The subject matter disclosed herein relates to interventional procedures and the equipment used in such procedures.
As medical technologies have matured, it has become possible to perform various surgical or interventional procedures in a minimally invasive manner. For example, minimally invasive procedures, such as certain surgical or interventional procedures, may utilize computer-assisted imaging and navigation techniques that allow a clinician to visualize the internal or obscured structures in the surgical area while the procedure is being performed. In this way, the clinician may perform the desired surgical or interventional procedure with a greater chance of success while minimizing or reducing tissue damage.
In practice, modern interventional medical procedures may bring together a wide variety of monitoring, imaging, and therapy devices to provide the functionality needed to carry out these complex interventional and surgical medical tasks. As a result, today's procedure rooms may contain a large number and variety of nominally free-standing systems that are brought together to meet the specific needs of a particular procedure. However, the user interactions with the various systems may only be lightly integrated, if at all. It is typically left to the operators (e.g., interventional physicians and support staff) to effectively integrate the information in their heads, which results in incomplete integration, lost information, repeat acquisitions to make needed information available again, longer exam times, higher dose, and less effective outcomes. Further, the multiplicity of systems brought together in the procedure room may lead to an inefficient use of space in the room as well as a less than optimal layout with respect to the various systems and their utilization.
In one embodiment, an interventional system is provided. The interventional system comprises a first platform comprising two or more imaging, monitoring, or tool navigation components. The two or more imaging, monitoring, or tool navigation components are configured to be used in contact with or in proximity to a patient. The interventional system further comprises a second platform in communication with the first platform. The second platform comprises processing, memory, and storage components. The second platform stores and executes routines for processing data acquired by the imaging, monitoring, or tool navigation components. The interventional system further comprises a third platform in communication with the second platform. The third platform comprises at least a user interface.
In a further embodiment, an integrated interventional system is provided. The integrated interventional system comprises two or more imaging subsystems in communication with a network. The imaging subsystems are configured to acquire image data during an examination or procedure and to publish the acquired image data in accordance with a publication/subscription communication protocol. The imaging subsystems each comprise one or more components configured for use in proximity to a patient that are provided as part of an integrated platform. The integrated interventional system also comprises a user interface subsystem in communication with the network. The user interface subsystem publishes control signals to one or more component subsystems and subscribes to receive the image data in accordance with the publication/subscription protocol.
In an additional embodiment, a consolidated interventional system is provided. The consolidated interventional system comprises a procedure room platform comprising two or more imaging, monitoring, navigational, or therapy subsystems, each comprising data generation components configured to be used on or proximate to a patient. The consolidated interventional system further comprises a server room platform comprising executable modules which, when executed, facilitate receipt of data from and control of the two or more imaging, monitoring, navigational, or therapy subsystems of the procedure room platform. The consolidated interventional system also comprises a user interface platform comprising at least a user interface configured to receive user inputs for operating at least the server room platform. The user interface platform, in some embodiments, may be provided as part of a control room aspect of the system.
These and other features, aspects, and advantages of the present invention will become better understood when the following detailed description is read with reference to the accompanying drawings in which like characters represent like parts throughout the drawings, wherein:
Modern interventional and surgical medical procedures may bring together a wide variety of monitoring, imaging, and therapy devices to facilitate the performance of these complex medical procedures. As a result, current procedure rooms typically contain a multiplicity of nominally free-standing systems that operate independent of one another and that are brought together to meet the specific needs of a particular procedure. For example, turning to
In the depicted example, video outputs 50 of each system 56 may be consolidated, such as through the use of a video switch that allows the display of data from multiple system modalities 56 onto a single screen 58 or several screens. That is, consolidation of information and images is generally via video integration of the outputs of several distinct and separately operating systems 56, with multiple cable paths connecting the separate pieces of equipment to one or more common or shared display devices 58.
Network connectivity 60 may be provided, but generally independently for each separate system modality 56 to a PACS or hospital network. Such an architecture, based on the ad hoc replacement or addition as new systems 56 become available, results in part from the independent development and incorporation of such systems 56. As a result, in such an implementation the various system modalities 56 operate, and communicate, independent of one another, even though the respective video outputs of each system modality may be aggregated for either separate or switchable display at a central site, e.g., tableside display 58. In this arrangement, the user interactions with the various systems 56 are only lightly integrated, if at all.
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With the foregoing specific examples in mind of specific types of devices that may be present and used in interventional or therapeutic contexts, an integrated system approach (
The preceding examples related to specific technologies or modalities, and their constituent components, that may be present in an interventional, therapeutic, surgical or navigational context. In contrast,
Those components of the various interventional, monitoring, and imaging modalities that are integrated in the system 150 and that are necessarily present near the patient (i.e., in the procedure or surgical room) may be provided as part of an integrated console or platform (e.g., a patient examination or procedure platform 154) within the surgical or procedure room. For example, in the depicted implementation, the in-procedure room components of the integrated system 150 may be provided as a combined or integrated platform 154 having built-in the components needed to physically interact with the patient based on the supported modalities. That is, the combined or integrated patient procedure platform 154 may include, in a consolidated or integrated fixture, platform, or cart, those components needed by the various imaging, monitoring or interventional modalities to be within the procedure room in proximity to the patient.
Conversely, some or all of those components that do not need to be in the procedure room, or at least which do not need to be in proximity to the patient, may be provided in a separate, integrated platform (e.g., processing platform 156) that may be in communication with, but separate from, the patient procedure platform 154. For example, the processing platform 156 may be provided in a separate room (e.g., a technology or server room) or in a portion of the procedure room that is removed from the patient. In one embodiment, the processing platform 156 provides processing and/or control functionality (including image formation and processing functionality) to the components of the patient procedure platform 154, such as to provide control signals to the components of the patient procedure platform 154 and/or to process signals acquired by the components of the patient procedure platform 154.
As will be appreciated, in such an integrated platform, processing circuitry 190 (e.g., general processing components), memory circuitry 192, storage hardware 194, and so forth, may be shared to reduce or eliminate duplication of components and to allow for consolidation into a single server or processing piece. For example, in such implementations, shared processing components 190 (e.g., one or more general or special purpose processors), memory 192 or storage components 194 (e.g., memory chips or circuits, hard drives, solid state drives, optical media and readers, and so forth), and communication components (e.g., network connections, cables, wires, and so forth) may be used to implement various software modules that support the different functionalities provided by the integrated patient procedure platform 154 and processing platform 156.
For example, one or more ultrasound software modules (i.e., ultrasound application routines) may be executable on the shared hardware components of the processing platform 156 to both drive or control the operation of the ultrasound components present in the procedure room (i.e., on the patient procedure platform 154) and/or to receive or process the data generated by the ultrasound components present in the procedure room. Similarly, one or more electrical monitoring software modules or routines, X-ray software modules or routines, and/or navigational or tracking system software modules or routines may also be executable on the shared hardware components of the processing platform 156 to drive or control the respective operation of the corresponding components present in the procedure room and/or to receive or process the data generated by the corresponding components present in the procedure room. Such modules or routines for implementing the various modalities supported by the patient procedure platform 154 and processing platform 156 may be simultaneously executable on the processing platform 156 (i.e., may run in parallel) or may be switched between if running in a non-parallel implementation. Examples of such software modules or routines include, but are not limited to, image or data acquisition, image processing, image display or visualization, image segmentation and measurement, image registration, image fusion, PACS communication, and so forth.
To the extent that certain software functions or functionality is common to the respective modalities, the corresponding software modules or routines may be configured to provide that functionality to each of the respective modalities. For example, a single communication module or set of routines may be configured to support data or control signal transmission for each of the respective modalities instead of each supported modality having its own communication module or routines. Thus, in one implementation, both hardware and software components of the integrated system may be generalized and shared to support multiple imaging and navigation systems used in a surgical or interventional context.
As will be appreciated, the present approach also provides the benefit that, as new modalities or instrumentation is added to the integrated patient procedure platform, support for such new modalities may be added to the processing platform 156 by loading or adding new or appropriate software modules or routines. In one implementation, the new devices may be automatically recognized or discovered by the system and/or automatically configured for use within the larger interventional suite. In this manner, new capabilities may be automatically enabled or allowed by the introduction of the new instrument to the system. In this manner, support for new or additional modalities may be easily integrated or supported in a consolidated platform, without having separate carts or consoles having to be present in the procedure or technical rooms.
The consolidated platform of
In addition to the depicted user interface station 160, the user interface platform or piece 158 may include other components or systems, such as patient data entry interface 162 (such as a communication link for querying or updating a patient database), a communication link for querying or updating a picture archiving and communication system (PACS) 164, third-party integration components 166, and/or image fusion components 168. As discussed above, in certain implementations, such components of the user interface platform 158 may be consolidated or optimized to share common hardware components and/or software modules or routines to facilitate the user interface and/or communication functions provided by the user interface platform 158.
With the foregoing in mind, data and control signals can be communicated between components of the integrated system 150 in various manners. For example, in accordance with the present disclosure, both point-to-point (e.g., client-server) and publish-subscribe models could be used for consolidating data and/or control signals, as could other suitable approaches. Further, ad hoc methods customized for specific devices and connections (components, subsystems, systems) could also be employed. A conceptual overview of the point-to-point based approach is shown in
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For example, the patient procedure platform 154 in the depicted example also includes electrical monitoring components 172 (e.g., electrodes and amplification circuitry), X-ray components 174 (e.g., tubes or other sources, detectors, and gantry or C-arm hardware), and/or navigational sensor components 176 (e.g., transmitters, receivers, and so forth used to track a surgical or interventional instrument). These respective components in the patient procedure platform 154 may correspondingly communicate with the corresponding components or modules within the processing platform 156 (e.g., processing circuitry 182 for supporting electrical monitoring, controllers and/or processing components 184 suitable for supporting X-ray components, and/or navigational system processing components 186 (e.g., position and orientation algorithm circuitry). As will be appreciated, the described components are only example. In other implementations other modalities and systems may be supported in the patient procedure and processing platforms.
The various processing components or modules of the processing platform 156 may, in this example, communicate with the user interface 160. The user interface 160 may in turn communicate with other functionality of the user interface platform 158, such as the patient data entry interface 162, PACS 164, 3rd party integration module 166, or image fusion module 168. Further, certain of the processing components or modules of the processing platform 156 may communicate with other modules or components of the user interface platform 158, such as (in the depicted example, the X-ray modality 184 and navigation system 186 both communicating with the image fusion module 168, which may include estimation and image generation routines what access one or more imaging feeds and output other imaging or parameters (e.g. transformations) to use in visualizations. Similarly, certain of the processing components or modules of the user interface platform 158 may communicate with other modules or components of the user interface platform 158, such as the PACS 164 and 3rd party integration module 166 communicating with a recording module 202 in the depicted example.
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In such a publish/subscribe architecture, various components may publish data, control signals or updates generated by the respective components and which is delivered to other components which are configured to receive such data, control signals, or updates as they become available (i.e., subscribers). For example, the 3rd party integration module 166 may be designated as a subscriber to data or updates published by the X-ray modality and navigation system. Thus, as new X-ray image and navigation tracking data becomes available, this data may be delivered to the 3rd party integration module 166, or to any other module of the user interface platform 158 specified as subscribing to receive such imaging or tracking updates. Likewise, the user interface components 160, patient data entry interface 162, PACS 164, recording module 202, and/or image fusion module 168 may be designated as subscribers to receive data or updates published by the respective imaging or monitoring modalities and/or as publishers to publish control signals to other components. For example, the image fusion module 168 may include estimation and image generation routines and may subscribe to the imaging feeds and publish either other imaging or parameters (e.g. transformations) to use in visualizations. In addition, one or more of the user interface components 160 may publish commands or instructions to the processing and/or procedure room components, such as to synchronize the start of an image or data acquisition or to configure such an acquisition. In such an example, the processing or procedure room components would in turn be subscribers to such commands while also being publishers of the acquired data.
Such an architecture may provide greater flexibility than other architectures, such as the point-to-point architecture, as the modules that publish and/or subscribe to particular control signals or data may be configured and changed as dictated by the situation. By way of example, unusual or unexpected data flows may be accommodated easily simply by designating a given component as a subscriber to the desired data. For example, in certain instances data or images generated using one modality may be displayed on a screen or output device associated with another modality. Thus, X-ray images could be displayed on the ultrasound screen, simply by making that display a subscriber to the X-ray data. Such an implementation may be helpful to a technician performing an echocardiogram who might otherwise not be able to see the X-ray display from the ultrasound station in the procedure room.
Technical effects of the invention include the elimination of duplicate equipment or components in an interventional suite. Further technical effects include the consolidation of image formation and processing functions in an interventional suite and the ability to group elements with like requirements (e.g., in the procedure room). Other technical effects include the elimination of the need for multiple connecting cables, etc. due to the consolidation of hardware and functions in an interventional suite. Business advantages include easier engineering of system upgrades, simplified validation and verification of the system in product development, and reduced system cost due to elimination of duplicate equipment. Clinical advantages include simplified user interaction with the system due to consolidation of components into a single system or interface, significant clutter reduction in the procedure room and the control room, and potentially better workflow, faster procedures, and better outcomes due to more highly integrated information.
This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to practice the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal languages of the claims.