Search

EP-4312773-B1 - PHYSIOLOGICAL ANALYSIS FROM VIDEO X-RAY IMAGING

EP4312773B1EP 4312773 B1EP4312773 B1EP 4312773B1EP-4312773-B1

Inventors

  • SEHNERT, WILLIAM J.
  • WANG, XIAOHUI
  • VOGELSANG, LEVON O.
  • FOOS, DAVID H.

Dates

Publication Date
20260506
Application Date
20220315

Claims (11)

  1. A method for radiographic imaging of a patient (P) using a radiographic imaging apparatus (10) having a control logic processor (40), an x-ray source (14), and a digital radiographic detector (16), the method comprising: directing radiographic energy from the x-ray source (14) through the patient (P); capturing (S200) a first radiographic image of an anatomy of the patient (P) in the digital radiographic detector (16); storing (S210) image acquisition factors used for capturing the first radiographic image in an electronic memory accessible by the control logic processor (40), the image factors including: an x-ray emission angle of the directed radiographic energy relative to a front surface of the digital radiographic detector (16); a distance between the x-ray source (14) and the digital radiographic detector (16); an x-ray energy value in units of kVp; an x-ray energy value in units of mAs; and a trigger condition related to patient (P) movement, wherein the trigger condition comprises a breathing pattern of the patient (P); capturing (S240) a second radiographic image of the anatomy of the patient (P) by accessing and applying the stored acquisition factors; and displaying or transmitting (S250, S260) a combination of the first and second radiographic images.
  2. The method of claim 1, further comprising storing (S210) a grayscale presentation value as an acquisition factor.
  3. The method of claim 1, further comprising capturing (S200, S240) the first and second radiographic images each during a separate tomographic examination.
  4. The method of claim 1, further comprising measuring a respiratory cycle of the patient (P) and capturing the second radiographic image by timing activation of the x-ray source (14) according to a preselected point of the measured respiratory cycle of the patient (P).
  5. The method of claim 1, further comprising acquiring (S200, S240) a series of radiographic images that each capture a different point in time during a respiratory cycle of the patient (P).
  6. The method of claim 1, further comprising measuring patient (P) inspiration using rib segmentation.
  7. The method of claim 1, further comprising attaching an inclinometer (28) to a patient bed (12) and determining an angular alignment of the x-ray source (14) to the digital radiographic detector (16) using the inclinometer (28).
  8. The method of claim 1, further comprising digitally subtracting (S250) the second captured radiographic image from the first captured radiographic image.
  9. The method of claim 1, further comprising attaching a color depth camera (30) to a collimator (26) of the x-ray source (14), attaching fiducials to a patient bed (12), and determining an angular alignment of the x-ray source (14) in relation to the digital radiographic detector (16) using images of the fiducials captured by the color depth camera (26).
  10. The method of anyone of the preceding claims, wherein the second radiographic image is captured in a subsequent imaging session, and the accessing the stored acquisition factors comprises a step of retrieving (S220) the image acquisition factors
  11. The method of anyone of the preceding claims, further comprising a step of energizing (S230) one or more actuators (22,32), which are configured to suitably position detector (16) and/or to guide the path of radiation from x-ray source (14), to automatically set up the system configuration.

Description

TECHNICAL FIELD The disclosure relates generally to radiographic imaging of the human anatomy and more particularly to solutions for improving consistency of image content used for monitoring and assessment of patient condition. BACKGROUND There are a number of conditions for which radiographic images are particularly effective for revealing patient condition, status, and likely outcome to the clinician. In many instances, for example, patients in the Intensive Care Unit (ICU) who suffer from severe cardio-pulmonary disfunction, such as due to pneumonia or heart failure, are routinely monitored using chest x-rays. Chest x-ray images allow the attending team to evaluate disease progression or response to a course of treatment, as evidenced by lung opacifications. Clinical assessment of changes in the lungs can be obtained by comparing the current x-ray with a recent prior x-ray. As part of this assessment, the clinician can observe changes in opacification between most current and next recent images, and judge how much change there is in the patient condition, with image content evaluated to indicate improvement, worsening, or relative stability. In addition to overall patient condition, the clinician may be further interested in the status of support tubing and related devices. For example, the patient may have various tubing apparatus inserted, such as endotracheal tube, feeding tubing, or central venous catheter. The proper position and functional aspects of such support devices can be observable in the captured images. Further, the clinician may also examine the periodic chest x-ray images for pneumothorax or other evidence of the presence of abnormal air pockets in the chest area. While recently obtained chest x-ray images offer great benefits to the clinician, there are a number of factors with negative impact on evaluation accuracy. These can include: (i) Inconsistent x-ray acquisition geometry. The acquisition geometry for a radiographic image involves the relative alignment of the x-ray tube, the patient, and the x-ray sensing detector. When comparing two chest x-ray images of the same subject taken at different times, positioning differences relating to components of the acquisition system can lead to difficulties in relating anatomic structures to each other and can make it difficult to ascertain the relative arrangement of tubing and support hardware features, as was noted above.(ii) Differences in x-ray acquisition technique. Differences in technique settings, such as set energy (kVp) and intensity (mAs) levels, can significantly change the appearance of conditions such as pneumonia or pulmonary edema and lung disease in general.(iii) Disparity in respiratory phase. Chest x-ray images can be obtained at different phases of respiration, such as full inspiration, full expiration, or some intermediate phase. Assessment of lung opacification requires image acquisition at full inspiration, otherwise spurious basal opacities can cause false positive findings. Pneumothoraces, on the other hand, are more conspicuous where images are acquired at full expiration.(iv) Grayscale variability. Variations in grayscale presentation can confound accurate assessment for x-ray images of the same subject taken at different times or using different equipment. Inconsistent grayscale presentation in chest x-rays complicates the ability to assess changes in lung opacification by the clinician. Grayscale variability can also cause difficulties for automatic image assessment by a software algorithm. It can be appreciated that there is a pressing need for methods that address problems that confound proper interpretation and use of x-ray images taken at different times, particularly for chest x-rays in the ICU environment. US 2003/016850 A1 relates to systems and graphical user interfaces for analyzing body images. A graphical user interface is provided having a display coupled to a microprocessing device and a memory device. The graphical user interface has an electronic representation of a first body image and a second body image and an electronic map representing the position of nodules on the first body image and second body image. US 2011/110496 A1 relates to an integrated portable digital X-ray imaging system and a method for processing a radiographic image of a patient, executed at least in part on a host processor, that initiates exposure in response to an instruction entered from an operator console and obtains radiographic image data from a digital detector that is subjected to the exposure. The obtained radiographic image data is analyzed according to a set of predefined criteria for diagnostic suitability of the image. One or more results of the diagnostic suitability analysis at the operator console is indicated and a listing of one or more corrective actions at the operator console according to the indicated results is provided. US 2008/310698 A1 discloses an image acquisition, archiving and rendering system