Interventional apparatus activated computed tomography (CT)

A system (100) includes an interventional apparatus (102) and an imaging scanner (101). The interventional apparatus includes a interventional instrument (204) configured to perform an image-guided interventional procedure for a patient. The interventional apparatus includes a position detector (122) that detects a position of the interventional instrument within a region of the patient at which the image-guided interventional procedure is performed from outside of the region of interest and generates a signal indicative of the detected position. The imaging scanner includes a controller (114) that activates the imaging scanner to scan the region of interest and the interventional instrument therein for one or more data acquisition cycles based on the movement signal.

FIELD OF THE INVENTION

The following generally relates to imaging and more particular to activating an imaging scanner to scan a region of interest of a subject and an interventional instrument (of an interventional apparatus) therein based on movement of the interventional instrument within the region of interest as determined by the interventional apparatus, and is described with particular application to a computed tomography (CT) imaging scanner; however, the following is also amenable to other imaging modalities.

BACKGROUND OF THE INVENTION

Interventional imaging includes using images to guide minimally invasive interventional procedures such as diagnostic, treatment, and/or other interventional procedures.

By way of example, with one transcatheter interventional procedure, a local anesthetic is injected or applied into the skin of a patient at an entry area to numb the entry area, a puncture is made to the entry area with a needle, scalpel, etc., and a plastic sheath is inserted into the artery. A catheter supporting an interventional instrument is then inserted and feed through the sheath and into the vessel, and moved to an area of interest of the patient, such as the heart, the brain, the lungs or other anatomical structure of interest, where the interventional procedure is performed.

The interventional instrument can then be employed to perform the interventional procedure. During the interventional procedure, images are periodically acquired and used to give the interventionalist orientation and update information on the progress of the procedure. Computed tomography (CT) images have been used to guide interventional procedures. However, since CT data acquisitions can deposit a relatively high amount of x-ray radiation dose, images in CT guided interventional procedures generally are acquired very rarely and only when needed. For example, typically, an image update is only acquired after the catheter has been moved or translated, forward or backward, a certain distance, since such movement may result in a change in the interventional situation.

Unfortunately, the interventionalist performing the interventional procedure has to determine when to acquire an image and manually trigger the CT scanner to acquire the image. As such, the interventionalist may error on the conservative side and initiate scanning before necessary, which may increase patient dose relative to initiating scanning a little later in time, while mitigating initiating scanning later than desired. Furthermore, the interventionalist is tasked with acts outside of the interventional procedure (i.e., determining when to scan and initiating scanning), and time consumed performing these acts could otherwise be used to perform the interventional procedure and/or interact with the patient.

SUMMARY OF THE INVENTION

Aspects of the present application address the above-referenced matters and others.

According to one aspect, a system includes an interventional apparatus and an imaging scanner. The interventional apparatus includes an interventional instrument configured to perform an image-guided interventional procedure for a patient. The interventional apparatus includes a position detector that detects a position of the interventional instrument within a region of the patient at which the image-guided interventional procedure is performed from outside of the region of interest and generates a signal indicative of the detected position. The imaging scanner includes a controller that activates the imaging scanner to scan the region of interest and the interventional instrument therein for one or more data acquisition cycles based on the movement signal.

According to another aspect, a method includes generating, with a position detector of an interventional apparatus, a movement signal indicative of a distance an interventional instrument of the interventional apparatus moves within a region of interest of a patient during an image-guided interventional procedure. The method further includes conveying the movement signal from the interventional apparatus to an imaging scanner used to generate images for the image-guided interventional procedure. The method further includes controlling, with a controller of the imaging scanner, scanning by the imaging scanner of the region of interest and the interventional instrument therein based on the movement signal for the image-guided interventional procedure.

According to another aspect, a computing readable storage medium encoded with computer readable instructions, which, when executed by one or more processors of a computing system, cause an imaging scanner to automatically scan a region of interest of a patient and an interventional instrument, of an interventional apparatus, therein in response to the a signal generated by the interventional apparatus, which is indicative of a movement of the interventional instrument within the region of interest, satisfying a predetermined threshold.

DETAILED DESCRIPTION

FIG. 1illustrates a system100including an imaging scanner101, such as a computed tomography (CT) imaging scanner, in connection with an interventional apparatus102.

The illustrated imaging scanner101includes a stationary gantry104and a rotating gantry106, which is rotatably supported by the stationary gantry104. The rotating gantry106rotates around an examination region108about a longitudinal or z-axis. A patient support110, such as a couch, supports a patient in the examination region108and is movable along the x, y and/or z-axis in coordination with the rotation of the rotating gantry106.

A radiation source112, such as an x-ray tube, is supported by and rotates with the rotating gantry106around the examination region108. A controller (“CTRLR”)114controls the radiation source112. By way of non-limiting example, the illustrated controller114is configured to activate the radiation source112(i.e., turn the radiation source112“on” such that the radiation source112emits radiation that traverses the examination region108) and deactivate the radiation source112(i.e., turn the radiation source112“off” such that such radiation does not traverses the examination region108). A radiation sensitive detector array116detects radiation that traverses the examination region108and generates projection data indicative of the detected radiation.

A reconstructor118reconstructs the projection data and generates volumetric image data indicative of the examination region108. The image data can be displayed, filmed, etc. A general purpose computing system serves as an operator console120, and includes an output device such as a display and an input device such as a keyboard, mouse, and/or the like. The console120includes a processor(s) and computer readable storage medium (e.g., physical memory) encoded with computer readable instructions, which, when executed by the processor allows a user to operate the scanner101such as initiating scanning, display reconstructed images, etc. Additionally or alternatively, the processor can execute computer readable instructions carried in signal medium (e.g., a carrier wave).

As briefly discussed above, the illustrated imaging scanner101is shown in connection with the interventional apparatus102. As described in greater detail below, the interventional apparatus102includes a position detector122that is configured to communicate with the imaging scanner101, for example, to convey a signal to the imaging scanner101(e.g., the console120and/or the source controller114) that triggers the imaging scanner101(e.g., with or without user interaction) to perform an action, such as activate the radiation source112and acquire data (i.e., perform a scan), based on a state such as a movement state or other state of the interventional apparatus102with respect to predetermined scan activation criteria, and/or other action.

As such, in one non-limiting embodiment, during an image-guided interventional procedure utilizing the interventional apparatus102, the interventionalist does not have to determine when to scan a region of interest of the subject (and the interventional instrument therein) positioned in the examination region108or manually trigger the imaging scanner101to scan the region of interest. Instead, the position detector122senses information about the position state of the interventional procedures and this information is utilized to determine when to scan the portion of the subject in the examination region108and to automatically trigger the scanner101to scan the subject. The foregoing allows the interventionalist to focus on the procedure and the patient, and may facilitate reducing patient dose relative to a configuration in which the position detector122is omitted. Of course, the interventionalist can still manually initiate scanning via the imaging scanner101to scan the subject and/or pause or terminate an automatically triggered scan.

FIG. 2schematically illustrates an example of the interventional apparatus102in connection with an example image guided procedure.

In this example, the interventional apparatus102includes an elongate flexible catheter202with an interventional instrument204affixed to an end205of the catheter202that enters an object or subject208and a sheath206through which the catheter202enters the object or subject208. The illustrated sheath206includes a first end210, which is inserted into the object or subject208, and a second end212which remains outside of the object or subject208. The second end212includes a hub or port214, which, generally, is geometrically larger than the first end210and sits or rests about an entry or access point216into the object or subject208created by the sheath206.

The object or subject208includes a tubular structure218that provides a pathway220to a region of interest222of the object or subject208. In the illustrated embodiment, the position detector122is disposed in connection with the hub214of the sheath206and can sense positional (e.g., translational, rotational, etc.) information about the catheter202relative to the sheath206. For example, the illustrated position detector122senses movement of the catheter202in and out of the sheath206, rotation of the catheter202within the sheath206, etc., and generates a movement signal indicative of the sensed movement.

The position detector122may be variously affixed to the sheath206. For example, in one embodiment, the position detector122may be part of the sheath206. In another embodiment, the position detector122is separate from but fixidly attached to the sheath206via an adhesive such as glue. In yet another embodiment, the position detector122is removeably attached to the sheath206. With this embodiment, a position detector122may be cleanable (e.g., sterilizeable, disinfectable, etc.) and alternately used with more than one sheath206. The position detector122conveys the movement signal to the controller114, directly and/or to the console120, via a wireless or wired (e.g., a cable) communications channel.

At least one of the console120or the controller114executes computer readable instructions for evaluating the movement signal and determining whether to activate the imaging scanner101to scan. In the illustrated embodiment, the computer readable instructions compute a distance that the catheter202has traveled (e.g., from the beginning of the procedure, relative to a last scan, relative to an identified landmark within the object or subject, etc.) based on the movement signal and compares this distance with a stored predetermined threshold distance. In one instance, where the distance in the movement signal satisfies the threshold, the controller114transmits a command signal that activates the source112to scan for a predetermined number of data acquisition cycles. Optionally, the console120can provide a notification indicating that the source112will be activated within a predetermined time period before activating the source112. Otherwise, the controller114does not activate the source112to scan.

In a variation of the above, the console120visually presents or provides a notification that indicates that data should be acquired and waits for a user confirmation. Such confirmation could be through an audible command such as a voice command from the user. Additionally or alternatively, the confirmation could be through a joystick, a foot pedal, a keyboard, a mouse, and/or other known input device. Additionally or alternatively, the user can manually invoke the imaging scanner101to acquire data independent of the trigger signal via an audible command and/or a joystick, a foot pedal, a keyboard, a mouse, the console120, and/or other known input device.

In a non-limiting application of the above, the subject208is a human patient, the entry point216is the femoral artery via the groin, and thus the sheath206is partially inserted into the femoral artery at the groin, with a sub-portion of the sheath206including the hub214remaining outside of the patient at the groin. In this example, the region of interest222is anatomical structure such as the heart (or brain, lungs, etc.), and the interventional device204affixed to the end of the catheter202is configured for performing an interventional procedure at the structure of interest. Examples of cardiac interventional procedures include, but are not limited to, angioplasty, angiography, balloon septostomy, etc.

The position detector122senses movement of the catheter202within the region of interest222based on movement of the catheter202with respect to the position detector122, and, if it is determined the movement of the catheter202corresponds to a distance that satisfies the predetermined distance threshold value, then the controller114invokes the scanner101to acquire data. The resulting displayed image visually shows the location of the interventional instrument204within the region of interest222. The interventionalist performing the procedure can utilize the displayed image to facilitate guiding and employing the interventional instrument204in connection with the interventional procedure.

FIG. 3schematically illustrates a non-limiting embodiment of the position detector122including a mechanical based motion sensor.

In this embodiment, the position detector122includes at least one element300configured to rotate. For explanatory purposes, the at least one element300includes a wheel302. However, other elements such as a ball, a roller, or other rotating element300may additionally or alternatively be used.

The illustrated wheel302is rotatably supported by the position detector122, for example, via a pin, rod, or the like through a center axis of the wheel302. Furthermore, the position detector122is affixed to the hub214such that the wheel302physically contacts an outer surface of the catheter202in response to the catheter202in the sheath206. A mechanism such as a spring or the like may be used to exert a force that facilitates ensuring physical contact of the wheel302with the catheter202.

A transducer304, such as a rotary encoder or the like, senses the rotational position of the wheel302relative to a predetermined reference position. The transducer304generates an analog or digital signal indicative of the rotational position of the wheel302relative to the reference position. The position detector122conveys the signal to the console120and/or controller114.

With this embodiment, each angular increment of the wheel302corresponds to a translational distance along the catheter202. As such, the signal from the position detector102is indicative of a translational movement distance of the catheter202in the sheath206and hence in the region of interest of the subject208. The wheel302is free to rotate in either direction, and the signal indicates the direction and magnitude of the movement, into or out of the sheath206.

In the illustrated embodiment, the position detector122includes single wheel302. In a variation, the position detector122may include more than one wheel302and/or other rotating element300. With this variation, one or more of the wheels302and/or other rotating element300may be used to determine the rotational position.

FIG. 4schematically illustrates another non-limiting embodiment of the position detector122including a mechanical based motion sensor.

In this embodiment, the catheter202includes a plurality of protrusions or nubs402, protruding outward from the catheter202. The plurality of protrusions402are separated from each other by a known distance, which correspond to a length of catheter202between protrusions402. The protrusions402may be part of the catheter202(e.g., ribs) or affixed thereto. The position detector122includes a transducer404or the like which, in response to physically contacting one of the protrusions402, generates a signal indicative of the physical contact.

The position detector122conveys the signal to the console120and/or controller114. With this embodiment, since the plurality of protrusions402are spaced at known distances, each signal indicating a protrusion402has been detected corresponds to a translational distance of the catheter202. As such, the signal from the position detector122is indicative of a translational movement distance of the catheter202in the sheath206and the region of interest of the object or subject208. As with the wheel302, the transducer404can indicate the direction and magnitude, and rotational or other motion of the catheter202in the sheath206.

FIG. 5schematically illustrates another non-limiting embodiment of the position detector122including an optical based motion sensor.

In this embodiment, the position detector122includes a transmitter502and a receiver504, and the catheter202includes a predetermined pattern506with a known reflective characteristic. By way of non-limiting example, the illustrated pattern506includes a plurality of bars508of alternating different colors (e.g., white and black, or red, green, blue, etc.) in which a distance between a given set of bars corresponds to a known translation distance. In other embodiment, the pattern506includes other reflective indicia. A power source510such as a battery provides power to energize the transmitter502and the receiver504.

In operation, the transmitter502(e.g., a light emitting diode (LED) or other light source) transmits light which illuminates the catheter202and reflects off the pattern506. The receiver504receives the reflected light and generates a signal indicative thereof. Since the bars508are spaced at known distances, the signal generated by the receiver504corresponds to a distance moved by the catheter202. As such, the signal from the position detector122is indicative of a movement distance of the catheter202in the sheath206and hence in the region of interest of the object or subject208.

In a variation, each bar508could also have a pattern, which can be used to determine rotational motion of the catheter202. Similar to above, the pattern can be determined based on the detected reflected signal, and a rotational distance can be determined based on the detected reflected signal.

FIG. 6schematically illustrates a variation ofFIG. 5in which a plurality of light transmitters602, powered by a battery or otherwise, are located along the catheter202at known distances apart and emit light that is detected by the receiver504. Since the light transmitters602are spaced at known distances, the signal from the receiver504corresponds to a translational distance of the catheter202. As such, the signal from the position detector122is indicative of a translational movement distance of the catheter202in the sheath206and hence in the region of interest of the object or subject208.

FIG. 7schematically illustrates another non-limiting embodiment of the position detector122including a radio frequency based motion sensor.

In this embodiment, a passive emitter700is attached to (e.g., embedded in, affixed to, etc.) the catheter202, near the interventional instrument204, and the position detector122includes a transceiver702that transmits signals having a wavelength within a predetermined wavelength range. The passive emitter700, in response to receiving signal in the predetermined wavelength range, emits a characteristic signal, which is received by the transceiver702.

A signal strength of the received signal indicates a relative distance between the passive emitter700and the transceiver702, and the transceiver702generates a signal indicative of the signal strength. Where the distance between the passive emitter700and the transceiver702corresponds to an length of the catheter202inserted into the sheath206, the signal from transceiver702is indicative of the translational movement of the catheter202.

It is to be understood that the examples ofFIGS. 3-7are non-limiting and other approaches are contemplated herein. In addition, one or more of the approaches ofFIGS. 3-7and/or other approaches can be combined, modified, etc.

FIG. 8illustrates a method for activating scanning by an imaging scanner during an image-guided interventional procedure by the interventional apparatus.

It is to be appreciated that the ordering of the following acts is non-limiting. As such, other orderings are also contemplated herein. Furthermore, one or more of the following acts may be omitted and/or one or more acts may be added.

At802, an interventional instrument of an interventional apparatus is positioned within a region of interest within a patient as described herein.

At804, the interventional instrument is moved within the region of interest, for example, by an interventionalist performing the interventional procedure with the interventional apparatus.

At806, a sensor of the interventional apparatus senses the movement and generates a signal indicative thereof.

At808, the signal is conveyed to the imaging scanner.

At810, the signal is evaluated to determine a relative distance the interventional instrument has moved within the patient.

At812, the distance is compared with a predetermined scanning threshold distance.

At814, the scanner is activated to scan only in response to the distance satisfying the threshold. As such, scans are performed automatically only when needed.

At816, one or more images generated from the scan are displayed.

Otherwise and/or afterwards, acts804-814are repeated one or more times.

Although described above in connection with computed tomography (CT), it is to be appreciated that the above is also applicable to other imaging modalities such as, but not only, positron emission tomography (PET), single photon emission tomography (SPECT), magnetic resonance imaging (MRI), ultrasound (US), three dimensional (3D) x-ray, and/or other imaging modalities.

The invention has been described herein with reference to the various embodiments. Modifications and alterations may occur to others upon reading the description herein. It is intended that the invention be construed as including all such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.