computing device and method

专利摘要:
COMPUTER DEVICE AND METHODA computing device includes a processor (212) that evaluates at least one digitization parameter of a selected digitization protocol to digitize an individual with an image acquisition system (102) based on a corresponding digitization parameter policy and generates a signal indicating that the scan parameter meets the scan parameter policy.
公开号:BR112012009111A2
申请号:R112012009111-5
申请日:2010-10-19
公开日:2020-08-18
发明作者:Matthew J. Walker；Mark E. Olszewski
申请人:Koninklijke Philips Electronics N.V；
IPC主号:

专利说明:

COMPUTER DEVICE AND METHOD
DESCRIPTION The following description refers, in general, to the image acquisition of an object or individual based on a digitization parameter policy and is described with - particular application the acquisition of image by tomography. computerized (CT). However, it is also amenable to 'other modes of image acquisition.
According to the literature, the acquisition of medical imaging is the largest source of exposure to radiation that can be controlled by the American population, with procedures increasing by 5% to 10% annually, and digitalized tomography (CT) scanning represents about half of the medical radiation incurred by the American population. In addition, studies have demonstrated "significant variability between vendors and institutions, as well as underutilization of existing CT scanning dose reduction technologies. Much of this radiation dose variability, and in particular, overdose to an individual patient was caused by the CT operator through deviations from the institution's standard protocols or recommended by the vendor, lack of knowledge / experience in determining the appropriate use of radiation dose reduction technologies, and sub-ideal selection of scanning parameters. 25 (for example , scanning range, x-ray technique, propagation window, etc.)., In addition, the incidence of 1 multiple or sequential CT scans is also increasing, exposing these patients to a non-insignificant risk associated with radiation doses cumulative.
Unfortunately, the only information available today to the CT operator at the time of scanning are numerical dose indices (for example, the dose index in CT by volume, is 6 dose-length product) that estimates radiation
. which will be issued (exposure) by the CT scanner for a * set of scanning parameters prescribed for O at this exam. Measurements of estimated or absorbed patient-specific radiation dose or OR, as well as measurements of estimated risk (for example, the SJ attributable risk to life time (LAR - “Lifetime Attributable Risk”)) are generally not available in the time of digitization. | In addition, most registered CT technologists have limited knowledge and / or understanding of medical physics to interpret and / or use these dose indices effectively when planning an exam. This knowledge limitation is further disturbed by variations between patients (for example, resulting from various combinations of body habits, age, gender, clinical indication, etc.). In addition, no guidance or training is available to determine the specific patient use of dose reduction technologies. scan of existing CT.
Aspects of the present patent application address the issues referred to above and others.
In one aspect, a computing device includes a processor that evaluates at least one digitization parameter of a digitization protocol selected to digitize an individual with an acquisition system. 25 images based on a corresponding scanning parameter policy and generates a signal indicating the 'fact that the scanning parameter meets the scanning parameter policy.
In another aspect, a method includes receiving, by a processor, at least one digitization parameter from a digitization protocol to digitize an object or individual with an image acquisition system. The method additionally includes receiving at least one scan parameter policy from the processor. The method additionally includes comparing, through a processor, at least one scan parameter with the scan parameter policy. The method additionally includes generating, through the processor, a signal indicating that E has at least one parameter meeting the parameter policy of. scanning.
'In another aspect, a method includes receiving information indicative of a scanning parameter used to scan a patient with an image acquisition system in a facility and determining, from the information received, whether the scanning parameter satisfies a parameter policy scanning for | scanning. The method additionally includes generating a signal | 15 indicative of the determination and provide the signal to a group of Do. reimbursement. The method additionally includes receiving a refund for a cost of the purchase procedure. image based on at least one of the adherence of the scan parameter to the policy or report adherence to the policy to the refund group.
In another aspect, a method includes "receiving information indicating whether a scan parameter used to scan a patient with an image acquisition system at a facility meets a scan parameter policy for 25 scanning and determining a refund amount with based on at least one of 7 adherence of the scan parameter to the policy or reporting adherence to the policy to the refund group, generating a signal indicating the determination.The method additionally includes reimbursing the installation based on the refund value.
In another aspect, a computer-readable storage medium containing instructions which, when MM | 4/32 performed by a computer, cause the computer to perform the acts of: receiving at least one digitization parameter from a selected digitization protocol to digitize an object or individual with an image acquisition system, receiving at least one policy % scan parameter, compare at least one. scan parameter with the 'scan parameter policy, and generate a signal indicating that at least one parameter meets the scan parameter policy.
In another aspect, a scan parameter policy generator for image acquisition includes a processor that generates scan parameter policies for image acquisition that are used with image acquisition systems to determine - suitable scanning protocol parameters for acquire images of patients.
The invention can take shape in various components and component arrangements, and in various stages and stage arrangements. The drawings are for the purpose of illustrating preferred embodiments only and are not to be construed as limiting the invention.
Figure 1 illustrates a digitization protocol and a parameter determiner in connection with a system. 25 image acquisition. Figure 2 illustrates a digitization protocol and an exemplary parameter determiner.
Figures 3A and 3B illustrate an exemplary scan parameter change.
Figure 4 illustrates a method for automatically populating a scanning protocol with scanning parameters, based on a policy.
Figure 5 illustrates a method for suggesting
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H | , | scan parameters for scan parameters | that do not satisfy a policy based on the policy. | Figure 6 illustrates a method for suggesting optimized scanning parameters based on a policy. ç Figure 7 illustrates a method for reimbursing costs. for a policy based image acquisition procedure] based on adherence to a policy. ; Figure 8 illustrates a method for reimbursing costs for an image acquisition procedure based on a 'policy based on reporting information on adherence to: policy. i Figure 9 illustrates a method to guide or Í train operators of image acquisition systems by reimbursing an image acquisition procedure based on - a policy. Figure 1 illustrates an image acquisition system 102 such as a computerized tomography (CT) scanner. The image acquisition system 102 includes a stationary bed 104 and a rotating bed 106, which is rotatably supported by stationary bed 104. The rotating bed 106 rotates around an examination region 108 on a longitudinal or z axis. A radiation source 110, such as a tube. 25 x-rays, is supported and rotates with the rotating bed 106, and emits ionization radiation. A collimator source 112 7 collimates the radiation to form radiation in the form of a fan, wedge or cone that crosses the examination region 108. A matrix of radiation-sensitive detectors 114 detects photons emitted by the radiation source 110 that cross the region of exam 108 and generates projection data indicative of the detected radiation. The array of radiation sensitive detectors 114 includes one or more rows of sensitive photosensitive pixels
. radiation. - A reconstructor 116 reconstructs the projection data. and generates volumetric image data indicative of the region of. exam 108, including any region of an object or individual arranged therein. A support 118, such as an O bed, supports the object or individual in the examination region 108. O. support 118 is movable along the z axis, in coordination with: rotation of the rotating bed 106 to facilitate helical, axial, or other desired scanning paths.
A general purpose computing system serves as an operator console 120, which includes human-readable output devices, such as a screen and / or a | printer, and input devices, such as a keyboard and / or mouse, The software residing on console 120 allows the operator to control the operation of system 102, for example - allowing the operator to select a scanning protocol, set scan parameters scanning protocol, start, pause and end the scan, view and / or manipulate the volumetric image data, and / or otherwise interact with the 102 system. In general, the scanning parameters correspond to values for settings such as KVp, mAS, number of slices, slice width, slope, filtering algorithm, scan duration, FOV - “Field-of-view”. 25 scanning, dose reduction algorithm, etc. A computing device 122 such as a computer, a workstation, or the like, includes a scanning protocol and a parameter determiner
124. The scanning protocol and parameter determiner 124 provides several scanning protocols for selection by a 102 system operator and makes it easy to fill a scanning protocol with appropriate scanning parameters. As more fully described below, in one example,
the scanning protocol and parameter determiner 124 initially fills in, replaces or suggests / recommends, for at least one standard or user-defined scanning parameter that does not meet a scanning parameter policy, a scanning parameter that satisfies. politics. Sensory feedback, such as visual feedback. (for example, colors, flashing, “graphic icons, etc.), 'auditory (for example, a bell, a beep, a song, etc.), and / or tactile (for example, a vibrating mouse) can be used to notify the system operator
102. As such, the digitization protocol and parameter determiner 124 can provide real-time feedback related to adherence to the digitization parameter policy and instructional guidelines for defining digitization parameters that satisfy the policy. . Although computing device 122 is displayed separately from system 102 in Figure 1, it should be appreciated that Ú at least one of the components of the scanning protocol and parameter determiner 124 may be part of console 120. In addition, computing device 122 and the console 120 includes one or more processors for executing one or more executable instructions per computer stored in memory, including instructions for implementing at least one subset of the scanning protocol components and »parameter determiner 124.
Figure 2 illustrates a digitization protocol and 7 exemplary parameter determiner 124.
A protocol selector 202 provides several protocols | scanning for selection by the operator. In realization | 30 illustrated, a protocol bank 204 stores one or more scanning protocols 206, including the provided scanning protocols. A bank of protocol parameter values 208 stores one or more parameter values 210 pr P O "us> y A MOTTA DT TT RT A A A E 2 ... Ó S o 8/32 for scanning protocols in the protocol bank
204. One or more of the 206 protocols may be defined by the vendor, the facility, and / or the clinician. Parameter values 210 for a selected 206 scanning protocol can be based on the type of scan (eg, chest, head, etc.) and / or other information such. such as patient information, including, but not limited to, patient demographics, pathology, previous scans, future scans (eg, post-radiation therapy), scans of other patients, and / or other information.
A protocol parameter validator 212 validates scan parameter values (also called scan parameters in this document) for the selected scan protocol and generates a signal indicating the | - same. In the illustrated embodiment, the parameter validator for | protocol 212 validates the parameters against a predetermined Ú policy. In one case, parameter validation occurs dynamically, in real time, as parameters are configured or defined for the selected scanning protocol. As such, the protocol parameters can be | suggested and / or the protocol can be filled with a set of parameters that satisfy the policy and | then presented to the operator. In addition, each time:. » 25 a parameter is configured or changed, the protocol parameter validator 212 can validate the scan parameters against the policy. As such, the protocol parameter validator 212 can provide relevant information for configuring scan parameters to plan an image acquisition exam or a series of image acquisition exams (including follow-up exams, post-radiation exams, other future exams) at the time of scanning. In some cases, this information can be used to guide and / or train the operator to define appropriate scanning parameters based on various objectives, such as reducing the dose to the patient, optimizing image quality, etc. : 5 When a standard or user-defined parameter. differs from a policy-based parameter, the protocol. scanning and parameter determiner 124 can respond 'in several ways. For example, in one embodiment, Protocol parameter validator 212 automatically updates parameters that do not satisfy the policy by replacing those parameters with parameters that satisfy the policy. With this realization, protocol selector 202 may require confirmation of the change by the authorized team | before allowing the protocol to be used for an imaging procedure. Protocol selector 202 can - indicate such changes in several ways. For example, in one case, the changed parameter is presented in a different color, size, font, etc., which may indicate the change and / or other information, such as a level of urgency. In another case, a graphic, textual and / or verbal message indicating the change is presented to the operator. In yet another case, changes to graphical user interface controls (for example, text boxes, drop-down menus, buttons, scroll bars, etc.) such as changes in color, shape and / or others. 25 changes are used to indicate, emphasize and / or highlight at least one scan parameter that does not] satisfy one or more policies and / or at least one substitute scan parameter that satisfies a policy, replaced by the scan parameter.
In another embodiment, the protocol parameter validator 212 suggests or recommends replacement parameters that do not satisfy the policy. In this embodiment, similarly, the substitution parameter can be.
presented in different color, size, font, etc., a textual and / or verbal message indicating that the suggestion can! be provided, and / or interface controls can be changed: to indicate the suggestion. An operator then accepts or rejects the suggestion. In one case, a parameter suggestion "can only be accepted or rejected by personnel authorized to. Reject and confirm a suggested policy parameter. U acceptance and / or rejection can be done via console 120 and / or otherwise, for example, through check mark, phone, email, page, text message, instant message, web service, etc.
For example, suppose that the protocol parameter validator 212 recommends changing a protocol parameter based on a policy. In this case, the operator, '15 if he has no acceptance / rejection authority, finds | - personnel who have confirmation / rejection authority. These personnel log in to the system and accept or reject the 'recommendation. In another case, the protocol parameter validator 212 sends a signal to a dispatching system, which runs software that sends a notification (for example, page, text message, etc.) to personnel who have acceptance authority / rejection. The shipping system can be part of the image acquisition system 100 or a different system. . 25 The notification can simply indicate that it is | personnel required to accept / reject a recommended scan parameter value. The notification may also include other relevant information such as the particular parameter, the initial parameter value, the recommended parameter value, patient history, and / or other information. The notification may also include other information. In this particular example, notified personnel access a web-based application on a
. computer device (for example, a desktop computer, - a cell phone, etc.) that allows staff to see the. protocol, including initial parameter values and any recommended parameter values, policy, and / or other information. Personnel may use the web-based "* application to accept or reject the recommendation. BR Other information that can be used to validate parameters, provide recommendations, and / or replace scan parameters includes, but is not limited to, information from the patient's state, such as physiological state (eg, heart rate, respiratory rate, blood chemistry, etc.), a physical state (eg, tired, rested, post-radiation therapy, etc.), a emotional state (eg anxious, excited, etc.), and / or another state. In addition, radiation dose information, such as cumulative dose (a cumulative lifetime radiation dose metric) from image acquisition performed and / or dose estimates expected for subsequent exams, etc., can be used to facilitate parameter validation, provide recommendations, and / or replace scanning parameters. radiation dose, automatic scan parameter change or suggestion can be to reduce the voltage in the x-ray tube to 80 kVp, reduce the current in the tube, reduce the scanning duration, switch to a prospectively limited technique, activate 7 a modulation of current in the tube, or another dose reduction algorithm, reduce the field of view of the scan, etc.
It should be appreciated that the change can be made from a standard, defined or policy-based parameter to another policy-based parameter. That is, policy validator 212 can determine that a particular standard or user-defined parameter does not satisfy the policy, and then change the parameter or suggest a parameter that satisfies the policy.
The change may cause another parameter (default parameter, defined or based on policy), which previously satisfied the policy, now% does not satisfy the policy.
In this case, the policy validator. 212 will also change or suggest a replacement parameter for this parameter.
Where more than one change or suggestion exists and / or a change or suggestion causes another parameter to fail validation, a set of rules and / or prioritizations can be used to determine a change in | appropriate parameters.
A policy bank 214 stores scan parameter policies, including, but not limited to, the policy used to validate the parameters of the selected scan + protocol.
In the illustrated embodiment, Policy Bank 214 includes at least one policy based on radiation dose 216. Such policy may indicate suggested protocol parameter values based on the patient's dose range or threshold for a particular entry, a series of scans, a patient, an installation, etc.
Such a policy can optimize or minimize doses to patients for the acquisition of diagnostic quality images.
An example of a dose policy is discussed 1. 25 below.
Other suitable policies include, but are not limited to, a policy based on contrast medium, a policy based on image quality, a policy based on multiple factors, such as policies based on radiation dose and image quality , and / or others.
A contrast-based policy can indicate an injection rate, an injection time for scanning, an injection amount, time between contrast studies,
. etc., for a particular scan, series of. scans in particular, patient in particular, etc. . This information can facilitate digitizing the patient to "generate enhanced images with optimal contrast, or images - during a particular phase of contrast uptake until the fade CG. A policy based on image quality. May indicate suggested protocol parameter values. based on an image noise threshold. A combined policy weighs (for example, uniformly or unevenly) several criteria (for example, dose, image noise, etc.).
A policy generator 218 generates scan policies, including, but not limited to, one or more policies 216 in policy bank 214. The illustrated policy generator 218 can generate scan policies based on multiple inputs, including, but not limited to, limiting 7 to a policy model (for example, a policy model 220 in a 222 model bank), rules (for example, a: rule from a 232 rule bank), radiation dose information in patient history and / or the facility, history of adherence to policies for the patient and / or the facility, operator input (eg, patient identification, demographic data, etc.), and / or other information. A policy can be generated, modified, deleted, etc. automatically, semi-automatically, and / or by .- 25 authorized personnel such as a staff member with appropriate user and / or user group permissions.
'A dose calculator 228 calculates or estimates the patient's radiation dose for a patient based on the scanning parameters. The calculated dose can be stored in a radiation dose storage 230, which can be local and / or remote memory. The radiation dose information can be stored on an individual scan basis for the patient, aggregated over a period of time such as by year, life, etc., for the patient, combined with the radiation dose information of one or more other procedures or modalities (for example, for planning radiation therapy), combined with radiation dose information for another (s) * patient (s), for example, to determine the radiation dose. for a particular facility, an average radiation dose 'for a procedure for one or more facilities, and / or otherwise. The generated radiation dose information includes the history of radiation dose information used by the policy generator 218 to generate policies such as radiation dose based policies. The radiation dose information can also be provided to the console 120, which can present the radiation dose in a human-readable format as a value, one. graphical object, and / or otherwise, in a graphical user interface (GUI - “Graphical User Interface") or similar 'on a screen. As an example, dose information can be displayed using a radiation dose graph with a color gradient, where the color is proportional to the degree of compliance with one or more radiation dose policies or the permissible radiation dose related to one or more specific policies or the permissible radiation dose according to the dose profile .25 radiation.
As additional examples, dose information can be displayed or represented using a graphical radiation dose histogram where the radiation dose with the current scanning parameters is displayed or represented by a position in said histogram, which represents statistics population-based doses for similar procedures. In addition, graphic representations of radiation dose reduction alternatives available on the scanner can be provided, with hints of color coding, checkbox, and / or others indicating that a specific technology is available / unavailable, is appropriate / inappropriate, and / or is enabled / disabled. * The radiation dose can also be used for. prospectively estimate and / or adjust the dose for subsequent imaging procedures by the same or a different patient.
The estimated dose can, similarly, be presented to the system operator.
With “the estimate”, Other dose estimates based on alternative scanning parameters can also be displayed.
A register 224 generates a register with information about the scanning protocol used by system 102. for an image acquisition procedure.
The generated record can include information such as original scanning parameters, scanning parameters defined by the operator, scanning parameters suggested by a policy, current scanning parameters used for the image acquisition procedure, and / or other information.
In the illustrated realization, the generated record includes the history of policy adherence information used - by the policy generator 218.. 25 Additionally or alternatively, the generated record includes the calculated and / or aggregated radiation dose information. 'The recorded information can be used for various purposes such as, but not limited to, quality certification, training, reimbursement, etc. In the illustrated embodiment, the record is stored in a 226 record store, which can be local memory and / or remote.
Monitoring the record may include analyzing time trends for relevant radiation dose parameters, as well as comparisons between scanners, departments, scanning operators, clinical indications, institutions, geographies, etc. This may include monitoring the frequency and / or severity of non-compliance with policies, rules, and / or recommendations / actions. Such information * can be used by pay-for-performance (P4P) systems,. pay-for-reporting (P4R), and / or other systems. As an example, a P4P service can only reimburse (pay) a healthcare provider (for example, a healthcare facility, a doctor, a medical group, etc.) for the image acquisition system based on adherence to a or more policies. Such payment can be all or nothing, depending on adherence, or a graduated system where the reimbursement is proportional to the level of adherence. Such a system can encourage improved quality and efficiency for a health provider in particular - through payment incentives and non-payment disincentives. In contrast, a P4R service may reimburse merely on the basis of reporting compliance. A combination of reporting and adherence can also be used for reimbursement purposes. It should be appreciated that The computing device 122, The scanning protocol and parameter determiner 124, one or more components of it, one or more of the policies, the dose information, the registration, the rules, OS. 25 scanning protocols, and / or the scanning protocol parameters can be individual to a scanner, 'shared between a facility, shared between facilities, etc.
Figures 3A and 3B illustrate an exemplary scan parameter change based on a radiation dose policy. In this example, the scan parameters correspond to the scan duration and the scan field of view (FOV) defined by a scan planning box superimposed on a scout / pilot image. As noted here, the parameter can be performed automatically or suggested for a semi-automatic or manual update. s Figure 3A shows an example of a user-defined cardiac CT scan planning box 302. Note the margin between the user-defined scan planning box 302 and a general anatomical region 304 in which the heart Its located. This margin can be based on standard configurations, an operator trying to ensure that no part of the heart is lost, a sub-ideal protocol (for example, an adult protocol for a child), and / or another reason. Figure 3B shows an updated cardiac CT angiography scan planning box 306. 7 Note that the margin between the scan planning box 306 and region 304 is less than the margin between the original scan planning box 302 and region 304. As a result, the same cardiac coverage can be achieved while reducing the dose to the patient. Clues such as clues 308 can be displayed to make it easier to show the change suggested or made automatically for the scan planning box. Figure 4 illustrates a method for employing a - 25 scan parameter policy to automatically fill in scan parameters for a 'scan protocol. At 402, patient information for a patient scheduled to be digitized is entered on the console
120. At 404, available scanning protocols are presented for selection. In 406, a scanning protocol from the available scanning protocols is selected. At 408, the scanning protocol is filled with standard parameters. In 410, a corresponding scan parameter policy is retrieved. * In 412, recorded information related to. previous image acquisition procedures and / or are obtained, if such information is available. As an example, for a radiation dose policy, deposited doses calculated for previous imaging procedures, estimated doses for future scheduled imaging procedures, lifetime doses, etc., can be obtained. In 414, the standard scanning parameters are evaluated based on the policy and, optionally, on - registered information. For subsequent evaluations of the same protocol, the results of acts 416 and 418 can be taken into account. In 416, scanning parameters that do not satisfy the policy are automatically changed to parameters that satisfy the policy, as described here. The scanning parameters can be changed dynamically, in real time as they are evaluated, and changes can be visually highlighted, so that. 25 operator can see which parameters have been changed and the parameter values.
'In 418, if a change requires acceptance or rejection by authorized personnel, the changes are accepted or rejected by authorized personnel.
At 420, the protocol is used to digitize the patient.
In 422, digitization information is recorded. This may include adding the scanning parameters (eg, standard, initial, user defined, based on policy, etc.) to the above noted record, indicative indications of adherence to the policy, radiation dose information, and / or other information.
Figure 5 illustrates a method for suggesting 7 digitization parameters based on a policy. scanning parameter. 'In 502 to 514 correspond to acts 402 to 414. In 516, scanning parameters are suggested for scanning parameters that do not satisfy the policy.
As noted here, this may include highlighting or otherwise emphasizing the scan parameter values that do not satisfy the policy and / or the scan parameter values displayed on the console screen or other screen. 7 In 518, the operator can continue with the current scan parameter values or change one or more: scan parameter values, for example, according to the suggested scan parameter values.
In 520, the protocol is used to scan the patient.
In 522, digitization protocol information is recorded. . 25 Figure 6 illustrates a method for optimizing scan parameters based on a 'scan parameter' policy.
In 602 to 614 correspond to acts 402 to 414. In 616, the replacement scanning parameters optimized for scanning parameters that satisfy the policy based on the policy are determined based on the policy.
In 618, the optimized replacement scan parameters are displayed via a screen or otherwise. As such, even if a scan parameter satisfies a policy, a different scan parameter may be more suitable for a particular purpose. For example, even if the estimated dose ç for a set of scanning parameters is within. of a range in a dose policy, a different set of scanning parameters can reduce the dose without compromising image quality. Such parameters can be presented to the user.
At 620, the operator can continue with the current scan parameter values or change one or more scan parameter values, for example, according to the suggested scan parameter values.
= In 622, the protocol is used to scan the patient.
In 624, digitization protocol information is recorded.
Figure 7 illustrates a method for reimbursing costs for an image acquisition procedure based on a policy based on adherence to a policy.
In 702, values of scanning parameters used to scan a patient in a unit. 25 health are recorded. In 704, the recorded scanning parameter values are checked against a scanning parameter policy for the installation.
In 706, information indicating the fact that the digitization parameter values satisfy the policy is generated. The information is provided to a refund group.
In 708, the reimbursement group reimburses the installation based on adherence to the policy. In one case, the group of
| | refund refunds the installation only if all scanning parameters have met the policy. In one case, the reimbursement group partially reimburses the installation based on the degree of adherence to the policy. This '5 can be done on an individual scan basis, on a 1' individual patient basis, on a BR aggregate scan basis for the entire facility, and / or on another | base. Figure 8 illustrates a method for reimbursing costs for an image acquisition procedure based on a policy based on reporting policy compliance information. ; In 802, scan parameter values used to scan a patient in a unit | 15 health are recorded. h: In 804, the scan parameter values recorded are checked against a scan parameter policy for the installation. In 806, information indicative of the fact that the values: 20 of digitization parameters satisfy the policy are | generated. The information is provided to a refund group. ! In 808, the reimbursement group reimburses the facility based on reporting adherence to the policy. | Figure 9 illustrates a method for orienting Or. 25 train operators of image acquisition systems.
In 902, digitization parameter values for an image acquisition procedure are provided via a console 120 input device such as a keyboard, mouse, etc. Values can be standard values or user-specified values. t In 904, a scan parameter policy for the image acquisition procedure is recovered. In 906, the digitization parameters entered are for MM ME 22/32 | checked against the scanning parameter policy.
The policy in particular can take patient demographics, history of image acquisition and / or other: information.
At 908, information indicating that a% scan parameter entered does not satisfy the policy is displayed.
. In 910, substitute scan parameters '' for scan parameters that do not meet the policy are displayed.
In 912, optionally, replacement optimized scan parameters for scan parameters that satisfy the policy are displayed.
In 914, a set of scanning parameters for the patient is identified.
In 916, the patient is scanned using the identified set of scanning parameters. In 918, digitization information, including the set of digitization parameters and policy adherence, is recorded.
It should be appreciated that the order of actions in the methods described in this document is not limiting. As such, one or more acts may occur in a different order, including concurrently with one or more acts. In addition, one or more of the acts can be omitted and / or one or more acts can be omitted. 25 added. In addition, the acts can be implemented through computer-readable instructions, which, when executed by a computer processor (s), cause the processor (s) to perform the described acts. In such a case, instructions are stored on a computer-readable storage medium associated with or otherwise accessible to a relevant computer, such as a dedicated workstation, a personal computer, a distributed computing system, the console 120, and / or another computer.
The following illustrates a non-limiting example of a dose-based ionization radiation policy, showing multiple types and sources of data, multiple rules, user permissions, and revision history. * Institution's Radiation dose policy [xS. W.41 1 1.09-221] (Policy.Institution.RadiationDose) 'Data Sources | Politics.National.UnitedStates.DoseRadiation.2011 | 10 Radiation.DoseGuideline.ACR2007 [www.acr.org] Guideline.SCCT.2009 [www.scct.org] InformationECGPatient Manufacturer. Scanner. ScannerInformation '15 Manufacturer. Scanner. Procedure + Manufacturer. Scanner. Scanning Parameters: Institution. Directory. LD AP Institution.RIS Permissions and Roles Institution.Directory.LDAP.User. (“Johnsmitheinstitution.org") = (READ) Institution.Directory.LDAP.User. (“Johnsmitheinstitution.org”) = (READ, WRITE) 2 25 Institution.Directory.LDAP.User. (“Bobthomaseinstitution.org") = (TRANSFER, SYNCHRONIZE]) 'Institution.Directory.LDAP.UserGroup. (“Physical”) = (CREATE-MANAGE, QA) Institution.Directory.LDAP.UserGroup. (“Technologist”) = (USE) Institution.Directory.LDAP.UserGroup. (“Senior Technologist") = (APPROVE) Institution.Directory, .LDAP.UserGroup.
(“Radiologist"]) = (USE, APPROVE) Rules to the CCTA prospective modulation rule and heart rate check If (InfoECG:: HRMedium) LE [65 bpm] * AND (Scanning Parameters.:: Scanning Type) NOTEQ [Perspective trigger] ' AND (Procedure:: Name) EQ [CCTA] AND (RIS :: Clinical Indication) EQ [Coronary Evaluation] Then <DO ALERT:: Operator> <DO GUI HIGHLIGHT Scanning Parameters :: Scanning Type COLOR = RED> <DO STATUS DISPLAY “The patient is a candidate for prospective modulation ”> <DO PREVENT:: Digitization>. End * Emergency department trauma rule] unrestricted If (RIS :: Clinical Indocation) EQ [Trauma]
AND (ScannerInfo:: ScannerLocation) EQ [DeptDeEmergency] Then <DO NOT ALERT:; Operator>. 25 <DO NOT PREVENT:: Scanning> <DO OVERRIDE:: AllRules> o <DO LOG:: Exceptions> End H CCTA scan duration exceeds statistically probable scan duration If (Procedure:: Name) EQ [CCTA] AND (RIS :: Clinical Indication) EQ [Coronary Evaluation] AND (Scanning Parameters:: Scanning Duration) GT [MEAN (Population Scanning DurationCCTA) +
2.0 * STDEV (Population Scan Duration Parameters CCTA)] oR (Scan Parameters :: Scan Duration) GT, 1.2 * [Procedure: Auto-Detect anatomic Duration). Then '<DO HIGHLIGHT GUI Scan Parameters :: Scan Duration COLOR = RED> <DO STATUS DISPLAY “The planned scan duration exceeds the probable anatomical scan duration. Please check "> <DO ADJUST Scanning Parameters:: Scanning Planning Box LENGTH = [MEAN (Population Scanning DurationCCTA) + 7 2.0 * STDEV (Population Scanning DurationCCTA)]> Ú <HIGHLIGHT GUI Scanning Parameters: Scanning Scanning> Scanning Parameters: À The planned dose exceeds the ACR practice guidelines for IE diagnostic reference levels (Procedure:: Name) EQ [BRAINS UNDER CONTRAST]. 25 AND Scanning Parameters:: CTDIvol) GT [ACR207:: DxRefNivel :: CerebralContrast)] 'Then < DO HIGHLIGHT GUI Scanning Parameters :: kVp COLOR = RED> <DO HIGHLIGHT GUI Scanning Parameters :: mAs COLOR = RED> <DO STATUS DISPLAY “The planned scan parameters result in an exposure that exceeds the ACR diagnostic reference level.
Please adjust. “> <DO PREVENT:: Scan> End Switch (Scan Parameters:: ProductDoseLength) 7 Case: LE [200]. <DO GUI SET RDPMETER :: 20% COLOR = GREEN>] Case: GE [950] <DO GUI SET RDPMETER:: 95% COLOR = YELLOW> <DO STATUS DISPLAY “The planned scanning parameters result in radiation exposure close to radiation dose policy.
Check Or adjust the scan parameters. “> DO LOG:: Warning> Case: GT [1000] <DO GUI SET RDPMETER:; 100% COLOR = RED> * <DO STATUS DISPLAY “The planned scanning parameters result in radiation exposure close to the radiation dose policy.
Please adjust the scan parameters or contact the supervisor to replace. ”> <DO PREVENT:: Scan> <DO NOTIFY:: Senior Technologist :; : SMS> End À Policy modification rule. 25 If (UserGroup) EQ [Radiologist] AND Policy.
Self EQ [MODIFY] 'Then <DO NOTIFY:: Physical :: Email> <DO REQUEST:: Physical :: Approval> End Revision History [01/01/2009 12:53:31] Institution.Directory.LDAP.User .
| 27/32 (“billjoneseoinstitution.org") -> CREATE [02/08/2010 18:32:07] Institution .Directory.LDAP.User. ("* Sarasmitheinstitution.org") -> MODIFY Radiation dose policies, such as the example 'It is shown above, can be based on a variety of data types and data sources.
For example, adequate data 'includes, but is not limited to, patient demographics (eg, age, gender, height, weight, body mass index, etc.), patient physiology (eg, heart rate, variability of heartbeat, 'oxygen saturation, etc.), radiosensitivity tables of organs (eg lung, chest, genitalia, orbits, etc.), tables of conversion coefficients specific to organs and / or anatomy (k factors ), "scanning parameters" (eg, tube current, tube voltage, rotation time, scan duration, tilt, field of view, collimation, patient centering, etc.), and / or scanning dose (eg ECG-triggered tube current modulation, automatic current selection, tube current based on body habit, or tube voltage modulation, including z-direction or craniocaudal, angular or transaxial direction, or modulation due or combined tension, prospective ECG modulation, dose modulation based on organs, dynamic z-collimation, adaptive collimation, wedge / bow tie filters, beam filters, etc.). Suitable data sources include, but are not limited to, professional society guidelines (ACR, SCCT, Í 30 AMA, AHA, etc.), industry standards (AAPM, MITA, etc.) and | scientific publications, standard vendor recommendations and protocols, clinical indication (for example, chest pain, suspected pulmonary embolism, suspected stroke
- cerebral, risk factors for a specific disease, etc.),. clinical context (eg trauma, screening, diagnosis, 'follow-up, etc.), history of previous examinations (eg "HIS / RIS / EMR / PACS, etc.) and / or cumulative radiation profile (eg , HIS / RIS / EMR / PACS, etc.), dose records (for example, this exam vs.
The history of the local BR vs. regional / national / world history vs. clinical indication and demographic data, etc.), operator characteristics (eg name, level of experience, past performance, etc.), rights of team members (eg permission to create and / or modify policies, permission to grant / revoke approval to scan, permission to modify scan parameters, permission to scan), and / or image quality measurements (eg, noise index, signal-to-noise ratio, 'carrier-to-noise ratio). Rules, as shown in the policy example above, can include one or more parameters, a comparison (for example, less than, greater than, etc.), one or more corresponding thresholds, and at least one action.
Rules can be combined using logical operations (for example, and, or, no, or exclusive, etc.) and / or other rule (s) (for example, 8 out of 10 rules must be satisfied, etc.). Rules can be prioritized (for example, they must be followed, Or. 25 can be classified in relation to other rules), and / or they can be ordered (for example, you must comply with Rule 1 before 'Rule 2, etc.). Conflicts between one or more rules can be managed during rule generation (that is, during the creation / management of the radiation dose policy). A general structure for a rule is shown below. if (parameter) (comparison) (threshold) then (action)
- else. (other action) "end" switch (parameter) case: (comparison) (threshold) ”(action). case: fcomparison) (threshold) (another action) case: (comparison) (threshold) (another action) otherwise: (another action) end For rules, parameters (for example, absolute or relative continuums, categorical, binary, etc.) ) and / or 7 thresholds (for example, diffuse or absolute, categorical, binary, absolute, or relative continuums) can be used.
Adequate thresholds include, but are not limited to, thresholds where appropriate dose levels can be determined based on clinical indication, prescribed CT procedure, patient-specific demographic data and / or physiological information.
Thresholds can also be defined with guidelines from hospitals and / or local departments by technologists. 25 seniors, physicians, and / or medical physicists, with regional or national quality and regulatory policies / guidelines, and / or: referring dose data from the current population derived from registration of similar population distributions (for example, exceeding 1 relative standard deviation comparative scanning / referral / referral) at a department, local, regional or international level.
Thresholds can take into consideration the anatomy to be digitized and the corresponding radiosensitivity of digitized organs and
| 30/32 history of cumulative radiation exposure levels | specific to the patient derived from EMR, HIS, RIS and PACS, and / or other thresholds. For the rules, actions can be aimed at people (for example, the operator) or the CT system (for example, * automatic update of scanning parameters). Actions . they can include several levels such as “no action” (ie, rule satisfied), “no action required” (ie, rule violated, but only record violation), “recommend action” (ie, oThe operator can further minimize the dose, however it is not necessary to do it), “immediate action necessary to start scanning” (that is, the operator must adjust scanning parameters and / or seek the supervisor's signature before starting the scanning; the scanner will not allow or actively avoid continuation if the rule is not met),. etc. | Exceeding dose thresholds can have varying degrees of '"consequences" related to the clinical context including "none" for trauma to "complete digitalization prevention" until appropriate changes have been made to pediatric bh and / or screening.
If dose reduction technologies on CT scanners are available and appropriate, | however, they were not selected or configured properly; by the technologist, the TC system can automatically change one or more parameters related to said policies, and optionally provide feedback / information to educate the 'user, If a policy allows a user to exceed one or | more parameter thresholds, the system can provide a reason | for a registration prompt, or require second approval | 30 senior technologist and / or resident physician / physicist level because i exceeds the recommended threshold for clinical indication and | patient-specific parameters. | Radiation dose policies can be combined
. and / or nested to create meta-policies with conflicts between | - one or more policies managed during creation and / or Oo. policy management. Radiation dose policies: "can be physically stored on a specific CT scanner console, in a local area and / or; remote network devices, or in any combination.
'In this way, radiation dose profiles can be downloadable and synchronized between scanners and / or institutions. i These policies can exist in proprietary or open source document object models (for example, DICOM, XML, HL7) and transferred using standard protocols (for example, HTTP, FTP, SOAP, etc.). In addition, radiation dose policies can be managed locally or | through network / web service (SMS, text, PDA, etc.). í The radiation dose policy system can | - optionally be connected in quality measurements of | image (IQ), such as noise index, to ensure that the IQ and dose reduction are balanced within a radiation dose policy. In addition, the system can 'also prevent underexposure ("underdose") to ensure the necessary | diagnostic IQ and minimize the potential for repeated scans. In addition, the radiation dose policy system can connect to off-line databases - line capturing reading preferences / 0I of doctors | - 25 learned to define threshold parameters for dose reduction based on preference.
1 Applications include y2 but are not limited to a CT scanner described in this document. Other applications include, but are not limited to, other types of image acquisition that use ionizing radiation (eg, x-rays, fluoroscopy, etc.).
The invention has been described here with reference to the various embodiments. Modifications and changes can occur
- to others when reading this description.
It is intended that a. invention is interpreted to include all such modifications and changes to the extent that they fall within the scope "of the appended claims or the equivalents thereof.

权利要求:
Claims (15)
[1]
1. COMPUTER DEVICE (122), characterized by comprising: a processor (212) that evaluates at least one digitization parameter of a digitization protocol already selected to digitize an individual with an electronic system. image acquisition (102) based on a corresponding scanning parameter policy and generates a signal indicating that the scanning parameter satisfies the scanning parameter policy.
[2]
2. DEVICE (122), according to claim 1, characterized in that the policy includes at least one of a radiation dose policy corresponding to exposure to ionization radiation, a contrast agent policy, or a quality policy of image. -
[3]
DEVICE (122), according to claim 1 or 2, characterized in that the processor (212) validates the: scanning parameter in response to the scanning parameter satisfying a predetermined threshold in the policy.
[4]
4, DEVICE (122) according to any one of claims 1 to 3, characterized in that The processor (212) displays, based on a policy, a suggested substitute scanning parameter that satisfies the policy in. 25 response to the digitization parameter does not satisfy the policy. Í
[5]
5. DEVICE (122) according to any one of claims 1 to 4, characterized in that the processor (212) displays, based on a policy, an optimized replacement scan parameter suggested for a scan parameter that satisfies the policy based on predetermined optimization criteria.
[6]
6. DEVICE (122) according to any one of claims 1 to 5, characterized in that the processor (212) displays, based on a policy, one or more alternative substitute scanning parameters that satisfy the policy.
[7]
7. DEVICE (122) according to any one of claims 1 to 6, characterized in that the processor. (212) automatically replaces, based on the policy, the scan parameter in response to the scan parameter not meeting the policy with a scan parameter that satisfies the policy.
[8]
8. DEVICE (122) according to any one of claims 4 to 7, characterized in that the substitute scanning parameter is used to guide or train a system operator (102).
[9]
DEVICE (122) according to any one of claims 1 to 8, characterized in that it further comprises: Ú a dose calculator (228) that generates and displays a radiation dose value indicative of a radiation dose for the individual based, at least in part, on the digitization parameter.
[10]
10. DEVICE (122), according to claim 9, characterized in that the processor suggests alternative sets of scanning parameters that. 25 reduce the dose deposited based on the policy.
[11]
11. DEVICE (122) according to claim 10, characterized in that each alternative set of digitization parameters is graphically presented with indications indicating a dose reduction value relative to the other of the alternative sets of digitization parameters.
[12]
12. DEVICE (122), according to any one of claims 1 to 11, characterized by additionally comprising: a register (224) that generates a register of digitization parameters used to digitize the individual, in which the register includes indications indicating whether the scanning parameter satisfied the policy and the registration is provided to pay to the enforcement group that uses O% registration to reimburse the cost of scanning based on. adherence to politics. '
[13]
13. DEVICE (122) according to any one of claims 1 to 12, characterized in that the record is provided to a pay-per-report group that uses the record to reimburse the cost of scanning based on reporting adherence to the policy.
[14]
14. DEVICE (122) according to any one of claims 1 to 13, characterized in that it additionally comprises: - a policy generator (218) that generates scanning parameter policies, including the corresponding scanning parameter policy.
[15]
15. METHOD, characterized by understanding the steps of: receiving, by a processor, at least one digitization parameter of a digitization protocol selected to digitize an object or individual with an image acquisition system (102); . 25 receive, by the processor, at least one scanning parameter policy; 1 compare, through the processor, the at least one scanning parameter with the scanning parameter policy; and generate, through the processor, a signal indicating that at least one parameter satisfies the digitization parameter policy.

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