Methods and apparatus for performing sonomammography and enhanced X-ray imaging

• US 5,938,613 A
• Filed: 04/11/1997
• Issued: 08/17/1999
• Est. Priority Date: 10/29/1993
• Status: Expired due to Term

• Current Assignee: United States Surgical Corporation (Medtronic Plc)
• Original Assignee: United States Surgical Corporation (Medtronic Plc)
• Inventors: Shmulewitz, Ascher
• Primary Examiner(s): Jaworski, Francis J.
• Application Number:
  US08/843,152
• Time in Patent Office: 858 Days
• Field of Search: 600/443, 600/437, 600/445, 600/417, 600/424, 600/429, 128/915
• US Class Current: 600/461
• CPC Class Codes: A61B 10/0233 Pointed or sharp biopsy instruments
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/00902 transparent or translucent
• CPC Class Codes: A61B 2017/00924 for ultrasonic waves
• CPC Class Codes: A61B 2562/168 Fluid filled sensor housings
• CPC Class Codes: A61B 6/4291 the detector being combined with a grid or grating
• CPC Class Codes: A61B 6/4417 related to combined acquisition of different diagnostic modalities
• CPC Class Codes: A61B 6/502 for diagnosis of breast, i.e. mammography
• CPC Class Codes: A61B 6/5247 combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
• CPC Class Codes: A61B 8/0825 for diagnosis of the breast, e.g. mammography
• CPC Class Codes: A61B 8/4209 by using holders, e.g. positioning frames
• CPC Class Codes: A61B 8/4272 involving the acoustic interface between the transducer and the tissue
• CPC Class Codes: A61B 8/4483 characterised by features of the ultrasound transducer
• CPC Class Codes: A61B 90/17 for soft tissue, e.g. breast-holding devices
• CPC Class Codes: Y10S 128/915 Ultrasound mammography

Abstract

Apparatus is provided that combines mammography equipment with an ultrasonic transducer to generate ultrasonic images of the internal structure of breast tissue that are in geometric registration with a mammogram. The apparatus includes a radiolucent and sonolucent compression plate, and in alternative embodiments, a gantry driven ultrasound transducer or a phased array ultrasonic transducer. Methods are provided for generating a mammogram and a plurality of corresponding ultrasound images without moving the breast between the mammogram exposure and the ultrasound imaging. Methods are also provided for viewing and analyzing the ultrasound images. Apparatus and methods are also provided for enhancing X-ray images obtained from conventional mammographic systems, and with reduced overall X-ray dosage to the patient.

Claims

1. Apparatus for performing an image-guided biopsy of biological tissue, the apparatus comprising:

a sonolucent compression plate against which biological tissue may be immobilized;

an ultrasonic transducer disposed adjacent the compression plate, the ultrasonic transducer generating a plurality of ultrasound images of the biological tissue;

a gantry which movably supports the ultrasonic transducer relative to the compression plate while the biological tissue remains immobilized against the compression plate;

a video display operatively connected to the ultrasonic transducer to display selected images of the plurality of ultrasound images; and

an instrument support mechanism movable relative to the compression plate in correlation with the ultrasonic transducer so that a biopsy may be performed that is guided by ultrasound images generated by the ultrasonic transducer.

2. Apparatus for performing an image-guided biopsy of biological tissue according to claim 1 which further comprises a gel pad acoustically coupled to the ultrasonic transducer.

3. Apparatus for performing an image-guided biopsy of biological tissue according to claim 2 wherein the gel pad is encapsulated in an enclosure.

4. Apparatus for performing an image-guided biopsy of biological tissue according to claim 2 wherein the gel pad includes an adherent surface.

5. Apparatus for performing an image-guided biopsy of biological tissue according to claim 2, wherein the gel pad is configured and dimensioned to conform to the shape of the biological tissue.

6. Apparatus for performing an image-guided biopsy of biological tissue according to claim 1, wherein the gantry includes a carriage which holds the ultrasonic transducer and a motor which moves the carriage laterally in a plane parallel to the compression plate.

7. Apparatus for performing an image-guided biopsy of biological tissue according to claim 1, wherein the instrument support mechanism supports an instrument for contact with the biological tissue laterally relative to the compression plate.

8. Apparatus for performing an image-guided biopsy of biological tissue according to claim 1, wherein the instrument support mechanism includes an instrument guide moveable in correlation with the gantry and an instrument support element disposed on the instrument guide, the instrument support element being movable relative to the instrument guide.

9. Apparatus for performing an image-guided biopsy of biological tissue according to claim 1, which further comprises an acoustic coupling agent supply member disposed in proximity to the ultrasonic transducer.

10. A method of obtaining an ultrasound image of interior features of a biological tissue, comprising a series of steps of:

immobilizing biological tissue with respect to a reference point;

repeatedly scanning and displaying a plurality of ultrasound images of the biological tissue with respect to the reference point by acoustically coupling an ultrasonic transducer to the biological tissue and supporting the ultrasonic transducer with a gantry adapted to mechanically move the ultrasonic scanner in a predetermined pattern;

aligning a biopsy instrument with the ultrasonic transducer so that a portion of the biopsy instrument is visible in at least one ultrasound image; and

maneuvering the biopsy instrument to a desired location within the biological tissue based on the display of at least one ultrasound image.

11. A method of obtaining an ultrasound image of interior features of a biological tissue according to claim 10, wherein the step of immobilizing biological tissue includes compressing the biological tissue with a compression plate.

12. A method of obtaining an ultrasound image of interior features of a biological tissue according to claim 11, wherein the step of immobilizing biological tissue further includes positioning a gel pad relative to the biological tissue and the compression plate to acoustically couple the biological tissue to the ultrasonic scanner.

13. A method of obtaining an ultrasound image of interior features of a biological tissue according to claim 12, wherein the step of immobilizing the biological tissue further includes adhering the gel pad to the biological tissue.

14. A method of obtaining an ultrasound image of interior features of a biological tissue according to claim 12, further comprising the step of supplying an acousting coupling agent to the ultrasonic transducer.