The present invention relates to lithotripters, and more particularly to a lithotripter with stone tracking and locking localization system comprising an X-ray machine, an ultrasound scanner, an ultrasound probe, a movable platform, a monitor, a system controller and a stone tracking and locking localization system. The X-ray generator is capable of exposing a stone across a range from 0 to 30 degrees(especially at 0 and 30 degrees), whereby the position of a stone embedded in a patient's body can be located in a three-dimensional way. The stone tracking and locking localization system can always lock on the position of the stone, and a system controller drives the platform so as to align the stone with the focal point (F2) for pulverizing the stone by focusing shock waves.
Because the styles of our daily diet today, the health problem of kidney stone has become more and more common, resulting in even life threatening hazard to a person and huge burdens to the society.
In the past twenty years, the most common medical treatment of stones in human bodies has changed from destructive operation to using an extracorporeal lithotripter to pulverize the stones.
Not only in tackling kidney stones, lithotripters are also used to pulverize the stones formed within the bladder and the urethra.
A lithotripter uses shock waves focusing process where the shock waves pass through the medium of water and human tissues and converge on a stone in the human body. The pressure wave convergence results in the highest pressures being found in the vicinity of stone (focal point F2). The shock waves may hurt the tissues near the stone. Therefore, the tracking, the locking, the focusing efficiency and the effect of treatment are directly related.
However, the safety and effect of treatment are affected by the movement of the stone following the vibrations of the internal organs due to respiration or other causes. As a consequence, the stone is easy to leave where the waves are already focused, and harmless and healthy tissues may be hit and damaged.
Therefore, the efficiency of tracking and locking localization system is important.
The primary objective of the present invention is to provide a lithotripter with stone tracking and locking localization system that integrates an X-ray machine, an ultrasound scanner, an ultrasound probe, a movable platform, a monitor, a system controller and a stone tracking and locking localization system. The X-ray machine is capable of illuminating the stones embedded in a patient's body in a three-dimensional way, whereby the positions of the stones will be displayed on the monitor and be located by the system controller, and the ultrasound probe located under the movable platform can move lateral and up down to contact the surface of body, whereby the image of a stone embedded in the patient can also be displayed on the monitor.
The secondary objective of the present invention is to provide a lithotripter with stone tracking and locking localization system capable of carrying out a tracking and locking process comprising the steps of initial setup, image capturing, stone detection, image comparison and positioning the stone. Thereby, the stone tracking and locking localization system then lock on the position of the stone, and the controller drives the platform so as to align the stone with the focal point F2 for pulverizing the stone by focusing shock waves.
It is a further objective of the present invention that the tracking and locking process of the present invention further comprises the step of using the stone shadow to assist the localization, whereby the precision of a stone position will be enhanced.
It is another objective of the present invention that the center lines of probe, shock cup and X-ray generator of the present invention aiming at the focal point (F2).
To achieve the above objectives, a lithotripter with stone tracking and locking localization system comprises an X-ray machine, an ultrasound scanner, an ultrasound probe, a movable platform, a monitor, a system controller and a stone tracking and locking localization system. The X-ray generator located under the movable platform is capable of illuminating across a range from 0 to 30 degrees, whereby the position of stones embedded in a patient's body can be located in a three-dimensional way. The ultrasound probe is located under the movable platform, whereby the image of a stone embedded in the patient can be displayed on the monitor. The stone tracking and locking localization system then lock on the position of the stone, and system controller drives the stone to the focal point F2 for the shaker for pulverizing the stone by focusing shock.
The various objects and advantages of the present invention will be more readily understood from the following detailed description when read in conjunction with the appended drawings.
Referring to
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Further, system controller 6 is connected drivers, AC motors, encoders and reduction gears, whereby the movable platform will move in three dimensions and the stone position of a patient thereon will be transported to the focal point F2 of the shock waves.
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(A) Initial setup: Assign the memory for tracking and locking image buffer in advance. And set up the initial values of various operation parameter. The image capture card is initialized and ready for receiving commands.
(B) Image grabbing: Images are taken by the technique of multithread and then stored in the buffer. The commands entered at the graphical user interface are processed by an event-driven scheme, whereby the response time to a user's command will be reduced. Further, the technique of double buffering is used to avoid missing the images and assure immediate tracking and locking.
(C) Stone detection: Using a brightness peek detection (local maxima peek). The peeks areas are extended to a predefined brightness level to form larger areas. Small isolated areas of just few pixel are excluded. The resulted regions are then considered as possible stone locations as shown in
(D) frame matching: Binary images produced according to the binary image processing of the prior frame and the subsequent one are matched, whereby the white overlapped regions will be weighted and the non-overlapped regions will be given less weight. The addition of all weight values is called matching value. The ROI is then moved in various directions to get various matching values; the direction of highest matching value will be used to determine the translation vector of the ROI.
(E) Stone location: The derived translation vector is added to the stone position previously determined. The new location is the center of the marked candidate location of the stone that is more close to the calculated new position.
Referring to
(A) Find local maxima;
(B) Calculate shadow, proximity and matching figure of merit for every local maximum;
(C) Calculate combined figure of merit for every local maximum;
(D) Find position of maximum figure of merit;
(E) Have found new stone position;
(F) Send out new position;
(G) Store as previous local maxima;
(H) Repeat the (A) to (G) for the next image.
In the step of a user's intervening, the user only uses mouse to mark the ROI. After the ROI is defined, all the gray-level values of the pixels in the ROI are calculated to obtain local maxima regions.
A simple morphological processing is then used to remove very small regions. In the binary diagram the white areas are possible stone regions, whose contours are much simplified, as shown in
In most of the cases, the stones in the ROI can be correctly located. However, the stone will move with the movements of the internal organs, resulting in vibrations of the stone region. Therefore, it is important to track and lock the movement of the stone region using the method of frame matching.
Referring to
(A) retrieving the binary image of the ROI in the prior frame;
(B) moving the ROI in any direction;
(C) deriving the binary image of the moved ROI;
(D) comparing the binary images of the moved ROI and the ROI in the prior frame;
(E) moving the ROI in other directions and obtaining respective matching values to determine the FOM (figure of merit) the moving of direction of the stone.
The detailed process is described as follows. The FOM is used as the reference image frame, and when the pixels of stone region in the prior frame matches the ones of current stone region, the matching max value of the FOM is calculated by Equation (1):
where P is the prior frame, C is the current frame and W is the weight value.
When the calculation is being performed, the ROI in the current frame is shifted in various directions to acquire a set of binary images. The set of binary images are compared against the prior image to get FOM values in various directions. The one having the highest FOM value is used to determine the moving direction.
The derived translation vector is added to the stone position previously determined, so that the new stone position after it moved can be determined.
Referring to
Therefore, the procedure of frame matching will precisely determine the moving direction of the stone and its location, whereby the problem of stone movement due to internal organ movements will be confined, and whereby the accuracy of pulverizing the stone will be improved.
To enhance the precision of stone position recognition, the present invention develops a system of assisting localization via stone shadow. During the imaging process, the ultrasound waves can't pass through dense material such as stones and bones. So a long shadow appears after a renal stone. The pixels in the shadow have a lower gray level values than those of the surrounding tissues. Also a stone has higher gray level values due to the strong reflection of ultrasound waves from the stone. However, if a region has a high value of gray level and there is a long shadow after it, the area is usually regarded as a stone.
Referring to
(A) determining shadow paths based on the contour in an image;
(B) retrieving candidate samples;
(C) comparing candidate samples;
(D) selecting a shadow path;
(E) determining stone location.
To carry on the procedure, a shadow path is pre-defined. Shadow starting positions only exist within ROI. If the stone shadow coincides with the tracking path, the matching result is optimal. Since a shadow sample has two characteristics: the stone portion and the shadow portion.
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The present invention is thus described, and it will be obvious that the same may be varied in many ways. Such variations are not to be regarded as a departure from the spirit and scope of the present invention, and all such modifications as would be obvious to one skilled in the art are intended to be included within the scope of the following claims.