The present invention relates to imaging, and, more specifically, to systems and methods for registering images and/or verifying image registrations obtained using various imaging modalities.
Medical imaging of internal organs provides important anatomic and diagnostic information, which medical personnel can employ to make therapeutic decisions. Medical images can be acquired using various non-invasive imaging procedures, such as computed topography (CT), magnetic resonance imaging (MRI), or ultrasound imaging. A CT system transmits x-rays through an anatomic site of interest, and based on the attenuation coefficients of the x-rays, cross-sectional images (“slices”) of the object can be reconstructed. As a result, the CT system is well suited for viewing details about bony structures, diagnosing diseases of the lung and chest, and detecting cancers. Advantages of CT imaging also include, for example, a short scan time for a complete scan (typically less than five minutes), low cost (about half the price of an MRI apparatus), the ability to accurately outline bony tissue inside the body, fewer motion artifacts due to fast imaging speeds (each scan time is less than 30 seconds), etc. CT systems, however, irradiate the patient and pose consequent risk; for this reason, CT scans are not recommended for pregnant women or children.
Ultrasound imaging, which involves passing high-frequency acoustic waves through the body, is another widely used technique. Ultrasound waves penetrate well through soft tissues and, due to their short wavelengths, can be focused to spots with dimensions of a few millimeters. In a typical ultrasound examination, a transducer probe is placed directly on the skin or inside a body opening. A thin layer of gel may be applied to the skin to provide direct contact between the transducer probe and skin and thereby allow efficient transfer of ultrasound energy into the body. An ultrasound image of internal anatomic structures can be constructed from the waves reflected by those structures—in particular, for example, from the amplitudes and phases of the reflection signals and/or the time it takes for the ultrasound waves to travel through the body. Because ultrasound images are captured in real-time, they can also show movement of the body's internal organs as well as blood flowing through the blood vessels. In addition, ultrasound imaging offers high temporal resolution, high sensitivity to acoustic scatterers (such as calcifications and gas bubbles), excellent visualization, low cost, portability, and no ionizing radiation exposure, and is thus generally considered safe even for pregnant women and children.
MRI is still another imaging modality that is used to visualize the target tissue; MRI can be used in conjunction with ultrasound to guide the ultrasound focus during therapy as further described below. In brief, MRI involves placing a patient into a homogeneous static magnetic field, thus aligning the spins of hydrogen nuclei in the tissue. Then, by applying a radio-frequency (RF) electromagnetic pulse of the right frequency (the “resonance frequency”), the spins may be flipped, temporarily destroying the alignment and inducing a response signal. Different tissues produce different response signals, resulting in a contrast among these tissues in MR images. Because the resonance frequency and the frequency of the response signal depend on the magnetic field strength, the origin and frequency of the response signal can be controlled by superposing magnetic gradient fields onto the homogeneous field to render the field strength dependent on position. By using time-varying gradient fields, MRI “scans” of the tissue can be obtained.
Many MRI protocols utilize time-dependent gradients in two or three mutually perpendicular directions. The relative strengths and timing of the gradient fields and RF pulses are specified in a pulse sequence. Time-dependent magnetic field gradients may be exploited, in combination with the tissue dependence of the MRI response signal, to visualize, for example, a brain tumor, and determine its location relative to the patient's skull. MRI has advantages including multi-planar imaging capability (without moving the patient), high signal-to-noise ratio, high sensitivity to subtle changes in soft tissue morphology and function, and no radiation exposure. But MRI suffers from its sensitivity to patient movement due to the long scan time (typically between 30 minutes to a few hours), lower-resolution images of bony structures, and interference from the operation of other radio-frequency (RF) devices.
Because each imaging technique has its own strengths and weaknesses and may provide different types of information, it may be advantageous in practice to combine different imaging techniques. For example, combining a CT scan with MRI can provide good details about bony structures as well as subtle differences between soft tissues. A combination of MRI and ultrasound imaging has been shown to provide additional diagnostic information for better diagnosis in intraoperative neurosurgical applications and breast biopsy guidance. Further, because ultrasound energy can be employed therapeutically—e.g., to heat and ablate diseased (e.g., cancerous) tissue without causing significant damage to surrounding healthy tissue—the combination of MRI and ultrasound provides imaging capability during therapeutic medical procedures. An ultrasound focusing system generally includes an acoustic transducer surface, or an array of transducer surfaces, to generate one or more ultrasound beams. In transducer arrays, the individual surfaces, or “elements,” are typically individually controllable—i.e., their vibration phases and/or amplitudes can be set independently of one another—allowing the beam to be steered in a desired direction and focused at a desired distance. The ultrasound system often also includes receiving elements, integrated into the transducer array or provided in form of a separate detector, that help monitor ultrasound-based treatment. For example, the receiving elements may detect ultrasound reflected by interfaces between the transducer and the target tissue, which may result from air bubbles on the skin that need to be removed to avoid skin burns. The receiving elements may also be used to detect cavitation in overheated tissues (i.e., the formation of cavities due to the collapse of bubbles formed in the liquid of the tissue).
A focused ultrasound transducer system may include MR tracking coils or other markers for determining the transducer position and orientation relative to the target tissue (such as a tumor) in the MR image. Based on computations of the required transducer element phases and amplitudes, the transducer array is then driven so as to focus ultrasound at the target. The ultrasound focus itself may be visualized using MRI or acoustic resonance force imaging (ARFI), and such visualization may be used to adjust the focus position. These methods are generally referred to as magnetic-resonance-guided focusing of ultrasound (MRgFUS).
To successfully integrate two or more imaging systems and/or combine information provided by distinct systems, it is necessary to register image data that may be obtained in different imaging coordinate systems. Conventional approaches to registration typically involve complex computational procedures and may not provide sufficient accuracy for therapeutic purposes. For this reason, utilizing such image registration without verification may result in an inaccurate application of energy and unsuccessful or lengthy treatment. Accordingly, there is a need for establishing and verifying registration of images obtained using different modalities in a sufficiently fast, reliable manner to support therapeutic applications.
Embodiments of the present invention provide systems and methods to evaluate and quantify the accuracy of image registration obtained using different modalities and in different coordinate systems. In various embodiments, the accuracy of the image registration relating two imaging coordinate systems (such as a CT system and an MRI system) is evaluated via the use of a third imaging modality (such as an ultrasound system). For example, the spatial relationship between the ultrasound coordinate system and the MRI coordinate system can be determined by obtaining an MR image that includes at least a portion of the ultrasound system (e.g., some of the transducer elements) in conjunction with the known spatial arrangement of the portion of the ultrasound system included in the MR image. Next, the coordinates of a previously acquired CT image of an anatomic region of interest may be transformed to coordinates in the MRI system using the image registration under study. Consequently, a distance between the anatomic region of interest and the ultrasound system may be computed in the MRI coordinate system. This distance may also be acoustically measured using the ultrasound system, and the measured distance in the ultrasound coordinate system may subsequently be transformed to the MRI coordinate system. By comparing the computed and measured distances in the MRI coordinate system, an error vector can be assigned based on the discrepancy therebetween. This error vector indicates the accuracy of the image registration under study—i.e., a smaller error vector indicates a smaller deviation of the computed distance from the measured distance and thus a higher registration accuracy. It should be stressed, of course, that this exemplary use of imaging modalities is for illustrative purposes only, and that any three modalities may be used (with any of the modalities functioning in any of the described roles) as appropriate to the application.
In some embodiments, the present invention also provides an approach for registering images (as opposed to verifying their registration) obtained in the distinct coordinate systems of two imaging modalities (e.g., a CT system and an MRI system) using a third modality (e.g., an ultrasound system). For example, the ultrasound coordinate system may be first registered with the MRI coordinate system via the use of an MR image of at least a portion of the ultrasound system and the known spatial arrangement of the ultrasound system as described above. Registration between the ultrasound coordinate system and CT coordinate system may be established via an ultrasound image and a CT image of the anatomic target of interest. Subsequently, the MRI and CT coordinate systems may be registered using the image registration relating the ultrasound and MRI coordinate systems and the image registration relating the ultrasound and CT coordinate systems.
Although the present invention has been described with reference to the use of the an ultrasound system for verifying and/or obtaining image registration between the MRI and CT coordinate systems, it is not intended that such details should be regarded as limitations upon the scope of the invention. For example, as noted above, the MRI coordinate system may be used to register the ultrasound and CT coordinate systems, and the CT system may be used to register the ultrasound and MRI systems. Moreover, image registrations between other imaging coordinate systems may also be evaluated and/or acquired by performing the approaches described herein.
Accordingly, in one aspect, the invention pertains to a method for verifying registration of images of an internal anatomic target obtained using a first imaging system and a second imaging system. In various embodiments, the method includes (a) acquiring a first image of the anatomic target and at least a portion of a third imaging system using the first imaging system; (b) measuring a distance between the third imaging system and the anatomic target using the third imaging system; (c) acquiring a second image of the anatomic target using the second imaging system; (d) registering the first image and the second image using the registration; and (e) based on (i) positions of the at least a portion of the third imaging system and the anatomic target in the first image and (ii) the measured distance, computing an error in the registration. In one implementation, the first, second, and third imaging systems include an MRI system, a CT system, and an ultrasound transducer system, respectively.
The method may further include obtaining the positions of the at least a portion of the third imaging system in the coordinate system of the third imaging system; the positions may be determined based on a time-of-flight method. In addition, the method may include computing a transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system based on the positions of the at least a portion of the third imaging system in the first image and in the coordinate system of the third imaging system. In one embodiment, the positions of the third imaging system are transformed from the coordinate system of the third imaging system to the coordinate system of the first imaging system. The second image of the anatomic target is transformed from the coordinate system of the second imaging system to the coordinate system of the first imaging system. Additionally, the distance between the third imaging system and the anatomic target is computed based on the transformed positions of the third imaging system and transformed second image in the coordinate system of the first imaging system.
The distance between the third imaging system and the anatomic target may be measured based on signals transmitted from and received by the third imaging system. In various embodiments, the method further includes transforming the measured distance from the coordinate system of the third imaging system to the coordinate system of the first imaging system. The error of the registration is then determined based on a deviation of the transformed measured distance from the computed distance. In one implementation, the error of the registration is compared to a predetermined threshold and the validity of the registration is determined based on the comparison.
In another aspect, the invention relates to a system for verifying registration of images of an internal anatomic target obtained using a first imaging system and a second imaging system. In some embodiments, the system includes the first imaging system for acquiring a first image of the anatomic target and at least a portion of a third imaging system; the second imaging system for acquiring a second image of the anatomic target; and a controller in communication with the first, second, and third imaging systems. In one implementation, the controller is configured to measure a distance between the third imaging system and the anatomic target; register the first image and the second image; and compute an error in the registration based on (i) positions of the at least a portion of the third imaging system and the anatomic target in the first image and (ii) the measured distance. The first, second, and third imaging systems may include an MRI system, a CT system, and an ultrasound transducer system, respectively.
The controller may be further configured to determine the positions of the at least a portion of the third imaging system in the coordinate system of the third imaging system; the positions may be determined based on a time-of-flight method. In addition, the controller may be configured to compute a transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system based on the positions of the at least a portion of the third imaging system in the first image and in the coordinate system of the third imaging system. In one embodiment, the controller transforms positions of the third imaging system from the coordinate system of the third imaging system to the coordinate system of the first imaging system. The controller transforms the second image of the anatomic target from the coordinate system of the second imaging system to the coordinate system of the first imaging system. Additionally, the controller is configured to compute the distance between the third imaging system and the anatomic target based on the transformed positions of the third imaging system and transformed second image in the coordinate system of the first imaging system.
Further, the controller may be configured to measure the distance between the third imaging system and the anatomic target based on signals transmitted from and received by the third imaging system. The controller may transform the measured distance from the coordinate system of the third imaging system to the coordinate system of the first imaging system. In addition, the controller may determines the error of the registration based on a deviation of the transformed measured distance from the computed distance, compare the error of the registration to a predetermined threshold, and determine validity of the registration based on the comparison.
Another aspect of the invention relates to a method for registering images of an internal anatomic target obtained using a first imaging system and a second imaging system. In various embodiments, the method includes (a) acquiring a first image of the anatomic target and at least a portion of a third imaging system using the first imaging system; (b) acquiring a second image of the anatomic target using the second imaging system; (c) acquiring a third image of the anatomic target using the third imaging system; (d) registering the second image and the third image; (e) based on (i) positions of the at least a portion of the third imaging system and the anatomic target in the first image and (ii) the registered second and third images, computing transformations relating a coordinate system of the first imaging system, a coordinate system of the second imaging system, and a coordinate system of the third imaging system. In one implementation, the first, second, and third imaging systems include an MRI system, a CT system, and an ultrasound transducer system, respectively.
The registration of the second image and the third image may include transforming coordinates associated with the internal anatomic target in the coordinate system of the second imaging system to coordinates in the coordinate system of the third imaging system. For example, the coordinates associated with the internal anatomic target in the coordinate system of the second imaging system may be fitted to the coordinates associated with the internal anatomic target in the coordinate system of the third imaging system.
In addition, the method may include obtaining the positions of the at least a portion of the third imaging system in the coordinate system of the third imaging system. In one embodiment, the positions are determined based on a time-of-flight method. The method may include computing the transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system based on the positions of the at least a portion of the third imaging system in the first image and in the coordinate system of the third imaging system. In some embodiments, the transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system is computed based on the transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system.
In yet another aspect, the invention pertains to a system for registering images of an internal anatomic target obtained using a first imaging system and a second imaging system. In some embodiments, the system includes the first imaging system for acquiring a first image of the anatomic target and at least a portion of a third imaging system; the second imaging system for acquiring a second image of the anatomic target; the third imaging system for acquiring a third image of the anatomic target using; and a controller in communication with the first, second, and third imaging systems. In one implementation, the controller is configured to register the second image and the third image; and compute transformations relating a coordinate system of the first imaging system, a coordinate system of the second imaging system, and a coordinate system of the third imaging system based on (i) positions of the at least a portion of the third imaging system and the anatomic target in the first image and (ii) the registered second and third images. The first, second, and third imaging systems may include, for example, an MRI system, a CT system, and an ultrasound transducer system, respectively.
The controller may be further configured to transform coordinates associated with the internal anatomic target in the coordinate system of the second imaging system to coordinates in the coordinate system of the third imaging system. For example, the controller may fit the coordinates associated with the internal anatomic target in the coordinate system of the second imaging system to the coordinates associated with the internal anatomic target in the coordinate system of the third imaging system.
In addition, the controller may determine the positions of the at least a portion of the third imaging system in the coordinate system of the third imaging system. In one embodiment, the positions are de based on a time-of-flight method. Further, the controller may be configured to compute the transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system based on the positions of the at least a portion of the third imaging system in the first image and in the coordinate system of the third imaging system. The controller may be configured to compute the transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system based on the transformation relating the coordinate system of the first imaging system and the coordinate system of the third imaging system.
Still another aspect of the invention relates to a method for detecting a moving anatomic feature during a treatment sequence. In various embodiments, the method includes (a) prior to the treatment sequence, (i) acquiring a first image of the anatomic feature and at least a portion of a first imaging system, and (ii) processing the first image to compute a shortest distance between the anatomic feature and the at least a portion of the first imaging system; and (b) during the treatment sequence, (i) measuring the shortest distance between the anatomic feature and the at least a portion of the first imaging system, (ii) comparing the measured shortest distance to the computed shortest distance obtained in step (a) to determine a deviation therefrom, and (iii) determining movement of the anatomic feature based on the deviation. In one implementation, the first image is acquired using a second imaging system; the method further includes acquiring a second image of the anatomic feature using a third imaging system prior to the treatment sequence. The first, second, and third imaging systems include an ultrasound transducer system, an MRI system, and a CT system, respectively.
The method may include obtaining positions of the at least a portion of the first imaging system in a coordinate system of the first imaging system; the positions may be determined based on a time-of-flight method. In addition, the method may include computing a transformation relating the coordinate system of the first imaging system and a coordinate system of the second imaging system based on the positions of the at least a portion of the first imaging system in the first image and in the coordinate system of the first imaging system. In one embodiment, the method further includes transforming the positions of the first imaging system from the coordinate system of the first imaging system to the coordinate system of the second imaging system based on the computed transformation.
In some embodiments, the method includes registering the first image and the second image. Additionally, the method includes transforming the second image of the anatomic feature from a coordinate system of the third imaging system to the coordinate system of the second imaging system. The shortest distance may then be computed based on the transformed positions of the first imaging system and transformed second image in the coordinate system of the second imaging system.
In various embodiments, the shortest distance between the anatomic feature and the at least a portion of the first imaging system is measured based on signals transmitted from and received by the first imaging system. In one implementation, the measured shortest distance is transformed from the coordinate system of the first imaging system to the coordinate system of the second imaging system. Further, the method further includes comparing the deviation to a predetermined threshold and determining movement of the anatomic feature based on the comparison.
In another aspect, the invention relates to a system for detecting a moving anatomic feature during a treatment sequence. In various embodiments, the system includes a first imaging system for acquiring a first image of the anatomic feature and at least a portion of a second imaging system prior to the treatment sequence; and a controller in communication with the first and second systems. In one implementation, the controller is configured to (a) prior to the treatment sequence, process the first image to compute a shortest distance between the anatomic feature and the at least a portion of the second imaging system; and (b) during the treatment sequence, (i) measure the shortest distance between the anatomic feature and the at least a portion of the second imaging system, (ii) compare the measured shortest distance to the computed shortest distance obtained in step (a) to determine a deviation therefrom, and (iii) determine movement of the anatomic feature based on the deviation. The system may further include a third imaging system for acquiring a second image of the anatomic feature prior to the treatment sequence. In one embodiment, the first, second, and third imaging systems include an MRI system, an ultrasound transducer system, and a CT system, respectively.
The controller may be further configured to obtain positions of the at least a portion of the second imaging system in a coordinate system of the second imaging system; the positions may be determined based on a time-of-flight method. In addition, the controller may compute a transformation relating the coordinate system of the second imaging system and a coordinate system of the first imaging system based on the positions of the at least a portion of the second imaging system in the first image and in the coordinate system of the second imaging system. In one embodiment, the controller is configured to transform the positions of the second imaging system from the coordinate system of the second imaging system to the coordinate system of the first imaging system based on the computed transformation.
In some embodiments, the controller is further configured to register the first image and the second image. Additionally, the may transform the second image of the anatomic feature from a coordinate system of the third imaging system to the coordinate system of the first imaging system. The controller may then compute the shortest distance based on the transformed positions of the second imaging system and transformed second image in the coordinate system of the first imaging system.
In various embodiments, the controller is further configured to measure the shortest distance based on signals transmitted from and received by the second imaging system. In one implementation, the controller transforms the measured shortest distance from the coordinate system of the second imaging system to the coordinate system of the first imaging system. Further, the controller compares the deviation to a predetermined threshold and determines movement of the anatomic feature based on the comparison.
In still another aspect, the invention relates to a method for detecting a moving anatomic feature during a treatment sequence having a plurality of treatment periods. In various embodiments, the method includes measuring a shortest distance between the anatomic feature and at least a portion of an imaging system (e.g., an ultrasound transducer system) during the treatment sequence; comparing the measured shortest distance in a current treatment period to the measured shortest distance in a previous treatment period to determine a deviation therefrom; and determining movement of the anatomic feature based on the deviation. The shortest distance between the anatomic feature and the at least a portion of the imaging system may be measured based on signals transmitted from and received by the imaging system. In addition, the method may include comparing the deviation to a predetermined threshold and determining movement of the anatomic feature based on the comparison.
In another aspect, the invention pertains to a system for detecting a moving anatomic feature during a treatment sequence having a plurality of treatment periods. In various embodiments, the system includes an imaging system (e.g., an ultrasound transducer system) for measuring a shortest distance between the anatomic feature and at least a portion of the imaging system during the treatment sequence; and a controller in communication with the imaging system. In one implementation, the controller is configured to compare the measured shortest distance in a current treatment period to the measured shortest distance in a previous treatment period to determine a deviation therefrom; and determine movement of the anatomic feature based on the deviation. The controller may be further configured to measure the shortest distance between the anatomic feature and the at least a portion of the imaging system based on signals transmitted from and received by the imaging system. In addition, the controller may compare the deviation to a predetermined threshold and determine movement of the anatomic feature based on the comparison.
As used herein, the terms “approximately,” “roughly,” and “substantially” mean±10%, and in some embodiments, ±5%. Reference throughout this specification to “one example,” “an example,” “one embodiment,” or “an embodiment” means that a particular feature, structure, or characteristic described in connection with the example is included in at least one example of the present technology. Thus, the occurrences of the phrases “in one example,” “in an example,” “one embodiment,” or “an embodiment” in various places throughout this specification are not necessarily all referring to the same example. Furthermore, the particular features, structures, routines, steps, or characteristics may be combined in any suitable manner in one or more examples of the technology. The headings provided herein are for convenience only and are not intended to limit or interpret the scope or meaning of the claimed technology.
In the drawings, like reference characters generally refer to the same parts throughout the different views. Also, the drawings are not necessarily to scale, with an emphasis instead generally being placed upon illustrating the principles of the invention. In the following description, various embodiments of the present invention are described with reference to the following drawings, in which:
The MRI controller 116 may control the pulse sequence, i.e., the relative timing and strengths of the magnetic field gradients and the RF excitation pulses and response detection periods. The MR response signals are amplified, conditioned, and digitized into raw data using a conventional image-processing system, and further transformed into arrays of image data by methods known to those of ordinary skill in the art. Based on the image data, a treatment region (e.g., a tumor) is identified. The image-processing system may be part of the MRI controller 116, or may be a separate device (e.g., a general-purpose computer containing image-processing software) in communication with the MRI controller 116. In some embodiments, one or more ultrasound systems 120 or one or more sensors 122 are displaced within the bore 106 of the MRI apparatus 102 as further described below.
In addition, the system controller 146 may be coupled to a user interface 147 and a memory device 148. The user interface 147 may be integrated with the system controller 146, and will generally include a user workstation for initiating imaging sequences, controlling such sequences, and manipulating data acquired during imaging sequences. The memory devices 148 may be local to the imaging system, or partially or completely remote from the system, and may be configured to receive raw, partially processed or fully processed data for CT image reconstruction.
During a typical CT scan, the x-ray scanner 132 rotates around the patient with a predetermined speed, and the x-ray source 136 emits narrow beams of x-rays through the body. The x-ray intensities transmitted through or reflected from the patient at various angles with respect to the patient's body are measured by the detector 138. A two-dimensional tomographic image (i.e., a “slice”) of the patient can be created based on the detected beam angles and intensities of the x-rays. Multiple “slices” obtained at different angles can then be processed to reconstruct a CT image. In some embodiments, the CT image of the patient is acquired at a planning stage, i.e., prior to a thermal treatment, to allow time for the treatment plan to be prepared.
The transducer elements 152 are separately controllable, i.e., they are each capable of emitting ultrasound waves at amplitudes and/or phases that are independent of the amplitudes and/or phases of the other transducers. A transducer controller 156 serves to drive the transducer elements 152. For n transducer elements, the controller 156 may contain n control circuits each comprising an amplifier and a phase delay circuit, each control circuit driving one of the transducer elements. The controller 156 may split an RF input signal, typically in the range from 0.1 MHz to 4 MHz, into n channels for the n control circuits. It may be configured to drive the individual transducer elements 152 of the array at the same frequency, but at different phases and different amplitudes so that they collectively produce a focused ultrasound beam. The transducer controller 156 desirably provides computational functionality, which may be implemented in software, hardware, firmware, hardwiring, or any combination thereof, to compute the required phases and amplitudes for a desired focus location 158. In general, the controller 156 may include several separable apparatus, such as a frequency generator, a beamformer containing the amplifier and phase delay circuitry, and a computer (e.g., a general-purpose computer) performing the computations and communicating the phases and amplitudes for the individual transducer elements 152 to the beamformer. Such systems are readily available or can be implemented without undue experimentation.
To perform ultrasound imaging, the controller 156 drives the transducer elements 152 to transmit acoustic signals into a region being imaged and to receive reflected signals from various structures and organs within the patient's body. By appropriately delaying the pulses applied to each transducer element 152, a focused ultrasound beam can be transmitted along a desired scan line. Acoustic signals reflected from a given point within the patient's body are received by the transducer elements 152 at different times. The transducer elements can then convert the received acoustic signals to electrical signals which are supplied to the beamformer. The delayed signals from each transducer element 152 are summed by the beamformer to provide a scanner signal that is a representation of the reflected energy level along a given scan line. This process is repeated for multiple scan lines to provide signals for generating an image of the prescribed region of the patient's body. Typically, the scan pattern is a sector scan, wherein the scan lines originate at the center of the ultrasound transducer and are directed at different angles. A linear, curvilinear or any other scan pattern can also be utilized.
The ultrasound system 150 may be disposed within the bore 106 of the MRI apparatus 102 or placed in the vicinity of the MRI apparatus 102. The combined MRI-ultrasound system is known to be capable of monitoring the application of ultrasound for treatment and/or safety purposes. To determine the relative position of the ultrasound system 150 and MRI apparatus 102, the ultrasound system 150 may further include MR trackers 160 associated therewith, arranged at a fixed position and orientation relative to the system 150. The trackers 160 may, for example, be incorporated into or attached to the ultrasound system housing. If the relative positions and orientations of the MR trackers 160 and ultrasound system 150 are known, MR scans that include, in the resulting images, the MR trackers 160 implicitly reveal the location of the ultrasound system 150 in MRI coordinates (in the coordinate system of the MRI apparatus 102). To aid in relating the ultrasound coordinate system to the MRI coordinate system, in some embodiments, an MR image including at least a portion (e.g., some transducer elements) of the ultrasound system 150 is acquired. This MR image may be used in combination with the known spatial arrangement of the ultrasound transducer elements to determine the locations of the transducer elements (not all of which need be included in the acquired MR image) in the MRI coordinate system as further described below.
While penetrating the patient, ultrasound waves typically encounter multiple layers of tissues, e.g., bone, muscle, or fat, whose density and structure, and, consequently, ultrasound propagation properties differ. Due to inhomogeneities and anisotropies in the tissues, the ultrasound wave fronts are often distorted. Moreover, signals from different transducer elements may encounter different thicknesses and contours of materials, and possibly air-filled or liquid-filled pockets between transducer elements and the region to be imaged or treated, resulting in different phase shifts and attenuations. Knowledge of the structure, density, and/or thickness of the multi-layer tissue structures is thus important for compensating for these effects by appropriate phase shifts and amplification factors imposed on the transducer elements, and for avoiding deterioration of focusing properties. While MRI generally provides high-sensitivity images of soft tissue (e.g., the brain), the CT scan creates images with more details about bony structures (e.g., the skull). Accordingly, it may be beneficial to combine image information obtained from the MRI apparatus 102 and CT system 130. To do so, of course, requires registration of the images and, therefore, registration of the MRI and CT coordinate systems.
Numerous conventional approaches to image registration are available. In various embodiments, the accuracy of the image registration obtained using any desired approach is verified and evaluated using two imaging modalities, e.g., the ultrasound system 150 in combination with the MRI apparatus 102.
Once the spatial parameters of the transducer elements and information acquired using the CT scan are both transformed to coordinates in the MRI coordinate system, the accuracy of the MRI-CT image registration may be evaluated. Referring to
Referring to
The distance vectors, RSDV and ADV, may be compared using any suitable approach. For example, a simple error function between the two distance vectors may be calculated as follows:
where Xregi, Yregi, and Zregi represent the values of RSDV for each transducer element i, and Xref1, Yrefi, and Zrefi represent the values of ADV for each transducer element i; xshift, yshift, and zshift represent global shift values that may be varied to obtain a minimal value of the error function; and Nel represents the number of transducer elements that are activated for an ADV measurement. The error function is used to evaluate the accuracy of the image registration. For example, if the minimal value of the error function cannot be found, or if the minimal value is above a predetermined threshold, the image registration is inaccurate (or at least not sufficiently accurate for medical treatment purposes). In some embodiments, each transducer element 152 is allowed to have an average error below 3 mm for registration verification purposes; accordingly, in an exemplary ultrasound system having 1000 transducer elements, the threshold value for determining the verification of the image registration is set as 104 mm2. This value can be adjusted based on the allowable error for each transducer element. Although a distance may sometimes be miscalculated for the transducer elements (e.g., due to measurement noise, etc.), because the foregoing approach evaluates the image registration by the use of a large number of transducer elements (e.g., on the order of a thousand), a small number of miscalculated elements may not significantly affect the minimal value of the error function. Accordingly, a high error value occurs only when the RSDV and ADV are inconsistent or corrupted.
In various embodiments, the time evolution of ADV and/or comparison between the ADV and RSDV during thermal treatment may be used to detect movement of the patient. As used herein, the term “during treatment” connotes the overall time of a treatment session and generally includes the time prior to, during, and after each sonication. Referring to
The newly measured ADV may then be compared to the ADV obtained at an earlier time during treatment (e.g., prior to any sonication being performed, a plurality of sonications before, or one sonication before). If the new ADV deviates significantly from the previously obtained ADV, the patient has likely moved in the interim. In various embodiments, when the deviation is above a threshold (e.g., 5,000 mm2 for 1000 transducer elements or each transducer element having an average error of 2.2 mm, or in percentage terms, more than 5% or 10%), the patient's movement is considered significant and corrective action may be performed to confirm and/or compensate for the movement.
In some embodiments, the time evolution of ADV during treatment is monitored to anticipate the patient's movement. For example, for a treatment involving 1000 transducer elements, if the ADV increases by 550 mm2 during each sonication, it is anticipated that the patient may move beyond what can be clinically tolerated by the tenth sonication. Accordingly, the treatment may be suspended at the end of the ninth sonication to avoid damage to healthy non-target tissue resulting from misalignment of the patient and the ultrasound system.
Referring to
Accordingly, comparing the ADV to the RSDV or to a previously obtained ADV may identify a suspected patient movement without the need for image reconstruction of the target, allowing movement to be detected in real time. The newly measured ADV best matches the computed RSDV (or the previously obtained ADV)—i.e., has the smallest deviation therefrom—when the error function in eq. (1) has a minimal value. Accordingly, patient movement may be detected by monitoring the value and/or the position (i.e., the values of xshift, yshift, and zshift) associated with the minimal value. The sensitivity of movement detection may be adjusted by changing the allowed deviation threshold.
As noted, if the comparison indicates that a significantly movement has likely occurred, a corrective action may be performed. The corrective action may include acquiring a new MR image to confirm the movement, suspending the ultrasound treatment, adjusting the positions of the ultrasound system and/or the patient to compensate for the movement, etc. For example, a newly acquired MR image of the anatomic target may be checked against the last valid MR image in order to confirm the movement. This is particularly useful when only some of the transducers in the array 153 are dedicated to measuring the ADV and thereby exhibit lower sensitivity (compared with the ADV measured using the entire transducer array). If the MR image comparison reveals that a movement occurred, the ultrasound treatment may be suspended until the position of the ultrasound system and/or the patient is adjusted. If, however, the MR image comparison shows that a movement either did not occur or was not clinically significant, the treatment proceeds as planned.
In some embodiments, the combined ultrasound and MRI system provides imaging registration between the MRI and CT coordinate systems with a sufficient accuracy for treatment purposes. With reference to the exemplary embodiment shown in
In an alternative embodiment, with reference to
Although the invention has been described with reference to the use of an ultrasound system for evaluating and/or obtaining a coordinate transformation relating the MRI and CT coordinate systems and/or detecting the patient's movement, it is not intended for this arrangement to limit the scope of the invention. For example, the MRI coordinate system may be used to register the ultrasound and CT coordinate systems, and similarly, the CT system may be used to register the ultrasound and MRI systems. In addition, other imaging modalities may also be used in lieu of any of the above-described imaging modalities to verify and/or obtain an imaging registration relating any two imaging systems using the approaches described above and/or detect a patient's movement in real time during treatment.
Moreover, it is to be understood that the features of the various embodiments described herein are not necessarily mutually exclusive and can exist in various combinations and permutations, even if such combinations or permutations are not made express herein, without departing from the spirit and scope of the invention. In fact, variations, modifications, and other implementations of what is described herein will occur to those of ordinary skill in the art without departing from the spirit and the scope of the invention.
In general, functionality for evaluating and/or computing an imaging registration between two or more imaging systems and/or detecting the patient's movement as described above, whether integrated with the controllers of MRI, the ultrasound system, and/or the CT scanning system, or provided by a separate external controller, may be structured in one or more modules implemented in hardware, software, or a combination of both. For embodiments in which the functions are provided as one or more software programs, the programs may be written in any of a number of high level languages such as FORTRAN, PASCAL, JAVA, C, C++, C#, BASIC, various scripting languages, and/or HTML. Additionally, the software can be implemented in an assembly language directed to the microprocessor resident on a target computer; for example, the software may be implemented in Intel 80×86 assembly language if it is configured to run on an IBM PC or PC clone. The software may be embodied on an article of manufacture including, but not limited to, a floppy disk, a jump drive, a hard disk, an optical disk, a magnetic tape, a PROM, an EPROM, EEPROM, field-programmable gate array, or CD-ROM. Embodiments using hardware circuitry may be implemented using, for example, one or more FPGA, CPLD or ASIC processors.
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