Patent Application
20160015352
The subject matter disclosed herein relates to a system for magnetic resonance imaging (MRI) and computed tomography (CT) compatible wireless physiological gated imaging. More specifically, a system for obtaining physiological data of a patient, generating trigger signals for the MRI or CT scanner, and wirelessly communicating the physiological data and/or trigger signals in the MRI or CT environment is disclosed.
As is known to those skilled in the art, a magnetic resonance imaging (MRI) system alternately generates a strong magnetic field and then detects the faint nuclear magnetic resonance (NMR signals given off by nuclei in the presence of the magnetic field. The NMR signals are received by antennas, also known as coils, and transmitted to the MRI scanner for reconstruction into an MRI image. In order to provide a clear image, it is desirable to minimize interference associated not only with external artifacts, such as electromagnetic interference, but also with motion artifacts, such as voluntary or physiologic motion.
As is also known to those skilled in the art, a computed tomography (CT) system takes a series of x-ray views of the desired object and reconstructs them to create cross-sectional images of the object. Many times, the tomographic slices may be combined to create 3-D images. A CT system relies upon x-ray particles being sent through the body and then detecting the amount of absorption or scattering of those particles to construct a representative image of the object based upon the density or other physical properties of the object or structure. Similar to an MRI scanner, a number of different artifacts may produce unwanted interference during a CT scan, such as motion artifact related to voluntary or physiologic motion.
Specifically, with respect to motion artifacts, MRI and CT imaging is complicated by the periodic motion of a patient, such as respiratory or cardiac motion. Cardiac motion includes, for example, motion of the heart and blood flow through blood vessels. In order to compensate for cardiac motion, segmented acquisition processes will divide the cardiac cycle into segments and acquire images over several heartbeats, at comparable points in the cardiac cycle. Thus, it is desirable to synchronize imaging with the periodic motion of the heart so that imaging can be acquired at specific desirable points within the cardiac cycle. Not only does this method help to reduce motion artifacts but it may also be used to acquire images at specific cardiac phases of the cardiac cycle as desired.
One method of image synchronization is performed by trigger monitoring. Trigger monitoring may be accomplished by acquiring a patient's electrocardiogram (ECG). ECG is most commonly recorded by attaching electrodes to the surface of the skin, whereby the electrodes pick up electrical impulses generated by the polarization and depolarization of cardiac tissue and translates them into a waveform. The waveform is used to detect the patient's QRS complex in real-time and “triggering” image acquisition based upon the detection of a reference point in the physiological signal, such as an R-wave location. A trigger delay may be implemented to delay image acquisition keyed off from the reference point to a later phase, such as diastole of the heart.
An alternative to detecting an ECG signal for trigger monitoring based on, e.g., the R-wave, is the approximation of a patient's cardiac phase by performing peripheral pulse oximetry using, e.g., photoplethsmography. Using this method, a patient's peripheral pulse is used to approximate diastole and systole. For example, images acquired immediately after the peak in the peripheral pulse wave are assigned to diastole. However, due to the delays in pressure wave propagation, use of peripheral pulse are typically not as accurate as using ECG signals for synchronizing a cardiac signal.
MRI and CT imaging is also complicated by respiratory motion which may also be a significant factor in causing motion artifacts. While breath-holding and signal averaging have been commonly practiced techniques, they are not always practical or effective for minimizing interference. Therefore, a similar synchronization process may be used to synchronize imaging with a patient's breathing by acquiring respiratory signals from the patient and using the patient's breathing waveform to trigger image acquisition during the patient's quiet phase. For example, the operator may trigger image acquisition during the inspiration slope, the expiration slope, or both. Moreover, a breathing waveform may be used to inform the operator of a patient's state during scanning, such as whether they are conscious.
The three physiological parameters described above: (1) ECG; (2) peripheral pulse (PP), and (3) respiratory (RESP) signals have been commonly used individually or in combination, to perform trigger monitoring. Currently existing cardiac triggering monitoring systems generally receive the physiological input data from ECG, PP and RESP methods and send trigger signals to the scanner for eliciting image acquisition during particular image acquisition windows. However, the existing methods use wired connections between the host scanner and the physiological sensors. Also, existing systems are generally inflexible with respect to interchanging the hardware for MRI and CT because of the separate cords and data formats specific to each type of application.
Thus, it would be desirable to provide an improved physiological data acquisition system to obtain and transmit physiologic waveform data wirelessly and to generate and deliver trigger signals to the host scanner. Also, it is desirable that the system be interchangeable between MRI and CT applications and be able to detect with which application it is being used.
The subject matter disclosed herein describes an MRI and CT compatible physiological data acquisition system. According to one embodiment of the invention, the physiological data acquisition system includes an acquisition module configured to receive signals from physiologic sensors attached to the patient and a transmitter configured to wirelessly communicate with a receiver module. The acquisition module includes a processor operable to generate waveform data and trigger data based upon the acquired physiologic data and transmit the data to the receiver module. The receiver module is configurable to be attached to the either an MRI or a CT scanner. The receiver module then is able to deliver a trigger signal to the host scanner for imaging the patient during a selected time frame based upon the patient's cardiac cycle, peripheral pulse, respiratory cycle, or any combination thereof.
The physiological data acquisition system is configurable to transmit and/or receive data between physiological sensors, a physiologic transmitter, a physiologic receiver, a portable tablet or another computer, and a MRI scanner or CT scanner.
It is an objective of the present invention to provide a wireless physiological monitoring system that sends physiologic waveform and trigger data to diagnostic imaging scanners.
It is also an objective of the present invention to use a single physiologic transmitter for both MRI and CT triggering applications. Since many clinical sites run multiple scanners, a single transmitter can be used in conjunction with multiple physiologic receivers.
It is a further objective of the present invention to provide a wireless communication system which allows for low latency, low jitter, and high reliability in the transmission of a trigger signal.
According to one embodiment of the invention, a trigger monitor system includes a transmitter and a receiver. The transmitter includes at least one input operable to receive a data signal corresponding to a physiological parameter from a patient and a processor operable to receive the data signal from each input. The physiological parameter inputs may be selected from electrocardiography (ECG) data, peripheral pulse data, and respiratory cycle data The processor is also operable to generate a filtered data signal from each data signal and/or a trigger signal as a function of the data signals or the filtered data signals. The transmitter also includes a transmit circuit operable to transmit the data signals, the filtered data signals, and/or the trigger signal. The receiver includes a receive circuit operable to receive the transmitted signal from the transmitter and a processor in communication with the receive circuit to receive the transmitted signal. When the transmitted signal is the trigger signal, the processor is in communication with a host scanner to transmit the trigger signal to the host scanner to initiate image acquisition of the patient.
According to another aspect of the invention, the trigger monitor system may include an external computer or a portable tablet operable to receive each of the signals from the transmitter and to show the received signal on a display. The host scanner maybe either a magnetic resonance imaging (MRI) scanner or a computed tomography (CT) scanner, and the receiver may be operable to detect the type of host scanner to which it is connected.
According to yet another aspect of the invention, the transmitter or receiver may be configured to process the physiological parameter data signal. The processor of either the transmitter or the receiver may be operable to process the data signal to produce at least one of a pulse rate, a respiratory rate, a heart rate, a PPG waveform, and an ECG waveform. Optionally, the transmitted signal may be either the data signal or the filtered data signal and the processor in the receiver is operable to generate the trigger signal as a function of the transmitted signal.
According to still another aspect of the invention, the transmitter provides an indicator when the physiological parameter input is not communicating properly. The transmitter may also include a first set of indicators providing a graphical representation of the placement of leads on a torso of the patient during an MRI scan and/or a second set of indicators providing a graphical representation of the placement of leads on the torso of the patient during a CT scan. Each of the first and second set of visual indicators indicates whether the lead is properly connected to the patient.
According to yet another aspect of the invention, the transmitter further comprises a rechargeable battery and a power source input. The power source can only be attached to the power source input when an ECG data input is disabled.
According to still another aspect of the invention, the transmit circuit is operable to transmit the data signal, the filtered data signal, or the trigger signal in a data packet. The transmit circuit transmits the data packet using at least two frequencies, and the receiver receives the data packer at each frequency. The processor in the receiver extracts the transmitted signal from each data packet. The transmitter may store at least two values of the data signal, filtered data signal, or trigger signal to be transmitted in a memory device on a first-in-first-out basis and include the stored values in the data packet.
According to another embodiment of the invention, a monitor system fir use with either a magnetic resonance imaging (MRI) scanner or a computed tomography (CT) scanner is disclosed. The monitor system includes a transmitter and receiver, where the transmitter includes at least one input operable to receive a data signal corresponding to a physiological parameter from a patient, a processor operable to receive the data signal from each input, and a transmit circuit operable to transmit each data signal. The receiver is in communication with the transmitter an in communication with the MRI or CT scanner, and the receiver includes a receive circuit operable to receive the data signal from the transmitter, and a processor in communication with the receive circuit to receive the data signal and operable to detect whether the receiver is connected to the MRI scanner or the CT scanner.
According to another aspect of the invention, a lead is placed on the patient to detect the physiological parameter and to generate the data signal corresponding to the physiological parameter, and the processor in the transmitter is operable to detect whether the lead is properly connected to the patient. The transmitter may include a first set of indicators providing a graphical representation of the placement of leads on a torso of the patient during an MRI scan and may further include a second set of indicators providing a graphical representation of the placement of leads on the torso of the patient during a CT scan. Each of the first and second set of visual indicators may indicate whether the lead is properly connected to the patient.
According to still another aspect of the invention, the processor of either the transmitter or the receiver is operable to generate a filtered data signal from each data signal and/or a trigger signal, where the trigger signal is a function of either the data signals or the filtered data signals. The processor of the receiver is in communication with the MRI or CT scanner to transmit the trigger signal to the MRI or CT scanner to initiate image acquisition of the patient.
According to still another embodiment of the invention, a method of initiating image acquisition on a host scanner from a physiological data acquisition system is disclosed. At least one sensor is connected to a patient, and a data signal is received from the sensor at a transmitter, where the signal corresponds to a physiological parameter of the patient. Either a filtered data signal or a trigger signal is generated from the data signal in a processor of the transmitter. The transmitter transmits at least one of the data signal, the filtered signal, and the trigger signal from the transmitter as a transmitted signal. A receiver in communication with the transmitter receives the transmitted signal. When the transmitted signal is a trigger signal, the receiver transmits the trigger signal from the receiver to a host scanner to initiate image acquisition on the host scanner.
According to still another aspect of the invention, the transmitter includes a set of indicators providing a graphical representation of multiple locations at which a lead for each sensor is to be placed on a torso of the patient during an imaging seam. The step of connecting the at least one sensor to the patient includes placing each sensor on the torso of the patient in one of the locations, and verifying that each indicator from the set of indicators shows that the sensor is placed correctly and operating normally. The host scanner may be either an MRI scanner or a CT scanner. The transmitter may include a first set of indicators providing a graphical representation of the locations at which a lead for each sensor is to be placed on a torso of the patient during an MRI scan and a second set of indicators providing a graphical representation of a plurality of locations at which a lead for each sensor is to be placed on a torso of the patient during a CT scan. The physiological data acquisition system may automatically identifying whether it is connected to an MRI scanner or a CT scanner. The first set of indicators is used to place each sensor when the physiological data acquisition system is connected to the MRI scanner, and the second set of indicators is used to place each sensor when the physiological data acquisition system is connected to the CT scanner.
These and other objects, advantages, and features of the invention will become apparent to those skilled in the art from the detailed description and the accompanying drawings. It should be understood, however, that the detailed description and accompanying drawings, while indicating preferred embodiments of the present invention, are given by way of illustration and not of limitation. Many changes and modifications may be made within the scope of the present invention without departing from the spirit thereof, and the invention includes all such modifications.
Various exemplary embodiments of the subject matter disclosed herein are illustrated in the accompanying drawings in which like reference numerals represent like parts throughout, and in which:
In describing the preferred embodiments of the invention which are illustrated in the drawings, specific terminology will be resorted to for the sake of clarity. However, it is not intended that the invention be limited to the specific terms so selected and it is understood that each specific term includes all technical equivalents which operate in a similar manner to accomplish a similar purpose. For example, the word “connected,” “attached,” or terms similar thereto are often used. They are not limited to direct connection but include connection through other elements and/or wireless connection where such connection is recognized as being equivalent by those skilled in the art.
The various features and advantageous details of the subject matter disclosed herein are explained more fully with reference to the non-limiting embodiments described in detail in the following description.
According to one embodiment of the present invention, a trigger monitor system, which interfaces with MRI and CT scanners, for use on patients requiring image acquisition synchronization is disclosed. The trigger monitor system may be implemented in a MRI environment as shown in
Referring to
A controller 20 for the MRI scanner 12 is typically located in the adjacent control room 11. An operator interface including, for example, a monitor 22 or other display unit and an input device such as a keyboard 24 are connected to the controller 20. The controller 20 may be connected to the MRI scanner 12 by cabling extending, for example, under the floor of the scan room 10 or in a shielded conduit to the MRI scanner 12. A penetration panel 23 in the wall may also provide connections to cables 21 running from the controller 20 into the scan room 10. The penetration panel 23 may include connectors for cabling to other medical equipment present in the scan room 10. Corresponding connectors on the other side of the penetration panel 23 within the scan room 10 permit appropriately shielded cables to be connected and run to the scanner 12 or to other medical equipment. A table 16 supports the patient being scanned and typically includes a sliding platform 19 allowing the patient to be moved into and out of the bore 14 of the MRI scanner 12.
Referring next to
The physiologic receiver 38 receives the data from the physiologic transmitter 32 and sends the data to the host scanner 40. A display 48 connected to the scanner 40 may provide a visual indication of the raw physiologic signal 34, the filtered waveform 33, the trigger signal 42, or a combination thereof. It is contemplated that the receiver 38 may transmit just raw physiologic signals 34 to the scanner 40 and the scanner 40 may perform further processing on the data. Optionally, the scanner 40 may be configured to receive the filtered waveform 33 and/or the trigger signal 42 and to perform further processing or to capture image data responsive to any of the data transmitted from the receiver 38. Thus, the scanner 40 may either process the raw physiologic signal 34 or the filtered waveform 33 data to generate a gating signal or utilize the gating signal 42 from the transmitter 32 for image triggering. The host scanner 40, which may be either an MRI or CT scanner, may also display the trigger signal 42 on the scanner display 48 to provide a visual indication to the operator of when imaging occurs. If the physiologic transmitter 32 generates and sends a trigger signal to the physiologic receiver 38, the physiologic receiver 38 may pass the trigger signal directly to the host scanner 40.
According to another embodiment of the invention, the physiologic receiver 38 may be configured to perform processing on the raw data 34 or the filtered waveform 33 received from the physiologic transmitter 32 to generate a trigger signal 42. The physiologic receiver 38 may perform further processing to format the trigger signal 42 and/or encapsulate the trigger signal in a message packet suitable for transmission to the host scanner 40 to which the physiologic receiver 38 is connected. The trigger monitor system 30 described herein allows the host scanner 40 to synchronize image acquisition responsive to the trigger signal, which may be required to eliminate motion artifacts and/or to obtain images at specific intervals within the cardiac or respiratory cycles.
According to the illustrated embodiment of the invention, the physiologic transmitter 32 of the trigger monitoring system 30 performs the function of interpreting physiologic signals 34 that it receives and turning it into waveform data. The physiologic transmitter 32 acquires physiological signals 34 from the patient as commonly known in the art. The transmitter processor or CPU 44 may receive raw data for certain body vital sign parameters, e.g., electrocardiogram (ECG) 50, peripheral pulse (PP) 52, and respiratory rate (RESP) 54. For each parameter, physiologic sensors or physiological acquisition devices unique to each parameter are used. Each of the physiologic sensors or devices will be described in greater detail below. The physiologic sensors, e.g., electrodes, are attached to the patient's body at various detection locations. Connectable leads or electrical connectors couple the physiologic sensors to the physiologic transmitter 32 via ports located on the physiological transmitter module.
According to one aspect of the present invention, ECG data 50 is collected from the patient. In collecting ECG data 50 from a patient, a number of surface electrodes are placed on the patient's chest at particular locations. For example, for MRI applications, a first electrode is placed at a first intercostal space, just left of the sternum. A second electrode is positioned at the level of the xyphoid, just left of the sternum. A third electrode is positioned on the patient's left side, horizontally aligned with the second electrode, and a fourth electrode is placed close to the left armpit. For CT applications, the electrodes may be configured in a box configuration around the torso. Each electrode is proximate to a limb of the patient where, for example, a first electrode is positioned at the right shoulder proximate the right arm, a second electrode is positioned at the left shoulder proximate the left aim, a third electrode is positioned at the left hip proximate the left leg, and a fourth electrode is positioned at the right hip proximate the right leg. The electrodes are connected to leads, often facilitated by conducting alligator clips, which deliver electrical activity information to the physiologic transmitter 32.
Due to differences in imaging physics, the electrode placement used for ECG may differ between MRI and CT, as described above. Different types of electrodes and/or leads may also be required for different types of scanners. The physiologic transmitter 32 according to the illustrated embodiment is able to detect the difference between the electrodes/leads attached to it and differentiates between MRI and CT. Depending on the particular scanner 40 that is being used, MRI or CT, the physiologic transmitter 32 can select the correct format and type of data to interpret and transmit. The physiologic transmitter 32 can also instruct the operator to place the ECG leads on the appropriate thoracic locations specific to MRI or CT, as visualized on the physiologic transmitter interface 62 and further described below.
According to another aspect of the present invention, peripheral pulse data 52 is collected from the patient. To collect peripheral pulse data 52, photoplethysmography may be used whereby pulses in the blood radiating to the periphery of the patient after each heartbeat can be detected. Pulses may be detected by using a photoplethsmograph connected to the patient's finger. The photoplethsmographs passes light at a desired wavelength, such as infrared (IR) or in the red spectrum, through the patient's finger to a photodetector. The light absorbance changes during a cardiac cycle and, therefore, the amount of light reflected and/or absorbed is measured, allowing determination of the absorbances due to the pulsing arterial blood. Photoplethysmography can also be connected on the patient's forehead in a similar matter but measuring the reflection of the light. Peripheral pulses 52 can alternatively be acquired by placing sensors at a patient's neck, wrist, foot, etc.
According to yet another aspect of the present invention, respiratory rate data 54 is collected from the patient. When collecting a patient's respiratory rhythm 54, a respiratory bellow or sensor pillow may be placed on a patient's chest or stomach region for recording their respiratory cycle. The sensor pillow is secured to the patient such that expansion and contraction of the chest or abdominal region during a respiratory cycle causes compression and decompression of the sensor pillow. The sensor pillow generates a signal corresponding to the compression and decompression and transmits the signal to the physiologic transmitter 32. The breathing cycle may be monitored to minimize breathing interference or allow the operator to assess the patient's level of consciousness during a scan. Optionally, the respiratory cycle may be monitored via the ECG electrodes by monitoring impedance changes across the chest between ECG electrodes. During the respiratory cycle, the rising and falling motion of the chest results in a varying impedance between electrodes.
In MRI and CT applications, the physiologic transmitter 32 can support three physiological parameters simultaneously, two physiological parameters simultaneously, or any one physiological parameter individually. It is understood that MRI and CT may require different sets of parameters; however, some or all of the parameters may be used for each scan application. For example, MRI scanning may utilize all three parameters, while CT scanning typically only utilizes the ECG data. It is understood that more than three physiological parameters may also be utilized while still remaining within the scope of the invention described herein. Each physiologic sensor may be connected and transmit a physiologic signal 34 to the physiologic transmitter 32 via a wired or wireless connection.
Referring now to
The processor 44 will further execute a stored application to perform trigger or gating analysis 37 on the filtered waveform. This analysis produces a gating signal 42 used to coordinate timing between data acquisition from the MRI or CT scanner 40 and receiving and recording the data for generation of an MRI or CT image. According to one embodiment of the invention, the gating signal is generated by the processor 44 as a function of the physiological data received to coordinate imaging, for example, with the heart beat or respiration of the patient. Gating may be performed using R-wave detection followed by gating methods, such as amplitude or vector gating. In the process of performing gating analysis 37 the processor 44 may compute peak levels for each parameter. The processor 44 will also create heart rate data to be provided to the operator.
The processor 44 sends the waveform, peak information, and heart rate data to the radio 46 of the physiologic transmitter 32 for wireless transmission. The physiologic transmitter radio 46 then transmits this information wirelessly to a physiologic receiver 38 and/or portable tablet 36 or external computer monitor 22, which may be done via Bluetooth, WiFi, or another form of wireless protocol, which will be further described herein. The processor 44 performs the function of controlling transmission of the radio 46. Transmission between the physiologic transmitter 32 and receivers 38 are typically one-way but it is contemplated that data may be exchanged in both directions.
Referring next to
The physiologic transmitter interface 62 may include a number of visual displays for relaying information to the operator and enhancing operation. In one embodiment of the present invention, the physiologic transmitter 32 has an interface 62 which may include an on/off button 64 for powering the module “on” when desired and powering the module “off” when not in use and in order to conserve the battery life. A digital display 66, such as a LCD display, may display the heart rate of the patient, which may be determined by, e.g., the ECG or peripheral pulse data. Optionally, device status and/or information for the technologist may be displayed. The physiologic transmitter 32 may also include a selection button or buttons, which may be pressed to select each waveform or a combination of waveforms to be sent to the physiologic receiver 38 or to be used to determine the trigger signal 42. The selected waveform may be identified, for example, on the digital display 66, by one or more LEDs located on the physiologic transmitter 32, or by any other suitable visual indicator.
The physiologic transmitter interface 62 may include a number of indicator lights, which may be in a first lit state or a second unlit state to relay information or provide alerts to the operator. A first indicator light may be a wireless indicator light 68 that becomes lit to indicate that wireless communication is functioning. The wireless indicator light 68 may include multiple “bars” 69, where a varying number of the bars 69 are illuminated to indicate the strength of a wireless connection between the transmitter 32 and another device. Optionally, the wireless indicator light may also display a different color light to indicate varying strength of the wireless connection. It is contemplated that the wireless communication may be, e.g., WiFi, Bluetooth, a proprietary protocol, as will be further discussed herein, or a combination thereof. The physiologic transmitter 32 may, for example, be configured to communicate with a tablet computer 36 via a WiFi connection and with the physiologic receiver 38 via the proprietary protocol. Another indicator light may be a battery indicator light 70 indicating that the device is fully charged. The battery indicator light 70 may also display a different color light to indicate that battery power is low or a blinking feature to indicate low battery life remaining. Another indicator light may he a charge notification light 72, which may become lit to indicate that the battery is currently being charged. The charge notification symbol 72 may be an icon in the shape of a plug or lighting strike. Another indicator light may be a heart rate indicator 74. If the indicator light 74 is lit, it is an indication that all leads 56 of a ECG are receiving data and a heart rate can be properly displayed from the ECG data. If the indicator light 74 is off, it is an indication that a lead(s) 56 has fallen off and/or ECG data is not being properly gathered. The heart rate indicator 74 may be in the for of a heart shaped icon. The transmitter 32 may also generate and transmit a message containing data corresponding to its operating status, such as the battery life and lead connection/operation status. The message may be transmitted either via a standard wireless protocol or via the proprietary protocol to another device in communication with the transmitter 32.
The physiologic transmitter interface 62 may also include a representation of a patient's torso 76 with a number of position indicator lights 78, 80 representative of the positioning of the surface electrodes on the patient's torso. Further, a first set of position indicator lights 78 may represent the positioning of the surface electrodes on the patient's torso during an MRI scan and a second set of position indicator lights 80 may represent the positioning of the surface electrodes on the patient's torso during a CT scan. Each set of leads 56 may require different characteristics. For example, the positioning of the leads 56 may require different lead lengths or the operating environment of an MRI scanner may have different shielding requirements for the leads 56 than for a CT scanner. The leads 56, therefore, may include an identifier incorporated, for example, in the electrical connector 57 for the lead 56. The identifier may be, for example, a set of jumpers corresponding to a bit pattern, an identification resistor having a different value for different lead sets, or any other suitable method of identifying the lead set. The physiologic transmitter 32 may be configured to detect the identifier and determine whether the set of leads is to be used for an MRI scan or a CT scan. Optionally, a single set of leads suitable for both an MRI scan and a CT scan may be provided. The physiologic transmitter 32 may receive a signal transmitted from the physiologic receiver 38 indicating whether the leads are to be configured for an MRI scan or a CT scan, where the physiologic receiver 38 has detected the type of scanner from a cable 100 connected between the physiologic receiver 38 and the host scanner 40 as discussed in more detail below. If, for example, the leads are to be used for an MRI scan, the interface will light the first set of position indicator lights 78 corresponding with the correct positioning for MRI. If the lead set is to be used for a CT scan, the interface will light the second set of position indicator lights 80 corresponding with the proper positioning for CT.
It is further contemplated that a different set of leads may be used for pediatric and adult imaging, and separate identifiers may be used for the pediatric and adult heads. In addition to detecting the type of scanner to which it will be connected, the physiologic transmitter 32 may detect if pediatric or adult imaging is to be performed. The physiologic transmitter 32 may include different filtering or gating algorithms based on whether pediatric or adult imaging is to be performed and execute the corresponding algorithm according to the detected identifier.
The position indicators 78, 80 may further indicate whether the leads are properly connected to the patient. The position indicators 78, 80 may be configured to operate in a first state and a second state. For example, the first state may be displaying a first color while the second state may be displaying a second color. Optionally, the first state may be a blinking light while the second state may be a solid light. In both the first and the second states, the position indicators 78, 80 function to provide an indication of the proper positioning of the leads on the patient's torso. In the first state, the position indicators 78, 80 will indicate that each of the leads are properly connected to the electrodes and in communication with the physiologic transmitter 32. In the second state, the position indicators 78, 80 will identify each lead not properly connected to the electrode or not in communication with the physiologic transmitter 32, for example, if a conductor within the lead fails. According to the illustrated embodiment, the position indicators 78, 80 will light in a first color, such as green, to show that each lead of the ECG cable is properly attached and that transmitter 32 is receiving electrical signals from each of the electrodes of the ECG. The position indicators 78, 80 will light in a second color, such as red, if the corresponding electrode has become detached or the lead has failed, alerting the operator of a problem with the lead set. It is further contemplated that the transmitter 32 may generate a data message to be transmitted to the receiver 38 providing the status of the leads connected to the patient.
Referring next to
The processor 49 of the tablet computer 36 executes a stored application to receive and/or transmit data via the wireless communication module and provide a visual representation of the data on a display 90 of the tablet computer 36. According to one embodiment of the invention, the wireless communication module is configured to communicate an appropriate communication standard, such as Bluetooth. Optionally, the wireless communication module may utilize any suitable communication protocol. Data is received by an antenna 92 connected to and typically integrated with the wireless communication module.
According to application requirements, the tablet. 36 may store the data on a memory device 94 and/or provide a visual representation of the data on a display 90. The memory device 94 may be volatile or non-volatile. Optionally, the tablet 36 may be removed from the scan room 10 and taken to a remote location where the stored data may he transmitted to another device, such as another computer, a monitor or other display device or a printer.
The data displayed on the tablet 36 or another computer may, for example, correspond to the data measured by the physiologic transmitter 32. The physiologic waveforms, peak information, raw physiologic data, gating trigger, or a combination thereof may be displayed on the tablet display 90 in order for the operator to make a qualitative assessment of the patient condition while undergoing the exam. When a tablet 36 or computer receives data from the physiologic transmitter 32, the display 90 may show one or more waveforms of the physiologic data, the trigger data, heart rate, pulse rate, or respiratory rate simultaneously on the display 90 and in substantially real time The tablet 36 is able to display multiple parameters, such as ECG, respiratory waveforms and peripheral pulse waveforms. The display 90 may also show the trigger rate and trigger pulse data 96. The display 90 may also allow the waveforms to change colors to indicate that a lead has become detached, thus alerting the operator.
Referring again to
The physiologic receiver 38 is configured to receive the data transmitted by the physiologic transmitter 32. According to application requirements, the physiologic receiver 38 may store the data on the memory device 43. The memory device may be volatile or non-volatile. The manner in which the physiologic receiver 38 uses the information provided from the physiologic transmitter is governed by the physiologic receiver 38 as well as by the preference of the technologist performing the examination.
Referring next to
The physiologic receiver 38 connects to the MRI or CT scanner using a cable 100 configured according to the application requirements. For an MRI scanner, a fiber optic cable may be required, and for a CT scanner, a cable with copper or other metal conductors may be required. Further, scanners from difference manufacturers may require different configurations of cables 100. Each cable 100 may require certain conductors be connected to certain pins of connectors or may, for example, require a set of conductors configured to transmit data via a network protocol, such as Ethernet. The physiologic receiver 38 may be configured to be used for both MRI and CT applications and for different scanners. Ports 104 on the receiver 38 allow for the connection of both MRI and CT scanner connectors 102. According to the illustrated embodiment, the physiologic receiver 38 includes multiple ports 104 where, for example, one port may be used for MRI scans and a second port may be used for CT scans. Optionally, a single port 104 may be included on the physiologic receiver 38 with internal logic circuits configurable to provide the appropriate signals to the port 104 as a function of the cable 100 connected to the port 104. It is also contemplated that the receiver 38 includes one or more ports, such as a Universal Serial Bus (USB) port, configured to communicate with an external device, for example, to transmit log data for remote processing.
The physiologic receiver 38 is able to adjust for connection to an MRI scanner or CT scanner by reading an identification module 101 in the cable 100. The identification module 101 may be incorporated, for example, in the electrical connector 102 for the cable 100. The identification module 101 may be, for example, a set of jumpers corresponding to a bit pattern, an identification resistor having a different value for different lead sets, or any other suitable method of identifying the lead set. The physiologic receiver 38 may be configured to detect the identification module 101 and determine whether the trigger monitoring system 30 is to be used for an MRI scan or a CT scan. Based on the host scanner 40, the physiologic receiver 38 will adjust the type and format of the data that is communicated. The physiologic receiver 38 may be configured to transmit a signal to the physiologic transmitter 32 to indicate whether the cable 100 connected is configured for an MRI scan or a CT scan such that the physiologic transmitter 32 may activate the appropriate position indicator lights 78, 80, as discussed above.
Referring next to
Typically, physiologic sensors must be attached to the patient within the scan room 10. Because of the wireless functionality of the system, the physiologic transmitter 32 may be installed on the patient outside of the scan room 10. In this respect, the operator can make sure that the physiological acquisition equipment is functioning before entering the scan room 10. The physiological acquisition equipment can also be installed on the patient in an examination room, where there is more room and comfort to the patient, as well as reducing the overall time a patient is in the scan room 10, which, in turn, permits increased utilization of the scanners. When it is shown that the physiological acquisition equipment is functioning properly, the patient can be brought into the scan room 10 or control room 11.
The wireless functionality also allows the operator to view the physiologic waveforms sent from the physiologic transmitter 32 on a tablet display 90 or on a computer display 22 from a remote location, such as a location outside of the scan room 10. The tablet display 90 can also be viewed from within the scan room 10 where the operator can easily move around with the tablet 36 and hold it easily in their hands during set up and scanning of the patient.
Referring next to
It is contemplated that the trigger monitoring system 30 is conveniently interchangeable between MRI and CT systems. Since many clinical sites run multiple scanners 40, a single physiologic transmitter 32 and receiver 38 may be utilized with both MRI and CT systems. Different leads 56 to the physiologic sensors and different cables 100 to the host scanners 40 may be plugged into each device. According to one embodiment of the invention, the transmitter 32 and receiver 38 are provided as pairs, where the devices are configured to only communicate with the other corresponding unit in the pair. This will avoid the potential for a transmitter 32 in a first scanner for transmitting gating signals that may be received by a receiver 38 in a second scanner. Optionally, a single transmitter 32 can be used in conjunction with multiple physiologic receivers 38, where each receiver 38 may be located by one of the scanners 40 and the transmitter 32 moved as required. Detection by the physiologic transmitter 32 and physiologic receiver 38, respectively, of the MRI or CT connectors ensures that the proper type and format of data is used. An initial setup routine may be executed to establish the transmitter 32 and the desired receiver 38 as a pair to avoid communications between devices on different scanners. Moreover, the physiologic transmitter 32 and physiologic receiver 38, respectively, include the appropriate ports for both MRI and CT system connectors and for different connectors associated with different manufacturers of the scanner 40.
A novel wireless transmission protocol has been developed for use which provides high reliability of transmission between wireless devices with low latency and low jitter. The protocol will be discussed with respect to the afore-discussed trigger monitor system 30. However, it is understood that the protocol may be utilized in various other applications requiring similar reliability with low latency and low jitter. The transmission of waveform data from the physiologic transmitter 32 to the physiologic receiver 38 requires the satisfaction of a number of quality of service requirements that support an overall performance index of the trigger monitor system 30. It is understood that the performance index may be influenced by other factors which are independent of wireless requirements, such as the filtering and gating performed by the processor of the physiologic transmitter prior to data communication.
The quality of services requirements are determined by timing and reliability factors required in the communication of waveform data for image synchronization. For example, the physiologic transmitter 32 sends triggering information to the host scanner 40 based on ECG, PP and RESP waveforms. The waveform with the finest temporal resolution is the ECG waveform, thus driving the desired timing requirements. The timing requirements for CT based applications are less stringent as CT applications can successfully trigger anywhere in the 70-80% period of the R-R wave cycle. Therefore, MRI timing requirements set the standard for timing requirements.
Timing requirements are dependent upon low latency and low jitter in the transmission of the gating trigger. As is understood in the art, latency is the duration of time from when a signal is sampled to when it is transmitted and jitter is the repeatability of the latency between multiple samples. According to one embodiment of the invention, it is desired to have a wireless latency less than 10 ms so as to not degrade the diagnostic quality of the exam. Moreover, it is desired to have a wireless jitter less than 2 ms. Jitter that is greater than 2 ms will create heartbeat to heartbeat variation in the collected data thereby reducing the diagnostic quality of the exam.
The trigger monitoring system 30 also relies upon the reliable transmission of the trigger pulse from the physiologic transmitter to the physiologic receiver. False positives (generating a trigger signal other than the desired point of the QRS waveform) will result in an image being acquired when not expected. False negatives (not generating a trigger signal at the desired point of the QRS waveform) will result in a scan not being acquired when expected. Receipt of a false positive trigger may occur, for example, if noise is introduced in the wireless data during transmission. A false negative may occur due, for example, to transmission failures of packets communicated between the transmitter and the receiver.
In MRI and CT imaging, a false negative results in missing images during a scan. Because consecutive scans of a targeted anatomy may be compiled to generate a three-dimensional image of the targeted anatomy, missing scans may result in missing sections of the targeted anatomy and lower quality images. In MRI applications, patients typically remain in place and a missed image can be re-acquired in a subsequent scan with little or no risk to the patient. However, because CT scans utilize x-ray radiation, the impact of missed triggers in CT is greater than in MRI. Missed sections of the targeted anatomy or low quality images may result in a repeated exam that can expose the patient to additional ionizing radiation which may be harmful to the patient. A false positive results in an image being taken at an unexpected or undesired location within a respiratory or cardiac cycle. The extra image may result in motion artifacts being generated within the image, reducing the quality of the image. Thus, it is desirable to minimize false negative and false positive detections during MRI and CT scans.
Referring now to
As illustrated in
The transmitter 210 sends data to the receiver 220 at multiple frequencies to increase reliability of the transmission. The delivery of data is made more reliable as a result of the frequency diversity because delivery at the at least four different frequencies results in back-up delivery in the ease of interference at a particular channel frequency. During operation, each receive circuit 226, 228, 230, 232remains at a specific channel, or frequency, and each receive circuit 226, 228, 230, 232 is preferably set to a different wireless channel. For each data sample sent to the receiver 220, the transmitter 210 is configured to transmit at varying frequencies and transmits the same data packet at the frequency corresponding to the channels at which each of the different receiver circuits 226, 228, 230, 232 are set. Use of multiple frequencies improves the probability that one of the channels will be clear to successfully transmit the data packet.
The transmitter 210 sends data to the receiver 220 at multiple frequencies according to a transmission schedule 250 as illustrated, for example, in
At the end of each transmission interval, the receiver 220 may verify that the data was transmitted successfully. According to one embodiment, the receiver 220 extracts the data sent from each data packet at each of the four frequencies. The data may be stored in memory on the receiver 220. Because the same data was used to generate the data packet which was transmitted at each frequency, the extracted data should be the same. The control circuit 234 in the receiver may compare the data extracted from each frequency against each other. If the data from each of the data packets is identical, the receiver confirms that the data was transmitted successfully. Optionally, if at least three frequencies are used to transmit the data, the control circuit 234 may use a majority voting method, where if the data from over half of the data packets is identical, the control circuit 234 uses the data from the majority of the data packets that are identical and confirms that the data was transmitted successfully. If the data from at least half of the data packets are different from each other, the control circuit 234 indicates that the data was not transmitted successfully and may ignore the data from that transmission interval.
According to another embodiment, the transmitter 210 may generate a checksum based on the data included in the data packet. The receiver 220 extracts the data and the checksum sent in each data packet at each of the four frequencies. The receiver 220 determines a checksum based on the data extracted from the data packet and compares the calculated checksum to the transmitted checksum. If receiver 220 determines that a data packet from any of the four frequencies was successfully transmitted as a result of matching checksums, the receiver 220 may utilize the data from that data packet and confirms that the data was transmitted successfully. It the receiver 220 determines that the calculated checksum does not match the transmitted checksum at any of the frequencies, the receiver 220 indicates the data was not transmitted successfully and may ignore the data from that transmission interval.
Spatial diversity may be achieved by using multiple receiving antennas. The receiving antennas are spatially displaced and act independently. Optionally, a circular antenna or antenna array may be configured to receive the transmissions from multiple polarizations. Multipath propagation can, for example, adversely affect the quality of service on a given antenna/radio pair, but the multipath impact will be different on the other antenna/radio pairs. Use of multiple antennas reduces the probability that multipath effects will impact overall quality of service. Thus, it is further contemplated that the receiver 220 may include four antennas 222. Each antenna 222 may be in communication with one of the receive circuits 226, 228, 230, 232 and may be configured to receive a transmission at the frequency corresponding to the respective receive circuit 226, 228, 230, 232. Thus, if interference exists along one transmission path, another transmission path may receive the transmission between the transmitter 210 and the receiver.
At the end of each transmission interval, the receiver 220 may execute a verification of successful transmission for the multiple antennas in a manner similar to that described above for transmission at multiple frequencies. The receiver 220 may verify successful transmission based on comparison of the data received at each antenna or, if available, may evaluate a checksum transmitted with the data.
It is further contemplated that the transmitter may employee frequency diversity and spatial diversity together. In other words, data may be transmitted at multiple frequencies and received by spatially displaced antennas. Verification of transmitted data may he a two-step process. For example, verification may first determine whether data received from the multiple antennas was successful. If the receiver 220 successfully received data at a majority of antennas, the receiver 220 may next determine whether the received data is the same across a majority of the frequencies. If the data is the same at the majority of antennas and across a majority of the transmission frequencies, the transmission was successful. In the event a checksum is utilized, any data packet successfully received, as verified by the checksum, indicates successful transmission.
As yet another method of ensuring reliable data transmission, the control circuit 216 of the transmitter 210 uses time diversity in which multiple samples of a signal are obtained prior to transmitting the signal to the receiver 220. With reference to
Although the control circuit 234 of the receiver 220 may execute according to a majority of values of a sample 262 being the same, it is also contemplated, that the data may include, for example, a checksum or other means of error detection. If the control circuit 234 determines based on the checksum that a received message is correct, it identifies the packet as containing good data. The data may then be stored and relied upon for future execution. Thus, if the transmitter 210 is using a four sample redundancy but three packets in a row are lost, the final packet will still contain valid data and the receiver 220 may rely on the single received sample 262 for execution.
It is further contemplated that the transmission protocol may utilize all three of the afore-described diversity techniques, namely frequency diversity, spatial diversity, and time diversity. Verification may be a multiple step process, verifying that one of the diversity techniques is successful prior to verifying that a subsequent diversity technique is successful. With multiple diversity techniques, it may be preferable to include a checksum, such that verification of successful transmission of any one data packet based on the checksum, results in the data from that data packet being used by the receiver 220.
It is also contemplated that multiple transmitters 210 and receivers 220 may be operating within range of each other. To avoid reception of and processing of data packets from other transmitters 210 and/or receivers 220, each transmitter 210 and receiver 220 may be established as a pair. The transmitter 210 and receiver 220 may be configured initially, for example, via hardware and/or software switches to only communicate with a paired device. Optionally, each transmitter 210 and receiver 220 may be configurable to communicate with multiple other devices; however, an initialization routine may be executed to connect the transmitter 210 and receiver 220 as a pair based, for example, on addresses or other identification within each device. During operation, although both the transmitter 210 and the receiver 220 may be configured to transmit a message to the other device, each transmission is unidirectional, requiring no acknowledgement. Thus, the source and/or destination address or other identifier is included in the data packet. The receiving device verifies that it is either the intended recipient or receiving a transmission from its corresponding paired device. If the received transmission is either not intended for the receiving device or not sent from its corresponding device, the data packet is discarded.
Thus, the wireless protocol disclosed herein utilizes multiple methods of improving reliability of data transmission between two devices without requiring an acknowledge signal. The data may be transmitted at multiple frequencies to avoid interference at any one frequency. The data may be transmitted and/or received utilizing multiple antennas or multi-directional antennas to avoid interference along any one transmission path. The data may also be saved and transmitted in batches such that each data sample is transmitted multiple times to avoid the loss of any one data transmission. It is contemplated that various combinations of the afore-mentioned techniques may be utilized to achieve improved reliability of transmissions.
It should be understood that the invention is not limited in its application to the details of construction and arrangements of the components set forth herein. The invention is capable of other embodiments and of being practiced or carried out in various ways. Variations and modifications of the foregoing are within the scope of the present invention. It also being understood that the invention disclosed and defined herein extends to all alternative combinations of two or more of the individual features mentioned or evident from the text and/or drawings. All of these different combinations constitute various alternative aspects of the present invention. The embodiments described herein explain the best modes known for practicing the invention and will enable others skilled in the art to utilize the invention.
This application claims priority to U.S. provisional application Ser. No. 62/025,171, filed Jul. 16, 2014, the entire contents of which is incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 62025171 | Jul 2014 | US |
