WO2007100262A1 - Method for integration of additional data for increasing the available information during medical imaging - Google Patents

Method for integration of additional data for increasing the available information during medical imaging Download PDF

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Publication number
WO2007100262A1
WO2007100262A1 PCT/NO2007/000088 NO2007000088W WO2007100262A1 WO 2007100262 A1 WO2007100262 A1 WO 2007100262A1 NO 2007000088 W NO2007000088 W NO 2007000088W WO 2007100262 A1 WO2007100262 A1 WO 2007100262A1
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data
images
information
patient
previous
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PCT/NO2007/000088
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French (fr)
Inventor
Reidar Brekken
Toril Haernes
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Sinvent As
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Publication of WO2007100262A1 publication Critical patent/WO2007100262A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
    • A61B8/5238—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for combining image data of patient, e.g. merging several images from different acquisition modes into one image
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4254—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors mounted on the probe

Definitions

  • the present invention relates to a method for simultaneous presentation of a combination of several types of real or simulated data/ images to improve clinical decision making during medical imaging. This system could be useful in clinical practice as well as for educational purposes.
  • medical image diagnostic is performed by using one separate image modality, e.g. CT, MR or ultrasound.
  • the different imaging modalities all have their distinct advantages and drawbacks, and hence they are used in different clinical applications.
  • the quality of each imaging modality is improving, and the number of applications is increasing.
  • New imaging approaches, also based on new imaging principles, are approaching.
  • the available methods for functional imaging based on traditional modalities are increasing.
  • These functional images are generated by extracting more information from the images (as compared to only visualization of structures or anatomy). Because the different modalities are based on different physical principles, they are imaging different properties of the objects and may therefore reveal different information about the potential pathology.
  • Clinical decisions are made by clinicians from different disciplines, e.g. surgeons, radiologists or physicians. As more advanced imaging methods become available, the need for interdisciplinary as well as intra-disciplinary teamwork may be even more critical. This may require tools for improving communication and exchange of information, e.g. between the radiologist, the cardiologist and the (cardiac) surgeon. Also, in smaller hospitals with few experts within each field and few patient cases, experts at external locations may have to be consulted.
  • the present invention provides a method for overcoming these and other disadvantages.
  • the method according to the present invention could also be useful in clinical practice as well as for educational purposes.
  • Fig. 1 shows ultrasound and CT in the same visualization.
  • CT gives a good overview of the anatomy, e.g. bones and contrast enhanced vessels, whereas ultrasound can be used for visualizing the softer tissue and the dynamic properties of the vessels.
  • the present invention is motivated by the recognition that there are lots of images and other complementary information that should be considered for clinical decision making at the time of an examination. The amount of possible information is likely to increase in the future.
  • the invention is any system or device used for integration of one or more imaging modalities, simulated results or other patient, population or model based images for the purpose of assisting decision making during a clinical procedure.
  • the envisioned use of the invention is primarily during diagnostic examinations while using one imaging modality (primarily real-time ultrasound imaging), to simultaneously be able to visualize corresponding and additional information from pre-acquired image/volume data (e.g. ultrasound, MR, PET or CT) and potentially also including some corresponding simulated data (e.g. the combination of ultrasound Doppler images and computational simulations of blood flow).
  • pre-acquired image/volume data e.g. ultrasound, MR, PET or CT
  • some corresponding simulated data e.g. the combination of ultrasound Doppler images and computational simulations of blood flow.
  • other information than patient specific images could be displayed in the same visualization environment, such as anatomical atlas information, population mean images as well as images from patients with typical pathology.
  • the simulated data may include both simulated images as well as functional/ biomedical simulations from cell/molecular level to organ or body functions.
  • the primary focus of the invention is to assist ultrasound imaging during a diagnostic examination by simultaneous visualization of other data.
  • the invention is however not limited to ultrasound being the primary modality of the examination.
  • the examination may include any surgical, interventional or other therapeutic procedure as well as diagnostics.
  • an important application may be to simultaneously visualize results from an earlier examination for comparison during patient follow-up.
  • the system could contain a database with various pathological and healthy cases for reference.
  • Other data such as statistical data (e.g. population means and normal deviations) or anatomical atlases/general models together with theoretic information/knowledge may be part of the system.
  • the system might also integrate any computer-assisted-diagnostic (CAD) tools for helping managing the potentially large amount of available data, and tools for biomechanical modeling and simulation for improved diagnostic capabilities.
  • CAD computer-assisted-diagnostic
  • the visualization can consist of one view with all images fused together or several simultaneous views with separate or fused images. By simultaneous, it is understood that the images need not necessarily be displayed at the exact same time instance, but rather in the same session.
  • the invention may therefore be realized by e.g. using a system which toggles between different images.
  • system is not limited to displaying data on a traditional computer screen.
  • haptics/ tactile devices and visualization methods for enhanced perception or virtual/ augmented reality.
  • the system may be connected to some data storing unit, making the storing and retrieval of visualizations (combined images) easy. Also, the system may have capabilities for connecting to a local or external network for internal or external telecommunication.
  • CT or MR data While performing a real-time ultrasound examination e.g. of the abdominal aorta, if e.g. pre-acquired CT or MR data is available for the patient, the CT or MR data can be visualized simultaneously. The different properties of the modalities can thereby be combined for assisting diagnostic decisions.
  • the CT or MR may be visualized either as 2D slices or 3D surfaces or volumes (it is understood that the data may be of any dimension, also 1D if appropriate, or higher dimensional data including dynamics and various parameterizations).
  • the ultrasound probe would be equipped with a position sensor that is tracked in space in order to decide which part of the CT or MR volume is visualized. All data would have to be registered according to the patient and a common coordinate system.
  • CT or MR data may give a better anatomical image, while ultrasound could be used for examining the functional/ dynamical properties of the aorta.
  • the examination could also include functional images such as Doppler velocity or contrast enhanced ultrasound together with blood-flow simulations (computational fluid dynamics, CFD) performed based on geometry segmented from MR or CT.
  • functional images such as Doppler velocity or contrast enhanced ultrasound together with blood-flow simulations (computational fluid dynamics, CFD) performed based on geometry segmented from MR or CT.
  • the system could be embedded in a virtual reality setting, making the operator able to visualize and interact with the data by using some 3D visualization device and some haptic device. This could e.g. be in order to manually correct segmentation of the aneurysm geometry used for blood- flow computations.
  • the operator e.g. a radiologist could easily communicate with the vascular surgeon or with an external expert for assistance regarding the diagnostic decision. Also, the case may easily be stored for education, documentation, later reference or for patient follow-up.
  • the operating team should have access to the same system for advising and instructing the team and guiding the procedure. Also during the operation the system should be up- dated with any new data, e.g. intra-operative images and positioning of surgical tools.
  • the operator could be repeating the procedure while being able to simultaneously review the earlier examinations (which may have been performed by a different operator). Thereby, he could closely examine the evolution of the pathology, while controlling that the measurements where performed in a comparable manner. E.g. compare the size of the aneurysm. This could improve quality and documentation.
  • the uniqueness of the suggested invention is that relevant data from different imaging modalities can be presented at the time of the examination, thereby improving the basis for clinical decision making.
  • the invention provides the possibility to include other data to further assist the decision. These data may be (but are not limited to) patient journal information, fluid or tissue samples, population based statistics both from healthy subjects and from patients with pathology and simulated and processed data.
  • An important application may be to visualize images from earlier examinations together with new images in order to monitor progress of disease or treatment. Also simulations for predicting the effect of different alternative treatments may be visualized for further supporting the decision making.
  • the suggested invention provides an improved approach to storing and exchanging clinically important information, thereby improving documentation and quality assurance regarding clinical decision making, treatment and follow-up.
  • the invention makes it possible to combine all relevant data and background material, it improves the possibilities of communication and telecommunication to assist in clinical decision making, and to make sure that results from the diagnosis are taken into account in the further treatment and follow-up.
  • the method may simplify storing of diagnostic results for documentation, references, education and for sharing experiences.
  • the invention may improve education as examples may be easily stored, and also because the student can get a more intuitive knowledge of how imaging modalities differ from each other and how they can be combined in an optimal manner.
  • the invention may be integrated in a more or less augmented reality setting, featuring various haptic/tactile and visualization devices that may improve data interpretation, interaction and processing.
  • the invention includes using a haptic device for interaction with data, e.g. surface editing for manual interaction during segmentation of an organ.

Abstract

The present invention relates to a method for improving clinical decision making during medical imaging in patients. The invention comprises using one primary imaging modality, and simultaneously visualizing corresponding and/or additional information from pre-acquired image/volume data in a visualization environment.

Description

Method for integration of additional data for increasing the available information during medical imaging
The present invention relates to a method for simultaneous presentation of a combination of several types of real or simulated data/ images to improve clinical decision making during medical imaging. This system could be useful in clinical practice as well as for educational purposes.
Traditionally, medical image diagnostic is performed by using one separate image modality, e.g. CT, MR or ultrasound. The different imaging modalities all have their distinct advantages and drawbacks, and hence they are used in different clinical applications. The quality of each imaging modality is improving, and the number of applications is increasing. New imaging approaches, also based on new imaging principles, are approaching. Also, the available methods for functional imaging based on traditional modalities are increasing. These functional images are generated by extracting more information from the images (as compared to only visualization of structures or anatomy). Because the different modalities are based on different physical principles, they are imaging different properties of the objects and may therefore reveal different information about the potential pathology.
Clinical decisions are made by clinicians from different disciplines, e.g. surgeons, radiologists or physicians. As more advanced imaging methods become available, the need for interdisciplinary as well as intra-disciplinary teamwork may be even more critical. This may require tools for improving communication and exchange of information, e.g. between the radiologist, the cardiologist and the (cardiac) surgeon. Also, in smaller hospitals with few experts within each field and few patient cases, experts at external locations may have to be consulted.
As the use of medical images is expected to increase across the medical disciplines, the medical students need to learn the different modalities, their benefits and drawbacks and to decide which modality to use. They should learn to exploit the benefits of the different images.
Traditional visualization and input devices, such as computer keyboards and 2D computer screens (more recent research provides possibilities to include some 3D perception to these screens), may not be well suited to display and interact with medical data representations (e.g. images, volumes or processing results such as segmentations or simulations).
The need for handling these challenges may be accelerated by:
- New and more advanced diagnostic tools and processing units, and
- Clinical expectations together with increasing public demands for correct diagnosis and treatment
The present invention provides a method for overcoming these and other disadvantages.
It is the object of the present invention to provide a method for optimizing clinical decision making during medical imaging by presenting a combination of several types of real or simulated data. The method according to the present invention could also be useful in clinical practice as well as for educational purposes.
These and other objects are reached by a method according to the independent claim 1. Further advantageous embodiments and features are reached by methods according to the dependent claims.
In the following, a detailed description of the present invention and non-limiting examples of the present invention.
Fig. 1 shows ultrasound and CT in the same visualization. CT gives a good overview of the anatomy, e.g. bones and contrast enhanced vessels, whereas ultrasound can be used for visualizing the softer tissue and the dynamic properties of the vessels. The present invention is motivated by the recognition that there are lots of images and other complementary information that should be considered for clinical decision making at the time of an examination. The amount of possible information is likely to increase in the future.
This information should be taken advantage of in an optimal and consistent manner. Further, the results (i.e. the basis for the clinical decisions) should be easy to communicate and store for expert assistance, documentation, references, patient follow-up or educational purposes.
The invention is any system or device used for integration of one or more imaging modalities, simulated results or other patient, population or model based images for the purpose of assisting decision making during a clinical procedure.
The envisioned use of the invention is primarily during diagnostic examinations while using one imaging modality (primarily real-time ultrasound imaging), to simultaneously be able to visualize corresponding and additional information from pre-acquired image/volume data (e.g. ultrasound, MR, PET or CT) and potentially also including some corresponding simulated data (e.g. the combination of ultrasound Doppler images and computational simulations of blood flow). Also, other information than patient specific images could be displayed in the same visualization environment, such as anatomical atlas information, population mean images as well as images from patients with typical pathology. By simultaneous visualization of these images, the operator can be provided a better basis for decision making.
The simulated data may include both simulated images as well as functional/ biomedical simulations from cell/molecular level to organ or body functions.
The primary focus of the invention is to assist ultrasound imaging during a diagnostic examination by simultaneous visualization of other data. The invention is however not limited to ultrasound being the primary modality of the examination. Also, the examination may include any surgical, interventional or other therapeutic procedure as well as diagnostics. In addition to visualizing different information about the current state of the patient, an important application may be to simultaneously visualize results from an earlier examination for comparison during patient follow-up.
Also, the system could contain a database with various pathological and healthy cases for reference. Other data, such as statistical data (e.g. population means and normal deviations) or anatomical atlases/general models together with theoretic information/knowledge may be part of the system.
The system might also integrate any computer-assisted-diagnostic (CAD) tools for helping managing the potentially large amount of available data, and tools for biomechanical modeling and simulation for improved diagnostic capabilities.
The visualization can consist of one view with all images fused together or several simultaneous views with separate or fused images. By simultaneous, it is understood that the images need not necessarily be displayed at the exact same time instance, but rather in the same session. The invention may therefore be realized by e.g. using a system which toggles between different images.
Further, the system is not limited to displaying data on a traditional computer screen. We suggest taking into account the potential of using haptics/ tactile devices and visualization methods for enhanced perception or virtual/ augmented reality.
The system may be connected to some data storing unit, making the storing and retrieval of visualizations (combined images) easy. Also, the system may have capabilities for connecting to a local or external network for internal or external telecommunication.
Example
Ultrasound examination of a patient with a suspected dangerous abdominal aortic aneurysm:
• While performing a real-time ultrasound examination e.g. of the abdominal aorta, if e.g. pre-acquired CT or MR data is available for the patient, the CT or MR data can be visualized simultaneously. The different properties of the modalities can thereby be combined for assisting diagnostic decisions. The CT or MR may be visualized either as 2D slices or 3D surfaces or volumes (it is understood that the data may be of any dimension, also 1D if appropriate, or higher dimensional data including dynamics and various parameterizations). In this example, the ultrasound probe would be equipped with a position sensor that is tracked in space in order to decide which part of the CT or MR volume is visualized. All data would have to be registered according to the patient and a common coordinate system. CT or MR data may give a better anatomical image, while ultrasound could be used for examining the functional/ dynamical properties of the aorta.
• Depending on the suspected diagnosis of the patient, in this case an abdominal aortic aneurysm, additional information such as reference images of known dangerous aneurysms, or some population based information may be visualized simultaneously.
• For detailed analysis, the examination could also include functional images such as Doppler velocity or contrast enhanced ultrasound together with blood-flow simulations (computational fluid dynamics, CFD) performed based on geometry segmented from MR or CT.
• The system could be embedded in a virtual reality setting, making the operator able to visualize and interact with the data by using some 3D visualization device and some haptic device. This could e.g. be in order to manually correct segmentation of the aneurysm geometry used for blood- flow computations.
• Because the system would combine all of the available relevant information, the operator e.g. a radiologist could easily communicate with the vascular surgeon or with an external expert for assistance regarding the diagnostic decision. Also, the case may easily be stored for education, documentation, later reference or for patient follow-up.
• During the interventional or surgical procedure, the operating team should have access to the same system for advising and instructing the team and guiding the procedure. Also during the operation the system should be up- dated with any new data, e.g. intra-operative images and positioning of surgical tools.
• During follow-up, the operator could be repeating the procedure while being able to simultaneously review the earlier examinations (which may have been performed by a different operator). Thereby, he could closely examine the evolution of the pathology, while controlling that the measurements where performed in a comparable manner. E.g. compare the size of the aneurysm. This could improve quality and documentation.
The uniqueness of the suggested invention is that relevant data from different imaging modalities can be presented at the time of the examination, thereby improving the basis for clinical decision making. Also, the invention provides the possibility to include other data to further assist the decision. These data may be (but are not limited to) patient journal information, fluid or tissue samples, population based statistics both from healthy subjects and from patients with pathology and simulated and processed data. An important application may be to visualize images from earlier examinations together with new images in order to monitor progress of disease or treatment. Also simulations for predicting the effect of different alternative treatments may be visualized for further supporting the decision making.
The suggested invention provides an improved approach to storing and exchanging clinically important information, thereby improving documentation and quality assurance regarding clinical decision making, treatment and follow-up.
Because the invention makes it possible to combine all relevant data and background material, it improves the possibilities of communication and telecommunication to assist in clinical decision making, and to make sure that results from the diagnosis are taken into account in the further treatment and follow-up.
For the same reason, the method may simplify storing of diagnostic results for documentation, references, education and for sharing experiences. The invention may improve education as examples may be easily stored, and also because the student can get a more intuitive knowledge of how imaging modalities differ from each other and how they can be combined in an optimal manner.
The invention may be integrated in a more or less augmented reality setting, featuring various haptic/tactile and visualization devices that may improve data interpretation, interaction and processing.
Also, the invention includes using a haptic device for interaction with data, e.g. surface editing for manual interaction during segmentation of an organ.

Claims

Claims
1. A method for improving clinical decision making during medical imaging in patients, characterized in using one primary imaging modality, and simultaneously visualizing corresponding and/or additional information from pre-acquired image/volume data in a visualization environment.
2. A method according to claim 1 , characterized in that the corresponding information may be from an earlier examination (any data acquisition procedure and imaging modality) of the same patient for monitoring the progress of disease or treatment.
3. A method according to claim 1 , characterized in also including corresponding simulated data in the same visualization environment.
4. A method according to claim 3, characterized in that the simulated data comprises predictive simulations of the effects of various treatment plans, including no treatment.
5. A method according to claim 1 , characterized in that the primary modality comprises ultrasound imaging and the pre-acquired image/volume data comprises MR, CT, PET and/or ultrasound data.
6. A method according to claim 3, characterized in that the simulated data comprises computational simulations of biomechanics, therein blood flow and material strains and stresses.
7. A method according to any of the previous claims, characterized in that other information than patient specific images is displayed in the same visualization environment.
8. A method according to claim 7, characterized in that the other information comprises patient specific information from patient journals, physiological sensors or fluid/tissue samples, and/or patient independent images based on population mean, anatomic atlas images, normal deviation and normal and pathological reference images.
9. A method according to any of the previous claims, characterized in that a position sensor is used for tracking devices during an examination for displaying images and/or devices correctly relatively to each other in the visualization environment and/or to register the various data to the patient.
10. A method according to any of the previous claims, characterized in that the information in the images themselves are used for displaying images correctly relatively to each other in the visualization environment and/or to register the various data to the patient.
11. A method according to any of the previous claims, characterized in that the information from ultrasound images may be displayed in real time and that the orientation and positioning of the ultrasound probe for imaging slices and/or 3D or 4D data is tracked by a positioning device and visualized in a 3D or 4D map from other pre-acquired images or simulated data of the whole or part of the patient.
12. A method according to claim 9 or 10, characterized in that the imaging and tracking of both the patient and the ultrasound imaging probe is performed in real time and that the real-time position and image information is used for continuous updating of the visualizations of other available images due to motion of the various devices and/or patient/organ motion.
13. A method according to any of the previous claims, characterized in that the combined information is stored for documentation, education, review, input to a reference case-database or other purposes.
14. A method according to any of the previous claims, characterized in that the combined information is used for communication over a computer network.
15. A method according to any of the previous claims, characterized in that the examination may be a simulation performed on a virtual patient (e.g. a mannequin) for training purposes.
16. A method according to claim 7, characterized in that said information comprises data from anatomical atlases, general models, theoretic information/knowledge and/or statistical data.
17. A method according to any of the previous claims, characterized in that the method integrates a computer-assisted- diagnostic (CAD) tool for managing the data, and tools for biomechanical modeling and simulation.
18. A method according to any of the previous claims, characterized in that the visualization consists of one view with all or some of the available images fused together.
19. A method according to any of the claims 1-17, characterized in that the visualization consists of several simultaneous views with separate or fused images.
20. A method according to any of the previous claims, characterized in that the data is displayed on a traditional computer screen.
21. A method according to any of the claims 1 -19, characterized in that the data is displayed on haptics/tactile devices and by means of visualization methods for enhanced perception or virtual/augmented reality.
PCT/NO2007/000088 2006-03-03 2007-03-05 Method for integration of additional data for increasing the available information during medical imaging WO2007100262A1 (en)

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US60/778,412 2006-03-03

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Cited By (2)

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WO2009039391A1 (en) * 2007-09-21 2009-03-26 The Methodist Hospital System Systems, methods and apparatuses for generating and using representations of individual or aggregate human medical data
US11062527B2 (en) 2018-09-28 2021-07-13 General Electric Company Overlay and manipulation of medical images in a virtual environment

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Publication number Priority date Publication date Assignee Title
WO2009039391A1 (en) * 2007-09-21 2009-03-26 The Methodist Hospital System Systems, methods and apparatuses for generating and using representations of individual or aggregate human medical data
US11062527B2 (en) 2018-09-28 2021-07-13 General Electric Company Overlay and manipulation of medical images in a virtual environment

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