Method for recording medical data in two modes

A laser beam scanner system records medical information on a direct-read-after-write optical data storage strip. The strip is adhered to a medium containing a picture, such as X-ray pictures, CAT-scan pictures, ultrasonic or NMR images, or microscope photos of tissue samples. The strip may record information such as a description or diagnosis related to the picture for archival storage.

TECHNICAL FIELD 
The invention relates to optical data information storage and more 
particularly to a method for recording on an information medium with both 
medical optical images and laser recorded direct-read-after-write (DRAW) 
reflective data, such as a medical diagnosis related to the optical image. 
BACKGROUND ART 
In the field of archival data storage, it is frequently necessary to store 
audio-visual information. Adding digital information by means of a small 
laser recorder could be of considerable value for stored X-ray pictures, 
CAT-scan pictures, microscope photographs, NMR and ultrasonic scan 
pictures, and other diagnostic images. Such add-on records have a 
potential of getting separated from the recorded film during storage in 
medical archives. Even if not separated, the differences in archival 
storage properties, say between film and paper, pose storage problems. 
In U.S. Pat. No. 4,236,332, Domo discloses a wallet-size medical record 
card to be carried by the individual containing a microfilm portion having 
some data visible to the eye and other data visible by magnification. The 
directly visible data is code characters pertaining to emergency medical 
conditions of the patent and the magnifiable data portions detail the 
medical history. Such cards are not intended for archival storage and 
cannot be used for that purpose. Cards cannot contain X-ray pictures, 
CAT-scan pictures and the like without loss of vital image resolution. 
In U.S. Pat. No. 4,110,010, Johnson et al. add bar codes along the edge of 
microfilm having image areas. These codes are used by the film reader to 
locate the desired frame. Bar codes are rather limited in the type and 
amount of information they can represent, so their use with detailed 
medical information is undesirable. 
An object of the invention is to provide recorded medical information, such 
as a diagnosis, directly on a medium with an accompanying visual image, 
such as an X-ray picture, CAT-, NMR-, or ultrasonic-scan picture or 
microscope photograph. 
A further object of the invention is to record the information either prior 
to, during, or after exposure forming the visual image. 
A further object of the invention is to record standard alphanumeric 
diagnoses, doctor composed spoken diagnoses or other recorded spoken words 
in combination with a medical picture on a storage medium, such as film. 
DISCLOSURE OF THE INVENTION 
The above objects have been met by recording medical information on a strip 
of direct-read-after-write laser recordable material disposed on a medical 
picture storage medium next to a medical image. The medium is typically 
film which could be either unexposed or exposed in plates, strips, or roll 
configuration. The film records visual images of a body, such as X-ray 
pictures, CAT-scan pictures, NMR- and ultrasonic-scan pictures, microscope 
photographs, and other diagnostic images. The data strip could be recorded 
in-situ on blank optical media or pre-recorded and added to the film. 
Analytical or interpretive data, such as a diagnosis, or an anatomical 
description, may be integrated with the picture record and both stored 
together. A laser beam records data on the strip of laser recordable 
material either by ablation of the metal layer, thereby forming cavities, 
or by deformation, thereby forming spots. Differences in reflectivity or 
transmissivity are detectable by a light detector. In this manner, data 
concerning the visual image may be digitally recorded and read directly 
from the strip. The reflective strip may contain prerecorded data, 
concurrently recorded data or data recorded after exposure of the 
photosensitive film portion of the media. 
No processing after laser recording is required for the recording strip 
since it is a direct-read-after-write material. The uniform surface 
reflectivity of this reflective strip before recording typically would 
range between 15% and 65%. For best mode of operation a reflectivity of 
25% to 50% would normally be used. The average reflectivity over a laser 
recorded hole might be in the range of 6% to 12%. Thus, the reflective 
contrast ratio of the recorded holes would range between 2:1 and 8:1. 
Photographic pre-formatting would create spots having a reflectivity of 
10%. 
The laser scanning system records and reads using a mirror directed laser 
beam and a photodetector. A photodetector array such as a CCD could also 
be used. A laser light source, such as a semiconductor laser, emits a beam 
which is directed to a first servo-controlled mirror. The mirror is 
mounted for rotation along an axis such that the beam may be moved 
laterally on the strip. The strip has data tracks running in the 
lengthwise direction of the strip. The lateral motion of the beam thus 
allows different tracks to be recorded and read. From the first mirror, 
the beam is directed toward a second servo-controlled mirror. This second 
mirror is mounted for rotation along an axis such that the beam may be 
moved lengthwise along the strip. In this way the beam moves along a 
track. Upon reading or writing one track, the first mirror moves an 
incremental amount so that the next track may be scanned. It is also 
possible to align the tracks in a crosswise direction and switch the 
scanning direction so that it is in the lateral direction of the strip. 
Differences in reflectivity between a data spot are detected by a light 
detector, such as a photodiode, which produces electrical signals 
corresponding to the spots. Prerecorded reference position information may 
be present on the strip to aid servo control. 
An advantage of the invention is that laser recorded data will not be 
separated from corresponding image data and both will have similar 
archival properties. The strip may be placed directly on the photographic 
film or on the film substrate.

BEST MODE FOR CARRYING OUT THE INVENTION 
With reference to FIG. 1, the data medium used in the present invention may 
be seen to comprise a photosensitive medium 11 having a planar major 
surface 13 which is divided into a photographic image areas 15 and a data 
strip 17. Photosensitive medium 11 is preferably photographic film in 
sheet form, for example X-ray film, plate film, microfiche film or high 
resolution photoplates of the type used in the semiconductor industry. The 
photographic image areas 15 are conventional photographic images, produced 
by usual photographic techniques, typically by exposure and development of 
the film. The image areas 15 may occupy the entirety of the film, except 
for the data strip, or discrete areas as shown in FIG. 1. The discrete 
areas may resemble motion picture film or roll film or microfiche film 
where several images are disposed on a unitary film member. Alternatively, 
only a single image may be on the film. 
The present invention features an optical data strip 17 which is a direct 
read-after-write (DRAW) material which may have either prerecorded 
information or user-written information, or both. The type of DRAW 
material used is relatively highly reflective material which forms a shiny 
field against low reflectivity spots such as pits, craters, holes or dark 
spots in the reflective surface which tend to be absorptive of light 
energy. The contrast differences between the low reflectivity spots and 
the shiny reflective field surrounding the spots cause variations at a 
detector when the spots are illuminated by light of lesser intensity than 
the light that originally created the spots. There are also laser 
recording materials which create reflective spots in a dark field. 
Data strip 17 is intended to provide an archival data record accompanying 
the photographic images on the same material in the same way that a movie 
sound track accompanies individual frames of film. Data is written in 
individual tracks extending in a longitudinal direction, as indicated by 
the spot patterns 19 and these spot patterns are analogous to sound track 
on a film, except that the data tracks contain a much higher density of 
information and are usually read in reflection, rather than in 
transmission. The information density is greater because each of the spots 
in the spot pattern is approximately 5 microns in diameter with a spacing 
of about 5-20 microns between spots. The spots may be either digital or 
analog data, but in either case are recorded by a laser in the usual way, 
for example as shown in U.S. Pat. No. 4,278,756 to Bouldin, et al. 
FIG. 2 is similar to FIG. 1 except that a larger photosensitive medium 21 
is used with a plurality of rows of images 23, 25 and 27. Accompanying 
each row of images is a corresponding data strip 33, 35 and 37. These data 
strips are analogous in construction to the strip of FIG. 1. Once again, 
it is not necessary that each row have individually different images. Each 
row may consist of either multiple images or a single image. The 
embodiment of FIG. 2 is a microfiche type medium where each row of images 
would have corresponding data on a data strip. The images are such that 
they can be viewed with the naked eye or with low power (magnification) 
optical systems. On the other hand, the data strips may not be read with 
the naked eye, but require either microscopic inspection or preferably 
reading by reflection of a scanning laser beam as explained below. 
FIG. 3 illustrates a first construction of the recording medium shown in 
FIG. 2. The sectional view includes a substrate 22 which is transparent 
and may be glass or one of the many polymeric substrate materials known in 
photographic arts. Applied to the substrate 22 is a subbing layer, not 
shown, and an emulsion layer 24. This emulsion layer has a photographic 
image area 15 made by exposure and development in the usual way. The wavy 
lines 26 represent filamentary black silver particles which characterize 
normal photographic black and clear images. Data strip 17 is a laser 
recording material made from silver-halide emulsion having fine grain 
size, less than 0.1 microns, by a silver diffusion transfer process 
described in U.S. Pat. No. 4,312,938 (Drexler and Bouldin), incorporated 
by reference herein. The data strip 17 is made prior to processing the 
image areas 15. 
In the patented process, silver-halide emulsion is exposed to a 
non-saturating level of actinic radiation to activate silver halide. The 
activated emulsion is then photographically developed to a gray color of 
an optical density of 0.05-2.0 to red light, forming an absorptive 
underlayer. There is no fixing after this first development step. The 
surface of the emulsion strip is then fogged by a fogging agent such as 
borohydride to produce silver precipitating nuclei from the part of the 
unexposed and undeveloped silver-halide emulsion. The strip is then 
contacted with a monobath containing a silver-halide solvent and a silver 
reducing agent to complex, transfer and reduce the remaining unexposed and 
undeveloped silver to reflective non-filamentary silver at the nuclei 
sites on the surface. The reflective layer contains from 20% to 50% silver 
particles of which 1% to 50% may be filamentary silver formed in the 
initial development step. Beneath the reflective layer is an absorptive 
underlayer. 
The reflective surface layer is characterized by non-filamentary particles 
28 overlying a concentration of filamentary particles which form the 
absorptive underlayer. Separating the data strip from the image area is an 
unprocessed silver-halide buffer area 30 which would remain generally 
clear since it is neither exposed nor developed. The buffer area 30 is not 
necessary, but is desirable because chemical processing of data strip 17 
differs from the processing of image area 15. The buffer area 30 may be 
fixed to remove silver halide so that the area will remain clear. This is 
optional. Both processes may occur by spraying of chemicals onto the 
surface of the film, with a mask covering buffer area 30. Such spray 
processing is well known in photolithography. However, in the present case 
it may be necessary to proceed in two steps. In the first step, 
conventional photographic processing of image area 26 takes place. 
Subsequently, the image area, together with the buffer area 30 is masked 
to allow separate processing of the data strip 28. After processing is 
complete, a transparent layer 32 is applied to the emulsion, forming a 
protective layer. Layer 32 may be any of the well known protective 
coatings, including a layer of clear gelatin. The remainder of the film, 
apart from the data strip 17, need not have fine grain size. Data strip 17 
can also be added to the photographic film in the form of an adhesive tape 
which is bonded to the photographic film either before or after the film 
is developed. 
FIG. 4 is similar to FIG. 3 except that substrate 34 is coated only with 
silver-halide emulsion to the right of line 36. The image area 15 is 
exposed, developed and fixed. A protective coating 38 may then be applied. 
A preformed strip 40 of laser recording material may then be disposed on 
the substrate. This may be a strip of Drexon material. Drexon is a 
trademark of Drexler Technology Corporation for reflective silver based 
laser recording material, such as that described in the aforementioned 
U.S. Pat. No. 4,312,938. Such a preformed strip of laser recording 
material would have its own thin substrate 39 carrying the emulsion layer. 
Alternatively, the recording material could be any of the other 
direct-read-after-write laser recording materials, for example such as 
that described in U.S. Pat. No. 4,230,939 issued to De Bont, et al. where 
the patent teaches a thin metallic recording layer of reflective metal 
such as Bi, Te, Ind, Sn, Cu, Al, Pt, Au, Rh, As, Sb, Ge, Se, Ga. Materials 
which are preferred are those having high reflectivity and low melting 
point, particularly Cd, Sn, Tl, Ind, Bi and amalgams. These materials may 
be deposited directly on substrate 34, as by sputtering, or may be 
premanufactured on a very thin substrate and adhered to the substrate by 
means of a subbing layer. After adhering the DRAW material to the 
substrate, a transparent protective coating 44 is applied. This coating 
material may be the same as protective material 38. 
With reference to FIG. 5, substrate 52 has a notch or groove 54 which 
allows placement of a DRAW material 56 therein. This DRAW material may be 
processed in situ from silver-halide material previously existing in the 
groove, as in the case of FIG. 3, or preexisting DRAW material which is 
placed in the groove, as with the preexisting DRAW material of FIG. 4. In 
either case, the photographic image area 15 is exposed and developed in 
the usual way, while an unexposed and undeveloped area 58 protects data 
strip 56. Since emulsion area 58 is unexposed and undeveloped, it remains 
clear and forms a protective layer over the data strip. 
In the embodiment of FIG. 6, no groove exists in substrate 60. Rather, a 
photographic image area 15 is exposed and developed in the usual way, with 
the remainder of the substrate being covered with emulsion which is masked 
and protected from exposure and development, forming a protected region 
62. On top of the protected region 62 a strip of DRAW material 64 is 
positioned. This DRAW material may be formed in situ by application of a 
silver-halide emulsion strip which is then processed, as data strip 17 in 
FIG. 3 is processed, or may be a preformed strip which is applied as in 
FIG. 4. The strip is then covered with a protective coating 66. 
With reference to FIG. 7, a substrate 70 is shown which carries a 
photographic image in a substrate portion not shown. This image may be 
above the substrate surface or within a groove of the substrate, as 
previously mentioned. The substate carries a secondary substrate 72 which 
is a thin flexible material, only a few mils thick carrying a DRAW 
material 74. The secondary substrate 72 is adhered to the primary 
substrate 70 by means of an adhesive or sticky substance, similar to dry 
adhesives found on tape. The DRAW material may be any of the materials 
previously discussed, such as DREXON material, except that the secondary 
substrate 72 is substituted for the substrate previously mentioned. A 
protective coating 76 is applied over the DRAW material. Using this 
embodiment, photographs of the prior art may be converted to the optical 
data and image medium of the present invention. In this situation, not 
shown in the drawing of FIG. 7, a portion of an image area is converted to 
a non-image area by application of the sticky DRAW material. The DRAW 
material rests above developed silver-halide emulsion, resembling FIG. 6, 
except that the emulsion is completely exposed and developed in the region 
underlying the secondary substrate. 
In all of these embodiments, a strip of DRAW material is positioned 
adjacent one or more photographic images for providing archival data 
storage of a similar quality for data as for the photo image. Remarks in 
the form of alphanumerics or voice may be recorded adjacent to the 
photographic image. By this means these two forms of communication will 
not be separated. This arrangement is of particular value to add 
analytical information to X-rays used for medical purposes, or for 
non-destructive testing or to add to photomicrographics of biological 
objects or metallurgical structures. 
Of course, while the photo images may be read by conventional means, 
low-powered laser or a photodetector array apparatus must be used to read 
the data strip. A laser apparatus is illustrated in FIG. 8, which 
illustrates the side view of the lengthwise dimension of the medium of 
FIG. 1 consisting of a data strip in combination with photo images. The 
data strip portion 41 of the medium is usually received in a movable 
holder 42 which brings the strip into the trajectory of a laser beam. A 
laser light source 43, preferably a pulsed semiconductor laser of infrared 
wavelength emits a beam 45 which passes through collimating and focusing 
optics 47. The beam is sampled by a beam splitter 49 which transmits a 
portion of the beam through a focusing lens 51 to a photodetector 53. The 
detector 53 confirms laser writing and is not essential. The beam is then 
directed to a first servo controlled mirror 55 which is mounted for 
rotation along axis 57 in the direction indicated by arrows B. The purpose 
of the mirror 55 is to find the lateral edges of the data strip in a 
coarse mode of operation and then in a fine mode of operation identify 
data paths which exist predetermined distances from the edges. 
From mirror 55, the beam is directed toward a mirror 61. This mirror is 
mounted for rotation at pivot 63. The purpose of mirror 55 is for fine 
control of motion of the beam along the length of the data strip. Coarse 
control of the lengthwise portion of the data strip relative to the beam 
is achieved by motion of the movable holder 42. The position of the holder 
may be established by a linear motor adjusted by a closed loop position 
servo system of the type used in magnetic disk drives. Reference position 
information may be prerecorded on the card so that position error signals 
may be generated and used as feedback in motor control. Upon reading one 
data path, the mirror 55 is slightly rotated. The motor moves holder 42 
lengthwise so that the path can be read again, and so on. As light is 
scattered and reflected from spots in the DRAW material, the reflectivity 
of the beam changes relative to surrounding material where no spots exist. 
The beam should deliver sufficient laser energy to the surface of the 
recording material to create spots of changed reflectivity in the data 
writing mode, but should not cause disruption of the surface so as to 
cause difficulty in the data reading mode. The wavelength of the laser 
should be compatible with the recording material to achieve this purpose. 
In the read mode, power is approximately 5% to 10% of the recording or 
writing power. 
Differences in reflectivity between a spot and surrounding material are 
detected by light detector 65 which may be a photodiode. Light is focused 
onto detector 65 by beam splitter 67 and focusing lens 69. Servo motors, 
not shown, control the positions of the mirrors and drive the mirrors in 
accord with instructions received from control circuits, as well as from 
feedback devices. The detector 65 produces electrical signals 
corresponding to pits. Other optics, not shown, could be used to observe 
the photo images, while data is being read or written on the data strip. 
A photodetector array such as a CCD could also be used. It could be either 
a linear array or area array. The number of detector elements per track 
would be approximately three elements to create a reading redundancy. The 
surface would be illuminated with low-cost light-emitting diodes 
generating power primarily in the near infra-red to match the sensitivity 
spectrum of the photodetector array.