System for facilitating pathological examination of a lesion in tissue

• US 6,684,092 B2
• Filed: 08/21/1998
• Issued: 01/27/2004
• Est. Priority Date: 02/24/1997
• Status: Expired due to Term

• Current Assignee: Caliber Imaging & Diagnostics, Inc.
• Original Assignee: Lucid Inc.
• Inventors: Zavislan, James M.
• Primary Examiner(s): SHAW, SHAWNA JEANNINE
• Application Number:
  US09/138,115
• Publication Number:
  US 20020010394A1
• Time in Patent Office: 1,985 Days
• Field of Search: 600/407, 600/476, 128/920, 128/922, 382/128, 382/132, 382/133, 382/305, 382/306, 382/195, 382/206, 707/10, 359/368
• US Class Current: 600/407
• CPC Class Codes: A61B 5/0059 using light, e.g. diagnosis by transillumination, diascopy, fluorescence A61B5/0093, A61B5/1455, A61B5/02416 and A61B5/0261 take precedence
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0068 Confocal scanning
• CPC Class Codes: G16H 10/40 for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/922 including image analysis

Abstract

In order to facilitate pathological examination of a lesion in in-vivo tissue, a system and method are provided having a computer system in which both a camera for producing a digital macroscopic picture of the lesion and an imager are coupled to the computer system. The imager is responsive to the computer system and has optics for scanning the lesion to generate images representing microscopic sections of the lesion which provide sufficient information for pathological examination of the lesion. The computer system generates location information, referencing the location in the macroscopic picture of the lesion where the lesion was scanned to the images, and stores data in an electronic file structure which contains at least a representation of the images, a representation of the macroscopic picture, and the location information. The file structure may then be sent to another computer system for viewing the images stored in the file structure to facilitate pathological examination of the lesion by persons trained to interpret such images, adding a diagnostic report about the lesion to the data of the file structure, and sending back the file structure to the computer system that originated it.

Claims

1. A method for facilitating pathological examination of a lesion located in non-histologically prepared tissue comprising the steps of:

producing a macroscopic picture of at least a portion of the lesion in the tissue;

generating images representing optically formed microscopic sections in said lesion or outside said lesion in said non-histologically prepared tissue which provide sufficient information for pathological examination of the lesion;

generating location information referencing a location in said macroscopic picture of one or more of said sections; and

storing data in an electronic file structure which comprises at least a representation of said images, a representation of said macroscopic picture, and said location information.

2. The method according to claim 1 further comprising the steps of:

performing said producing, generating images, generating location information, and storing steps at a first location;

sending said electronic file structure from said first location to a second location; and

receiving and storing said electronic file structure at said second location.

3. The method according to claim 2 further comprising the step of:

performing at said second location a pathological examination of said lesion responsive to said data in said received electronic file structure.

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

adding a diagnostic report about said pathological examination to said data in said electronic file structure at said second location; and

sending said electronic file structure from said second location to said first location after said adding step is carried out.

5. The method according to claim 4 wherein said adding step further comprises adding a digital signature to said diagnostic report to authenticate said diagnostic report.

6. The method according to claim 4 further comprising the step of archiving at said second location said electronic file structure after said adding step is carried out.

7. The method according to claim 2 further comprising the step of sending from said second location to said first location a request for images of additional sections of said lesion.

8. The method according to claim 2 further comprising the steps of:

adding to said data in said electronic file structure at said first location information for checking the integrity of the images stored in said electronic file structure; and

verifying the integrity of the images stored in said electronic file structure at said second location responsive to said information in said electronic file structure for checking the integrity of the images.

9. The method according to claim 2 further comprising the step of selecting the location in said non-histologically prepared tissue of each of said images of said sections at said first location.

10. The method according to claim 9 wherein said selecting step for one or more of said images is performed automatically.

11. The method according to claim 9 wherein said selecting step for one or more of said images is performed manually by a user.

12. The method according to claim 2 further comprising the step of selecting the depth of one or more of said images in said non-histologically prepared tissue at said first location prior to carrying out said generating step.

13. The method according to claim 1 further comprising the step of adding to said data in said electronic file structure information for checking the integrity of the images stored in said electronic file structure.

14. The method according to claim 1 further comprising the step of adding to said data in said electronic file structure information about a patient associated with said lesion.

15. The method according to claim 1 wherein said images represent a standard suite of images of the lesion.

16. The method according to claim 1 wherein said tissue represents one of a naturally exposed surface and a surgically exposed surface of the body of a patient.

17. The method according to claim 1 further comprising the steps of:

storing said electronic file structure as a multiplicity of said file structures at a first location;

sending together said multiplicity of file structures to a second location; and

receiving and storing said multiplicity of file structures at said second location.

18. The method according to claim 17 further comprising the step of:

performing at said second location a pathological examination responsive to the data in at least one of said multiplicity of file structures.

19. The method according to claim 1 wherein said generating images step further comprising the step of imaging separately said tissue for each of said images of said microscopic sections.

20. The method according to claim 19 wherein said generating images step further comprises the step of selecting the location of one or more of said microscopic sections of said tissue prior to carrying out said imaging step for each of said images of said microscopic sections.

21. The method according to claim 1 wherein said generating step further comprises the step of generating images by one of optical coherence tomography or two-photon laser microscopy.

22. An apparatus for facilitating pathological examination of a lesion located in non-histologically prepared tissue comprising:

a computer system;

means coupled to said computer system for producing a digital macroscopic picture of at least a portion of the lesion;

an imager coupled to said computer system for generating images representing optically formed microscopic sections in said lesion or outside said lesion in said non-histologically prepared tissue which provide sufficient information for pathological examination of the lesion; and

said computer system further comprises means for generating location information referencing a location in said macroscopic picture of one or more of said sections, and means for storing data in an electronic file structure which comprises at least a representation of said images, a representation of said macroscopic picture, and said location information.

23. The apparatus according to claim 22 wherein said computer system represents a first computer system, and said apparatus further comprises:

a second computer system;

means for sending said electronic file structure from said first computer system to said second computer system; and

said second computer system further comprises means for receiving and storing said electronic file structure.

24. The apparatus according to claim 23 wherein said second computer system further comprises means for viewing images responsive to said data stored in said electronic file structure to assist in the pathological examination of said lesion.

25. The apparatus according to claim 24 wherein said second computer system further comprises:

means for adding a diagnostic report about the pathological examination to said data in said electronic file structure; and

means for sending said electronic file structure from said second computer system to said first computer system.

26. The apparatus according to claim 25 wherein said adding means further comprises means for adding a digital signature to said diagnostic report to authenticate said diagnostic report.

27. The apparatus according to claim 25 wherein said second computer system further comprises means for archiving said electronic file structure.

28. The apparatus according to claim 23 wherein said second computer system further comprises means for sending from said second computer system to said first computer system a request for images of additional sections of said lesion.

29. The apparatus according to claim 23 wherein:

said storing means of said first computer system further comprises means for storing in the data of the electronic file structure information for checking the integrity of the data representing images in said electronic file structure; and

said second computer system further comprises means for verifying the integrity of the images stored in said electronic file structure responsive to said information in said electronic file structure for checking the integrity of the images.

30. The apparatus according to claim 23 wherein said first computer system further comprises means for selecting the location in said non-histologically prepared tissue of each of said images of said sections in which said selecting means is capable of operation without the aid of said second computer system.

31. The apparatus according to claim 30 wherein said selecting means for one or more of said images is performed automatically by said first computer system.

32. The apparatus according to claim 30 wherein said selecting means for one or more of said images is performed manually by a user using said first computer system.

33. The apparatus according to claim 23 wherein said first computer system further comprises means for selecting the depths of one or more of said images in said non-histologically prepared tissue prior to generating said images and enablement of said sending means.

34. The apparatus according to claim 22 wherein said storing means further comprises means for storing in the data of the electronic file structure information for checking the integrity of the data representing images in said electronic file structure.

35. The apparatus according to claim 22 wherein said storing means further comprises means for storing in the data of the electronic file structure information about a patient associated with said lesion.

36. The apparatus according to claim 22 wherein said images represent a standard suite of confocal images of the lesion.

37. The apparatus according to claim 22 wherein said tissue represents one of a naturally exposed surface and a surgically exposed surface of the body of a patient.

38. The apparatus according to claim 22 wherein said imager is one of a confocal imager, an imager operating by optical coherence tomography, and a two-photon laser microscope.

39. The apparatus according to claim 22 wherein said storing means further comprises means for storing said electronic file structure as a multiplicity of said file structures, said computer system is a first computer system, and said apparatus further comprises:

a second computer system;

means for sending together said multiplicity of file structures to said second computer system; and

said second computer system comprising means for receiving and storing said multiplicity of file structures.

40. The apparatus according to claim 39 further comprising:

means for viewing images responsive to said data stored in at least one of said multiplicity of file structures.

41. The apparatus according to claim 22 further comprising means for positioning the imager with respect to said tissue, wherein said computer further comprises means for enabling the selection of the location of each of said microscopic sections of said lesion in said tissue with said positioning means prior to said imager generating the image of the microscopic section.

42. A system for facilitating pathological examination of a lesion located in tissue comprising:

a computer system;

a confocal imager coupled to said computer system which operates in one mode for scanning different sections of the lesion to generate confocal images representing microscopic sections of said lesion which provide sufficient information for pathological examination of the lesion, and operates in a second mode for producing, responsive to said computer system, a digital macroscopic picture of the lesion; and

said computer system further comprises means for generating location information referencing the location in said macroscopic picture of the lesion to said sections, and means for storing data in an electronic file structure which comprises at least a representation of said confocal images, a representation of said macroscopic picture, and said location information.

43. A method for facilitating pathological examination of a lesion located in non-histologically prepared tissue comprising the steps of:

generating images representing optically formed microscopic sections in said lesion or outside said lesion in said non-histologically prepared tissue in which said images provide first information for pathological examination of the lesion;

producing second information to provide a location of one or more of said images with respect to said tissue; and

storing data which represents said first and second information to provide an electronic file structure.

44. The method according to claim 43 further comprising the step of building an image in accordance with at least said second information which identifies the location in said tissue where each of the images was generated.

45. The method according to claim 44 further comprising the step of generating a picture of the area of the tissue from which said images are generated.

46. The method according to claim 45 further comprising the step of displaying said image built in accordance with at least said second information as an overlay on said picture.

47. The method according to claim 43 further comprising the steps of:

performing said generating, producing, and storing steps at a first location;

sending said electronic file structure from said first location to a second location; and

receiving and storing said electronic file structure at said second location.

48. The method according to claim 47 further comprising the step of:

performing at said second location a pathological examination of said lesion in accordance with said data in said received electronic file structure.

49. The method according to claim 48 further comprising the steps of:

adding a diagnostic report about said pathological examination to said data in said electronic file structure at said second location; and

sending said electronic file structure from said second location to said first location after said adding step is carried out.

50. The method according to claim 49 wherein said adding step further comprises the step of adding a digital signature to authenticate said diagnostic report.

51. The method according to claim 47 further comprising the step of selecting the location in said non-histologically prepared tissue of each of said images of said sections at said first location.

52. The method according to claim 51 wherein said selecting step for one or more of said images is performed automatically.

53. The method according to claim 51 wherein said selecting step for one or more of said images is performed manually by a user.

54. The method according to claim 51 wherein at least one said selected location provides an image inside the lesion.

55. The method according to claim 43 wherein said generating step further comprises the step of scanning the lesion with the aid of confocal optics to generate confocal images representing microscopic sections of said lesion.

56. The method according to claim 43 wherein said images represent a standard suite of images of the lesion.

57. The method according to claim 43 wherein said generating step further comprises the step of imaging separately said tissue for each of said images of said microscopic sections.

58. The method according to claim 57 wherein said generating step further comprises the step of selecting the location of one or more of said microscopic sections of said tissue prior to carrying out said imaging step for each of said images of said microscopic sections.

59. The method according to claim 43 wherein said generating step further comprising the step of generating images by one of optical coherence tomography or two-photon laser microscopy.

60. The method according to claim 43 wherein said step of producing second information is carried out prior to said generating step, and said generating step further comprising generating said images of microscopic sections in accordance with said produced second information to locate where in the tissue each image of the optically formed microscopic section is to be taken.

61. An apparatus for facilitating pathological examination of a lesion located in non-histologically prepared tissue comprising:

a computer system;

an imager coupled to said computer system for generating images representing optically formed microscopic sections in said lesion or outside said lesion in said non-histologically prepared tissue in which said images provide first information for pathological examination of the lesion; and

said computer system further comprises means for producing second information to provide a location of one or more of said images with respect to said tissue, and means for storing data which represents said first and second information to provide an electronic file structure.

62. The apparatus according to claim 61 wherein said computer system represents a first computer system, and said apparatus further comprises:

a second computer system;

means for sending said electronic file structure from said first computer system to said second computer system; and

said second computer system further comprises means for receiving and storing said electronic file structure.

63. The apparatus according to claim 62 wherein said second computer system further comprises means for building an image in accordance with at least said second information which identifies the location in said tissue where each of the images was generated.

64. The apparatus according to claim 63 wherein said second computer system further comprises means for generating a picture of the area of the tissue from which said images are generated.

65. The apparatus according to claim 64 wherein said second computer system further comprises means for displaying said image built in accordance with at least said second information as an overlay on said picture.

66. The apparatus according to claim 62 wherein said second computer system further comprises means for viewing images responsive to said data stored in said electronic file structure to assist in the pathological examination of said lesion.

67. The apparatus according to claim 66 wherein said second computer system further comprises:

means for adding a diagnostic report about the pathological examination to said data in said electronic file structure; and

means for sending said electronic file structure from said second computer system to said first computer system.

68. The apparatus according to claim 67 wherein said adding means further comprises means for adding a digital signature to authenticate the diagnostic report.

69. The apparatus according to claim 62 wherein said first computer system further comprises means for selecting the location in said non-histologically prepared tissue of each of said images of said sections in which said selecting means is capable of operation without the aid of said second computer system.

70. The apparatus according to claim 69 wherein said selecting means for one or more of said images is performed automatically by said first computer system.

71. The apparatus according to claim 69 wherein said selecting means for one or more of said images is performed manually by a user using said first computer system.

72. The apparatus according to claim 69 wherein at least one said selected location provides an image inside the lesion.

73. The apparatus according to claim 62 wherein said first computer system is capable of operation without the aid of the second computer system.

74. The apparatus according to claim 62 wherein said second computer system and said first computer system are at locations different from each other.

75. The apparatus according to claim 61 wherein said image further comprises means for scanning the lesion through confocal optics to generate confocal images representing microscopic sections of said lesion.

76. The apparatus according to claim 61 wherein said images represent a standard suite of images of the lesion.

77. The apparatus according to claim 61 further comprising means for positioning the imager with respect to the tissue, wherein said computer further comprises means for enabling the selection of the location of each of said microscopic sections of said lesion in said tissue with said positioning means prior to said imager generating the image of the microscopic section.

78. The apparatus according to claim 61 further comprising means for positioning the imager, wherein said computer further comprises means for enabling the selection of the location of each of said microscopic sections of said lesion in said tissue with said positioning means prior to said imager generating the image of the microscopic section to provide said first information sufficient for pathological examination, and said positioning means operates to direct said imager to each location in the tissue associated with said second information to generate each said image.

79. A method for facilitating examination of non-histologically prepared tissue comprising the steps of:

producing a macroscopic picture of the tissue;

capturing images of optically formed microscopic sections of said non-histologically prepared tissue which have sufficient information for examination of the tissue;

generating location information referencing the location in said macroscopic picture of the tissue to said sections; and

storing data in an electronic file structure which comprises at least a representation of said images, a representation of said macroscopic picture, and said location information.

80. The method according to claim 79 further comprising the step of selecting the location of one or more of said microscopic sections of said tissue prior to carrying out said capturing step for each of said images of said microscopic sections.

81. The method according to claim 79 wherein said tissue has a lesion.

82. The method according to claim 79 wherein said images are captured in accordance with one of two-photon microscopy, confocal microscopy, and optical coherence tomography to generate images of microscopic sections.

83. A method for facilitating pathological examination of a lesion located in non-histologically prepared tissue comprising the steps of:

generating images representing optically formed microscopic sections in said lesion or outside said lesion in said non-histologically prepared tissue in which said images provide first information for pathological examination of the lesion;

producing second information to provide a location of one or more of said images with respect to said tissue;

storing data representing at least said first and second information, wherein said generating, producing, and storing steps are carried out at a first location;

transferring said data from said first location to a second location;

receiving and storing said data at said second location; and

selecting the depth of one or more of said images in said non-histologically prepared tissue at said first location prior to carrying out said generating step.

84. The method according to claim 83 wherein said transferring step is carried out via one of a network, disk, tape, or CDROM.

85. An apparatus for facilitating pathological examination of a lesion located in non-histologically prepared tissue comprising:

a first computer system;

a second computer system;

an imager coupled to said first computer system for generating images representing optically formed microscopic sections in said lesion or outside said lesion in said non-histologically prepared tissue in which said images provide first information for pathological examination of the lesion;

said first computer system comprises means for producing second information to provide a location of one or more of said images with respect to said tissue, and means for transferring data representing at least said first and second information to said second computer system;

said second computer system comprises means for receiving and storing said data for pathological examination of said lesion; and

said first computer system further comprises means for selecting the depths of one or more of said images in said non-histologically prepared tissue prior to generating said images and enablement of said transferring means.

86. The apparatus according to claim 85 wherein said transferring mean is operative by one of a network, disk, tape, or CDROM.

87. The apparatus according to claim 85 wherein said first computer system is capable of operating independent of said second computer system.

88. A system for facilitating telepathological examination of a lesion in tissue comprising:

a first computer system coupled to a confocal imager which produces through confocal optics confocal images representing optically formed microscopic sections of said lesion and stores the confocal images in at least one file;

a second computer system which enables pathological examination of the lesion represented in the confocal images stored in the file; and

means for transferring the file from said first computer system to said second computer system, wherein said first computer system further comprises means for selecting the location in said tissue of each of said images of said sections capable of operation without the aid of said second computer system.

89. The system according to claim 88 wherein said transferring means further comprises means for delivering the file from said first computer system to said second computer system.

90. The system according to claim 89 wherein said delivering means utilizes an Internet or LAN network.

91. The system according to claim 89 wherein said confocal images are stored in said file with information referencing a location of at least one of said confocal images with respect to said tissue.

92. A system for facilitating telepathological examination of a lesion in tissue comprising:

a first computer system coupled to an imager which operates by one of two-photon laser microscopy and optical coherence tomography to produce images representing microscopic sections of said lesion and stores the images in at least one file;

a second computer system which enables pathological examination of the lesion represented in the images stored in the file; and

means for transferring the file from said first computer system to said second computer system, wherein said first computer system further comprises means for selecting the location in said tissue of each of said images of said sections capable of operation without the aid of said second computer system.

93. The system according to claim 92 wherein said transferring means further comprises means for delivering the file from the first computer system to the second computer system.

94. The system according to claim 93 wherein said delivering means utilizes an Internet or LAN network.

95. The system according to claim 92 wherein said images are stored in said file with information referencing a location of at least one of said images with respect to said tissue.

96. An apparatus for facilitating a pathologist in the telepathological examination of optically sectioned images of a lesion in tissue having a computer system comprising:

means for receiving at least one file storing the optically sectioned images of the lesion representing one or more microscopic sections;

means for viewing the images stored in the file to assist the pathologist in the pathological examination of the lesion in which said viewing means is at a different location separate from a location where the received images were generated and is capable of operating independent of means for generating said images; and

means for enabling the pathologist to generate a diagnostic report of the lesion based on the viewed images.

97. The apparatus according to claim 96 wherein said images represent images taken in accordance with confocal microscopy by scanning of the lesion through confocal optics.

98. The apparatus according to claim 96 wherein said lesion represents one of naturally or surgically exposed tissue.

99. The apparatus according to claim 96 wherein said images are received in said file with information referencing a location of at least one of said images with respect to said tissue.

100. A method for telepathological examination of images of a lesion in tissue generated in accordance with confocal microscopy, two-photon laser microscopy, or optical coherence tomography comprising the steps of:

receiving at least one electronic file storing the images of the lesion representing one or more microscopic sections;

viewing the images stored in the electronic file to assist in the pathological examination of the lesion in which said viewing step is carried out at a different location separate from a location where received imaged were generated and independent of the generation of said images stored in said file; and

generating a diagnostic report of the lesion based on the viewed images.

101. The method according to claim 100 wherein said images are received in said file with information referencing a location of at least one of said images with respect to said tissue.

102. An apparatus for facilitating a pathologist in the telepathological examination of optically sectioned images of a lesion in tissue having a computer system comprising:

means for receiving at least one file storing the optically sectioned images of the lesion representing one or more microscopic sections;

means for viewing the images stored in the file to assist the pathologist in the pathological examination of the lesion in which said viewing means is capable of operating independent of means for generating said images; and

means for enabling the pathologist to generate a diagnostic report of the lesion based on the viewed images, wherein said images represent images of the lesion taken in accordance with one of two-photon laser microscopy or optical coherence tomography.

103. The apparatus according to claim 102 wherein said lesion represents one of naturally or surgically exposed tissue.

104. The apparatus according to claim 102 wherein said images are received in said file with information referencing a location of at least one of said images with respect to said tissue.

105. The apparatus according to claim 102 wherein said viewing means is at a different location separate from a location where the received images were generated.

106. An apparatus for facilitating telepathological examination of a lesion located in non-histologically prepared tissue comprising:

a computer system having information providing the locations in tissue to be imaged;

an imager coupled to said computer system for generating images representing optically formed microscopic sections;

means for positioning said imager in accordance with said information in which said computer system directs said positioning means to position said imager to provide said images of said tissue at each of said locations; and

said computer system further comprising means for transferring data representing at least said information and images to another computer for examination of said lesion.

107. The apparatus according to claim 106 wherein said imager operates in accordance with confocal microscopy.

108. The apparatus according to claim 106 wherein said imager operates in accordance with two-photon laser microscopy or optical coherence tomography.