WO2021133359A1 - A more efficient novel system with modernized conventional coronary angiography device - Google Patents

A more efficient novel system with modernized conventional coronary angiography device Download PDF

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Publication number
WO2021133359A1
WO2021133359A1 PCT/TR2020/051392 TR2020051392W WO2021133359A1 WO 2021133359 A1 WO2021133359 A1 WO 2021133359A1 TR 2020051392 W TR2020051392 W TR 2020051392W WO 2021133359 A1 WO2021133359 A1 WO 2021133359A1
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angiography
detector
image
cdte
angiography device
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PCT/TR2020/051392
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French (fr)
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Mehmet BAYBURT
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Selcuk Universitesi
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    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01L—SEMICONDUCTOR DEVICES NOT COVERED BY CLASS H10
    • H01L27/00—Devices consisting of a plurality of semiconductor or other solid-state components formed in or on a common substrate
    • H01L27/14—Devices consisting of a plurality of semiconductor or other solid-state components formed in or on a common substrate including semiconductor components sensitive to infrared radiation, light, electromagnetic radiation of shorter wavelength or corpuscular radiation and specially adapted either for the conversion of the energy of such radiation into electrical energy or for the control of electrical energy by such radiation
    • H01L27/144—Devices controlled by radiation
    • H01L27/146—Imager structures
    • H01L27/14601—Structural or functional details thereof
    • H01L27/14609—Pixel-elements with integrated switching, control, storage or amplification elements
    • 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
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computed tomography [CT]
    • A61B6/032—Transmission computed tomography [CT]
    • 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
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computed tomography [CT]
    • A61B6/037—Emission tomography
    • 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
    • A61B6/48—Diagnostic techniques
    • A61B6/486—Diagnostic techniques involving generating temporal series of image data
    • A61B6/487—Diagnostic techniques involving generating temporal series of image data involving fluoroscopy
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01L—SEMICONDUCTOR DEVICES NOT COVERED BY CLASS H10
    • H01L27/00—Devices consisting of a plurality of semiconductor or other solid-state components formed in or on a common substrate
    • H01L27/14—Devices consisting of a plurality of semiconductor or other solid-state components formed in or on a common substrate including semiconductor components sensitive to infrared radiation, light, electromagnetic radiation of shorter wavelength or corpuscular radiation and specially adapted either for the conversion of the energy of such radiation into electrical energy or for the control of electrical energy by such radiation
    • H01L27/144—Devices controlled by radiation
    • H01L27/146—Imager structures
    • H01L27/14643—Photodiode arrays; MOS imagers
    • H01L27/14654—Blooming suppression
    • H01L27/14656—Overflow drain structures
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01L—SEMICONDUCTOR DEVICES NOT COVERED BY CLASS H10
    • H01L27/00—Devices consisting of a plurality of semiconductor or other solid-state components formed in or on a common substrate
    • H01L27/14—Devices consisting of a plurality of semiconductor or other solid-state components formed in or on a common substrate including semiconductor components sensitive to infrared radiation, light, electromagnetic radiation of shorter wavelength or corpuscular radiation and specially adapted either for the conversion of the energy of such radiation into electrical energy or for the control of electrical energy by such radiation
    • H01L27/144—Devices controlled by radiation
    • H01L27/146—Imager structures
    • H01L27/14683—Processes or apparatus peculiar to the manufacture or treatment of these devices or parts thereof
    • H01L27/14696—The active layers comprising only AIIBVI compounds, e.g. CdS, ZnS, CdTe
    • 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
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/503—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of the heart
    • 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
    • A61B6/54—Control of apparatus or devices for radiation diagnosis
    • A61B6/542—Control of apparatus or devices for radiation diagnosis involving control of exposure

Definitions

  • the present invention relates to a device that is developed for diagnosing whether there is an occlusion in coronaries and treatment thereof in the medical field.
  • the present invention particularly relates to creating a novel type of angiography device developed to be more rapid, in a smaller size, lighter, and more efficient by removing the detectors used in coronary angiography device and, instead, adapting a semiconductor detector.
  • Coronary artery disease is the narrowing or blockage of the coronary arteries, generally due to atherosclerosis (vessel stiffness) .
  • Atherosclerosis also known as hardening or blockage of the arteries, is a buildup of cholesterol and fatty deposits (called plaque) on the inner walls of the arteries. These plaques may limit the blood flow to the heart muscle by clogging the arteries physically or by causing aberrant artery tone or function. Without adequate blood flow, the heart's need for oxygen and the vital nutrients for functioning properly cannot be met. This causes chest pain that is called angina.
  • Angine is an alerting symptom of heart disease. Even though the symptoms of the heart attack (myocardial infarctus) are similar with angine, they are two separate diseases.
  • a heart attack (injury to the heart muscle) may occur.
  • the treatment of coronary artery disease consists of reducing the risk factors, intake of drugs as prescribed, possibly, invasive and/or surgical interventions and regular medical checks.
  • the treatment of coronary artery is crucial for reducing the risk of having a heart attack or a stroke.
  • Coronary angio is a diagnosis method that images coronary vessels that nourishes the heart.
  • Angiography with its common use fluoroscopic systems, is an x- ray imaging method. It comprises an X-ray device and a detector system to sense X-rays. The imaging procedure is performed by giving an X-ray absorbent (contrast material) to patient. Imaging physics is based on the principle that as the x-ray passes through the material, in other words, through the patient, the tissue it passes through, creates an image depending on the X-ray absorption amount. In this method, as a subtraction technique, the image is taken without absorbent and the image is taken by giving absorbent. The two images are subtracted from each other and by this way only the vessel image remains.
  • the image quality depends on the density of the X-ray used and most importantly the detector system.
  • Conventional Angiography is a system where two films are generated by projecting the X-ray on the film and then, the point-to-point subtraction process is implemented between these films.
  • Systems that use scintillation detector can be grouped in three types as follows: First group systems where a detector named image intensifier is used. In these systems, Csl type scintillation detectors are used. This detector converts incoming X-rays into visible light. The image is formed by increasing the density of this light and projecting it on phosphor screen. This image is digitalized by scanning with a vidicon camera. In the second group system, Csl type scintillation detector is also used. The image intensifier is used.
  • the light is not reflected on the phosphor screen, but a digital image is obtained by dropping it on a CCD camera chip.
  • the detector used in the third group system is also the Csl scintillation detector, but the CCD camera is attached right to the detector. These are called as amorphous structured systems.
  • Angiography which is generally done on the inguinal area, can now be done on the wrist (radial artery). Coronary angiography can be done through the inguinal vessel (femoral artery) or wrist (radial artery) to monitor the heart vessels. If there is an anomaly related to these vessels, the angiography procedure can be done through other vessels occasionally. Basically, in this technique, a sheath is placed inside the vessel after local anesthesia is applied to the entry site.
  • the vessels that nourish the heart are reached by means of a catheter (1.5-2 mm) inserted through the vessel sheath, and then the film of the coronary vessels is obtained by injecting the opaque material (dye) to the coronary vessels through the catheter. Since the concentration of the dye material decreases when it is mixed into the blood and the blood in the vessel is in motion, the image to be obtained covers a very short period.
  • the vessel sheath is removed, and the pressure is applied for 10-20 minutes to stop bleeding.
  • the angio procedure carried out from the inguinal vessel (femoral artery) it is more troublesome for the patient because of staying in bed for at least 4-6 hours after the procedure and vascular problems may occur compared to the procedures carried out through the arm.
  • inguinal vessel that is larger in order to perform some complex balloon-stent procedures.
  • Performing the angio procedure from the wrist vessel (radial artery) is more advantageous than inguinal angio in terms of patient comfort.
  • the patient can be discharged immediately.
  • the probability of angio-related problems in the wrist vessel (radial artery) is much lower.
  • the most important risk of angiography is the risk of death around 2/4000 and the risk of stroke around 1/1000. Bleeding problems in the groin or arm may occur at a rate of 5/1000 or there may be other vascular problems.
  • the risks of angiography are largely seen in people with severe cardiovascular disease.
  • tomographic angiography Another diagnostic method applied thanks to today's developing technology is tomographic angiography (virtual angiography).
  • opaque material is injected through a vessel in the arm using special tomography devices for coronary angiography, and the tomography of the heart vessels is done. It is a very reliable test if the heart vessels are in normal condition, but if there is a vascular constriction in the heart, its reliability is low when evaluating these constrictions.
  • the disadvantages are that the patient is given more opaque material compared to normal angiography and the radiation dose that the patient receives is higher than normal angiography.
  • computed tomography systems the fluoroscopy method based on receiving light images by means of semiconductor detectors is used.
  • SNR signal-to noise ratio
  • Csl type scintillation detectors used in existing systems also inconvenience to determine the difference between healthy tissues and the examined lesion during imaging procedure.
  • the invention of the patent document numbered EP2046202B1 in the state of the art relates to determination of an optimal rotational trajectory of predetermined RA based on optimal view maps.
  • a method for determining the optimal trajectory for 3D X-ray rotational coronary angiography for an X-ray system of a C-arm is disclosed.
  • the C-arm X-ray system has at least two degrees of movement freedom. These are defined through a propeller-type motion of the C-arm expressed in left/right coronary artery oblique angle and one a roll motion of the C-arm expressed in a caudal/cranial angle.
  • the method comprises the following steps respectively.
  • a 3-dimensional representation of a center-line of a body vessel of a region of interest is generated.
  • at least one optimal view map is generated.
  • an optimal trajectory for the C-arm of the X-ray system within the limits of the optimal view map is calculated, wherein an optimal trajectory is at least determined by movements of the C-arm within its two degrees of freedom allowing image projections with minimal foreshortening and overlap of the while minimizing the regions of interest's exposure to X-rays.
  • the present invention relates to a device, which fulfills the abovementioned necessities and brings some further advantages, that is developed for diagnosing whether there is an occlusion in coronaries and treatment thereof in the medical field.
  • the X-ray source contains a more rapid, smaller, lighter and more efficient CdTe or CdZnTe type semiconductor detector, unlike the angiography devices currently used to capture the spectrum of the rays produced from the X-ray source.
  • the object of the invention is to increase the image quality compared to the existing systems by using a more rapid, smaller, and much more efficient CdTe or CdZnTe type semiconductor detector instead of the Csl type detector used in a conventional device.
  • the object of the invention is to ensure that the exposure period of the patient to radiation is also shortened by increasing the system resolution, which negatively affects the image quality.
  • Another object of the invention is to ensure to obtain better quality images with high SNR (>15) values on the cardiovascular phantom Using a CdTe or CdZnTe type semiconductor detector instead of a Csl type scintillation detector in the device.
  • Another object of the invention is to ensure that the image is obtained in high quality, because the SNR value of the CdTe or CdZnTe type semiconductor detector used is higher than 15
  • Another object of the invention is to reduce the radiation dose received by the patient and the angio application team and to increase the patient's comfort and to make the application more economical by means of obtaining a better-quality image with lower density dye in the developed device.
  • Another object of the invention is to ensure that the developed device can be easily transported and used when and where it is needed, thanks to its smaller size and lower weight, and to ensure that it provides practical application.
  • Another object of the invention is to contribute to the minimization of the risk of sudden heart attack by means of diagnosing cardiovascular diseases having a high mortality rate more easily thanks to the high SNR value and ease of application of the device.
  • Another object of the invention is to ensure that the diagnosis and treatment procedures are performed simultaneously by means of obtaining a high-resolution image with the device, thus increasing the success of all procedures, as well as reducing the duration, speed, cost, and discomfort and risks that concern the patient.
  • the main object of the inventive angiography device is to reduce the radiation rate received by both patients and healthcare personnel by improving the image quality, to ensure patient comfort during the procedure and to make the angiography procedure more rapid and more efficient.
  • CdTe or CdZnTe type semiconductor detector is used instead of the Csl type scintillation detector used in the existing amorphous systems. Owing to the improved image quality of the angiography device, even if the density of the contrast material in the vessel decreases in coronary angiography, a high-quality image can be obtained thanks to the CdTe or CdZnTe type semiconductor detector used in the angiography device.
  • the basic factor that determines the image quality is the signal-to-noise ratio (SNR) value and its permissible limit is 5.
  • SNR value is determined by means of proportioning the amplitude of the signals received from the detector and belonging to the sample examined, to the amplitude of the electronic noise signals.
  • the image quality improves as said SNR value increases.
  • the SNR value of the Csl type scintillation detectors used in angiography systems in the state of the art is 7-8
  • the CdTe or CdZnTe type semiconductor detector used in the inventive angiography device has an approximately 100% efficiency in the 0-100 keV energy range and the SNR value is greater than 15.
  • the improvement of the image quality of the angiography device obtaining a better-quality image by injecting the contrast material into the vessel facilitates the diagnosis and treatment process performed by the doctor as well as reducing the disadvantages found in the existing methods by providing the procedure to be completed in a shorter time. Since the application takes less time, the use of medical materials to be used also decreases, and thus, it is ensured that the cost of the procedure is also reduced.
  • the improvement of the image quality also provides convenience for the medical personnel in the diagnosis period. Above all, the amount of the radiation dose that is received by everyone is reduced.
  • the contrast (dye) material is given by means of injection. Then, the image of the area, where dye material is injected, is taken by using X-rays.
  • the CdTe or CdZnTe type semiconductor detector used has high efficiency against X-rays and it allows the total dye dose needed to be injected in one time for obtaining the whole vessel image easily and in high resolution. In this way, the patient's urination problem will be reduced by consuming less water after the operation since the patient takes a small amount of iodine.
  • the inventive angiography device is used for diagnosis, treatment, and support in angiography application.
  • This angiography device consists of an X-ray source and detector system. After the installation of the X-ray device and detector system, which are used to take the image of the injected contrast (dye) material in the vessel, is completed, test measurements are performed to determine whether these components work together correctly.
  • the spectrum of the rays generated from the X-ray source at various energy values is obtained with semiconductor detectors of the CdTe or CdZnTe type.
  • the electronic noise levels of the outputs of the detector system are determined by being controlled through an oscilloscope when the ray source does not exist and by connecting a discriminator to the output system in accordance with these noise levels, electronic noise signals are cut, and noise-free signals are used.
  • the X-rays sent from the source are converted into analog electrical signals by means of the detector after passing over the relevant area of the patient. After amplifying the amplitude and filtering the signals generated by the CdTe or CdZnTe type semiconductor detector by the amplifier, these signals are converted into digital data by the ADC (Analogue to Digital Converter).
  • ADC Analogue to Digital Converter
  • digital data is converted to analog data, it is easier to transport them and it is a requirement to be able to process images by a computer.
  • These digital signals are converted into digital codes per unit energy value of the X-rays coming to the detector by the data processing computer and converted into images, and they are saved.
  • the computer program used for implementing these processes will be used for rendering the image. For this, there is no additional software cost as the detector system will be adapted to the program.
  • the developed angiography device has been integrated into other imaging systems such as CT, PET, SPECT, etc., and used to meet the imaging needs in different areas.

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Abstract

An angiography device developed for the diagnosis of occlusion in the coronary vessels and the treatment thereof in the medical field characterized in that, it comprises; an X-ray source for intravenous imaging of the injected contrast (dye) material; the X-ray source containing a more rapid, smaller, lighter and more efficient CdTe or CdZnTe type semiconductor detector, unlike the angiography devices currently used to capture the spectrum of the rays produced from the X-ray source.

Description

DESCRIPTION
A MORE EFFICIENT NOVEL SYSTEM WITH MODERNIZED CONVENTIONAL
CORONARY ANGIOGRAPHY DEVICE
Technical Field of The Invention
The present invention relates to a device that is developed for diagnosing whether there is an occlusion in coronaries and treatment thereof in the medical field.
The present invention particularly relates to creating a novel type of angiography device developed to be more rapid, in a smaller size, lighter, and more efficient by removing the detectors used in coronary angiography device and, instead, adapting a semiconductor detector.
STATE OF THE ART
Coronary artery disease is the narrowing or blockage of the coronary arteries, generally due to atherosclerosis (vessel stiffness) . Atherosclerosis, also known as hardening or blockage of the arteries, is a buildup of cholesterol and fatty deposits (called plaque) on the inner walls of the arteries. These plaques may limit the blood flow to the heart muscle by clogging the arteries physically or by causing aberrant artery tone or function. Without adequate blood flow, the heart's need for oxygen and the vital nutrients for functioning properly cannot be met. This causes chest pain that is called angina. Angine is an alerting symptom of heart disease. Even though the symptoms of the heart attack (myocardial infarctus) are similar with angine, they are two separate diseases. If the blood flow to a certain part of the heart muscle completely stops or the energy need of the heart exceed the blood flow amount, a heart attack (injury to the heart muscle) may occur. The treatment of coronary artery disease consists of reducing the risk factors, intake of drugs as prescribed, possibly, invasive and/or surgical interventions and regular medical checks. The treatment of coronary artery is crucial for reducing the risk of having a heart attack or a stroke.
The treatment of coronary artery is crucial for reducing the risk of having a heart attack or a stroke. Today, different methods such as EKG, effort test and angiography are used for the diagnosis of coronary artery disease. Coronary angio (angiography) is a diagnosis method that images coronary vessels that nourishes the heart.
Angiography, with its common use fluoroscopic systems, is an x- ray imaging method. It comprises an X-ray device and a detector system to sense X-rays. The imaging procedure is performed by giving an X-ray absorbent (contrast material) to patient. Imaging physics is based on the principle that as the x-ray passes through the material, in other words, through the patient, the tissue it passes through, creates an image depending on the X-ray absorption amount. In this method, as a subtraction technique, the image is taken without absorbent and the image is taken by giving absorbent. The two images are subtracted from each other and by this way only the vessel image remains. Here, the image quality (SNR) depends on the density of the X-ray used and most importantly the detector system.
In the state of the art, systems that uses conventional angiography and scintillation detector are known.
Conventional Angiography is a system where two films are generated by projecting the X-ray on the film and then, the point-to-point subtraction process is implemented between these films. Systems that use scintillation detector can be grouped in three types as follows: First group systems where a detector named image intensifier is used. In these systems, Csl type scintillation detectors are used. This detector converts incoming X-rays into visible light. The image is formed by increasing the density of this light and projecting it on phosphor screen. This image is digitalized by scanning with a vidicon camera. In the second group system, Csl type scintillation detector is also used. The image intensifier is used. Unlike the other system, the light is not reflected on the phosphor screen, but a digital image is obtained by dropping it on a CCD camera chip. The detector used in the third group system is also the Csl scintillation detector, but the CCD camera is attached right to the detector. These are called as amorphous structured systems.
In the coronary angio imaging system, scintillation detectors, amorphous selenium, CCD (Charge Coupled Device) or CMOS (Complementary Metal Oxide Semiconductor) convert the radiation received by the patient into light information and imaging is performed with systems that display this light. Angiography, which is generally done on the inguinal area, can now be done on the wrist (radial artery). Coronary angiography can be done through the inguinal vessel (femoral artery) or wrist (radial artery) to monitor the heart vessels. If there is an anomaly related to these vessels, the angiography procedure can be done through other vessels occasionally. Basically, in this technique, a sheath is placed inside the vessel after local anesthesia is applied to the entry site. The vessels that nourish the heart are reached by means of a catheter (1.5-2 mm) inserted through the vessel sheath, and then the film of the coronary vessels is obtained by injecting the opaque material (dye) to the coronary vessels through the catheter. Since the concentration of the dye material decreases when it is mixed into the blood and the blood in the vessel is in motion, the image to be obtained covers a very short period. After the procedure, the vessel sheath is removed, and the pressure is applied for 10-20 minutes to stop bleeding. In the angio procedure carried out from the inguinal vessel (femoral artery), it is more troublesome for the patient because of staying in bed for at least 4-6 hours after the procedure and vascular problems may occur compared to the procedures carried out through the arm. However, it is an advantage to have an inguinal vessel that is larger in order to perform some complex balloon-stent procedures. Performing the angio procedure from the wrist vessel (radial artery) is more advantageous than inguinal angio in terms of patient comfort. After the arm angio procedure, the patient can be discharged immediately. The probability of angio-related problems in the wrist vessel (radial artery) is much lower. The most important risk of angiography is the risk of death around 2/4000 and the risk of stroke around 1/1000. Bleeding problems in the groin or arm may occur at a rate of 5/1000 or there may be other vascular problems. The risks of angiography are largely seen in people with severe cardiovascular disease. Another diagnostic method applied thanks to today's developing technology is tomographic angiography (virtual angiography). In this method, opaque material is injected through a vessel in the arm using special tomography devices for coronary angiography, and the tomography of the heart vessels is done. It is a very reliable test if the heart vessels are in normal condition, but if there is a vascular constriction in the heart, its reliability is low when evaluating these constrictions. In this technique, the disadvantages are that the patient is given more opaque material compared to normal angiography and the radiation dose that the patient receives is higher than normal angiography. In computed tomography systems, the fluoroscopy method based on receiving light images by means of semiconductor detectors is used. This light image varies based on the type of detector used in the system, and as a result, it affects the quality of the image taken. The most important parameter affecting the image quality is the characteristic parameter for each detector, called SNR (signal-to noise ratio). Simply, SNR is defined as the ratio of the signal data received from the system when there is a radiation source to the signal data received from the same system when there is no source. A high SNR value is a desired feature for all detection systems. In an existing angiography system, the Csl type crystal scintillation detectors are used. Due to the fact that the images obtained from these detectors are based on the scintillation principle (optical photon generation in the crystal), some disadvantages caused by the structure of the system such as the image outputs not at the desired height, the distance between the detector and the patient, the use of image intensifiers cause the SNR value to remain low (~7-8). Csl type scintillation detectors used in existing systems also inconvenience to determine the difference between healthy tissues and the examined lesion during imaging procedure.
Today, there are many studies aiming to increase the reliability of the findings obtained through angiography and to promote patients' comfort during the procedure. The invention of the patent document numbered EP2046202B1 in the state of the art relates to determination of an optimal rotational trajectory of predetermined RA based on optimal view maps. A method for determining the optimal trajectory for 3D X-ray rotational coronary angiography for an X-ray system of a C-arm is disclosed. The C-arm X-ray system has at least two degrees of movement freedom. These are defined through a propeller-type motion of the C-arm expressed in left/right coronary artery oblique angle and one a roll motion of the C-arm expressed in a caudal/cranial angle. The method comprises the following steps respectively. First, a 3-dimensional representation of a center-line of a body vessel of a region of interest is generated. Secondly, at least one optimal view map is generated. Lastly, an optimal trajectory for the C-arm of the X-ray system within the limits of the optimal view map is calculated, wherein an optimal trajectory is at least determined by movements of the C-arm within its two degrees of freedom allowing image projections with minimal foreshortening and overlap of the while minimizing the regions of interest's exposure to X-rays. In consequence thereof, due to the necessitation for a modernized device to be used in the diagnosis and treatment of coronary artery occlusion, which reduces the resolution problem existing in the state of the art, a development that can respond to this necessitation in a rapid, small-sized, lighter, and more efficient manner than existing ones has become necessary.
Brief Description of the Invention
The present invention relates to a device, which fulfills the abovementioned necessities and brings some further advantages, that is developed for diagnosing whether there is an occlusion in coronaries and treatment thereof in the medical field.
With the angiography device developed for the diagnosis of occlusion in the coronary vessels and the treatment thereof in the medical field, for obtaining the intravenous image of the contrast (dye) material injected, the X-ray source contains a more rapid, smaller, lighter and more efficient CdTe or CdZnTe type semiconductor detector, unlike the angiography devices currently used to capture the spectrum of the rays produced from the X-ray source. Based on the state of the art, the object of the invention is to increase the image quality compared to the existing systems by using a more rapid, smaller, and much more efficient CdTe or CdZnTe type semiconductor detector instead of the Csl type detector used in a conventional device. The object of the invention is to ensure that the exposure period of the patient to radiation is also shortened by increasing the system resolution, which negatively affects the image quality.
Another object of the invention is to ensure to obtain better quality images with high SNR (>15) values on the cardiovascular phantom Using a CdTe or CdZnTe type semiconductor detector instead of a Csl type scintillation detector in the device.
Another object of the invention is to ensure that the image is obtained in high quality, because the SNR value of the CdTe or CdZnTe type semiconductor detector used is higher than 15
Another object of the invention is to reduce the radiation dose received by the patient and the angio application team and to increase the patient's comfort and to make the application more economical by means of obtaining a better-quality image with lower density dye in the developed device.
Another object of the invention is to ensure that the developed device can be easily transported and used when and where it is needed, thanks to its smaller size and lower weight, and to ensure that it provides practical application.
Another object of the invention is to contribute to the minimization of the risk of sudden heart attack by means of diagnosing cardiovascular diseases having a high mortality rate more easily thanks to the high SNR value and ease of application of the device.
Another object of the invention is to ensure that the diagnosis and treatment procedures are performed simultaneously by means of obtaining a high-resolution image with the device, thus increasing the success of all procedures, as well as reducing the duration, speed, cost, and discomfort and risks that concern the patient. The structural and characteristic features of the invention and all the advantages thereof will be more clearly understood by means of the detailed description below, and therefore, the evaluation should be conducted by taking detailed description into the consideration.
Detailed Description of The Invention
The main object of the inventive angiography device is to reduce the radiation rate received by both patients and healthcare personnel by improving the image quality, to ensure patient comfort during the procedure and to make the angiography procedure more rapid and more efficient. For this purpose, in said angiography device, CdTe or CdZnTe type semiconductor detector is used instead of the Csl type scintillation detector used in the existing amorphous systems. Owing to the improved image quality of the angiography device, even if the density of the contrast material in the vessel decreases in coronary angiography, a high-quality image can be obtained thanks to the CdTe or CdZnTe type semiconductor detector used in the angiography device.
In today's imaging systems, the basic factor that determines the image quality is the signal-to-noise ratio (SNR) value and its permissible limit is 5. The SNR value is determined by means of proportioning the amplitude of the signals received from the detector and belonging to the sample examined, to the amplitude of the electronic noise signals. The image quality improves as said SNR value increases. Although the SNR value of the Csl type scintillation detectors used in angiography systems in the state of the art is 7-8, the CdTe or CdZnTe type semiconductor detector used in the inventive angiography device has an approximately 100% efficiency in the 0-100 keV energy range and the SNR value is greater than 15. Considering X-rays having 120 kVp energy, their SNR values are 9.79 for the Csl detector, while the SNR value for the inventive CdTe or CdZnTe type semiconductor detector is 38.56. Since imaging with a CdTe or CdZnTe type semiconductor detector on the cardiovascular phantom provides improvement in the SNR, in other words, the image quality, the amount of radiation and dye material given to the patient has been substantially reduced. On the other hand, facilitating the application by means of the inventive angiography device has further reduced the problems experienced in the existing systems. Thanks to the improvement of the image quality of the angiography device, obtaining a better-quality image by injecting the contrast material into the vessel facilitates the diagnosis and treatment process performed by the doctor as well as reducing the disadvantages found in the existing methods by providing the procedure to be completed in a shorter time. Since the application takes less time, the use of medical materials to be used also decreases, and thus, it is ensured that the cost of the procedure is also reduced. The improvement of the image quality also provides convenience for the medical personnel in the diagnosis period. Above all, the amount of the radiation dose that is received by everyone is reduced.
In said angiography device, the contrast (dye) material is given by means of injection. Then, the image of the area, where dye material is injected, is taken by using X-rays. At this stage, the CdTe or CdZnTe type semiconductor detector used has high efficiency against X-rays and it allows the total dye dose needed to be injected in one time for obtaining the whole vessel image easily and in high resolution. In this way, the patient's urination problem will be reduced by consuming less water after the operation since the patient takes a small amount of iodine.
The inventive angiography device is used for diagnosis, treatment, and support in angiography application. This angiography device consists of an X-ray source and detector system. After the installation of the X-ray device and detector system, which are used to take the image of the injected contrast (dye) material in the vessel, is completed, test measurements are performed to determine whether these components work together correctly. The spectrum of the rays generated from the X-ray source at various energy values is obtained with semiconductor detectors of the CdTe or CdZnTe type. The electronic noise levels of the outputs of the detector system are determined by being controlled through an oscilloscope when the ray source does not exist and by connecting a discriminator to the output system in accordance with these noise levels, electronic noise signals are cut, and noise-free signals are used.
In the angiography device, the X-rays sent from the source are converted into analog electrical signals by means of the detector after passing over the relevant area of the patient. After amplifying the amplitude and filtering the signals generated by the CdTe or CdZnTe type semiconductor detector by the amplifier, these signals are converted into digital data by the ADC (Analogue to Digital Converter). When digital data is converted to analog data, it is easier to transport them and it is a requirement to be able to process images by a computer. These digital signals are converted into digital codes per unit energy value of the X-rays coming to the detector by the data processing computer and converted into images, and they are saved. The computer program used for implementing these processes will be used for rendering the image. For this, there is no additional software cost as the detector system will be adapted to the program.
In a preferred embodiment of the invention, the developed angiography device has been integrated into other imaging systems such as CT, PET, SPECT, etc., and used to meet the imaging needs in different areas.

Claims

1.An angiography device developed for the diagnosis of occlusion in the coronary vessels and the treatment thereof in the medical field, characterized in that it comprises CdTe or CdZnTe type semiconductor detector having high SNR (>15) value on the cardiovascular phantom to take the spectrum of the rays generated from the X-ray source in order to improve the image quality.
2.An operation method of an angiography device that is developed for diagnosing whether there is an occlusion in coronaries and treatment thereof in the medical field, characterized by comprising the steps of;
- converting the X-rays sent from the source into analog electrical signals by means of the detector after passing over the relevant area of the patient;
- converting the signals into digital data by the ADC (Analogue to Digital Converter) after amplifying the amplitude and filtering the signals produced by the CdTe or CdZnTe type semiconductor detector by the amplifier.
3. An angiography device according to Claim 1, characterized by comprising the step of; rendering into image and saving the same by means of converting the digital signals into the digital codes per unit of the energy value of the X-rays arriving at the CdTe or CdZnTe type of semiconductor dedector by the data processing computer.
PCT/TR2020/051392 2019-12-27 2020-12-25 A more efficient novel system with modernized conventional coronary angiography device WO2021133359A1 (en)

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