Patent Description:
Mobile X-ray imaging systems are frequently used during medical procedures and surgical interventions, in order to acquire 2D or 3D X-ray images. The acquired images may be used to provide physicians with information about the anatomical situation of the person and/or the position and orientation of surgical instruments during surgery.

X-ray imaging systems may be used in the context of a surgical intervention carried out onto a person's bone, for example for implantation of orthopedic implants such as pedicular screws in the spine, implantation of various orthopedic implants in bones, or reduction and fixation of fractures during traumatological procedures, or insertion of catheters or stents during cardio-vascular or urology procedures. X-ray imaging systems may also be used in the context of positioning guides or canulae at desired positions with respect to one or several predefined regions of interest.

The X-ray imaging system may be coupled to other surgical systems, such as a surgical motorized system, a localization system, etc. The X-ray images acquired by the X-ray imaging system may be used to control these other surgical systems.

Conventional X-ray imaging systems use X-rays to produce two-dimensional (2D) images of a region of interest to be imaged. However, 2D images provide limited information. Therefore, three-dimensional (3D) imaging techniques have been developed.

For example, computer tomography is a class of stationary X-ray imaging system used for 3D reconstruction. Tomography reconstruction algorithms, such as cone-beam reconstruction techniques, may be used to reconstruct a 3D image from an imaging dataset comprising multiple 2D images of a region of interest acquired by 2D X-ray detectors. However, computer tomography devices are generally not available in an operating room.

An X-ray imaging system used to acquire such multiple 2D images may comprise a C-arm.

Known C-arm devices that can produce 2D or 3D images are disclosed for example in documents <CIT>, <CIT>, <CIT>, and <CIT>.

A C-arm presents, in a manner known per se, a C-shaped structure, that is to say a structure substantially shaped as a semicircle. An X-ray source, or X-ray generator, and an X-ray detector, or image detector, are mounted on the C-arm.

The X-ray source and the X-ray detector are mounted on the two opposite semicircle ends of the C-arm, so as to face each other. In order to perform an X-ray imaging, a person must be positioned between the two opposite ends of the C-arms, thus between the X-ray source and the X-ray detector.

The C-arm is mounted on a base via mechanical connections which allow some degrees of freedom. Indeed, the C-arm has to be moved in different positions and orientations around and along a table on which the person lies, so as to acquire the images required to perform the X-ray imaging.

More particularly, the C-arm may first be positioned away from the base, in order to reach the table on which the person lies, so that the person is positioned between the X-ray source and X-ray detector. Then, the C-arm may be rotated, in a movement called an orbital rotation, around an axis of rotation approximately perpendicular to a plane formed by the C-arm. The C-arm may simultaneously or successively be translated along the table, or perpendicularly to the table, and/or rotated around different axes of rotation.

The mechanical complexity required to give the C-arm the several degrees of freedom which are necessary for X-ray imaging is high.

In order to provide a C-arm capable of enough mobility, known X-ray imaging systems include a motorized arm on which the C-arm is mounted, and which moves the C-arm in the required positions and orientations. The motorized arm is mounted on the base. <CIT> and <CIT> each disclose an X-ray imaging system comprising a motorized arm and a C-arm adapted to be mounted on a mobile base by means of the motorized arm, wherein the motorized arm presents at least three rotation axes directed along a substantially common vertical direction.

However, the C-arm has a consequent weight of around <NUM>, and the number of positions and orientations necessary to perform the X-ray imaging is high. Consequently, the motorized arm is heavy, complex and massive. The motorized arm is therefore costly, and requires a lot of space in the room where the imaging is performed in order to move the C-arm. In particular, in order to move the C-arm in orbital rotation, the motorized arm must extend significantly, which requires complex mechanism and a large available empty space.

Furthermore, the movement of the motorized arm, therefore the position of the C-arm, cannot be controlled with absolute accuracy. The position of the C-arm is thus susceptible to deviate from the commanded position. Thus, the exact relative position of a region of interest relative to a previous region of interest cannot be deduced from the commanded movement of the C-arm. When several separate regions of interest must be acquired, the position of the C-arm must therefore be recalibrated for each region of interest to acquire. Additional recalibration means, such as a recalibration algorithm, are then necessary. This is the case for example when the X-ray imaging requires imaging successively a region of interest corresponding to a foot and then a region of interest corresponding to a knee or a hip, or requires imaging successively several regions of interest corresponding to several different vertebrae.

One possible solution to overcome this problem is the use of a base fixed to the ground. In this case, it cannot be located too close to the table, otherwise the base may hinder the doctor performing the X-ray imaging in certain positions of the system. This further contributes to the complexity, weight and space needed by the imaging system, as the C-arm must be positioned significantly away from the base in order to reach the table.

One other possible solution to overcome this problem is the use of holonomic drive systems, such as described in documents <CIT> or <CIT>. But a drawback of this solution is that it is not adapted to displacements on long distances, such as from the X-ray imaging system storage room to the operating room. Moreover, holonomic drive systems cannot be operated manually, notably in case of power outage.

A general aim of the invention is to propose an improved 2D and 3D X-ray imaging system, with an enhanced mobility without the drawbacks of the state of the art.

Another aim of the invention is to propose a mobile X-ray imaging system comprising a motorized arm which is simpler and smaller than conventional motorized arms, while allowing a wide range of positions and orientations of the C-arm.

Another aim of the invention is to provide an X-ray imaging system providing an increased accuracy of the motorized arm displacements. According to a first aspect, the invention is directed towards an X-ray imaging system comprising a mobile base, a motorized arm, and a control unit adapted to control an actuation of the mobile base and/or the motorized arm, and a C-arm adapted to be mounted on the mobile base by means of the motorized arm, wherein the C-arm comprises an X-ray source and an X-ray detector,
wherein the motorized arm presents at least three rotation axes directed along a substantially common vertical direction. The system further comprises a sensor adapted to measure a force and/or torque applied by a user on the motorized arm and/or the C-arm, and the control unit comprises a cooperative mode, wherein in the cooperative mode, the control unit is adapted to control a movement of the motorized arm in response to the force and/or torque detected by the sensor.

Some preferred but not limiting features of the X-ray imaging system described above are the following, taken individually or in combination:.

According to a second aspect, the invention is direction towards a method for acquiring an imaging dataset with an X-ray imaging system according to the first aspect, comprising the following steps:.

Some preferred but not limiting features of the method for acquiring an imaging dataset described above are the following, taken individually or in combination:.

Other features and advantages of the invention will emerge from the following description, which is purely illustrative and non-limiting and must be considered with respect to the appended figures in which:.

Examples of an X-ray imaging system according to different embodiments of the invention are illustrated in <FIG>.

The X-ray imaging system comprises a mobile base <NUM>, a motorized arm <NUM>, and a C-arm <NUM> adapted to be mounted on the mobile base <NUM> by means of the motorized arm <NUM>.

The C-arm <NUM> comprises an X-ray source <NUM> and an X-ray detector <NUM>.

The motorized arm <NUM> presents at least three rotation axes Z1, Z2, Z3 directed along a substantially common vertical direction Z. An example of such three rotation axes Z1, Z2, Z3 is illustrated in the example embodiment of <FIG>.

A region of interest corresponds to a volume to be acquired by an X-ray imaging technique.

An imaging dataset comprises at least one 2D image or projection of a region of interest acquired by the X-ray imaging device, and/or at least one 3D image of a region of interest. The at least one 3D image of the region of interest may be determined from the at least one 2D image acquired by the X-ray imaging system using tomography techniques.

A horizontal plane H is a plane normal to the vertical direction Z. The horizontal plane H is defined by a longitudinal direction Y and a transverse direction X orthogonal to the longitudinal direction Y.

A table on which a person to be imaged lies may extend in a substantially horizontal plane H. The longitudinal direction Y extends in a direction of a length of the table. The transverse direction X extends in a direction of a width of the table. A ground of the room in which the X-ray imaging is performed may extend in the horizontal plane H.

A vertical plane V corresponds to a plane defined by the vertical direction Z and the transverse direction X.

The movement of the C-arm <NUM> is managed by means of a single motorized arm <NUM>, and is therefore simple.

The three rotation axes Z1, Z2, Z3 directed along a substantially common vertical direction Z are substantially parallel and articulate different segments of the motorized arm <NUM> relative to each other, so as to allow the motorized arm <NUM> to access quickly a wide range of positions in a wide variety of directions. The X-ray imaging system thus allows complex trajectories to be followed, which enables imaging of a large variety of regions of interests, under a large variety of constraints.

More particularly, the motorized arm <NUM> may move the C-arm <NUM> by a rotation or a combination of rotations of different segments of the motorized arm <NUM> around one or several of the three rotation axes Z1, Z2, Z3 of the motorized arm <NUM>.

The motorized arm <NUM> may for example move the C-arm <NUM> in the horizontal plane H substantially normal to the vertical direction Z, for example in translation in the transverse direction X, the longitudinal direction Y, or any combination of directions comprised in the horizontal plane H.

A motorized arm <NUM> comprising three substantially parallel rotation axes Z1, Z2, Z3 also allows a high level of precision of the movement of the motorized arm <NUM>, and therefore an accurate positioning and orienting of the C-arm <NUM>.

The X-ray imaging system thus makes it possible to successively acquire distant imaging datasets of distant regions of interest, by moving the C-arm <NUM> between the successive acquisitions, while knowing that the movement command has been respected. The effective position of the C-arm <NUM> substantially corresponds to the commanded position of the C-arm <NUM>. Thus, the position of the X-ray source <NUM> and of the X-ray detector <NUM> are known for each successive acquisition of an imaging dataset.

Therefore, when several successive imaging datasets of several separate regions of interest must be acquired, the relative position of the acquired images of the next region of interest relative to the acquired images of the previous region of interest can accurately be deduced from the commanded movement of the C-arm <NUM>. Therefore, the position of the C-arm <NUM> does not have to be recalibrated by specific recalibration means for the acquired images of different regions of interest.

The C-arm <NUM> may be positioned successively at different regions of interest, for example a foot, a knee, a hip, several vertebrae, etc. The C-arm <NUM> successively performs X-ray imaging acquisitions at each of the several regions of interest, in order to acquire several imaging datasets corresponding to each of the several regions of interest. The position of the C-arm <NUM> may be deduced at any time from the commanded movement of the motorized arm <NUM>, as the command is known to have been respected.

In one example, in an imaging for a scoliosis-related surgical procedure, the X-ray imaging system may have to acquire several imaging datasets of a spine of the person. Each imaging dataset is used to reconstruct a 3D image of a portion of the spine, and each 3D image may be registered with the others without necessitating cumbersome instruments of tedious workflow.

In another example such as a knee or hip surgery, the X-ray imaging system may have to acquire a first imaging dataset of a hip of the person, a second imaging dataset of a knee of the person, and a third imaging dataset of an ankle of the person. Each imaging dataset may be registered with the others.

Finally, the base <NUM> is a mobile base <NUM>. Therefore, the base <NUM> may be moved according to the region of interest to acquire, and may be moved in order to cooperate with a movement of the motorized arm <NUM>. The mobile base <NUM> may be moved between successive acquisitions of different regions of interest. For example, the mobile base <NUM> may be positioned as close as possible to the region of interest to be acquired without hindering the doctor performing the X-ray imaging. This further reduces the complexity, weight and space needed by the X-ray imaging system.

This solution thus offers a greater flexibility in the acquisitions of imaging datasets with no loss of accuracy and with no significant impact on the weight and cost of the X-ray imaging system.

In the following, the term C-arm <NUM> has a broad signification, and is used to designate an imaging system including a curved segment. More specifically, the term C-arm <NUM> may refer for example to an imaging gantry presenting a C-shaped structure, or an O-shaped structure.

The C-arm <NUM> may present a C-shaped structure, that is to say a structure substantially shaped as a semicircle, ending with two opposite ends. Embodiments of such a C-arm <NUM> with a C-shaped structure are illustrated by way of a non-limiting example in <FIG>.

The C-shaped structure of the C-arm <NUM> may be substantially planar. The C-arm <NUM>, more particularly the C-shaped structure of the C-arm <NUM>, may be made of carbon.

The X-ray source <NUM>, or X-ray generator, and the X-ray detector <NUM>, or image detector, may be mounted on the C-shaped structure of the C-arm <NUM>. Each of the X-ray source <NUM> and the X-ray detector <NUM> may be mounted next to a respective one of the two opposite ends of the C-arm <NUM>. Thus, the X-ray source <NUM> and the X-ray detector <NUM> face each other. When the C-arm <NUM> is positioned around a table on which a person lies, the person is positioned substantially between the X-ray source <NUM> and the X-ray detector <NUM>.

The C-shaped structure of the C-arm <NUM> may extend substantially in a C-arm plane.

The C-arm <NUM> may comprise an isocenter C corresponding substantially to a center of the semicircular C-shaped structure of the C-arm <NUM>. The isocenter C of the C-arm <NUM> is comprised in the C-arm plane. The isocenter C may substantially correspond to a middle of a portion connecting the X-ray source <NUM> and the X-ray detector <NUM>. <FIG> illustrates an example of an isocenter C of a C-arm <NUM> with a C-shaped structure.

A rotation of the C-arm <NUM> around the transverse rotation axis X1 is characterized by an angle alpha. The angle alpha corresponds to an angle formed between the C-arm plane and the vertical plane V.

In a nominal position of the C-arm <NUM>, the C-arm plane corresponds to the vertical plane V. The angle alpha is equal to <NUM>°.

When the angle alpha is not equal to zero, that is to say when the C-arm <NUM> is rotated around the transverse rotation axis X1 relative to the nominal position, the C-arm plane is inclined respective to the vertical plane V defined by the transverse direction X and the vertical direction Z.

The C-arm <NUM> may present an O-shaped structure. Embodiments of such a C-arm <NUM> with an O-shaped structure are illustrated by way of a non-limiting example in <FIG>.

A C-arm <NUM> with an O-shaped structure may be similar to a C-arm <NUM> with a C-shaped structure, except that the semicircle of the C-shaped structure is closed so as to form a full ring. A radius of curvature of a C-arm <NUM> may be substantially the same whether the C-arm <NUM> has a C-shaped structure or an O-shaped structure.

The isocenter C of the C-arm <NUM> may correspond substantially to a center of the circle of the O-shaped structure. <FIG> illustrates an example of an isocenter C of a C-arm <NUM> with an O-shaped structure.

The C-arm <NUM> is mounted on the motorized arm <NUM>. The motorized arm <NUM> is mounted on the mobile base <NUM>. The motorized arm <NUM> may comprise a proximal end adapted to be mounted on the mobile base <NUM>, and a distal end on which the C-arm <NUM> is adapted to be mounted.

The motorized arm <NUM> may be a robotic arm of the SCARA (Selective Compliance Articulated Robot Arm) type.

Each rotation axis Z1, Z2, Z3 of the motorized arm <NUM> may correspond to a respective pivot connection <NUM>, <NUM>, <NUM>. The motorized arm <NUM> may thus comprise three pivot connections <NUM>, <NUM>, <NUM> directed along the substantially common vertical direction Z, each pivot connection <NUM>, <NUM>, <NUM> establishing a respective rotation axis Z1, Z2, Z3. Such parallel-axis pivot connections <NUM>, <NUM>, <NUM> provide a motorized arm <NUM> which is rigid in the vertical direction Z, but is slightly compliant in the other directions.

The motorized arm <NUM> may further present a translation axis Z0 in the vertical direction Z, an example of the translation axis Z0 being illustrated in the example embodiment illustrated in <FIG>.

The motorized arm <NUM> is therefore a poly-articulated motorized arm <NUM>, allowing translation of a segment of the motorized arm <NUM> in the vertical direction Z relative to another segment of the motorized arm <NUM>.

The poly-articulated motorized arm <NUM> may move the C-arm <NUM> in translation along the vertical direction Z, that is to say adjusts a position along the vertical direction Z of the C-arm <NUM> relative to the mobile base <NUM> and/or table on which the person lies. The motorized arm <NUM> is thus adapted to move the C-arm <NUM> upwardly or downwardly relative to the region of interest to be imaged.

This feature is particularly important when the X-ray acquisition necessitates to move the C-arm <NUM> according to complex trajectories, in particular for 3D acquisition. This feature also allows the X-ray imaging system to adapt to varying positions of operating tables in the vertical direction Z.

The translation axis Z0 may coincide with one of the three rotation axes Z1, Z2, Z3 of the C-arm <NUM>.

The translation axis Z0 in the vertical direction Z of the motorized arm <NUM> may be achieved by way of a slide connection directed along the vertical direction Z. More particularly, at least one of the pivot connections <NUM>, <NUM>, <NUM> of the motorized arm <NUM> may also be a slide connection configured to allow a translation along the vertical direction Z.

The motorized arm <NUM> may further present at least one additional rotation axis X1, Y1. <FIG> and <FIG> illustrate in a non-limiting manner two additional rotation axes X1, Y1 of different embodiments of X-ray imaging systems. Each additional rotation axis X1, Y1 of the motorized arm <NUM> may correspond to a respective additional pivot connection.

The additional rotation axis X1, Y1 may correspond to a C-arm rotation axis Y1. The C-arm rotation axis Y1 may be directed in the longitudinal direction Y and pass through the isocenter C of the C-arm <NUM>. Thus, the motorized arm <NUM> may change an orientation of the C-arm <NUM> around the C-arm rotation axis Y1, that is to say may control an orbital rotation of the C-arm <NUM>.

The additional rotation axis X1, Y1 may correspond to a transverse rotation axis X1.

Therefore, the motorized arm <NUM> may change an orientation of the C-arm <NUM> relative to the vertical plane V, that is to say may change the angle alpha of the C-arm <NUM>. Thus, the C-arm <NUM> may be tilted by an angle alpha, which may be constant or variable, relative to the vertical plane V.

Therefore, the X-ray imaging system allows even more complex trajectories to be followed, thus allows imaging of an even larger variety of regions of interests, such as a shoulder, under an even larger variety of constraints. More particularly, the X-ray imaging system allows trajectories involving translation in the horizontal plane H, simultaneously with alpha angle relative to the vertical plane V, while maintaining the isocenter C of the C-arm <NUM> in a desired position relative to the region of interest.

At least one of the pivot connections <NUM>, <NUM>, <NUM> of the motorized arm <NUM> may allow both a rotation around a substantially vertical rotation axis Z1, Z2, Z3 and a rotation around the additional rotation axis X1, Y1.

The motorized arm <NUM> may further present at least two additional rotation axes X1, Y1. One of the at least two additional rotation axes X1, Y1 may be a C-arm rotation axis Y1, and another of the at least two additional rotation axes X1, Y1 may be a transverse rotation axis X1.

The mobile base <NUM> may be positioned as close as possible to the region of interest to be acquired, in particular in the transverse direction X, so as to minimize a distance between the base <NUM> and the C-arm <NUM>, and/or in the longitudinal direction Y. Thus, the lever arm resulting from the combination of the weight of the C-arm <NUM> and of the motorized arm <NUM> and their distance to the mobile base <NUM> is minimized, and the stabilization of the X-ray imaging system is facilitated.

The mobile base <NUM> may be positioned at an offset relative to the region of interest to be acquired. For example, the base <NUM> may be moved so as to be spaced apart from the region of interest in the longitudinal direction Y. The movement of the motorized arm <NUM> may compensate the position of the base <NUM> so as to maintain the C-arm <NUM> on the region of interest during movement of the mobile base <NUM>.

Therefore, the X-ray imaging system may continue acquiring an imaging dataset of the region of interest, as the C-arm <NUM> is maintained in an optimal position for imaging the region of interest, while freeing up space next to the region of interest. Thus, the user may access easily to the region of interest during the acquisition or between two acquisitions of the same region of interest, without being hindered by the X-ray imaging system.

The mobile base <NUM> may comprise a trolley with wheels so as to be slidable in every direction on the ground of the room in which the X-ray imaging is performed, the ground extending substantially in the horizontal plane H.

The mobile base <NUM> may comprise front wheels and rear wheels, the front wheels being closest to the motorized arm <NUM>. The front and/or rear wheels may include a pair of spaced apart side wheels, the side wheels being spaced apart in the longitudinal direction Y.

Said front wheels and rear wheels may be of different sizes. Especially, the rear wheels may be of a greater dimension than the front wheels, so as to ensure a greater stability to the X-ray imaging system while the C-arm is moving.

The mobile base <NUM> may comprise motorization means adapted to move the mobile base <NUM> in a substantially horizontal plane H, that is to say to move the mobile base <NUM> in translation on the ground.

The mobile base <NUM> may comprise base position determining means adapted to determine a position of the mobile base <NUM> in said horizontal plane H.

The base position determining means may comprise a base position sensor adapted to determine a displacement of the mobile base <NUM> in the horizontal plane H base <NUM> on the determination of the position of the mobile base <NUM> in the horizontal plane H.

The base position determining means may comprise a base position tracker positioned on the mobile base <NUM>. The base position tracker may be adapted to be detected by a camera, and localized according to the images acquired by the camera and showing the base position tracker.

The mobile base <NUM> may comprise base motorization means adapted to automatically move the base <NUM>.

The motorized arm <NUM> may present a kinematic chain of six axes Z0, Z1, Z2, Z3, X1, Y1, starting from the mobile base <NUM> and comprising successively:.

The three successive rotation axes Z1, Z2, Z3 of the motorized arm <NUM> may correspond to a proximal rotation axis Z1, an intermediate rotation axis Z2, and a distal rotation axis Z3. When the motorized arm <NUM> is in a fully extended position, that is to say when the distance between the proximal end and the distal end of the motorized arm <NUM> is maximal, the proximal rotation axis Z1 is located closest to the base <NUM>, the distal rotation axis Z3 is located closest to the C-arm <NUM>, and the intermediate rotation axis Z2 is located between the proximal rotation axis Z1 and the distal rotation axis Z3.

The proximal end of the motorized arm <NUM> may be mounted on the base <NUM> by means of the proximal rotation axis Z1. The C-arm <NUM> may be mounted on the distal end of the motorized arm <NUM> by means of the distal rotation axis Z3.

The proximal, intermediate and distal rotation axes Z1, Z2, Z3 may correspond respectively to a proximal, intermediate and distal pivot connections <NUM>, <NUM>, <NUM> of the motorized arm <NUM>. The proximal pivot connection <NUM> connects the proximal end of the motorized arm <NUM> to the base <NUM>. The distal pivot connection <NUM> connects the distal end of the motorized arm <NUM> to the C-arm <NUM>.

The motorized arm <NUM> may comprise a proximal segment, an intermediate segment and a distal segment. The proximal segment of the motorized arm <NUM> is adapted to be mounted to and articulated to the mobile base <NUM> by means of the proximal pivot connection <NUM>, the distal segment is adapted to be articulated to the proximal segment by means of the intermediate pivot connection <NUM>, and the C-arm <NUM> is adapted to be mounted to and articulated to the distal segment of the motorized arm <NUM> by means of the distal pivot connection <NUM>.

The motorized arm <NUM> may comprise motorization means adapted to rotate the different segments of the motorized arm <NUM> around the substantially vertical rotation axes Z1, Z2, Z3 relative to each other.

The translation axis Z0 in the vertical direction Z may coincide with the proximal rotation axis Z1. More specifically, the proximal pivot connection <NUM> may also be a slide connection, allowing both a rotation around the vertical rotation axis Z1 and a translation along the vertical rotation axis Z1. This configuration is mechanically simple. Alternatively, the translation axis Z0 in the vertical direction Z may coincide with the distal rotation axis Z3, the distal pivot connection <NUM> also being a slide connection.

One additional rotation axis X1, Y1 may correspond to the transverse rotation axis X1, and another additional rotation axis X1, Y1 may correspond to the C-arm rotation axis Y1.

The distal pivot connection <NUM> may also allow a rotation of the C-arm <NUM> around the C-arm rotation axis Y1 and/or the transverse rotation axis X1. Alternatively, the X-ray imaging system may comprise an additional pivot connection directed along the C-arm rotation axis Y1 and/or an additional pivot connection directed along the transverse rotation axis X1, the additional pivot connection(s) being separate from the distal pivot connection <NUM> and allowing a rotation around the C-arm rotation axis Y1 and/or the transverse rotation axis X1.

The distal rotation axis Z3 and/or C-arm rotation axis Y1 and/or transverse rotation axis X1 may be located at a distal end of the motorized arm <NUM>.

More specifically, the respective pivot connection(s) corresponding to the distal rotation axis Z3 and/or C-arm rotation axis Y1 and/or transverse rotation axis X1 may be integrated in a mechanical part forming the distal end of the motorized arm <NUM>.

Therefore, a rotation around the distal rotation axis Z3 and/or C-arm rotation axis Y1 and/or transverse rotation axis X1 only incurs a corresponding rotation of the C-arm <NUM>, without incurring a rotation of the motorized arm <NUM>.

Therefore, the motorized arm <NUM> may have significantly smaller dimensions and be significantly simpler than conventional motorized arm <NUM>. The cost of the X-ray imaging system, as well as the room space needed to move the C-arm <NUM> in order to perform X-ray imaging is reduced.

In particular, when the C-arm rotation axis Y1 is located at the distal end of the motorized arm <NUM>, the motorized arm <NUM> may control an orbital rotation of the C-arm <NUM> without incurring a corresponding rotation of the motorized arm <NUM> around the C-arm rotation axis Y1.

When the distal rotation axis Z3 is located at a distal end of the motorized arm <NUM>, a rotation around the distal rotation axis Z3 incurs only a corresponding rotation of the C-arm <NUM> around the vertical rotation axis Z3, without incurring a rotation of the motorized arm <NUM> around the vertical direction Z. Such a rotation of the C-arm <NUM> around the distal rotation axis Z3 without incurring a rotation of the motorized arm <NUM> is referred to as wig-wag. Wig-wag allows the C-arm <NUM> to be oriented with an angle relative to the distal segment of the motorized arm <NUM>. Wig-wag may be commanded so as to ensure that the C-arm <NUM> remains with a constant angle relative to the operating table throughout the displacement of the C-arm <NUM> in the horizontal plane H, for example remains perpendicular to the operating table.

The X-ray imaging system comprises a control unit adapted to control an actuation of the mobile base <NUM> and/or the motorized arm <NUM> and/or the C-arm.

More particularly, the control unit may be adapted to control actuation of the motorization means of the base <NUM> and/or motorized arm <NUM> and/or stabilization means <NUM> of the X-ray imaging system. The motorization means of the X-ray imaging system may be electric motors.

The control unit may comprise storage means, processing means such as a processor, and/or communication means.

The control unit may be integrated in the mobile base <NUM> of the X-ray imaging system. Alternatively, the control unit may be integrated in a separate cart. Said separate cart may comprise a user interface.

The control unit may alternatively be remote, for example may be placed in a separate control room of the hospital or in a data center.

The wide number of positions and orientations accessible to the C-arm <NUM> thanks to the movement of the motorized arm <NUM> leads to the center of mass of the X-ray imaging system to move significantly. Indeed, the distance between the base <NUM> and the C-arm <NUM> may undergo important variations in different directions during image acquisition.

The weights of the C-arm <NUM> and of the motorized arm <NUM> are significant. The weight of the C-arm <NUM> may be around <NUM>, and the weight of the motorized arm <NUM> may be around <NUM>.

Therefore, the displacement of the center of mass of the X-ray imaging system during image acquisition may lead to the tilting or falling of the X-ray imaging system, or the toppling of the mobile base <NUM>.

When the motorized arm <NUM> is extended so as to position the C-arm <NUM> away from the base <NUM> in the transverse direction X and/or longitudinal direction Y, the center of mass is moved away from the base <NUM> in said transverse direction X and/or longitudinal direction Y. There is then a risk that the X-ray imaging system could topple.

More particularly, the dimension of the mobile base <NUM> in the longitudinal direction Y, that is to say the space separating the side wheels of the base <NUM>, is small, as it is restricted for example by the need for the mobile base <NUM> to go through door frames, so as to be displaced from one room to another.

Thus, when the C-arm <NUM> is moved away from the base <NUM> both in the longitudinal and in the transverse direction X, all the more when the C-arm <NUM> is tilted with a given alpha angle, there is a risk that the X-ray imaging system could topple, especially around the transverse direction X.

The X-ray imaging system may further comprise a toppling risk detection unit.

The toppling risk detection unit is adapted to estimate a toppling risk of the X-ray imaging system.

Said toppling risk detection unit may be configured to continuously estimate a toppling risk of the X-ray imaging system based on encoders position of each axis of the motorized arm and a geometric model of the X-ray imaging system including a mass distribution of the X-ray imaging system.

Said mass distribution of the X-ray imaging system depends on the position and orientation of the motorized arm <NUM> and C-arm <NUM> and determines the position of the center of mass of the X-ray imaging system.

The motorized arm <NUM> may further be adapted to uncouple the C-arm <NUM> from the mobile base <NUM> when the toppling risk detection unit detects a toppling risk greater than a predetermined threshold. This uncoupling of the C-arm <NUM> may consist in a movement of the motorized arm <NUM> adapted to cause a progressive lowering down of the C-arm <NUM> until the C-arm <NUM> rests on the ground, the C-arm <NUM> thus being stabilized. Said uncoupling may be forbidden if any part of the C-arm, notably the flat panel detector, may enter in collision with the patient or another person in the operating room in the lowering movement.

The X-ray imaging system may further comprise one or more force and/or acceleration sensors adapted to detect a force and/or torque applied to the system, for example by a user. Indeed, the user may for example lean on the C-arm <NUM> or on the motorized arm <NUM>, which will consequently change the center of mass of the system. The toppling risk detection unit may estimate the toppling risk of the X-ray imaging system taking into account such force and/or torque applied to the system.

The X-ray imaging system may further comprise stabilization means <NUM> adapted to stabilize the X-ray imaging system.

The stabilization means <NUM> are adapted to control the displacement of the center of mass of the X-ray imaging system, more particularly to keep the center of mass of the X-ray imaging system close to the mobile base <NUM>, in order to avoid tilting or falling of the X-ray imaging system, or toppling of the mobile base <NUM>.

The stabilization means <NUM> may be mobile. More particularly, a position of the stabilization means <NUM> may be adapted in real time as the X-ray imaging system is moved during image acquisition or surgery, so as to counter the weight of the C-arm <NUM> and the motorized arm <NUM>. The displacement of the stabilization means <NUM> may be calculated by the control unit by taking into account the weight of each element of the X-ray imaging system and the distance of each element relative to the base <NUM>. The displacement of the stabilization means <NUM> may further take into account a force and/or torque applied to the system, for example by a user.

The stabilization means <NUM> may be adapted to be moved manually by an operator.

Alternatively, the stabilization means <NUM> may comprise motorization means adapted to automatically move the stabilization means <NUM>. The control unit may be adapted to control said motorization means, so as to control the movement of the stabilization means <NUM>, more particularly according to a position and orientation of the C-arm <NUM> and/or of the motorized arm <NUM>. If the stabilization means cannot be further deployed because of an obstacle, for example the operating table, the user may be warned through the user interface that the stabilization is not optimal or ensured.

The stabilization means <NUM> may comprise mobile counterweights. The counterweights may be integrated inside the base <NUM> and/or linked to the motorized arm <NUM>. The counterweights may have a weight roughly equal to the combined weights of the C-arm <NUM> and the motorized arm <NUM>. For example, for a C-arm <NUM> weighing around <NUM> and a motorized arm <NUM> weighing around <NUM>, the counterweights may for example weight around <NUM>.

The movement of the mobile counterweights may be controlled so that the more the C-arm <NUM> is moved away from the mobile base <NUM> in the transverse and/or longitudinal direction Y, the more the counterweights may be moved, oppositely to the C-arm <NUM>, in said transverse and/or longitudinal direction Y.

Such mobile counterweights allow satisfactory stabilization of the X-ray imaging system in the transverse direction X, for most or all accessible positions and orientations of the C-arm <NUM>. Indeed, the dimension of the mobile base <NUM> in the transverse direction X is sufficient to allow a significant displacement of the counterweights integrated in the base <NUM> along the transverse direction X, thus avoid a toppling of the X-ray imaging system around the C-arm rotation axis Y1.

Such mobile counterweights also allow satisfactory stabilization of the X-ray imaging system in the longitudinal direction Y for a certain range of positions and orientations of the C-arm <NUM>. However, the dimension of the mobile base <NUM> in the longitudinal direction Y being restricted, a movement of counterweights integrated inside the mobile base <NUM> along the longitudinal direction Y may not be enough to stabilize the X-ray imaging system in all the positions and orientations accessible to the C-arm <NUM>.

The stabilization means <NUM> may comprise retractable stabilization means <NUM> adapted to be moved between a retracted position and a deployed position.

In the deployed position, the stabilization means <NUM> provide stabilization of the X-ray imaging system. Examples of X-ray imaging systems with deployed stabilization means are illustrated in a non-limitative way in <FIG> and <FIG>.

The deployed position may correspond to a maximum deployment state, the retracted position may correspond to a minimum deployment state. The retractable stabilization means <NUM> may be adapted to be moved in a number of intermediate positions between the retracted position and the deployed position, for example according to a state of extension of the motorized arm <NUM>.

The stabilization means <NUM> may be implemented in alternative or in addition to the mobile counterweights in order to provide additional stabilization in any stabilization direction.

The retractable stabilization means <NUM> may be deployed substantially proportionally to the extension of the motorized arm <NUM> in the stabilization direction, that is to say to a distance between the proximal end and the distal end of the motorized arm <NUM> in the stabilization direction.

In the retracted position, the retractable stabilization means <NUM> may extend completely inside the mobile base <NUM>. In the deployed position, the retractable stabilization means <NUM> may extend at least partially outwardly from the mobile base <NUM>.

The stabilization means <NUM> may be deployed only when the C-arm <NUM> must be moved towards extreme positions away from the base <NUM> in the longitudinal and/or transverse directions X, Y, and/or when the C-arm <NUM> must be tilted with a given alpha angle. Alternatively, the stabilization means <NUM> may be deployed during the whole imaging procedure, or at any stage of the imaging procedure.

The retractable stabilization means <NUM> may be motorized so as to automatically deploy or retract according to a command of the control unit.

A displacement of the retractable stabilization means <NUM> between the retracted position and the deployed position may include a translation of the retractable stabilization means <NUM> along the stabilization direction.

Said translation may be substantially proportional to a distance between the proximal end and the distal end of the motorized arm <NUM> in the stabilization direction.

In a first embodiment, the retractable stabilization means <NUM> include two balance weights. A distance separating the two balance weights is greater in the deployed position than in the retracted position. The two balance weights may extend close to or on the ground, in both the deployed and the retracted positions.

The two balance weights may be mounted on the two sides of the mobile base <NUM>.

The stabilization direction may correspond to the longitudinal direction Y.

The two balance weights may be disposed at respective ends of two retractable stabilizing feet mounted on the mobile base <NUM>.

In a first example, each of the two balance weights is fixed to a respective side of the base <NUM> by a respective pivot connection directed along the vertical direction Z. Each pivot connection allows rotation of the respective balance weight around the vertical direction Z. The balance weight may be rotated by substantially <NUM>° around the vertical direction Z between the retracted position and the deployed position.

In the retracted position, each balance weight may be positioned against the side of the mobile base <NUM> on which it is mounted, and may extend substantially in the transverse direction X. The retracted position allows a lesser footprint of the base <NUM> on the ground, and may be used for transport of the X-ray imaging system. In particular, the footprint of the base <NUM> in the longitudinal direction Y when the stabilization means <NUM> are retracted is the same as the footprint of a base <NUM> without said retractable stabilization means <NUM>. Therefore, the stabilization is performed without increasing the footprint of the base <NUM>.

In the deployed position, the balance weights may be positioned substantially perpendicularly to the side of the mobile base <NUM> on which it is mounted, and may extend substantially in the longitudinal direction Y. Each balance weight may extend at least partially outside the base <NUM>, an end of the balance weight extending in the base <NUM> and another end of the balance weight extending away from the base <NUM> in the longitudinal direction Y. The deployed position allows a maximum dimension of the base <NUM> in the longitudinal direction Y, thus stabilizing the X-ray imaging system in the longitudinal direction Y.

In a second example, each of the two balance weights may be retracted or deployed by a translation in a longitudinal direction Y, in a longitudinal direction Y, and/or in diagonal direction between the longitudinal direction Y and the transverse direction X. For example, each of the two balance weights may be retracted or deployed by a translation in a direction oriented at substantially <NUM>° from the longitudinal direction Y and the transverse direction X, as illustrated example in <FIG> and <FIG>.

The stabilization direction of a first balance weight located on a first side of the base <NUM> may be symmetrical relative to an axis oriented in the traverse direction X and passing through a center of the base <NUM> to the stabilization direction of a second balance weight located on a second opposite side of the base <NUM>.

In a second embodiment, the retractable stabilization means <NUM> include at least one retractable suction pad. The at least one retractable suction pad is adapted to adhere to the ground in the deployed position.

More specifically, each suction pad may extend substantially in the vertical direction Z. In the retracted position, the suction pad may be partially or integrally retracted inside the base <NUM>. The suction pad may be moved towards the deployed position by a downward vertical translation, and may reach the deployed position when the suction pad contacts the ground. Suction by the suction pad may be activated for example by a motor such as an electric motor, or by a pump.

Several suction pads may be arranged at different locations relative to the base <NUM>, so as to maximize the suction provided by the suction pads and thus the corresponding stabilization of the X-ray imaging system.

The X-ray imaging system may further comprise alerting means adapted to alert an operator to move the stabilization means <NUM> when the toppling risk detection unit detects a toppling risk. The alert may for example be a visual and/or an audible alert.

Thus, the user is alerted as to the need of using stabilization means <NUM> according to a configuration of the X-ray imaging system.

In alternative, the alerting means may be adapted to alert the control unit to move the stabilization means <NUM> when the toppling risk detection unit detects a toppling risk, so that the control unit may automatically move the stabilization means <NUM> accordingly.

The toppling risk detection unit may be adapted to determine an authorized area of motion of the C-arm <NUM> according to toppling parameters.

The control unit is adapted to restrict a movement of the motorized arm <NUM> so as to keep the C-arm <NUM> within said determined authorized area of motion.

The control unit thus allows movement of the motorized arm <NUM> when the C-arm <NUM> remains within the determined authorized area of motion, and restricts movement of the motorized arm <NUM> which would lead the C-arm <NUM> to be positioned outside said determined authorized area of motion.

The determined authorized area of motion may correspond to an area for the C-arm <NUM> wherein the overall balance of the X-ray imaging system, that is to say the stability of the X-ray imaging system, is ensured. Thus, the X-ray imaging system cannot move to positions and orientations where the weight distribution would be inappropriate and risk toppling of the X-ray imaging system.

Alternatively, the control unit may allow movement of the motorized arm <NUM> which correspond to the C-arm <NUM> being positioned either inside or outside the authorized area of motion, but generate an alert when the C-arm <NUM> is located outside said authorized area of motion. Therefore, the user is alerted as to a potential risk concerning the stability of the X-ray imaging system.

The authorized area may be determined in real time during the imaging procedure, according to a movement of the mobile base <NUM> and/or the motorized arm <NUM>.

The authorized area of motion may be an area defined relative to the base <NUM>. Some positions of the C-arm <NUM> are thus forbidden, so that the C-arm <NUM> is not moved in positions too far away from the base <NUM>. Alternatively, the authorized area of motion may be an area defined relative to the center of mass of the X-ray imaging system, so as to keep said center of mass in an area which does not generate a toppling risk of the X-ray imaging system.

The authorized area of motion may correspond to at least one authorized rotation limit on at least one of the at least three rotation axes Z1, Z2, Z3 of the motorized arm <NUM>.

The toppling parameters used by the toppling risk detection unit in order to determine the authorized area of motion may comprise a weight and/or a position of the motorized arm <NUM>, the C-arm <NUM>, and/or the base <NUM>. The toppling parameters may include force and/or torque applied to the system.

If the X-ray imaging system comprises stabilization means <NUM>, the toppling parameters used by the toppling risk detection unit in order to determine the authorized area of motion may include operating parameters of the stabilization means <NUM>.

Such operating parameters of the stabilization means <NUM> may include a weight and/or a position of the stabilization means <NUM>, and/or may reflect a configuration of the stabilization means <NUM>.

For example, the authorized area may be wider when the stabilization means <NUM> are in the deployed position, than when the stabilization means <NUM> are in the retracted position. Indeed, the range of positions and orientations of the C-arm <NUM> without compromising the stability of the system is wider when the stabilization means <NUM> are deployed.

The X-ray imaging system may further comprise a user interface adapted to allow a user to control a movement of the mobile base <NUM> and/or the motorized arm <NUM>.

The user interface may also be adapted to control an X-ray acquisition by the C-arm <NUM>.

The user interface may comprise switches, such as a power switch adapted to begin or stop an image acquisition by the C-arm <NUM>, an emergency button adapted to stop a movement of the motorized arm <NUM> and/or the C-arm <NUM>, etc..

The user interface may be integrated in the base <NUM>, more particularly may be positioned on an external face of the base <NUM>, so as to be visible by a user positioned near the base <NUM>.

Alternatively, the user interface may be remote from the base <NUM>. For example, the user interface may be displayed on a screen of a computer distant from the base <NUM>, the screen comprising virtual buttons allowing a user to control actuation of the motorized arm <NUM>. Alternatively, the user interface may be duplicated remotely to allow remote control.

The X-ray imaging system further comprises a sensor adapted to measure a force and/or torque applied by a user on the motorized arm <NUM> and/or the C-arm <NUM>.

The control unit comprises a cooperative mode. In the cooperative mode, the control unit is adapted to control a movement of the motorized arm <NUM> in response to the force and/or torque detected by the sensor.

The cooperative mode may be parameterized so that:.

Thus, in the cooperative mode, the movement of the motorized arm <NUM>, thus of the C-arm <NUM>, may be controlled, or driven, by a user directly manipulating the C-arm <NUM> or the motorized arm <NUM>. A user action on the X-ray imaging system may lead to a corresponding C-arm <NUM> movement only in some directions, so as to give the user some freedom on the positioning of the C-arm <NUM> while maintaining a satisfactory precision in said positioning of the C-arm <NUM>.

For example, the control unit may apply a substantially proportional force and/or torque to the motorized arm <NUM> to the force and/or torque detected in the horizontal plane H, but not to the force and/or torque detected in the vertical direction Z. Thus, the user may not change the vertical position of the C-arm <NUM> by applying a force and/or torque on the X-ray imaging system. Alternatively, the collaborative mode may be parameterized so that a user action on the X-ray imaging system may only lead to move the C-arm <NUM> in the vertical direction Z. Thus, the rest of the positioning and orientating of the C-arm <NUM> is automatically managed by the control unit.

Alternatively, the control unit may apply a substantially proportional force and/or torque to the motorized arm <NUM> to the force and/or torque applied by a user on the C-arm <NUM> in order to modify the alpha angle of the C-arm <NUM>, but not in any other directions.

The cooperative mode may be activated or deactivated by a user, for example by pressing a corresponding button on the X-ray imaging system, or by selecting a corresponding option on the user interface.

The X-ray imaging system may be adapted to be actuated towards a parking configuration optimized to reduce a footprint of said X-ray imaging system. The parking configuration is optimized for storage, whether inside or outside the operating room, and/or for transport.

The parking configuration may consist in a specific position and orientation of the motorized arm <NUM> and C-arm <NUM> so as to reduce the footprint of the X-ray imaging system and minimize the risk of collision of any critical part of the X-ray imaging system with the environment when displaced (walls, doors etc.). Furthermore, in the parking configuration, the X-ray imaging system may be stabilized so as to minimize or eliminate the toppling risk.

The mobile base <NUM> may be present an external surface adapted for such parking configuration. More particularly, an external surface of the mobile base <NUM> may be complementary in shape to the C-arm <NUM>. The external surface of the mobile base may be curved with a radius of curvature corresponding substantially to a radius of curvature of the C-shaped structure, or the O-shaped structure, of the C-arm <NUM>.

In the parking configuration, the C-arm <NUM> may lie at least partially on the external surface of the mobile base <NUM>. More specifically, the C-shaped structure, or the O-shaped structure, of the C-arm <NUM> may rest on the mobile base <NUM>, so that the mobile base <NUM> at least partially supports a weight of the X-ray imaging system. This allows a greater mechanical rest of the motorized arm <NUM>. Especially during transportation, as the mobile base <NUM> may be displaced on uneven ground, it is the mobile base <NUM> which then absorbs the resulting vibrations of the X-ray imaging system, instead of the motorized arm <NUM>, thus preserving the motorized arm <NUM>. Examples corresponding to an embodiment in which the C-arm <NUM> lies on the mobile base <NUM> are illustrated in <FIG>, and <FIG>.

The X-ray imaging system may be placed in the parking configuration by automatic and synchronized actuations of the motorized arm <NUM> and C-arm <NUM>, for example in response to the pressing of a button by the user at the end of surgery.

The X-ray imaging system may present an asymmetrical architecture. More specifically, the motorized arm <NUM> may be mounted off-center relative to a plane of symmetry of the mobile base <NUM>. The plane of symmetry of the mobile base <NUM> may be oriented in the vertical direction Z and in the transverse direction X, and may pass substantially through a center of an external surface of the mobile base <NUM>. For example, the proximal pivot connection <NUM> may be positioned off-center relative to the plane of symmetry of the mobile base <NUM>, the mobile arm <NUM> being mounted to the mobile base <NUM> by way of the proximal pivot connection <NUM>. Examples of X-ray imaging systems with an asymmetrical architecture are illustrated, in a non-limitative way, in <FIG>, <FIG>, <FIG> and <FIG>.

Such an asymmetrical architecture of the X-ray imaging system may not result in an asymmetrical area of motion of the C-arm <NUM>, as the off-center positioning of the motorized arm <NUM> may be compensated by an adequate management of mechanical abutments and configuration of the control unit.

The asymmetrical architecture may allow an optimization of the footprint of the X-ray imaging system when the X-ray imaging system is in the parking configuration. More specifically, in the parking configuration, the C-arm <NUM> may entirely lie within the footprint of the mobile base <NUM>. Thus, the sensitive parts of the C-arm <NUM>, in particular the X-ray source <NUM> and the X-ray detector <NUM>, are protected from collision with adjacent elements. Examples of X-ray imaging systems with an asymmetrical architecture, the X-ray imaging systems being in the parking configuration are illustrated, in a non-limitative way, in <FIG> and <FIG>.

Alternatively, the X-ray imaging system may present a symmetrical architecture. More specifically, the motorized arm <NUM> may be mounted substantially at the plane of symmetry of the mobile base <NUM>. Thus, the authorized area of motion of the C-arm <NUM> is symmetrical relative to the mobile base <NUM>. Examples of X-ray imaging systems with a symmetrical architecture are illustrated, in a non-limitative way, in <FIG>, <FIG>, <FIG> and <FIG>.

Parking positions of X-ray imaging systems presenting a symmetrical architecture is represented by way of a non-limiting example, in <FIG> and <FIG>.

The X-ray imaging system may further comprise a battery-powered supply unit for safe operation in the case of a power outage.

The battery-powered supply unit may be dimensioned so as the X-ray imaging system can return to the parking configuration on said battery. More specifically, the battery may be dimensioned so as to supply power to actuate the mobile arm <NUM> and/or the C-arm <NUM> in order to place the X-ray imaging system back into the parking configuration, independently of the previous configuration, in terms of position of the C-arm <NUM> and mobile arm <NUM>, of the X-ray imaging system.

The battery may be integrated in the mobile base <NUM>.

Thus, in the case of a power outage, the battery may place the X-ray imaging system in the parking configuration. The X-ray imaging system thus does not risk falling on the patient, and may then be easily transported outside the operation room, so that it is not susceptible to represent any risk for the patient.

A method for acquiring an imaging dataset with an X-ray imaging system according to any of the embodiments disclosed above comprises the following steps:.

This method allows to acquire imaging dataset by an X-ray imaging system comprising a simple single motorized arm <NUM>. The movement of the motorized arm <NUM> and mobile base <NUM> may be controlled accurately so as to position the C-arm <NUM> in a wide range of positions in directions relative of the predetermined region of interest, with a high level of precision.

The method thus makes it possible to successively acquire distant imaging datasets of distant regions of interest, by moving the C-arm <NUM> between the successive acquisitions, while knowing that the movement command has been respected. Therefore, the position of the C-arm <NUM> does not have to be recalibrated in a specific recalibration step for each region of interest acquired.

The C-arm <NUM> is positioned relative to a predetermined region of interest. That is to say, the C-arm <NUM> is positioned so as to be able to begin acquisition of the predetermined region of interest, at least a part of the region of interest being positioned between the X-ray source <NUM> and the X-ray detector <NUM>. The base <NUM> may be positioned along the operating table on which the person lies, at a distance from the operating table.

The method may comprise the following steps, performed successively for at least one additional region(s) of interest, after acquiring the imaging dataset of the predetermined region of interest in step S2:.

This method allows the acquisition of at least two imaging datasets, corresponding to at least two regions of interest (at least the predetermined region of interest, and at least one additional region of interest).

The at least two imaging datasets may be geometrically registered together by using the motorized arm <NUM> kinematic model. Indeed, the C-arm <NUM> displacement throughout the process, in particular between two imaging acquisitions, may be accurately tracked, as the commanded motorized arm <NUM> movement corresponds to the actual observed motorized arm <NUM> movement.

Therefore, a position of the C-arm <NUM> relative to an additional region of interest may be deduced from a reference position of the C-arm <NUM> relative to the predetermined region of interest and from the estimated displacement of the motorized arm <NUM>.

The steps S3, S4, S5 and S6 may be repeated successively for at least two additional regions of interest.

In one example, the predetermined region of interest is a knee of a person, a first additional region of interest is a hip of the person, and a second additional region of interest is an ankle of the person. A first imaging dataset may be a 3D image of the knee, a second imaging dataset may comprise at least two 3D projections of the hip, and a third imaging dataset may comprise at least two 2D projections of the ankle of the person.

In another example, at least two regions of interest among the predetermined region of interest and the at least one additional region(s) of interest are two different sections of a spine of a person. These regions of interest may correspond to imaging acquisitions during a procedure performed on a person having scoliosis, and allows tracking the way the spine is repositioned during surgery.

The method may further comprise performing the following steps before each acquisition of an imaging dataset of a region of interest:.

The method further comprises a step S7 of registering the at least one additional region(s) of interest with the predetermined region of interest based <NUM> on the displacement of the motorized arm <NUM> estimated in step S4.

The reference tracker may be a calibration marker such as a radiopaque fiducial.

The reference tracker is positioned on the person, in a known position relative to the region of interest to acquire. The reference tracker may be fixed onto the person.

The C-arm <NUM> may be positioned roughly on the reference tracker, either manually by a user, or automatically by the control unit. The C-arm <NUM> then acquires an image or an imaging dataset.

The reference tracker is thus visible in at least one acquired image of each of the imaging datasets acquired by the X-ray imaging system, or a subset of the acquired imaging dataset. The position of the C-arm <NUM> may thus be determined from the position of the reference tracker in the acquired image. More particularly, the position of the X-ray detector <NUM> relative to the person and the relative positions of the X-ray detector <NUM> between the different image acquisitions are therefore known. The position of the C-arm <NUM> may correspondingly be adjusted.

The method may further comprise the following steps, performed substantially simultaneously:.

The control unit may be adapted to synchronize the movement of the motorized arm <NUM> with the displacement of the mobile base <NUM>, when the base position sensors detect a movement of the base <NUM>. The control unit may command an automatic movement of the base <NUM> via the base motorization means.

The mobile base <NUM> and the motorized arm <NUM> are moved in a synchronized manner, so as to maintain the C-arm <NUM> in a fixed position relative to the region of interest to be imaged. The movement of the motorized arm <NUM> compensates in real time the movement of the base <NUM>.

Therefore, when the mobile base <NUM> is moved, for example by a user, the C-arm <NUM> remains at substantially the same position with respect to the region of interest to acquire and may go on with the image acquisition without interrupting the image acquisition.

Therefore, the mobile base <NUM> may be moved during surgery or even during image acquisition, while the C-arm <NUM> remains in a stable position relative to the region of interest to be imaged.

More particularly, the base <NUM> may be translated in the horizontal plane H along the longitudinal direction Y and/or along the transverse direction X, while maintaining the C-arm <NUM> in a fixed position thanks to a synchronized counter-movement of the motorized arm <NUM>.

For example, if the user wants to free up space where the base <NUM> is located, the user can move the base <NUM> without causing movement of the C-arm <NUM>.

The method may further comprise a step S110 of controlling, in a coordinated manner, a movement of the motorized arm <NUM> around at least two of the at least three rotation axes Z1, Z2, Z3, so as to move the C-arm <NUM> in a substantially horizontal plane H attached to the mobile base <NUM>.

This step allows moving the C-arm <NUM> without causing any variation of the position along the vertical direction Z, or any variation of the alpha angle of the C-arm <NUM>.

The method may further comprise a step S120 of controlling, in a coordinated manner, a movement of the motorized arm <NUM> around at least two of the at least three rotation axes Z1, Z2, Z3, so as to move the C-arm <NUM> around a fixed point or a fixed axis.

The fixed point or fixed axis may be located substantially at an isocenter C of the C-arm <NUM>, at a substantially equal distance from the X-ray source <NUM> and the X-ray detector <NUM>.

The C-arm <NUM> thus remains on the fixed point or axis, while its position and/or orientation, for example its alpha angle or wig-wag, is moved. For example, the C-arm <NUM> may be positioned on a vertebra and then be maintained in a fixed position relative to the vertebra while its alpha angle and/or wig-wag is modified. Alternatively, the C-arm <NUM> may be positioned on a vertebra and then the motorized arm <NUM> may be manually moved so as to align the C-arm <NUM> relative to the vertebral plates, while maintaining a center of the C-arm <NUM> in a fixed position.

The method may further comprise a step S130 of memorizing, by a control unit, at least one position of the C-arm <NUM> along with corresponding position parameters of the motorized arm <NUM>.

The position parameters of the motorized arm <NUM> may be representative of an extension of the motorized arm <NUM>, thus of a position of the C-arm <NUM>. For example, the position parameters may comprise angular values of a state of angular rotation of the different segments of the motorized arm <NUM> around each of the rotation axes X1, X2, X3.

The method may further comprise a step S140 of controlling a movement of the motorized arm <NUM> in order to position the C-arm <NUM> to a position memorized by the control unit.

Therefore, a user performing the imaging may command the motorized arm <NUM> to automatically go back and forth between several memorized imaging positions.

Claim 1:
X-ray imaging system comprising a mobile base (<NUM>), a motorized arm (<NUM>), a C-arm (<NUM>) adapted to be mounted on the mobile base (<NUM>) by means of the motorized arm (<NUM>), and a control unit adapted to control an actuation of the mobile base (<NUM>) and/or the motorized arm (<NUM>),
wherein the C-arm (<NUM>) comprises an X-ray source (<NUM>) and an X-ray detector (<NUM>),
wherein the motorized arm (<NUM>) presents at least three rotation axes (Z1, Z2, Z3) directed along a substantially common vertical direction (Z),
the system being characterized in that it further comprises a sensor adapted to measure a force and/or torque applied by a user on the motorized arm (<NUM>) and/or the C-arm (<NUM>),
and that the control unit comprises a cooperative mode, wherein in the cooperative mode, the control unit is adapted to control a movement of the motorized arm (<NUM>) in response to the force and/or torque detected by the sensor.