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EP-4734850-A1 - MEDICAL SCANNER

EP4734850A1EP 4734850 A1EP4734850 A1EP 4734850A1EP-4734850-A1

Abstract

A medical scanner has a detection system to enable a Valsalva maneuver to be identified. The scanner is controlled to cease the delivery of scanning radiation or cease contrast injection, or else user advice is provided to cease the delivery of scanning radiation or cease contrast injection, in response to detection of a Valsalva maneuver.

Inventors

  • MOTIYAR, Rahul
  • KNOESTER, Jaap
  • SENEGAS, Julien Thomas
  • WEISS, STEFFEN

Assignees

  • Koninklijke Philips N.V.

Dates

Publication Date
20260506
Application Date
20240619

Claims (11)

  1. 1. A medical scanner, comprising: a scanning system; a detection system for generating a detection output; and a processor configured to: interpret the detection output thereby to detect a Valsalva maneuver when present; and provide output instructions advising to cease the delivery of scanning radiation or to cease contrast injection, or control the medical scanner to cease the delivery of scanning radiation or cease contrast injection, in response to detection of a Valsalva maneuver.
  2. 2. The medical scanner of claim 1, wherein the detection system comprises an in-bore camera.
  3. 3. The medical scanner of claim 2, wherein the processor arrangement is configured to interpret signals generated by the in-bore camera to detect one or more of: respiration rate; heart rate; blood pressure; facial expression; and skin tone variation.
  4. 4. The medical scanner of claim 3, wherein the processor arrangement is configured to detect a Valsalva maneuver based on a change of skin tone from a baseline skin tone.
  5. 5. The medical scanner claim 3 or 4, wherein the processor arrangement is configured to detect a Valsalva Maneuver based on a drop of PPG amplitude from a remote PPG signal.
  6. 6. The medical scanner of any one of claims 1 to 5, wherein the processor arrangement is configured to interpret the detection output thereby to detect Valsalva maneuver during a surview, and when detected to generate advisory information for a subsequent clinical scan.
  7. 7. The medical scanner of any one of claims 1 to 5, wherein the processor arrangement is configured to cease delivery of scanning radiation or provide instructions for a scan operator to end the delivery of scanning radiation if a Valsalva maneuver is detected during a contrast scan.
  8. 8. The medical scanner of any one of claims 1 to 5, wherein the processor arrangement is configured to end contrast injection if Valsalva maneuver is detected during a breath hold of a contrast scan.
  9. 9. The medical scanner of any one of claims 1 to 8, further comprising a display for presenting information to a subject while scanning takes place, wherein the processor arrangement is further configured to control the display to present breath hold instructions to the subject.
  10. 10. The medical scanner of any one of claims 1 to 9, wherein the scanning system is a CT scanning system.
  11. 11. The medical scanner of any one of claims 1 to 9, wherein the scanning system is a MRI scanning system.

Description

MEDICAL SCANNER FIELD OF THE INVENTION This invention relates to medical scanners, and in particular relates to detection of the Valsalva maneuver during a scan. BACKGROUND OF THE INVENTION The primary cause for motion artefacts in radiology exams, such as CT scanning using a contrast agent, is the Valsalva maneuver. The Valsalva maneuver is one important factor which causes a transient interruption of contrast (TIC) in the veins and arteries that leads to the need for a repetition of scans or re-injection of the contrast agent. Reappointments will even be needed if there is already enough contrast agent present in the body. The Valsalva maneuver is the forced attempt to expire air against a closed airway, resulting in increased intra-abdominal, intrathoracic, and pharyngeal pressure. This phenomenon of sudden fixating of breathing and tensioning of the chest muscles causes a contrast agent to slow down in the first few seconds and then move too quickly once the a sympathetic response is triggered to loosen up the heart muscles, and blood flow increases. The contrast agent may then be unable to reach the location at the desired time and the radiographer and scanner may then miss the scanning window. This transient interruption of contrast is a common phenomenon in CT pulmonary angiography (CTPA) studies. The contrast opacification of the pulmonary arteries is suboptimal due to an increase in the flow of un-opacified blood from the inferior vena cava (IVC) to the right side of the heart, often during deep inspiration. There are several types of CT exams which are supposed to be performed during a breath hold and without the Valsalva maneuver, such as chest and abdomen CT scans, and scans for cardiac and pulmonary embolism cases. There are also some specific exams which, if conducted during a Valsalva maneuver, can given improved detection and better characterization of anatomy, such as a CT scan of a Hernia, or an ultrasound scan for Vena Cava function. Thus, it is desirable to be able to detect the presence of the Valsalva maneuver, to confirm its presence if it is desired, or take remedial action when it is not desired. SUMMARY OF THE INVENTION The invention is defined by the claims. According to examples in accordance with an aspect of the invention, there is provided a medical scanner, comprising: a scanning system; a detection system for generating a detection output; and a processor configured to: interpret the detection output thereby to detect a Valsalva maneuver when present; and provide output instructions advising to cease the delivery of scanning radiation or to cease contrast injection, or control the medical scanner to cease the delivery of scanning radiation or cease contrast injection, in response to detection of a Valsalva maneuver. This system enables detection of a Valsalva maneuver, and takes appropriate action when detected. At least in some situations, this involves ceasing contrast injection or ceasing imaging (or providing instructions to the operator to do so). In some other situations, it may be appropriate to provide user advice or training. For those CT exams which are supposed to be done during a breath hold but without the Valsalva maneuver, when a Valsalva maneuver is detected, the scan should be stopped and no further contrast agent should be added (so that another scan can be performed without delivering more than a desired amount of contrast agent). In other situations, the Valsalva maneuver may be desired, to help in the detection and better characterization of the anatomy such as for a CT scan of a hernia, or an ultrasound scan for Vena Cava function etc. In those situations, the detection of the Valsalva Maneuver may be detected to confirm its presence. Thus, while one primary use of the system is to cease radiation exposure and contrast injection when the Valsalva maneuver is detected, the detection may be used for other purposes in other use cases of the medical scanner. The detection system for example comprises an in-bore camera. This provides a low cost solution. The processor arrangement may then be configured to interpret signals generated by the in-bore camera to detect one or more of: respiration rate; heart rate; blood pressure; facial expression; and skin tone variation. Thus, the camera may be used to detect various vital signs, and one or more of these may be used to detect a Valsalva maneuver. For example, in a first arrangement the processor arrangement may be configured to detect a Valsalva maneuver based on a change of skin tone from a baseline skin tone. In a second arrangement, the processor arrangement may be configured to detect a Valsalva Maneuver based on a drop of PPG amplitude from a remote PPG signal. In one possible use case, the processor arrangement may be configured to interpret the detection output thereby to detect Valsalva maneuver during a surview, and when detected to generate advisory information for a subsequent clinical scan. In