray beam, and all the components of the mechanism.
  • Figure-2 Shows a perspective view of the location of the electromechanical locator mechanism, on a generic digital mammograph, with its main elements assembled.
  • Figure-3 Shows an exploded view of the mechanism components.
  • Figure-4 It shows a perspective view of the electromechanical locator mechanism and the fenestrated compression plate.
  • Figure-5 It shows the general connection diagram of the electromechanical locator mechanism, the components that integrate it and the interrelation between them.
  • Figure-6 It shows the flowchart of the computer application installed in the display station, where we start from a file in which the same.
  • Figure-7 Shows the display station, once inside the location application.
  • Figure-8 It shows the location application, in which we can see the calibration point (14) printed on the mammogram in the two projections as well.
  • Figure-9 It shows a compressed breast resting on a mammogram detector with a fenestrated compression plate.
  • Figure-10 It shows an interconnection flow diagram of the application, where the locator mechanism intervenes, with other stereotactic equipment.
  • Figure-1 Shows the appearance of a DC servo motor.
  • Figure-12 Shows the appearance of the control unit.
  • the electronic locator mechanism which according to figure 1, comprises a base (2) of the mechanism assembly, in which two linear guides to both are established sides, that is to say on each of the longitudinal sides, said guides corresponding to the reference (3) of that figure 1.
  • a bridge (4) with its corresponding linear guide (5) is moved, according to a linear displacement on the X axis, and on whose bridge (4) the laser pointing pointer (1) is also mounted. , serving this to mark the point of the injury that interests.
  • Figure 2 shows the electromechanical mechanism locator on a generic digital mammograph (6), with its main elements assembled.
  • a fenestrated compression plate (7) is arranged, which is movable upwards / downwards along said mammograph (6).
  • the electromechanical locator mechanism to perform the radiological procedure is placed on the groove of the protective visor (8), at the exit of the X-ray beam (9).
  • Figure 4 shows a perspective view of the same electromechanical locator mechanism with the components already described, as well as the fenestrated compression plate (7) shown in Figure 2, the point corresponding
  • Figure 5 shows the general connection diagram of the electromechanical locator mechanism that is being described, with the components that integrate it and the interrelation between them, including what can be considered a viewing station (1 1), with monitor (12 ) and PC (13) seeing the control unit (14), the linear actuator (15), fed through alternating current control voltage (16) and also showing the blocks corresponding to the servomotors (16) and ( 17), all related to the considered electromechanical locator mechanism represented, in this figure 5, by the block (18).
  • the control unit (14) being responsible for the actuation of the servomotors (16) and (17), which will allow the guides (3) to move, and as Last purpose, bring the pointing pointer (1) to the desired point.
  • the referred set will have a supply voltage controlled by the control unit (14) and by the application itself.
  • Figure 6 shows a flow chart of the computer application installed in the viewing station (1 1), starting from a file (19) in which that viewing station (1 1) is located.
  • the mechanism will have been placed in the mammograph, on the corresponding groove of the protective visor (8) shown in figure 2.
  • the locator calibration is continued, consisting of moving the locator pointer to the position (0 ⁇ ) of the compression plate (7), this information being sent to the locator via WIFI, afterwards the examination is started and the guided location of the lesion is carried out, by means of a grid that corresponds to the block (27) of that figure 6, grid (27) that is recorded in the application, the position being sent to the locator desired, through the block (28), continuing with the radiological procedures, according to the block (29), moving with the last mammogram (30) so that the locator is outside the radiation field, according to the block (31), ending , by block (32), what is the procedure performed.
  • Figure 7 shows the display station that had been referenced with (1 1) in Figure 5, once inside the location application, showing at the bottom of the screen, the location grid (32) that logically corresponds to the block (27) corresponding to the diagram of Figure 6. On that location grid (32) the mammogram of the breast (33), compressed, will be performed with the fenestrated compression plate (7).
  • Figure 8 shows the location application, in which you can see the calibration point (34) printed on the mammogram, in the two projections as well.
  • a compressed breast (35) is shown, resting on a detector (36) of a digital mammograph, with the fenestrated compression plate (7).
  • the focal point F the distance between F and D between said focal point F and the detector, and the distance FO between the focal point F and the object, as well as the starting point (0 ⁇ ) of the locator .
  • the window (1 1) of the fenestrated compression plate (7) is enlarged in the ratio FD / FO, an important factor in the calibration and in the precision of the mechanism when locating the lesion.
  • Figure 10 shows the flow diagram of the interconnection of the application, where the locator flow mechanism ends with the stereotactic equipment, so that the location and marking of an injury, with the locator mechanism, will facilitate the task to the time to perform other radiological procedures such as stereotactic biopsies in the most complex cases.
  • FIG. 10 shows the block, the stereotactic equipment (39), the monitor (12) with the PC (13) already referred to in figure 6, the stereotaxy station (40) the mammography station (41), the information block (42), the lesion locator (43) and the corresponding marker (44), and the direct current servo motor and the corresponding control unit to references (17) and (14) respectively of Figure 5.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Animal Behavior & Ethology (AREA)
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  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • High Energy & Nuclear Physics (AREA)
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  • Apparatus For Radiation Diagnosis (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

Le mécanisme comprend un pointeur indicateur laser (1) déplaçable de manière linéaire sur la région correspondante à étudier de la poitrine de la patiente, lequel pointeur indicateur laser s'arrête en un point correspondant à des coordonnées (x,y) déterminées auparavant, en fonction du point exact de la lésion à localiser, de sorte qu'une fois la lésion localisée dans le plan, le mécanisme ou dispositif revient à la position (0Ό). Le mécanisme comprend essentiellement une base (2) comportant deux guides linéaires (3) et un pont (4) déplaçable sur lesdits guides et portant un autre guide ainsi qu'un pointeur indicateur laser (1), de sorte que les déplacements peuvent être effectués dans n'importe quelle direction au moyen de deux servomoteurs (16) et (17), qui sont commandés par une unité de commande (14) reliée à une station de visualisation (1 1) d'image numérique qui avec un écran (12) et le PC correspondant (13) recevront les coordonnées exactes par le biais d'une application informatique. L'image qui montre la région est fournie par un mammographe numérique (6).
PCT/ES2015/070714 2014-10-01 2015-10-01 Mécanisme électromécanique permettant de localiser des lésions non palpables sur des mammographies WO2016051005A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ES201431446A ES2532523A1 (es) 2014-10-01 2014-10-01 Mecanismo electromecánico localizador de lesiones no palpables en mamografías
ESP201431446 2014-10-01

Publications (1)

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WO2016051005A1 true WO2016051005A1 (fr) 2016-04-07

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107773257A (zh) * 2016-08-24 2018-03-09 南京普爱医疗设备股份有限公司 一种用于医用x射线机的c形臂拆装运输机构

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4259585A (en) * 1977-11-28 1981-03-31 Robert Novak X-ray examination apparatus
US5320111A (en) * 1992-02-07 1994-06-14 Livingston Products, Inc. Light beam locator and guide for a biopsy needle
WO2000044281A1 (fr) * 1999-02-01 2000-08-03 Ultratouch Corporation Appareil et procedes permettant de deceler les anomalies dans les tissus humains
US20090299218A1 (en) * 2005-08-22 2009-12-03 Wolfgang Holler Compression plate for a mammography unit and a mammography unit

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP3431303B2 (ja) * 1994-09-12 2003-07-28 株式会社東芝 乳房撮影装置

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4259585A (en) * 1977-11-28 1981-03-31 Robert Novak X-ray examination apparatus
US5320111A (en) * 1992-02-07 1994-06-14 Livingston Products, Inc. Light beam locator and guide for a biopsy needle
WO2000044281A1 (fr) * 1999-02-01 2000-08-03 Ultratouch Corporation Appareil et procedes permettant de deceler les anomalies dans les tissus humains
US20090299218A1 (en) * 2005-08-22 2009-12-03 Wolfgang Holler Compression plate for a mammography unit and a mammography unit

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
MOLINA: "Avances in las Técnicas of Imagen para the Diagnóstico from Mama'';", October 2011 (2011-10-01), Retrieved from the Internet <URL:http://www.fatedocencia.info/1002/1002.pdf.> *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107773257A (zh) * 2016-08-24 2018-03-09 南京普爱医疗设备股份有限公司 一种用于医用x射线机的c形臂拆装运输机构

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