Source: https://patents.google.com/patent/US10178978B2/en
Timestamp: 2020-04-05 01:04:02
Document Index: 764672174

Matched Legal Cases: ['art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art.\n16']

US10178978B2 - Mobile fluoroscopic imaging system - Google Patents
Mobile fluoroscopic imaging system Download PDF
US10178978B2
US10178978B2 US15/829,405 US201715829405A US10178978B2 US 10178978 B2 US10178978 B2 US 10178978B2 US 201715829405 A US201715829405 A US 201715829405A US 10178978 B2 US10178978 B2 US 10178978B2
US15/829,405
US20180153487A1 (en
2010-12-13 Priority to US42261510P priority Critical
2011-01-31 Priority to US201161438221P priority
2011-12-13 Priority to US13/324,677 priority patent/US9125611B2/en
2015-07-31 Priority to US14/815,738 priority patent/US9833206B2/en
2017-12-01 Application filed by ORTHOSCAN Inc filed Critical ORTHOSCAN Inc
2017-12-01 Priority to US15/829,405 priority patent/US10178978B2/en
2017-12-14 Assigned to ORTHOSCAN, INC. reassignment ORTHOSCAN, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: EAVES, CHRISTOPHER B.
2018-06-07 Publication of US20180153487A1 publication Critical patent/US20180153487A1/en
2019-01-15 Publication of US10178978B2 publication Critical patent/US10178978B2/en
238000003384 imaging method Methods 0 title claims abstract description 193
Mini C-arm units are compact fluoroscopic imaging systems designed for real-time imaging of, for example, extremities. However what is needed are systems with superior form factors and modular configurations for improved mobility and imaging flexibility.
In some embodiments, disclosed herein is a portable, reconfigurable imaging system that can advantageously be placed on a tabletop surface, for example. The system can include a support, an x-ray source carried by the support, an x-ray detector carried by the support and positionable at a distance from the source, a primary x-ray propagation axis extending between the source and the detector, a first surface an art opposite side of the source from the detector, a second surface on an opposite side of the detector from the source, and at, least a third surface generally parallel to the axis. The system can be stably placed on a horizontal surface on either of the first or second surfaces such that the axis extends generally vertically, or on the third surface such that the axis extends generally horizontally. The distance along the axis between the source and the detector can either be fixed or adjustable. The detector can be a flat detector in some embodiments. The system can also include a connector, for removable connection to a cart. The system can also include a monitor, which can be either connected via wires or wirelessly to the detector. The system can also include least a first control panel on the source, and at least a second control panel on at least one of the detector and the support. The source can be configured to produce a pulsed x-ray beam.
In some embodiments, disclosed is a table top imaging system, including an x-ray source carried by the support, an x-ray detector carried by the support and positionable at a distance horn the source, and a primary x-ray propagation axis extending between the source and the detector. The distance between the source and the detector is adjustable along the axis, and the axis is angularly adjustable throughout an angular range. In some embodiments, the angular range can be, for example, at least about 15, 30, 45, 60, 75, 90, 105, 120, 135, 150, 165, 180, or more degrees.
FIGS. 4C-4F illustrate handles, or pip points for use in lifting or moving the core mobile imaging system.
FIGS. 5A-5C illustrate that the core mobile imaging system can be removably attached to stationary or movable cart that can have a base, wheels, and an elongate member that can be vertically oriented as illustrated.
FIG. 13D illustrates a plank, developed for a C-arm, type imaging system.
Disclosed, herein, are mobile digital imaging systems capable of fluoroscopic x-ray and static x-ray imaging. The device can provide an imaging solution similar to that of a mobile C-arm, but with an improved mechanical form factor focused on, for example, the mobility of the system, and the versatility of its application. In some embodiments, instead of an arcuate C-arm, the system includes a backing component that could be relatively linear to connect an x-ray source assembly and a detector assembly (that could be non-arcuate or include stable base elements) such that the system can lie in a stable position in various vertical and/or horizontal orientations, e.g., on a tabletop. As such the core system could have, notwithstanding the space required for an anatomical structure to be imaged between the x-ray source and the detector, a generally cubical or rectangular prism-type profile. The system can also be modularly reversibly attachable to a cart or wall mount, and move in at least one, two, three, or more degrees of freedom relative to the cart or wall mount. In this regard, the core imaging system can be movable axially, or rotate in one, two, or more axes relative to the cart or wall mount. The core imaging system can be axially reducible, such as along its length to allow for a smaller footprint for storage and also to vary the source to intensifier distance when clinically desirable.
In some embodiments, the core mobile imaging system can weigh less than about 100, 75, 60, 50, 40, 30 or less pounds and could be powered by a small portable power source or standard AC current. The system can allow the user to view images on a screen connected via a wired connection or wireless protocol including USB, FireWire, Bluetooth, infrared, Wi-Fi, cellular, or other connection to, for example, a tablet computer, desktop or laptop computer, mobile phone, television, projector, or specialized medical-grade monitor. The system could also interface with a Digital Imaging and Communications in Medicine (DICOM). Picture Archiving and Communication System (PACS), or other electronic medical record system. The core mobile imaging system can optionally be mounted to several accessory components to provide positioning assistance based on the specific needs of the user. These accessory components may or may not be mobile, and may or may not be transported with the core mobile imaging system.
FIGS. 1A-1E illustrate various views of a core mobile imaging system 100 that includes an x-ray source assembly 102, a detector assembly 104, and a connecting element 106 operably connecting the x-ray source assembly 102 and the detector assembly 104. The x-ray source assembly 102 and the detector assembly can be separated by a distance D1. While distance D1 can be fixed, in some embodiments, one or both of the x-ray source assembly 102 and the detector assembly 104 are movable along the longitudinal axis A1 of the core mobile imaging system 100 to increase or decrease distance D1 according to the patient's anatomy, size, and desired imaging. As such, the maximal fixed or variable distance D1 could be between about 12 inches to about 48 inches, or between about 12 inches to about 24 inches to some embodiments. The distance D1 could be zero or near zero in an adjustable system where either or both of the x-ray source assembly 102 and detector assembly 104 are axially movable with respect to each other. The space 110 between x-ray source assembly 102 and detector assembly 104 is reserved for an item, such as a body part such as a hand, wrist, forearm, elbow, humerus, shoulder, skull, cervical, thoracic, lumbar, or sacral spine, hip, femur, knee, leg, ankle, or foot, to be imaged. In some embodiments, the space 110 could be between about 20 cm and 60 cm, or between about 25 cm and about 30 cm in length between the x-ray source assembly and the detector assembly 104. The width of the space 110 could be between about 30 cm to about 90 cm, between about 45 cm to about 75 cm, or about 60 cm in some embodiments. In some embodiments, the space 110 is generally cubical. The imaging system 100 can also include one, two, or more handles 112 for ease in transport, such as attached to the x-ray source assembly 102 and/or detector assembly 104 along the posterior side of the imaging system 100 as illustrated in FIG. 1A. In some embodiments, the imaging system 100 has a major axis end-to-end distance (length) that is at least about 110%, 120%, 130%, 140%, 150%, 175%, 200%, or more of a minor axis (width) side-to-side distance. In some embodiments, the core mobile imaging system 100 has a length of between about 90 cm to about 250 cm, or between, about 120 cm and about 190 cm; a width of between about 30 cm to about 75 cm, or between about 45 cm to about 75 cm; and/or a height of between about 30 cm to about 75 cm, or between about 45 cm to about 75 cm measured when the system 100 is positioned on a flat surface with its longitudinal axis-oriented horizontally.
The detector assembly 104 can be a flat detector design in some embodiments. The flat panel image receptor generally includes a planar substrate such as glass laminated with an array of sensors such as amorphous silicon crystals that convert x-ray energy to electrical signals. That is, the sensors emit an electric potential when struck by photons of x-ray energy. The magnitude of the potential is related to the intensity of the x-ray beam. The electrical signals can be read out from a row/column matrix and then converted to digital data. In one embodiment, the flat panel image receptor can include a Cesium Iodide scintillating layer or an amorphous silicon glass substrate. The scintillating layer converts x-ray energy into light. An array of photodiodes on the glass substrate convert the light into electrical signals. The electrical signals are read out of a row/column matrix that is accessed using thin film transistor switches on the amorphous silicon substrate. The analog data is then converted to a digital format for downstream processing. Suitable amorphous silicon-based, flat panel image receptors are described, for example, in U.S. Pat. Nos. 5,079,426; 5,117,114; 5,164,809; and 5,262,649 which are hereby incorporated by reference in their entireties. The flat panel image receptor can be of any dimension such as, for example, 20 cm×25 cm, and the system can be easily upgraded to incorporate larger flat, panel image receptors. In some embodiments, the flat panel image receptor has a dimension, such as a thickness, of no more than about 30 cm, 25 cm, 20 cm, 18 cm, 16 cm, 14 cm, 12 cm, 10 cm, 8 cm, 6 cm, 4 cm, or less.
A generally linear connecting element 106, or a system with linear surfaces (e.g., feet or one, two, three, or more flat or relatively flat surfaces of the x-ray source assembly 102 and/or receptor assembly 104) akin to a rectangular or square box for example, can be advantageous in that it can allow the core mobile imaging system 100 to be able to stably rest in several configurations based on the geometry of the outer housings of the unit. In contrast, a conventional C-arm or mini C-arm could not be stably positioned with the C-arm resting on the flat surface, but would instead rock back and forth or possibly fall on its side. Furthermore, the systems, such us those described herein have a smaller overall footprint and such can be more easily transported and stored. In some embodiments, the core mobile imaging system can stand on top of a flat surface such as a desk, table, floor, etc. in several positions such as upright, (with the longitudinal axis A1 of the device aligned vertically) with the x-ray source assembly 102 superior to (above) the receptor assembly 104 as illustrated in FIG. 1C; upside-down with the x-ray source assembly 102 inferior to (below) the receptor assembly 104; flat (with the longitudinal axis A1 of the device aligned horizontally) with the x-ray source assembly 102 located in a lateral position to the image receptor assembly 104 with the handles 112 facing upward; in a lateral decubitus position (with the longitudinal axis A1 of the device aligned horizontally) with the x-ray source assembly 102 located in a lateral position to the image receptor assembly 104 with the handles 112 facing the front (or facing the user position); or in a lateral decubitus position (with the longitudinal axis A1 of the device aligned horizontally) with the x-ray source assembly 102 located in a lateral position to the image receptor assembly with the handles 112 feeing the back (or facing the imaging target). The connecting element 106 need not be entirely linear so long as the system 100 is stable when positioned, for example, on a tabletop.
FIG. 2A is an end view of a core mobile imaging system 100, illustrating the external face of the x-ray source assembly 102 and connecting element 106. FIG. 2B illustrates a side view of a horizontally oriented imaging, system 100, also allowing a control panel 114 on the x-ray source assembly 102. In other embodiments, the control panel 114 can be located on the detection assembly 104, connecting element 106, or elsewhere on the imaging system 100. The control panel 114 can include one, two, or more functions for operating the imaging system 100 including, for example, fluoro, rotate, anterior-posterior and lateral image hold, kv/mA (bright/dark), print, save, and the like. When activated using, for example, the control console, the diagnostic imaging system, and, in particular, the x-ray source exposure can be either continuous or pulsed. In the pulsed mode, radiography procedures can be performed, such as CINE, Spot Film and DSA, thereby generating radiographic image representations. The x-ray source can be gated on and off in the pulsed mode using a conventional grid control circuitry or a pulse fluoro high-voltage power supply.
FIG. 2C illustrates a slightly angled view of the system of FIG. 2B, illustrating the connecting element 106 as a looped bar that wraps circumferentially around the base members 113, 115 of both the respective x-ray source assembly 102 and the image detection assembly 104. In this embodiment the base members 113, 115 rather than the connecting element 106 are in contact with a base surface (e.g., a table top or a floor) and provide stability for the device while on the base surface.
FIG. 3A illustrates the portability of the core mobile imaging system 100, that could include one or more wheels 116 attached either to the x-ray source assembly 102 or the detector assembly 104 portion of the system, or even attached to the connecting element 106. Wheels 116 allow the systems 100 to be easily transported by rolling along the ground. The system 100 can also have one or more handles 112 as previously described. FIGS. 3B and 3C illustrates the core mobile imaging system 100 ready for imaging and having the longitudinal axis of the system 100 vertically and horizontally oriented, respectively.
FIG. 4A illustrates the core mobile imaging system 100 conveniently positioned on a tabletop with, the longitudinal axis of the system 100 oriented horizontally. As previously noted, the imaging system 100 can also be positioned on either its left or right side, e.g., in lateral decubitus positions depending on the desired imaging position. The imaging system 100 can be light enough to be moved from the tabletop to the floor using handles 112, and then being rolled utilizing the wheels 116. FIG. 4B illustrates the core mobile imaging system 100 being transported with its longitudinal axis oriented generally vertically.
FIGS. 4C-4F illustrate handles 112, or grip points for use in lifting or moving the core mobile imaging system 100. As shown in the views of FIGS. 4C-4D, the handles 112 or grip points could be external and extend, outwardly, or be internal, recessed in the x-ray source assembly, connecting element, and/or the detector assembly, as illustrated in FIGS. 4E-4F. In other embodiments, the handles 112 could be movable with respect to extend outwardly during use, but be retractable internally while not in use.
In some embodiments as shown in FIGS. 5A-5C, the core mobile imaging system 100 can be removably dockable via a coupler to a stationary or movable cart 126 that can have a base 124, wheels 122, and an elongate member 120 that can be vertically oriented as illustrated. The cart 126 can include casters mounted into the base 124 to allow the cart 126 to balance various attached components. In some embodiments, one or more articulating joints 128 removably connects the connecting element 106 of the core mobile imaging system 100 with the elongate member 120 of the cart 126, to allow the imaging system 100 to have one, two, three, or more degrees of freedom with respect to the elongate member 120 of the cart 126. FIG. 5A illustrates the core mobile imaging system 100 with its longitudinal axis oriented horizontally, and attached to the elongate member 120 of the cart 126. FIG. 5B illustrates the core mobile imaging system 100 of FIG. 5A with its longitudinal axis oriented vertically, while FIG. 5C is a side view of FIG. 5B. In some embodiments, the elongate member 120 can have an axial length of between about 2 feet and about 8 feet, or between about 3 feet and about 6 feet.
FIGS. 6A-6C schematically illustrate non-limiting examples of possible degrees of freedom the core mobile imaging system 100 with respect to the elongate member 120 of the cart 126, according to some embodiments of the invention. As illustrated in FIG. 6A, the mobile imaging system 100 can move axially along the longitudinal axis A2 of the elongate member 120. As illustrated in FIG. 6B, the mobile imaging system 100 can rotate in a clockwise or counterclockwise direction in a plane that is parallel to the longitudinal axis A2 of the elongate member 120. Rotation could be limited to no more than about 30 degrees, 60 degrees, 120 degrees, 180 degrees, or 240 degrees, or the mobile imaging system could be configured to fully rotate 360 degrees. As illustrated in FIG. 6C, the mobile imaging system, 100 of the elongate member 120. The system can include one, two, or more locking mechanisms to reversibly fix the core mobile imaging system 100 in a specified position.
FIG. 10 illustrates a custom military-grade specification case 150 for a core mobile imaging system 100, according to one embodiment of the invention. The case 150 is preferably rigid and can allow the imaging system 100 to be packaged, shipped and endure climatic or environmental duress for shipping or use in environments outside an air-conditioned controlled space. The case 150 can be envisioned in several different designs and form factors but would include such embodiments as a rugged outer shell that protects the device from vibration, shock, handling, electromagnetic radiation, moisture and other potential hazards. The case 150 could also serve as a platform upon which the imaging system 100 can be rested during use as a positioning aid, or to keep the imaging system 100 from coming into contact with various hazardous conditions that may exist on the ground at, the point of use.
FIG. 11A illustrates another embodiment a case 150 that may have a protective insert 158 that may be made of foam or similar material for the imaging system 100 shown in FIG. 11B and previously described. FIG. 11C illustrates the imaging system 100 within case 150 being rolled by a transporter using wheels 122 and handle 112.
In some embodiments, the core mobile imaging system 100 comprises one, two, or more wireless terminals that can display images, control functions of the core mobile imaging system, or both. Traditional x-ray devices such as plate x-ray systems, dental x-ray systems, digital radiographic systems, and fluoroscopic x-ray systems have included displays and/or controls discrete from, but still hard-wired or tethered to, the imaging component to provide increased measures of safety and convenience for the operator. However, these controls were limited to a predetermined location or useful range as the monitor for the data was fixed in one or several locations. When wireless controls were provided, they were limited in function and did not combine and/or include the video signal required to monitor the device. While PACS servers and viewing stations have increased the flexibility of viewing options, they do not allow the user to combine real-time control and monitoring of the x-ray data from a single portable (untethered) monitoring station. The operation of an x-ray device is usually controlled by a single control station, or a number of fixed control stations that are either physically connected to the device itself, or positioned at one or more predetermined locations for reasons of safety or convenience. The use of a combination wireless video image viewer/monitor and control system will allow a user to advantageously watch real tune data and/or review previous data and control the functions/parameters of the x-ray producing device with the same remote device from any number of locations within, the recommended wireless communication, distance, allowing a larger degree of occupational safety, versatility in the use of the device, and greater flexibility in positioning the x-ray subject. The ability of the core mobile imaging system 100 to interface, such as wirelessly with various monitor devices allows the core mobile imaging system 100 to be transported from a first location to a second location without the burden of a large, heavy, and/or bulky monitor device physically attached. The core mobile imaging system 100 is advantageously configured to interface with a wireless combination image viewer and function control device that can be transported separately from the core mobile imaging system itself, further increasing the portability of the system.
In some embodiments, the core mobile imaging system 100 is configured to broadcast the video signal (which includes, but is not limited to static x-ray image data, dynamic fluoroscopic x-ray imaging data, e.g., between about 3 frames per second and about 70 frames per second, or between, about 15 frames per second and about 60 frames per second) from a video processor on the core mobile imaging system 100 via a wireless communication protocol to one, two, or more devices that will process, transmit, retransmit and/or display the video signal. The core mobile imaging system 100 will be able to transmit this signal to a standard or high-definition television, medical grade monitor, tablet computer, laptop computer, desktop computer, smartphone, wireless device, network interface, network hub, and/or other device(s) capable of receiving, broadcasting, and/or displaying this signal. This signal could be a standard or non-standard protocol such as, for example, 802.11x, 802.16x, Bluetooth, FireWire, Wibree, ZigBee, Wireless USB, UWB, VEmesh, EnOcean, CDMA, UMTS, LTE, or any other protocol listed herein.
In addition to sending imaging data wirelessly, the core mobile imaging system 100 can also be configured to communicate wirelessly (such as to a combination image viewer/remote control system) via hardware and/or software to allow a user remote, untethered input of data and commands to the system, as well as data monitoring, system configuration and control of system functions. Examples of such interactions would include but not limited to, data input system configuration input, system settings input, system control input, notification of functions or events, initiation of functions or events, and the like. FIG. 13A illustrates a core mobile imaging system 100 and a wireless remote viewer/control 170. The wireless remote viewer/control could have a touchscreen 172 (or a screen that does not respond to touch controls), one, two, or more physical controls, or a combination thereof. While illustrated for clarity in relatively close proximity to each other, it will be understood that the wireless remote viewer/control 170 could be located in a location further remote from the core mobile imaging system, such as at least about 10 feet, 25 feet, 50 feet, 100 feet, 200 feet, 500 feet, 1000 feet, a mile, or more; or in a different room, a different floor, a different building, or even a different city.
In some embodiments, the core mobile imaging system 100 is motorized such that it is configured to move in response to a command provided by a wireless remote control system. For example, the system 100 can include position sensors, e.g., a global positioning system chip, camera, accelerometer and/or gyroscope, such that a remote user can track the system 100 and/or remotely determine the position of or order the system (such as one having wheels) to move in a desired direction, such as forward, in reverse, laterally, or to rotate; adjust the axial distance between the x-ray source assembly and the detector assembly; and/or to move or rotate an connecting element operably connected to an elongate member of a cart illustrated, in FIGS. 6A-7A for example.
Power systems for x-ray producing devices are typically built into the large cabinets associated with the x-ray device. In large digital radiographic systems, the generators require large capacitive loads to operate and as such require large cabinets to house the electronics that are typically door or wall mounted with a specified receptacle and associated electronic infrastructure to supply the unit. Mobile fluoroscopes that move room to room in the same way house the power electronics within the large mobile cabinet(s) to allow convenient transport. For conventional miniature fluoroscopes (miniature C-arms) the power electronics are built into the main cabinet of the system for ease of use and transport.
In a mobile application for an x-ray device in which the physical size of the cabinet housing the x-ray device is a design constraint, the power electronics could be housed in an external compact enclosure separated from and spaced apart from the core mobile imaging system 100 itself, ruggedized and having a minimized footprint. This discrete compact power electronics unit would allow for the cure mobile imaging system 100 to be lighter in weight, more compact in form factor, and allow multiple, more flexible transport configurations by nesting the external power unit within the volume of the x-ray device. In a similar manner in which the transformer and AG or DC power circuits for a laptop computer are decoupled from the body of the laptop computer itself in an external power unit, such an external power unit would provide advantages in weight, configuration versatility, transportation versatility, serviceability and form factor for a core mobile imaging system.
In order to acquire load-bearing views of certain anatomical structures, e.g., a foot, an x-ray device should allow a pattern an area to stand under which, and lateral to which, an image receptor or x-ray source is positioned, depending on whether the desired view is Posterior-Anterior (PA), Anterior-Posterior (AP), oblique, or lateral for example. However, with respect to these image views using mobile or portable fluoroscopy technology, the view in which the image receptor assembly 104 is positioned below the foot has been very limited by the use of image intensifier-type image receptors which have a considerable height or vertical dimension. As an example, when positioning an image-intensified fluoroscopy underneath a foot for an AP view of the metatarsals, the weight of the patient is supported either above the image intensifier, or occasionally on top of the image receptor/intensifier itself. This requires the patient to step up and overcome the vertical height of the intensifier, typically in excess of 14 inches (35 cm), which may be challenging and create a risk of the patient falling off the device, especially given a patient with a foot injury. This has typically limited the utility of such a device to obtain the view, which has often required the use of a “diving board” or plank 191 positioned several feet vertically about the ground developed for a much larger C-arm type imaging system between the x-ray source assembly 102 and the receptor assembly 104, and just superior to the receptor assembly 104 on which the patient stands on, as illustrated in FIG. 13D (such as one developed by Dr. Michael Graham). With the use of a flat detector in a fluoroscope, the overall height of the component placed under the foot can be much smaller (typically less than about 6 inches (15 cm)) allowing the user to either stand directly on the detector assembly 104 housing for foe view, or utilizing a much smaller, shorter and more transportable accessory for positioning the patient's foot, to be imaged over the detector assembly 104. This anatomy-positioning accessory, such as a foot-positioning accessory, could allow for positioning of the patient and the x-ray imaging device to obtain, the load-bearing or standing foot views (e.g., AP, PA, lateral, and/or oblique views). This foot-positioning accessory could also be compact, and capable of nesting within the physical volume of the x-ray imaging device when not in use, or attached to the core mobile imaging system 100 in various combinations to provide desired x-ray views when the imaging system is in use. While described herein primarily as a foot-positioning accessory, the accessory could also be utilized to rest other anatomical structures to be imaged, such as a hand or arm for example, which could be advantageous in a patient who is comatose or otherwise altered, sedated, demented, or otherwise has weakness or paralysis such that they are unable to keep the anatomical structure to be imaged suspended in the air between the x-ray source assembly and the detector assembly sufficient to take the desired imaging.
In some embodiments, a relatively short height of the foot positioning accessory 190, e.g., under about 24 inches, 18 inches, 15 inches, 12 inches, 10 inches, or less in height on which the patient would stand for load bearing views can be accommodated by using a flat detector image receptor rather than an image intensified image receptor. In some embodiments, the foot-positioning, accessory 190 has a maximum length dimension of no more than, about 4 feet, 3.5 feet, 3 feet, 2.5 feet, 2 feet, 1.5 feet, 1 foot, or less and/or a maximum width dimension of no more than about 4 feet, 3.5 feet, 3 feet, 2.5 feet, 2 feet, 1.5 feet, 1 foot, or less. This relatively lower height provides for a safer examination for the patient and operator and an easier pose for the patient as they are not required to climb several feet above the ground as with the embodiment illustrated in FIG. 13. The foot-positioning accessory 190 would either be directly attached or detached and separate from the core mobile imaging system 100 depending on the view and stability required for the desired imaging view.
Typical uses of mobile c-arm fluoroscopes and miniature c-arm fluoroscopes in particular are limited by their mobile cabinets bulk and overall weight, (typically over 400 lbs. (181 kg)). Many operating theaters and examination rooms have limited space for surgical operation, personnel and equipment, and this space is typically a budgeted commodity when space planning and operating. Attacking and positioning a fluoroscope within this surgical environment or examination room in a manner that minimizes the impact on footprint, volume and weight with the objective of improving workflow and available space creates a distinct advantage for as imaging device. Creating a core mobile imaging system with a suitably light mass, e.g., less than about 100, 80, 60, 50, 40, 30 or less pounds, and small overall footprint would allow for mounting the device on a number of positioning aids to accommodate these goals of reduced footprint or space requirement. Three non-limiting such means of accomplishing this would be to design the x-ray device in such a way as to have common mounting hardware points to attach or affix to several different mounting accessories such as a counterbalanced ceiling mounted surgical positioning arm, or wall mounted static positioned bracket or mobile cart with a footprint smaller than currently available comparable imaging modalities.
The systems described above could be useful for a wide range of diagnostic and therapeutic applications. For example, the systems could be used when real-time observation of a suspected fracture under stress or motion could confirm a fracture. Using the real-time imaging capacity of imaging systems as described herein, a physician can obtain a first diagnostic screening opinion without having to wait for films to be developed. The systems described above can also assist during open and closed reduction of fractures. In closed reduction, fracture fragments are aligned, without surgery (e.g., by applying traction). The use of a mobile imaging system as described above can be particularly useful during external fixation because it allows bone fragment alignment to be viewed noninvasively in real time. In open reduction, surgery is performed to reduce the fracture, and internal fixation devices, such as pins, screws, plates, and intermedullary rods, may be used. The mobile imaging system can allow correct insertion of the fixation devices to be monitored fluoroscopically. This procedure allows quick visualization of, for example, whether the pin has actually traversed the bone completely and is resting in soft tissue. If incorrect placement of the fixation devices is noted, it can then be immediately corrected.
Injuries resulting from a retained foreign body (typically wood, metal, or glass) in an extremity such, as the hand or foot are very common. The standard procedure in such injuries is first to identify the location of the foreign body using radiographic films and then to remove the object. When necessary, fluoroscopic visualization can help with the removal. The ability to visualize the foreign body from various protections, as is possible with mobile imaging units as described herein, is especially useful in that it enables the image of the foreign body to be cast away from underlying bone. Metal and glass fragments are easily visualized on x-ray images.
Mobile imaging systems as described herein could be particularly useful for assessing joint conditions because x-ray images of the joint can be obtained in real time and from a variety of different projections as the joint is exercised. Joint disorders are often dearly detectable on motion of the joint. One example would be when a patient has painful clicking or popping that accompanies a certain motion; the joint can be visualized in real time during this motion to diagnose the cause of the pain. With fluoroscopy, real-time visualization of a contrast medium as it flows through a joint is also possible. Because the typical joint is a collection of different bones held together by cartilage and ligaments, contrast flow studies often help to show cartilage and ligament tears, as well as bone fractures. Arthrography (contrast-enhanced joint studies) has been shown to be efficacious in detecting wrist, elbow, and knee abnormalities.
Bone spurs—bony tissue growths that often cause severe pain—occur fairly commonly in the feet; typically, they can be well identified on radiographs. However, fluoroscopy is especially useful in assessing the course of surgical intervention. Fluoroscopically guided bone biopsies and cyst aspirations can be readily accomplished because fluoroscopic imaging can easily demonstrate the location of a metallic needle in tissue and allows real-time imaging. Bone biopsies may be indicated for suspected bone neoplasms or for assessment of the severity of osteoporosis. Cyst aspirations are often, necessary as a result of infectious conditions in which fluid collects in a specific region of the body. The aforementioned imaging systems can be utilized to perform the above.
Although certain embodiments of the disclosure have been described in detail certain variations and modifications will be apparent to those skilled in the art, including embodiments that do not provide all the features and benefits described herein. It will be understood by those skilled in the art that the present disclosure extends beyond the specifically disclosed embodiments to other alternative or additional embodiments and/or uses and obvious modifications and equivalents thereof. In addition, while a number of variations have been shown and described in varying detail, other modifications, which are within the scope of the present disclosure, will be readily apparent to those of skill in the art based upon this disclosure. It is also contemplated that various combinations or subcombinations of the specific features and aspects of the embodiments may be made and still fall within the scope of the present disclosure. Accordingly, it should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted for one another in order to form varying modes of the present disclosure. Thus, it is intended that the scope of the present disclosure herein disclosed should not be limited by the particular disclosed embodiments described above. For all of the embodiments described above, the steps of any methods need not be performed sequentially.
at least a third surface and a fourth surface generally parallel to the primary x-ray propagation axis;
wherein the system can be free-standing, on each of the first surface such that the primary x-ray propagation axis extends generally vertically, the second surface such that the primary x-ray propagation axis extends generally vertically, the third surface such that the primary x-ray propagation axis extends generally horizontally, and the fourth surface such that the primary x-ray propagation axis extends generally horizontally, and wherein the system is configured to take images using the x-ray source and the x-ray detector when placed on a supporting surface on either of the first or second surfaces such that the primary x-ray propagation axis extends generally vertically, or on either of the third or fourth surfaces such that the primary x-ray propagation axis extends generally horizontally.
2. The imaging system of claim 1, wherein the distance along the primary x-ray propagation axis between the source and the detector is adjustable.
3. The imaging system of claim 1, wherein the detector is a flat detector.
4. The imaging system of claim 1, further comprising a monitor.
5. The imaging system of claim 4, wherein the monitor is wirelessly connectable to the detector.
6. The imaging system of claim 1, further comprising at least a first control panel on the source, and at least a second control panel on at least one of the detector and the support.
7. The imaging system of claim 1, wherein the source is configured to produce a pulsed x-ray beam.
8. The imaging system of claim 1, further comprising a connector coupled to the support.
9. The imaging system of claim 8, wherein the connector is configured to detach and reattach to an elongate member having an axis, and allow movement of the support, x-ray source, and x-ray detector in at least one degree of freedom with respect to the elongate member axis.
10. The imaging system of claim 9, further comprising a mechanism configured to mechanically move the connector with respect to a track.
11. The imaging system of claim 9, wherein reversible attachment of the connector to the elongate member allows linear translation of the support, x-ray source, and x-ray detector along the elongate member axis.
12. The imaging system of claim 9, wherein reversible attachment of the connector to the elongate member allows rotation of the support, x-ray source, and x-ray detector in a plane substantially parallel to the elongate member axis.
13. The imaging system of claim 9, wherein reversible attachment of the connector to the elongate member allows rotation of the support, x-ray source, and x-ray detector in a plane substantially perpendicular to the elongate member axis.
14. The imaging system of claim 9, further comprising at least one locking element configured to reversibly fix the connector and support in a specified position with respect to the elongate member.
15. The imaging system of claim 9, wherein the elongate member is a track vertically fixed to a portable cart.
16. A portable, imaging system, comprising:
a first surface on at least one of an opposite side of the source from the detector and an opposite side of the detector from the source;
at least a second surface generally parallel to the primary x-ray propagation axis, wherein the system can be free-standing, on each of the first surface such that the primary x-ray propagation axis extends generally vertically, and the second surface such that the primary x-ray propagation axis extends generally horizontally, and wherein the system is configured to take images using the x-ray source and the x-ray detector when placed on a supporting surface on either of the first surface such that the primary x-ray propagation axis extends generally vertically, or on the second surface such that the primary x-ray propagation axis extends generally horizontally; and
wherein the connector is configured to detach and reattach to an elongate member having an axis, and allow movement of the support, x-ray source, and x-ray detector in at least one degree of freedom with respect to the elongate member axis.
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