U.S. patent application number 12/402141 was filed with the patent office on 2010-04-01 for modular system for diagnosis and surgical operation on a breast.
This patent application is currently assigned to MIR MEDICAL IMAGING RESEARCH HOLDING GMBH. Invention is credited to Willi Kalender, Harry Schilling.
Application Number | 20100080349 12/402141 |
Document ID | / |
Family ID | 40524871 |
Filed Date | 2010-04-01 |
United States Patent
Application |
20100080349 |
Kind Code |
A1 |
Kalender; Willi ; et
al. |
April 1, 2010 |
Modular System for Diagnosis and Surgical Operation on a Breast
Abstract
An X-ray machine for examining a breast of a female patient has
a CT scanner attached to a patient's table. An instrument holder
that is adapted to be moved to be located underneath a gantry of
the CT scanner is provided with a positioning unit for positioning
an instrument for examining or operating close to the breast. An
exact position of the instrument holder relative to the gantry or
the breast to be examined can be determined with a measuring
system. Thereby, it is possible to position an examining or
surgical intervention instrument extremely precisely.
Inventors: |
Kalender; Willi;
(Moehrendorf, DE) ; Schilling; Harry; (Eichstaett,
DE) |
Correspondence
Address: |
DAFFER MCDANIEL LLP
P.O. BOX 684908
AUSTIN
TX
78768
US
|
Assignee: |
MIR MEDICAL IMAGING RESEARCH
HOLDING GMBH
Moehrendorf
DE
|
Family ID: |
40524871 |
Appl. No.: |
12/402141 |
Filed: |
March 11, 2009 |
Current U.S.
Class: |
378/37 |
Current CPC
Class: |
A61B 5/4312 20130101;
A61B 6/583 20130101; A61B 2017/00084 20130101; A61B 2090/376
20160201; A61B 6/4275 20130101; A61B 6/107 20130101; A61B 6/035
20130101; A61B 2090/3762 20160201; G06T 7/12 20170101; A61B 6/502
20130101; A61B 5/704 20130101; A61B 5/015 20130101; G06T 2207/30096
20130101; A61B 6/06 20130101; G01K 11/30 20130101; G06T 2207/30068
20130101; G06T 7/74 20170101; A61B 6/032 20130101; A61B 6/0435
20130101; A61B 6/027 20130101; A61B 90/17 20160201; A61B 18/00
20130101; G06T 2207/10081 20130101 |
Class at
Publication: |
378/37 |
International
Class: |
A61B 6/04 20060101
A61B006/04 |
Foreign Application Data
Date |
Code |
Application Number |
Sep 29, 2008 |
DE |
102008042430.7 |
Claims
1. An X-ray machine for imaging a breast of a female patient and
performing surgical intervention on the breast, comprising: a
gantry that is rotatable approximately about a vertical rotation
axis; a gantry lift drive configured to move the gantry in a
vertical direction, wherein a vertical movement of the gantry is
dependent upon the rotational movement of the gantry; an X-ray tube
and an X-ray detector mounted on the gantry; a horizontally
disposed patient's table having a cutout portion for a breast,
wherein the gantry is suspended from a lower side of the patient's
table; and an instrument holder for accommodating at least one
operating instrument in the vicinity of the breast through the
gantry from below the patient's table so that a surgical
intervention can be effected with the operating instrument.
2. The X-ray machine according to claim 1, further comprising a
mobile platform for supporting the instrument holder via a
positioning unit, wherein the mobile platform is adapted to be
inserted underneath the gantry from a side of the X-ray
machine.
3. The X-ray machine according to claim 2, wherein the mobile
platform comprises at least one measuring system for determining a
position of the mobile platform relative to the gantry or another
component firmly connected to the gantry, and wherein the mobile
platform is configured to utilize position information determined
with the measuring system for exact positioning of the instrument
holder.
4. The X-ray machine according to claim 2, wherein the positioning
unit is a hexapod.
5. The X-ray machine according to claim 2, wherein the mobile
platform comprises wheels, slides or air bearings.
6. The X-ray machine according to claim 1, further comprising an
articulated arm for supporting the instrument holder, wherein the
articulated arm is configured for attachment to a structural
component of the X-ray machine.
7. The X-ray machine according to claim 6, wherein the structural
component is a gantry suspension for suspending the gantry below
the patient's table or another component firmly connected to the
gantry suspension.
8. The X-ray machine according to claim 6, wherein the articulated
arm is adapted to be unfastened from the structural component with
a rapid closure means.
9. A method for operating an X-ray machine, comprising: producing a
three-dimensional X-ray exposure; detecting a position of a
surgical intervention instrument relative to a gantry of the X-ray
machine; and calculating a position of the surgical intervention
instrument with respect to the three-dimensional X-ray
exposure.
10. The method according to claim 9, wherein the step of producing
the three-dimensional X-ray exposure is performed prior to the step
of detecting a position of the surgical intervention
instrument.
11. The method according to claim 9, wherein the step of producing
the three-dimensional X-ray exposure is performed subsequent to the
step of detecting a position of the surgical intervention
instrument.
12. The method according to claim 9, further comprising performing
a surgical invention subsequent to calculating a position of the
surgical intervention instrument.
13. The method according to claim 12, further comprising producing
additional X-ray exposures during the step of performing the
surgical intervention to check a position of the surgical
intervention instrument within the X-ray machine.
Description
PRIORITY CLAIM
[0001] This application claims priority to pending German
Application No. 102008042430.7 filed on Sep. 29, 2008.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The invention relates to an X-ray machine for imaging a
breast of a female patient. With this machine it is possible to
perform a surgical operation on a breast.
[0004] 2. Description of Related Art
[0005] Various X-ray machines are known for performing an
examination of a female breast. An X-ray facility having a rotating
gantry with an X-ray tube and a detector is located below a
patient's table on which a patient to be examined rests. A machine
of this kind is disclosed for example in U.S. Pat. No. 4,015,836. A
disadvantage of this prior art is the large requirement of space,
and also the lack of access to a breast to be examined.
Furthermore, the patient is put into a relatively uncomfortable
position with her head lying low, in order that as large as
possible a part of the breast can be covered by the X-ray machine.
An improvement is represented by an arrangement described in U.S.
Patent Application Publication No. 2006/0094950. Here, the patient
is in a more comfortable position. However, the breast to be
examined is accessible only with special instruments. A
disadvantage of this arrangement is the large requirement of space
resulting from the large structural shape of the gantry. An X-ray
machine based on a spiral CT scanner is disclosed in U.S. Patent
Application Publication No. 2007/0064867. Here, the resolution is
limited by low stability of the mechanical design. In addition,
here too the breast to be examined cannot be accessed from
outside.
BRIEF SUMMARY OF THE INVENTION
[0006] The following description of the objective of the disclosure
provided herein, the description of embodiment of an X-ray machine
for imaging a breast of a female patient and performing surgical
intervention of the breast, as well as the description of a method
for operating such an X-ray machine is not to be construed in any
way as limiting the subject matter of the appended claims.
[0007] The objective of the disclosure provided herein is to design
an X-ray machine which images a female breast in a diagnostically
correct manner, and also rapidly and at favorable cost, and at the
same time makes it possible to perform a surgical operation or
intervention on the breast. In addition, the machine is to provide
a physician performing treatment with good and ergonomically
advantageous access to the breast.
[0008] An embodiment of an X-ray machine for imaging a breast of a
female patient and performing surgical intervention on the breast
includes a gantry that is rotatable approximately about a vertical
rotation axis and a gantry lift drive configured to move the gantry
in a vertical direction, wherein a vertical movement of the gantry
is dependent upon the rotational movement of the gantry. The X-ray
machine further includes an X-ray tube and an X-ray detector
mounted on the gantry and a horizontally disposed patient's table
having a cutout portion for a breast, wherein the gantry is
suspended from a lower side of the patient's table. In addition,
the X-ray machine includes an instrument holder for accommodating
at least one operating instrument in the vicinity of the breast
through the gantry from below the patient's table so that surgical
intervention can be effected with the operating instrument.
[0009] An embodiment of a method for operating an X-ray machine
includes producing a three-dimensional X-ray exposure, detecting a
position of a surgical intervention instrument relative to a gantry
of the X-ray machine, and calculating a position of the surgical
intervention instrument with respect to the three-dimensional X-ray
exposure.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] In the following the invention is described by way of
example, without limitation of the general inventive concept, on
examples of embodiments and with reference to the drawings.
[0011] FIG. 1 shows a perspective view of an example of an X-ray
machine.
[0012] FIG. 2 shows a positioning unit with a hexapod.
[0013] FIG. 3 shows a partial side view of an example of an X-ray
machine.
[0014] FIG. 4 shows a partial cross-sectional view of an example of
an X-ray machine having an articulated arm to support an instrument
holder.
[0015] While the invention is susceptible to various modifications
and alternative forms, specific embodiments thereof are shown by
way of example in the drawings and will herein be described in
detail. It should be understood, however, that the drawings and
detailed description thereto are not intended to limit the
invention to the particular form disclosed, but on the contrary,
the intention is to cover all modifications, equivalents and
alternatives falling within the spirit and scope of the present
invention as defined by the appended claims.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
[0016] FIG. 1 shows perspective view of an example of an X-ray
machine. A patient 30 is positioned on a patient's table 20. A
breast to be examined is suspended through a breast cutout portion
21 in the patient's table into an exposure range of a gantry 10.
The gantry 10 is a spiral computer tomography gantry with an X-ray
tube and a detector which rotate about the breast to be examined.
During the rotation, the breast is imaged, i.e. exposed to X-rays
to obtain X-ray images. Simultaneously with the rotation, a
displacement of the gantry in a vertical direction is performed via
a gantry lift drive 11 so that the breast is scanned along a spiral
trajectory. The height of the patient's table 20 can be adjusted by
means of a patient's table lift drive 22. In a case in which a
patient's table is firmly installed, it can be optionally adapted
to be rotated about an axis of the patient's table lift drive
22.
[0017] A mobile platform 130 is located below the gantry 10. During
an examination, this mobile platform can be moved to or removed
from below the gantry. It may be provided with wheels which
advantageously can be locked in position. Optionally, it can roll
or slide along the floor or on rails. Slide or air-bearings are of
special advantage. The mobile platform may have a separate drive
for exact positioning below the gantry or may be moved there
manually. Guide rails or positioning aids embedded in the floor,
such as induction loops, can simplify exact positioning. An
instrument holder covered from view by the gantry is held in an
operating position close to a breast by means of a positioning unit
120. The positioning unit may be, for example, a hexapod or also an
articulated arm. For exact positioning, position measuring systems
131a, 131b and 131c are provided which determine the distance from
measurement marks 132a, 132b, and 132c on the gantry suspension
with measurement signals 133a, 133b, and 133c, which may be, for
example, light signals. Optionally, on basis of the measurement
made with the position measuring systems, an automatic or even
manual correction of the position of the mobile platform may be
effected. Alternatively and/or additionally, the position data
obtained from the measuring system can be used for calculating the
exact position of the instrument holder. Basically, the measuring
system may operate according to any known principles for position
or distance measurement. Preferably, it operates with optical
sensors such as laser sensors or also ultrasound sensors or radio
sensors.
[0018] FIG. 2 illustrates a positioning unit 120 for positioning
the instrument holder 124 in a correct operating position with
respect to a breast. Exact positioning is here effected by means of
a hexapod 121. In some embodiments, an articulated arm with at
least one revolute or swivel joint 123 is provided between the
instrument holder and a intervention instrument 122. A plurality of
joints may be provided. Because of the hexapod, however, this is
usually not necessary in the illustrated embodiment.
[0019] FIG. 3 illustrates a partial side view of an example of an
X-ray machine. For better illustration, the gantry is shown in
cross-section. An X-ray tube 15 is located within the gantry
housing 29 which generates an X-ray fan or X-ray beam 16 to be
transmitted through the breast 31. The radiation is received by a
detector 14 connected to an evaluation unit (not shown). The gantry
is supported to rotate around the breast by a gantry pivot bearing
13, and its distance from the patient table 20 can be adjusted with
a gantry lift drive 11. With this, a scan of the breast 31 to be
examined is possible along a spiral trajectory.
[0020] FIG. 4 illustrates an example of an X-ray machine having an
articulated arm 126 for positioning the instrument holder 124 and
the intervention instrument 122. This articulated arm is shown
attached to the supports of the gantry suspension. Advantageously,
it can be removed from or re-attached to the gantry suspension
during an examination or treatment. The articulated arm can be also
attached to the patient's table 20 itself or to another structural
component connected thereto, instead of to the gantry suspension.
Preferably, an attachment of this kind can be released in a simple
way and manner, for example with a quick acting closure, so that
the entire structural component group including the articulated arm
126 can be rapidly assembled and again dismantled. In some
embodiments, the arm may be also used on a mobile platform 130 as
similarly described for the hexapod illustrated in FIG. 1. The
articulated arm shown in FIG. 4 has a plurality of pivot joints
123a, 123b, 123c, 123d, 123e and 123f. Preferably, rotary drives
and/or angle sensors and/or position sensors are incorporated in
the pivot joints. A measuring system may be present also on the
instrument holder, so that an exact position of the instrument
holder with respect to the gantry 10 and/or the patient's table can
be determined.
[0021] An X-ray machine for imaging a breast of a female patient
comprises a patient's table 20 from which a gantry 10 of a spiral
computer tomograph is suspended. The patient's table 20 has a
breast cutout portion 21 through which a breast 31 of a patient 30
is suspended preferably downwards in a direction towards the gantry
10. The gantry 10 has a gantry lift drive 11 with which it can be
moved relative to the patient's table. For taking an X-ray
exposure, the gantry rotates around the breast 31 of a female
patient. Simultaneously and/or at staggered time intervals, a
displacement of the gantry 10 is effected along a longitudinal
direction of the breast, i.e. preferably in a vertical direction.
Optionally, the displacement can be made continuously at constant
speed or proportional to the rotation of the gantry. Alternatively,
the displacement can be also effected stepwise so that, for
example, a displacement by an amount equal to one width of the
detector 14 is made following each single revolution of the
gantry.
[0022] For surgical intervention, in particular a biopsy, an
instrument 122 is provided with which the intervention or operation
is effected from below into the free opening of the gantry. With
this, samples can be taken from, or contrast agents injected into,
a breast without affecting the gantry. The instrument is preferably
located on an instrument holder 124 which is optionally connected
via an articulated arm 126 with the patient's table or the gantry
suspension 125. As an alternative to this, the instrument holder
124 can be disposed on a mobile platform 130. In such cases, it is
especially advantageous when the instrument holder, for being
exactly positioned, is connected to the mobile platform via a
hexapod 121. Measuring facilities are provided for exactly
positioning the instrument holder 124. In the case of an
articulated arm, its pivot joints are preferably provided with
angle or position sensors. Furthermore, a measuring system can be
provided which establishes optionally the position of the
instrument holder or also that of the mobile platform with respect
to the gantry, the patient's table or another component part firmly
connected therewith. The measuring system transmits corresponding
correcting information to the articulated arm or the hexapod.
[0023] With the X-ray machines described herein, X-ray exposures or
examinations of a breast can be performed initially without the
instrument holder or the instrument for surgical intervention.
Owing to the design in which the gantry is suspended from the
patient's table, a compact and space saving construction is
achieved, in which also an examining or treating physician or other
personnel have access to a breast to be examined. Thus, for
example, a contrast agent can be injected into the breast prior to
an exposure being made, or between two exposures. If a surgical
intervention or operation such as a biopsy is to be made, then the
instrument holder with an appropriate instrument is inserted from
below the gantry. This is particularly simple when a mobile
platform is available. In particular, a mobile platform may be
moved from a lateral location to a location beneath the gantry, for
example on wheels. In most cases, an exact adjustment will not be
necessary, so that simple marks on the floor will be sufficient. An
exact adjustment of the instrument holder with the instrument may
then be effected with a positioning unit mounted to the mobile
platform on a basis of position data that have been established by
at least one measuring system. Following a surgical intervention,
for example a biopsy, the mobile platform can be again removed from
the region of the gantry, so that the breast is again accessible to
an examining physician. With the devices and systems described
herein, it is not necessary to re-locate the patient between an
X-ray exposure and a biopsy. Furthermore, it is not necessary to
mark the locations of punctures on the skin in accordance with an
X-ray image and then perform a biopsy through these punctures.
Instead, a biopsy now can be performed with exact control based on
X-ray data.
[0024] In some cases, an exact positioning of an instrument can be
monitored during a surgical intervention. For this, one or a
plurality of X-ray exposures are made during the intervention to
check the instrument or the position of the instrument.
Advantageously, the gantry rotates continuously during the
intervention and makes exposures which are displaced from each
other by approximately 90.degree.. Thereby, the intervention or
operating instrument can be controlled in two planes. Thus, for
example, it can be ascertained whether a biopsy needle is subject
to bending.
[0025] A method for operating an X-ray machine includes producing a
three-dimensional X-ray exposure, detecting a position of an
intervention instrument relative to a gantry, and calculating a
position of the intervention instrument with respect to the
three-dimensional X-ray exposure. With this method the order of the
first two steps can be interchanged. In either case, the
calculation of the position of the intervention instrument 121 is
by means of its position relative to the gantry or to a component
connected to the gantry.
[0026] In the X-ray machines described herein, at least one
measuring system for determining a position of the instrument
holder or of a component connected thereto relative to the gantry
or a component firmly connected thereto may be adapted to supply
position information for positioning at least one of the instrument
holder and the operating instrument relative to the breast.
[0027] It will be appreciated to those skilled in the art having
the benefit of this disclosure that this invention is believed to
provide an X-ray machine for imaging a breast of a female patient
and performing surgical intervention of the breast as well as a
method for operating such an X-ray machine. Further modifications
and alternative embodiments of various aspects of the invention
will be apparent to those skilled in the art in view of this
description. Accordingly, this description is to be construed as
illustrative only and is for the purpose of teaching those skilled
in the art the general manner of carrying out the invention. It is
to be understood that the forms of the invention shown and
described herein are to be taken as the presently preferred
embodiments. Elements and materials may be substituted for those
illustrated and described herein, parts and processes may be
reversed, and certain features of the invention may be utilized
independently, all as would be apparent to one skilled in the art
after having the benefit of this description of the invention.
Changes may be made in the elements described herein without
departing from the spirit and scope of the invention as described
in the following claims.
* * * * *