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WO1993003449A1 - Systeme d'archivage d'images medicales et procede de memorisation - Google Patents

Systeme d'archivage d'images medicales et procede de memorisation Download PDF

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Publication number
WO1993003449A1
WO1993003449A1 PCT/US1992/006209 US9206209W WO9303449A1 WO 1993003449 A1 WO1993003449 A1 WO 1993003449A1 US 9206209 W US9206209 W US 9206209W WO 9303449 A1 WO9303449 A1 WO 9303449A1
Authority
WO
WIPO (PCT)
Prior art keywords
image
frame
digitized
record card
images
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1992/006209
Other languages
English (en)
Inventor
Marc Boroditsky
Kenneth Davenport
John Schumann
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Novus Technologies Inc
Original Assignee
Novus Technologies Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Novus Technologies Inc filed Critical Novus Technologies Inc
Publication of WO1993003449A1 publication Critical patent/WO1993003449A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T1/00—General purpose image data processing
    • G06T1/0007—Image acquisition
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G16H10/65—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records stored on portable record carriers, e.g. on smartcards, RFID tags or CD
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/20—ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing

Definitions

  • This invention relates to the storage and management of information, and, more particularly, to the capture, transmittal, and archiving of medical images.
  • Medical imaging plays an important role in evaluating the health of patients and detecting and diagnosing any abnormalities.
  • Medical imaging includes radiology and radiography, and includes, for example, X-ray imaging, sonography, nuclear medicine, computed axial tomography (CT) scans, magnetic resonance imaging (MRI) , and invasive and motion studies. In these procedures, images on film of the body are prepared and retained for study, to satisfy legal requirements, or as otherwise might be required.
  • CT computed axial tomography
  • MRI magnetic resonance imaging
  • Some medical procedures produce large amounts of film.
  • the typical CT scanner performs 12-15 studies per day, generating 4 to 6 sheets of 14 inch by 17 inch film per study.
  • Some radiology centers have several CT scanners and MRI machines, each producing on the order of 75 sheets of film per day. As more efficient machines are developed, even more films can be generated.
  • Optical disks have been considered for storage of medical images. "Write once-read many" type optical disks meet legal requirements, because the digital information is permanently burned into the disk and cannot be altered. However, optical disk reading/writing equipment is so expensive that it may not be practical for each doctor's office so that the medical record can be supplemented as necessary.
  • the present invention fulfills this need, and further provides related advantages.
  • the present invention provides an apparatus and method for the computerized capture of medical images from digital imaging equipment such as CT, MRI, and ultrasound, the output of these images into hard copy (film) , and the permanent storage of these images in digital form.
  • the apparatus is compatible with a wide variety of medical image- producing devices, and is relatively inexpensive.
  • the record card that archives the images is small in size, is readily transported, and can be used for both images and other aspects of the patient's medical history.
  • an apparatus for storing discrete medical images comprises means for receiving a film writing device output signal from a medical imaging device, and means for capturing a single image frame from the output signal.
  • the apparatus further has means for digitizing the captured single image frame, means for selecting and associating with the digitized single image frame a location on a record card at which the digitized single frame is to be stored, means for storing a plurality of the digitized single frames and their respective permanent storage locations, and means for reversibly compressing the information of the image of the digitized single frame.
  • an archiving system stores discrete medical radiological images on a record card having an imaging surface thereon.
  • the apparatus includes means for receiving a film writing device output signal from a medical imaging device.
  • the output signal can be either analog (video) or digital.
  • a frame grabber selectively captures a single frame from the output signal.
  • no frame grabber is required, and the signal is captured directly.
  • a digitizer receives the single frame from the frame grabber and provides a digitized frame output. (The frame grabber and digitizer are available as a single unit commercially.)
  • a controller permits an operator to identify a location on the record card at which the digitized single frame is to be stored as a discrete record.
  • the frame Before the frame is recorded on the record card, it may be stored in a memory having a capacity sufficiently large to store a plurality of single frames.
  • a data compressor reversibly compresses the digitized single frame using differential pulse code modulation.
  • a card writer writes a digitized compressed frame onto the imaging surface of the record card responsive to the location selected using the controller.
  • the record card permits a large number of compressed frames to be stored thereon.
  • Each digitized single compressed frame is also controllably exposed onto a sheet of X-ray film to generate hard copy of the image identical in reconstituted content to that recorded onto the record card.
  • a controller permits an operator to identify a placement location for a particular image on a current sheet of film.
  • CT, MRI, and ultrasound nuclear medicine images are commonly recorded in a 512 x 512 pixel matrix configuration.
  • Each sheet of film may typically have between l and 20 images, placed in a column/row configuration.
  • the operator incrementally selects the location of each discrete image on the sheets as they are generated by the imaging equipment.
  • the apparatus' controller permits the operator to simultaneously identify the image location on the film as well as the record card.
  • the controller is graphically represented on a computer monitor with software which allows the operator to select the number of images per sheet, expose desired images in a selected location on the sheet, save the images to the record card, and print the images to film.
  • Radiologic devices are those that capture an image directly in digital, or digital converted to analog, form, and include, for example, CT, MRI, ultrasound, and nuclear medicine methodologies.
  • Radiographic devices on the other hand, first record the image in an analog manner, such as on film. The film can later be scanned to produce a digital signal, but there may be degradation of image quality during the scanning operation.
  • a conventional X-ray recorded on film is an example of a radiographic process ⁇
  • the apparatus is structured to receive and use the film writing device output signal from a medical imaging device, it can utilize feeds from a variety of different imaging devices, such as various brands of CT scanners, MRI units, ultrasound devices, etc.
  • the apparatus has analog-to-digital conversion capability, so that images can be stored and recalled on demand for output to film recording devices.
  • the apparatus also provides for output of the plurality of images to a laser film camera, other film recording device, or a multimodality unit (MMU) that receives inputs from several different input devices.
  • MMU multimodality unit
  • the invention further encompasses a method for storing discrete medical images generated by a medical radiologic device on a record card having an imaging surface thereon.
  • the method comprises the steps of furnishing a film writing device output signal from a medical imaging device, capturing a single image frame from the video feed, and digitizing the captured single frame. Additional steps include selecting and associating with the digitized single frame a location on a record card at which the digitized single frame is to be stored, temporarily storing a plurality of the compressed single frames and their respective permanent storage locations, compressing the information of the image of the digitized single frame, and permanently recording a selected group of the stored frames at the individually selected, discrete locations of the record card.
  • the present invention provides an important advance in the art of medical image management, control, and archiving.
  • the present approach permits a large number of images to be recorded on a laser record card the size of a standard credit card.
  • the card stores the images in an easily searched format.
  • the facility that produces the images can keep a copy of the record card as a permanent record, and a copy can be furnished to the patient on the conveniently carried card. Other true copies can be produced easily and inexpensively, as needed.
  • the record card can be kept in the patient's file, and separate storage facilities are not required.
  • Figure 1 is a block diagram of the apparatus of the present invention, which reflects the method of the invention.
  • FIG. 1 illustrates a medical archiving apparatus 20, incorporating the features of the present invention.
  • a medical radiologic image is received by the apparatus 20 from a radiologic source 22, which is typically a CT scanner, an MRI device, an ultrasound device, or a nuclear medicine device.
  • a radiologic source 22 typically a CT scanner, an MRI device, an ultrasound device, or a nuclear medicine device.
  • an "image" is a final graphic representation of clinical diagnostic information as read by a physician, in either digital or analog form. That the graphic information is in such a final, processed form is significant. There is no capability to alter the image so that its graphic representation may be changed. The image is not raw, unprocessed information, so that the final image could vary depending upon the selection of a different operator than the person operating the source 22.
  • the apparatus 20 receives a film writing device output image signal or feed 24 from the medical imaging device 22. That is, the apparatus 20 operates with an image that is suitable for output directly to a film writing device such as a laser camera.
  • the image feed 24 is levelled and adjusted for optimal contrast by circuitry in the source 22. Commercial CT scanners and MRI systems, and comparable systems, have this capability built in.
  • the source 22 is not a part of the present invention, and it is important only that the apparatus 20 is adapted to receive such a film writing device output image signal 24.
  • the image carried on the feed 24 from the source 22 is viewed by a person operating the system, such as a radiologist or technician, on a monitor of an operator controller 26.
  • the operator commands an analog (video) or digital interface board 28 within the apparatus to capture the selected image frame 24.
  • the software for operating the controller 26 is attached as Exhibit A.
  • the analog signal is captured by an ISA AT compatible interface board capable of digitizing and displaying video from the source 22.
  • Video input can be programmed to capture imagery at 256 gray shades with alphanumeric overlay at bandwidths greater than 250 MHz (megahertz) .
  • Video timing on the digitization is fully programmable and provides a pixel clock frequency range of between 0.25 and 150 megasamples per second. Display resolution is variable up to a 2048 x 2048 pixel matrix on the host operator controller 26.
  • the digital signal is also captured by an ISA AT compatible interface board capable of receiving digital data from the source 22 at a rate of 4 MB (megabytes) per second along a parallel RS 485 communication link.
  • the video or digital interface board 28 provides a number of digital signal processing capabilities including image sub-sampling, replication, bi ⁇ linear interpolation, rearrangement, and histogramming.
  • the single frame is moved off of the interface 28 along the host processor BUS and into random access memory (RAM) 32.
  • RAM random access memory
  • Host transfer rates along the BUS are 3 MB per second.
  • Enough RAM is provided to temporarily store a plurality of the image frames.
  • the operator designates, utilizing the operator controller 26, an eventual storage location of each selected frame on both a current sheet of film being generated, numeral 36 and a record card, numeral 60, and that location is stored with the respective digitized frame in the host processor/memory 32.
  • the film 36 records the information in the conventional matrix row/column format.
  • the record card records the information in a series of linear tracks on the card. In the preferred format, the image information is stored first in order on the tracks, and any database information is stored last in order on the tracks.
  • the operator may designate that a particular captured frame is to be written into any particular location, such as location L6. That location is stored in the label of that particular captured frame, and it is later written into the designated location L6 of the record card. After each image location of the record card 60 is selected for later use, it is indicated to the operator as no longer available for subsequent selection.
  • the location identifier for each selected frame is also placed into memory.
  • the operator Prior to the selected group of images being committed to the designated sheet of film, the operator may change which images are selected for permanent recording, and the locations on the record card at which they are to be permanently recorded. However, the operator cannot change the content of the image. Alternatively, the operator may permanently write each image as it is selected to the record card 60.
  • the commitment of images to conventional film 36 takes place through a direct transfer of the digital image frame(s) to a laser camera 38 via a digital interface 40.
  • the digital interface board 40 sends images at a 0.05 to 4 MB per second programmable burst rate, and supports all major manufacturers of laser cameras 38.
  • the operator controls a variety of camera functions on a bi-directional RS 232 serial communication link with a data rate of 80 to 9600 Baud.
  • Camera interface functions include: Setting of printer parameters, "new sheet”, “expose image” (position) , "print film”, query of printer status, "erase image", "open study", and "close study”.
  • a film 36 might be prepared selectively with one, several, or all of the images stored in the memory 32 for a particular study, but is usually prepared with all of the images.
  • the film 36 version of the captured images may be prepared for immediate use by a physician, and record cards 60 would be prepared for the patient and for the file.
  • the operator controller 26 includes a graphically represented "keypad" 27 which allows the operator to capture images from the source 22 and place them into a desired location on a sheet of film, and indicate which images are to be saved to the optical card.
  • the controller presents the operator with a column/row matrix format which emulates the current sheet of film, and which can be sized in varying formats (e.g., 1, 2, 4 , 9, 12, 15, or 20 images per sheet) at the operator's discretion.
  • a column/row matrix format which emulates the current sheet of film, and which can be sized in varying formats (e.g., 1, 2, 4 , 9, 12, 15, or 20 images per sheet) at the operator's discretion.
  • a sub-sampled "thumbnail” representation of that image appears in the chosen column/row location, enabling the operator to preview the sheet of film prior to its printing.
  • the operator also has the ability to call any one of the thumbnail images, from current or past sheets, onto the screen in full resolution for on-screen viewing.
  • the operator controller 26 also has a complete database on both a sheet-by- sheet and image-by-image basis of the images committed to the card and film during the study.
  • the record card 60 is an optical data card termed a LaserCard, which is manufactured, by Drexler Technology of Mountain View, CA.
  • the preferred optical data card 60, as well as the optical card writer/reader unit 46, are available commercially, and are described in US patents 4,542,288; 4,284,716; and 4,544,835, whose disclosures are incorporated by reference.
  • part of the surface of the optical card 60 is covered with a medium that is sensitive to laser light of a particular frequency.
  • a laser in the writer/reader unit 46 writes a pattern of digital pulses into the medium.
  • the laser beam impinges on the optical recording layer, it creates holes in the layer called "pits".
  • the ratio of reflected light varies, depending upon whether the beam impinges on holes (written data reflectivity) or an unwritten area of the recording layer (background reflectivity) .
  • the differences in these reflectivities are picked up by a sensor and converted into signals.
  • the pattern formed in the medium of the optical card 60 is permanent. It can be written only once, but can be read an indefinite number of times. The life of the optical card is expected to be at least 30-100 years, so that images can be stored for extended periods on the medium.
  • the optical card 60 also has space thereon for recording comments on the images in the image locations, or other aspects of the patient's medical history.
  • optical cards 60 have a permanent storage capacity of 2.86 megabytes of information (with error correction) .
  • the number of image locations was indicated as 80.
  • each image is committed under user control from the host processor/memory 32 to the record card writer/reader unit 46 to be permanently written to the record card 60, it is processed by an image compressor (which also may be operated in the reverse direction to be an image decompressor, when images are to be read from the record card 60) .
  • the image compressor resides in the host processor 32, and encodes each discrete image frame to reduce pixel redundancy.
  • the user can select on the controller 26 a desired level of compression.
  • the procedure analyzes an inputted information set, and produces an output that contains the same, or nearly the same, amount of information but with reduced storage requirements.
  • a number of image compression techniques are known in the art. Typically, the greater the degree of compression, the greater the loss of information or distortion of the image.
  • the image compressor preferably utilizes a combination of run length coding and differential pulse code modulation (DPCM) , an effective approach for compressing medical images that typically include large dark areas at the perimeters of the image.
  • DPCM differential pulse code modulation
  • the run length coding identifies those areas at the perimeter of the image which are essentially of uniform black appearance in a highly compressed form using only a few bytes of information.
  • the perimeter of the actual image is indicated by the beginning and end location of each non-black portion of the image on each raster line scan of the image.
  • the differential pulse code modulation technique permits a high compression ratio without noticeable impact on the utility of the image after subsequent decompression for viewing.
  • Differential pulse code modulation is known in the art and is described in the following patents: 4,758,883; 4,725,885; 4,663,660; and 4,369,463, whose disclosures are incorporated by reference.
  • Differential pulse code modulation avoids the blocky effect that results from some digital compression techniques. Moreover, it is well suited for medical imaging, where much of the image is monotone black.
  • the apparatus 20 may be used to read a card 60 prepared in a previous study.
  • the card 60 is retrieved from a filing system and placed into the write/read device 46.
  • a "Read Card” function on the operator controller 26 is employed to bring both images and database data on the study into the controller 26.
  • the operator can call into the film matrix any single sheet or any desired combination of images from the prior study for thumbnail viewing, selected full resolution viewing of single images, and printing to film.
  • the operator controller utilizes a "critical image” subset function to identify those images deemed of greatest diagnostic use. Images can be tagged as critical either at the time they are captured, or later when the radiologist has rendered their findings on the study. "Critical images” may be brought into the film matrix immediately upon completion of the card reading process, if desired.
  • the apparatus of the present invention may be constructed in part by assembling commercially available hardware elements.
  • the video or digital interface 28 is implemented as two distinct boards available as the DI Receive and VI from adaptive
  • the digital output and camera interface are represented by the DI transmit and CI boards, also from Adaptive Video, Inc.
  • the memory 32 is preferably single inline memory modules.
  • the operator commands are preferably generated by a personal computer programmed for
  • the preferred optical card writer/reader 46 is a Nippon Conlux Model LC304.
  • the preferred record card 60 is a LaserCard, manufactured by Drexler Technology, Mountain View, CA.
  • the preferred laser camera 38 is a 3M Lasercam or a GE Laser camera Model 952.
  • the present invention provides an important advance in the art of medical image archiving technology. Images can be permanently stored and readily retrieved, from a record card that is inexpensive and achieves a reduction in volume of about 100 times in physical storage space requirements.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Primary Health Care (AREA)
  • Public Health (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Physics & Mathematics (AREA)
  • General Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Measuring And Recording Apparatus For Diagnosis (AREA)

Abstract

Un système d'archivage mémorise des images radiologiques médicales discrètes sur une carte d'enregistrement pourvue d'une surface d'imagerie. L'appareil (20) permettant la mémorisation d'images médicales discrètes comprend des moyens pour recevoir (28), d'un d'un dispositif d'imagerie médicale (22), un signal de sortie de dispositif d'enregistrement sur film, et des moyens pour capter une image individuelle à partir du signal de sortie. L'image individuelle captée est numérisée et associée à un emplacement choisi sur une carte d'enregistrement, auquel l'image individuelle numérisée doit être mémorisée en permanence par un processeur/mémoire (32). Une pluralité des images individuelles numérisées et leurs emplacements respectifs de stockage permanent sont mémorisés provisoirement dans le processeur/mémoire (32). Les images numérisées sont comprimées de manière réversible, et enregistrées de manière permanente (46) aux emplacements discrets et choisis individuellement de la carte d'enregistrement (60). Ces images peuvent être rappelées ultérieurement à partir de la carte d'enregistrement (60), décomprimées, et visualisées sur un moniteur ou enregistrées sur film (36). Ces opérations sont toutes sous la commande d'un contrôleur utilisateur graphique (26).
PCT/US1992/006209 1991-08-05 1992-07-31 Systeme d'archivage d'images medicales et procede de memorisation Ceased WO1993003449A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US741,256 1976-11-12
US917,937 1986-10-14
US74125691A 1991-08-05 1991-08-05
US91793792A 1992-07-28 1992-07-28

Publications (1)

Publication Number Publication Date
WO1993003449A1 true WO1993003449A1 (fr) 1993-02-18

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL9301907A (nl) * 1993-11-04 1995-06-01 Paul Peter Hendrikus Schalkwij Werkwijze voor het elektronisch opslaan van stralingsbeelden.
WO1996015503A1 (fr) * 1994-11-10 1996-05-23 Csb-System Software-Entwicklung & Unternehmensberatung Gmbh Support d'integration pour la saisie, le traitement, la transmission et l'archivage de renseignements d'ordre medical accessibles concernant un individu et disponibles a tout moment sur ledit individu
WO2001002979A3 (fr) * 1999-06-30 2001-12-06 Sunesi Clinical Systems Propri Acquisition de donnees medicales a partir d'un patient et traitement des donnees
WO2002025926A1 (fr) * 2000-09-20 2002-03-28 Fifteenseven Limited Unite portative destinee a envoyer des images numeriques

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4398223A (en) * 1955-06-14 1983-08-09 Lemelson Jerome H System for recording video information on a record card
US4857992A (en) * 1986-12-24 1989-08-15 U.S. Philips Corporation Image display apparatus and method
US5032927A (en) * 1988-03-01 1991-07-16 Fuji Photo Film Co., Ltd. Image signal recording apparatus capable of recording compressed image data together with audio data

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4398223A (en) * 1955-06-14 1983-08-09 Lemelson Jerome H System for recording video information on a record card
US4857992A (en) * 1986-12-24 1989-08-15 U.S. Philips Corporation Image display apparatus and method
US5032927A (en) * 1988-03-01 1991-07-16 Fuji Photo Film Co., Ltd. Image signal recording apparatus capable of recording compressed image data together with audio data

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
OPTICAL INFORMATION SYSTEMS, July-August 1988, BROWN et al., "A New Patient Record System Using the Laser Card", pages 156-161. *
SPIE, Vol. 1248, Storage and Retrieval Systems and Applications, 1990, SIEDBAND et al., "Optical Data Card Medical Imaging", pages 204-209. *
SPIE, Vol. 767, Medical Imaging, 1987, SIEDBAND, "Data Card System for Filmless Radiography", pages 831-833. *

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL9301907A (nl) * 1993-11-04 1995-06-01 Paul Peter Hendrikus Schalkwij Werkwijze voor het elektronisch opslaan van stralingsbeelden.
WO1996015503A1 (fr) * 1994-11-10 1996-05-23 Csb-System Software-Entwicklung & Unternehmensberatung Gmbh Support d'integration pour la saisie, le traitement, la transmission et l'archivage de renseignements d'ordre medical accessibles concernant un individu et disponibles a tout moment sur ledit individu
WO2001002979A3 (fr) * 1999-06-30 2001-12-06 Sunesi Clinical Systems Propri Acquisition de donnees medicales a partir d'un patient et traitement des donnees
WO2002025926A1 (fr) * 2000-09-20 2002-03-28 Fifteenseven Limited Unite portative destinee a envoyer des images numeriques

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