CT integrated respiratory monitor

• US 7,182,083 B2
• Filed: 10/25/2002
• Issued: 02/27/2007
• Est. Priority Date: 04/03/2002
• Status: Expired due to Fees

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Inventors: Yanof, Jeffrey H., Johnson, Peter C.
• Primary Examiner(s): Hayes; Michael J.
• Assistant Examiner(s): Mendoza; Michael G.
• Application Number:
  US10/280,626
• Publication Number:
  US 20030188757A1
• Time in Patent Office: 1,586 Days
• Field of Search: 128/204.23, 128/898, 128/916, 600/428, 600/534, 600/443
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/1135 by monitoring thoracic expansion
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: Y10S 128/916 Ultrasound 3-D imaging

Abstract

An integrated respiratory monitor and imaging device apparatus (10) is provided. The apparatus is useful for establishing pre-operative and intra-operative breath hold congruency in patients and for other interventional work. The apparatus (10) includes a respiratory monitor system (12) and an imaging device (14). The respiratory monitor system is adapted to engage a patient and generate a respiratory signal representative of a breath hold level of the patient during a breath hold. The imaging device (14) is adapted to scan the patient during the breath hold and generate a volumetric image data set of the patient. The respiratory sensor and imaging device are operatively connected to associate the respiratory signal representative of the breath hold level of the patient together with the volumetric image data set of the patient. A data storage device (64) is provided for storing a set of respiratory signals in association with a corresponding set of volumetric image data sets in the subject apparatus (10). A scanner gating function is provided to center the image acquisition time at selected points in the respiratory cycle such as at a minimum to minimize motion artifacts in the resultant image.

Claims

1. An apparatus comprising:

a respiratory sensor adapted to generate a respiratory signal representative of breath hold levels of a patient during a breath hold;

an imaging device operatively connected with said respiratory sensor and configured to scan the patient during said breath hold and generate a volumetric image data set of the patient, the imaging device being programmed to record said volumetric image volume data set of the patient and said respiratory signal representative of the breath hold levels of the patent taken at a plurality of points in time during said breath hold; and

,

a breath hold determining circuit receiving said respiratory signal and generating a breath hold sustained signal indicating that said respiratory signal remained within a predetermined range during a predetermined time period, the breath hold sustained signal being associated in said apparatus with said volumetric image data set of the patient.

2. The apparatus according to claim 1 further including:

a human readable patient display device observable by the patient for displaying visual indicia of said breath hold levels.

3. The apparatus according to claim 2 wherein said visual indicia is an animated representation of a physiological structure of said patient.

4. The apparatus according to claim 2 wherein said visual indicia is a bar graph.

5. The apparatus according to claim 1 further including:

a data storage device for storing said volumetric image data set and said data representative of the respiratory signal.

6. The apparatus according to claim 1 further including:

a human readable operator display device observable by an operator of said integrated apparatus for displaying visual indicia of said respiratory signal during said breath hold together with an image of the patient developed from said volumetric image data set based on said volumetric image data set.

7. The apparatus according to claim 6 wherein said visual indicia is a graphical display of said respiratory signal on said operator display device.

8. The apparatus according to claim 1 wherein said breath hold determining circuit is adapted to receive said respiratory signal and generate a breath hold interlock signal when a level of said respiratory signal is within a predetermined range for a said predetermined time period.

9. The apparatus according to claim 8 further including a parameter storage, wherein:

said predetermined range is selectable by an operator of the apparatus based on a percentage of patient vital capacity values set in said parameter storage of the apparatus; and

,

said predetermined time period is selectable by the operator of the apparatus by setting time values in said parameter storage.

10. The apparatus according to claim 8 wherein said predetermined range is 5% vital capacity VC of said patient and said predetermined time period is 2–

4 seconds.

11. The apparatus according to claim 8 further including:

a gating circuit operatively associated with said imaging device and responsive to said breath hold interlock signal to initiate said scan of said patient.

12. The apparatus according to claim 11 wherein:

the apparatus includes a first input for use by an operator of the apparatus to selectively request initiation of a scan of the patient; and

,

the gating circuit is responsive to said first input to initiate said scan only in a presence of said breath hold interlock signal.

13. The apparatus according to claim 8 further including a visual breath hold interlock display to provide an operator of the apparatus with visual indicia that the patient has sustained a breath hold for said predetermined time period at a level within said predetermined range.

14. The apparatus according to claim 1 wherein the respiratory sensor and the imaging device are operatively connected to record substantially the entire respiratory signal during said breath hold.

15. The apparatus according to claim 8 wherein:

said breath hold determining circuit is adapted to change a logical level of said breath hold interlock signal when a level of said respiratory signal is outside of said predetermined range; and

,

said imaging device is adapted to interrupt said scan of the patient in response to said change in said logical level of said breath hold interlock signal.

16. The apparatus according to claim 15 wherein:

said imaging device is adapted to resume said scan of the patient in response to a further change in logical level of said breath hold interlock signal.

17. The apparatus according to claim 8 wherein:

said breath hold determining circuit is adapted to change a logical level of said breath hold interlock signal when a level of said respiratory signal is outside of said predetermined range; and

,

said imaging device is adapted to associate indicia of said change in said logical level of said breath hold interlock signal together with said volumetric image data set of the patient.

18. The apparatus according to claim 1 wherein the respiratory sensor includes a belt worn across the abdomen or chest of the patient, the belt generating said respiratory signal in response to motion of said patient during breathing.

19. The apparatus according to claim 1 wherein the respiratory sensor includes a probe member adapted on a first end to contact the abdomen or chest of the patient and adapted on a second end for operative attachment with said imaging device, the probe member generating said respiratory signal in response to motion of said patient relative to said imaging device during breathing.

20. The apparatus according to claim 1 wherein:

the respiratory sensor and the imaging device are operatively connected to record the respiratory signal taken at said plurality of points in time during said breath hold together with the volumetric image volume data set in a paired relationship.

21. The apparatus according to claim 20 wherein:

the respiratory sensor and the imaging device are operatively connected to record substantially the entire respiratory signal during said breath hold and said volumetric image volume data set in said paired relationship.

22. The apparatus according to claim 1 wherein:

the respiratory sensor and the imaging device are operatively connected to record said respiratory signal taken at said plurality of points of time during substantially the entire breath hold.

23. An apparatus for establishing pre-operative and intra-operative breath hold congruency in patients, the apparatus comprising:

a respiratory sensor generating a first respiratory signal representative of pre-operative breath hold levels of a patient during a pre-operative breath hold and a second respiratory signal representative of intra-operative breath hold levels of the patient during an intra-operative breath hold;

an imaging device operatively connected with said respiratory sensor and configured to scan the patient during said pre-operative breath hold and generate a pro-operative volumetric image data set of the patient, the imaging device being programmed to associate said first respiratory signal representative of the pre-operative breath hold levels of the patient obtained a plurality of times during said breath hold together with said pre-operative volumetric image data set of the patient;

a data storage device for storing first data representative of the first respiratory signal obtained said plurality of times during said breath hold in association with the pre-operative volumetric image data set;

a breath hold determining circuit receiving said first respiratory signal and generating a breath hold interlock signal when a level of said first respiratory signal is within a predetermined range for a predetermined time period, the breath hold determining circuit being adapted to generate a breath hold sustained signal after said predetermined time period indicating that said respiratory signal remained within said predetermined range during said predetermined time period, the breath hold sustained signal being associated in said apparatus with said pre-operative volumetric image data set of the patient; and

,

a human readable display device observable by the patient for displaying first visual indicia of said pre-operative breath hold levels based on said first data from said data storage device, together with second visual indicia of said intra-operative breath hold levels generated by said respiratory sensor.

24. The apparatus according to claim 23 wherein:

said human readable patient display device displays said first visible indicia in a non-moving fashion as a target for said patient, and displays said second visual indicia and a moving image representative of said intra-operative breath hold levels of the patient.

25. The apparatus according to claim 23 wherein said data storage device is adapted to store said first data representative of first respiratory signal and said pre-operative volumetric image data set in a pair relationship.

26. The apparatus according to claim 23 wherein the respiratory sensor and the image device are operatively connected to associate the first respiratory signal representative of the pre-operative breath hold level of the patient obtained a plurality of times substantially during said entire breath hold.

27. An apparatus comprising:

a respiratory sensor configured to generate a respiratory signal representative of a plurality of points of a respiratory cycle of a patient during normal breathing;

an imaging device configured to scan the patient during said normal breathing and generate a volumetric image data set of the patient, the imaging device having a characteristic projection acquisition time interval T and being responsive to a trigger signal to initiate said scan of said patient during said normal breathing; and

,

a processor programmed to calculate an average minimum of said respiratory signal and estimate a time MIN of a next occurrence of said calculated average minimum, the processor generating said trigger signal at a time in said respiratory cycle MIN−

T/2 to substantially center said projection acquisition time interval about said average minimum of said respiratory cycle to minimize motion artifacts in said volumetric image data set.

28. An apparatus comprising:

a respiratory sensor configured to generate a respiratory signal representative of breath hold levels of a patient during a breath hold;

an imaging device configured to scan the patient during said breath hold and generate a volumetric image data set of the patient, the imaging device being programmed to store data of said respiratory signal representative of the breath hold levels of the patent taken a plurality of times during said breath hold with said volumetric image data set of the patient ; and

,

a breath hold determining circuit receiving said respiratory signal and generating a breath hold sustained signal indicating that said respiratory signal remained within a predetermined range during a predetermined time period, the breath hold sustained signal being associated in said apparatus with said volumetric image data set of the patient.

29. The apparatus according to claim 28 further including:

a human readable patient display device observable by the patient for displaying visual indicia of said breath hold levels.

30. The apparatus according to claim 29 wherein said visual indicia is an animated representation of a physiological structure of said patient.

31. The apparatus according to claim 29 wherein said visual indicia is a bar graph.

32. The apparatus according to claim 28 further including:

a data storage device for storing said volumetric image data set paired with said data of the respiratory signal.

33. The apparatus according to claim 28 further including:

a human readable operator display device observable by an operator of said integrated apparatus for displaying visual indicia of said respiratory signal during said breath hold together with an image of the patient developed from said volumetric image data set based on said volumetric image data set.

34. The apparatus according to claim 33 wherein said visual indicia is a graphical display of said respiratory signal on said operator display device.

35. The apparatus according to claim 28 wherein said breath hold determining circuit is adapted to receive said respiratory signal and generate a breath hold interlock signal when a level of said respiratory signal is within said predetermined range for said predetermined time period.

36. The apparatus according to claim 35 further including a parameter storage, wherein:

said predetermined range is selectable by an operator of the integrated apparatus based on a percentage of patient vital capacity values set in said parameter storage of the apparatus; and

,

said predetermined time period is selectable by the operator of the integrated apparatus by setting time values in said parameter storage.

37. The apparatus according to claim 35 wherein said predetermined range is 5% vital capacity VC of said patient and said predetermined time period is 2–

4 seconds.

38. The apparatus according to claim 35 further including:

a gating circuit operatively associated with said imaging device and responsive to said breath hold interlock signal to initiate said scan of said patient.

39. The apparatus according to claim 38 wherein:

the apparatus includes a first input for use by an operator of the apparatus to selectively request initiation of a scan of the patient; and

,

the gating circuit is responsive to said first input to initiate said scan only in a presence of said breath hold interlock signal.

40. The apparatus according to claim 35 further including a visual breath hold interlock display to provide an operator of the apparatus with visual indicia that the patient has sustained a breath hold for said predetermined time period at a level within said predetermined range.

41. The apparatus according to claim 35 wherein:

said breath hold determining circuit is adapted to change the logical level of said breath hold interlock signal when a level of said respiratory signal is outside of said predetermined range; and

,

said imaging device is adapted to interrupt said scan of the patient in response to said change in logical level of said breath hold interlock signal.

42. The apparatus according to claim 41 wherein:

said imaging device is adapted to resume said scan of the patient in response to a further change in logical level of said breath hold interlock signal.

43. The apparatus according to claim 35 wherein:

said breath hold determining circuit is adapted to change the logical level of said breath hold interlock signal when a level of said respiratory signal is outside of said predetermined range; and

,

said imaging device is adapted to associate indicia of said change in logical level of said breath hold interlock signal together with said volumetric image data set of the patient.

44. The apparatus according to claim 28 wherein the respiratory sensor includes a belt worn across the abdomen or chest of the patient, the belt generating said respiratory signal in response to motion of said patient during breathing.

45. The apparatus according to claim 28 wherein the respiratory sensor includes a probe member adapted on a first end to contact the abdomen or chest of the patient and adapted on a second end for operative attachment to said imaging device, the probe member generating said respiratory signal in response to motion of said patient relative to said imaging device during breathing.

46. The apparatus according to claim 28 wherein the respiratory sensor and the imaging device are operatively connected to store data of the respiratory signal representative of the breath hold level of the patient taken a plurality of times during the entire breath hold together with the volumetric image data set of the patient.

47. An apparatus comprising:

a respiratory sensor configured to generate respiratory signals representative of breath hold levels of a patient at a plurality of times during a breath hold;

an imaging device programmed to scan the patient during said breath hold generate a volumetric image data set of the patient, and store;

i) said volumetric image data set of the patient and ii) said respiratory signals representative of said breath hold levels of the patient at said plurality of times during said breath; and

,

a breath hold determining circuit receiving said respiratory signals and generating a breath hold sustained signal indicating that said respiratory signals remained within a predetermined range during a predetermined time period, the breath hold sustained signal being associated in said apparatus with said volumetric image data set of the patient.

48. The apparatus according to claim 47 wherein said breath hold determining circuit is adapted to generate a breath hold interlock signal when a level of said respiratory signals is within said predetermined range for a predetermined time period, and wherein said breath hold determining circuit is adapted to change a logical level of said breath hold interlock signal when a level of said respiratory signals is outside of said predetermined range, said imaging device is adapted to interrupt said scan of the patient in response to said change in said logical level of said breath hold interlock signal, and said imaging device is adapted to resume said scan of the patient in response to a further change in logical level of said breath hold interlock signal.

49. The apparatus according to claim 47 wherein the respiratory sensor includes a one of:

a belt worn across the abdomen or chest of the patient, the belt generating said respiratory signal in response to motion of said patient during breathing; and

a probe member adapted on a first end to contact the abdomen or chest of the patient and adapted on a second end for operative attachment to said imaging device, the probe member generating said respiratory signal in response to motion of said patient relative to said imaging device during breathing.

50. The apparatus according to claim 47 further including:

a data storage storing said respiratory signals and said volumetric image data set of the patient in a paired relationship.

51. The apparatus according to claim 47 wherein the respiratory sensor is adapted to generate said respiratory signals as a plurality of breath hold level data of the patient during substantially the entire breath hold.