Source: https://patents.google.com/patent/US9833206B2/en
Timestamp: 2019-08-21 14:22:01
Document Index: 2739983

Matched Legal Cases: ['art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art 126', 'art.\n9']

US9833206B2 - Mobile fluoroscopic imaging system - Google Patents
US9833206B2
US9833206B2 US14/815,738 US201514815738A US9833206B2 US 9833206 B2 US9833206 B2 US 9833206B2 US 201514815738 A US201514815738 A US 201514815738A US 9833206 B2 US9833206 B2 US 9833206B2
US14/815,738
US20150335302A1 (en
2015-07-31 Application filed by ORTHOSCAN Inc filed Critical ORTHOSCAN Inc
2015-11-26 Publication of US20150335302A1 publication Critical patent/US20150335302A1/en
2017-01-19 Assigned to ORTHOSCAN, INC. reassignment ORTHOSCAN, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: EAVES, CHRISTOPHER B.
2017-12-05 Publication of US9833206B2 publication Critical patent/US9833206B2/en
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 on an 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 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. The source can be configured to produce a pulsed x-ray beam.
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 showing 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.
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-41), 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.
FIG. 7A illustrates a core mobile imaging system 100 movable axially along the elongate member 120 as described previously in FIG. 6A. Also illustrated is a display 130 with controls 132 (such as a keyboard or touchscreen on the display, for example) that can be connected via wires or wirelessly to the core mobile imaging system 100. A worm drive lift or similar mechanism allows for axial movement of the core mobile imaging system 100, for ease in imaging the appropriate anatomy of a patient. For example, being able to lower the imaging system 100 can allow for convenient imaging of a patient's foot or ankle without the patient having to lift his extremity of the ground. Being able to adjust the imaging system can allow for serial imaging of the cervical, thoracic, lumbar, and sacral spine, for example while the patient remains in the standing position. Furthermore, the one, two, three, or more degrees of freedom can allow for taking multiple images from different angles, increasing the sensitivity and specificity of diagnosis. FIG. 7B illustrates in side profile three possible mounting configurations for the core mobile imaging system 100 against a fixed vertically-oriented wall mount or elongate member 120 as previously described, with the connecting element 106 (also referred to herein as a deck) adjacent to the elongate member 120 or wall as in position (1); the connecting element 106 is in a relatively superior position as in position (2); and where the connecting element 106 is in a relatively inferior position as in position (3). The imaging system 100 can be easily attached and detached from the wall mount using clips, interlocking components, and the like.
Case 150 can be shaped as a rectangular box corresponding to the form factor of the imaging system, or another desired shape, and include one, two, three, or more movable panels 152 to gain access to various components. For example, opening the panel 152 in between the x-ray source assembly and the detector assembly can be sufficient to image a desired anatomical structure. Case 150 may include wheels 122 for transport as previously described. In some embodiments, a wired (or wireless) conduit 156 connects the core mobile imaging system 100 to a second case 154 housing a display. CPU, or other components.
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 time 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 order to acquire load-bearing views of certain anatomical structures, e.g., a foot, an x-ray device should allow a patient 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 fluoroscope 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 the 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. 131D. 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. Attaching 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 an 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.
at least a third surface generally parallel to the axis, wherein the system can be free-standing, on each of the first surface such that the axis extends generally vertically, the second surface such that the axis extends generally vertically, and the third surface such that the 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 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; and
2. The imaging system of claim 1, wherein the distance along the x-ray propagation axis between the source and the detector is adjustable.
8. The imaging system of claim 1, wherein the elongate member is a track vertically fixed to a portable cart.
9. The imaging system of claim 8, further comprising a mechanism configured to mechanically move the connector with respect to the track.
10. The imaging system of claim 1, 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.
11. The imaging system of claim 1, 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.
12. The imaging system of claim 1, 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.
13. The imaging system of claim 1, 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.
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Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:EAVES, CHRISTOPHER B.;REEL/FRAME:041021/0371
2017-09-24 FEPP Fee payment procedure