System and method to adaptively control contrast-enhanced diagnostic imaging procedure

• US 8,755,865 B2
• Filed: 05/05/2011
• Issued: 06/17/2014
• Est. Priority Date: 11/22/2006
• Status: Active Grant

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Gonzalez Molezzi, Marcela, McDaniel, Holly Ann, Trevino, Scott Eugene
• Primary Examiner(s): Le, Long V.
• Assistant Examiner(s): HOFFA, ANGELA MARIE
• Application Number:
  US13/101,216
• Publication Number:
  US 20110208046A1
• Time in Patent Office: 1,139 Days
• Field of Search: None
• US Class Current: 600/431
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/027 characterised by the use of a particular data acquisition trajectory, e.g. helical or spiral
• CPC Class Codes: A61B 6/03 Computed tomography [CT] echo-tomography A61B8/14
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/481 involving the use of contrast agent, e.g. microbubbles introduced into the bloodstream analysis of echo signal exploiting properties of a contrast enhancer in devices for short-range imaging with acoustic waves G01S7/52039
• CPC Class Codes: A61B 8/543 involving acquisition triggered by a physiological signal
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/63 for local operation

Abstract

A system and method are provided for determining individualized scan and injection protocols for contrast-enhanced diagnostic imaging. Taking into account parameters specific to the scan subject, injection-related parameters, and scan parameters, the system and method can determine an optimal timing for a scan sequence to begin, to ensure that the scan sequence coincides with a desired contrast enhancement. Some embodiments further provide for real-time triggering of the scan commencement based on bolus tracking, and can adapt the scan and injection protocols in real-time based on monitored dynamic scan subject parameters and/or actual enhancement values determined from image data.

Claims

1. A non-transitory computer-readable storage medium having a set of instructions stored thereon which, when executed by the computer, causes the computer to:

prompt a user to enter patient-specific information for a given scan patient;

prompt a user to select a scan type;

receive bolus tracking data for the given patient from a timing bolus scan;

identify an expected post-delivery peak contrast enhancement period based on the patient-specific information, the scan type, and the bolus tracking data;

provide an individualized scan protocol defining a contrast agent delivery, an x-ray dosage, and scan sequence timing, based upon the patient-specific information, the scan type, and the bolus tracking data;

perform a single dynamic scan session comprising a first scan sequence to acquire image data and a second scan sequence to acquire image data;

wherein, in performing the single dynamic scan session, the instructions further cause the computer to;

trigger commencement of the first scan sequence to acquire image data from a region-of-interest (ROI), the first scan sequence based on the individualized scan protocol;

reconstruct an image from the acquired image data;

update the x-ray dosage to an updated x-ray dosage based on the reconstructed image, the updated x-ray dosage comprising a maximum x-ray dosage to be applied during the single dynamic scan session and coincides with a post-delivery peak contrast enhancement period; and

trigger commencement of the second scan sequence to acquire image data from the ROI, the second scan sequence based on the updated x-ray dosage;

wherein, in updating the x-ray dosage to an updated x-ray dosage, the instructions further cause the computer to;

determine a present enhancement value of a contrast agent based on the reconstructed image;

determine if the present enhancement value of the contrast agent has reached or will reach the expected post-delivery peak contrast enhancement period sooner or later than expected;

if the present enhancement value of the contrast agent has reached or will reach the expected post-delivery peak contrast enhancement period sooner or later than expected, then adjust the x-ray dosage to the updated x-ray dosage; and

if the present enhancement value of the contrast agent has reached the expected post-delivery peak contrast enhancement period at an expected time, then the updated x-ray dosage is the same as the x-ray dosage.

2. The computer-readable storage medium of claim 1 wherein the set of instructions further causes the computer to receive the bolus tracking data as the bolus travels through the given patient.

3. The computer-readable storage medium of claim 2 wherein the set of instructions further causes the computer to trigger commencement of the first scan sequence based upon the bolus tracking data.

4. The computer-readable storage medium of claim 1 wherein the set of instructions further causes the computer to display default contrast agent parameters to a user after entry of the patient-specific information, selection of the scan type, and receipt of the bolus tracking data.

5. The computer-readable storage medium of claim 4 wherein the default contrast agent parameters include the projected post-delivery peak contrast enhancement time.

6. The computer-readable storage medium of claim 4 wherein the instructions further cause the computer to display the contrast agent parameters and a number of scan parameters to the user and prompt the user to confirm the parameters prior to contrast delivery and scan commencement.

7. The computer-readable storage medium of claim 1 wherein the instructions further cause the computer to control a contrast pump to deliver a contrast agent to the patient in accordance with the protocol.

8. The computer readable storage medium of claim 1 wherein, if the present enhancement of contrast has reached or will reach the expected post-delivery peak contrast enhancement period sooner or later than expected, the instructions further cause the computer to adjust at least one of scan parameters and contrast agent parameters in the second scan sequence.

9. The computer readable storage medium of claim 8 wherein, in adjusting at least one of the scan parameters and the contrast agent parameters, the instructions further cause the computer to adjust pitch, or gantry rotation in a CT scan such that a period of maximum x-ray dosage of the CT scan substantially coincides with a peak contrast enhancement value.

10. The computer readable storage medium of claim 8 wherein, in adjusting at least one of the scan parameters and the contrast agent parameters, the instructions further cause the computer to adjust contrast agent flow rate, pressure, or volume to achieve a maximum contrast enhancement value during a period of maximum x-ray dosage of a CT scan.

11. A system control for a diagnostic imaging apparatus comprising:

a user interface adapted to permit a user to enter data specific to a given scan;

a contrast delivery device configured to cause a contrast agent to be delivered to a scan subject;

a data processing module configured to reconstruct an image from scan data; and

a scan protocol module connected to receive data entered by the user on the user interface and programmed to;

identify an expected post-delivery peak contrast enhancement period based on entered data specific to the given scan;

prescribe a scan protocol for a first image acquisition of the given scan to acquire scan data from a region-of-interest (ROI);

reconstruct an image from scan data acquired from the first image acquisition;

determine an enhancement value of the contrast agent in the ROI from the reconstructed image;

determine if the enhancement value of the contrast agent has reached or will reach the expected post-delivery peak contrast enhancement period sooner or later than expected;

if the enhancement value of the contrast agent has not or will not reach the expected post-delivery peak contrast enhancement period sooner or later than expected, then;

adjust an x-ray dosage of the scan protocol the adjusted x-ray dosage comprising a maximum x-ray dosage to be applied during the given scan and coincides with a post-delivery peak contrast enhancement period; and

cause the commencement of a second image acquisition of the given scan to acquire scan data from the ROI, the second image acquisition performed using the adjusted x-ray dosage; and

if the enhancement value of the contrast agent has reached or will reach the expected post-delivery peak contrast enhancement period at the expected peak contrast enhancement period, then do not adjust the x-ray dosage of the scan protocol.

12. The system control of claim 11 wherein the data specific to the given scan includes at least one of a static scan subject parameter and a scan type.

13. The system control of claim 11 wherein the prescribed scan protocol includes a contrast agent delivery protocol.

14. The system control of claim 13 wherein the prescribed scan protocol includes a number of contrast agent delivery protocols corresponding to a number of injection phases of a diagnostic imaging scan.

15. The system control of claim 11 wherein the contrast delivery device includes at least one of an automated contrast injection device to inject the contrast agent and an indicator to inform an operator when to administer the contrast agent.

16. A method for contrast-enhanced diagnostic imaging comprising:

estimating, for a given scan subject, a post-delivery peak contrast agent enhancement period based on a number of subject parameters, a number of contrast agent parameters, and a number of scan parameters of an imaging scan sequence, the imaging scan sequence comprising a single dynamic scan session;

executing the imaging scan sequence comprising a data scan portion timed to coincide with the estimated post-delivery peak contrast agent enhancement period;

controlling administration of a contrast agent via a scan protocol module of a diagnostic imaging system during the imaging scan sequence;

acquiring scan data of a region-of-interest (ROI) of the scan subject during the data scan portion;

reconstructing an image of the ROI of the scan subject based at least on the acquired scan data;

comparing a present enhancement value of the contrast agent with the estimated post-delivery peak contrast agent enhancement period based on the reconstructed image;

if the present enhancement value of the contrast agent has reached or will reach the estimated peak contrast agent enhancement period sooner or later than expected, then;

adapting a first scan parameter of the number of scan parameters of the imaging scan sequence to adjust an x-ray dosage of the imaging scan sequence so as to generate an adapted imaging scan sequence, with the adjusted x-ray dosage to be applied so as to coincide with a post-delivery peak contrast enhancement period;

executing the adapted imaging scan sequence comprising the adapted first scan parameter; and

acquiring scan data of the ROI of the scan subject during the data scan portion of the adapted imaging scan sequence; and

if the present enhancement value of the contrast agent has reached or will reach the post-delivery peak contrast agent enhancement period at the estimated post-delivery peak contrast agent enhancement period, then do not adapt the scan parameters of the imaging scan sequence.

17. The method of claim 16 wherein adapting a first scan parameter to adjust an x-ray dosage of the imaging scan sequence comprises causing a maximum x-ray dosage to be applied during a peak contrast enhancement period of the contrast agent.

18. The method of claim 17 wherein the number of subject parameters include at least one of subject weight, gender, age, height, and body mass index, heart rate, blood pressure, respiratory rate, and timing bolus data.

19. The method of claim 16 wherein the number of contrast agent parameters include at least one of contrast agent type, bolus type, number of injection phases, contrast agent volume, contrast agent flow rate, injection duration, and contrast enhancement duration.