Method and CT system for recording and distributing whole-body CT data of a polytraumatized patient

A method and CT system are disclosed for recording and distributing whole-body CT data of a polytraumatized patient. In at least one embodiment the method includes producing a whole-body topogram including division and assignment of z-coordinate regions of the whole-body topogram to different body regions; performing a whole-body CT scan with the recording of CT raw data; assigning the CT raw data to the different body regions; reconstructing CT image datasets on a computer of the CT system; and sending only body region-specific CT image datasets to a number of remote workstations operated by technical specialists.

PRIORITY STATEMENT

The present application hereby claims priority under 35 U.S.C. §119 to German patent application number DE 10 2011 079 270.8 filed Jul. 15, 2011, the entire contents of which are hereby incorporated herein by reference.

FIELD

At least one embodiment of the invention generally relates to a method and/or CT system for recording and distributing whole-body CT data of a polytraumatized patient using a CT system, with which, to perform a differential diagnosis, reconstructed CT image datasets are sent from the CT system to a number of remote workstations operated by technical specialists to determine a diagnosis.

BACKGROUND

It is generally known that in traumatology whole-body CT scans are used increasingly, in some instances as the first and only imaging operation, in the context of a trauma room algorithm to reduce overall imaging time as much as possible and to determine a reliable diagnosis at an early stage, thereby increasing the patient's chances of survival and rehabilitation.

One problem with this procedure is that supplying the data from the whole-body CT results in extremely long data transfer times due to the size of the datasets in relation to existing data transfer rates in a standard network, in which the individual workstations of the diagnosing experts are located. This largely eliminates the time advantage that results from performing a whole-body CT rather than a number of individual examinations.

SUMMARY

At least one embodiment of the invention is directed to an improved method for the more efficient transfer of CT data to specific workstations.

Advantageous developments of the invention are the subject matter of subordinate claims.

The inventors have identified the following:

If, in the context of a trauma room algorithm including the performance of a whole-body CT scan, the diagnosis in the region of different organs is to be distributed to different experts or time phases of the trauma room algorithm are to be distributed, the whole-body CT dataset can expediently be broken down into body regions or injured regions before being sent to different experts' workstations, in order to reduce the quantity of data that has to be transferred to each workstation. This also benefits algorithms for further processing the CT image data at the workstations, e.g. CAD algorithms for detecting pathologies, as smaller image datasets can be processed more successfully.

It is therefore not necessary to transfer the complete whole-body CT datasets by way of the hospital network to the diagnosis workstations after CT acquisition. Nor is it necessary for the experts at their workstations to find the relevant image regions within the complete whole-body CT datasets first. Until now in the prior art it was necessary to search the entire existing whole-body CT image dataset using automatic algorithms for this purpose. This also resulted in not insignificant delays in the workflow until now.

According to at least one embodiment of the present invention, before the data is sent, it is divided up into the body regions required for the respective diagnoses by the respective experts and only the reconstructed CT data is sent, which is of relevance for the examination in each instance. In some instances different reconstruction parameters can even be used during the reconstruction of the body regions, which are particularly favorable for the examination in question, based on the already known assignment of the predetermined body regions to specific diagnostic viewing. It is thus possible to reconstruct for example body regions, which are used to perform orthopedic diagnoses, using parameters which highlight bony structures particularly clearly, while body regions, which are sent to experts in the diagnosis of organs, e.g. spleen, liver, kidneys, etc., are reconstructed using parameters which allow soft part structures to be identified particularly clearly. If a multi-energy CT is also used, these requirements can also be applied correspondingly when using combination parameters for image combination or with multi-component breakdowns.

Generally one important advantage of at least one embodiment of this method is the fast availability of the smaller, broken-down datasets by way of a hospital network. The reduced size of the datasets means that they can also be viewed and processed more quickly. When breaking down the image data on the basis of topograms at the scanner it is possible to use specific parameterizations, e.g. specific head reconstruction kernels, for the respective body regions during the reconstruction of the CT raw data, thereby supplying improved image data generally for the respective examination.

In accordance with at least one embodiment of the basic concept described above, in at least one embodiment the inventors propose a method for recording and distributing whole-body CT data of an, in particular polytraumatized, patient using a CT system, said method having at least the following successive method steps:producing a whole-body topogram including division and assignment of z-coordinate regions of the whole-body topogram to different body regions,performing a whole-body CT scan with the recording of CT raw data,assigning the CT raw data to the different body regions based on the determined z-coordinate regions,reconstructing CT image datasets on a computer of the CT system, representing the different body regions of the z-coordinate regions, andsending body region-specific CT image datasets in each instance to a number of remote workstations operated by technical specialists to determine a diagnosis in respect of the body region sent thereto.

In addition to the method described above with its different embodiments, the inventors also propose at least one embodiment of a CT system having a dedicated control and computation unit and a number of workstations in different medical specialist areas connected thereto in the manner of a network to form a diagnosis system, with computer programs for performing the method steps of one of at least one embodiment of the preceding method being stored in the control and computation unit and the workstations.

It should be noted that these Figures are intended to illustrate the general characteristics of methods, structure and/or materials utilized in certain example embodiments and to supplement the written description provided below. These drawings are not, however, to scale and may not precisely reflect the precise structural or performance characteristics of any given embodiment, and should not be interpreted as defining or limiting the range of values or properties encompassed by example embodiments. The use of similar or identical reference numbers in the various drawings is intended to indicate the presence of a similar or identical element or feature.

DETAILED DESCRIPTION OF THE EXAMPLE EMBODIMENTS

Methods discussed below, some of which are illustrated by the flow charts, may be implemented by hardware, software, firmware, middleware, microcode, hardware description languages, or any combination thereof. When implemented in software, firmware, middleware or microcode, the program code or code segments to perform the necessary tasks will be stored in a machine or computer readable medium such as a storage medium or non-transitory computer readable medium. A processor(s) will perform the necessary tasks.

In accordance with at least one embodiment of the basic concept described above, in at least one embodiment the inventors propose a method for recording and distributing whole-body CT data of an, in particular polytraumatized, patient using a CT system, said method having at least the following successive method steps:producing a whole-body topogram including division and assignment of z-coordinate regions of the whole-body topogram to different body regions,performing a whole-body CT scan with the recording of CT raw data,assigning the CT raw data to the different body regions based on the determined z-coordinate regions,reconstructing CT image datasets on a computer of the CT system, representing the different body regions of the z-coordinate regions, andsending body region-specific CT image datasets in each instance to a number of remote workstations operated by technical specialists to determine a diagnosis in respect of the body region sent thereto.

It is naturally assumed in the description of at least one embodiment of this method that the z-coordinate region corresponds to the typical z-coordinates of the CT system used and the z-axis corresponds to the system axis, about which the gantry of the CT system rotates where there is no tilting.

As a result of the performance of this method only the CT data actually required for a specific diagnosis from a whole-body CT is transferred, thereby greatly reducing the quantity of data transferred and also avoiding the need for selecting data from all the CT data of a whole-body CT at the workstation.

With at least one embodiment of this inventive method each body region-specific CT image dataset can advantageously be reconstructed using individual reconstruction parameters. This allows optimum adaptation to the requirements of the specific diagnosis in each instance during the reconstruction—unlike the prior art in which all the scan data of a whole-body CT was reconstructed using the same reconstruction parameters.

It is also particularly advantageous if the body regions in the topogram are determined by means of automatic identification methods for typical body marks. In other words the limits of predefined body regions are identified automatically in that certain distinctive structures of the human body are automatically searched for and identified in the topogram, for example using pattern recognition methods, and then certain body regions are marked out, at least in respect of their z-positions, on the basis of their now known positions.

In principle in this process z-regions for body regions that overlap at least partially can also be marked out. In an extreme instance complete overlaps of predefined body regions can also occur. It is thus possible for example to define the body region of the spinal column, which runs from head to pelvis, with further body regions for lung or abdomen present therein. As described above, different reconstruction parameters can also be applied for these different body regions depending on the material to be assessed, for example bone or soft tissue. For example the same body region can even be reconstructed using two different reconstruction parameters depending on the tissue to be assessed, as is advantageous for the examination of the cranial bone on the one hand and the brain structure on the other hand. It is important that only the part of the reconstructed CT data that is relevant for the purpose is sent to the competent expert for the diagnosis in each instance.

To ensure the smoothest and fastest flow of data acquisition and data distribution possible, it is also advantageous, if an option for the manual correction of previously automatically identified body regions is provided in addition to the purely automatic identification of body features and determination of the desired body regions. With severely polytraumatized patients in particular it may be possible that some body features cannot be identified automatically because of the injury present, so that manual correction or manual inputting of the z-coordinate region for a desired body region is advantageous here.

It is also favorable if the different transferred CT datasets of the body regions are shown at the different workstations in different display modes tailored to the respective diagnosis. Thus for example different display variants for the CT data can be shown depending on the task in hand, such as for example slice displays in different planes, modified 3D displays or even calculated projections.

In addition to the method described above with its different embodiments, the inventors also propose at least one embodiment of a CT system having a dedicated control and computation unit and a number of workstations in different medical specialist areas connected thereto in the manner of a network to form a diagnosis system, with computer programs for performing the method steps of one of at least one embodiment of the preceding method being stored in the control and computation unit and the workstations.

FIG. 1shows by way of example a CT system1with which the inventive method is performed. The CT system1shown has a first emitter/detector system with an x-ray tube2and a detector3located opposite it. Such a CT system1can optionally also have a second x-ray tube4with a detector5located opposite it. Both emitter/detector systems are present on a gantry, which is disposed in a gantry housing6and rotates during scanning about a system axis9. If two emitter/detector systems are used, it is possible in a simple manner on the one hand to achieve increased temporal resolution for supplementary cardio examinations or it is possible to scan with different energies at the same time, so that material breakdown is also possible and as a result supplementary examination information can be supplied in the body regions under consideration.

The—generally polytraumatized—patient7is positioned on a movable examination couch8, which can be moved along the system axis9through the scan field present in the gantry housing6, in which process the attenuation of the x-ray radiation emitted by the x-ray tubes is measured by the detectors, with a whole-body topogram being recorded first, a z-distribution to different body regions taking place automatically and in some instances with manual assistance and the respectively reconstructed CT image data then only being distributed individually by way of a network16to the specialist diagnostic workstations15.xin each instance for the respective diagnosis of relevance for the body regions.

In principle according to an embodiment of the invention a simple whole-body CT is performed but in addition a contrast agent bolus can be injected into the patient7with the aid of a contrast agent applicator11, so that blood vessels can be identified more easily. For cardio recordings heart activity can also be measured with the aid of an EKG line12and an EKG-gated scan can be performed.

The CT system is controlled with the aid of a control and computation unit10by way of a control and data line18, by way of which the raw data D from the detectors3and5and the control commands S are transferred. Present in the memory13of the control and computation unit10are computer programs14, which can also perform an embodiment of the inventive method described above. CT image data19, in particular also of the topogram, can additionally be output by way of this control and computation unit10, it being possible to assist the distribution of the body regions by way of manual inputs.

FIG. 2shows a schematic diagram of a topogram with body marks and z-distribution to body regions, including common reconstruction and body region-specific distribution of the CT datasets to connected specialist diagnostic workstations, in the form of a first scenario. According to this typical body structures, known as landmarks, are searched for in the topogram17, which was recorded using the CT system fromFIG. 1. In the topogram shown here these landmarks M are shown by rectangles. The landmarks M found in this manner are used to divide the topogram17into a plurality of body regions I-VI. After reconstruction of the detector data by means of the whole-body scan performed thereafter, the reconstructed CT image data is divided up according to the z-coordinates of the body regions found and specifically only the CT data required for the respective specific diagnosis—in other words fractionated whole-body CT image data—is sent by way of the network16to the specific diagnostic workstations15.1to15.5.

In this instance identification of the body regions takes place for example by body parsing on topograms, so that the raw data does not have to be analyzed further and is already present for the individual body regions after the reconstruction. For the purpose of viewing the data special trauma layouts can be provided in the postprocessing applications, in which important views of the body regions are preconfigured, e.g. projection of the pelvic bone, in order to identify breaks, which can also be produced on the basis of identified landmarks.

One improvement to this method can reside—as shown in FIG.3—in the performance of an individual reconstruction of the individual body regions with individual reconstruction parameter sets P1-P4in each instance in addition to the method shown inFIG. 2. In the example shown the body regions I, II and III are reconstructed with the parameter set P1, the body regions IV with the parameter set P2, the body regions I and V with the parameter set P3and the body region VI with the parameter set P4, so that the best display conditions for the different diagnostic requirements, such as optimum bone display or optimum soft part display, are already present during reconstruction as the optimum parameter set has been selected.

FinallyFIG. 4also shows a schematic diagram of an embodiment of the inventive method for recording and distributing whole-body CT data of a polytraumatized patient using a CT system. According to this in method step S1a whole-body topogram “T” is first produces with the aid of a CT system and then in method step S2there is a division and assignment “A” of z-coordinate regions of the whole-body topogram to different body regions. This is followed in method step S3by the actual whole-body CT scan in which CT raw data is recorded, which is reconstructed after being assigned to the different body regions on the basis of the determined z-coordinate regions in a common manner or using different reconstruction parameter sets for the body region-specific reconstruction datasets “R1to Rn”. In method step S4diagnosis-specific image datasets “Sa to Sb” are then produced, from which all unnecessary data is eliminated before they are transferred to the individual specialist diagnostic workstations. Finally in method step S5the actual body region-specific differential diagnosis “Da to Dz” takes place at the individual diagnostic workstations.

Generally therefore an embodiment of the invention presents a method and CT system for recording and distributing whole-body CT data of a polytraumatized patient, with a whole-body topogram being produced first with division and allocation of z-coordinate regions of the whole-body topogram to different body regions, a whole-body CT scan being performed with the recording of CT raw data, the CT raw data being assigned to the different body regions and CT image datasets being reconstructed on a computer of the CT system and then only body region-specific CT image datasets being sent to a number of remote diagnostic workstations operated by technical specialists.

Even though the invention was illustrated and described in detail using the example embodiment, the invention is not restricted by the disclosed examples and other variations can be derived therefrom by the person skilled in the art without departing from the scope of protection of the invention.