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WO2025108564A1 - Method of radiography of a patient body - Google Patents

Method of radiography of a patient body Download PDF

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Publication number
WO2025108564A1
WO2025108564A1 PCT/EP2023/083060 EP2023083060W WO2025108564A1 WO 2025108564 A1 WO2025108564 A1 WO 2025108564A1 EP 2023083060 W EP2023083060 W EP 2023083060W WO 2025108564 A1 WO2025108564 A1 WO 2025108564A1
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WO
WIPO (PCT)
Prior art keywords
patient body
patient
vertical scanning
body height
resonance imaging
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.)
Pending
Application number
PCT/EP2023/083060
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French (fr)
Inventor
Pascal Desaute
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EOS Imaging SA
Original Assignee
EOS Imaging SA
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Filing date
Publication date
Application filed by EOS Imaging SA filed Critical EOS Imaging SA
Priority to PCT/EP2023/083060 priority Critical patent/WO2025108564A1/en
Publication of WO2025108564A1 publication Critical patent/WO2025108564A1/en
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

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Classifications

    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/48—NMR imaging systems
    • G01R33/4808—Multimodal MR, e.g. MR combined with positron emission tomography [PET], MR combined with ultrasound or MR combined with computed tomography [CT]
    • G01R33/4812—MR combined with X-ray or 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
    • A61B6/44—Constructional features of apparatus for radiation diagnosis
    • A61B6/4417—Constructional features of apparatus for radiation diagnosis related to combined acquisition of different diagnostic modalities
    • 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
    • A61B6/52—Devices using data or image processing specially adapted for radiation diagnosis
    • A61B6/5211—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data
    • A61B6/5229—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image
    • A61B6/5247—Devices using data or image processing specially adapted for radiation diagnosis involving processing of medical diagnostic data combining image data of a patient, e.g. combining a functional image with an anatomical image combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/28—Details of apparatus provided for in groups G01R33/44 - G01R33/64
    • G01R33/32—Excitation or detection systems, e.g. using radio frequency signals
    • G01R33/323—Detection of MR without the use of RF or microwaves, e.g. force-detected MR, thermally detected MR, MR detection via electrical conductivity, optically detected MR
    • G01R33/326—Detection of MR without the use of RF or microwaves, e.g. force-detected MR, thermally detected MR, MR detection via electrical conductivity, optically detected MR involving a SQUID
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
    • G01R33/00—Arrangements or instruments for measuring magnetic variables
    • G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
    • G01R33/44—Arrangements or instruments for measuring magnetic variables involving magnetic resonance using nuclear magnetic resonance [NMR]
    • G01R33/445—MR involving a non-standard magnetic field B0, e.g. of low magnitude as in the earth's magnetic field or in nanoTesla spectroscopy, comprising a polarizing magnetic field for pre-polarisation, B0 with a temporal variation of its magnitude or direction such as field cycling of B0 or rotation of the direction of B0, or spatially inhomogeneous B0 like in fringe-field MR or in stray-field 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]

Definitions

  • the invention relates to the technical field of the methods of radiography of a patient body and of the associated radiography apparatuses to implement such methods of radiography of a patient body.
  • 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.
  • This object is achieved with a method of radiography of at least a portion of a height of a patient body in standing position, comprising: one or more first vertical scanning of said portion of patient body height by a first radiation source and a first radiation detector cooperating to make a first 2D image of a first part of said portion of patient body height, one or more second vertical scanning of said portion of patient body height by a second radiation source and a second radiation detector cooperating to make a second 2D image of said first part of said portion of patient body height, said first vertical scanning and said second vertical scanning being performed synchronously, 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 magnetic resonance imaging of a 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
  • the magnetic field is the main magnetic field.
  • the magnetic field is a static polarization magnetic field oriented in the vertical direction.
  • This static polarization magnetic field is of less than 20 milli-Tesla, or between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla.
  • the magnetic field is preferably created by using a first coil located in a horizontal plan above the patient, which means it is located in the top of a radiological apparatus implementing the method of radiology according to the invention, a second coil located in a horizontal plan below the patient, which means it is located in the bottom of a radiological apparatus implementing the method of radiology according to the invention.
  • 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.
  • said magnetic resonance imaging is performed with a magnetic field between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla.
  • said cryogenic quantum detector is a superconducting quantum interference device (SQUID) which is refrigerated by a cryogenic refrigeration system.
  • SQUID superconducting quantum interference device
  • said superconducting quantum interference device is a low critic temperature superconducting quantum interference device.
  • a flux transformer disposed upstream of said superconducting quantum interference device, a primary detection antenna disposed upstream of said flux transformer.
  • said magnetic resonance imaging is performed by using a magnetic field detection antenna which: is transparent to X-ray radiation, is vertically mobile so as to cover at least partly or fully said second part of said portion of patient body height during performance of said first vertical scanning and said second vertical scanning.
  • a magnetic field detection antenna which: is transparent to X-ray radiation, is vertically mobile so as to cover at least partly or fully said second part of said portion of patient body height during performance of said first vertical scanning and said second vertical scanning.
  • said magnetic field detection antenna surrounds the patient body so as to also perform the function of a brace so as to maintain patient body immobile during performance of said first vertical scanning and said second vertical scanning.
  • said magnetic resonance imaging is performed after performance of said first vertical scanning and said second vertical scanning.
  • said magnetic resonance imaging being performed during performance of said first vertical scanning and said second vertical scanning.
  • said patient belongs to a first category of people with pacemakers and/or metallic fragments and/or metallic implants.
  • said patient belongs to a category of young people (less than 18 years old).
  • the use of a very low X-ray dose globally received by patient thanks to the use of said first and second vertical scanning, is especially important for young people who are much more sensitive to the level of X-ray they can receive.
  • said complementary data, used to make said patient specific 3D reconstruction on at least said second part of said portion of patient body height comprise said magnetic resonance imaging of said second part of said portion of patient body height, Hence, the aforementioned synergy created between both these simple frontal and lateral 2D X-ray imaging and magnetic resonance imaging is improved.
  • 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.
  • said magnetic resonance imaging is performed with a static polarization magnetic field oriented in the vertical direction, said static polarization magnetic field being of less than 20 milli-Tesla, or between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milliTesla and 5 milli-Tesla, by using a first coil located in a horizontal plane above the patient, a second coil located in a horizontal plane below the patient.
  • the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
  • said magnetic resonance imaging is performed by correcting the inhomogeneities of said static polarization magnetic field, so as to make said static polarization magnetic field more homogeneous, by adding one or more shim coils, which are located either within said first coil and/or within said second coil, or in at least a vertical panel of a gantry cover of a radiological apparatus implemented the method of radiography.
  • the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
  • said magnetic resonance imaging is performed by creating gradients in the X, Y and Z directions of said static polarization magnetic field, by adding one or more gradient coils, which are located either within said first coil and/or within said second coil, or in at least a vertical panel of a gantry cover of a radiological apparatus implemented the method of radiography.
  • the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
  • 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 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 3D reconstruction.
  • 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 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 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.
  • Fig. 1 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in off mode, and the magnetic resonance imaging both in off and on modes.
  • Fig. 2 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in on mode, and the magnetic resonance imaging both in off and on modes.
  • Fig. 3 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 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, and the magnetic resonance imaging both in off and on modes.
  • 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.
  • third column 13 and fourth column 14 can be replaced by a single a vertical pilar 19 (not shown on figures) along which a horizontal bar supporting both the third frontal vertically sliding support 17 and the fourth lateral vertically sliding support 18 is vertically sliding, this pilar 19 being in a comer of the encapsulated gantry 10.
  • 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.
  • 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.
  • 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 radiological apparatus 1 also comprises a magnetic resonance imaging system which comprises: a first electric circuit 41, a second electric circuit 42, an antenna 43, a cryogenic quantum detection system 44 including a cryogenic quantum detector 45 cooled by a cryogenic refrigeration system 46.
  • a magnetic resonance imaging system which comprises: a first electric circuit 41, a second electric circuit 42, an antenna 43, a cryogenic quantum detection system 44 including a cryogenic quantum detector 45 cooled by a cryogenic refrigeration system 46.
  • There are vertical panels 51 and 52 of a gantry cover of a radiological apparatus implemented the method of radiography.
  • the vertical panel 51 is in a first vertical plan YZ, behind the patient 50.
  • the vertical plan 52 is in a second vertical plan XZ orthogonal to first vertical plan YZ and on the side of the patient 50. Both vertical panels 51 and 52 will be X-ray transparent.
  • 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 B 1 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, and the magnetic resonance imaging both in off and on modes.
  • 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.
  • the first electric circuit 41 is a top horizontal coil located at the top level of the radiological apparatus 1, whereas the second electric circuit 42 is also a bottom horizontal coil but located at the bottom level of the radiological apparatus 1, under the patient platform 6.
  • Top horizontal coil 41 and bottom horizontal coil 42 are disposed face to face so as to create a magnetic field in between, preferably a static vertically oriented magnetic field. Shim coils may also be added to make this static vertically oriented magnetic field more stable and more homogeneous. Some gradient coils are used to generate a variable gradient of the value of this magnetic field in both X, Y and Z directions.
  • a cylindric antenna 43 comprises a primary detection antenna which will send its detected signal to the cryogenic quantum detector 45 which is preferably a very sensitive SQUID detector 45 cooled by a cryogenic cooling or refrigeration system 46.
  • the primary detection antenna is also globally called magnetic field detection antenna 43.
  • This primary detection antenna is also called pick up coil.
  • This cylindric antenna 43 is located around the patient body and in the space located between the horizontal coil 41 and the bottom horizontal coil 42.
  • the antenna 43 may also comprise an excitation coil, preferably concentrically disposed, creating a horizontal oriented magnetic field, variable and time dependent.
  • the excitation coil is disposed outside of antenna 43 in gantry cover around the patient platform 6, creating a horizontal oriented magnetic field, variable and time dependent.
  • the magnetic resonance imaging is performed with a static polarization magnetic field BO oriented in the vertical direction Z, the static polarization magnetic field being of less than 20 milli-Tesla, or between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla, by using a first coil 41 located in a horizontal plane XY above the patient 50, a second coil 42 located in a horizontal plane XY below the patient 50.
  • the magnetic resonance imaging is performed by correcting the inhomogeneities of the static polarization magnetic field BO, so as to make the static polarization magnetic field BO more homogeneous, by adding one or more shim coils, which are located either within the first coil 41 and/or within the second coil 42, or in one or the other of vertical panels 51 or 52, in both vertical panel 51 and 52 of a gantry cover of a radiological apparatus implemented the method of radiography.
  • the vertical panel 51 is in a first vertical plan YZ, behind the patient 50.
  • the vertical plan 52 is in a second vertical plan XZ orthogonal to first vertical plan YZ and on the side of the patient 50.
  • the magnetic resonance imaging is performed by creating gradients in the X and/or Y and/or Z directions of the static polarization magnetic field BO, preferably in the X and Y and Z directions of the static polarization magnetic field BO, by adding one or more gradient coils, which are located either within the first coil 41 and/or within the second coil 42, or in at least a vertical panel 51 and/or 52 of a gantry cover of a radiological apparatus implemented the method of radiography.
  • the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
  • the excitation antenna instead of being within antenna 43, can alternatively be in one or the other of vertical panels 51 or 52, or in both vertical panel 51 and 52 of a gantry cover of a radiological apparatus implemented the method of radiography; then there would be two excitation antennas, one in panel 51 and another one in panel 52.
  • the magnetic resonance imaging is performed by using a magnetic field detection antenna 43 which is transparent to X-ray radiation, is vertically mobile so as to cover at least partly or fully this second part H2 of this portion of patient body height during performance of the first vertical scanning and the second vertical scanning.
  • This magnetic field detection antenna 43 surrounds the patient body so as to also perform the function of a brace so as to maintain patient body immobile during performance of the first vertical scanning and the second vertical scanning.
  • this magnetic field detection antenna 43 remains immobile around the patient body at a chosen patient height corresponding to second short part H2 during performance of the magnetic resonance imaging.
  • the magnetic resonance imaging can be preferably performed with a magnetic field between 0.1 milli-Tesla and 10 milli-Tesla, more preferably between 0.5 milli-Tesla and 5 milliTesla, for example about 1 milli-Tesla.
  • This magnetic field is the static vertical magnetic field BO created by the top horizontal coil 41 and the bottom horizontal coil 42, in the space between the top horizontal coil 41 and bottom horizontal coil 42.
  • the cryogenic quantum detector 45 can be preferably a superconducting quantum interference device (SQUID) 45 which is refrigerated by a cryogenic refrigeration system 46.
  • This superconducting quantum interference device 45 is preferably a low critic temperature superconducting quantum interference device 45.
  • a flux transformer disposed upstream of said superconducting quantum interference device 45, the primary detection antenna disposed upstream of said flux transformer, the primary detection antenna being a part of the magnetic field detection antenna 43.
  • Fig. 3 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.
  • 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 magnetic resonance imaging 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 magnetic resonance imaging of this second part H2 of this portion of patient body height.
  • 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 magnetic resonance imaging 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 magnetic resonance imaging 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.
  • the magnetic resonance imaging is performed with a magnetic field of less than 20 milliTesla, associated to the cryogenic quantum detector 45.
  • 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 said portion of patient body height also comprise the magnetic resonance imaging of this second part H2 of this portion of patient body height.
  • 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 magnetic resonance imaging 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.

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Abstract

This invention relates to a method of radiography of at least a portion of a height of a patient body in standing position, comprising: one or more first vertical scanning of said portion of patient body height by a first radiation source (21) and a first radiation detector (23), one or more second vertical scanning of said portion of patient body height by a second radiation source (22) and a second radiation detector (24), wherein further comprising: making a patient specific 3D reconstruction on at least a second part (H2) of said portion of patient body height, at least combining therefore together both said first and second 2D images with complementary data, making a magnetic resonance imaging of a second part (H2) of said portion of patient body height, said second part (H2) of said portion of patient body height being shorter, or at least twice shorter, than said first part (H1) of said portion of patient body height, said second part (H2) 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 magnetic resonance imaging being performed: with a magnetic field of less than 20 milli-Tesla, associated to a cryogenic quantum detector (45).

Description

METHOD OF RADIOGRAPHY OF A PATIENT BODY
FIELD OF THE INVENTION
The invention relates to the technical field of the methods of radiography of a patient body and of the associated radiography apparatuses to implement such methods of radiography of a patient body.
BACKGROUND OF THE INVENTION
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. There is a need to improve this medical situation. Some of these techniques can be used simultaneously, for example computed tomography and magnetic resonance imaging in patent US 11534122B2 or US 11639567B2, or for example computed tomography and positron emission tomography in patent application US 2021 1389399 Al.
There is an intrinsic complementarity between: on the one hand, some X-ray imaging, o dedicated to enhancing bone structure within patient body, and on the other hand, magnetic resonance imaging, o dedicated to enhancing soft tissue within patient body, so as to get a full and complete picture of the inside of patient body.
This complementarity would appear at first sight to be more interesting between X-ray computed tomography and magnetic resonance imaging, because: both X-ray computed tomography and magnetic resonance imaging are performed: o performed during a long time,
■ on a patient lying still in horizontal position, o providing for a 3D reconstruction, ■ rather fine,
■ but on a quite limited part of patient body, corresponding to a relatively small region of interest within patient body, o to the cost of both:
■ a high global radiation dose received by the patient,
■ a high level of magnetic field produced by the apparatus,
■ leading therefore to rare performance on rather small region of interest within patient body.
However, there would be still an important obstacle to overcome: computed tomography requires an apparatus with bulky metallic parts, and especially with moving bulky metallic parts, magnetic resonance imaging needs a high magnetic field, hence the coupling between on the one hand these bulky metallic parts and on the other hand this high magnetic field would run the risk of disturbing correct working of this magnetic resonance imaging.
On the contrary, there would seem to be at first sight a practical duality between: on the one hand, simple bidirectional (frontal and lateral) 2D X-ray imaging, o performed by vertical scanning,
■ during a short time, o providing for a 3D reconstruction,
■ relatively coarse,
■ but on a rather large part of patient body, and on the other hand, sophisticated magnetic resonance imaging, o performed by horizontal scanning,
■ during a long time, o providing for a 3D reconstruction,
■ finer,
■ but on a notably more limited part of patient body.
SUMMARY OF THE INVENTION
Whereas, indeed, the apparently low compatibility between simple bidirectional (frontal and lateral) 2D X-ray imaging and sophisticated magnetic resonance imaging, would be deeply improved by the invention which proposes: first, to use a very small level of magnetic field associated with a very sensitive detection system, to avoid former detrimental coupling between metallic parts of apparatus and surrounding magnetic field, while still being able to precisely detect variations of such a small level of magnetic field, and second, creating interesting synergy between both these simple frontal and lateral 2D X-ray imaging and sophisticated magnetic resonance imaging, simple frontal and lateral 2D X-ray imaging helping better focusing of sophisticated magnetic resonance imaging on a specific region of interest while at the same time sophisticated magnetic resonance imaging improving image quality of 3D reconstruction from simple frontal and lateral 2D X-ray imaging on this specific region of interest, both leading to improved diagnosis derived from each patient imaging, thereby reducing the number of needed patient imaging in due course of time, o indeed, magnetic resonance imaging usually performs a scout view to better focus on the region of interest, such scout view can be cancelled, because either the scout view of the first and second vertical scanning or the first and second vertical scanning can replace the usual magnetic resonance imaging scout view.
Besides, such a newly proposed combination would lead to a drastic reduction of the global weight of the radiological apparatus which would integrate together both frontal and lateral 2D X-ray imaging and magnetic resonance imaging. Indeed, the huge magnets weighting one or more tons, needed to provide a magnetic field of one or more Tesla, would no more be needed.
This object is achieved with a method of radiography of at least a portion of a height of a patient body in standing position, comprising: one or more first vertical scanning of said portion of patient body height by a first radiation source and a first radiation detector cooperating to make a first 2D image of a first part of said portion of patient body height, one or more second vertical scanning of said portion of patient body height by a second radiation source and a second radiation detector cooperating to make a second 2D image of said first part of said portion of patient body height, said first vertical scanning and said second vertical scanning being performed synchronously, 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 magnetic resonance imaging of a 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, 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 magnetic resonance imaging being performed: with a magnetic field of less than 20 milliTesla, associated to a cryogenic quantum detector.
The magnetic field is the main magnetic field.
The magnetic field is a static polarization magnetic field oriented in the vertical direction. This static polarization magnetic field is of less than 20 milli-Tesla, or between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla.
The magnetic field is preferably created by using a first coil located in a horizontal plan above the patient, which means it is located in the top of a radiological apparatus implementing the method of radiology according to the invention, a second coil located in a horizontal plan below the patient, which means it is located in the bottom of a radiological apparatus implementing the method of radiology according to the invention.
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.
Preferably, said magnetic resonance imaging is performed with a magnetic field between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla.
Hence, the aforementioned compatibility between simple bidirectional (frontal and lateral) 2D X-ray imaging and sophisticated magnetic resonance imaging is further improved.
Preferably, said cryogenic quantum detector is a superconducting quantum interference device (SQUID) which is refrigerated by a cryogenic refrigeration system.
Hence, the aforementioned compatibility between simple bidirectional (frontal and lateral) 2D X-ray imaging and sophisticated magnetic resonance imaging is further improved.
Preferably, said superconducting quantum interference device is a low critic temperature superconducting quantum interference device.
Preferably, to detect variations of said magnetic field, there is a use of: a flux transformer disposed upstream of said superconducting quantum interference device, a primary detection antenna disposed upstream of said flux transformer.
Preferably, said magnetic resonance imaging is performed by using a magnetic field detection antenna which: is transparent to X-ray radiation, is vertically mobile so as to cover at least partly or fully said second part of said portion of patient body height during performance of said first vertical scanning and said second vertical scanning.
Hence, the aforementioned compatibility between simple bidirectional (frontal and lateral) 2D X-ray imaging and sophisticated magnetic resonance imaging is further improved. Preferably, said magnetic field detection antenna surrounds the patient body so as to also perform the function of a brace so as to maintain patient body immobile during performance of said first vertical scanning and said second vertical scanning.
Hence, not only is the aforementioned compatibility between simple bidirectional (frontal and lateral) 2D X-ray imaging and sophisticated magnetic resonance imaging further improved, but also the intrinsic quality of the 2D images is further improved, thanks to the magnetic field detection antenna thereby fulfilling a double function, both detecting variations of magnetic field so as to bring additional information to X-rays 2D images and simultaneously avoiding patient parasitic moves so as to further improve the X-rays 2D images intrinsic quality.
Preferably, said magnetic resonance imaging is performed after performance of said first vertical scanning and said second vertical scanning.
Hence, the aforementioned synergy created between both these simple frontal and lateral 2D X-ray imaging and sophisticated magnetic resonance imaging is deeply improved, the use of standard 2D images as scout view for magnetic resonance imaging leading to an even better focusing of the region of interest for the magnetic resonance imaging.
Preferably, said magnetic resonance imaging being performed during performance of said first vertical scanning and said second vertical scanning.
Hence, the aforementioned synergy created between both these simple frontal and lateral 2D X-ray imaging and sophisticated magnetic resonance imaging is improved, while an accurate and permanent correspondence between 2D images and magnetic resonance imaging is kept.
Preferably, said patient belongs to a first category of people with pacemakers and/or metallic fragments and/or metallic implants.
Hence, the very use of a very small level of magnetic field associated with a very sensitive detection system, so as to avoid former detrimental coupling between metallic parts of apparatus and surrounding magnetic field, offers to this specific first category of patients a very safe radiography process as well as still kept efficient.
Preferably, said patient belongs to a category of young people (less than 18 years old).
Hence, the use of a very low X-ray dose globally received by patient, thanks to the use of said first and second vertical scanning, is especially important for young people who are much more sensitive to the level of X-ray they can receive.
Preferably, said complementary data, used to make said patient specific 3D reconstruction on at least said second part of said portion of patient body height, comprise said magnetic resonance imaging of said second part of said portion of patient body height, Hence, the aforementioned synergy created between both these simple frontal and lateral 2D X-ray imaging and magnetic resonance imaging is improved.
Preferably, 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.
Hence, the patient specific 3D reconstruction is made more precise and more accurate.
Preferably, said magnetic resonance imaging is performed with a static polarization magnetic field oriented in the vertical direction, said static polarization magnetic field being of less than 20 milli-Tesla, or between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milliTesla and 5 milli-Tesla, by using a first coil located in a horizontal plane above the patient, a second coil located in a horizontal plane below the patient.
Hence, the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
Preferably, said magnetic resonance imaging is performed by correcting the inhomogeneities of said static polarization magnetic field, so as to make said static polarization magnetic field more homogeneous, by adding one or more shim coils, which are located either within said first coil and/or within said second coil, or in at least a vertical panel of a gantry cover of a radiological apparatus implemented the method of radiography.
Hence, the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
Preferably, said magnetic resonance imaging is performed by creating gradients in the X, Y and Z directions of said static polarization magnetic field, by adding one or more gradient coils, which are located either within said first coil and/or within said second coil, or in at least a vertical panel of a gantry cover of a radiological apparatus implemented the method of radiography.
Hence, the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
Preferably, 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.
Hence, the patient specific 3D reconstruction is made more precise and more accurate.
Preferably, 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 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 3D reconstruction.
Hence, the patient specific 3D reconstruction is made more precise and more accurate.
Preferably, said modeling process uses artificial intelligence, and preferably uses deep learning or generative adversarial network.
Hence, the patient specific 3D reconstruction is made more precise and more accurate.
Preferably, 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.
Hence, the patient specific 3D reconstruction is made more precise and more accurate.
Preferably, there is a 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.
Hence, the cross-scattering between X-rays with different incidences on patient body is reduced, while keeping a good global compacity and rather low global weight of the radiological apparatus.
Preferably, 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.
Hence, the cross-scattering between X-rays with different incidences on patient body is further reduced, while keeping a good global compacity and rather low global weight of the radiological apparatus.
Preferably, said first vertical gap is comprised between 1cm and 5cm, advantageously between 1.5cm and 3cm.
Hence, the cross-scattering between X-rays with different incidences on patient body is further reduced, while keeping a good global compacity and rather low global weight of the radiological apparatus.
2D means bi-dimensional, and 3D means tri-dimensional. Further features and advantages of the invention will appear from the following description of embodiments of the invention, given as non-limiting examples, with reference to the accompanying drawings listed hereunder.
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in off mode, and the magnetic resonance imaging both in off and on modes.
Fig. 2 shows an example of the radiological apparatus according to an embodiment of the invention, showing the vertical scanning in on mode, and the magnetic resonance imaging both in off and on modes.
Fig. 3 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.
DETAILED DESCRIPTION OF THE INVENTION
On all figures, 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, whereas 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. On all figures, 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, and the magnetic resonance imaging both in off and on modes.
There is a radiological apparatus 1. 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.
Advantageously, 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.
There are a first column 11 along which a first frontal vertically sliding support 15 is vertically sliding, a second column 12 along which a second lateral vertically sliding support 16 is vertically sliding, the 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.
There are a third column 13 along which the third frontal vertically sliding support 17 is vertically sliding, a fourth column 14 along which the fourth lateral vertically sliding support 18 is vertically sliding, the third column 13 and the fourth column 14 being mechanically independent from each other so that, neither the third column 13 supports any weight of the fourth lateral vertically sliding support 18, nor the fourth column 14 supports any weight of the third frontal vertically sliding support 17.
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.
As an alternative third column 13 and fourth column 14 can be replaced by a single a vertical pilar 19 (not shown on figures) along which a horizontal bar supporting both the third frontal vertically sliding support 17 and the fourth lateral vertically sliding support 18 is vertically sliding, this pilar 19 being in a comer of the encapsulated gantry 10.
Then, 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.
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.
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.
Preferably, 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.
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 radiological apparatus 1 also comprises a magnetic resonance imaging system which comprises: a first electric circuit 41, a second electric circuit 42, an antenna 43, a cryogenic quantum detection system 44 including a cryogenic quantum detector 45 cooled by a cryogenic refrigeration system 46. There are vertical panels 51 and 52 of a gantry cover of a radiological apparatus implemented the method of radiography. The vertical panel 51 is in a first vertical plan YZ, behind the patient 50. The vertical plan 52 is in a second vertical plan XZ orthogonal to first vertical plan YZ and on the side of the patient 50. Both vertical panels 51 and 52 will be X-ray transparent.
Preferably, 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. Advantageously, in a square array having three rows from A to C and three columns from 1 to 3: 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 B 1 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, and the magnetic resonance imaging both in off and on modes.
The frontal radiation source 21 is associated to a frontal collimator to narrow frontal emitted beam 25 toward standing patient 50. 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. After end of first vertical scanning, at the output of frontal radiation detector 23 there is a first 2D image, the frontal 2D image of a standing patient or of an organ of this standing patient. The height of frontal beam 25 considered is very small since it is the height of the frontal beam 25 which will enter the frontal collimation tunnel 27 before reaching the sensitive surface of the frontal radiation detector 23. 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. 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. After end of second vertical scanning, at 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. The height of 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.
Preferably, there is a first vertical gap (not visible on figures since too small) between on the one hand the frontal radiation source 21 and the frontal radiation detector 23 and on the other hand the lateral radiation source 22 and the lateral radiation detector 24, such that the first vertical scanning and the second vertical scanning are performed synchronously but with a first time shift in between, so as to further reduce cross-scattering between the first and second 2D images. Advantageously, 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.
The first electric circuit 41 is a top horizontal coil located at the top level of the radiological apparatus 1, whereas the second electric circuit 42 is also a bottom horizontal coil but located at the bottom level of the radiological apparatus 1, under the patient platform 6. Top horizontal coil 41 and bottom horizontal coil 42 are disposed face to face so as to create a magnetic field in between, preferably a static vertically oriented magnetic field. Shim coils may also be added to make this static vertically oriented magnetic field more stable and more homogeneous. Some gradient coils are used to generate a variable gradient of the value of this magnetic field in both X, Y and Z directions. A cylindric antenna 43 comprises a primary detection antenna which will send its detected signal to the cryogenic quantum detector 45 which is preferably a very sensitive SQUID detector 45 cooled by a cryogenic cooling or refrigeration system 46. The primary detection antenna is also globally called magnetic field detection antenna 43. This primary detection antenna is also called pick up coil. This cylindric antenna 43 is located around the patient body and in the space located between the horizontal coil 41 and the bottom horizontal coil 42.
The antenna 43 may also comprise an excitation coil, preferably concentrically disposed, creating a horizontal oriented magnetic field, variable and time dependent.
As an alternative, the excitation coil, is disposed outside of antenna 43 in gantry cover around the patient platform 6, creating a horizontal oriented magnetic field, variable and time dependent.
The magnetic resonance imaging is performed with a static polarization magnetic field BO oriented in the vertical direction Z, the static polarization magnetic field being of less than 20 milli-Tesla, or between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla, by using a first coil 41 located in a horizontal plane XY above the patient 50, a second coil 42 located in a horizontal plane XY below the patient 50.
The magnetic resonance imaging is performed by correcting the inhomogeneities of the static polarization magnetic field BO, so as to make the static polarization magnetic field BO more homogeneous, by adding one or more shim coils, which are located either within the first coil 41 and/or within the second coil 42, or in one or the other of vertical panels 51 or 52, in both vertical panel 51 and 52 of a gantry cover of a radiological apparatus implemented the method of radiography. The vertical panel 51 is in a first vertical plan YZ, behind the patient 50. The vertical plan 52 is in a second vertical plan XZ orthogonal to first vertical plan YZ and on the side of the patient 50.
The magnetic resonance imaging is performed by creating gradients in the X and/or Y and/or Z directions of the static polarization magnetic field BO, preferably in the X and Y and Z directions of the static polarization magnetic field BO, by adding one or more gradient coils, which are located either within the first coil 41 and/or within the second coil 42, or in at least a vertical panel 51 and/or 52 of a gantry cover of a radiological apparatus implemented the method of radiography.
Hence, the magnetic resonance imaging can be performed in a way which is both simpler and more efficient.
The excitation antenna, instead of being within antenna 43, can alternatively be in one or the other of vertical panels 51 or 52, or in both vertical panel 51 and 52 of a gantry cover of a radiological apparatus implemented the method of radiography; then there would be two excitation antennas, one in panel 51 and another one in panel 52.
The magnetic resonance imaging is performed by using a magnetic field detection antenna 43 which is transparent to X-ray radiation, is vertically mobile so as to cover at least partly or fully this second part H2 of this portion of patient body height during performance of the first vertical scanning and the second vertical scanning. This magnetic field detection antenna 43 surrounds the patient body so as to also perform the function of a brace so as to maintain patient body immobile during performance of the first vertical scanning and the second vertical scanning. Preferably, this magnetic field detection antenna 43 remains immobile around the patient body at a chosen patient height corresponding to second short part H2 during performance of the magnetic resonance imaging.
The magnetic resonance imaging can be preferably performed with a magnetic field between 0.1 milli-Tesla and 10 milli-Tesla, more preferably between 0.5 milli-Tesla and 5 milliTesla, for example about 1 milli-Tesla. This magnetic field is the static vertical magnetic field BO created by the top horizontal coil 41 and the bottom horizontal coil 42, in the space between the top horizontal coil 41 and bottom horizontal coil 42.
The cryogenic quantum detector 45 can be preferably a superconducting quantum interference device (SQUID) 45 which is refrigerated by a cryogenic refrigeration system 46. This superconducting quantum interference device 45 is preferably a low critic temperature superconducting quantum interference device 45. Preferably, to detect variations of said magnetic field, there is a use of a flux transformer disposed upstream of said superconducting quantum interference device 45, the primary detection antenna disposed upstream of said flux transformer, the primary detection antenna being a part of the magnetic field detection antenna 43.
Fig. 3 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
25 between directions DI and D2, which after having crossed patient body in crossing zone 29, will be received and detected by the frontal radiation detector 23.
The lateral radiation source 22 is a punctual source which emission expands in a fan beam
26 between directions D3 and D4, which after having crossed patient body in crossing zone 29, will be received and detected by the lateral radiation detector 24.
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.
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 magnetic resonance imaging 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 magnetic resonance imaging of this second part H2 of this portion of patient body height.
In an option, the first vertical scanning and the second vertical scanning are performed a first time to build respectively first and second scout views, the 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 magnetic resonance imaging 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.
In another option, the first vertical scanning and said second vertical scanning are performed a first time to build respectively first and second scout views, the 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 magnetic resonance imaging 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.
The magnetic resonance imaging is performed with a magnetic field of less than 20 milliTesla, associated to the cryogenic quantum detector 45. 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.
In a preferred option, these complementary data, used to make this patient specific 3D reconstruction on at least this second part H2 of said portion of patient body height, also comprise the magnetic resonance imaging of this second part H2 of this portion of patient body height.
Preferably too, 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.
Still preferably, 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 magnetic resonance imaging 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.
The invention has been described with reference to preferred embodiments. However, many variations are possible within the scope of the invention.

Claims

1 / Method of radiography of at least a portion of a height of a patient body in standing position, comprising:
- one or more first vertical scanning of said portion of patient body height by a first radiation source (21) and a first radiation detector (23) cooperating to make a first 2D image of a first part (Hl) of said portion of patient body height,
- one or more second vertical scanning of said portion of patient body height by a second radiation source (22) and a second radiation detector (24) cooperating to make a second 2D image of said first part (Hl) of said portion of patient body height,
- said first vertical scanning and said second vertical scanning being performed synchronously,
- said first and second 2D images viewing said first part (Hl) 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 (H2) of said portion of patient body height, at least combining therefore together both said first and second 2D images with complementary data, making a magnetic resonance imaging of a second part (H2) of said portion of patient body height, said second part (H2) of said portion of patient body height being shorter, or at least twice shorter, than said first part (Hl) of said portion of patient body height, o said second part (H2) 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, o said magnetic resonance imaging being performed:
■ with a magnetic field of less than 20 milli-Tesla,
■ associated to a cryogenic quantum detector (45).
2 / Method of radiography according to claim 1, wherein: said magnetic resonance imaging is performed with a magnetic field between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla.
3 / Method of radiography according to any of preceding claims, wherein: said cryogenic quantum detector (45) is a superconducting quantum interference device (SQUID) which is refrigerated by a cryogenic refrigeration system (46). / Method of radiography according to claim 3, wherein: said superconducting quantum interference device (45) is a low critic temperature superconducting quantum interference device. / Method of radiography according to claim 3 or 4, wherein: to detect variations of said magnetic field, there is a use of: o a flux transformer disposed upstream of said superconducting quantum interference device (45), o a primary detection antenna disposed upstream of said flux transformer.
6 / Method of radiography according to any of preceding claims, wherein: said magnetic resonance imaging is performed by using a magnetic field detection antenna (43) which: o is transparent to X-ray radiation, o is vertically mobile so as to cover at least partly or fully said second part (H2) of said portion of patient body height during performance of said first vertical scanning and said second vertical scanning. / Method of radiography according to claim 6, wherein: said magnetic field detection antenna (43) surrounds the patient body so as to also perform the function of a brace so as to maintain patient body immobile during performance of said first vertical scanning and said second vertical scanning.
8 / Method of radiography according to any of claims 1 to 7, wherein: said magnetic resonance imaging is performed after performance of said first vertical scanning and said second vertical scanning.
9 / Method of radiography according to any of claims 1 to 7, wherein: said magnetic resonance imaging being performed during performance of said first vertical scanning and said second vertical scanning.
10 / Method of radiography according to any of preceding claims, wherein: said patient belongs to a first category of people with pacemakers and/or metallic fragments and/or metallic implants. / Method of radiography according to any of preceding claims, wherein: said patient belongs to a category of young people (less than 18 years old). / Method of radiography according to any of preceding claims, wherein: said complementary data, used to make said patient specific 3D reconstruction on at least said second part (H2) of said portion of patient body height, comprise said magnetic resonance imaging of said second part (H2) of said portion of patient body height. / Method of radiography according to claim 12, wherein: said complementary data, used to make said patient specific 3D reconstruction on at least said second part (H2) of said portion of patient body height, also comprise 3D generic data. / Method of radiography according to any of preceding claims, wherein: said magnetic resonance imaging is performed: o with a static polarization magnetic field (BO) oriented in the vertical direction (Z), said static polarization magnetic field being of less than 20 milli-Tesla, or between 0.1 milli-Tesla and 10 milli-Tesla or between 0.5 milli-Tesla and 5 milli-Tesla, by using:
■ a first coil (41) located in a horizontal plane (XY) above the patient (50),
■ a second coil (42) located in a horizontal plane (XY) below the patient (50). / Method of radiography according to claim 14, wherein: said magnetic resonance imaging is performed: o by correcting the inhomogeneities of said static polarization magnetic field (B0), so as to make said static polarization magnetic field (B0) more homogeneous, by adding:
■ one or more shim coils, which are located: • either within said first coil (41) and/or within said second coil (42),
• or in at least a vertical panel (51, 52) of a gantry cover of a radiological apparatus implemented the method of radiography. / Method of radiography according to claim 14 or 15, wherein: said magnetic resonance imaging being performed: o by creating gradients in the X, Y and Z directions of said static polarization magnetic field (BO), by adding:
■ one or more gradient coils, which are located:
• either within said first coil (41) and/or within said second coil (42),
• or in at least a vertical panel (51, 52) of a gantry cover of a radiological apparatus implemented the method of radiography.
PCT/EP2023/083060 2023-11-24 2023-11-24 Method of radiography of a patient body Pending WO2025108564A1 (en)

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