Patent Description:
Embodiments described herein generally relate to quality assurance of patient positioning, and more particularly, to improving patient positioning in breast imaging, such as it relates to mammographic or tomosynthesis image acquisition.

Proper positioning is important when performing radiation-based imaging of a patient for a variety of reasons. First, the position of the target tissue is crucial to obtain a quality image that can be used for diagnosis. Second, it is desirable to minimize a patient's total exposure to radiation during a study and, thus, subsequent imaging to obtain proper positioning is not ideal. Third, due to regulations in many jurisdictions, subsequent imaging used solely to correct poor positioning may be counted against a practitioner or organization, and frequent re-imaging may result in revocation of a license and/or accreditation. Fourth, improper positioning for an image may require a patient to make subsequent visits to an imaging center, placing additional burden on the patient. For at least these reasons, there is a need for improved techniques, which may be automated or semi-automated, for quality assurance in patient positioning, for assessing prior information longitudinally across a patient record, and for minimizing the amount of radiation exposure to patients in a workflow efficient manner.

<CIT> discloses systems and methods for automatically and dynamically modifying an image acquisition parameter for use in tomosynthesis breast imaging. A selected image acquisition parameter is modified in response to a measured characteristic of an imaged object such as a breast, and thus tailored to provide the highest quality image for the particular object.

<CIT> discloses a system and method for imaging of a subject through the use of low dose exposure aided positioning. The subject is positioned in an X-ray imaging system and imaged with a low dose pre-shot X-ray exposure to verify the positioning of the subject. If the subject's positioning is acceptable, the subject is then imaged with a full dose X-ray exposure. If the subject's positioning is not acceptable, the subject is repositioned and re-imaged with a low dose pre-shot X-ray exposure until the subject's positioning is acceptable.

The following presents a simplified summary in order to provide a basic understanding of some novel embodiments described herein. This summary is not an extensive overview, and it is not intended to identify key/critical elements or to delineate the scope thereof. Its sole purpose is to present some concepts in a simplified form as a prelude to the more detailed description that is presented later. The invention is defined by independent claims <NUM> and <NUM>.

Techniques for patient positioning quality assurance prior to image acquisition are described. In the present disclosure, a system includes an x-ray source configured to expose human tissue to radiation. In some examples, the human tissue may include breast tissue. An x-ray detector may be configured to detect the radiation and generate a pre-diagnostic image of the human tissue. As used herein, a pre-diagnostic image is an automated exposure control (AEC) scout image in which (a) a relatively low amount of radiation exposure to the tissue is utilized (a "pre-diagnostic dose level") and analyzed in order to determine the optimal exposure parameters to generate a diagnostic quality image, such as could be, but not necessarily, generated by the automated exposure control system of a breast imaging system; and (b) is not intended to be presented for clinical or diagnostic interpretation by a physician or other healthcare provider or staff. A position analysis module is configured to receive the pre-diagnostic image and determine whether the human tissue is positioned correctly based upon one or more predefined positioning criteria. A non-transitory computer-readable storage medium may be configured to store the results of the positional analysis module determination. A display may be configured to display the determination of the position analysis module within a user interface.

In the present disclosure, an imaging system includes an x-ray source to expose human tissue to radiation at pre-diagnostic dose levels, an x-ray detector to detect the radiation and generate a pre-diagnostic image of the human tissue, and a position analysis module to receive the pre-diagnostic image and determine whether the human tissue is positioned correctly based upon one or more predefined positioning criteria.

In an example, a computer-implemented method may include exposing human tissue to radiation by an x-ray source, an x-ray detector module configured to detect the radiation and generate a pre-diagnostic image of the human tissue, receiving the pre-diagnostic image at a position analysis module, and determining, by the position analysis module, whether the human tissue is positioned correctly based upon one or more predefined positioning criteria.

In some examples, the human tissue is a breast and the imaging system is operative to capture a diagnostic mammogram of the breast. In various examples, a radiation level used to generate the pre-diagnostic image is substantially less than a radiation level to generate a diagnostic image. In some examples, the pre-diagnostic image is of a lower resolution than a diagnostic image. In the present disclosure, the pre-diagnostic image is an automated exposure control (AEC) scout image. In some examples, the pre-diagnostic image is of a mediolateral oblique (MLO) view of a breast. In various examples, the pre-diagnostic image is of a cranial-caudal (CC) view of a breast. In examples, the predefined criteria are compared to one or more detected anatomical landmarks. In various examples, the one or more detected anatomical landmarks are selected from the group comprising an inframammary fold, nipple, pectoral muscles, or chest wall. In some examples, the predefined criteria include a comparison between the pre-diagnostic image and one or more of previous pre-diagnostic images or previous diagnostic images. In the present disclosure, the imaging system may include a display configured to display the determination of the position analysis module within a user interface. In various examples, the pre-diagnostic image is of a substantially similar resolution to a diagnostic image. In the present disclosure, a diagnostic image is automatically taken based upon the determination of the position analysis module. In various examples, a diagnostic image procedure is automatically interrupted based upon the determination of the position analysis module. In some examples, a diagnostic image procedure is interrupted in response to receiving a user input based upon the determination of the position analysis module.

To the accomplishment of the foregoing and related ends, certain illustrative aspects are described herein in connection with the following description and the annexed drawings. These aspects are indicative of the various ways in which the principles disclosed herein can be practiced and all aspects thereof are intended to be within the scope of the claimed subject matter. Other advantages and novel features will become apparent from the following detailed description when considered in conjunction with the drawings.

Various embodiments are generally directed to techniques for patient positioning quality assurance prior to mammographic image acquisition are described. In an embodiment, a system may include an x-ray source configured to expose human tissue to radiation. An x-ray detector may be configured to detect the radiation and generate a pre-diagnostic image of the human tissue. As used herein, a pre-diagnostic image is one in which (a) a relatively low amount of radiation exposure to the tissue is utilized and analyzed in order to determine the optimal exposure parameters to generate a diagnostic quality image, such as could be, but not necessarily, generated by the automated exposure control system of a breast imaging system; and (b) is not intended to be presented for clinical or diagnostic interpretation by a physician or other healthcare provider or staff. An exemplary comparison between a diagnostic image and a pre-diagnostic image is illustrated by <FIG>. A position analysis module may be configured to receive the pre-diagnostic image and determine whether the human tissue is positioned correctly based upon one or more predefined positioning criteria. A non-transitory computer-readable storage medium may be configured to store the results of the positional analysis module determination. A display may be configured to display the determination of the position analysis module within a user interface. Other embodiments are described and claimed.

With general reference to notations and nomenclature used herein, the detailed descriptions which follow may be presented in terms of program procedures executed on a computer or network of computers. These procedural descriptions and representations are used by those skilled in the art to most effectively convey the substance of their work to others skilled in the art.

A procedure is here, and generally, conceived to be a self-consistent sequence of operations leading to a desired result. These operations are those requiring physical manipulations of physical quantities. Usually, though not necessarily, these quantities take the form of electrical, magnetic or optical signals capable of being stored, transferred, combined, compared, and otherwise manipulated. It proves convenient at times, principally for reasons of common usage, to refer to these signals as bits, values, elements, symbols, characters, terms, numbers, or the like. It should be noted, however, that all of these and similar terms are to be associated with the appropriate physical quantities and are merely convenient labels applied to those quantities.

Various embodiments also relate to apparatus or systems for performing these operations. In some embodiments, these apparatus may be specially constructed for the required purpose or it may comprise a computing device selectively activated, operated, and/or configured by a computer program stored in the computing device and/or hardware of the computing device. Various machines may be used with programs written and/or hardware configured in accordance with the teachings herein, including specialized apparatus to perform the required method steps. The required structure for a variety of these machines will appear from the description given.

<FIG> illustrates a block diagram for an imaging system <NUM>. In one embodiment, the imaging system <NUM> may comprise one or more components. Although the imaging system <NUM> shown in <FIG> has a limited number of elements in a certain topology, it may be appreciated that the imaging system <NUM> may include more or less elements in alternate topologies as desired for a given implementation. The imaging system <NUM> may include a plurality of modules, including imaging module <NUM>, pre-diagnostic imaging module <NUM>, and position analysis module <NUM>, which may each include one or more processing units, storage units, network interfaces, or other hardware and software elements described in more detail herein. In some embodiments, these modules may be included within a single imaging device, utilizing shared CPU <NUM>. In other embodiments, one or more modules may be part of a distributed architecture, an example of which is described with respect to <FIG>.

In an embodiment, each module of imaging system <NUM> may comprise without limitation an imaging system, mobile computing device, a smart phone, a desktop computer, or other devices described herein. In various embodiments, imaging system <NUM> may comprise or implement multiple components or modules. As used herein the terms "component" and "module" are intended to refer to computer-related entities, comprising either hardware, a combination of hardware and software, software, or software in execution. For example, a component and/or module can be implemented as a process running on a processor, such as CPU <NUM>, a hard disk drive, multiple storage drives (of optical and/or magnetic storage medium), an object, an executable, a thread of execution, a program, logic, circuitry, a controller, and/or a computer. By way of illustration, both an application running on a server and the server can be a component and/or module. One or more components and/or modules can reside within a process and/or thread of execution, and a component and/or module can be localized on one computer and/or distributed between two or more computers as desired for a given implementation.

The various devices within system <NUM>, and components and/or modules within a device of system <NUM>, may be communicatively coupled via various types of communications media as indicated by various lines or arrows. In various embodiments, the various modules and storages of system <NUM> may be organized as a distributed system. A distributed system typically comprises multiple autonomous computers that communicate through a computer network. It is worthy to note that although some embodiments may utilize a distributed system when describing various enhanced techniques for data retrieval, it may be appreciated that the enhanced techniques for data retrieval may be implemented by a single computing device as well.

In an embodiment, imaging module <NUM> may include an x-ray source <NUM> and x-ray detector <NUM>, which may be used to perform breast imaging. In some embodiments imaging module <NUM> may be configured to perform breast imaging, such as x-ray mammography and/or tomosynthesis, which is a method for performing high-resolution limited-angle tomography at radiographic dose levels. While mammography is used as an exemplary embodiment through the description, it can be appreciated that the techniques described herein may be applicable to other procedures in which radiation minimization and proper patient positioning is desirable.

X-ray source <NUM> may be configured to expose human tissue to x-rays, which may be detected by x-ray detector <NUM>. X-ray detector <NUM> may be configured to respond to the fluence of incident x-rays over a wide range. X-ray detector <NUM> may be configured to absorb x-rays, produce an electronic signal, digitize the signal, and store the results in one of storage <NUM> and/or <NUM>. The output image may be saved as a two-dimensional matrix, where each element represents the x-ray transmission corresponding to a path through the breast tissue. Three-dimensional images and matrices may be generated in some embodiments, depending on the imaging modality, such as tomosynthesis, computed tomography, and the like. The image may be digitally processed such that when it is displayed on a display device or printed on laser film, it will illustrate the key features required for diagnosis. Such diagnostic images may be stored in storage <NUM> so that they may be viewed on a user interface of display <NUM>. In an embodiment, images may also be archived in image database <NUM>. In this manner, patient records may be maintained and past images may be used to evaluate patient positioning when compared to new images.

Imaging system <NUM> includes pre-diagnostic imaging module <NUM>, which is configured to generate automated exposure control (AEC) scout images using x-ray source <NUM> and x-ray detector <NUM>. AEC scout images may be stored in storage <NUM>, which may be a temporary storage used for calibration operations and, in some embodiments, in conjunction with position analysis module <NUM>, discussed below. AEC scout images may be pre-diagnostic, as described herein, and used to measure and calibrate radiation levels within an imaging system prior to taking diagnostic images. In other words, AEC scout images may be taken prior to typical diagnostic images. In some embodiments, AEC scout images may be of a lower resolution than diagnostic images. However, in other examples, AEC scout images may be of similar resolution to diagnostic images. Pre-diagnostic AEC scout images may be acquired using <NUM>-<NUM>% of the radiation dose as would a diagnostic image of the same tissue, in some examples. It can be appreciated, however, that pre-diagnostic images may use more or less radiation in particular embodiments, but will typically be less than a diagnostic image. In some embodiments, the AEC scout image may be acquired in a single x-ray exposure; in other embodiments, the AEC scout image may be acquired over multiple x-ray exposures.

Since AEC scout images typically have very low radiation exposure when compared to diagnostic images, it is advantageous to utilize them to perform patient positioning. While the very low radiation dosage of pre-diagnostic images is beneficial to patients during positioning and used to determine necessary x-ray parameters to generate a diagnostic quality image, the low level of radiation exposure used may also lead to significantly decreased quality of the pre-diagnostic image, which is a key reason it is not presented for human interpretation. However, despite the inherent difficulties in analyzing low-quality pre-diagnostic images, advanced image analysis software modules may still be utilized to automatically or semi-automatically process and extract relevant information to assist with proper patient positioning. In an example, pre-diagnostic images may have increased noise and reduced contrast, when compared to diagnostic images. An exemplary comparison between a diagnostic image and a pre-diagnostic image is illustrated by <FIG>. To mitigate reduced quality of pre-diagnostic images, some embodiments may automatically or semi-automatically decrease the resolution of the pre-diagnostic image, which may inflate a local signal-to-noise ratio of objects and/or anatomy within the pre-diagnostic image.

Imaging system <NUM> may include position analysis module <NUM>, operative on CPU <NUM>, and configured to identify one or more anatomical landmarks within a pre-diagnostic image. Further, position analysis module <NUM> may determine whether a patient's position is proper based upon one or more position criteria stored within position criteria repository <NUM>. Criteria for proper positioning may be predefined as set forth by various accrediting bodies, such as the Food and Drug Administration, American College of Radiology, European Commission, and others. Some examples of criteria indicating improper and proper positioning are illustrated below with respect to <FIG>.

In an embodiment, position analysis module <NUM> may receive a pre-diagnostic image from pre-diagnostic image module <NUM>. Position analysis module <NUM> may evaluate the received image, which may be of a lower quality when compared to a diagnostic image. Using algorithms optimized to identify anatomical landmarks within low quality pre-diagnostic images, position analysis module <NUM> may identify one or more anatomical landmarks as discussed with respect to <FIG> below. Some pertinent anatomical landmarks that may be used to determine proper positioning include, but are not limited to, the nipple, pectoralis muscle, or other non-targeted anatomical structures being in view such as ears, fingers, stomach, and so on. In an exemplary embodiment, position analysis module <NUM> may be optimized to detect and identify landmarks of particularly low contrast in pre-diagnostic quality images, such as the nipple or internal structures such as the edge of the pectoralis muscle.

Once identified, characteristics of detected anatomical landmarks (e.g. location, position, presence, size, relationship to other landmarks, etc.) may be compared to one or more predefined criteria from position criteria repository <NUM>. Based upon the comparison, position analysis module <NUM> may make a position determination. Further, position analysis module <NUM> may make a position determination based upon the relationship of a first landmark to one or more additional landmarks, and/or a comparison of a current pre-diagnostic view with a previous pre-diagnostic or diagnostic view accessible from image database <NUM>. A position determination may indicate whether a patient is currently in an acceptable position, or needs to be repositioned.

In an embodiment, display device <NUM> may include a user interface configured to receive and display a determination of patient positioning from position analysis module <NUM>. For example, a practitioner may be notified via the user interface of display <NUM> that a patient is properly or improperly positioned. Further, position analysis module <NUM> may indicate to a practitioner, based upon a position determination, suggested movements for a patient to obtain proper positioning prior to a diagnostic image. In addition to a notification via the user interface of display <NUM>, other techniques for notification of improper position may be used. Non-limiting examples include audio notification, haptic notification, visual indication using lights, and/or one or more prompts within the user interface.

In one example, in response to the display <NUM> notifying the practitioner that the patient is improperly positioned, the practitioner may be provided with an option via the display device <NUM> to interrupt the imaging module <NUM> from taking the full exposure diagnostic image. If the practitioner selects the option to interrupt, the input is received via the display device <NUM> and the imaging module <NUM> prevents the x-ray source <NUM> from being activated. The practitioner may then manually reposition the patient and may then repeat or restart the procedure starting with the pre-diagnostic image and another determination of patient positioning. In another example, a determination of patient positioning from a position analysis module <NUM> that the patient is improperly positioned may be used to automatically interrupt the imaging module <NUM> from taking the full exposure diagnostic by activating the x-ray source. Similar to above, the practitioner can then reposition the patient and repeat or restart the imaging procedure starting with the pre-diagnostic imaging and position determination. In this manner, unnecessary radiation may be reduced during an imaging study of the patient because full-exposure of the higher dose is interrupted either automatically or manually via the practitioner.

In some embodiments, a determination of patient positioning from a position analysis module <NUM> may be used to automatically allow a diagnostic image to be taken immediately, substantially immediately, or otherwise within an image timing duration following a determination that a patient is properly positioned. In this manner, once a patient is determined to be properly positioned by position analysis module <NUM>, a diagnostic image may be automatically taken by imaging module <NUM> quickly thereafter while the patient is in the proper position, minimizing the opportunity for the patient to be placed in an improper position. Likewise, a determination of patient positioning from a position analysis module may be used to automatically terminate a diagnostic image exposure when improper patient positioning is detected. In this manner, unnecessary radiation may be reduced during an imaging study of the patient. The image timing duration may include various time values, including, without limitation, less than <NUM> second, <NUM> second, <NUM> seconds, <NUM> seconds, <NUM> seconds, <NUM> seconds, <NUM> seconds, <NUM> minute, <NUM> minutes, <NUM> minutes, <NUM> minutes, and values and ranges between any two of these values (including endpoints).

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. Specifically, pre-diagnostic mammography image <NUM> illustrates a mediolateral oblique (MLO) view of the breast. As illustrated within <FIG>, a series of anatomical landmarks may be identified by a position analysis module to determine whether a patient is properly positioned prior to taking a diagnostic image of the patient's breast. While four landmarks are illustrated within <FIG>, it can be appreciated that other landmarks may be used in addition to those illustrated. A position analysis module may compare characteristics (e.g., location, position, presence, size, relationship to other landmarks, etc.) of a particular landmark to one or more predefined criteria and make a position determination based upon a review of one or more landmarks. In some embodiments, a position analysis module may make a position determination based upon the relationship of a first landmark to one or more additional landmarks. In various embodiments, a position analysis module may compare a landmark from a first view to one or more landmarks from additional views, which may be taken from a current or previous study of the patient.

As a first example, nipple <NUM> may be identified by a position analysis module. In some embodiments, the alignment of nipple <NUM> may be compared to one or more predefined criteria to determine whether a patient is properly positioned. For example, the absence of a nipple within pre-diagnostic mammography image <NUM> may indicate to a position analysis module that a patient is improperly positioned.

As a second example, inframammary fold <NUM> may be identified by a position analysis module. Inframammary fold <NUM> may represent the anatomical boundary formed at the inferior border of the breast, where it joins with the chest. The presence of inframammary fold <NUM> may provide evidence that a patient is properly positioned, while absence of inframammary fold <NUM> within pre-diagnostic mammography image <NUM> may indicate that the patient is improperly positioned.

As a third example, posterior nipple line (PNL) <NUM> may be identified by a position analysis module. PNL <NUM> may represent a line drawn posteriorly and perpendicularly from the nipple towards the pectoral muscle on the mammogram. In some embodiments, a comparison may be made between this line on different views (MLO, CC) to determine whether positioning of a patient is satisfactory. As one example, in an adequately exposed breast, the difference between a measurement of the PNL line may be within approximately <NUM> between views, or between breasts of the same view.

In a fourth example, pectoralis muscle <NUM> may be identified by a position analysis module. Pectoralis muscle <NUM> may be especially pronounced in MLO views and may be analyzed to determine whether a sufficient amount of breast tissue is depicted within the pre-diagnostic mammography image <NUM> to make a diagnosis. Insufficient breast tissue coverage may indicate improper positioning of a patient.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. Specifically, pre-diagnostic mammography image <NUM> illustrates a cranial-caudal (CC) view of the breast. Like with MLO view, one or more anatomical landmarks, such as nipple <NUM> and PNL <NUM> may be identified by a position analysis module. A position analysis module may compare characteristics (e.g. location, position, presence, size, relationship to other landmarks, etc.) of a particular landmark to one or more predefined criteria and make a position determination based upon a review of one or more landmarks. In various embodiments, a position analysis module may make a position determination based upon the relationship of a first landmark to one or more additional landmarks. In exemplary embodiments, a position analysis module may compare a landmark from a first view to one or more landmarks from additional views, which may be taken from a current or previous study of the patient.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM> as lacking a nipple within a profile of the breast, which may indicate improper positioning of a patient.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM> as lacking a pectoralis muscle. In this example, the lack of a pectoralis muscle may indicate to a position analysis module that insufficient breast tissue is present within a pre-diagnostic image, and that the patient is therefore improperly positioned.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM> as lacking sufficient definition between breast tissue and the edge of the pectoralis muscle, which may indicate improper placement of a patient.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM>, which includes a PNL line <NUM> that below the lower edge of the pectoralis muscle.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM>, which may lack adequate coverage of the lower quadrant of the breast tissue, and may indicate improper patient positioning.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM> as lacking, or insufficiently visualizing, the inframammary fold, which may indicate improper patient positioning.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM> in a comparison between two CC views. In an embodiment, the CC views may be from the same study and may represent the right and left breasts of a patient. As illustrated by region <NUM>, a position analysis module may identify a pectoralis in the middle of the two breasts, which may indicate all, or most (for example, an amount over a threshold), breast tissue along chest wall is included in the image, and may provide evidence of proper patient positioning.

<FIG> illustrates a pre-diagnostic mammography image <NUM> according to an embodiment. As illustrated within pre-diagnostic mammography image <NUM>, a position analysis module may identify region <NUM> and region <NUM> in a comparison between breast <NUM> and <NUM>. In an embodiment, pre-diagnostic images of breasts <NUM> and <NUM> may be from the same study. However, in other embodiments, one of the images of breasts <NUM> or <NUM> may be from a previous study, and may comprise a diagnostic or pre-diagnostic image. As set forth within regions <NUM> and <NUM>, the image of breast <NUM> may be misaligned with the image of breast <NUM>, indicating poor patient positioning.

Included herein is a set of flow charts representative of exemplary methodologies for performing novel aspects of the disclosed architecture. While, for purposes of simplicity of explanation, the one or more methodologies shown herein, for example, in the form of a flow chart or flow diagram, are shown and described as a series of acts, it is to be understood and appreciated that the methodologies are not limited by the order of acts, as some acts may, in accordance therewith, occur in a different order and/or concurrently with other acts from that shown and described herein. For example, those skilled in the art will understand and appreciate that a methodology could alternatively be represented as a series of interrelated states or events, such as in a state diagram. Moreover, not all acts illustrated in a methodology may be required for a novel implementation.

<FIG> illustrates a logic flow <NUM> according to an embodiment. The logic flow <NUM> may be representative of some or all of the operations executed by one or more embodiments described herein, such as imaging system <NUM>, for example. At <NUM>, human tissue may be exposed to radiation by an x-ray source.

At <NUM>, radiation may be detected by an x-ray detector and a pre-diagnostic image of the human tissue is generated by a pre-diagnostic imaging module. The output image is an AEC scout image. AEC scout images may be pre-diagnostic and used to measure and calibrate radiation levels within an imaging system prior to taking diagnostic images. In other words, AEC scout images may be taken prior to typical diagnostic images, be of a lower resolution than diagnostic images, and require less radiation than diagnostic images. In some embodiments, pre-diagnostic AEC scout images may contain approximately <NUM>% of the radiation as a diagnostic image (or another amount below the amount of radiation for capturing a diagnostic image) (i.e., a pre-diagnostic dose level). While the very low radiation dosage of pre-diagnostic images is beneficial to patients, it also may significantly decrease the resolution of an image.

At <NUM>, the pre-diagnostic image may be received by a position analysis module. Position analysis module <NUM> may evaluate the received image, which may be of a low resolution when compared to a diagnostic image. Using algorithms optimized to identify anatomical landmarks within low resolution pre-diagnostic images, a position analysis module may identify one or more anatomical landmarks as discussed above.

At <NUM>, it may be determined whether the human tissue is positioned correctly based upon one or more predefined positioning criteria. Once identified, characteristics of detected anatomical landmarks (e.g., location, position, presence, size, relationship to other landmarks, etc.) may be compared to one or more predefined criteria from position criteria repository. Based upon the comparison, a position analysis module may make a position determination. In some embodiments, a position analysis module may make a position determination based upon the relationship of a first landmark to one or more additional landmarks, and/or a comparison of a current pre-diagnostic view with a previous pre-diagnostic or diagnostic view accessible from an image database.

At <NUM>, the determination of the position analysis module may be stored on a non-transitory computer-readable storage medium. In an embodiment, one or more pre-diagnostic images may also be stored on the non-transitory computer-readable storage medium, or another local or remote storage medium. In this manner, the determination and/or one or more pre-diagnostic images may be referenced and used within a position analysis within the current study or a future study. In some embodiments, a user interface of a display device may display the determination of the position analysis module. A display device may be configured to receive and display a determination of patient positioning from a position analysis module. For example, a practitioner may be notified via the user interface of a display device that a patient is properly or improperly positioned. In various embodiments, a position analysis module may indicate to a practitioner, based upon a position determination, suggested movements for a patient to obtain proper positioning prior to a diagnostic image.

At <NUM>, based on the determination of the position analysis module that the patient is improperly positioned, the imaging module is automatically interrupted before activating and taking the full exposure diagnostic image and exposing the patient to radiation from the x-ray source. Alternatively, at <NUM>, based on the determination of the position analysis module that the patient is improperly positioned, the display device displays a selection for the practitioner to interrupt the diagnostic image. The input is received and in response the imaging module may be interrupted prior to activating and exposing the patient to radiation from the x-ray source.

<FIG> illustrate a comparison between diagnostic (<FIG>) and pre-diagnostic (<FIG>) images of a breast. As can be seen within <FIG>, the diagnostic image includes greater detail, and a clear view of the breast. As can be seen within <FIG>, the pre-diagnostic image includes significantly less detail, due in part, to a significantly lower level of radiation used to generate the image. A significant reduction in radiation may lead to pre-diagnostic images with increased noise and reduced contrast when compared to diagnostic images, which can be seen in the comparison of <FIG>.

<FIG> illustrates an article of manufacture according to an embodiment. Storage medium <NUM> may comprise any computer-readable storage medium or machine-readable storage medium, such as an optical, magnetic or semiconductor storage medium. In some embodiments, storage medium <NUM> may comprise a non-transitory storage medium. In various embodiments, storage medium <NUM> may comprise an article of manufacture. In some embodiments, storage medium <NUM> may store computer-executable instructions, such as computer-executable instructions to implement logic flow <NUM>, for example. Examples of a computer-readable storage medium or machine-readable storage medium may include any tangible media capable of storing electronic data, including volatile memory or non-volatile memory, removable or non-removable memory, erasable or non-erasable memory, writeable or re-writeable memory, and so forth. Examples of computer-executable instructions may include any suitable type of code, such as source code, compiled code, interpreted code, executable code, static code, dynamic code, object-oriented code, visual code, and the like. The embodiments are not limited to these examples.

<FIG> illustrates a block diagram of a centralized system <NUM>. The centralized system <NUM> may implement some or all of the structure and/or operations for the web services system <NUM> in a single computing entity, such as entirely within a single device <NUM>.

The device <NUM> may comprise any electronic device capable of receiving, processing, and sending information for the web services system <NUM>. Examples of an electronic device may include without limitation an imaging system, client device, a personal digital assistant (PDA), a mobile computing device, a smart phone, a cellular telephone, ebook readers, a messaging device, a computer, a personal computer (PC), a desktop computer, a laptop computer, a notebook computer, a netbook computer, a handheld computer, a tablet computer, a server, a server array or server farm, a web server, a network server, an Internet server, a work station, a network appliance, a web appliance, a distributed computing system, multiprocessor systems, processor-based systems, consumer electronics, programmable consumer electronics, game devices, television, set top box, wireless access point, base station, subscriber station, mobile subscriber center, radio network controller, router, hub, gateway, bridge, switch, machine, or combination thereof.

The device <NUM> may execute processing operations or logic for the web services system <NUM> using a processing component <NUM>. The processing component <NUM> may comprise various hardware elements, software elements, or a combination of both. Examples of hardware elements may include devices, logic devices, components, processors, microprocessors, circuits, processor circuits, circuit elements (e.g., transistors, resistors, capacitors, inductors, and so forth), integrated circuits, application specific integrated circuits (ASIC), programmable logic devices (PLD), digital signal processors (DSP), field programmable gate array (FPGA), memory units, logic gates, registers, semiconductor device, chips, microchips, chip sets, and so forth. Examples of software elements may include software components, programs, applications, computer programs, application programs, system programs, software development programs, machine programs, operating system software, middleware, firmware, software modules, routines, subroutines, functions, methods, procedures, software interfaces, application program interfaces (API), instruction sets, computing code, computer code, code segments, computer code segments, words, values, symbols, or any combination thereof. Determining whether an embodiment is implemented using hardware elements and/or software elements may vary in accordance with any number of factors, such as desired computational rate, power levels, heat tolerances, processing cycle budget, input data rates, output data rates, memory resources, data bus speeds and other design or performance constraints, as desired for a given implementation.

The device <NUM> may execute communications operations or logic for the web services system <NUM> using communications component <NUM>. The communications component <NUM> may implement any well-known communications techniques and protocols, such as techniques suitable for use with packet-switched networks (e.g., public networks such as the Internet, private networks such as an enterprise intranet, and so forth), circuit-switched networks (e.g., the public switched telephone network), or a combination of packet-switched networks and circuit-switched networks (with suitable gateways and translators). The communications component <NUM> may include various types of standard communication elements, such as one or more communications interfaces, network interfaces, network interface cards (NIC), radios, wireless transmitters/receivers (transceivers), wired and/or wireless communication media, physical connectors, and so forth. By way of example, and not limitation, communication media <NUM>, <NUM> include wired communications media and wireless communications media. Examples of wired communications media may include a wire, cable, metal leads, printed circuit boards (PCB), backplanes, switch fabrics, semiconductor material, twisted-pair wire, co-axial cable, fiber optics, a propagated signal, and so forth. Examples of wireless communications media may include acoustic, radio-frequency (RF) spectrum, infrared and other wireless media.

The device <NUM> may communicate with other devices <NUM>, <NUM> over a communications media <NUM>, <NUM>, respectively, using communications signals <NUM>, <NUM>, respectively, via the communications component <NUM>. The devices <NUM>, <NUM>, may be internal or external to the device <NUM> as desired for a given implementation.

For example, device <NUM> may correspond to a client device such as a phone used by a user. Signals <NUM> sent over media <NUM> may therefore comprise communication between the phone and the web services system <NUM> in which the phone transmits a request and receives a web page or other data in response.

Device <NUM> may correspond to a second user device used by a different user from the first user, described above. In one embodiment, device <NUM> may submit information to the web services system <NUM> using signals <NUM> sent over media <NUM> to construct an invitation to the first user to join the services offered by web services system <NUM>. For example, if web services system <NUM> comprises a social networking service, the information sent as signals <NUM> may include a name and contact information for the first user, the contact information including phone number or other information used later by the web services system <NUM> to recognize an incoming request from the user. In other embodiments, device <NUM> may correspond to a device used by a different user that is a friend of the first user on a social networking service, the signals <NUM> including status information, news, images, contact information, or other social-networking information that is eventually transmitted to device <NUM> for viewing by the first user as part of the social networking functionality of the web services system <NUM>.

<FIG> illustrates a block diagram of a distributed system <NUM>. The distributed system <NUM> may distribute portions of the structure and/or operations for the disclosed embodiments across multiple computing entities. Examples of distributed system <NUM> may include without limitation a client-server architecture, a <NUM>-tier architecture, an N-tier architecture, a tightly-coupled or clustered architecture, a peer-to-peer architecture, a master-slave architecture, a shared database architecture, and other types of distributed systems.

The distributed system <NUM> may comprise a client device <NUM> and a server device <NUM>. In general, the client device <NUM> and the server device <NUM> may be the same or similar to the client device <NUM> as described with reference to <FIG>. For instance, the client system <NUM> and the server system <NUM> may each comprise a processing component <NUM>, <NUM> and a communications component <NUM>, <NUM> which are the same or similar to the processing component <NUM> and the communications component <NUM>, respectively, as described with reference to <FIG>. In another example, the devices <NUM>, <NUM> may communicate over a communications media <NUM> using communications signals <NUM> via the communications components <NUM>, <NUM>.

The client device <NUM> may comprise or employ one or more client programs that operate to perform various methodologies in accordance with the described embodiments. In one embodiment, for example, the client device <NUM> may implement some steps described with respect to <FIG>.

The server device <NUM> may comprise or employ one or more server programs that operate to perform various methodologies in accordance with the described embodiments. In one embodiment, for example, the server device <NUM> may implement some steps described with respect to <FIG>.

<FIG> illustrates an embodiment of an exemplary computing architecture <NUM> suitable for implementing various embodiments as previously described. In one embodiment, the computing architecture <NUM> may comprise or be implemented as part of an electronic device. Examples of an electronic device may include those described herein.

As used in this application, the terms "system" and "component" are intended to refer to a computer-related entity, either hardware, a combination of hardware and software, software, or software in execution, examples of which are provided by the exemplary computing architecture <NUM>. For example, a component can be, but is not limited to being, a process running on a processor, a processor, a hard disk drive, multiple storage drives (of optical and/or magnetic storage medium), an object, an executable, a thread of execution, a program, and/or a computer. By way of illustration, both an application running on a server and the server can be a component. One or more components can reside within a process and/or thread of execution, and a component can be localized on one computer and/or distributed between two or more computers. Further, components may be communicatively coupled to each other by various types of communications media to coordinate operations. The coordination may involve the unidirectional or bi-directional exchange of information. For instance, the components may communicate information in the form of signals communicated over the communications media. The information can be implemented as signals allocated to various signal lines. In such allocations, each message is a signal. Further embodiments, however, may alternatively employ data messages. Such data messages may be sent across various connections. Exemplary connections include parallel interfaces, serial interfaces, and bus interfaces.

As shown in <FIG>, the computing architecture <NUM> comprises a processing unit <NUM>, a system memory <NUM> and a system bus <NUM>. Dual microprocessors, multi-core processors, and other multi-processor architectures may also be employed as the processing unit <NUM>.

Interface adapters may connect to the system bus <NUM> via a slot architecture, for example.

The computing architecture <NUM> may comprise or implement various articles of manufacture. An article of manufacture may comprise a computer-readable storage medium to store logic, as described above with respect to <FIG>.

The computer <NUM> may include various types of computer-readable storage media in the form of one or more lower speed memory units, including an internal (or external) hard disk drive (HDD) <NUM>, a magnetic floppy disk drive (FDD) <NUM> to read from or write to a removable magnetic disk <NUM>, and an optical disk drive <NUM> to read from or write to a removable optical disk <NUM> (e.g., a CD-ROM, DVD, or Blu-ray). The HDD <NUM>, FDD <NUM> and optical disk drive <NUM> can be connected to the system bus <NUM> by a HDD interface <NUM>, an FDD interface <NUM> and an optical drive interface <NUM>, respectively. The HDD interface <NUM> for external drive implementations can include at least one or both of Universal Serial Bus (USB) and IEEE <NUM> interface technologies.

The drives and associated computer-readable media provide volatile and/or nonvolatile storage of data, data structures, computer-executable instructions, and so forth. For example, a number of program modules can be stored in the drives and memory units <NUM>, <NUM>, including an operating system <NUM>, one or more application programs <NUM>, other program modules <NUM>, and program data <NUM>. In one embodiment, the one or more application programs <NUM>, other program modules <NUM>, and program data <NUM> can include, for example, the various applications and/or components to implement the disclosed embodiments.

A user can enter commands and information into the computer <NUM> through one or more wire/wireless input devices, for example, a keyboard <NUM> and a pointing device, such as a mouse <NUM>. Other input devices may include microphones, infra-red (IR) remote controls, radio-frequency (RF) remote controls, game pads, stylus pens, card readers, dongles, finger print readers, gloves, graphics tablets, joysticks, keyboards, retina readers, touch screens (e.g., capacitive, resistive, etc.), trackballs, trackpads, sensors, styluses, and the like. These and other input devices are often connected to the processing unit <NUM> through an input device interface <NUM> that is coupled to the system bus <NUM>, but can be connected by other interfaces such as a parallel port, IEEE <NUM> serial port, a game port, a USB port, an IR interface, and so forth.

A display <NUM> is also connected to the system bus <NUM> via an interface, such as a video adaptor <NUM>. The display <NUM> may be internal or external to the computer <NUM>. In addition to the display <NUM>, a computer typically includes other peripheral output devices, such as speakers, printers, and so forth.

When used in a WAN networking environment, the computer <NUM> can include a modem <NUM>, or is connected to a communications server on the WAN <NUM>, or has other means for establishing communications over the WAN <NUM>, such as by way of the Internet. The modem <NUM>, which can be internal or external and a wire and/or wireless device, connects to the system bus <NUM> via the input device interface <NUM>. In a networked environment, program modules depicted relative to the computer <NUM>, or portions thereof, can be stored in the remote memory/storage device <NUM>. It will be appreciated that the network connections shown are exemplary and other means of establishing a communications link between the computers can be used.

The computer <NUM> is operable to communicate with wire and wireless devices or entities using the IEEE <NUM> family of standards, such as wireless devices operatively disposed in wireless communication (e.g., IEEE <NUM> over-the-air modulation techniques). This includes at least Wi-Fi (or Wireless Fidelity), WiMax, and Bluetooth™ wireless technologies, among others. Thus, the communication can be a predefined structure as with a conventional network or simply an ad hoc communication between at least two devices. Wi-Fi networks use radio technologies called IEEE <NUM>. 11x (a, b, g, n, etc.) to provide secure, reliable, fast wireless connectivity. A Wi-Fi network can be used to connect computers to each other, to the Internet, and to wire networks (which use IEEE <NUM>-related media and functions).

<FIG> illustrates a block diagram of an exemplary communications architecture <NUM> suitable for implementing various embodiments as previously described. The communications architecture <NUM> includes various common communications elements, such as a transmitter, receiver, transceiver, radio, network interface, baseband processor, antenna, amplifiers, filters, power supplies, and so forth. The embodiments, however, are not limited to implementation by the communications architecture <NUM>.

As shown in <FIG>, the communications architecture <NUM> comprises includes one or more clients <NUM> and servers <NUM>. The clients <NUM> may implement the client device <NUM>, for example. The servers <NUM> may implement the server device <NUM>, for example. The clients <NUM> and the servers <NUM> are operatively connected to one or more respective client data stores <NUM> and server data stores <NUM> that can be employed to store information local to the respective clients <NUM> and servers <NUM>, such as cookies and/or associated contextual information.

The clients <NUM> and the servers <NUM> may communicate information between each other using a communication framework <NUM>. The communications framework <NUM> may implement any well-known communications techniques and protocols. The communications framework <NUM> may be implemented as a packet-switched network (e.g., public networks such as the Internet, private networks such as an enterprise intranet, and so forth), a circuit-switched network (e.g., the public switched telephone network), or a combination of a packet-switched network and a circuit-switched network (with suitable gateways and translators).

The communications framework <NUM> may implement various network interfaces arranged to accept, communicate, and connect to a communications network. A network interface may be regarded as a specialized form of an input output interface. Network interfaces may employ connection protocols including without limitation direct connect, Ethernet (e.g., thick, thin, twisted pair <NUM>/<NUM>/<NUM> Base T, and the like), token ring, wireless network interfaces, cellular network interfaces, IEEE <NUM>. 11a-x network interfaces, IEEE <NUM> network interfaces, IEEE <NUM> network interfaces, and the like. Further, multiple network interfaces may be used to engage with various communications network types. For example, multiple network interfaces may be employed to allow for the communication over broadcast, multicast, and unicast networks. Should processing requirements dictate a greater amount speed and capacity, distributed network controller architectures may similarly be employed to pool, load balance, and otherwise increase the communicative bandwidth required by clients <NUM> and the servers <NUM>. A communications network may be any one and the combination of wired and/or wireless networks including without limitation a direct interconnection, a secured custom connection, a private network (e.g., an enterprise intranet), a public network (e.g., the Internet), a Personal Area Network (PAN), a Local Area Network (LAN), a Metropolitan Area Network (MAN), an Operating Missions as Nodes on the Internet (OMNI), a Wide Area Network (WAN), a wireless network, a cellular network, and other communications networks.

Some embodiments may be described using the expression "one embodiment" or "an embodiment" along with their derivatives. These terms mean that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Further, some embodiments may be described using the expression "coupled" and "connected" along with their derivatives.

With general reference to notations and nomenclature used herein, the detailed descriptions herein may be presented in terms of program procedures executed on a computer or network of computers. These procedural descriptions and representations are used by those skilled in the art to most effectively convey the substance of their work to others skilled in the art.

Further, the manipulations performed are often referred to in terms, such as adding or comparing, which are commonly associated with mental operations performed by a human operator. No such capability of a human operator is necessary, or desirable in most cases, in any of the operations described herein which form part of one or more embodiments. Rather, the operations are machine operations. Useful machines for performing operations of various embodiments include general purpose digital computers or similar devices.

Various embodiments also relate to apparatus or systems for performing these operations. This apparatus may be specially constructed for the required purpose or it may comprise a general purpose computer as selectively activated or reconfigured by a computer program stored in the computer. The procedures presented herein are not inherently related to a particular computer or other apparatus. Various general purpose machines may be used with programs written in accordance with the teachings herein, or it may prove convenient to construct more specialized apparatus to perform the required method steps. The required structure for a variety of these machines will appear from the description given.

In the foregoing Detailed Description, it can be seen that various features are grouped together in a single embodiment for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the claimed embodiments require more features than are expressly recited in each claim. Rather, as the following claims reflect, inventive subject matter lies in less than all features of a single disclosed embodiment. Thus the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separate embodiment. Moreover, the terms "first," "second," "third," and so forth, are used merely as labels, and are not intended to impose numerical requirements on their objects.

Claim 1:
An imaging system (<NUM>), comprising:
an x-ray source (<NUM>) arranged to expose human tissue to radiation at pre-diagnostic dose levels;
an x-ray detector (<NUM>) arranged to detect the radiation;
a pre-diagnostic imaging module (<NUM>) configured to generate a pre-diagnostic image of the human tissue, wherein the pre-diagnostic image is an automated exposure control (AEC) scout image; and
a position analysis module (<NUM>) arranged to receive the pre-diagnostic image and determine whether the human tissue in the pre-diagnostic image is in a predetermined position based upon one or more predefined positioning criteria, wherein the predefined criteria are compared to one or more detected anatomical landmarks,
wherein the imaging system (<NUM>) is configured to automatically interrupt a diagnostic image procedure or to automatically take a diagnostic image based upon the determination of the position analysis module (<NUM>).