Surgery – Diagnostic testing – Detecting nuclear – electromagnetic – or ultrasonic radiation
Reexamination Certificate
2001-05-14
2004-01-06
Ruhl, Dennis (Department: 3737)
Surgery
Diagnostic testing
Detecting nuclear, electromagnetic, or ultrasonic radiation
Reexamination Certificate
active
06675038
ABSTRACT:
FIELD
This patent specification relates to medical ultrasound imaging systems. In particular, it relates to an easy-to-use user interface that promotes consistent and reliable recordation of probe position during a breast ultrasound scan.
BACKGROUND
Ultrasound imaging systems have become increasingly popular for use in medical diagnosis because they are non-invasive, easy to use, capable of real-time operation, and do not subject patients to the dangers of electromagnetic radiation. Instead of electromagnetic radiation, an ultrasound imaging system transmits sound waves of very high frequency (e.g., 1 MHz to 15 MHz) into the patient and processes echoes scattered from structures in the patient's body to derive and display information relating to these structures.
Ultrasound imaging systems have been increasingly used in breast cancer screening, detection, treatment, and research. Most commonly, a breast ultrasound procedure involves the placement of an ultrasound probe over a region of interest of the breast, with the radiologist or other medical professional (hereinafter “user”) simultaneously viewing a real-time ultrasound image output on a computer monitor. The monitor also usually displays relevant text and/or graphical information near the ultrasound image for simultaneous viewing by the user. The user then presses a button to freeze the display, at which time the display may be printed on a printer or stored in digital format for later viewing and analysis.
Because much downstream analysis, interpretation, and decisionmaking may be performed based on the printed or stored information, it is crucial to ensure that the text annotation and/or graphical information relevant to the ultrasound image be both correct and properly formatted. As PACS (picture archiving and communication systems) and teleradiology (i.e., the calling up of archived images from remote locations by telephone line or internet connection) continue to increase in importance, the accurate and consistent annotation of ultrasound and other medical images will become increasingly important. Additionally, it is expected that accurate and consistent annotation of ultrasound and other medical images will become increasingly important as historical archives of breast ultrasounds and other medical images are built up over time for statistical analysis or other research purposes.
FIG. 1
shows a conventional ultrasound display
100
comprising an ultrasound image
102
, a body marker region
104
, other ultrasound parameters
106
, and a user-typed text string
108
. Body marker region
104
has the important purpose of illustrating to a subsequent viewer the position of the ultrasound probe when the ultrasound image
102
was taken. Body marker region
104
comprises left and right breast icons
110
and
112
, respectively, against which a movable probe icon
114
is manipulated by the user to reflect the current position of the ultrasound probe. Most commonly, a trackball input is used to manipulate the location of probe icon
114
relative to the breast icons, while a probe orientation knob is rotated to manipulate the orientation of the probe icon
114
relative to the breast icons. Other ultrasound parameters
106
is a text display of relevant parameters such as time, date, probe power, frame rate, etc.
User-typed text string
108
, shown in
FIG. 1
by the characters “ph lesion” (representing the term “phantom lesion”), is input by the user by positioning a freely movable text cursor, using a trackball, to the relevant location on the ultrasound output
100
and then entering the relevant text portion. This is usually done to point out certain aspects of the ultrasound image
102
that may be interesting to a subsequent viewer but that may, or may not, be immediately apparent to the subsequent viewer.
Finally, ultrasound display
100
comprises a probe position text sequence
116
placed within the body marker region
104
. In conventional systems, the probe position text sequence
116
is typed in by the user, using the same or similar text input mode that is used to enter the user-typed text string
108
. The probe position text sequence
116
is shown in
FIG. 1
as having been only partially input, with a cursor moving to the right as it is typed in by the user. The probe position text sequence
116
is intended to textually communicate the position of the ultrasound probe as graphically expressed by the location and orientation of the probe icon
114
. As used herein, the term “location” refers to the x-y placement of the ultrasound probe/probe icon (and also the z coordinate if applicable). The term “orientation” refers to the direction in which probe icon/ultrasound probe transducer array is pointed. The term “position” refers to the collective location and orientation information.
As known in the art, typical examples of probe position text sequence
116
may include: (i) “Left BR, Antiradial, 1:30, 3 cm,” meaning that the probe is over the left breast, is at a radius of 3 cm from the left nipple at an angle of 1:30 (i.e., 45 degrees from vertical using clock coordinates), and has an orientation in the antiradial direction (i.e., is tangent to a circle centered on the left nipple at the 1:30 location); (ii) “Left BR, Radial, 6:00, 5 cm,” meaning that the probe is located over the left breast 5 cm directly below the left nipple and is oriented in the radial direction, (iii), “Right BR, Trans, 10:00, 4 cm,” meaning that the probe is located over the right breast at 4 cm in the 10:00 direction from the right nipple and is oriented in the transverse direction (i.e., parallel to a line between the two breast nipples), (iv) “Right BR, Long, 7:00, 8 cm,” meaning that the probe is over the right breast at 8 cm in the 7:00 direction and is oriented in the longitudinal direction (i.e., parallel to the longitudinal or sagittal axis of the body), and (v) “Left BR, Oblique, 8:00, 3 cm” meaning that the probe is over the left breast at 3 cm in the 3:00 direction, and is not oriented along any standard direction. As known in the art, examples (i) and (ii) above express the orientation of the probe with respect to a radial/antiradial coordinate system, while examples (iii) and (iv) express the orientation of the probe with respect to a transverse/longitudinal coordinate system. In general, the “oblique” designation in example (v) may be used with either the radial/antiradial or transverse/longitudinal coordinate system.
One problem that arises with the system of
FIG. 1
is that the user is required to alphanumerically key in the probe position text sequence
116
when such text is desired. This process can be cumbersome, can lead to user frustration, and, when many breast ultrasound scans are being recorded, can lead to user fatigue. Sonographers must routinely manipulate the ultrasound probe with one hand and operate the ultrasound system controls and keyboard with the other. The hand that manipulates the probe is often times gloved and/or encumbered by having ultrasound gel on it. With interventional procedures including biopsies and ductography, contamination may occur from blood and/or nipple discharge as well. Conventional annotation mechanics that require any keyboard entries mean that the operator either has to stop, wipe their hands, and then type with both hands, or, use a keyboard designed for two hands with a single hand. Further, unless the operator truly goes to the sink and washes thoroughly and carefully before typing on the keyboard, there is the potential for contamination of the keyboard with pathogens such as fomites. These could be passed on to later patients by the operator. Also, there is the potential for damage of the equipment by moisture from the ultrasound gel deposited on the keyboard and controls.
Moreover, any delays incurred while typing in the probe position text sequence
116
can lead to the possibility that the ultrasound probe may have moved slightly in the meantime. Due to frustration, fatigue, or other factors, the user may return to properly adjust the probe icon
114
Chin Donald
Cupples Tommy Earl
Maroc Karen D.
Cooper & Dunham LLP
Jain Ruby
Ruhl Dennis
U-Systems Inc.
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