WO2012073164A1 - Device and method for ultrasound imaging - Google Patents

Device and method for ultrasound imaging Download PDF

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Publication number
WO2012073164A1
WO2012073164A1 PCT/IB2011/055300 IB2011055300W WO2012073164A1 WO 2012073164 A1 WO2012073164 A1 WO 2012073164A1 IB 2011055300 W IB2011055300 W IB 2011055300W WO 2012073164 A1 WO2012073164 A1 WO 2012073164A1
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ultrasound
transducer
body part
patient
image
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PCT/IB2011/055300
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French (fr)
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David Nigel Roundhill
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Koninklijke Philips Electronics N.V.
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Publication of WO2012073164A1 publication Critical patent/WO2012073164A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/461—Displaying means of special interest
    • A61B8/464—Displaying means of special interest involving a plurality of displays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
    • A61B8/467—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means
    • A61B8/469—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient characterised by special input means for selection of a region of interest
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
    • A61B2034/101—Computer-aided simulation of surgical operations
    • A61B2034/102—Modelling of surgical devices, implants or prosthesis
    • A61B2034/104—Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B2090/364—Correlation of different images or relation of image positions in respect to the body
    • A61B2090/367—Correlation of different images or relation of image positions in respect to the body creating a 3D dataset from 2D images using position information
    • 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
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0825—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the breast, e.g. mammography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4254—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors mounted on the probe
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4263—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors not mounted on the probe, e.g. mounted on an external reference frame

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Abstract

A device and method for ultrasound imaging wherein ultrasound scanning of a selected body part of a patient is spatially indicated, as corresponding to a video image of a selected body part of a patient.

Description

Device and method for ultrasound imaging
FIELD OF THE INVENTION
The invention relates to the field of medical ultrasound imaging. In particular, the invention relates to the field of the acquisition of ultrasound images of selected regions of the human body by freehand ultrasound scanning of a selected body part of a patient.
The invention further relates to a medical imaging system comprising:
- a camera, arranged to provide a video image of a selected body part of a patient, the video image being displayed on a patient image display,
- an ultrasound system comprising a transducer,
- the transducer capable of being used to ultrasonically scan the selected body part of the patient, and arranged in cooperation with,
- a transducer position tracker, for determination of a position of the transducer during an ultrasound scan,
- the transducer position tracker further providing an output of the position of the transducer during the ultrasound scan to,
- a video/data integration processor, such means being responsive to the transducer position tracker and the video image of the selected body part and arranged to locate a visual indicator of the path scanned by the transducer in the video image of the selected body part.
and to a method of operating a medical imaging system comprising the steps of:
- Imaging a selected body part of a patient to produce a video image,
- Displaying the video image,
- Scanning a portion of the selected body part with an ultrasound transducer,
- Determining the position and/or movement of the transducer over the scanned portion,
- Comparing the position and/or movement of the transducer with the video image of the selected body part. BACKGROUND OF THE INVENTION
Ultrasound is used extensively in the medical field as a means of non-invasive imaging of various parts of the human body. The ultrasound images produced by scanning, or surveying, a region of the body can be used by medical professionals for investigative and diagnostic purposes. Ultrasound imaging can be used independently of other imaging techniques, or complementary to other imaging techniques such as X-ray or MRI imaging.
As an example, consider the use of ultrasound imaging as a means for screening of breast cancers. In many screening programs, 40% to 60% of mammograms, the current default examination in many regions for the early detection of breast cancer, are performed on dense breasts. A significant number of these examinations result in ambiguous or non-specific X-ray mammogram results. Further information is needed by the clinician, which preferably should be available via a reliable and complementary method. One option is the use of whole breast imaging using ultrasound. In some geographical regions, ultrasound imaging has proved so effective it has become the option of choice, used instead of X-ray mammography as a primary screening modality.
The technical equipment required to produce the ultrasound images is designed to transmit sound into the body and analyse the echoes returning as the sound is reflected by different materials and structures within the body. In order to make the process effective, contact between the patient and the transducer emitting the ultrasound pulses for imaging is optimized as much as possible because ultrasound pulses do not travel effectively through the air. Some areas of the body are easier to image with ultrasound than others, due to, for example, body topography or composition.
Continuing with the example of whole breast imaging, solutions for covering the entire region of interest have included apparatus that requires the patient to lie prone, with a breast hanging into a water bath, or supine, with the breast being scanned using an apparatus that mechanically translates the transducer across the surface of the breast. Some of the challenges in imaging the breast with ultrasound include providing effective acoustic coupling, dealing with the mechanical properties of the breast, the significant size variation from patient to patient, and access to key anatomical components. For a whole breast scan, for example, the most comprehensive examination covers a survey of the region of the breast tissue and the region towards the underarm containing the lymph nodes and axilla.
Commercial solutions have been provided but these remain limited in their application, and some have not been accepted in the clinical environment. An alternative form of ultrasound imaging to mechanical translation of the transducer includes a freehand scan of the body by an operator who manually translates an ultrasound transducer over the region of interest or selected body part. The transducer usually consists of an array of elements, which may be extend in 2 or 3 dimensions, each element producing an ultrasound beam which is cooperatively combined with the output from other elements to facilitate formation of a desired beam profile. The returning reflections are detected by the transducer elements and processed to form an ultrasound image, the ultrasound image usually being displayed to the operator. The positioning of the transducer can be monitored e.g. by means of a transducer position tracker. It is possible to formulate an image with a required quality level - with different parameters, which may be quantified for comparison with the acquired data and images, or with the transducer operation. The integrity if the data set comprising multiple ultrasound images is affected, for example, by the speed of movement of the transducer during scanning, and also by the effectiveness of the acoustic coupling provided by the contact maintained with the body part being surveyed.
Operation of the ultrasound equipment used for freehand scanning is carried out by trained personnel, who tailor their expertise in the use of the equipment to produce the best possible ultrasound images. Such optimization is done in real time while the operator or technician is manipulating the transducer across the selected body part of the patient. Some technicians are more capable than others, leading to a situation whereby a scan or survey may not be carried out correctly or may be incomplete. In the example of whole breast scanning for cancer detection, an incomplete scan or survey can be seriously misleading.
A known problem with this type of ultrasound scanning is that the quality or completeness of the scan or survey is heavily dependent on the skill and expertise of the operator.
SUMMARY OF THE INVENTION
It is an object of the present invention to overcome this problem by improving the quality and completeness of the ultrasound scan or survey being performed on a selected body part.
This object is fulfilled according to the present invention by provision of a medical imaging system, such that
- the visual indicator is arranged to be displayed superimposed on a corresponding portion of the selected body part of the video image on the patient image display. Such a medical imaging system comprises an ultrasound imaging system having an ultrasound transducer for scanning a patient; a video imaging device for creating an image of a selected body part of the patient to be scanned; a transducer position tracker (or sensor) which identifies the location of the ultrasound transducer in relation to the selected body part being scanned; and a video/data integration processor, responsive to the image of the selected body part and the position of the ultrasound transducer, which overlays a visual indicator over the image which indicates the path travelled by the transducer during the scanning of the patient. The visual indicator thus indicates to the operator areas of the selected body part which have been scanned and areas of the selected body part which have yet to be scanned or were missed during the previous scanning of the body part.
In accordance with a further aspect of the present invention, the visual indicator can depict information about the quality of scanning of a particular region, such as poor acoustic coupling or regions that were completely scanned.
An advantage of the invention is that the selected body part of the patient is visible to the technician or clinician on a display, and the scan area surveyed using the ultrasound transducer is made visible in that context by use of a visual indicator. The visual indicator is superimposed on the video image of the region of the selected body part which has just been investigated by the ultrasound. The area actually covered is highlighted with respect to the total area of the selected body part, and only a glance is required to see which part of the patient has been scanned previously.
Further, the scan can be checked for selected quality parameters. A decision on how well the scan or survey meets a chosen quality parameter can be displayed in the same manner using other visual indicators, which are also immediately visible to the technician or clinician. For example, a scan which is performed with too much speed can be detected from the output of the transducer position tracker. Such a scan should be repeated to obtain better ultrasound data over that particular area. A visual indicator representing the excess speed can be displayed and may comprise a colour, e.g. red for a scan which has been effected too fast or a shading pattern, or an outline, or text warning. (In addition, an audible warning can be given - such an audible warning would prompt the operator to look at the display to make sure that the visual indicators are noticed or could indicate a particular kind of problem with the scan). This problem is then immediately evident to the operator who can reposition the transducer and repeat the scan movement more slowly. The operator is aware of the precise region to scan again due to the display images and can more accurately scan the correct area again. The ultrasound transducer moves in multiple degrees of freedom, often classed into linear and rotational motion. A theoretically good scan moves steadily and linearly across a target area and data is collected from adjacent equally spaced regions which are used to form an overall image. If a rotational movement is introduced then the effect of this movement is not equal at all depths accessed by the ultrasound beam. Rotation introduces quality issues which may be more apparent at a depth of 6cm below the skin surface of the patient than at the skin surface itself. This is also influenced by the speed of the scan, the image again being more compromised at depth than at the skin surface.
In a further embodiment of the invention there is provided a medical imaging system, wherein a second visual indicator relating to a second ultrasound scan on a second portion is further superimposed on a second corresponding portion of the video image.
When a survey of a selected body part of a patient is being conducted, it is often necessary to make several sweeps with the transducer in order to cover the entire region of interest. It is thus advantageous to be able to combine information from a second ultrasound scan with the information already obtained from a first ultrasound scan and to display both sets of information simultaneously to the operator. In a simple example, the first and second visual indicators may both represent the quality of the scan speed over two spatially distinct areas of the region of interest. This gives the operator the opportunity to observe exactly which parts of the region of interest have been scanned correctly and thus decide what part or parts to scan next.
In a traditional approach to breast screening with ultrasound, volumetric data has been acquired in sets. Spatially registered image data can be reviewed during (or after) the ultrasound examination and may be used to subsequently locate a region of concern. Such a region can be highlighted by means of the invention.
In a further embodiment of the invention there is provided a medical imaging system , wherein the visual indicator comprises a first visual characteristic signifying a first quality parameter, and/or a second visual characteristic signifying a second quality parameter, and/or a third visual characteristic signifying a third quality parameter.
In a further embodiment of the invention there is provided a medical imaging system, wherein the first quality parameter relates to properly acquired ultrasound data in relation to an acquisition protocol, and/or the second quality parameter relates to incorrect acquisition of ultrasound data and/or the third quality parameter relates to areas of the selected body part of the patient missed by the ultrasound scan. The information required by the technician or clinician can be dependent on the purpose of the ultrasound scan. Basic information such as scan coverage and correct scan implementation may be supplemented by other visual identifiers for quality parameters chosen by the user. A particularly important quality parameter for freehand ultrasound scanning is the identification of areas of the selected body part of the patient which have not been scanned.
For whole breast examinations, missing a small region of the breast or associated tissue can lead to serious consequences. By means of the present invention, the scanned regions are identified and displayed, and analysis can be provided to determine missed regions (or the operator can see the missed regions on the display), and the missed region can be very visibly highlighted to indicate to the operator that a further sweep with the ultrasound transducer is required in that area. Thus it is ensured that the entire breast and associated tissue is scanned.
In a further embodiment of the invention there is provided a medical imaging device wherein the transducer position tracker comprises an accelerometer, or an
electromagnetic location means, or optical location means.
The transducer position tracker is a device which monitors the position of the ultrasound transducer and movement of the transducer. During a single ultrasound scan or sweep the trajectory of the transducer can be monitored. This allows the ultrasound data and trajectory of the ultrasound transducer to be correlated with the associated parts of the video image of the patient.
In a further embodiment of the invention there is provided a medical imaging system, wherein an ultrasound image produced from the ultrasound scan is also displayed on the patient image display.
In a further embodiment of the invention there is provided a medical imaging system wherein the medical imaging system further comprises an ultrasound image display for display of the ultrasound image.
An ultrasound technician is trained to look at the ultrasound images produced by use of the ultrasound transducer. In order to facilitate ease of use of the medical imaging system, the invention provides for the possibility that the normal ultrasound image can be displayed such that both the ultrasound image and the image on patient image display can be viewed simultaneously. This can be achieved either by allocating a section of the patient image display for the ultrasound image or by providing a separate display for the ultrasound image located conveniently adjacent to the patient image display. Use of the invention thus lowers the threshold of operator skill required to perform an exam of a patient. Less training is required while maintaining, or even improving, the consistency and quality of the data obtained from the patient.
In a further embodiment of the invention there is provided a medical imaging system, wherein the ultrasound scan performed is a whole breast scan.
Whole breast imaging has been an area of interest for many years. The solutions provided in the clinical environment have so far not fully addressed the specific issues associated with this type of examination, such as mechanical properties of the breast, size variation from patient to patient, and access to the associated regions of the body (e.g. axilla and lymph nodes) which should be scanned as part of a complete examination. The invention, although applicable to many kinds of ultrasound examination, is particularly effective in deadline with the challenges presented by whole breast imaging through quality controlled use of the freehand scanning technique. Optical means provide feedback on the completeness of the breast image acquisition and the clinician is provided with a
photographic image of the breast being scanned. The photograph is overlaid with colour or shading showing the past position of the transducer and the breast while being scanned and the visual information provided can be augmented with other indicators showing tissue deformation or missed regions.
In another aspect of the invention there is provided a method of operating a medical imaging system comprising the step of:
- Superimposing a visual indicator of the position and/or movement of the ultrasound transducer over the scanned portion of the selected body part in the video image.
An advantage of the invention is that the selected body part of the patient is visible to the technician or clinician on a display, and the scan area surveyed using the ultrasound transducer is made visible in that context by use of a visual indicator. The visual indicator is superimposed on the video image of the region of the selected body part which has just been investigated by the ultrasound. The area actually covered is highlighted with respect to the total area of the selected body part, and only a glance is required to see which part of the patient has been scanned previously.
Further, the scan can be checked for selected quality parameters. A decision on how well the scan or survey meets a chosen quality parameter can be displayed in the same manner using other visual indicators, which are also immediately visible to the technician or clinician. For example, a scan which is performed with too much speed can be detected from the output of the transducer position tracker. Such a scan should be repeated to obtain better ultrasound data over that particular area. A visual indicator representing the excess speed can be displayed and may comprise a colour, e.g. red for a scan which has been effected too fast or a shading pattern, or an outline, or text warning. (In addition, an audible warning can be given - such an audible warning would prompt the operator to look at the display to make sure that the visual indicators are noticed or could indicate a particular kind of problem with the scan). This problem is then immediately evident to the operator who can reposition the ultrasound transducer and repeat the scan movement more slowly. The operator is aware of the precise region to scan again due to the display images and can more accurately scan the correct area again.
The ultrasound transducer moves in multiple degrees of freedom, often classed into linear and rotational motion. A theoretically good scan moves steadily and linearly across a target area and data is collected from adjacent equally spaced regions which are used to form an overall image. If a rotational movement is introduced then the effect of this movement is not equal at all depths accessed by the ultrasound beam. Rotation introduces quality issues which may be more apparent at a depth of 6cm below the skin surface of the patient than at the skin surface itself. This is also influenced by the speed of the scan, the image again being more compromised at depth than at the skin surface.
In a further embodiment of the invention there is provided a method of operating a medical imaging system, comprising the further step of:
- Retaining a first result of a visual indicator for first ultrasound scan on the video image while displaying a second result of a visual indicator of a second ultrasound scan.
When a survey of a selected body part of a patient is being conducted, it is often necessary to make several sweeps with the ultrasound transducer in order to cover the entire region of interest. It is thus advantageous to be able to combine information from a second ultrasound scan with the information already obtained from a first ultrasound scan and to display both sets of information simultaneously to the operator. In a simple example, the first and second visual indicators may both represent the quality of the scan speed over two spatially distinct areas of the region of interest. This gives the operator the opportunity to observe exactly which parts of the region of interest have been scanned correctly and thus decide what part or parts to scan next.
In a traditional approach to breast screening with ultrasound, volumetric data has been acquired in sets. Spatially registered image data can be reviewed during (or after) the ultrasound examination and may be used to subsequently locate a region of concern. Such a region can be highlighted by means of the invention.
In a further embodiment of the invention there is provided a method of operating a medical imaging system, comprising the further steps of:
- Determining an area of the selected body part of the patient missed by the ultrasound scan by analysis of the first and second results,
- Representing the area by means of a third visual indicator,
- Displaying the third visual indicator on a corresponding area of the video image.
The information required by the technician or clinician can be dependent on the purpose of the ultrasound scan. Basic information such as scan coverage and correct scan implementation may be supplemented by other visual identifiers for quality parameters chosen by the user. A particularly important quality parameter for freehand ultrasound scanning is the identification of areas of the selected body part of the patient which have not been scanned.
For whole breast examinations, missing a small region of the breast or associated tissue can lead to serious consequences. By means of the present invention, the scanned regions are identified and displayed, and analysis can be provided to determine missed regions (or the operator can see the missed regions on the display), and the missed region can be very visibly highlighted to indicate to the operator that a further sweep with the ultrasound transducer is required in that area. Thus it is ensured that the entire breast and associated tissue is scanned.
In a further aspect of the invention there is provided a method of operating a medical image system, comprising the further steps of:
- Obtaining an ultrasound image of the selected body part by means of the ultrasound transducer,
- Displaying the ultrasound image.
An ultrasound technician is trained to look at the ultrasound images produced by use of the ultrasound transducer. In order to facilitate ease of use of the medical imaging system, the invention provides for the possibility that the normal ultrasound image can be displayed such that both the ultrasound image and the image on patient image display can be viewed simultaneously. This can be achieved either by allocating a section of the patient image display for the ultrasound image or by providing a separate display for the ultrasound image located conveniently adjacent to the patient image display. Use of the invention thus lowers the threshold of operator skill required to perform an exam of a patient. Less training is required while maintaining, or even improving, the consistency and quality of the data obtained from the patient.
In a further aspect of the invention there is provided a method of operating a medical imaging system, comprising the further step of:
- Selecting the whole breast region as the selected body part.
Whole breast imaging has been an area of interest for many years. The solutions provided in the clinical environment have so far not fully addressed the specific issues associated with this type of examination, such as mechanical properties of the breast, size variation from patient to patient, and access to the associated regions of the body (e.g. axilla and lymph nodes) which should be scanned as part of a complete examination. The invention, although applicable to many kinds of ultrasound examination, is particularly effective in deadline with the challenges presented by whole breast imaging through quality controlled use of the freehand scanning technique. Optical means provide feedback on the completeness of the breast image acquisition and the clinician is provided with a
photographic image of the breast being scanned. The photograph is overlaid with colour or shading showing the past position of the ultrasound transducer and the breast while being scanned and the visual information provided can be augmented with other indicators showing tissue deformation or missed regions.
BRIEF DESCRIPTION OF THE FIGURES :
The invention will be further elucidated by reference to the following figures: Fig. 1 shows a schematic drawing of a device according to the invention Fig. 2 shows a schematic drawing of the patient image display of the invention Fig. 3 shows a flowchart of a method according to the invention
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
The invention will be described here in terms of ultrasound scanning as applied to whole breast imaging, but it should be understood that the principles of the invention can be applied to the ultrasound investigation of any part of the human body.
Fig. 1 illustrates a medical imaging system 1. This medical imaging system 1 comprises an ultrasound system 2 comprising an ultrasound transducer 3 which can be applied to a patient in order to form an ultrasound image of a selected body part of the patient. A camera 5 is placed above the selected body part of the patient and operated so as to produce a video image of the selected body part on a patient image display 6. The transducer 3 is monitored in terms of its position by a transducer position tracker 4, incorporating a spatial field generator 9.
A suitable transducer position tracker 4 is the Percunav™ system available from the Traxtal division of Philips Healthcare of Andover, MA, USA. The Percunav system uses a magnetic field transmitter as a spatial field generator 9 to envelop the body part being scanned with an r.f or magnetic field. A sensor (not shown) attached to the ultrasound transducer 3 locates the position of the ultrasound transducer in the three dimensional coordinates of the magnetic field and this position information is transmitted to the integration processor 7. A sensor (not shown), cooperating with the transducer position tracker 4, attached to the patient examination table locates the patient in the magnetic field. It is usual to register specific anatomical landmarks by placing the ultrasound transducer 3 on those landmarks and instructing the system that the ultrasound transducer 3 position and a specific landmark correspond. A possible means of achieving this would be to highlight targets on the video screen or patient image display to and ask the operator to place the transducer at that point and indicate that point to the system. An obvious landmark would be the nipple, for example, but there is no reason to constrain the choice to that point - landmarks can be arbitrary. The position of the transducer 3 is thereby capable of being related to the part of the patient being imaged by the camera 5 by a video/data integration processor 7.
The technique of registration depends on the ultrasound system being used. Manual registration is not always necessary, some systems having a method of automatic registration. In an optical approach, for example, it is possible that anatomical landmarks and manual registration may not be needed - the video capture of the ultrasound transducer position being sufficient. Registration is often particularly important where the ultrasound images are being related to data from another imaging technique. For example, CT scanning data must be correctly related to ultrasound scanning data when the ultrasound images are used to guide procedures involving ablation of tissue.
Alternatively it is possible to track an ultrasound transducer, in multiple degrees of freedom, for example by means of the ultrasound images captured. According to patent applications WO2009/147620 A2 and WO2009/147621 A2, the ultrasound transducer motion and position can be determined during a freehand ultrasound scan, when multiple planar ultrasound images are available in an extended field of view or volume, these images resulting from acquisition using electronic beam steering from a 2D transducer array probe (i.e. matrix or checkerboard arrangement of the transducer probe elements). The transducer array probe can steer an ultrasound beam in a number of arbitrary directions. Images from the different directions are used to form an extended field of view ultrasound image but can also be utilized to track the motion of the ultrasound transducer in several directions.
Matching of successively acquired images can be used to estimate the transducer motion, including the velocity, distance travelled, or path covered. The applications go on further to describe that the techniques applied to 2D images (panoramic ultrasound imaging) can also be applied to 3D images (bi-plane ultrasound imaging, freehand 3D imaging) by considering images from different planar orientations. Thus the transducer motion in 3D is determined.
Such a means for tracking the position and motion of the ultrasound transducer is highly compatible with the present invention.
The operator or technician conducting the ultrasound procedure receives feedback on the ultrasound scanning and positioning of the transducer in two ways. The internal anatomy of the breast being scanned is shown in an ultrasound image 10 on the ultrasound system image display 11. Also shown on the display 11 or on a separate patient display monitor 6, e.g., the Percunav system display, is the video image of the body part being scanned, in this example, the patient's breast. According to the invention, the device is arranged so that visual indicators 8 of the region(s) of the body part which have been scanned are superimposed on corresponding parts of the video image of the patient displayed on the patient display monitor 6. As the ultrasound transducer 3 is moved over the patient's body in acoustic contact with the skin of the patient, the path over which the ultrasound transducer 3 has travelled is indicated on the patient display monitor 6 of the body part by a build-up of the visual indicators 8 over the image of the body part. As the transducer 3 scans more and more of the patient's anatomy, the anatomy in the video display is increasingly overlaid by visual indicators 8. Feedback, by these visual means on the progress and completeness of the scanning is thus available to the operator or technician.
The quality and completeness of the scanning can be measured against predetermined criteria. Comparison of the area of the body part covered by visual indicators 8 against the appropriate areas to be scanned during a particular procedure is made using the video/data integration processor 7. The video/data integration processor 7 may thereby detect regions or areas of the body part which have been missed during scanning, such as spaces between adjacent sweeps with the transducer 3. The operator can thus be alerted to rescan areas that have been missed so that a collection of images which fully cover the body part are obtained.
Fig. 2 further illustrates an example of the patient image display 6 of the invention in greater detail. The video image of the patient is overlaid in this example by rectangular visual indicators 8, each rectangle depicting a sweep of the ultrasound transducer over the area of the body part covered by the indicator. Three visual indicators can be seen at 8a, 8b, 8c, each of which conveys different information about the quality of the scanning performed at that region of the body part. Visual characteristic 8a, here shaded gray, indicates a good quality ultrasound scan. Visual characteristic 8b, here show with right- slanting stripes, indicates a particular scan region where the scan was not properly acquired. This may be detected by ultrasound signal dropout at that region, such as may occur when the acoustic contact with the skin is poor. Visual characteristic 8c, here shown with left-slanting stripes, indicates a region missed by the ultrasound scan. This can be detected by the occurrence of gaps or spaces between the visual indicators laid down by adjacent scanning paths of the transducer, for instance. In this way the visual indicators 8 not only show the operator the regions of the body part which have been scanned, but also the quality of the scanning performed at those regions.
Fig. 3 illustrates a method of operating a medical imaging system according to the invention. The method involves imaging a selected body part of a patient to produce a video image 101 and displaying the video image 102. This is followed by scanning a portion of the selected body part with an ultrasound transducer 103. By determining the position and/or movement of the transducer over the scanned portion 104, the next step of locating the position and/or movement of the transducer with the video image of the body part is facilitated 105. Superimposing a visual indicator of the position and/or movement of the ultrasound transducer over the scanned portion, the visual indicator being optionally representative of the local quality of the ultrasound scan, on a corresponding portion of the video image 106 is the final method step.
It will be appreciated by those skilled in the art that the ultrasonic scanning can be performed by freehand manual scanning with an ultrasound probe, or by mechanical translation of an ultrasound transducer 3 over a selected body part of a patient. It will also be appreciated that the transducer position tracker 4 can be implemented as an accelerometer, or an electromagnetic location device, or an optical locating device.

Claims

List of reference numerals
1. medical imaging system
2. ultrasound system
3. ultrasound transducer
4. transducer position tracker
5. camera
6. patient image display
7. video/data integration processor 8. visual indicator
a. first visual characteristic b. second visual characteristic c. third visual characteristic 9. spatial field generator
10. ultrasound image of selected body part
11. ultrasound image display
101 to 106 method steps according to the invention
CLAIMS:
1. A medical imaging system (1) comprising:
- a camera (5), arranged to provide a video image of a selected body part of a patient, the video image being displayed on a patient image display (6),
- an ultrasound system (2) comprising a transducer (3),
- the transducer (3) capable of being used to ultrasonically scan the selected body part of the patient, and arranged in cooperation with,
- a transducer position tracker (4), for determination of a position of the transducer (3) during an ultrasound scan,
- the transducer position tracker further providing an output of the position of the transducer (3) during the ultrasound scan to,
- a video/data integration processor (7), such means being responsive to the transducer position tracker (4) and the video image of the selected body part and arranged to locate a visual indicator (8) of the path scanned by the transducer in the video image of the selected body part.
wherein,
- the visual indicator (8) is arranged to be displayed superimposed on a corresponding portion of the selected body part of the video image on the patient image display (6). 2. A medical imaging system as claimed in claim 1, wherein a second visual indicator relating to a second ultrasound scan on a second portion is further superimposed on a second corresponding portion of the video image.
3. A medical imaging system as claimed in claims 1 and/or 2, wherein the visual indicator (8) comprises a first visual characteristic (8a) signifying a first quality parameter, and/or a second visual characteristic (8b) signifying a second quality parameter, and/or a third visual characteristic (8c) signifying a third quality parameter.
4. A medical imaging system as claimed in claim 3, wherein the first quality parameter relates to properly acquired ultrasound data in relation to an acquisition protocol, and/or the second quality parameter relates to incorrect acquisition of ultrasound data and/or the third quality parameter relates to areas of the selected body part of the patient missed by the ultrasound scan.
5. A medical imaging device as claimed in claim 1, wherein the transducer position tracker comprises an accelerometer, or an electromagnetic location means, or optical location means.
6. A medical imaging system as claimed in any of the above claims, wherein an ultrasound image produced from the ultrasound scan is also displayed on the patient image display. 7. A medical imaging system as claimed in any of the above claims further comprising an ultrasound image display (11) for display of the ultrasound image.
8. A medical imaging system as claimed in any of the above claims, wherein the ultrasound scan performed is a whole breast scan.
9. A method of operating a medical imaging system comprising steps of:
- Imaging a selected body part of a patient to produce a video image ( 101),
- Displaying the video image (102),
- Scanning a portion of the selected body part with an ultrasound transducer (103),
- Determining the position and/or movement of the transducer over the scanned portion (104 ),
- Comparing the position and/or movement of the transducer with the video image of the selected body part ( 105),
wherein the method further comprises the step of:
- Superimposing a visual indicator of the position and/or movement of the ultrasound transducer over the scanned portion of the selected body part in the video image (106 ).
10. A method of operating a medical imaging system according to claim 9, comprising the further step of:
- Retaining a first result of a visual indicator for first ultrasound scan on the video image while displaying a second result of a visual indicator of a second ultrasound scan.
11. A method of operating a medical imaging system according to claim 10, comprising the further steps of:
- Determining an area of the selected body part of the patient missed by the ultrasound scan by analysis of the first and second results,
- Representing the area by means of a third visual indicator,
- Displaying the third visual indicator on a corresponding area of the video image.
12. A method of operating a medical image system according to claims 9 or 10 or 11, comprising the further steps of:
- Obtaining an ultrasound image of the selected body part by means of the ultrasound transducer,
- Displaying the ultrasound image.
13. A method of operating a medical imaging system according to any of the above claims 9 to 12, comprising the further step of:
Selecting the whole breast region as the selected body part.
PCT/IB2011/055300 2010-12-03 2011-11-25 Device and method for ultrasound imaging WO2012073164A1 (en)

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