Patent Publication Number: US-2022233782-A1

Title: Volume monitoring systems

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to and the benefit of U.S. Patent Application Ser. No. 62/141,723, filed Apr. 1, 2015, entitled “Volume Monitoring Device Utilizing Hall Sensors”. This application is also a continuation-in-part of U.S. patent application Ser. No. 14/222,331, filed Mar. 21, 2014, entitled “Volume Monitoring Device Utilizing Light Based Systems”; which is a continuation-in-part of U.S. patent application Ser. No. 13/975,052, filed Aug. 23, 2013, entitled “Volume Monitoring Device”; which is a continuation-in-part of U.S. patent application Ser. No. 13/839,771, filed Mar. 15, 2013, entitled “Devices and Methods for Modulating Medium Delivery”; which claims priority to and the benefit of U.S. Provisional Application Ser. No. 61/694,137, filed Aug. 28, 2012, entitled “Devices and Methods for Modulating Medium Delivery.” This application is also a continuation-in-part of U.S. patent application Ser. No. 14/851,958, filed Sep. 11, 2015, entitled “Reservoir for Collection and Reuse of Diverted Medium”; which claims priority to and the benefit of U.S. Provisional Application Ser. No. 62/082,260, filed Nov. 20, 2014, entitled “Devices and Methods for Modulating Medium Delivery”; and U.S. Provisional Application Ser. No. 62/048,974, filed Sep. 11, 2014, entitled “Devices and Method for Modulating Medium Delivery.” The disclosures of each of these applications are hereby incorporated by reference herein in their entireties. 
    
    
     INTRODUCTION 
     This disclosure pertains to systems, devices, and methods used to control, transform or otherwise modulate the delivery of a substance, such as radiopaque contrast, to a delivery site and/or systems, devices, and methods that may be used to measure or otherwise make quantitative assessments of a medium delivered to a delivery site. More specifically, it is the intention of the following systems, devices, and methods to modulate and/or assess the delivery of media to a vessel, vascular bed, organ, and/or other corporeal structures so as optimize the delivery of media to the intended site, while reducing inadvertent or excessive introduction of the media to other vessels, vascular beds, organs, and/or other structures, including systemic introduction. 
     The terms medium (media), agent, substance, material, medicament; and the like, are used generically herein to describe a variety of fluidal materials that may include, at least in part, a substance used in the performance of a diagnostic, therapeutic or/and prophylactic medical procedure and such use is not intended to be limiting. 
     SUMMARY 
     This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This summary is not intended to identify key features or essential features of the claimed subject matter, is not intended to describe each disclosed embodiment or every implementation of the claimed subject matter, and is not intended to be used as an aid in determining the scope of the claimed subject matter. Many other novel advantages, features, and relationships will become apparent as this description proceeds. The figures and the description that follow more particularly exemplify illustrative embodiments. 
     In one aspect, the technology relates to an apparatus having: a syringe housing; a plunger having a shaft, wherein the plunger is slidably received within the syringe housing between a first position and a second position; at least one Hall sensor disposed within the shaft; and at least one magnet fixed proximate the syringe housing. In an embodiment, the magnet includes a plurality of magnets disposed about the syringe housing. In another embodiment, a magnet retention ring is disposed about the syringe housing, wherein the plurality of magnets are disposed within the magnet retention ring. In yet another embodiment, the Hall sensor includes a plurality of Hall sensors. In still another embodiment, the shaft defines an interior chamber and the plurality of Hall sensors are disposed linearly within the chamber. 
     In another embodiment of the above aspect, a wireless transmitter is disposed within the chamber. In an embodiment, the apparatus further has a circuit board, wherein the plurality of Hall sensors are disposed on the circuit board; a battery is disposed on the circuit board, wherein the battery is configured to provide power to at least one of the plurality of Hall sensors; and a switch is disposed on the circuit board for selectively connecting power between the battery and the at least one of the plurality of Hall sensors. In another embodiment, the switch is activated based on a movement of the plunger. 
     In another aspect, the technology relates to an apparatus having: a syringe housing defining an axis; a plunger slidably disposed along the axis within the syringe housing; a plurality of Hall sensors disposed along the plunger; at least one magnet fixed relative to the axis, such that a movement of the plunger along the axis moves at least one of the plurality of Hall sensors through a magnetic field created by the at least one magnet. In an embodiment, the at least one magnet includes a plurality of magnets disposed about the axis, so as to create a substantially circular magnetic field. In another embodiment, the apparatus further has a magnet retention ring disposed about the syringe housing and wherein the plurality of magnets are disposed within the magnet retention ring. In yet another embodiment, a wireless transmitter is disposed within the plunger. In still another embodiment, a battery is disposed within the plunger, wherein the battery is configured to provide power to the wireless transmitter and at least one of the plurality of Hall sensors; and a switch disposed within the plunger for selectively connecting power between the battery and the wireless transmitter and at least one of the plurality of Hall sensors. 
     In another embodiment of the above aspect, the switch is activated based on a movement of the plunger. In an embodiment, the switch includes a reed switch. In another embodiment, the plunger is configured for rotational movement about the axis, and wherein the at least one of the plurality of Hall sensors is disposed so as to pass through the magnetic field at any angular position of the plunger about the axis. In yet another embodiment, the magnet retention ring is disposed proximate a proximal end of the syringe housing. In still another embodiment, the magnet is secured directly to the syringe housing. 
     In another aspect, the technology relates to a method of determining a condition of a syringe having a syringe housing and a plunger slidably disposed in the syringe housing, the method including receiving a first signal from a first Hall sensor, wherein a position of the first Hall sensor on the plunger is known. In an embodiment, method further includes determining a second position of the plunger based at least in part on a received second signal. 
     Further, in another aspect, the technology relates to a system for modulating a fluid being delivered to a patient and the ability to measure the amount delivered. A myriad of ways of measuring a volume in a chamber, and the subsequent amount of medium injected to a site in a patient, are described. Further, the ability to modulate the delivery of a medium to a patient is exemplarily described. The modulation in one aspect may include diversion of a portion of medium being injected by a syringe (or the like). An aspect of the technology relates to measurement of a total amount of medium ejected from a syringe/chamber, while measuring an amount of medium diverted away from the patient into a “diversion” reservoir, so as to determine the actual volume delivered to an intended site in the patient. 
     In another aspect, the technology relates to a method of determining an amount of medium injected into a patient, the method including: receiving an injection signal from a sensor associated with an injection syringe; receiving a diversion signal from a sensor associated with a diversion reservoir; and determining the amount of medium injected based at least in part on the injection signal and the diversion signal. In an embodiment, the method includes sending a signal associated with the amount of medium injected. In another embodiment, the method includes displaying the amount of medium injected. In yet another embodiment, the method includes receiving a flush signal associated with a valve of a saline flush system. In still another embodiment, the method includes disregarding at least one of the injection signal and the diversion signal based at least in part on the flush signal. In another embodiment, the method includes adjusting a position of at least one valve based at least in part on the flush signal. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       There are shown in the drawings, embodiments which are presently preferred, it being understood, however, that the technology is not limited to the precise arrangements and instrumentalities shown. 
         FIG. 1A  depicts an exemplary synchronized agent delivery with indirect modulation, adjacent a distal portion of a treatment system therefor. 
         FIG. 1B  depicts a top view of an exemplary synchronized agent delivery with indirect modulation, adjacent a proximal portion of such a treatment system. 
         FIG. 1C  depicts a side view of an exemplary synchronized agent delivery with indirect modulation, adjacent a proximal portion of such a treatment system. 
         FIG. 1D  depicts a side sectional view of the brake mechanism of the exemplary synchronized agent delivery arrangement of  FIG. 1C . 
         FIG. 2  depicts a perspective view of an embodiment of a monitoring syringe. 
         FIG. 3  depicts a partially exploded perspective view of the monitoring syringe of  FIG. 2 . 
         FIGS. 4A-4C  depict partial enlarged perspective views of other embodiments of monitoring syringes. 
         FIGS. 5A-5C  depict embodiments of a monitoring syringe. 
         FIG. 6  depicts a partially exploded perspective view of another embodiment of a monitoring syringe. 
         FIG. 7A  depicts a first method of using a monitoring device. 
         FIG. 7B  depicts a second method of using a monitoring device. 
         FIG. 8  depicts one example of a suitable operating environment in which one or more of the present examples may be implemented. 
         FIG. 9  depicts a perspective view of a first embodiment of a monitoring syringe utilizing a Hall sensor module. 
         FIG. 10  depicts a partial perspective sectional view of the monitoring syringe of  FIG. 9 , depicting the Hall sensor module. 
         FIG. 11  depicts a partial exploded perspective view of the monitoring syringe of  FIG. 10 . 
         FIG. 12  depicts a partial perspective view of a Hall sensor module. 
         FIG. 13  depicts a perspective view of a second embodiment of a monitoring syringe utilizing a Hall sensor module. 
         FIG. 14  illustrates an exemplary medium management system. 
         FIG. 15A  is a perspective view of another example of a medium diversion reservoir. 
         FIG. 15B  is a perspective exploded view of the medium diversion reservoir of  FIG. 15A . 
         FIG. 15C  is a cross-sectional view of the exemplary medium diversion reservoir in a first configuration, taken along line  15 C- 15 C of  FIG. 15A . 
         FIG. 15D  is a cross-sectional view of the exemplary medium diversion reservoir in a second configuration, taken along line  15 C- 15 C of  FIG. 15A . 
         FIG. 16  illustrates another exemplary medium diversion reservoir. 
         FIG. 17  illustrates another exemplary medium management system. 
         FIG. 18  depicts a method of determining an amount of medium injected into a patient. 
     
    
    
     DETAILED DESCRIPTION 
     There are numerous occasions in the diagnostic, prophylactic and treatment practice of medicine wherein an agent, medicant, or medium is preferably delivered to a specific site within the body, as opposed to a more general, systemic introduction. One such exemplary occasion is the delivery of contrast media to coronary vasculature in the diagnosis (i.e., angiography) and treatment (i.e., balloon angioplasty and stenting) of coronary vascular disease. The description, as well as the devices and methods described herein, may be used in modulating and/or monitoring medium delivery to the coronary vasculature in prevention of toxic systemic effects of such an agent. One skilled in the art, however, would recognize that there are many other applications wherein the controlled delivery and/or quantitative assessment of a media to a specific vessel, structure, organ or site of the body may also benefit from the devices and methods disclosed herein. For simplicity, these devices and methods may be described as they relate to contrast media delivery modulation and/or measurement. As such, they may be used in the prevention of Contrast Induced Nephropathy; however, it is not intended, nor should it be construed, so as to limit the use to this sole purpose. Exemplary other uses may include the delivery, injection, modulation, or measurement of: cancer treatment agent to a tumor, thrombolytic to an occluded artery, occluding or sclerosing agent to a vascular malformation or diseased tissue; genetic agent to a muscular bed, neural cavity or organ, emulsion to the eye, bulking agent to musculature and/or sphincter, imaging agent to the lymphatic system, antibiotics to an infected tissue, supplements in the dialysis of the kidney, to name but a few. 
     EXAMPLE—PREVENTION OF CONTRAST INDUCED NEPHROPATHY 
     Contrast Induced Nephropathy (CIN) is a form of kidney damage caused by the toxic effects of dyes (radiopaque contrast media) used, for example, by cardiologists to image the heart and its blood vessels during commonly performed heart procedures, such as angiography, angioplasty, and stenting. In general, the dye is toxic and is known to damage kidneys. Although most healthy patients tolerate some amount of the “toxicity,” patients with poorly or non-functioning kidneys may suffer from rapidly declining health, poor quality of life, and significantly shortened life expectancy. Potential consequences of CIN include: irreversible damage to the kidneys, longer hospital stays, increased risk of heart disease, increased risk of long-term dialysis, and ultimately, a higher mortality risk. For patients who acquire CIN, their risk of dying remains higher than others without CIN, and this risk can continue up to five years after their procedure. CIN has a significant economic burden on the healthcare system and currently there is no treatment available to reverse damage to the kidneys or improper kidney performance, once a patient develops CIN. 
     To date, there have been attempts in reducing the toxic effects of contrast media on patients who undergo procedures involving dyes, especially those patients who are at high risk for developing CIN. Some of these efforts have been to: change the inherent toxicity (of a chemical or molecular nature) of the dyes, reduce the total amount of contrast agent injected (through injection management and/or dye concentration), and remove media through coronary vasculature isolation and blood/contrast agent collection systems, to name a few. These methods and devices used in the control of the toxic effects of contrast agents have had their inherent compromises in effectively delivering a contrast media specifically to a target site while minimizing the systemic effects. As an example, changing the composition of a dye and/or injection concentration may help reduce a contrast agent&#39;s inherent toxicity at the expense of the contrast agent&#39;s ability to perform its intended function (e.g., visualization of vasculature). Conversely, the ability to “collect” contrast agent laden blood “downstream” from the visualization site may ensure visualization, but requires the complexity of placement and operation of a collection system. 
     Other attempts to manage the amount of contrast agent delivered to a patient have employed automated, powered (versus manual, syringe-injected) contrast media injection systems. Close monitoring and control of the total quantity of contrast agent injected may have a positive impact in reducing the incidence of CIN. However, these injection systems are expensive (including capital equipment and disposables), cumbersome to use within a cath lab, and take additional time and expertise to set up and operate properly. Improper use could negate any benefits seen by better management of the quantity of the contrast agent delivered to a patient, and the additional time required to set up such a system may also add significant complexity to a procedure. The devices and methods described herein may measure or otherwise quantitatively assess the amount of medium injected or delivered to a delivery site using a relatively fast, simple, economical, and safe system. 
     The measurement systems described herein may be employed as a system of quantitative assessment or in combination with a modulator. Additional systems are described in U.S. patent application Ser. No. 13/839,771, the disclosure of which is hereby incorporated by reference herein in its entirety.  FIGS. 1A-1D  depict embodiments where a modulator is constructed so as to measure the amount of an agent delivered from the system. Conversely,  FIG. 2 , for example, describes the use of a measurement system for the quantitative assessment of the volume of medium delivered and the inherent analysis of the total volume delivered versus some predetermined critical amount, such as the Gurm ratio, whether or not it is used with a modulator. 
     It should be understood that measurements may be performed prior to a medium being modulated, simultaneously with modulation, or after the modulation process, if desired. Further, it is also contemplated that the measurement devices and methods may be used with any of the modulation systems, such as described in U.S. patent application Ser. No. 13/839,771. Moreover, the embodiments described herein are exemplary in nature and should not be construed as limiting the various combinations possible. 
     Some embodiments of control and modulation devices disclosed herein may send and/or receive a sensor signal so as to coordinate a valving, controlling, or otherwise modulating function on an injection agent before the agent enters an intended target injection site. Modulation may include, for example, valving (or otherwise modulating) an injection dispensed from an injection device. As described in U.S. patent application Ser. No. 14/839,771, indirect valving (or otherwise controlling mechanisms) may be proximally or distally positioned within, about, and/or upon the agent delivery system. An example of an indirect modulation control system  10  is depicted in  FIGS. 1A-1D . In this example, a sensor  12  is deployed distally on a delivery catheter  14  (as seen in  FIG. 1A ) and a modulating device  30  (of  FIG. 1B ) is provided proximally. The sensor  12  of  FIG. 1A  is an exemplary pressure sensor positioned on the distal tip of the delivery catheter  14 . As described previously, this is only one example of a type of sensor that may be used in obtaining a signal to synchronize the delivery of medium with the blood flow rate. Moreover,  FIG. 1A  illustrates the positioning of the sensor  12  upon the distal tip of the delivery catheter  14  within the aorta  16  to the left coronary artery  18 , off the aortic root  20 . The exemplary positioning of the sensor  12  in  FIG. 1A  should not be limited to that shown in order to perform the functions described herein, since there may be a multitude of sensor types (and commensurate signals) positioned at various locations on (i.e., as a function of respiration), through (i.e., as a function of imaging) and within the body (i.e., as a function of a variable proximate a target delivery site). Clearly, even the placement of a distal pressure sensor in exemplary  FIG. 1A  could take many forms, such as: a pressure wire alongside the catheter, a lumen within the catheter body for pressure measurement, a pressure sensor deployed within the distal tip of the catheter, and a pressure sensor deployed distally of the distal tip of the catheter and into the target vessel, to name but a few. 
     Referring to  FIG. 1B , modulating device  30  may include an inlet port  32  (from the injection device) and an outlet port  34  (to the delivery catheter  14 ). The flow of injection fluid may pass through the injection port  32  and into a fluid chamber  36  within a body or housing  38  of the modulator  30 . The modulator  30  may have a plurality of vane/plates  40  attached to a cylindrical hub  42  disposed within the fluid chamber  36 . The vanes  40  and hub  42  may be formed to define a “pinwheel” structure of vane-hub that is capable of rotating freely (relative to fluid chamber  36  and body  38  of modulator  30 ) upon the injection of medium into the fluid chamber  36  through the injection port  32 . The hub  42  may be designed to preferentially rotate in one direction. For example,  FIG. 1B  illustrates the preferential flow of fluid and rotation of the vane-hub, in a clockwise direction, via flow arrows  44 . From the fluid chamber  36 , injection fluid may flow out of the modulator  30  via the outlet port  34 . 
     One advantage of the vane-hub modulator  30  depicted in  FIG. 1B  is that it may be easy to measure, or otherwise identify, the total volume of injection fluid delivered through the modulating device  30  (over time) since the volume of fluid passing through the device  30  during one rotation of the vane  40  or hub  42  may be easily determined, and the number of rotations simply counted by a counting mechanism. Alternatively, each “cell” of fluid between adjacent vanes  40  may be readily counted by a counting mechanism. The counting mechanism may include a magnetic, mechanical, ultrasonic, infrared or similar measurement device capable of identifying the number of times a vane  40  and/or some other element of the device  30  has passed within its field of measurement, or by determining the number of times the axis of the hub  42  has rotated. The output of such a counting mechanism may be utilized to determine and display (in real time) the total volume of medium used during a procedure. Advantageously, in the management of medium injected, an operator or physician may readily see the amount of medium used (as determined by the counting mechanism and presented by a suitable display or indicative output). The determination of the volume (via calculations or conversions based on, for example, counted rotations) may be performed as part of the counting device, or may be performed by a display device. In addition to providing volume measurements, the counting mechanism, signal, or display may incorporate various algorithms to alert the operator before or when maximum volume of agent has been administered (based upon an operator-determined value, Maximum Acceptable Contrast Dose, Gurm ratio, etc.), For example, the Maximum Acceptable Contrast Dose index, as described by Cigarroa, et al. (June 1989) “Dosing of Contrast Material to Prevent Nephropathy in Patients with Renal Disease” Am Jour of Med. 649-652, suggests that a maximum amount of contrast injected (in mL) be equal to 5 ml×body weight (Kg)/Baseline Serum Creatinine level (in mg/dL). In another example, the maximum amount of contrast injected (in mL) as described in Gurm, et al. “Renal Function-Based Dosing to Define Safe Limits of Radiographic Contrast Media in Patients Undergoing Percutaneous Coronary Interventions” JACC 2011:58:907-14, suggests that the maximum contrast used (in mL) should be less than, or equal to, 2 if it is divided by a calculated Creatinine Clearance (mL/min) of the patient. Regardless of the indicator utilized, the system may include a display that not only provides total volume used, but also warns the operator of use as compared to one or more indicators of a maximum administration. 
     Continuing with the description of the exemplary modulation device  30  shown in  FIGS. 1B-1C , the vane-hub modulator  30  may include two components. The first, the body  38  (described above) may be situated adjacent a controller/actuator  46  and may include the input port  32 , the output port  34  and the fluid chamber  36  with rotating vane  40  and hub  42 . The body  38  may come into contact with bodily fluids and, accordingly, may be disposable. The controller/actuator  46  may also include a brake mechanism  48 , sensor signal, receiver  50 , and the like may be used to clutch, brake, or otherwise inhibit the rotation of the hub  42  so as to provide resistance to rotation. The resistance induced to the rotation may be coordinated with a signal from sensor  12  of  FIG. 1A , so as to modulate an injection from an injector to improve an agent fluid flow. 
     The braking, or clutching, of the modulator  30  of  FIG. 1C  may be performed through a variety of mechanisms, to include, for example, mechanical, hydromechanical, electromechanical, electromagnetic, chemomechanical, etc.  FIG. 1C  illustrates one such mechanism  48  for braking a shaft  52  of the hub  42 , using electromagnetic force. The exemplary braking structure  48  is further detailed in  FIG. 1D , wherein the longitudinal shaft  52  of the hub  42  is coupled to a hysteresis plate or disc  54  positioned within a magnetic coil  56 . When electricity is applied to the magnetic coil  56 , a magnetic flux is transferred to the hysteresis disc  54  (as it passes through the field) causing a magnetic “drag” on the disc  54 . The drag, or braking, applied to the hysteresis disc  54  (and thus the shaft  52  of the hub  42 ) may be increased or decreased with increasing or decreasing voltage applied to the magnetic field to modulate the flow of medium as intended. When electrical current is removed, the connected disc  54  may rotate freely about an axis of shaft  52 . Upon modulating, braking mechanism  48  of  FIG. 1D  may increase the drag (reduce the flow rate) of the agent as needed to improve the flow profile of the agent or fluid. 
       FIGS. 1A -AD describe one system to regulate the flow profile and determine the volume of injection agent through a modulator, and as such, are intended to illustrate the modulation monitoring, control, and measurement concepts disclosed herein without limitation. Therefore, this embodiment is but one example how one might use a modulator device and a measurement device to control the delivery of an agent, as well as measure the amount of agent delivered. 
     Other embodiments including devices and methods in quantitative assessment, or otherwise measurement, of the volume of delivery of an agent are described below. It is to be understood that these measurement devices may also be used in combination with a variety of agent modulators and the description is intended to be exemplary and not limiting. 
       FIGS. 2 and 3  depict a perspective view and a perspective exploded view, respectively, of a monitoring syringe  100 . The monitoring syringe  100  includes a syringe housing  102  (or chamber) defining an inner bore  104 . A plunger  106  including a shaft  108  and a piston  110  is slidably received in the bore  104 . More specifically, the piston  110  is slidably engaged with an interior surface of the bore  104  and linear movement M of the shaft  108  within the bore  104  moves the piston  110 . Movement M is along the syringe axis A S . The plunger  106  is moved back and forth within the bore  104  by the movement of a thumb pad, such as a thumb-ring  112 , as described in more detail below. As the plunger  106  is moved M in a direction towards the discharge end  114  of the syringe housing  102 , the fluid contained therein is discharged into a tube or needle (not shown) and delivered to a patient. Note that throughout the description a cylindrical-type chamber  102  and inner bore  104  are described; however, it is contemplated that there may be a variety of constructions of a housing/bore  102 / 104  and plunger  106  that provide the function as anticipated herein and the shape (including rectangular, ovular, triangular cross-section, etc.), in and of itself, should not be limiting. 
     In the depicted embodiment, a light sensor module  118  is secured to an exterior surface of the syringe housing  102 . The light sensor module  118  includes a light sensor housing  119  that encloses a light sensor  120 . In certain embodiments, the light sensor  120  may be a linear array comprising a plurality of pixels, such as model no. TSL1406R manufactured by AMS-TAOS USA, Inc., of Plano, Tex. In other embodiments, the light sensor  120  may be one or more discrete light sensors, such as photoresistors. In general, a greater number of discrete light sensor elements (pixels, photoresistors, or otherwise), may improve accuracy. One or more leads or wires  124  extend from an end of the light sensor module  118 , as required or desired for a particular application. However, one skilled in the art would readily recognize that wires  124  need not be utilized with different sensor configurations. For example; using a light sensor on a circuit board may require alternative connections. A cable  126  connects at an end  128  to an interface unit that analyzes the output of the light sensor module  118  and provides this information to a user of the monitoring syringe  100 , typically on a display. In other embodiments, communication may be via a radio, Bluetooth, of other wireless connection. The displayed information may include volume of the chamber, volume remaining, volume dispensed, fluid type, flow rate, fluid pressure or temperature and/or other information, as required or desired for a particular application. 
     In the depicted embodiment, the shaft  108  of the plunger  106  is substantially translucent, meaning light may generally pass through the shaft  108 . A discrete portion or band  130  may be disposed on or formed with the shaft  108 . The band  130 , in this case, is a portion of the shaft  108  having a translucency less than the translucency of the remainder of shaft  108 , or an opacity greater than the opacity of the remainder of the shaft. As the plunger  106  is slidingly moved M along the axis A s , the band  130  of lesser transparency passes in front of the light sensor  120  of the light sensor element  118 . Light passes through the plunger portion having higher translucency and is received by the light sensor module  118 . The light sensor module  118  sends a signal to the interface unit that determines the position of the plunger  106  within the syringe housing  102 , based on the opacity of band  130  along the light sensor  120 . Thus, the position of the plunger  106  can be determined. The interface may also determine the various types of information listed above, based on a known diameter and length of the bore  104  of the syringe housing  102 . Two finger rings or tabs  132  receive the fingers of a user during use. A stop  134  prevents the plunger  106  from being pulled out of the syringe housing  102 . 
       FIGS. 4A-4C  depict various alternative configurations of plungers that may be utilized with various monitoring syringes herein.  FIG. 4A  depicts a partial enlarged perspective view of another embodiment of a monitoring syringe  200 . In this embodiment, a plunger  206  includes a shaft  208 . Rather than the discrete band depicted above in  FIGS. 2 and 3 , the depicted embodiment includes a gradation  230  of varying translucency/opacity along the plunger shaft  208 . In the depicted embodiment, the gradation  230  is darker (i.e., less translucent or more opaque) proximate the piston  210  Proximate the stop  234 , the translucency of the gradation  230  is higher (and conversely, the opacity lower). The transition of the gradation may be smooth or in discrete bands. In certain embodiments such as the one depicted in  FIG. 4A , no shading may be present proximate the stop  234  and the translucency of that portion may be the same as that of the shaft  208 , generally. 
       FIG. 4B  depicts a partial enlarged perspective view of another embodiment of a monitoring syringe  300 . In this embodiment, a plunger  306  includes a shaft  308 . Rather than the discrete higher opacity band depicted above in  FIGS. 2 and 3 , the depicted embodiment utilizes a shaft  308  having a discrete band  330  of higher translucency. That is, the portion of the shaft  330  disposed between the piston  310  and stop  334  is substantially opaque, while the band  330  is substantially translucent. 
       FIG. 4C  depicts a partial enlarged perspective view of another embodiment of a monitoring syringe  400 . In this embodiment, a plunger  406  includes a shaft  408 . The gradation  430  is disposed opposite the gradation of the embodiment of  FIG. 4A . In the embodiment of  FIG. 4C , the gradation  430  is darker (i.e., less translucent or more opaque) proximate the stop  434 . Proximate the piston  410 , the translucency of the gradation  430  is higher. The transition of the gradation  430  may be smooth or in discrete bands. In certain embodiments, no shading may be present proximate the piston  410  and the translucency of that portion may be the same as that of the shaft  408 , generally. 
     Any of the configurations of the plungers depicted in  FIG. 2, 3 , or  4 A- 4 C may be utilized with the monitoring syringes depicted herein. That is, plungers having discrete bands of opacity or translucency, or plungers having increasing or decreasing gradations (measured from the piston to the stop) may be utilized with syringes utilizing light sensor modules. Regardless of plunger opacity/translucency configuration, the light sensor modules detect changes of light being received as the monitoring syringe is used. Depending on the location of one or more light sensors within the light sensor module, the changes enable an interface device to determine the position of the plunger and, accordingly, the volume and other characteristics or conditions of the device. 
     The various embodiments of measuring syringes of  FIGS. 2-4C  describe devices that generally include a light sensor module and/or light sensor positioned on, in, or proximate the device housing or bore. The portion of the device including the variation of translucency is principally positioned on, in, or proximate the device plunger. Of course, the configuration of the components can be reversed if desired, such that the housing/bore includes variations in translucency, while the plunger includes a light sensor or light sensor module. These embodiments are also considered within the scope of the technology. 
       FIGS. 5A-5C  depict various embodiments of monitoring syringes.  FIG. 5A  depicts a monitoring syringe  600  utilizing a sensor module  618 . The sensor module  618  includes a sensor housing  619  and a linear array  620 . The linear array  620  includes a plurality of pixels  620   a . In the depicted embodiment, the monitoring syringe  600  includes a plunger  606  having a shaft  608  including a translucent band  630 . The band  630  need not be completely translucent, but merely sufficiently translucent such that the pixels  620   a  within the light array  620  may detect a change in light received. In this embodiment, the received light is ambient light  640  that may be present in a room such as a surgical suite. Conversely, light source  640  may be from a source other than ambient light, such as an infrared or ultraviolet light generator, for example. Additionally, the light sensor module  618  may be configured with filters to receive light of only a predetermined wavelength (e.g., infrared, ultraviolet, etc.). Alternatively, the plunger  606  or shaft  608  may be configured with a filter to filter the received light to the desired wavelength. 
       FIG. 5B  depicts a monitoring syringe  700  utilizing a sensor module.  718 . The sensor module includes a sensor housing  719  and a light sensor  720  that includes discrete light sensor elements  720   a , such as for example, photoresistors. In the depicted embodiment, the monitoring syringe  700  includes a plunger  706  having a shaft  708  including a gradation  730 , wherein the gradation  730  is less translucent proximate the piston  710  and more translucent proximate the stop  734 . Instead of utilizing ambient light as with the previous embodiments, the monitoring syringe of  FIG. 5B  utilizes a light emitter module  750 , such as, for example, light emitting diodes (LEDs). The light emitter module  750  is secured to the syringe housing  702  in a manner similar to the light sensor module  718 . The light emitter module  750  includes an emitter housing  752  and a light emitter  740  including a plurality of light emitter elements  740   a . In the depicted embodiment, the discrete light emitter elements  740   a  may be disposed opposite and aligned with the discrete light sensor elements  720   a , but this is not required. Additionally, the light emitter elements  740   a  may be configured to only emit light having a particular wavelength, or the light may be filtered so as to restrict the light that is emitted and/or sensed. As the gradation  730  passes between the light sensor module  718  and the light emitter module  750 , light signals are received by the discrete light sensor elements  720   a . The light sensor module  718  sends signals to an interface, which processes the signals to determine the position of piston  710 . The light sensor module  718  and light emitter module  750  are disposed approximately 180 degrees from each other about the circumference of the syringe housing  702 . In other embodiments, the modules  718 ,  750  may be disposed less than about 180 degrees from each other. In certain embodiments, the modules  718 ,  750  may be disposed about 90 degrees from each other. If desired, the modules  718 ,  750  may be contained in a common housing. 
       FIG. 5C  depicts a monitoring sensor  800  utilizing a sensor module  818 . The sensor module includes a sensor housing  819  and a light sensor  820  that includes discrete light sensor elements  820   a , such as photoresistors. In the depicted embodiment, the monitoring syringe  800  includes a plunger  806  having a shaft  808  including a gradation  830 , wherein the gradation  830  is less translucent proximate the piston  810  and more translucent proximate the stop  834 . The monitoring syringe  800  utilizes a light emitter module  850 . The light emitter module  850  is secured to the syringe housing  802  in a manner similar to the light sensor module  818 . The light emitter module  850  includes an emitter housing  852  and a light emitter  840  including a plurality of light emitter elements  840   a . Note that the emitter housing  852  and sensor housing  819  may include a structural element (e.g., tape or adhesive) to facilitate fixation of emitters/sensors to the chamber, or may include emitters/sensors being disposed within the chamber wall. In the depicted embodiment, the discrete light emitters  840   a  are disposed opposite and aligned with the discrete light sensor elements  820   a , but this is not required. Additionally, the light emitter elements  840   a  may be configured to only emit light having a particular wavelength (for example, near infrared light generator), or may be filtered. As the gradation  830  passes between the light emitter module  818  and the light sensor module  850 , light signals are received by the discrete light sensor elements  820   a . The light sensor module  818  sends signals to an interface, which processes the signals to determine the position of piston  810 . The light sensor module  818  and light emitter module  850  are disposed approximately 180 degrees from each other about the circumference of the syringe housing  802 . In other embodiments, the modules  818 ,  850  may be disposed as described above with regard to  FIG. 5B . The monitoring syringe  800  of  FIG. 5C  utilizes a light sensor module  818  and light emitter module  850  having higher sensor and emitter densities than those of  FIGS. 5A and 5B . As described above, this may result in greater positional accuracy. 
       FIG. 6  depicts another embodiment of a monitoring syringe  900 . In this case, the light sensor housing  919 , containing the light sensor  920  and wires  924 , is detachably secured to the syringe housing  902 . The light sensor housing  919  may be secured with clips, C-clamps, resilient catches, or other elements  960  that allow the light sensor housing  919  to be removed from the syringe housing  902 . Such a configuration may be desirable so the light sensor housing  919  and related components may be reused on a different syringe, typically after a medical procedure. The light sensor housing  919  may be removed from a first syringe housing  902  and reattached to a second syringe housing at a later time. Once the wires  924  (or similar connective instruments) are reconnected to the interface (as described above) a calibration program may be executed so as to calibrate the light sensor module  918  for the new syringe. 
     The embodiments described herein may include various elements or components to measure and/or detect a displacement of a plunger within a chamber, such as a syringe. And, with the detection of a positional relationship of a plunger within a chamber, a user may explicitly or implicitly determine a volume of media that may have been ejected from a chamber. Some of the embodiments described may include various sources in the generation of light, as well as components to detect or sense the light, depending on the positional relationship of the plunger/piston and the chamber. Linear encoders, inductive sensors, capacitive touch sensors (with metal actuator in plunger), ultrasonic emitters/receivers, pressure sensors, optical encoders (with fine pitch slots and light source), strain gauges (i.e., to measure weight), electromagnetic emitters/receivers (e.g., navigational systems) are alternative technologies contemplated for the use of measuring an injection delivered from an injector to a patient, with or without measuring a “diversion” reservoir. Other alternative embodiments capable of identifying positional relationships of a plunger and chamber (and changes thereof) may include, without limitation, the following technologies. A Hall sensor (coiled wire along syringe axis) may be placed on, or in proximity to, the chamber with a magnet attached to the plunger (so as to act as a variable proximity sensor). Multiple low sensitivity Hall sensors may be disposed along the chamber of the syringe with a magnet attached to the plunger. Still other embodiments of systems utilizing multiple Hall sensors are described herein. Laser light may be emitted and detected to determine a positional relationship of the plunger along the chamber axis. An absolute encoder may be used to “read” the direct displacement of the plunger. 
       FIG. 9  depicts a perspective view of an embodiment of a monitoring syringe  1200  utilizing a Hall sensor module, which is described in more detail below. The monitoring syringe  1200  includes a syringe housing  1202  defining an inner bore  1204 . A plunger or piston, which is described in more detail below, is slidably received in the bore  1204 . More specifically, the piston is slidably engaged with an interior surface of the bore  1204  and linear movement M of a plunger shaft within the bore  1204  moves the piston. Movement M is along the syringe axis A S . A thumb ring  1212  may be utilized to push and pull the plunger along axis A S , as described in more detail below. As the plunger is moved M in a direction towards the discharge end  1214   a  of the syringe housing  1202 , the fluid (e.g., media) contained therein is discharged into a tube or needle (not shown) and delivered to a patient. Two finger rings or tabs  1232  receive the fingers of a user during use. Note that throughout the description a cylindrical-type housing  1202  and inner bore  1204  are described; however, it is contemplated that there may be a variety of constructions of a housing/bore  1202 / 1204  and plunger that provide the function as anticipated herein and the shape (including rectangular, ovular, triangular cross-section, etc.), in and of itself, should not be limiting. The monitoring syringe  1200  also includes a Hall sensor module  1250 , described in more detail below. One component of the Hall sensor module  1250  is a magnet retention ring  1252 , which is disposed on an outer or exterior surface of the syringe housing  1202 . In the depicted embodiment, the magnetic retention ring  1252  is disposed proximate a proximal end  1214   b  of the housing  1202 , but it may be disposed in other locations along the housing  1202 . 
       FIG. 10  depicts a partial perspective sectional view of the monitoring syringe  1200  of  FIG. 9 , depicting the Hall sensor module  1250 . Certain components  1250   a  of the Hall sensor module  1250  are disposed within an inner chamber of a hollow shaft  1208  of the plunger  1206 , while certain components  1250   b  are disposed on an exterior surface of the syringe housing. These various components  1250   a ,  1250   b  are described in more detail below. So-called internal components  1250   a  (i.e., internal to the plunger  1206 ) include retention inserts  1254   a ,  1254   b , a base or circuit board  1256 , and a plurality of Hall sensors  1258  disposed thereon. One or more batteries  1260  and a control switch  1262  may also be secured to the circuit board  1256 . Signals from the Hall sensors  1258  may be first processed by the circuit board  1256 , which may determine the position of the plunger  1206 , the volume of media in the syringe, etc., and then send this information to an associated system via the transmitter  1280  for further analysis, display to a doctor, etc. In another embodiment, e.g., if a non-processing base  1256  is used, the signals from each Hall sensor  1258  may be sent directly via the transmitter  1280  to an associated system for processing. 
     The distal retention insert  1254   a  may be inserted into the shaft  1208  so as to be near the piston  1210 . The distal retention insert  1254   a  may define a void  1264 , which may contain a wireless transmitter  1280 , such as a Bluetooth transmitter. The transmitter  1280  may send signals from the Hall sensors  1258  to an associated signal processing device such as described herein. In an alternative embodiment, a cable connection such as described above, may be utilized. The proximal retention insert  1254   b  is disposed in the hollow shaft  1208  near the thumb ring  1212 . Together, the distal retention insert  1254   a  and the proximal retention insert  1254   b  support, protect, and retain the circuit board  1256  within the hollow shaft  1208 . These two components may be configured for a snug fit in the shaft  1208 , or may include a key or other projection to engage with an opening or slot in the shaft  1208 , so as to prevent rotation. The retention inserts  1254   a ,  1254   b  may be permanently fixed within the shaft  1208 , although configuring the inserts  1254   a ,  1254   b  for removal may be advantageous so as to allow for replacement or repair of the circuit board  1256 , batteries  1260 , etc. In one embodiment, the thumb ring  1212  may include a resilient base  1264  including a plurality of projections  1266  that may be engageable with mating slots  1268  in the shaft  1208 . Disengaging these projections  1266  allows for removal of the retention inserts  1254   a ,  1254   b  and other internal components. A plurality of Hall sensors  1258  are depicted. A greater or fewer number of sensors  1258  may be utilized in various embodiments, although a greater number of sensors  1258  may provide for more accurate determinations with regard the position of the plunger  1206 . The Hall sensors  1258  are disposed linearly within the chamber so as to be substantially aligned with, or parallel to, the axis A S . 
     External components  1250   b  include the magnet retention ring  1252 , which holds a plurality of magnets  1270 , which are arc magnets, in the depicted embodiment. In other embodiments, cube, cylindrical, or other magnets may be utilized. The positions of the magnets  1270  are fixed relative to and about the syringe housing. The arc magnets  1270  form a substantially circular magnetic field through which the shaft  1208  (and the Hall sensors  1258 ) pass when the shaft  1208  is withdrawn from or inserted into the inner bore of the syringe. The circular magnetic field enables the Hall sensors  1258  to detect the field, regardless of the rotational position of the plunger  1206  about the axis A S . In other embodiments, the magnets  1270  may be secured directly to the syringe housing without the magnet retention ring. 
       FIG. 11  depicts a partial exploded perspective view of a portion of the monitoring syringe  1200 , as seen in  FIG. 10 . More specifically, the plunger  1206 , Hall sensor module internal components  1250   a , and Hall sensor module external components  1250   b  are depicted. In general, certain of these components are described above in  FIGS. 9-10  and are not necessarily described further. In the depicted embodiment, however, both the distal retention insert  1254   a  and proximal retention insert  1254   b  include shaped recesses  1272  that are configured to receive the circuit board  1256  so as to hold that element in place. The recesses  1272  are disposed in the inserts  1254   a ,  1254   b  so as to conserve space within the hollow shaft  1208  of the plunger  1206 . On a side of the circuit board  1256  opposite the Hall sensors  1258  are disposed a plurality of batteries  1260 . This is also depicted in  FIG. 12 . Additionally, a switch  1262  may be disposed proximate the batteries  1260  or elsewhere within the hollow shaft  1208 . The switch  1262 , in certain embodiments, may be a reed switch that detects plunger movement and moves to an engaged or activated position. The switch  1262  is not required but may help preserve power when the syringe  1200  is not in use. When activated, the switch  1262  selectively connects power from the batteries  1260  to either or both of the plurality of Hall sensors  1258  and the wireless transmitter  1280 . In other embodiments, a manually-operated switched, such as a pull tab, button, or rocker switch may be actuated by the user. 
     In a further embodiment of a system, the measurement components of a monitoring syringe  1200  could also be utilized to measure a volume of medium diverted by a modulator to a medium diversion reservoir, in systems that employ a reservoir in the introduction of contrast to a patient. Such medium diversion reservoirs, and their incorporation into related medium management and monitoring systems, are described elsewhere herein. In such cases, the inner bone  1204  may form a fluid reservoir to capture medium that may diverted by a modulator away from the injection of medium to the delivery catheter. In an additional embodiment of a reservoir, the chamber may be sufficiently pressurized by a force acting upon the plunger  1206  to facilitate controlled filling, release and measurement of a medium within the chamber. The force may bias the piston  1210  into the fluid contained in the bore  1204 , while the Hall sensors  1258  continue to detect a position of the plunger  1206 . In the depicted example, to configure the monitoring syringe  1200  as a pressurized diversion reservoir, a spring  1209  may be disposed about the hollow shaft  1208  of the plunger  1206 . This spring  1209  biases the piston  1210  towards the discharge end  1214   a  of the syringe housing  1202 . Other spring configurations and/or biasing mechanisms may be utilized, wherein they may be generally disposed about the syringe axis A s  so as to provide for a balanced application of force. 
       FIG. 13  depicts a perspective view of a second embodiment of a monitoring syringe  1300  utilizing a Hall sensor module. The monitoring syringe  1300  includes a syringe housing  1302  defining a hollow inner bore. A plunger  1306  including a shaft  1308  and a piston  1310  is slidably received in the bore. More specifically, the piston  1310  may be slidably engaged with an interior surface of the bore and linear movement M of the shaft  1308 , within the bore, moves the piston  1310 . Movement M is along the syringe axis A S . The plunger  1306  is moved back and forth within the bore  1304  by the movement of a thumb pad, such as a thumb-ring  1312 . As the plunger  1306  is moved M in a direction towards the discharge end  1314   a  of the syringe housing  1302 , the fluid contained therein is discharged into a manifold assembly, tube, or needle (not shown) and delivered to a patient. 
     As an alternative embodiment to that depicted in  FIGS. 10-11 , a Hall sensor module  1318  may be secured to an exterior surface of the syringe housing  1302 , rather than securement to the plunger. The Hall sensor module  1318  includes a Hall sensor housing  1319  that encloses a plurality of Hall sensors  1320 . As described above with regard to  FIGS. 9-11 , a greater number of discrete Hall sensor elements may improve accuracy. One or more leads or wires  1324  extend from an end of the Hall sensor module  1318 . A cable  1326  connects at an end  1328  to an interface unit that analyzes the output of the Hall sensor module  1318  and provides this information to a user of the monitoring syringe  1300 , typically on a display. In other embodiments, communication may be via a radio, Bluetooth, of other wireless connection, as described herein. The displayed information may include volume of the chamber, volume remaining, volume dispensed, fluid type, flow rate, fluid pressure or temperature and/or other information, as required or desired for a particular application. As described above, the signals from the Hall sensors may first be processed by an associated circuit board then sent to an interface unit, or the discrete signals may be sent to the interface unit for processing. 
     In the depicted embodiment, the shaft  1308  of the plunger  1306  has one or more magnets  1330  disposed thereon or within the shaft  1308 . The magnet  1330 , in this case; includes a plurality of arc magnets disposed about the shaft  1308 . As the plunger  1306  is slidingly moved M along the axis A S , the magnet  1330  passes in front of the Hall sensors  1320  of the Hall sensor module  1318 . The magnetic field generated by the magnet  1330  is detected by the Hall sensor  1320 . The Hall sensor  1320  sends a signal to the interface unit that determines the position of the plunger  1306  within the syringe housing  1302 , based on the position of the magnet  1330  as detected by an individual Hall sensor  1320 . Thus, the position of the plunger  1306  can be determined. The interface may also determine the various types of information listed above, based on a known diameter and length of the bore  1304  of the syringe housing  1302 . Two finger rings or tabs  1332  receive the fingers of a user during use. A stop  1334  prevents the plunger  1306  from being pulled out of the syringe housing  1302 . 
     Although the embodiments depicted in  FIGS. 9-13  depict a plurality of Hall sensors, other embodiments of monitoring syringes may utilize one or more sensors of various types. For example, a single sensor, or multiple sensors, may be used to measure a magnetic field, material resistance, capacitance, etc. The measurements from such sensors may be utilized to determine the linear position of the plunger within the syringe. Examples of such sensors include, but not limited to, Hall effect sensors (as described in more detail herein), inductive sensors, capacitive touch sensors, and others. 
       FIG. 7A  depicts a first method  1000   a  of using a monitoring syringe utilizing light signals. At operation  1002   a , a signal is received from a light sensor, the position of which on a monitoring syringe is known. Other characteristics of the light sensor, such as receptive wavelength, may be known. Based on the position of the light sensor and the signal received from said sensor, a position of a piston is then determined in operation  1004   a . In certain embodiments of the method  1000   a , a light signal is emitted from the first emitter in operation  1006   a . In embodiments where multiple light sensors are used, a light signal may be received at a second light sensor having known characteristics (e.g., position) in operation  1008   a . An updated position may then be determined based on the characteristic of the second light sensor and the signal in operation  1010   a . At any time a light signal is received from a known light sensor, a condition of the syringe (such as those described herein) may be determined, as in operation  1012   a.    
       FIG. 7B  depicts a second method  1000   b  of using a monitoring syringe utilizing Hall sensors. At operation  1002   b , a signal is received from a first Hall sensor, the position of which in a plunger shaft is known, relative to other Hall sensors in the shaft. Based on the position of the first Hall sensor and the signal received from said sensor, a position of a piston is then determined in operation  1004   b . Since a cross-sectional area, diameter, or other dimension of the syringe is known, the amount of media in the syringe based on the position of the piston can be determined. In embodiments where multiple Hall sensors are used, a signal may be received from a second Hall light sensor having known characteristics (e.g., position) in operation  1006   b . An updated position of the piston may then be determined based on the received signal from the second Hall sensor and the signal in operation  1008   b . At any time a signal is received from a known Hall sensor, a condition of the syringe (such as those described herein) may be determined, as in operation  1010   b . As described above, the method  1000   b  may be performed on the circuit board within the monitoring syringe, then sent to an associated system via the transmitter for further analysis or display to a surgeon, etc. In an alternative embodiment, each signal may be sent via the transmitter to an associated system for processing, analysis, display, etc. 
     In addition, the methods described in  FIGS. 7A-7B , when used in a system employing a diversion reservoir, may further incorporate a measurement determined in a chamber collecting medium diverted from an injection (i.e., through a modulator). Having a total amount of medium injected by the syringe (as determined by a sensing apparatus), minus the amount of medium diverted (as determined by a sensing apparatus), provides the total amount of the injection actually delivered to the patient. 
       FIG. 8  illustrates one example of a suitable operating environment  1100  in which one or more of the present embodiments may be implemented. This is only one example of a suitable operating environment and is not intended to suggest any limitation as to the scope of use or functionality. Other well-known computing systems, environments, and/or configurations that may be suitable for use include, but are not limited to, personal computers, server computers, hand-held or laptop devices, multiprocessor systems, microprocessor-based systems, programmable consumer electronics such as smart phones, network PCs, minicomputers, mainframe computers, smartphones, tablets, distributed computing environments that include any of the above systems or devices, and the like. 
     In its most basic configuration, operating environment  1100  typically includes at least one processing unit  1102  and memory  1104 . Depending on the exact configuration and type of computing device, memory  1104  (storing, among other things, instructions to perform the monitoring methods described herein) may be volatile (such as RAM), non-volatile (such as ROM, flash memory, etc.), or some combination of the two. This most basic configuration is illustrated in  FIG. 8  by line  1106 . Further, environment  1100  may also include storage devices (removable,  1108 , and/or non-removable,  1110 ) including, but not limited to, magnetic or optical disks or tape. Similarly, environment  1100  may also have input device(s)  1114  such as touch screens, keyboard, mouse, pen, voice input, etc. and/or output device(s)  1116  such as a display, speakers, printer, etc. Also included in the environment may be one or more communication connections,  1112 , such as LAN, WAN, point to point, Bluetooth, RF, etc. 
     Operating environment  1100  typically includes at least some form of computer readable media. Computer readable media can be any available media that can be accessed by processing unit  1102  or other devices comprising the operating environment. By way of example, and not limitation, computer readable media may comprise computer storage media and communication media. Computer storage media includes volatile and nonvolatile, removable and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules or other data. Computer storage media includes, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disks (DVD) or other optical storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices, solid state storage, or any other tangible medium which can be used to store the desired information. Communication media embodies computer readable instructions, data structures, program modules, or other data in a modulated data signal such as a carrier wave or other transport mechanism and includes any information delivery media. The term “modulated data signal” means a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal. By way of example, and not limitation, communication media includes wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared and other wireless media. Combinations of the any of the above should also be included within the scope of computer readable media. 
     The operating environment  1100  may be a single computer operating in a networked environment using logical connections to one or more remote computers. The remote computer may be a personal computer, a server, a router, a network PC, a peer device or other common network node, and typically includes many or all of the elements described above as well as others not so mentioned. The logical connections may include any method supported by available communications media. Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets and the Internet. In some embodiments, the components described herein comprise such modules or instructions executable by computer system  1100  that may be stored on computer storage medium and other tangible mediums and transmitted in communication media. Computer storage media includes volatile and non-volatile, removable and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules, or other data. Combinations of any of the above should also be included within the scope of readable media. In some embodiments, computer system  1100  is part of a network that stores data in remote storage media for use by the computer system  1100 . 
     The monitoring syringes such as those described above may be utilized in various types of medium management systems to control and monitor medium injection into patients. Two exemplary medium management systems, as well as components thereof, are described below in the following figures. These are but two types of systems that may benefit from the monitoring technologies described herein. Other systems and configurations thereof will be apparent to a person of skill in the art. 
       FIGS. 14-16  illustrate another medium management system  1400  that may include, as shown in the illustrated embodiment, a flow diverter assembly (i.e., a modulator)  1402  and a diversion reservoir  1404 . In this embodiment, tubular member  1406   a  extends from the valve  1426  of the flow diverter assembly  1402  to a medium diversion reservoir  1404 , and tubular member  1406   b  extends from diversion reservoir  1404  to medium reservoir (e.g., contrast agent vial)  1410 . Medium from the medium reservoir  1410  (e.g., contrast agent vial) is permitted to flow away from the medium reservoir  1410  and through diversion reservoir  1404  via tubular members  1406   b  and tubular member  1412 . In the illustrated arrangement (of  FIG. 14 ), syringe  1414  may be fluidly coupled to medium reservoir  1410  by tubular members  1406   b ,  1412 ,  1416  and  1418 , coupling those components together by a manifold  1420  and through stopcock  1422 . When the syringe  1414  is being loaded with medium from medium reservoir  1410 , the stopcock  1422  may be positioned to permit medium flow between tubular members  1416  and  1418 , but not to tubular member  1424  disposed between the stopcock  1422  and the valve  1426  of the flow diverter assembly  1402 . The syringe  1414  may be any of the monitoring syringes described herein (e.g., using light sensors, Hall sensors, etc.) or of the monitoring syringes known in the art. Drawing back the syringe  1414  may pull medium from the medium reservoir  1410  through tubular member  1406   b , and/or diversion reservoir  1404 , and through tubular member  1412 . Medium from the medium reservoir  1410  and/or medium residing in the diversion reservoir  1404  may then be further drawn, into and toward, syringe  1414  through tubular members  1416  and  1418 . Once the syringe  1414  is loaded with medium from medium reservoir  1410  and/or diversion reservoir  1404 , valve B on manifold  1420  may then be manipulated to prohibit flow back to medium reservoir  1410  and diversion reservoir  1404  via tubular member  1412  (and such flow may be further inhibited by a check valve disposed between diversion reservoir  1404  and medium reservoir  1410 ), and the stopcock  1422  may be positioned to allow flow through the tubular members  1418 ,  1424 ,  1416  and manifold  1420 . 
     During contrast injection procedures incorporating a modulator (such as flow diverter assembly  1402 ) a portion of the injected medium flow from the syringe  1414  may be diverted away from the medium flow path to injection catheter  1428  by the flow diverter assembly  1402 . In the modulation/reservoir system  1400  illustrated in  FIGS. 14-16 , such diverted medium flow passing through the flow diverter assembly  1402  flows into the diversion reservoir  1404 , as opposed to the diverted medium flowing directly into the medium reservoir  1410  or some other outflow/overflow reservoir/chamber. Advantageously, the diversion reservoir  1404  provides means for collecting overflow medium diverted by the flow diverter assembly  1402 , for possible re-use as the syringe  1414  may be again activated to pull medium into the system (e.g., for introduction into the patient via catheter  1428 ). The use of such a diversion reservoir in this manner, with an associated check valve preventing back flow of medium into the medium reservoir  1410 , allows for capture and re-use of medium that is already introduced into the system (e.g., in the diversion reservoir  1404 ) while preserving the integrity of the medium disposed within medium reservoir  1410  in its original form. 
     The medium management system  1400  may also include a saline reservoir  1430  that can be used to flush portions thereof. In the depicted system  1400  of  FIG. 14 , the saline reservoir  1430  is connected to the manifold  1420  via a tube  1432  and can be isolated from the remainder of the system  1400  with valve A. Valve A may include a position or other sensor S that detects a position of the valve A. A flush signal is sent from the valve A sensor S to a monitoring/display system  1434 , which also may be configured to monitor the positon of valve B and stopcock  1422  (using sensors S), as well as the output from the various sensors on the monitoring syringe  1414  and/or the sensors on the diversion reservoir  1404 . For example, when the valve A is in an open position, the monitoring/display system  1434  may disregard signals from the monitoring syringe  1414  and/or diversion reservoir  1404  (as those readings are not reflective of contrast being injected from or drawn into the syringe  1414 ). In another example, if the valve A is in an open position, the monitoring/display system  1434  may display an instruction or emit a signal to remind an operator to close valve B and/or stopcock  1422  so as to isolate those portions of the system  1400 . In another, more complex example, the system  1400  uses automated valve B and/or stopcock  1422  and closes these valves upon receiving an open signal from valve A. 
     One embodiment of the diversion reservoir  1404  is illustrated in  FIGS. 15A-15D .  FIG. 15A  shows an assembled view of diversion reservoir  1404  along with its associated tubular members  1406   a  and  1412 .  FIG. 15B  is an exploded view of the assembly of  FIG. 15A . The system  1400  may further include a second supply conduit  1412  in fluid communication with the supply conduit  1406   b  and the diversion conduit  1406   a , wherein the second supply conduit  1412  is fluidly coupled to the fluid medium flow path. Tubular members  1406   a  and  1412  are sealably connected to a first end cap or manifold  1502  on diversion reservoir  1404 , as further shown in  FIG. 15C , which is a sectional view taken through lines  15 C- 15 C in  FIG. 15A . A first end of a through-tube  1506  is sealably connected to an interior side of first end cap  1502 , as at  1504 . Through-tube  1506  includes an inner conduit  1508  extending therethrough. Inner conduit  1508  is in fluid communication with the interiors of tubular members  1406   a  and  1412  via their adjacent couplings in the first end cap  1502 , as illustrated in  FIG. 15C . A second end of through-tube  1506  is sealably connected to a check valve assembly  1540 , as at  1510 , and the inner conduit  1508  is in fluid communication with the check valve assembly  1540 . The check valve assembly  1540  is, in turn, in fluid communication with the tubular member  1406   a . As seen in  FIG. 15C , the check valve assembly  1540  includes a moveable valve plate  1512  (or other suitable structure allowing one way flow through the valve) which is operable to permit flow from the medium reservoir  1410  (e.g., medium contrast vial) via tubular conduit  1406   b  into the inner conduit  1508  of through-tube  1506 , but to inhibit flow in reverse thereof. This arrangement may allow flow of medium from fluid reservoir  1410  via tubular conduit  1406   b , inner conduit  1508  of through-tube  1506 , and tubular conduit  1412  to the syringe  1414 . Moreover, medium flow diverted by flow diverter assembly  1402  may also be permitted to flow via tubular member  1406   a  into inner conduit  1508  of through-tube  1506 , but inhibited from flowing to the medium reservoir  1410  by check valve assembly  1540 . A second end cap  1514  on diversion reservoir  1404  is secured about the check valve assembly  1540 . 
     The diversion reservoir  1404  is designed to accommodate flow of medium from the flow diverter assembly  1402 , to collect and hold such medium and then, if desired, urge such collected medium back into the system for use in delivering additional medium to the patient via injection catheter  1428 . In one embodiment to accomplish this end, diversion reservoir  1404  may include an elastic expansion tube  1516  disposed about through-tube  1506 . As seen in  FIGS. 15C and 15D , expansion tube  1516  extends along a portion of a length of through-tube  1506 . Expansion tube  1516  may be formed of silicone (or like flexible) material sealably secured adjacent each end thereof about the through-tube  1506  by first and second retention washers  1518  and  1520 , respectively, or by other suitable sealable and mechanical fastening arrangements. An outer surface of the through-tube  1506  may include interference elements such as surface features or an annular interference rim  1506   a  (see  FIG. 15C ) to further facilitate the sealing of the expansion tube  1516  to the through-tube  1506  via the retention washer  1518  and  1520 . 
     A housing tubular outer shell  1522  may be connected between the first end cap  1502  and second end cap  1514 , thereby covering the expansion tube  1516  and other diversion reservoir components therein. The shell  1522  may serve to protect the components of the diversion reservoir  1404  therein, limit the extent of inflation or expansion of expansion tube  1516 , and/or (if the shell  1522  is either transparent or translucent) allow observation of the condition (e.g., expanded state) of expansion tube  1516  therein. 
       FIG. 15D  illustrates the diversion reservoir  1404  in perspective sectional view (again, as taken along lines  15 C- 15 C in.  FIG. 15A ) with the expansion tube  1516  shown in an exemplary stretched and expanded state, as opposed to its relaxed state shown in  FIG. 15C . The expansion tube  1516  of the diversion reservoir  1404  receives medium flow from the flow diverter assembly  1402 , via tubular member  1406   a . This medium flow, as illustrated by flow arrows  1524  in  FIG. 15D , flows from tubular member  1406   a  into the inner conduit  1508  of through-tube  1506  adjacent the first end of through-tube  1506 . Through-tube  1506  can be a portion of the medium supply conduit  1406   b  that resides within reservoir chamber  1526 . Flow out of the through-tube  1506  is inhibited at its second end by the check valve assembly  1540 . However, the supply conduit through-tube  1506  may have one or more apertures  1528  therethrough which allows an interior of the expansion tube  1516  to be in fluid communication with the inner conduit  1508  and reservoir chamber  1526 . Medium from the flow diverter assembly  1402  can thus flow through apertures  1528  and into a medium reservoir or chamber  1526  defined by the expansion tube  1516 . This medium chamber  1526  is defined between the inner surface of expansion tube  1516  and the outer surface of through-tube  1506 , whereby the expansion tube  1516  forms an elastic bladder disposed around the supply conduit  1506 , with the walls of expansion tube  1516  capable of imparting a force on the fluid medium within the chamber  1526 . A surface within chamber  1526  is capable of imparting a variable or constant force on the fluid medium within the chamber  1526 , and the surface is defined at least in part by a wall of the elastic bladder of expansion tube  1516 . The medium chamber  1526  thus receives and collects the diverted portion of the flow of medium from the flow diverter assembly  1402 . The diversion reservoir  1404  comprises a variable or constant force biasing member disposed relative to at least one surface within the reservoir chamber  1526  to urge the surface against the fluid medium within the reservoir chamber  1526 . The expandable wall of the expansion tube  1516  thus defines a surface within the medium chamber  1526  capable of imparting a force (variable or constant) on the fluid medium within the medium chamber  1526 . In one embodiment, the second end cap  1514  includes an aperture  1530  therethrough to permit the escape of gas within the cover  1522  and thereby readily permit expansion of the expansion tube  1516  therein. 
     In use, as the pressure of medium within the flow diverter assembly  1402  increases enough to allow flow therethrough, medium flows from the diverter valve  1426  via the tubular member  1406   a  to the diversion reservoir  1404 . Fluid coupling is provided by a medium supply conduit  1406   b  disposed between, and fluidly coupled to, the diversion reservoir  1404  and the sterile medium container  1410 . A diversion supply conduit  1406   a  is disposed between, and fluidly coupled to, the diversion reservoir  1404  and the flow diverter assembly  1402  so as to supply the reservoir  1404  with the diverted portion of the fluid medium from the flow diverter assembly  1402 . Medium flows within the diversion reservoir  1404  as illustrated by arrows  1524  into medium chamber  1526 , thereby stretching the walls of the expansion tube  1516  and expanding chamber  1526  to accommodate the diverted medium flow. Accordingly, as the medium pressure provided via syringe  1414  increases in the system, the flow diverter assembly  1402  relatively diverts medium so that the flow to the patient relatively increases as relatively less flow is diverted by the flow diverter assembly  1402  into the diversion reservoir  1404 . The medium contained in the chamber  1526  may be available for further infusion into the patient via the modulation/reservoir system  1400 . As an example, an operator may activate valve B to allow medium flow from the chamber  1526  of the diversion reservoir  1404  into the syringe  1414  (which is being withdrawn to draw such fluid therein). If the fluid needed is greater than the volume retained within the chamber  1526 , the force of check valve  1512  is overcome and further medium is withdrawn from the medium reservoir  1410  (e.g., contrast agent vial). Once a sufficient amount of medium has been withdrawn from the chamber  1526  and/or reservoir chamber  1410 , valve B may be closed and the modulation/reservoir system  1400  may be again in condition for delivery of medium via injection catheter  1428 , by activation of injection syringe  1414  by an operator. As long as the stopcock  1422  is disposed to allow flow into tubular members  1416  and  1424 , the flow modulator assembly  1402  may automatically activate to divert excess medium, thereby ultimately reducing the amount of medium introduced into the patient via injection catheter  1428  (e.g., thus introducing no more medium than necessary to attain operative opacity). In one embodiment shown, as the pressure is increased in the modulator  1402 , the resistance to medium flow into the diversion circuit is increased by operation of the flow diverter assembly  1402 . The process may be repeated by an operator as many times as deemed necessary to complete the procedure desired. Use of the modulation/reservoir system  1400  in this manner may achieve the advantageous reduction of introduction of unnecessary medium into the patient while achieving the necessary amount and flow of medium in the patient for diagnostic or treatment means (e.g., for opacity). In addition, the diversion reservoir  1404  may allow re-use of the diverted outflow of medium. 
     The diversion reservoir illustrated in  FIGS. 15A-15D  presents one form of such a reservoir. Alternative forms are contemplated as well. For example, an alternative form of elastic bladder or elastic surface may be provided that functionally allows the receipt of medium overflow from the flow diverter assembly  1402  into an expansion chamber, and then further allows the flow of medium from the medium reservoir  1410  through the diversion reservoir  1404  and into the modulation/reservoir system  1400  for use. An alternative means of placing force on the medium within the chamber in the diversion reservoir  1404  may be attained by a bias plunger, such as illustrated schematically in  FIG. 16 . The diverted portion of the fluid medium flows through a diversion conduit  1406   a  away from the flow diverter assembly  1402 . The system  1400  comprises a medium reservoir  1410  containing a supply source of fluid medium for the system  1400  and a supply conduit  1406   b  through the reservoir chamber  1602  that fluidly connects the medium reservoir  1410  and the diverter conduit  1406   a . The supply conduit  1406   b  comprises a check valve  1508   a  to prevent the flow of fluid medium from the supply conduit  1406   b  into the medium reservoir  1410 . Diversion reservoir  1404   a  includes a plunger  1604  slidably disposed in housing  1606  and moveable in a linear fashion relative to the housing  1606 , as illustrated by movement line  1608 . Thus, the surface  1610  is movable in a linear direction relative to the fluid medium within the reservoir chamber  1602 . A proximal face or surface  1610  of the plunger  1604  thus defines a portion of a chamber  1602  within the housing  1606  for diverted medium that is received therein via the tubular member  1406   a.    
     Like the diversion reservoir  1400  illustrated in  FIGS. 15A-15D , diversion reservoir  1404   a  may include a first end cap  1502   a  that acts as a manifold for medium flow. Tubular member  1406   a  is connected to first end cap  1502   a , as is tubular member  1412 . Chamber  1602  is in fluid communication with the interiors of tubular members  1406   a  and  1412 , such as via manifold  1612  within the first end cap  1502   a , as seen in  FIG. 16 . A through-tube  1506   a  is also in fluid communication with the manifold  1612 , and extends through the housing  1606  of the diversion reservoir  1404   a  to a check valve  1508   a . Check valve  1508   a  permits medium flow from medium reservoir  1410  via tubular member  1406   b  into through-tube  1506   a  but prevents backflow. Medium from the medium reservoir  1410  can then flow from the diversion reservoir  1404   a  into the syringe  1414  via tubular member  1412 . 
     When medium is diverted by the flow diverter assembly  1402  into the diversion reservoir  1404   a , medium flows as illustrated by flow arrows  1524   a  from tubular member  1406   a , through manifold  1612 , and into the chamber  1602 . The diversion reservoir  1404   a  comprises a variable or constant force biasing member such as spring  1614  disposed relative to at least one surface  1610  within the reservoir chamber  1602  to urge the surface  1610  against the fluid medium within the reservoir chamber  1602 . In an exemplary embodiment, surface  1610  is planar. The face  1610  of the plunger  1604  is biased by spring  1614  toward the manifold chamber  1612 , and thus defines a moveable surface  1610  for the chamber  1602  that can move away and expand chamber  1602  as more medium is introduced therein, when the bias of the force acting against it is overcome. This bias acts on the plunger  1604  within the housing  1606 , as illustrated schematically by force arrows  1616 , and such force may be achieved by suitable means such as springs, weight distribution, linear actuator, or other force elements. The use of a linearly moving plunger  1604  (as its movement is illustrated by arrows  1608 ) may permit more ready measurement of how much medium has actually been diverted by the flow diverter assembly  1402  and thereby, by derivation, how much medium has actually been delivered to a patient by the injection catheter  1428 . Measurement may be performed by utilizing a light-based, Hall sensor-based, or other type of monitoring system  1618  disposed in or on the housing  1606 , or in or on other structures (such as the plunger) of the diversion reservoir  1404 , as such systems are described herein. The plunger  1604  thus provides a linear expansion element (surface  1610 ) that serves to apply force to the overflow medium collected for possible re-use in the chamber  1602 . 
     The diversion reservoir  1404   a  operates in a similar manner to the diversion reservoir  1404 , discussed above, by providing an expandable chamber for medium diverted by the flow diverter/modulating assembly  1402 , wherein the chamber (e.g., chamber  1602 ,  1526 ) has at least one surface acting upon it to urge the medium therein back toward the injection device  1414  (via conduit  1412 ) for possible re-use. Likewise, medium which has been diverted by the flow diverter assembly  1402  into the diversion reservoir chamber  1602  is not permitted to flow back to the diverter assembly  1402 , nor to flow to the medium reservoir  1410  (via check valve  1508   a ). In alternative embodiments for modulation/reservoir systems, the diversion reservoir is configured so that flow through it to the medium reservoir  1410  is not permitted or necessary. One such arrangement is illustrated in  FIG. 17 , in connection with a modulation/reservoir system  1400   a . In these arrangements, there may be no necessity for a through-tube arrangement through the diversion reservoir. The diversion reservoir simply provides an expandable chamber therein for retaining and re-using medium diverted from the flow diverter assembly  1402 . Such diversion reservoirs  1404   b  may employ a bladder form of chamber or a constant or variable force resistance form of chamber, such as those illustrated and discussed herein, where at least one surface therein is capable of imparting a sufficient force upon the fluid medium within the chamber. For example, the diversion reservoir  1404   b  may be constructed to function similar to the spring-based monitoring syringe  1200  depicted in  FIG. 11 . Although the “injection function” of the syringe  1200  may not be needed to function as a diversion reservoir, one can see the advantages of using the measurement capabilities derived from the chamber as described in  FIG. 11  as it might function as a “diversion reservoir”, utilizing spring  1209  to bias piston  1210 .  FIG. 17  illustrates an arrangement where the medium reservoir chamber  1410  is connected via tubular member  1406   c  to a T-connector  1702  disposed between a diversion reservoir  1404   b  (without a through-tube) and the flow diverter assembly  1402 . The T-connector  1702  connects at its first end to the tubular members  1412  and  1406   a  and at its second end to tubular member  1406   d  that leads to the diversion reservoir  1404   b . A side fitting of the T-connector  1702  leads via tubular member  1406   c  to the medium reservoir  1410 . A check valve  1508   b  is disposed between the T-connector  1702  and the medium chamber  1410  to prevent back flow of medium from the flow diverter assembly  1402  and/or diversion reservoir  1404   b  into the medium container  1410 . In operation, the configuration illustrated in  FIG. 17  may be similar to that described above with respect to  FIG. 14 . As the pressure of medium within the flow diverter assembly  1402  increases enough to allow flow therethrough, medium flows from the valve  1426  via tubular member  1406   a  to the T-connector  1702 . Medium may then flow from the T-connector  1702  via tubular member  1406   d  to the diversion reservoir  1404   b . Medium flowing into the diversion reservoir  1404   b  moves the piston therein to accommodate the diverted medium flow. In operation, medium provided via syringe  1414  may be diverted by the flow diverter assembly  1402  away from injection to the patient, and accumulate in the diversion reservoir  1404   b.    
     The medium contained in the expandable chamber within the diversion reservoir  1404   b  may be available for further infusion into the patient via the modulation/reservoir system  1400   a . To do so, an operator activates valve B to allow medium flow from the chamber within the diversion reservoir  1404   b  into the syringe  1414  (which is being withdrawn to draw such fluid therein). If the fluid needed is greater than the volume retained in the chamber reservoir  1404   b , the force of check valve  1508   b  is overcome and further medium is then withdrawn from the medium reservoir  1410 . Once a sufficient amount of medium has been withdrawn from the chamber within the diversion reservoir  1404   b  and/or reservoir chamber  1410 , valve B is again closed and the modulation system  1400   a  is again in condition for delivery of medium via injection catheter  1428 , by activation of injection syringe  1414  by an operator. As long as the stopcock  1422  is disposed to allow flow into tubular members  1416  and  1424 , the flow diverter assembly  1402  will then again be automatically activated to divert excess medium when a threshold pressure for activation of the flow diverter assembly  1402  is attained, thereby ultimately reducing the amount of medium introduced into the patient via injection catheter  1428 . Again, as pressure is increasing going into flow diverter system  1402 , the flow through the diverter  1402  is relatively decreasing (thus, flow to the patient may be relatively increasing at the same time by operation of the flow diverter assembly  1402 ). The process can be repeated by an operator as many times as deemed necessary to complete the procedure desired. Use of the modulation/reservoir system  1400   a  in this manner achieves the advantageous reduction of introduction of unnecessary medium into the patient while achieving the necessary amount and flow of medium in the patient for the desired diagnostic or treatment process. Furthermore, the modulating/reservoir assembly may advantageously allow an operator to change out the injection delivery system (i.e., guide catheter, diagnostic catheter, treatment tools, etc.) without changing the flow modulator. Moreover, the diversion reservoir may allow simplistic re-use of the diverted medium. 
       FIG. 18  depicts a method  1800  of determining an amount of medium injected into a patient. The method begins at operation  1802 , where an injection signal is received from a sensor associated with an injection syringe. In operation  1804 , a diversion signal is received from a sensor associated with a diversion reservoir. Each of the injection signals and the diversion signals may be received from the various types of monitoring systems as described herein, including light-based sensor systems, Hall sensor-based systems, and so on. These signals can include position signals (e.g., position of the piston), which may be used to determine a volume of medium contained within the injection syringe and/or the diversion reservoir. With this information, the amount of medium injected may be determines based at least in part on the injection signal and the diversion signal, in operation  1806 . In an example, the amount injected is the difference between the volume in the injection syringe minus the volume in the diversion reservoir. Operations  1802 - 1806  are constantly updated as medium is injected into the patient. 
     In operation  1808 , a signal associated with the amount of medium injected is sent. The summation of the total amount medium injected in a patient over time can be maintained. Signals and measurement data may be provided to an operator in the form of an audible or visual signal which can indicate to the operator of the system (i.e., a surgeon or technician) the amount of fluid injected. The signals can include a visual display of the amount injected (e.g., on a monitoring display), or a signal that may indicate to the user that a maximum amount of contrast has been injected, or that none of the medium ejected from the syringe has been received in the diversion reservoir (which may be an indication of a valve or system problem). The systems described herein also include a saline flush system. Saline volumes passing through the system should be ignored so the amount of medium injected is not incorrectly calculated. As such, the method  1800  contemplates receiving a flush signal associated with a valve of a saline flush system, operation  1810 . At operation  1812 , subsequent injection signals and/or diversion signals are disregarded based at least in part on the received flush signal. The injection and/or diversion signals may be ignored while the flush signal is still received, which allows the operator to flush the system without the saline volume passing through the system causing a miscalculation of the injected medium. In optional operation  1814 , a position of at least one valve based at least in part on the flush signal may be adjusted, if automated valves are being utilized in the system. Otherwise, in systems where manual valves are used, the flush signal received in operation  1810  may cause a signal to be emitted, which may be used to signal an operator to close the valves not associated with the flush system (e.g., valve B and stopcock  1422  in  FIG. 14 ). Further, it is assumed that it is understood that the order of the steps in  FIG. 18  maybe performed in a different order as shown without deterring from the scope of the invention. As an example, without being wholly inclusive, one might collect data from the diversion sensor before the injection sensor 
     The monitoring systems described herein may be utilized to deliver any types of fluids to a patient during a medical procedure. Such fluids may include medium (media), agents, substances, materials, medicaments, and the like. It should be noted that these terms are used generically herein to describe a variety of fluidal materials that may include, at least in part, a substance used in the performance of a diagnostic, therapeutic or/and prophylactic medical procedure and such use is not intended to be limiting. It should be understood that the medium delivery modulation and/or measurement devices and methods described herein are not limited to the particular, representative embodiments as described, since variations may be made to these embodiments without departing from the scope and spirit of the disclosure. Likewise, terminology employed in the description of embodiments is not intended to be limiting and is used merely for the purpose of conveyance of the concept. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art of which the disclosed devices and methods pertain. 
     The materials utilized in the manufacture of the monitoring syringe may be those typical in medical applications. Plastics such as polycarbonate may be utilized for the syringe housing and plunger. The band or gradation may be printed directly on the plunger shaft, or may be printed on a discrete plastic sheet or sheath that may then be affixed to the plunger shaft. Various types of printing may be utilized to change the translucency or opacity of the band or gradation. In some embodiments, the type of printing may be based on the type of light to be received by the sensors. For example, carbon-based printing may be utilized for sensors that detect infrared light. Thus, the band or gradation may be utilized as the filter described above. 
     While there have been described herein what are to be considered exemplary and preferred embodiments of the present technology, other modifications of the technology will become apparent to those skilled in the art from the teachings herein. The particular methods of manufacture and geometries disclosed herein are exemplary in nature and are not to be considered limiting. It is therefore desired to be secured all such modifications as fall within the spirit and scope of the technology. Accordingly, what is desired to be secured by Letters Patent is the technology as defined and differentiated herein, and all equivalents.