Method of and apparatus for predicting computed tomography contrast enhancement

• US 5,583,902 A
• Filed: 10/06/1995
• Issued: 12/10/1996
• Est. Priority Date: 10/06/1995
• Status: Expired due to Term

• Current Assignee: Bayer Healthcare LLC (Bayer AG)
• Original Assignee: BHB General Partnership, LLC
• Inventors: Bae, Kyongtae T.
• Primary Examiner(s): Porta, David P.
• Assistant Examiner(s): Bruce, David Vernon
• Application Number:
  US08/539,859
• Time in Patent Office: 431 Days
• Field of Search: 364/413.14, 364/413.15, 378/210, 378/4, 378/8, 378/95, 378/98.9, 378/98.11, 378/98.12, 378/901
• US Class Current: 378/8
• CPC Class Codes: A61B 6/507 for determination of haemodynamic parameters, e.g. perfusion CT
• CPC Class Codes: A61M 2005/14292 Computer-based infusion planning or simulation of spatio-temporal infusate distribution
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

A method and apparatus are disclosed for predicting prior to injection an organ specific contrast enhancement in a patient for a preselected contrast injection protocol for pre-determining a computed tomography scan. The invention is preferably implemented in a computer program which creates a mathematical model of human cardiovascular physiology in a hypothetical patient with a specific body habitus subjected to the pre-selected contrast injection protocol. The predicted contrast enhancement is then displayed for operator approval and may be then used to control a CT scanner to perform the scan with the pre-selected injection protocol. The mathematical model includes models of organs and vessels using differential equations to describe mass transport of contrast agent through the cardiovascular system.

Claims

1. A method of scanning a tissue in a patient using computed tomography, said patient having a plurality of patient specific parameters, wherein the tissue to be scanned is enhanced with an intravascularly injected contrast agent, comprising the steps of:

selecting an injection protocol for the contrast agent;

predicting, using a mathematical model, prior to implementing said injection protocol a tissue enhancement level as a function of an elapsed time after injection based on the injection protocol and said patient specific parameters;

determining a set of parameters for an optimum scan based on the predicted tissue enhancement level; and

performing the scan in accordance with the pre-determined set of optimum scan parameters.

2. The method of claim 1 wherein the step of predicting the tissue enhancement level comprises the steps of:

providing a mathematical model which describes contrast agent transport throughout the patient'"'"'s cardiovascular system;

inputting into the mathematical model as said patient specific parameters patient specific information and contrast agent specific information which affects physiological parameters of contrast enhancement; and

using the mathematical model to compute a contrast agent concentration as a function of time.

3. The method of claim 2 wherein the step of providing a mathematical model includes the steps of:

providing a compartmental model of the human cardiovascular system including vessel compartments representing blood vessels and organ compartments representing organs;

assigning at least one differential equation describing contrast agent transport to each vessel compartment; and

assigning at least one differential equation describing contrast agent transport to each organ compartment.

4. The method of claim 3 further comprising the steps of:

assigning a standard input blood flow and a standard vessel volume for each vessel compartment;

assigning a standard input blood flow, a standard capillary volume, and a standard extravascular volume for each organ compartment;

adjusting the standard input blood flow of each vessel compartment and each organ compartment as being proportional to a ratio of cardiac output of the patient to a standard cardiac output; and

adjusting the standard capillary volume and the standard extravascular volume of each organ compartment as being proportional to the ratio of blood volume of the patient to a standard blood volume.

5. The method of claim 4 wherein each organ compartment is further subdivided into a capillary compartment and an extravascular compartment and the step of assigning at least one differential equation to each organ compartment includes assigning at least one differential equation to each capillary compartment and each extravascular compartment.

6. The method of claim 2 wherein the inputting step includes the steps of:

inputting a permeability factor;

inputting a patient habitus;

inputting a patient blood volume;

inputting a patient cardiac output;

inputting a contrast concentration value;

inputting an injection method;

inputting an injection time; and

inputting an injection rate.

7. The method of claim 6 wherein the step of inputting a patient habitus includes inputting the patient'"'"'s age, gender, weight, and height.

8. The method of claim 7 wherein the step of inputting the patient blood volume includes the step of computing the patient'"'"'s blood volume.

9. The method of claim 8 wherein the step of inputting the patient cardiac output includes the steps of calculating a standard cardiac output and adjusting the standard cardiac output proportional to a ratio of a cardiac output of the patient to a standard cardiac output.

10. The method of claim 2 further comprising the steps of:

converting the computed contrast agent concentration into the tissue enhancement level as expressed in computed tomography enhancement units; and

displaying the tissue enhancement level in computed tomography enhancement units as a function of time.

11. A method for predicting a tissue enhancement level as a function of time for a specific tissue in a patient receiving an intravascularly injected contrast agent via a specified injection protocol, said method comprising the steps of:

providing a mathematical model of the cardiovascular system of the patient, said model mathematically describing the transport of said contrast agent through said cardiovascular system,

inputting into said model a plurality of patient specific parameters which impact the transport of said contrast agent,

using said model to calculate a predicted concentration of said contrast agent in said tissue as a function of time in response to said specified injection protocol, and

displaying said predicted contrast agent concentration as a function of time as representative of said tissue enhancement level as a function of time.

12. The method of claim 11 further comprising the step of inputting a set of parameters into said model corresponding to said specified injection protocol, said predicted concentrations being responsive thereto.

13. The method of claim 12 further comprising the step of comparing a minimum threshold value with said tissue enhancement level to thereby determine a start time and time duration of acceptable tissue enhancement level during which a CT scan may be taken.

14. The method of claim 13 wherein said mathematical model comprises a plurality of compartments representative of significant organs and vessels in said cardiovascular system, each of said compartments being characterized by at least one differential equation.

15. The method of claim 14 wherein said mathematical model is embodied in a computer program.

16. A computer being programmed for predicting a structure specific CT enhancement level in a patient for a given patient habitus and a specific contrast injection protocol comprising:

a computer having a memory;

a computer program in said memory, said program having means for accepting patient specific information and contrast specific information which affect physiological parameters of contrast enhancement and means for computing and outputting operator selected organ specific contrast concentration as a function of time.

17. The computer of claim 16 wherein the means for computing organ specific contrast concentration comprises a mathematical compartmental model of the human cardiovascular system including vessel compartments representing blood vessels and organ compartments representing organs;

at least one differential equation describing contrast transport to each vessel compartment; and

at least one differential equation describing contrast transport to each organ compartment.

18. The computer of claim 17 wherein said computer program further comprises:

means for assigning a standard input blood flow and standard vessel volume for each vessel compartment;

means for assigning a standard input blood flow, a standard capillary volume, and a standard extravascular volume for each organ compartment;

means for adjusting the standard input blood flow of each vessel compartment and each organ compartment as being proportional to a ratio of cardiac output of the patient to a standard cardiac output;

means for adjusting the standard capillary volume and the standard extravascular volume of each organ compartment as being proportional to the ratio of blood volume of the patient to a standard blood volume.

19. The computer of claim 18 wherein said computer program further comprises means for further subdividing each organ into a capillary compartment and an extravascular compartment and the step of assigning at least one differential equation to each organ compartment includes assigning at least one differential equation to each capillary compartment and each extravascular compartment.

20. The computer of claim 19 wherein said computer program further comprises means for converting the computed contrast concentration into computed tomography enhancement units and means for displaying the enhancement level of the organ in computed tomography enhancements units as a function of time.

21. A computed tomography machine comprising:

a computed tomography machine;

a computer having a memory connected to said computed tomography machine for controlling its operation; and

a computer program in said computer memory, said computer program having means for predicting a structure specific CT enhancement level in a patient for a given patient habitus and a specific contrast injection protocol.

22. The computed tomography machine of claim 21, wherein said computer program comprises:

means for predicting prior to implementing an injection protocol an organ enhancement level as a function of time elapsed after implementing the injection protocol based on the injection protocol and patient specific parameters;

means for determining an optimum scan start time and scan duration based on the predicted enhancement level; and

means for performing the scan in accordance with the pre-determined scan start time and scan duration.