WO2025108563A1 - Appareil radiologique - Google Patents
Appareil radiologique Download PDFInfo
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- WO2025108563A1 WO2025108563A1 PCT/EP2023/083059 EP2023083059W WO2025108563A1 WO 2025108563 A1 WO2025108563 A1 WO 2025108563A1 EP 2023083059 W EP2023083059 W EP 2023083059W WO 2025108563 A1 WO2025108563 A1 WO 2025108563A1
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- frontal
- lateral
- computed tomography
- vertical scanning
- sliding support
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/03—Computed tomography [CT]
- A61B6/032—Transmission computed tomography [CT]
- A61B6/035—Mechanical aspects of CT
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/022—Stereoscopic imaging
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
- A61B6/03—Computed tomography [CT]
- A61B6/032—Transmission computed tomography [CT]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/40—Arrangements for generating radiation specially adapted for radiation diagnosis
- A61B6/4007—Arrangements for generating radiation specially adapted for radiation diagnosis characterised by using a plurality of source units
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/40—Arrangements for generating radiation specially adapted for radiation diagnosis
- A61B6/4007—Arrangements for generating radiation specially adapted for radiation diagnosis characterised by using a plurality of source units
- A61B6/4014—Arrangements for generating radiation specially adapted for radiation diagnosis characterised by using a plurality of source units arranged in multiple source-detector units
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/46—Arrangements for interfacing with the operator or the patient
- A61B6/461—Displaying means of special interest
- A61B6/466—Displaying means of special interest adapted to display 3D data
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/48—Diagnostic techniques
- A61B6/488—Diagnostic techniques involving pre-scan acquisition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
- A61B6/505—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of bone
Definitions
- the invention relates to the technical field of radiological apparatuses as well as of methods of radiography of patient body implemented by these radiological apparatuses.
- imaging techniques To image the inside of the patient body, to perform the best possible diagnostic as to potential risk of illness, several well-known imaging techniques are at hand. Among which can be found for instance positron emission tomography, simple bidirectional (frontal and lateral) 2D X-ray imaging or helicoidal complex computed tomography, sophisticated magnetic resonance imaging. All these imaging techniques work in different spectral domains: gammarays, X-rays, magnetic field. Depending on the type of patient, on the type of organ located within the region of interest, the type of malformation or illness to be detected and cured, one or more of these imaging will be used, most often successively and separately, what does not help the medical expert to perform a quick, relevant and reliable diagnosis on a patient.
- Such common radiological apparatus should have big, heavy and bulky, movable parts, and among them some big, heavy and bulky, visible movable parts which could run the risk of a collision with the patient during performance of X-ray imaging, if for instance the patient cannot remain completely quiet and still.
- Too big, heavy and bulky, movable parts of a radiological apparatus present many drawbacks, among which limited scanning speed and specific braking systems to be able to curtail the movable parts when needed in safe conditions, and especially the visible movable parts for which the security braking constraints are notably harder than for invisible movables parts.
- Visible movables parts are parts that can be seen and touched accidentally by a patient which does not remain completely quiet and still during performance of X-ray imaging
- invisible movables parts are parts that cannot be seen nor touched accidentally by a patient which does not remain completely quiet and still during performance of X-ray imaging because such invisible movables parts are within a closed cover or within a fully enclosed housing.
- the invention proposes a specific implementation of the different sources and detectors, both of simple 2D X-ray imaging and of computed tomography, altogether with a head to tail distribution of sources and detectors (source of 2D X-ray with detector of computed tomography, and source of computed tomography with detector of 2D X- ray), and without needing to implement the classical C-arms which linked mechanically each type of source to the associated type of detector so that there was an exact correspondence between source and associated detector by mechanical construction. This lack of mechanical link between each source and associated detector could however require some software correction to precisely reestablish such correspondence.
- a radiological apparatus comprising: a gantry encapsulated within a cover, a patient platform, a frontal radiation source associated to a frontal radiation detector, both sliding vertically together so as to perform a frontal vertical scanning of a patient standing on said platform, a lateral radiation source associated to a lateral radiation detector, both sliding vertically together so as to perform a lateral vertical scanning of a patient standing on said platform, wherein it also comprises: a frontal computed tomography source associated to a frontal computed tomography detector, both sliding vertically together so as to perform a frontal vertical scanning of a patient standing on said platform, a lateral computed tomography source associated to a lateral computed tomography detector, both sliding vertically together so as to perform a lateral vertical scanning of a patient standing on said platform, wherein it also comprises: a first frontal vertically sliding support mechanically linking together, so that they remain immobile with respect to each other during the frontal vertical scanning, both: the frontal radiation source
- Said computed tomography of said second part of said portion of patient body height comprises preferably: first computed tomography images made by a first computed tomography source associated to a first computed tomography detector according to different incidences, advantageously a set of frontal computed tomography images made by a frontal computed tomography source associated to a frontal computed tomography detector according to different incidences in the frontal region, second computed tomography images made by a second computed tomography source associated to a second computed tomography detector according to different incidences, advantageously a set of lateral computed tomography images made by a lateral computed tomography source associated to a lateral computed tomography detector according to different incidences in the lateral region.
- Preferred embodiments comprise one or more of the following features, which can be taken separately or together, either in partial combination or in full combination.
- the third frontal vertically sliding support and the fourth lateral vertically sliding support are mechanically independent from each other so that they could vertically slide independently from each other.
- the aforementioned reduction of global weight is more important, as well as well as the aforementioned reduction of weight of the movable parts, altogether with the aforementioned reduction of the momentum of these movable parts.
- the radiological apparatus also comprises: a third column along which the third frontal vertically sliding support is vertically sliding, a fourth column along which the fourth lateral vertically sliding support is vertically sliding, the third column and the fourth column being mechanically independent from each other so that: neither the third column supports any weight of the fourth lateral vertically sliding support, nor the fourth column supports any weight of the third frontal vertically sliding support.
- the aforementioned reduction of global weight is more important, as well as well as the aforementioned reduction of weight of the movable parts, altogether with the aforementioned reduction of the momentum of these movable parts.
- the third frontal vertically sliding support and the fourth lateral vertically sliding support are mechanically linked together so that they can vertically slide only together while remaining immobile with respect to each other during frontal and lateral vertical scanning.
- the radiological apparatus also comprises: a vertical pilar along which a horizontal bar supporting both the third frontal vertically sliding support and the fourth lateral vertically sliding support is vertically sliding, said pilar being in a comer of said encapsulated gantry.
- each of said frontal and lateral radiation sources is an X-ray tube encapsulated within a housing, with at least a liquid metal bearing located between a rotating anode of said X-ray tube and an envelope of said X-ray tube, said envelope maintaining vacuum inside said X-ray tube.
- said gantry cover top view is L shaped
- each of said frontal and lateral radiation sources is located: outside said L shaped gantry cover, inside angular sector of said L, and is encapsulated within a housing sliding vertically with said radiation source it encapsulates.
- said L shaped gantry cover top view recovers squares Cl, C2, C3, B3, A3, said frontal and lateral radiation sources housings are respectively located within squares Bl and A2, said patient platform recovers square B2, square Al remains entirely free and void.
- said first and second 2D images viewing said first part of said portion of patient body height according to different angles of incidence, wherein further comprising: making a patient specific 3D reconstruction on at least a second part of said portion of patient body height, at least combining therefore together both said first and second 2D images with complementary data, making a computed tomography of said second part of said portion of patient body height, said second part of said portion of patient body height being shorter, or at least twice shorter, than said first part of said portion of patient body height, o said second part of said portion of patient body height being determined by at least one of said one or more first vertical scanning and at least one of said one or more second vertical scanning, said complementary data, used to make said patient specific 3D reconstruction on at least said second part of said portion of patient body height, comprising said computed tomography of said second part of said portion of patient body height.
- said complementary data, used to make said patient specific 3D reconstruction on at least said second part of said portion of patient body height also comprise 3D generic data.
- the patient specific 3D reconstruction is made more precise and more accurate.
- making a patient specific 3D reconstruction on at least a second part of said portion of patient body height, at least combining therefore together both said first and second 2D images with complementary data comprises: making as patient specific modeling, a patient specific provisional 3D reconstruction on at least said first part of said portion of patient body height, using both: as patient specific data therefore, at least both first and second 2D images, as generic data therefore, a 3D generic model, and as modeling process therefore, a process combining said both first and second 2D images with said 3D generic model so as to get at said patient specific provisional 3D reconstruction, said complementary data, used to make said patient specific 3D reconstruction on at least said second part of said portion of patient body height, are used so as to upgrade said patient specific provisional 3D reconstruction into a patient specific final 3D reconstruction of said second part of said portion of patient body height by modifying, or by enriching and/or correcting, said patient specific provisional 3D reconstruction with said computed tomography of said second part of said portion of patient body height.
- the patient specific 3D reconstruction is made more precise and more accurate.
- said modeling process uses artificial intelligence, and preferably uses deep learning or generative adversarial network.
- the patient specific 3D reconstruction is made more precise and more accurate.
- said first vertical scanning and said second vertical scanning are performed a first time to build a respectively first and second scout views
- said first vertical scanning and said second vertical scanning are performed a second time so as to build respectively first and second 2D images therefrom, based on said first and second scout views
- said computed tomography is performed during second time performance of said first vertical scanning and said second vertical scanning
- said second part of said portion of patient body height is determined by said first vertical scanning during said first time by said second vertical scanning during said first time.
- said first vertical scanning and said second vertical scanning are performed a first time to build a respectively first and second scout views
- said first vertical scanning and said second vertical scanning are performed a second time so as to build respectively first and second 2D images therefrom, based on said first and second scout views
- said computed tomography is performed after second time performance of said first vertical scanning and said second vertical scanning
- said second part of said portion of patient body height is determined by said first vertical scanning during said second time by said second vertical scanning during said second time.
- the radiography method also uses: a first computed tomography source associated to a first computed tomography detector, both sliding vertically together so as to perform a frontal vertical scanning of a second part of a patient body height, said second part being smaller than said first part, a second computed tomography source associated to a second computed tomography detector, both sliding vertically together so as to perform a lateral vertical scanning of said second part of a patient body height, a first vertically sliding support mechanically linking together, so that they remain immobile with respect to each other during the first vertical scanning, both: the first radiation source, and the first computed tomography detector, a second vertically sliding support mechanically linking together, so that they remain immobile with respect to each other during the second vertical scanning, both: the second radiation source, and the second computed tomography detector, a third vertically sliding support mechanically linking together, so that they remain immobile with respect to each other during the first vertical scanning, both: the first radiation detector, and the first computed tomography source,
- the computed tomography is performed by the cooperation of: at least one computed tomography source which is a distributed source comprising at least one line array of emitters, which is both: vertically mobile during performance of said first vertical scanning and said second vertical scanning, and horizontally static during performance of said first vertical scanning and said second vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least one computed tomography detector, so as to build the computed tomography of said second part of said portion of patient body height.
- at least one computed tomography source which is a distributed source comprising at least one line array of emitters, which is both: vertically mobile during performance of said first vertical scanning and said second vertical scanning, and horizontally static during performance of said first vertical scanning and said second vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least one computed tomography detector, so as to build the computed tomography of said second part of said portion of patient
- said emitters are between 10 and 100 emitters, or between 15 and 70 emitters or between 20 and 50 emitters.
- said emitters are pulsed emitters.
- said emitters are cold cathode X-ray emitters.
- this specific implementation of sources and detectors within the radiological apparatus improves the reduction of global weight is more important, as well as well as the reduction of weight of the movable parts, altogether with the reduction of the momentum of these movable parts.
- said cold cathode X-ray emitters are either carbon nano tubes based cold cathode X-ray emitters, or silicon based cold cathode X-ray emitters, or field emission electron based cold cathode X-ray emitters.
- said first and second detectors are multi-energy counting detectors, preferably Energy Resolved Photon Counting Detectors (ERPCD), with at least two energy bins or with at least four energy bins or with at least six energy bins, and/or with at most ten energy bins.
- ERPD Energy Resolved Photon Counting Detectors
- the patient specific 3D reconstruction is made more precise and more accurate.
- first vertical gap between on the one hand said first radiation source and radiation detector and on the other hand said second radiation source and radiation detector, such that said first vertical scanning and said second vertical scanning are performed synchronously but with a first time shift in between, so as to further reduce cross-scattering between said first and second 2D images.
- a first scattering rejection grid is located upstream said first computed tomography detector so as to reduce cross-scattering between a first image made by said first computed tomography detector and a second image made by said second computed tomography detector of computed tomography and to reduce self- scattering in said first image made by said first computed tomography detector
- a second scattering rejection grid is located upstream said second computed tomography detector so as to reduce cross-scattering between a first image made by said first computed tomography detector and a second image made by said second computed tomography detector of computed tomography and to reduce self- scattering in said second image made by said second computed tomography detector.
- emissions of first computed tomography source usually the frontal computed tomography source
- emissions of second computed tomography source usually lateral computed tomography source
- a first collimation tunnel is located upstream said first radiation detector so as to further reduce cross-scattering between said first and second 2D images
- a second collimation tunnel is located upstream said second radiation detector so as to further reduce cross-scattering between said first and second 2D images.
- said first vertical gap is comprised between 1cm and 5cm, advantageously between 1.5cm and 3cm.
- the radiology method uses: a first computed tomography source associated to a first computed tomography detector, both sliding vertically together so as to perform a frontal vertical scanning of a second part of a patient body height, said second part being smaller than said first part, a second computed tomography source associated to a second computed tomography detector, both sliding vertically together so as to perform a lateral vertical scanning of said second part of a patient body height, there is a second vertical gap, between said first radiation source and said first computed tomography source, as well as between said second radiation source and said second computed tomography source, such that said first vertical scanning and said second vertical scanning are performed synchronously but with a second time shift in between, so as to further reduce cross-scattering between on the one hand said first and second 2D images and on the other hand said computed tomography.
- said second vertical gap is comprised between 25% and 150% of the height of said first computed tomography detector and between 25% and 150% of the height of said second computed tomography detector, advantageously between 50% and 100% of the height of said first computed tomography detector and between 50% and 100% of the height of said second computed tomography detector, and/or is comprised between 3cm and 20cm, advantageously between 5cm and 12cm.
- said patient specific provisional 3D reconstruction is upgraded into a patient specific final 3D reconstruction by using as complementary data not the raw computed tomography images but corrected computed tomography images which are obtained by upgrading the raw computed tomography images by an artificial intelligence process so as to reduce cross-scattering effect between first and second computed tomography images respectively made by first and second computed tomography detectors and/or so as to reduce self- scattering effect on first and second computed tomography images respectively made by first and second computed tomography detectors.
- the patient specific 3D reconstruction is made more precise and more accurate.
- said artificial intelligence process either is a deep learning process or uses a generative adversarial network, so as to reduce cross-scattering effect between first and second computed tomography images respectively made by first and second computed tomography detectors and/or so as to reduce self-scattering effect on first and second computed tomography images respectively made by first and second computed tomography detectors.
- the patient specific 3D reconstruction is made more precise and more accurate.
- first vertical scanning and said second vertical scanning being performed synchronously, - said first and second 2D images viewing at least part of said portion of patient body height according to different angles of incidence, preferably a frontal 2D image and a lateral 2D image, said frontal 2D image and said lateral 2D image being orthogonal to each other,
- said first and second computed tomography images viewing at least part of said portion of patient body height according to different angles of incidence, preferably frontal computed tomography images and lateral computed tomography images, said frontal computed tomography images and said lateral computed tomography images being orthogonal to each other, at least one of said one or more first vertical scanning and at least one of said one or more second vertical scanning and at least one of said one or more third vertical scanning and at least one of said one or more fourth vertical scanning being all performed synchronously, wherein there is a first vertical gap between on the one hand said first radiation source and said first radiation detector and on the other hand said second radiation source and said second radiation detector, such that said at least one first vertical scanning and said at least one second vertical scanning are performed synchronously but with a first time shift in between, so as to reduce cross-scattering between said first and second 2D images, and wherein there is a second vertical gap between on the one hand said first radiation source and said first radiation detector and on the other hand said first computed tom
- said first computed tomography source is a distributed source comprising at least one line array of emitters, advantageously between 10 and 100 emitters, which is both vertically mobile during performance of said third vertical scanning, and horizontally static during performance of said third vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least said first computed tomography detector, so as to build said first computed tomography images
- said second computed tomography source is a distributed source comprising at least one line array of emitters, advantageously between 10 and 100 emitters, which is both vertically mobile during performance of said fourth vertical scanning, and horizontally static during performance of said fourth vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least said second computed tomography detector, so as to build said second computed tomography images.
- said first and second 2D images viewing at least part of said portion of patient body height according to different angles of incidence, preferably a frontal 2D image and a lateral 2D image, said frontal 2D image and said lateral 2D image being orthogonal to each other, - one or more third vertical scanning of said portion of patient body height by a first computed tomography source and a first computed tomography detector cooperating to make first computed tomography images of at least part of said portion of patient body height,
- said first and second computed tomography images viewing at least part of said portion of patient body height according to different angles of incidence, preferably frontal computed tomography images and lateral computed tomography images, said frontal computed tomography images and said lateral computed tomography images being orthogonal to each other, at least one of said one or more first vertical scanning and at least one of said one or more second vertical scanning and at least one of said one or more third vertical scanning and at least one of said one or more fourth vertical scanning being all performed synchronously, wherein there is a vertical gap between on the one hand said first radiation source and said first radiation detector and on the other hand said first computed tomography source and said first computed tomography detector, preferably as well as between on the one hand said second radiation source and said second radiation detector and on the other hand said second computed tomography source and said second computed tomography detector, such that said at least one first vertical scanning and said at least one third vertical scanning are performed synchronously but with a time shift in between, so as to reduce cross-
- said first computed tomography source is a distributed source comprising at least one line array of emitters, advantageously between 10 and 100 emitters, which is both vertically mobile during performance of said third vertical scanning, and horizontally static during performance of said third vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least said first computed tomography detector, so as to build said first computed tomography images
- said second computed tomography source is a distributed source comprising at least one line array of emitters, advantageously between 10 and 100 emitters, which is both vertically mobile during performance of said fourth vertical scanning, and horizontally static during performance of said fourth vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least said second computed tomography detector, so as to build said second computed tomography images.
- said first and second computed tomography images viewing at least part of said portion of patient body height according to different angles of incidence, preferably frontal computed tomography images and lateral computed tomography images, said frontal computed tomography images and said lateral computed tomography images being orthogonal to each other, wherein there is a vertical gap between on the one hand said first computed tomography source and said first computed tomography detector and on the other hand said second computed tomography source and said second computed tomography detector, such that said at least one first vertical scanning and said at least one second vertical scanning are performed synchronously but with a time shift in between, so as to reduce cross-scattering between said first and second computed tomography images.
- said first computed tomography source is a distributed source comprising at least one line array of emitters, advantageously between 10 and 100 emitters, which is both vertically mobile during performance of said first vertical scanning, and horizontally static during performance of said first vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least said first computed tomography detector, so as to build said first computed tomography images
- said second computed tomography source is a distributed source comprising at least one line array of emitters, advantageously between 10 and 100 emitters, which is both vertically mobile during performance of said second vertical scanning, and horizontally static during performance of said second vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by said emitters progressing along said line array of emitters, with at least said second computed tomography detector, so as to build said second computed tomography images.
- 2D means bi-dimensional
- 3D means tri-dimensional
- Fig. 1 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in off mode, the computed tomography in off mode.
- Fig. 2 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in on mode, the computed tomography in off mode.
- Fig. 3 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in on mode, the computed tomography in on mode.
- Fig. 4 shows an example of the radiological apparatus according to another embodiment of the invention, showing the vertical scanning in on mode, the computed tomography in on mode.
- Fig. 5 shows an example of a preferred embodiment for frontal radiation source and lateral radiation source, as well as for frontal radiation detector and lateral radiation detector.
- Fig. 6 shows an example of a preferred embodiment for frontal computed tomography source and lateral computed tomography source, as well as for frontal computed tomography detector and lateral computed tomography detector.
- Fig. 7 shows an example of a first embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- Fig. 8 shows an example of a second embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- Fig. 9 shows an example of a third embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- Fig. 10 shows an example of a fourth embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- Fig. 11 shows an example of a fifth embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- the space orientation is the following one: there is a vertical direction Z, a horizontal plane XY with a first horizontal direction X and a second horizontal direction Y, X being also called the frontal direction and Y the lateral direction.
- a frontal beam sent along the frontal direction X makes a frontal image or a frontal view of a patient
- a lateral beam sent along the lateral direction Y makes a lateral image or a lateral view of a patient.
- Vertical scanning and vertical sliding are performed along vertical direction Z.
- the patient is referenced 50.
- Fig. 1 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in off mode, the computed tomography in off mode.
- This radiological apparatus 1 comprises a gantry 10 encapsulated within a cover (not shown on figures, in order to show all the internal parts of the radiological apparatus).
- a patient platform 6 is located in the middle of the gantry 10. During performance of the patient examination, the patient is standing vertically along direction Z, on this patient platform 6, which can be set up at different heights along direction Z, so as to adapt to different heights of different patients.
- this patient platform 6 there are only two positions for this patient platform 6: either the feet of the patient are needed, and the platform 6 is in top position at about 30cm-40cm above the floor, or the feet of the patient are not needed, and the platform 6 is in bottom position close to the floor.
- the gantry 10 comprises four column 11, 12, 13, 14, respectively bearing four vertically sliding supports 15, 16, 17, 18.
- first column 11 along which a first frontal vertically sliding support 15 is vertically sliding
- second column 12 along which a second lateral vertically sliding support 16 is vertically sliding
- first column 11 and the second column 12 being mechanically independent from each other so that, neither the first column 11 supports any weight of the second lateral vertically sliding support 16, nor the second column 12 supports any weight of the first frontal vertically sliding support 15.
- the first frontal vertically sliding support 15 and the second lateral vertically sliding support 16 are mechanically independent from each other so that they could vertically slide independently from each other.
- the third frontal vertically sliding support 17 and the fourth lateral vertically sliding support 18 are mechanically independent from each other so that they could vertically slide independently from each other.
- the first frontal vertically sliding support 15 and the second lateral vertically sliding support 16 and the third frontal vertically sliding support 17 and the fourth lateral vertically sliding support 18 are all mechanically independent from one another, so that any vertically sliding support could vertically slide independently from the three other vertically sliding supports.
- the first frontal vertically sliding support 15 and the second lateral vertically sliding support 16 are mechanically independent from each other so that they could vertically slide independently from each other.
- the first frontal vertically sliding support 15 and the second lateral vertically sliding support 16 are both mechanically independent from one another, so that that they could vertically slide independently from both the third frontal vertically sliding support 17 and the fourth lateral vertically sliding support 18.
- the radiological apparatus 1 also comprises: a frontal radiation source 21, a frontal radiation detector 23, a lateral radiation source 22, a lateral radiation detector 24, a frontal computed tomography source 31, a frontal computed tomography detector 33, a lateral computed tomography source 32, a lateral computed tomography detector 34.
- the frontal radiation source 21 is associated to the frontal radiation detector 23, both sliding vertically together so as to perform a frontal vertical scanning of a patient standing on the platform 6.
- the lateral radiation source 22 is associated to the lateral radiation detector 24, both sliding vertically together so as to perform a lateral vertical scanning of a patient standing on the platform 6.
- Each of these frontal and lateral radiation sources 21 and 22 is an X-ray tube encapsulated within a housing, with at least a liquid metal bearing located between a rotating anode of this X-ray tube and an envelope of this X-ray tube, this envelope maintaining vacuum inside this X-ray tube.
- the first and second radiation detectors 23 and 24 are multi-energy counting detectors, preferably Energy Resolved Photon Counting Detectors (ERPCD), with at least two energy bins or with at least four energy bins or with at least six energy bins, and/or with at most ten energy bins.
- ERPD Energy Resolved Photon Counting Detectors
- the frontal collimation tunnel 27 is located upstream the frontal radiation detector 23 so as to further reduce cross-scattering between the first and second 2D images
- the lateral collimation tunnel 28 is located upstream the lateral radiation detector 24 so as to further reduce cross-scattering between said first and second 2D images.
- the frontal computed tomography source 31 is associated to a frontal computed tomography detector 33, both sliding vertically together so as to perform a frontal vertical scanning of a patient standing on the platform 6.
- the lateral computed tomography source 32 is associated to the lateral computed tomography detector 34, both sliding vertically together so as to perform a lateral vertical scanning of a patient standing on the platform 6.
- a frontal scattering rejection grid (not shown on figures) is located upstream the frontal computed tomography detector 33 so as to reduce cross-scattering on the first and second computed tomography images and to reduce self- scattering in said first image made by said first computed tomography detector
- a lateral scattering rejection grid (not shown on figures) is located upstream the lateral computed tomography detector 34 so as to reduce cross-scattering on the first and second computed tomography images and to reduce selfscattering in said second image made by said second computed tomography detector.
- the first frontal vertically sliding support 15 mechanically links together, so that they remain immobile with respect to each other at least during the frontal vertical scanning, and also preferably permanently, both, the frontal radiation source 21 being located outside the gantry cover, and the frontal computed tomography detector 33 being located outside the gantry cover.
- the frontal tomography detector 33 is preferably located above the frontal radiation source 21.
- the second lateral vertically sliding support 16 mechanically links together, so that they remain immobile with respect to each other at least during the lateral vertical scanning, and also preferably permanently, both, the lateral radiation source 22 being located outside the gantry cover, and the lateral computed tomography detector 34 being located outside the gantry cover.
- the lateral tomography detector 34 is preferably located above the lateral radiation source 22.
- the third frontal vertically sliding support 17 mechanically links together, so that they remain immobile with respect to each other at least during the frontal vertical scanning, and also preferably permanently, both, the frontal radiation detector 23 being located inside the gantry cover, and the frontal computed tomography source 31 being located inside the gantry cover.
- the frontal tomography source 31 is preferably located above the frontal radiation detector 23.
- the fourth lateral vertically sliding support 18 mechanically links together, so that they remain immobile with respect to each other at least during the lateral vertical scanning, and also preferably permanently, both, the lateral radiation detector 24 being located inside the gantry cover, and the lateral computed tomography source 32 being located inside the gantry cover.
- the lateral tomography source 32 is preferably located above the lateral radiation detector 24.
- the gantry cover top view is L shaped, each of the frontal and lateral radiation sources 21 and 22 is located, outside this L shaped gantry cover, inside angular sector of this L, and is encapsulated within a housing sliding vertically with said radiation source 21 or 22 it encapsulates.
- this L shaped gantry cover top view recovers squares Cl, C2, C3, B3, A3, the frontal and lateral radiation sources 21 and 22 housings are respectively located within squares Bl and A2, the patient platform 6 recovers square B2, square Al remains entirely free and void.
- Fig. 2 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in on mode, the computed tomography in off mode.
- the frontal radiation source 21 is associated to a frontal collimator to narrow frontal emitted beam 25 toward standing patient 50.
- the frontal beam 25 After going through standing patient 50, the frontal beam 25 enters in a frontal collimation tunnel 27 before reaching the sensitive surface of the frontal radiation detector 23.
- This frontal collimator is located just at the output of the frontal radiation source 21, whereas this frontal collimation tunnel 27 is located just at the input of the frontal radiation detector 23.
- Part of frontal beam 25 is cross-scattered toward the lateral radiation detector 24.
- Frontal beam 25 may practically be considered as a planar beam, as a horizontal planar beam.
- the lateral radiation source 22 is associated to a lateral collimator to narrow lateral emitted beam 26 toward standing patient 50.
- the lateral beam 26 After going through standing patient 50, the lateral beam 26 enters in a lateral collimation tunnel 28 before reaching the sensitive surface of the lateral radiation detector 24.
- This lateral collimator is located just at the output of the lateral radiation source 22, whereas this lateral collimation tunnel 28 is located just at the input of the lateral radiation detector 24.
- Part of lateral beam 26 is cross-scattered toward the frontal radiation detector 23.
- the output of lateral radiation detector 24 there is a second 2D image, the lateral 2D image of a standing patient or of an organ of this standing patient.
- lateral beam 26 considered is very small since it is the height of the lateral beam 26 which will enter the lateral collimation tunnel 28 before reaching the sensitive surface of the lateral radiation detector 24.
- Lateral beam 26 may practically be considered as a planar beam, as a horizontal planar beam.
- this first vertical gap is comprised between 1cm and 5cm, advantageously between 1.5cm and 3cm. This first vertical gap should make a small (but not visible on figures) gap between both horizontal beams 25 and 26.
- Fig. 3 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in on mode, the computed tomography in on mode.
- first computed tomography source 31 associated to a first computed tomography detector 33, both sliding vertically together so as to perform a frontal vertical scanning of a second short part H2 of a patient body height, this second short part H2 being smaller than this first part Hl.
- the frontal computed tomography source 31 is a distributed source which comprises several emitters distributed in a line array which emit successively in time from one end to the other end of the line array, so as to perform a static horizontal scan of the patient body, at each vertical position of the dynamic vertical scan of the patient height.
- Each emitter is a punctual source which emission expands in a cone beam 37, which after having crossed patient body, will be received and detected by the frontal computed tomography bi-dimensional detector 33.
- the lateral computed tomography source 32 is a distributed source which comprises several emitters distributed in a line array.
- the emitters emit successively in time from one end to the other end of the line array, so as to perform a static horizontal scan of the patient body, at each vertical position of the dynamic vertical scan of the patient height.
- Each emitter is a punctual source which emission expands in a cone beam 38, which after having crossed patient body, will be received and detected by the lateral computed tomography bi-dimensional detector 34.
- this second vertical gap is comprised between 25% and 150% of the height of the first computed tomography detector 32 and between 25% and 150% of the height of the second computed tomography detector 34, advantageously between 50% and 100% of the height of the first computed tomography detector 32 and between 50% and 100% of the height of the second computed tomography detector 34, and/or is comprised between 3cm and 20cm, advantageously between 5cm and 12cm.
- Fig. 4 shows an example of the radiological apparatus according to another embodiment of the invention, showing the vertical scanning in on mode, the computed tomography in on mode.
- the third frontal vertically sliding support 17 and the fourth lateral vertically sliding support 18 are mechanically linked together so that they can vertically slide only together while remaining immobile with respect to each other during first frontal and second lateral vertical scanning.
- Fig. 5 shows an example of a preferred embodiment for frontal radiation source and lateral radiation source, as well as for frontal radiation detector and lateral radiation detector.
- the frontal radiation source 21 is a punctual source which emission expands in a fan beam
- the lateral radiation source 22 is a punctual source which emission expands in a fan beam
- Crossing zone 29 is limited by a quadrilateral M1-M2-M3-M4.
- Both fan beams of frontal radiation source 21 and of lateral radiation source 22 preferably have a horizontal extension of between 20 and 25 degrees and a vertical extension of between 0.10 and 0.20 degrees.
- the X- ray emission is preferably a continuous emission.
- Fig. 6 shows an example of a preferred embodiment for frontal computed tomography source and lateral computed tomography source, as well as for frontal computed tomography detector and lateral computed tomography detector.
- the frontal computed tomography source 31 is a distributed source which comprises several emitters 35 distributed in a line array.
- the emitters 35 emit successively in time from one end to the other end of the line array, so as to perform a static horizontal scan of the patient body located in crossing zone 29, at each vertical position of the dynamic vertical scan of the patient height.
- Each emitter 35 is a punctual source which emission expands in a cone beam 37 between directions shown by the arrows starting from the emitter 35, which after having crossed patient body in crossing zone 29, will be received and detected by the frontal computed tomography bi-dimensional detector 33 which preferably works in fast frame-mode.
- the lateral computed tomography source 32 is a distributed source which comprises several emitters 36 distributed in a line array.
- the emitters 36 emit successively in time from one end to the other end of the line array, so as to perform a static horizontal scan of the patient body located in crossing zone 29, at each vertical position of the dynamic vertical scan of the patient height.
- Each emitter 36 is a punctual source which emission expands in a cone beam 38 between directions shown by the arrows starting from the emitter 36, which after having crossed patient body in crossing zone 29, will be received and detected by the lateral computed tomography bi-dimensional detector 34 which preferably works in fast frame-mode.
- the X-ray emission is preferably a pulsed emission.
- radiological apparatus 1 With previously described radiological apparatus 1 , is performed a method of radiography of at least a portion of a height of a patient body in standing position. This method of radiography of at least a portion of a height of a patient body in standing position will now be described in link with all the figures embodying the radiological apparatus 1.
- This method of radiography of at least a portion of a height of a patient body in standing position comprises, one or more first vertical scanning of this portion of patient body height by a frontal radiation source 21 and a frontal radiation detector 23 cooperating to make a first 2D image of a first long part Hl of this portion of patient body height, one or more second vertical scanning of this portion of patient body height by a lateral radiation source 22 and a lateral radiation detector 24 cooperating to make a second 2D image of a first long part Hl of this portion of patient body height, this first vertical scanning and this second vertical scanning being performed synchronously, these first and second 2D images viewing this first long part Hl of this portion of patient body height according to different angles of incidence, frontal and lateral, which are oriented at right angle from each other.
- This method of radiography of at least a portion of a height of a patient body in standing position also comprises making a patient specific 3D reconstruction on at least a second short part H2 of this portion of patient body height, at least combining therefore together both these first and second 2D images with complementary data.
- This method of radiography of at least a portion of a height of a patient body in standing position also comprises making a computed tomography of this second short part H2 of this portion of patient body height, this second short part H2 of this portion of patient body height being shorter, or at least twice shorter, than this first long part Hl of this portion of patient body height.
- This second short part H2 of this portion of patient body height is determined by at least one of the one or more first vertical scanning and at least one of the one or more second vertical scanning.
- These complementary data, used to make this patient specific 3D reconstruction on at least this second short part H2 of this portion of patient body height comprise the computed tomography of this second part H2 of this portion of patient body height.
- the computed tomography is performed by the cooperation of, at least one computed tomography source, either the frontal computed tomography source 31 or the lateral computed tomography source 32, preferably both the frontal computed tomography source 31 and the lateral computed tomography source 32, with at least one computed tomography detector, either the frontal computed tomography detector 33 or the lateral computed tomography detector 34, preferably both the frontal computed tomography detector 33 and the lateral computed tomography detector 34, so as to build the computed tomography of said second part of said portion of patient body height.
- This at least one computed tomography source is preferably a distributed source comprising at least one line array of emitters.
- This distributed source comprising at least one line array of emitters is both, vertically mobile during performance of the first vertical scanning and the second vertical scanning, and horizontally static during performance of the first vertical scanning and the second vertical scanning, with a horizontal scanning performed by successive signal emissions respectively by these emitters progressing along this line array of emitters.
- These emitters can be between 10 and 100 emitters, or preferably between 15 and 70 emitters or between 20 and 50 emitters. These emitters can be pulsed emitters. These emitters are cold cathode X-ray emitters. These cold cathode X-ray emitters are, for example, either carbon nano tubes based cold cathode X-ray emitters, or silicon based cold cathode X-ray emitters, or field emission electron based cold cathode X-ray emitters.
- first vertical scanning and the second vertical scanning are performed a first time to build respectively first and second scout views
- first vertical scanning and the second vertical scanning are performed a second time so as to build respectively first and second 2D images therefrom, based on these first and second scout views.
- the computed tomography, first frontal computed tomography images and second lateral computed tomography images is performed during second time performance of the first vertical scanning and the second vertical scanning. This second short part H2 of this portion of patient body height is determined by the first vertical scanning during the first time and by the second vertical scanning during the first time.
- first vertical scanning and said second vertical scanning are performed a first time to build respectively first and second scout views
- first vertical scanning and the second vertical scanning are performed a second time so as to build respectively first and second 2D images therefrom, based on these first and second scout views.
- the computed tomography, first frontal computed tomography images and second lateral computed tomography images is performed after second time performance of the first vertical scanning and the second vertical scanning. This second short part H2 of said portion of patient body height is determined by the first vertical scanning during the second time and by the second vertical scanning during the second time.
- This first long part Hl of patient body height or of portion of patient body height could be for example the whole patient body height or the whole patient spine height.
- the second short part H2 would be a reduced region of the first long part Hl, and this second H2 of patient body height or of portion of patient body height could be a limited region corresponding either to a patient height corresponding to a specific number of vertebrae like for example the thoracic vertebrae or the lumbar vertebrae or the cervical vertebrae or the sacrum plate, or alternatively to a patient height corresponding to a specific patient organ like stomach or liver or a lung for example.
- these complementary data, used to make this patient specific 3D reconstruction on at least this second part H2 of this portion of patient body height also comprise 3D generic data.
- making a patient specific 3D reconstruction on at least this second short part H2 of this portion of patient body height, at least combining therefore together both the first and second 2D images with complementary data comprises, making as patient specific modeling, a patient specific provisional 3D reconstruction on at least the first long part Hl of this portion of patient body height, using both, as patient specific data therefore, at least both first and second 2D images, as generic data therefore, a 3D generic model, and as modeling process therefore, a process combining both the first and second 2D images with the 3D generic model so as to get at this patient specific provisional 3D reconstruction.
- the complementary data, used to make said patient specific 3D reconstruction on at least this second short part H2 of this portion of patient body height, are used so as to upgrade this patient specific provisional 3D reconstruction into a patient specific final 3D reconstruction of this second part H2 of this portion of patient body height by modifying, or by enriching and/or correcting, this patient specific provisional 3D reconstruction with the computed tomography of this second part H2 of this portion of patient body height.
- the modeling process can use artificial intelligence, and preferably uses deep learning or generative adversarial network.
- Fig. 7 shows an example of a first embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- the 2D images 101 are used to make a patient specific 3D reconstruction 103 by a modeling process 102 using complementary data 104.
- These complementary data 104 comprise the computed tomography images 105, first and second computed tomography images, frontal and lateral computed tomography images.
- Fig. 8 shows an example of a second embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- the 2D images 201 are used to make a patient specific 3D reconstruction 203 by a modeling process 202 using complementary data 204.
- These complementary data 204 comprise both the computed tomography images 205, first and second computed tomography images, frontal and lateral computed tomography images, and 3D generic data 206.
- Fig. 9 shows an example of a third embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- the 2D images 301 are used to make a patient specific provisional 3D reconstruction 313 by a modeling process 312 using the 3D generic data 306 included in the complementary data 304.
- the patient specific provisional 3D reconstruction 313 is used to make a patient specific final 3D reconstruction 323 by another modeling process 322 using the computed tomography images 305, first and second computed tomography images, frontal and lateral computed tomography images, included in the complementary data 304.
- Fig. 10 shows an example of a fourth embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- the 2D images 401 are used to make a patient specific provisional 3D reconstruction 413 by a modeling process 412 using the 3D generic data 406 included in the complementary data 404.
- the patient specific provisional 3D reconstruction 413 is used to make a patient specific final 3D reconstruction 423 by another modeling process 422 using the computed tomography images, first and second computed tomography images, frontal and lateral computed tomography images, included in the complementary data 404.
- the computed tomography images which are used are not the raw computed tomography images 405 as obtained from the computed tomography detectors 33 and 34, but are corrected computed tomography images 415 obtained from the raw computed tomography images 405 by an artificial intelligence process 410 so as to reduce cross-scattering effect between first and second raw computed tomography images 405 respectively made by first and second computed tomography detectors 33 and 34 and/or so as to reduce self- scattering effect on first and second raw computed tomography images 405 respectively made by first and second computed tomography detectors 33 and 34.
- Fig. 11 shows an example of a fifth embodiment of patient specific 3D reconstruction in the method of radiography implemented by a radiological apparatus.
- the 2D images 501 are used to make a patient specific provisional 3D reconstruction 513 by a modeling process 512 using the 3D generic data 506 included in the complementary data 504.
- the patient specific provisional 3D reconstruction 513 is used to make a patient specific intermediate 3D reconstruction 533 by another modeling process 532 using the computed tomography images 505, first and second computed tomography images, frontal and lateral computed tomography images, included in the complementary data 504, which are the first and second raw computed tomography images 505 respectively made by first and second computed tomography detectors 33 and 34.
- the patient specific provisional 3D reconstruction 513 is also used to make a patient specific final 3D reconstruction 543 by still another modeling process 542 using the computed tomography images, first and second computed tomography images, frontal and lateral computed tomography images, included in the complementary data 504.
- the computed tomography images which are used are not the raw computed tomography images 505 as obtained from the computed tomography detectors 33 and 34, but are corrected computed tomography images 515 obtained from the raw computed tomography images 505 by an artificial intelligence process 510 so as to reduce cross-scattering effect between first and second raw computed tomography images 505, by simulating and correcting such cross-scattering effect between first and second raw computed tomography images 505, respectively made by first and second computed tomography detectors 33 and 34 and/or so as to reduce self-scattering effect on first and second raw computed tomography images 505 respectively made by first and second computed tomography detectors 33 and 34.
- This artificial intelligence process 510 uses the patient specific intermediate 3D reconstruction 533 to make the corrected computed tomography images 515 from the raw computed tomography images 505.
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Abstract
La présente invention concerne un appareil radiologique comprenant : un portique (10) encapsulé à l'intérieur d'un couvercle, une plate-forme patient (6), une source de rayonnement frontal (21) associée à un détecteur de rayonnement frontal (23), une source de rayonnement latéral (22) associée à un détecteur de rayonnement latéral (24), une source de tomodensitométrie frontale (31) associée à un détecteur de tomodensitométrie frontale (33), une source de tomodensitométrie latérale (32) associée à un détecteur de tomodensitométrie latérale (34), un premier support frontal coulissant verticalement (15) reliant mécaniquement ensemble, à la fois, la source de rayonnement frontal (21) et le détecteur de tomodensitométrie frontale (33), un second support latéral coulissant verticalement (16) reliant mécaniquement ensemble, à la fois, la source de rayonnement latéral (22) et le détecteur de tomodensitométrie latérale (34), un troisième support frontal coulissant verticalement (17) reliant mécaniquement ensemble, les deux, le détecteur de rayonnement frontal (23) étant situé à l'intérieur du couvercle de portique et de la source de tomodensitométrie frontale (31), un quatrième support latéral coulissant verticalement (18) reliant mécaniquement ensemble, à la fois, le détecteur de rayonnement latéral (24) et la source de tomodensitométrie latérale (32).
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| PCT/EP2023/083059 WO2025108563A1 (fr) | 2023-11-24 | 2023-11-24 | Appareil radiologique |
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| PCT/EP2023/083059 WO2025108563A1 (fr) | 2023-11-24 | 2023-11-24 | Appareil radiologique |
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| US20120224761A1 (en) * | 2011-03-04 | 2012-09-06 | Frederik Bender | Method for providing a 3D image data record of a physiological object with a metal object therein |
| US11534122B2 (en) | 2012-09-20 | 2022-12-27 | Virginia Tech Intellectual Properties, Inc. | Stationary source computed tomography and CT-MRI systems |
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