ES2689751T3

Generating an estimate of patient radiation dose resulting from medical imaging scans

Abstract

A procedure (400) implemented by computer to generate an image formation model corresponding to a first individual (120), the procedure comprising: selecting (405) an initial mathematical phantom for the first individual receiving an image formation scan, basing the selection on the age and gender of the first individual; receiving one or more scan images (410) of the first individual; select (415) from the images obtained from multiple individuals a reference set of locator images having a body geometry, size and position that closely matches the initial mathematical phantom; determining (420) a transformation between at least one of the locator images and at least one of the scanning images of the first individual; and deforming the initial mathematical phantom based on the transformation whereby a deformed mathematical phantom resulting from the transformation coincides (425) better with a size, shape and positions of the organs of the first individual.

ES2689751T3, drawing sheet 1 — Sheet 1 of 11

Term

5.2 yearsto projected expiry

Projected expiry 8 December 2031, counted from filing; an application has no term until it is granted.

14 claims: 4 independent, 10 dependent

1
5 10 15 20 25 30 35 40 45 50 55 REIVINDICACIONES 1. Un procedimiento (400) implementado por ordenador para generar un modelo de formación de imágenes correspondiente a un primer individuo (120), comprendiendo el procedimiento:seleccionar (405) un fantoma matemático inicial para el primer individuo que recibe un escaneo de formación de imágenes, basándose la selección en la edad y el género del primer individuo;recibir una o más imágenes (410) de exploración del primer individuo;seleccionar (415) a partir de las imágenes obtenidas de múltiples individuos un conjunto de referencia de imágenes de localizador que tengan una geometría, tamaño y posición corporales que coincida estrechamente con el fantoma matemático inicial;determinar (420) una transformación entre al menos una de las imágenes de localizador y al menos una de las imágenes de exploración del primer individuo;y deformar el fantoma matemático inicial basándose en la transformación por la cual un fantoma matemático deformado resultante de la transformación coincide (425) mejor con un tamaño, una forma y unas posiciones de los órganos del primer individuo.
2
El procedimiento implementado por ordenador de la reivindicación 1, en el que determinar una transformación entre al menos una de las imágenes de localizador y al menos una de las imágenes de exploración del primer individuo comprende realizar un procedimiento de registro de imágenes mapeando un conjunto de puntos de una de las imágenes de localizador en un conjunto correspondiente de puntos de una de las imágenes de exploración del individuo.
3
El procedimiento implementado por ordenador de la reivindicación 1, en el que el escaneo de formación de imágenes es un escaneo portomografía computarizada (TC) realizado por un aparato de escaneo por TC.
4
Un procedimiento implementado por ordenador para generar un modelo de formación de imágenes correspondiente a un individuo (120), comprendiendo el procedimiento:seleccionar un fantoma matemático inicial para un individuo (120) que recibe un escaneo de formación de imágenes realizado por un aparato (105) de escaneo de imágenes;segmentar un escaneo de referencia asociado con el individuo para identificar un volumen tridimensional (3D) de una pluralidad de puntos de referencia anatómicos del individuo presentes en el escaneo de referencia;determinar, para al menos uno de la pluralidad de puntos de referencia anatómicos, un centroide del volumen 3D respectivo;hacer coincidir uno o más de los puntos de referencia anatómicos identificados en el escaneo de referencia segmentado con los puntos de referencia anatómicos correspondientes en el fantoma matemático inicial;y deformar el fantoma matemático inicial basándose en los puntos de referencia anatómicos coincidentes, comprendiendo la deformación del fantoma matemático inicial: determinar un mapa de desplazamiento tridimensional que representa el desplazamiento desde al menos un centroide de los puntos de referencia anatómicos identificados a los centroides de los puntos de referencia anatómicos correspondientes del fantoma matemático inicial;voxelizar el escaneo de formación de imágenes inicial;transformar el fantoma matemático inicial voxelizado para que coincida con el mapa de desplazamiento tridimensional;y determinar si dos o más de los puntos de referencia anatómicos correspondientes del fantoma matemático inicial se superponen en un mismo volumen físico dentro del fantoma matemático inicial voxelizado y transformado.
5
El procedimiento de las reivindicaciones 1 o 4, que comprende además:recibir un conjunto de parámetros que describen el escaneo de formación de imágenes y el aparato de escaneo de imágenes que se usa para realizar el escaneo de formación de imágenes;simular el escaneo de formación de imágenes usando el fantoma matemático deformado y el conjunto de parámetros recibido;y estimar, basándose en la simulación, las cantidades de radiación absorbidas por el individuo como resultado de la realización del escaneo de formación de imágenes.
6
Un sistema, que comprende:un procesador;y una memoria que almacena un programa de aplicación configurado para realizar una operación para generar un modelo de formación de imágenes correspondiente a un primer individuo, comprendiendo la operación: seleccionar un fantoma matemático inicial para el primer individuo que recibe un escaneo de formación de imágenes, basándose la selección en la edad y el género del primer individuo, recibir una o más imágenes de exploración del primer individuo, 5 10 15 20 25 30 35 40 45 50 55 seleccionar, a partir de las imágenes obtenidas de múltiples individuos, un conjunto de referencia de imágenes de localizador que tengan una geometría, tamaño y posición corporales que coincida estrechamente con el fantoma matemático inicial;determinar una transformación entre al menos una de las imágenes de localizador y al menos una de las imágenes de exploración del primer individuo, y deformar el fantoma matemático inicial basándose en la transformación por la cual un fantoma matemático deformado resultante de la transformación coincide mejor con un tamaño, una forma y unas posiciones de los órganos del primer individuo.
7
Un sistema (125, 130), que comprende:un procesador (205, 305);y una memoria (220, 320) que almacena un programa (232) de aplicación configurado para realizar una operación para generar un modelo de formación de imágenes correspondiente a un individuo, comprendiendo la operación: seleccionar un fantoma matemático inicial para el individuo que recibe un escaneo por tomografía computarizada (TC), segmentar (610) un escaneo por TC de referencia asociado con el individuo para identificar (615) un volumen tridimensional (3D) de una pluralidad de puntos de referencia anatómicos del individuo presentes en el escaneo por TC de referencia, determinar, para al menos uno de la pluralidad de puntos de referencia anatómicos, un centroide del volumen 3D respectivo;hacer coincidir (620) uno o más de los puntos de referencia anatómicos identificados en el escaneo por TC de referencia segmentado con los puntos de referencia anatómicos correspondientes en el fantoma matemático inicial, y deformar el fantoma matemático inicial basándose en los puntos de referencia anatómicos coincidentes, en el que deformar el fantoma matemático inicial basándose en los puntos de referencia anatómicos coincidentes comprende: determinar (625) un mapa de desplazamiento tridimensional que representa el desplazamiento desde el al menos un centroide de los puntos de referencia anatómicos identificados a los centroides de los puntos de referencia anatómicos correspondientes del fantoma matemático inicial;voxelizar el escaneo de formación de imágenes inicial;transformar (630) el fantoma matemático inicial voxelizado para que coincida con el mapa de desplazamiento tridimensional;y determinar si dos o más de los puntos de referencia anatómicos correspondientes del fantoma matemático inicial se superponen en un mismo volumen físico dentro del fantoma matemático inicial voxelizado y transformado.
8
El procedimiento implementado por ordenador de la reivindicación 3, que comprende además:recibir un conjunto de parámetros que describen el escaneo de formación de imágenes y el aparato (105) de escaneo por TC que se usa para realizar el escaneo por TC del primer individuo (120);acceder a una biblioteca (335) de simulaciones que comprende una pluralidad de simulaciones completadas previamente que estiman la absorción de dosis de radiación correspondiente al uno o más segundos individuos;evaluar (328) la pluralidad de simulaciones completadas previamente que estiman la absorción de dosis de radiación correspondiente al uno o más segundos individuos;proporcionar una búsqueda en tiempo real, basada en la evaluación, de una de la pluralidad de simulaciones completadas previamente en la biblioteca (335) de simulaciones que tiene un conjunto de parámetros que coincide dentro de una medida de tolerancia especificada con el conjunto de parámetros recibido y el fantoma matemático deformado;y determinar (1030) la estimación de la absorción de dosis de radiación asociada con la una de las simulaciones completadas previamente buscada en la biblioteca de simulaciones como la estimación de la dosis de radiación absorbida por el primer individuo.
9
El procedimiento implementado por ordenador de la reivindicación 8, en el que la estimación de la dosis de radiación absorbida por el primer individuo proporciona estimaciones de una dosis absorbida por órgano para uno o más órganos del primer individuo.
10
El procedimiento implementado por ordenador de la reivindicación 8, que comprende, además, almacenar el conjunto de parámetros y la estimación de la dosis de radiación absorbida por el primer individuo en la biblioteca de simulaciones.
11
El procedimiento implementado por ordenador de la reivindicación 3, en el que recibir una o más imágenes de exploración del primer individuo comprende:capturar, usando el aparato (105) de escaneo por TC y antes de realizar el escaneo por TC, una proyección bidimensional (2D) del primer individuo.
12
El procedimiento implementado por ordenador de la reivindicación 1, en el que determinar la transformación entre al menos una de las imágenes de exploración del primer individuo y la al menos una de las imágenes de localizador comprende:realizar un procedimiento de registro de imágenes mapeando un conjunto de puntos de una de las imágenes de 5 localizador en un conjunto correspondiente de puntos de una de las imágenes de exploración del primer individuo.
13
El procedimiento implementado por ordenador de la reivindicación 1, en el que el fantoma matemático inicial comprende un conjunto de curvas elementales racionales no uniformes (NURB).
14
El procedimiento implementado por ordenador de la reivindicación 1, que comprende además seleccionar al menos una de las imágenes de localizador basándose en la proximidad de la coincidencia de la 10 misma con el fantoma matemático inicial en una región a representar en el escaneo de formación de imágenes recibido por el primer individuo, en el que la transformación se determina entre la al menos una de las imágenes de localizador seleccionada y al menos una de las imágenes de exploración del primer individuo.

Independent claims14

266 paragraphs in 1 section, as filed

DESCRIPTION

Generation of a suitable model to estimate the radiation dose of a patient resulting from medical imaging scans

Field of the Invention

The embodiments of the invention generally refer to approaches to estimate a patient's radiation exposure during computed tomography (CT) scans.

Background

As is known, a CT scan system uses ionizing radiation (x-rays) to generate images of tissues, organs and other structures within a body. X-ray data resulting from a CT scan can be converted to images on a computer display screen. For example, CT scanning provides a collection of data used to create a three-dimensional (3D) volume corresponding to the scanned portion of a patient's body. The 3D volume is then cut to create images of body tissue at small intervals along an axis of the patient's body. Such cuts may include both lateral and transverse cuts (as well as other cuts) depending on the tissues or structures of which images are being formed.

The use of CT scans and ionizing radiation for medical imaging have grown exponentially in the last decade. And modern techniques, such as CT scanning, provide much more detailed and valuable diagnostic information than conventional x-ray imaging. At the same time, however, patients are exposed to substantially higher radiation doses. For example, a typical chest CT scan will expose a patient to between 100 and 250 times the dose of a conventional chest radiograph depending on the voltage and current of the CT scan system, the protocol followed to perform the procedure, and the size and shape of the patient being scanned.

Despite the increasing use of CT scans (and the resulting radiation exposure) the amount of radiation to which a patient is exposed during a procedure and, more importantly, the cumulative dose in many procedures, are not parameters They are regularly monitored for a patient, and neither are these parameters an easily accessible part of the patient's medical records. This occurs in part because the amount of radiation absorbed by internal organs and tissues cannot be measured directly in living patients as part of a CT examination, and the results obtained in corpses, although more precise, do not correspond well with absorption of doses in living tissues.

Similarly, approaches to estimate the dose currently used also provide inaccurate results. For example, one approach is to rely on a limited number of physical imaging symptoms to represent a particular patient. However, the available imaging symptoms do not adequately represent the wide variation in the size and weight of people in the population of individuals receiving CT scans. As a result, single point surface measurements are those that are currently made in most cases where the dose is not estimated at all. However, this leads to poor and highly variable results, depending on where the single point dose is measured. More generally, surface measurements of radiation exposure do not provide an accurate measure of actual absorption for internal tissues, organs and structures.

EP 1913421 discloses the concept that medical images are collected in a plurality of cardiac and respiratory phases. The images are transformed into a series of compensated respiratory images with the plurality of cardiac phases, but all in a common breathing phase. The series of compensated respiratory images is transformed into an image in a selected cardiac phase and in the common breathing phase. In some embodiments, a database of closed transformation matrices is generated. The database can be based on patient-specific information or information generated from a group of patients. The database may represent respiratory movement, cardiac contractile movement, other physiological movements or combinations thereof. To correct the movement of a current image, the transformation matrices collected in the database are used to estimate a current set of transformation matrices that represent the movement in the current image, and a motion-compensated image is generated based on the movement. current set of transformation matrices.

Document US 2010/046815 refers to a system for registering a container model with an image data set based on a linked model comprising a reference object model and the container model, the system comprising: a unit of placement to place the attached model in a space of the image data set, thereby creating a attached attached model comprising a reference object model placed and a container model placed; a calculation unit for calculating a deformation field based on a reference point offset field comprising the reference point offset of the reference object model located relative to the corresponding reference points in the image data set ; a transformation unit to transform the joined model placed using the deformation field, thereby creating a transformed joined model that

it comprises a transformed reference object model and a transformed container model; and a recording unit for registering the transformed vessel model with the image data set based on the modification of the transformed vessel model and the optimization of an objective function of the modified transformed vessel model, in which the objective function comprises a prior location term based on a location of the modified transformed vessel model in relation to the transformed joined model. Therefore, the system is arranged to model a container taking into account the location of a container model in relation to an anatomical reference structure described by a reference model.

Summary

In a first aspect of the invention, a computer-implemented method is provided to generate an imaging model corresponding to a first individual, the method according to claim 1. In a second aspect of the invention, a method is provided. implemented by computer to generate an imaging model corresponding to an individual, the method according to claim 4. In another aspect of the invention, a system according to claim 6 is provided, while another aspect of the invention provides another system according to claim 7.

The embodiments provide techniques to estimate a patient's radiation exposure during computed tomography (CT) scans. An embodiment includes a computer-implemented procedure to generate an image formation model that corresponds to an individual. This procedure may include, in general, selecting an initial imaging phantom for an individual receiving an imaging scan, in which the imaging phantom has one or more associated location images and receives one or more Scanning images of the individual. This procedure may also include determining a transformation between at least one of the locator images associated with the imaging phantom and deforming the initial imaging phantom based on the transformation.

In a specific embodiment, the imaging scan is a computed tomography (CT) scan, in other cases the imaging scan is a fluoroscopy scan, a PET scan, an angiography scan, etc. This procedure may also include receiving a set of parameters that describe the imaging scan and CT scanning devices used to perform the CT scan, simulate the imaging scan using the imaging phantom deformed and the set of parameters received, and estimate, based on the simulation, the amounts of radiation absorbed by the individual as a result of performing the imaging scan. In a specific embodiment, the simulation is a Monte Carlo simulation.

Another embodiment includes a procedure to generate an image formation model corresponding to an individual. This procedure may generally include selecting an initial imaging phantom for an individual receiving a CT scan and segmenting a reference CT scan associated with the individual to identify a three-dimensional (3D) volume of a plurality of anatomical reference points of the individual present in the reference CT scan. This procedure may also include matching one or more of the anatomical reference points identified in the scan by segmented reference CT with the corresponding anatomical reference points in the initial imaging phantom and deforming the initial imaging phantom based on matching anatomical landmarks.

Additional embodiments include a computer-readable storage medium that stores an application that, when run on a processor, performs the above-mentioned procedure as well as a system that has a processor and a memory that stores an asset management application program of business information that, when executed in the processor, performs the procedure mentioned above.

Brief description of the drawings

In order that the aforementioned aspects are achieved and can be understood in detail, a more specific description of the embodiments of the invention, briefly summarized above, may be made by reference to the attached drawings. However, note that the accompanying drawings illustrate only the usual embodiments of the invention and, therefore, are not limiting of its scope, since the invention may admit other equally effective embodiments.

Figure 1 illustrates an example of a CT scanning system and related computer systems

configured to provide estimates of the patient's radiation dose, according to a

embodiment of the invention.

Figure 2 illustrates an example of an imaging system used to obtain scan data by

TC, according to one embodiment.

Figure 3 illustrates an example of a dose estimation system used to estimate and track the accumulated dose of the patient, in accordance with one embodiment.

Figure 4 illustrates a procedure for generating a suitable model for estimating the radiation dose of the patient resulting from CT scans, in accordance with one embodiment.

Figure 5A illustrates an exemplary image representing a deformable phantom, in accordance with one embodiment.

Figure 5B illustrates an example of a two-dimensional (2D) reference image of a portion of a human body corresponding to the phantom shown in Figure 5A, in accordance with one embodiment.

Figure 6 illustrates another procedure for generating a suitable model for estimating the radiation dose resulting from CT scans, in accordance with one embodiment.

Figure 7 illustrates an exemplary section of a phantom superimposed on a corresponding CT scan of a patient, in accordance with one embodiment.

Figure 8 illustrates an example of a cross-section of an imaging phantom superimposed on a corresponding cross-section CT scan of a patient, in accordance with one embodiment.

Figure 9 illustrates an example of a CT image segmentation and an organ volume shift for an imaging phantom, in accordance with one embodiment.

Figure 10 illustrates a procedure for a dose estimation service to provide patient dose estimates to multiple CT scan providers, in accordance with one embodiment.

Figure 11 illustrates an exemplary calculation infrastructure for a patient dose estimation service system configured to support multiple CT scan providers, in accordance with one embodiment.

Detailed description

The embodiments of the invention generally refer to approaches to estimate the patient's radiation exposure during computed tomography (CT) scans. More specifically, the embodiments of the invention provide efficient approaches to generate a suitable patient model used to make such an estimate, approaches to estimate the patient's dose interpolating the results of multiple simulations, and approaches for a service provider to host a service. Dose estimation that is available to multiple providers of CT scans. As described in detail below, the dose administration system provides a unique system to track radiation doses through modalities and to present information to practitioners in a meaningful and easily understood format. Routine consideration of the cumulative dose to order diagnostic imaging tests can lead to a more informed decision-making procedure and, ultimately, benefit patient safety and care.

In one embodiment, a virtual imaging phantom is generated to model a particular patient receiving a CT scan. The virtual imaging phantom can be generated by deforming an existing mathematical phantom to better match the size, shape, and organ positions of a patient who is exposed to radiation in a CT scan. Initially, a mathematical phantom can be selected based on, for example, the age and gender of the patient. The specific geometry of the patient can be achieved by deforming the selected mathematical phantom using the transformations obtained by analyzing the scan image locators of that patient. Note that, in this context, as those skilled in the art understand, a locator generally refers to a 2D image projection of a patient (usually an anterior / posterior x-ray image and / or a d image ray Lateral X). In such an approach, the selected mathematical phantom may have its own set of locator image reference. The reference images for a given virtual phantom are selected to match the geometry, size and placement of that phantom (for example, with arms up or to the sides) and can be selected from images obtained from multiple individuals.

Next, image recording techniques are used to map points of the patient locator image into reference image points (or images) associated with the virtual phantom. In doing so, a set of transformations is produced that can be used to deform the virtual phantom to better match the patient's geometry. A similar approach involves the use of a reference set of 3D data (selected CT scans) for the phantom and the use of 3D image recording techniques to map points of a CT scan of a particular patient at scan points by Reference CT associated with a given phantom.

Similarly, image segmentation can be used to identify a 3D volume within a

CT scan corresponding to organs, tissues or structures of interest in a CT scan of a patient. The 3D volume can be a bounding box, or a more precise 3D volume considered to represent an organ, etc. Once identified, a displacement between the position of the organ in the phantom and the corresponding position in the CT scan of the patient can be determined. Instead of operating on individual image points (as in 2D / 3D image registration techniques), the image segmentation approach works using larger 3D volumes from the CT image as data points to determine a transformation of a virtual phantom and a certain patient.

In each of these cases, the resulting hybrid phantom provides a much more accurate mathematical representation of a specific patient for use in a dose simulation than unmodified phantoms alone. Once the transformations are determined, the virtual hybrid phantom can be used to simulate a particular CT procedure for the patient. For example, well-known Monte Carlo simulation techniques have been developed to estimate the dose absorbed by an organ for a virtual phantom. These simulation techniques use the virtual phantom (transformed in relation to a given patient) together with a series of configurations related to the model and the CT scan procedure that will be performed, in order to calculate precise estimates of the dose absorbed by the patient. organ. For example, a CT scanner can be modeled using kVp, i.e. peak kilovoltage, target angle of the X-ray generator, fan angle, collimation, cutting thickness, focus distance to the axis, flat filters (material and thickness) and filters of beam shaping (material and geometry). Of course, these (and other parameters) can be selected as available or as necessary to meet the needs of a specific case.

However, estimating the dose of organ absorbed by an organ using a Monte Carlo simulation may require significant amounts of calculation time, much more time than is required to perform a real CT scan. Given the high utilization of CT scanning systems in many imaging facilities, in cases where an estimate of the total cumulative dose should not exceed a prescribed maximum, this delay is simply not manageable. Even in cases where the estimate is not used before performing a certain procedure, unless the patient dose estimates can be determined, relatively, in the same order of time required to perform a procedure, keep a record of the Dose estimation for a given scanning system becomes unmanageable, since simulations will simply fall further and further back compared to current scans. This problem grows exponentially for a SaaS provider that hosts a cloud dose estimation service for multiple imaging facilities.

Consequently, in one embodiment, estimates of the determined patient dose for a given procedure can be generated by interpolation between two (or more) simulations completed previously. If there are no “nearby” simulations available, then the virtual hybrid phantom, the CT scanner and the procedure data can be added to a queue of complete Monte Carlo simulations to be performed. Over time, a large library of simulations allows real-time dose estimates to be provided as the procedures are programmed and performed. Doing so allows cumulative dose amounts to be captured for a given patient, as well as the cumulative dose limits to be observed.

In addition, in one embodiment, software such as a service provider (SaaS) or cloud model can be used to perform dose estimates, maintain a library of calculated simulations, as well as run Monte Carlo simulations. In such a case, a CT scan provider can provide the SaaS provider with the parameters of a particular CT procedure. For example, client software (or even a secure web-based portal) in an imaging center can be used to provide the SaaS provider with a selected virtual phantom, along with the transformations used to create hybrid phantom modeling. of a specific individual and the equipment and protocol to be used in performing a CT procedure. Once received, the service provider can select the appropriate simulations from the library to interpolate and return an estimate of the dose absorbed by the patient's organ to the imaging center.

It is important to note that the SaaS provider does not need to receive any real identifying information about a particular individual or patient receiving a CT scan. Instead, the SaaS provider receives only information related to a virtual phantom and a Tc system / procedure. As a result, the service provider's operations may not require compliance with a variety of laws and / or regulations related to the privacy of personal health information. In addition, by providing dose estimates for multiple imaging centers, the resulting simulation library becomes more diverse and is much more likely to find candidates for interpolation than a simulation library generated solely from scanning procedures performed by A single imaging center. Furthermore, the centralization of the Monte Carlo simulation and simulation library allows for improvements in phantoms, a Monte Carlo simulation engine and interpolation techniques to be shared by all imaging centers that use the cloud-based service. Finally, this approach allows the imaging center to maintain information that links the cumulative dose to specific patients, allowing the actual patient data to remain with each individual provider. At the same time, the SaaS provider can, of course, communicate with the imaging centers using a variety of standardized protocols for the exchange of images and data, including, for example, communications and digital imaging in medicine ( DICOM), archiving and communication systems of

images (PACS), international health standards level seven (HL7), ICD-9, diagnostic codes and procedure ICD-10, etc.

In addition, the following description refers to embodiments of the invention. However, it should be understood that the invention is not limited to the specific embodiments described. On the contrary, any combination of the following characteristics and elements, whether related to the different embodiments or not, is contemplated to implement and practice the invention. Furthermore, although the embodiments of the invention can achieve advantages over other possible solutions and / or over the prior art, the fact that a specific advantage is achieved or not by a given embodiment is not limiting to the invention. Therefore, the following aspects, features, embodiments and advantages are merely illustrative and are not considered elements or limitations of the appended claims, except when explicitly stated in one or more claims. Similarly, the reference to "the invention" should not be construed as a generalization of any object of the invention disclosed herein and will not be considered as an element or limitation of the appended claims, except when explicitly stated in one or various claims.

As those skilled in the art will appreciate, aspects of the present invention can be incorporated as a computer program system, procedure or product. Accordingly, aspects of the present invention may take the form of a fully hardware embodiment, a completely software embodiment (which includes firmware, resident software, microcode, etc.) or an embodiment that combines aspects of software and hardware that, in general, they may be referred to herein as "circuit", "module" or "system". In addition, aspects of the present invention may take the form of a computer program product incorporated into one or more computer-readable media that has a computer-readable program code incorporated therein.

Any combination of one or more computer readable media may be used. The computer readable medium can be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared or semiconductor system, apparatus or device, or any suitable combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following: an electrical connection that has one or more cables, a laptop diskette, a hard disk, a random access memory (RAM), a read-only memory (ROM), a programmable read-only memory erasable (EPROM or flash memory ), an optical fiber, a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device or any suitable combination of the foregoing. In the context of this document, a computer readable storage medium may be any tangible medium that may contain or store a program for use by or in connection with an instruction execution system, apparatus or device.

The flow and block diagrams in the figures illustrate the architecture, functionality and operation of possible implementations of computer software systems, procedures and products in accordance with various embodiments of the present invention. In this regard, each block in the flow or block diagrams may represent a module, segment or portion of the code, comprising one or more executable instructions to implement the specified logical function (s). In some alternative implementations, the functions indicated in the block may occur outside the order indicated in the figures. For example, two blocks shown in succession can, in fact, be executed substantially simultaneously, or the blocks can sometimes be executed in the reverse order, depending on the functionality involved. Each block of the block diagrams and / or the flow charts, and the block combinations in the block diagrams and / or the flow charts can be implemented by special purpose hardware based systems that perform the specified functions or actions, or combinations of special purpose hardware and computer instructions.

Embodiments of the invention can be provided to end users through a cloud computing infrastructure. Cloud computing refers, in general, to the provision of scalable computing resources, such as a service over a network. More formally, cloud computing can be defined as a computing capability that provides an abstraction between the computing resource and its underlying technical architecture (e.g., servers, storage, networks), allowing convenient and low network access it demands a shared group of configurable computing resources that can be quickly provided and released with a minimal effort of management or interaction from the service provider. Therefore, cloud computing allows users to access virtual computing resources (for example, storage, data, applications, and even complete virtualized computer systems) in “the cloud,” regardless of the underlying physical systems (or locations of those systems) used to provide computing resources.

Typically, cloud computing resources are provided to a user in the form of pay-per-use, where users only pay for the actual computer resources used (for example, an amount of storage space consumed by a user or a series of virtualized systems instantiated by the

Username). A user can access any of the resources that reside in the cloud at any time and from anywhere through the internet. In the context of the present invention, a service provider can provide imaging centers with patient dose estimates in both predictive and informative perspectives. For example, a dose estimation interface can be used to present virtual phantom and CT data to the cloud-based provider.

The flow and block diagrams in the figures illustrate the architecture, functionality and operation of possible implementations of computer software systems, procedures and products in accordance with various embodiments of the present invention. In this regard, each block in the flow or block diagrams may represent a module, segment or portion of the code, comprising one or more executable instructions to implement the specified logical function (s). It should also be noted that, in some alternative implementations, the functions indicated in the block may occur outside the order indicated in the figures. For example, two blocks shown in succession can, in fact, be executed substantially simultaneously, or the blocks can sometimes be executed in the reverse order, depending on the functionality involved. It will also be noted that each block of the block diagrams and / or the flowcharts, and the block combinations in the block diagrams and / or the flowcharts can be implemented by special purpose hardware based systems that perform the functions or specified actions, or combinations of special purpose hardware and computer instructions.

In addition, the specific embodiments of the invention described below are based on a specific example of a CT computed tomography scanning system that uses a client-server architecture to provide a dose estimate to a set of imaging. However, it should be understood that the techniques described herein can be adapted for use with other medical imaging technologies that are based on exposing individuals to limited radiation doses as part of the imaging procedure (e.g., PET scans, conventional radiographs and fluoroscopy and angiography, etc.).

Figure 1 illustrates an example of a CT scan environment 100 and related computer systems configured to provide estimates of the radiation dose of the patient, in accordance with an embodiment of the invention. As shown, the CT scan environment 100 includes a CT scan system 105, an imaging system 125 and a dose estimation system 130. In addition, the dose estimation system 130 includes an imaging database 132 and a simulation library 134.

As is known, the CT scanner 105 provides a device used to bombard a subject 120 with X-rays from an X-ray source 110. X-rays emitted from the X-ray source 110 pass through tissues, organs and structures. of subject 120 at different speeds (some of which are absorbed by said tissues, organs and structures) depending on the density and type of matter that X-rays pass through. The sensors arranged with a ring 115 detect the amount of radiation that passes through the subject 120. The resulting sensor information is passed to the imaging system 125. The imaging system 125 provides a computer device configured to receive, store and generate images from the sensor data obtained from the CT scanner.

The imaging system 125 allows an operator to perform a specific CT procedure, as well as to receive the data obtained by performing CT scans. For example, the imaging system 125 may be configured to "display in window" various body structures based on their ability to block the X-rays emitted from the source 110. CT scan images (often called “cuts”) are usually made in relation to an axial or transverse plane, perpendicular to the long axis of the body. However, the CT scanner 105 may allow the imaging data to be reformatted in various planes or as volumetric (3D) representations of the structures. Once a CT scan is performed, the imaging data generated by the 105 CT scanner can be stored, allowing the resulting scan images to be reviewed or evaluated in other ways. In one embodiment, the imaging data can be formatted using the well-known DICOM standard and stored in a PACS repository.

In one embodiment, the dose estimation system 130 provides a computer system and software applications configured to estimate a quantity of absorbed dose per patient for a given patient receiving a given CT scan. Note that such an estimate can be made in a predictive sense (that is, before performing a scan) but can also be made after the fact.

In the predictive case, the dose estimation system 130 may provide an estimate of the patient's dose before performing a CT scan. In addition, in one embodiment, the dose estimation system 130 may be configured to automatically generate alerts based on configurable thresholds. The criteria for generating an alert can use a rule engine that can take into account age, gender, ICD9 / ICD10 coding and other information about a particular patient or procedure (for example, a specific cumulative dose limit). More generally, dose thresholds can be flexible enough to reflect legislative, institutional or treatment requirements for dose monitoring. In a

embodiment, the resulting dose estimates can be stored as part of the patient's medical records / history maintained by an imaging center, a hospital or other provider.

In addition, dose thresholds can optionally be used to create incident reports addressed to the appropriate practitioners. Incident reports may include a description of a procedure and any dose estimate that exceeds a rule or threshold along with any additional information necessary to provide a context for the intervention or decision-making of the physician. In one embodiment, said report can be printed / sent by email using a customizable XML template.

The imaging symptoms 132 may provide accepted mathematical models of portions of human tissue, organs, structures, etc. For example, the imaging symptoms 132 may provide a set of non-uniform rational elemental curves (NURBS) used to create a three-dimensional (3D) model of a human body (or a portion thereof). Alternatively, imaging symptoms can be represented using a constructive solid geometry (CSG) or other mathematical representation. In general, different imaging symptoms 132 may be provided to model individuals based on age and gender. However, as indicated above, the virtual geometry and body shape of an imaging phantom selected according to age and / or gender may (or may not) correspond to the size, shape and organ position of a Real person who has a CT procedure. Accordingly, in one embodiment, the dose estimation system 130 may be configured to deform a virtual phantom to better model a specific patient. Exemplary embodiments for deforming a virtual imaging phantom 122 are explained in more detail below.

Once an imaging phantom is deformed to model a specific individual, the dose estimation system 130 can perform a simulation to estimate a first step dose deposition amount resulting from a given CT scan procedure. For example, in one embodiment, a Monte Carlo simulation can be performed using the CT scan parameters, the TC procedure parameters, and the deformed phantom to arrive at a dose estimate. However, other simulation approaches could also be used. The results of a given dose estimation simulation can be stored in the simulation library 134.

For example, the CT scanner can be parameterized for a simulation based on the current and voltage of the X-ray tube, the CT scanner mode, the kVp, the target angle of the X-ray generator, the fan angle, the collimation, the cutting thickness, the distance from the focus to the axis, flat filters (material and thickness), beam forming filters (material and geometry). Although a variety of approaches can be used in the simulation procedure, in one embodiment, kVp, objective angle and filtration are used to model the x-ray phantom, as described in "Computation of bremsstrahlung X-ray spectra over an energy range 15 KeV to 300 KeV ”from WJ Iles, United Kingdom, National Radiation Protection Board, NRPB, 1987.

In addition, the distance from the focus to the axis determines the distance from the X-ray source to the axis of rotation, and the fan angle determines how the beam propagates widely on the cutting plane. Of course, these (and other parameters) can be selected as available or as necessary to meet the needs of a specific case. Usually, however, energy deposition is stored by cut for each anatomical region defined in the phantom. A normalization simulation of a CTDIvol phantom can be performed for each CT model. This energy deposition information per cut, combined with the masses for each anatomical region, is sufficient to calculate the absorbed dose in each region for a given scan region (using a subset of our full body simulation).

However, performing a Monte Carlo simulation usually requires substantial processing time to complete, much longer than performing the CT scan itself. Accordingly, in one embodiment, the dose estimation system 130 estimates the dose by interpolating between two (or more) simulations in the simulation library 134. For example, a first-pass patient dose can be calculated using a multivariate dispersion interpolation of existing simulation data. Patient dose information is refined as more applicable simulations are added. Similarly, new scanner models can be added to the simulation library 134 as measurements and calibration specifications of these scanners are obtained.

The simulation library 134 provides a database of Monte Carlo simulation results. In one embodiment, the simulation library 134 stores information on dose / energy deposition for a set of symptoms, both supplied and deformed for individual patients, for a group of compatible medical imaging scanners, for example, training modalities of images by CT, RF, XA, among others. In one embodiment, the simulation library 134 is used to provide a real-time search and / or calculation of dose distributions given the acquisition parameters, the description of the patient and the scanning region.

As indicated, the simulation library 134 can be automatically increased in time as additional Monte Carlo simulations are completed. For example, simulations to be performed can be added to a queue as CT scan exams occur. Priority can be given to

simulations in an area with few existing data points. In doing so, it improves the probability of identifying simulations to be interpolated, that is, it improves the simulation “space” covered by the simulation library 134. Similarly, more simulations available in the simulation library 134 allow more stringent thresholds to select the simulations to be interpolated in a given case, which leads to greater accuracy in dose estimates.

Note that, although shown in Figure 1 as part of a CT scan environment 100, the dose estimation system 130 (and the phantoms 132 and the library 134) can be provided as a hosted service accessed by / from the 100 scanning environment by CT. For example, an imaging center may use a client interface in the imaging system 125 (for example, a secure web portal or a specialized client application) to interact with a hosted dose estimation provider. An example of such an embodiment is explained in greater detail below with respect to Figures 11 and 12.

Figure 2 illustrates an example of an imaging system 125 used to obtain CT scan data and manage patient dose estimates, in accordance with one embodiment. As shown, the imaging system 125 includes, without limitation, a central processing unit 205 (CPU), a TC system interface 214, a network interface 215, an interconnection 217, a memory 225 and a storage 230 . The imaging system 125 may also include an I / O device interface 210 that connects the I / O devices 212 (eg, keyboard, screen and mouse devices) to the imaging system 125.

CPU 205 retrieves and executes programming instructions stored in memory 225. Similarly, CPU 205 stores and retrieves application data residing in memory 225. Interconnection 217 facilitates the transmission of programming instructions and application data between CPU 205, I / O device interface 210, storage 230, network interface 215 and memory 225. CPU 205 is included to be representative of a single CPU, multiple CPUs, a single CPU that has multiple processing cores, and the like. And memory 225 is included, in general, to be representative of a random access memory. Storage 230 may be a disk drive storage device. Although shown as a single unit, storage 230 may be a combination of fixed and / or removable storage devices, such as disk drives, solid state storage devices (SSD), connected network (NAS) or a network of storage area (SAN). In addition, storage 230 (or connections to storage depots) can be adapted to a variety of standards for data storage related to healthcare settings (eg, a PACS depot).

As shown, memory 220 includes an image forming control component 222, an image storage component 224, and a dose estimation interface 226. And storage 235, imaging protocols 232 and alarm thresholds 234. The image forming control component 222 corresponds to the software applications used to perform a particular CT scanning procedure, as specified by an image forming protocol 232. The imaging protocols 232 specify, in general, the position, time and duration to perform a specific CT procedure using a specific scan mode. The image storage component 224 provides software configured to store images and derived CT data while performing a particular CT procedure or interacting with a storage tank suitable for storing such images and data. For example, CT scan data can be sent via a TCP / IP connection (through a network interface) to / from a PACS repository.

The dose estimation interface 226 provides software components configured to interact with the dose estimation system 130 to obtain an estimate of the patient dose that may result from a specific CT procedure. As indicated, in one embodiment, the dose estimation interface 226 may interact with local systems in the CT imaging environment. However, in an alternative embodiment, the dose estimation interface 226 may interact with a hosted service provider. In that case, interface 226 may send requests for patient dose estimates to the hosted service provider. In addition, such a request may indicate a phantom of imaging, transformations in that phantom, and the equipment and the CT scanning protocols that are followed for a given imaging scan. In any case, when used in a predictive sense (that is, before performing a procedure), the estimation of the patient dose can be compared with the thresholds and alarm rules to determine if an alarm should be issued before it is issued. perform a certain procedure (for example, an alarm that indicates that a certain procedure will exceed (or probably exceed) a cumulative dose limit for a particular patient, organ or body part, etc.).

Figure 3 illustrates an example of a dose estimation system 130 used to estimate and track the cumulative patient dose, in accordance with one embodiment. As shown, the dose estimation system 130 includes, without limitation, a central processing unit (CPU) 305, a network interface 315, an interconnection 320, a memory 325 and a storage 330. The dose estimation system 130 may also include an I / O device interface 310 that connects the I / O devices 312 (eg, keyboard, screen and mouse devices) to the dose estimation system 130.

Like CPU 205, CPU 305 is included to be representative of a single CPU, multiple CPUs, a single CPU that has multiple processing cores, etc., and memory 325 is included, in general, to be representative of a random access memory. Interconnection 317 is used to transmit programming instructions and application data between CPU 305, I / O device interface 310, storage 330, network interface 315 and memory 325. The network interface 315 is configured to transmit data through the communications network, for example, to receive requests for an imaging system for dose estimation. Storage 330, such as a hard disk drive or a solid state storage (SSD) drive, can store non-volatile data.

As shown, memory 320 includes a dose estimation tool 321, which provides a set of software components. By way of illustration, the dose estimation tool 321 includes a Monte Carlo simulation component 322, a simulation selection component 324, an image registration / segmentation component 326 and a dose interpolation component 328. And storage 330 contains data 332 of imaging symptoms, protocols for CT imaging and a simulation library 336.

The Monte Carlo simulation component 322 is configured to estimate the patient radiation dose based on a simulation using 332 imaging data and a specific set of CT imaging equipment and a protocol 334 specified images. As indicated, in one embodiment, the data 332 of imaging symptoms may be deformed or otherwise transformed to better adapt to the physical characteristics of a given patient.

The image registration / segmentation component 326 may be configured to determine a set of transformations to deform the data 332 of imaging errors before performing a Monte Carlo simulation using that phantom. For example, the image registration / segmentation component 326 may evaluate a reference or locator image associated with a phantom together with a patient scan locator image using image registration techniques. Image registration is the procedure to align two images in a common coordinate system. An image registration algorithm determines a set of transformations to establish a correspondence between the two images. Once the transformations between the patient's scan image and a reference image of a phantom are determined, the same transformations can be used to deform the phantom. Such deformations can scale, translate and rotate the geometry of the virtual phantom so that it corresponds to the patient.

In another embodiment, image segmentation is used to identify a relative size and position of the organs, tissues, and anatomical structures of a patient. In such a case, the CT scan data available to a patient can be segmented to identify geometric volumes that are believed to correspond to an organ (or other structure of interest). For example, in one embodiment, image segmentation can be used to identify a bounding box that is believed to contain a specific organ or structure. Other segmentation approaches can be used to provide a more definitive 3D volumetric region corresponding to an organ or structure. Once identified, this information is used to shift the geometry of the corresponding organ (or structure of interest) in the virtual phantom.

Note that, although shown as part of the dose estimation server 130, in one embodiment, the image registration / segmentation component 326 is part of the imaging system 125, or another part of the computer infrastructure in an installation Image formation Doing so allows a provider that hosts a dose estimation service to receive transformations to deform a given virtual phantom, without receiving any information that can be used to identify a patient receiving a CT scan in an imaging facility. This approach can simplify (or eliminate) certain legal or regulatory requirements associated with entities that process protected health information or medical records.

After completing a Monte Carlo simulation, the resulting patient dose estimates, together with the parameters supplied to the simulation component 322 are stored in the simulation library 335. In turn, the dose interpolation component 328 is used to determine an estimate of the patient dose from the simulations in the simulation library 335, without performing a complete Monte Carlo simulation. To do this, the simulation selection component 324 can compare the parameters of a CT scan, the equipment used to perform the CT scan and the deformed imaging phantom to represent a specific individual. This information is used to identify a set of two or (or more) simulations to interpolate. Although a variety of approaches can be used, in one embodiment, the selection component 324 can use a distance measure to compare the deformed phantom, the CT procedure and the CT equipment with ones in the simulation library 335. In one embodiment, the 2 highest (or N highest) choices are selected for interpolation. Alternatively, any simulation with a measure of general similarity within a specified threshold is selected for interpolation. In this case, when adjusting the thresholds, more or less simulations are used for interpolation.

Taking into account the set of parameters that describe the scanner and the patient for an exam (kVp, angle

objective, gantry inclination, height, weight, etc.), the system allows customizable tolerances to be established for each variable (for example, the actual kVp is within 10 kV simulation). When simulations are sought, only simulations that are within the tolerance for all given parameters will be taken into account in the calculation. In one embodiment, the simulation results can be interpolated using the known Shepard method. The standard deviation in the simulation result set is used as a measure of uncertainty (for example, for the set of 5 simulations used, the dose absorbed by the chest has a standard deviation of 0.2 mSv and the dose absorbed by the liver it has a standard deviation of 0.15 mSv).

Figure 4 illustrates a procedure 400 for generating a suitable model for estimating the radiation dose of a patient resulting from CT scans, in accordance with one embodiment. More specifically, method 400 illustrates an exemplary embodiment where image recording techniques are used to deform a virtual phantom. As shown, procedure 400 begins in step 405, where the dose estimation tool selects a virtual phantom with pre-mapped locator images. As indicated, the virtual phantom can be selected based on the age and gender of an individual receiving the CT procedure in question. In step 410, the dose estimation tool receives a scan image of the individual for whom the dose estimation is being performed. The scan image provides a 2D image projection of the individual, such as an anterior / posterior and / or lateral scan image taken by the CT scan system before performing a complete CT procedure. Alternatively, the scan image could be a 3D volume of the individual obtained as part of a previous CT scan procedure. In step 415, the pre-mapped locator images corresponding to the use to deform the selected virtual phantom are obtained. Pre-mapped images can be selected based on the relevant regions of the patient to be scanned. For example, for a patient who will receive (or receive) a chest CT scan, the selected reference image may represent this region of an individual with a body geometry that closely matches the virtual phantom.

Figure 5A illustrates an exemplary image representing a deformable phantom, in accordance with one embodiment. As shown, image 500 provides a front / rear view 501 and a side view 502 of a virtual image phantom. As shown in views 501 and 502, the geometry of this phantom includes a bone structure representing ribs 505, spine 515 and legs 522. In addition, views 501 and 502 include a geometry representing organs, including the stomach 510 and a kidney 515. The virtual phantom (as depicted in views 501 and 502) provides an approximation to the size, shape and position of the organs, human tissues and structures.

Although, obviously, it is an approximation to the real human anatomy, it is generally accepted that virtual phantoms provide reasonably accurate estimates of dose absorption. Figure 5B illustrates an example of a 2D reference image of a portion of a human body corresponding to the phantom shown in Figure 5A, in accordance with one embodiment. As shown, the relative positions, size and shape of the bones, tissues and organs, in the reference image, coincide with the corresponding positions in the virtual phantom.

Referring again to the procedure 400, in step 420, the dose estimation tool performs an image recording procedure to determine a transformation between the patient scan images and the reference images used to represent the virtual phantom. The result of the image registration is a mapping from points in the 2D scan locator to points in the reference image (or vice versa). Similarly, in cases of a 3D scan image of the patient (ie, a current or previous CT scan), 3D image recording techniques can map points between the patient's 3D scan image and the points in a reference image corresponding to the phantom in a 3D coordinate space.

In step 425, this same transformation is used to deform the geometry that represents the virtual phantom. By deforming the virtual phantom using transformations obtained from the image registration procedure, the size, shape and positions of the organs represented by the virtual phantom geometry coincide with the geometry of the real patient much more precisely. For example, performing an image registration procedure using the reference image shown in 5B and a patient scan locator provides a transformation that can be used to deform the virtual phantom shown in Figure 5A. The deformed virtual phantom can be used to estimate the dose absorbed by an organ resulting from a given CT procedure (before or after the procedure is performed). That is, the dose estimates obtained from a Monte Carlo simulation are adapted to the patient, being also more precise and consistent when used to estimate the patient dose in multiple scans.

Figure 6 illustrates another procedure for generating a suitable model for estimating a radiation dose resulting from CT scans, in accordance with one embodiment. More specifically, method 600 illustrates an exemplary embodiment where image segmentation techniques are used to deform a virtual phantom. Like procedure 400, procedure 600 begins when the dose estimation tool selects a phantom imaging phantom, for example, based on the age and gender of a patient (step 605). However, instead of recovering the patient's 2D image locators, the dose estimation tool receives a 3D scan volume from some portion of the patient.

(in step 610), for example, a CT scan from a previous CT scan of the chest and abdomen. Once obtained, image segmentation is used to identify tissues, organs, structures or other reference points in the image volume (step 615). Although a variety of available segmentation approaches can be used, in one embodiment, image segmentation provides a minimal bounding box that surrounds each identified organ or structure.

In step 620, the dose estimation tool matches the organs and other anatomical reference points (for example, the position of the bone) identified in the CT scan segmentation with corresponding reference points in the virtual phantom. For example, Figure 7 illustrates an exemplary cut of a CT scan superimposed with a corresponding cut of a virtual phantom, in accordance with one embodiment. In this example, the virtual phantom cut 700 includes a line 702 representing the volume delimited by the phantom along with portions of the cut of the heart 701, the lungs 703, the spine 704 and the humerus 705. However, the location and The position of the heart and lungs in the virtual phantom does not correspond well with the position of these organs as depicted on CT. For example, the open space region of the lungs (at 706) does not match the size or position of the lungs 702 in the phantom. Similarly, the 702 phantom boundary line does not correspond well with the patient. The use of this phantom to estimate the dose results, therefore, in a much higher dose absorption than would actually occur, because the phantom does not represent the large amounts of adipose tissue in this patient.

At the same time, other reference points of the phantom align well with the patient. For example, the spine and arms are placed, in general, both in the phantom (spine 704, humerus 705) and on CT. Consequently, in step 625, the dose estimation system determines a 3D displacement map based on the coincident anatomical or structural reference points.

For example, in Fig. 7, the phantom cut 700 shows an unmodified or non-deformed phantom and the phantom cut 710 shows the same phantom cut after moving using the procedure of Fig. 6 (or after deforming using a Image registration technique according to the procedure in Figure 4).

As shown in the phantom cut 710, after deforming using the identified organ volumes and the displacement of a specific patient, the 702 'boundary line now more closely follows the contours of the patient's CT scan, and the lungs 703 'and the 701' heart of the phantom have shifted to better reflect the position of these organs in the scan. At the same time, other anatomical landmarks, such as the spine and humerus, remain in the same general position. The imaging phantom shown in the cut 700 is shown superimposed with the corresponding CT scan cut of a patient in the cut 720. Similarly, the deformed phantom shown in the cut 710 is shown superimposed with the scan cut by corresponding CT of a patient in section 730.

Referring again to Figure 6, in step 630, the dose estimation tool generates a 3D bitmap representation of the displaced organs, tissues and structures of the virtual phantom. As indicated above, the virtual phantom can be described as a series of non-uniform rational elemental curves (NURBS), while CT scan data is usually represented as a series of single point values of 3D coordinates known as “voxels ", Short for" volume element, "extending the concept of pixel to a third dimension, and with a variety of known approaches available to "voxelize" a collection of NURB or CSG data. In doing so, it converts the geometric or mathematical representation of the NURB or CSG data into a 3D matrix of voxel values. In one embodiment, step 630 (the voxelization stage) is performed in order to avoid discontinuities that are often a problem with Monte Carlo simulations in mathematical phantoms (based on NURB or CSG). In addition, voxel-based models are very suitable for GPU-based computer procedures to achieve improved speed.

Once the bitmap phantom is generated, it can be used to estimate the dose absorbed by an organ resulting from a given CT procedure (or before or after such a procedure is performed). Like image segmentation approaches, dose estimates made using the deformed phantom using the segmentation approach are tailored to the patient, resulting in more accurate and consistent dose estimates, both for individual and multiple scans.

Figure 8 illustrates an example of a cross-section of an imaging phantom superimposed with a corresponding cross-sectional CT scan of a patient, in accordance with one embodiment. In this example, a cross-sectional view 800 corresponds to the view 710 of Figure 7 and a cross-sectional view 850 corresponds to the view 730 of Figure 7. The cross-sectional view is created by composing a linear section of individual cuts to create a longitudinal image. As shown, cross-sectional views 800 and 805 provide a full-length view that includes components not present in the patient's superimposed CT image, for example, brain 801 and kidney 802. As shown in view 800, a limit 810 of the virtual phantom does not correspond well with the contour of the patient (that is, with the size of the body delimited by the patient's skin). However, in view 850, a boundary 815 of the phantom has been shifted to better match the CT scan data of this patient. Similarly, internal organs, structures and other tissues can also move.

Importantly, this example illustrates that displacement may occur for virtual phantom elements that are not part of the patient's CT scan data. For example, kidney 802 could be displaced by the movement of other organs for which CT scan data is available, as shown by the displaced position of kidney 802 'in view 850. In addition, this example illustrates that a virtual phantom is needed to estimate patient dose, even when CT scan data is available. This occurs because, although the CT scan in this example was limited to the thorax and abdomen, X-ray scattering will result in some absorption by this patient's brain, kidneys and other organs and tissues. In other words, the virtual phantom is necessary to estimate the absorption of organ doses for organs from which images have not been formed as part of a given CT scan or procedure.

Figure 9 illustrates another example of a CT image segmentation and an organ volume shift for an imaging phantom, in accordance with one embodiment. In this example, a volume 900 of CT corresponding to an imaging includes a set of bounding boxes representing a segmented image position for a variety of organs, for example, liver 905, gallbladder 910 and adrenal gland 915 right. In addition, volume 900 shows arrows representing the displacement of these organs based on an image segmentation of the CT scan data. In this specific example, the liver 905 has moved down and to the right, while the gallbladder 910 has moved up and to the front of the liver 905 and the right adrenal gland 915 has moved up and to the on the left, towards the space previously occupied by the liver 905. In addition, in this example, the organs are represented by bounding squares, and move according to a geometric centroid. However, in an alternative embodiment, image segmentation (or for the phantom or for a patient's CT image data) can provide a more precise geometric volume that represents an element of an organic tissue or a body structure. In such a case, the displacement could be based on a centroid of organ mass, for example, when the centroid of the liver is located on one side depending on the mass or other approach that represents the topology of a given organ volume.

As illustrated in this example, the displacement of an organ (for example, liver 905) in a phantom depending on its corresponding position in a reference CT scan, may require the displacement of other organs (for example, the gallbladder 910 biliary and the adrenal gland 915) as a result. This occurs because, obviously, two organs should not occupy the same physical volume when the phantom is used to perform a dose estimation analysis. Consequently, in one embodiment, the dose estimation tool can displace organs, tissues or structures to reach a "stable state."

Note that the exemplary embodiments illustrated in Figures 4 and 6 can be used separately or together to deform a virtual phantom. The specific approach or the combination of selected approaches can be adapted to the needs in a specific case depending on the available imaging symptoms, 2D and / or 3D mapped reference images, as well as on the availability and type of images of locator scan and / or the previous CT scan data for a given patient.

In one embodiment, host systems of cloud provider models are used to perform dose estimates, maintain a library of calculated simulations, as well as run Monte Carlo simulations to increase the library of simulations with new cases. For example, Figure 10 illustrates a procedure 1000 for a dose estimation service to provide patient dose estimates to multiple providers of CT scans.

As shown, procedure 1000 begins in step 1005 where the dose estimation service receives an image phantom (or a reference to an image phantom) together with 2D or 3D image registration transformations or a volumetric offset field 3D and a voxelization of phantoms. In an alternative embodiment, the dose estimation service may receive data describing the deformed phantom, such as transformed NURBS resulting from the 2D or 3D image registration procedure or the CT field displacement techniques described above.

In step 1010, the dose estimation service receives parameters from a CT scan system and an imaging plan for a CT scan performed (or performed) on a patient. Once the parameters of the patient, the scanning equipment and the CT scan provider are received, the dose estimation service can identify two (or more) simulations in the library that match the transformed phantom, the system parameters CT scan and imaging plan (step 1015). The supplier can set customizable tolerances for each variable (for example, the actual kVp is within 10 kV simulation). Further evaluating the simulations, only the simulations within the tolerance for all (or a specified set of) given parameters are taken into account in the calculation. In one embodiment, the simulation results can be interpolated using the known Shepard method. The standard deviation in the simulation result set is used as a measure of uncertainty (for example, for the set of 5 simulations used, the dose absorbed by the chest has an SD of 0.2 mSv and the dose absorbed by the liver has an SD of 0.15 mSv).

In step 1020, the dose estimation service determines whether the matching simulations identified in step 1015 are within a tolerance parameter (or meet other thresholds or criteria). If not, then the

Image phantom (and deformations / transformations) and the parameters received are added to a queue of patient / scanner / image plan scenarios to simulate (step 1025). As indicated, the simulation can use Monte Carlo simulation techniques to determine the estimates of the absorbed dose per organ adapted both to the individual patient (based on the deformed phantom) and to the specific imaging facility based on the CT scanner. and calibration / adjustment data.

However, as the simulation library of a SaaS provider grows, most requests should identify a set of interpolation simulations. In step 1030, the dose estimation service performs a multivariate dispersion interpolation using the matching simulations identified in step 1015 to estimate the absorbed organ dose for a specific patient and the associated CT scan procedure. Note that such analysis can be performed much faster than a complete Monte Carlo simulation, allowing dose estimates to keep pace with a sequence of procedures performed in a particular imaging facility (or facilities) as well as simultaneously providing a particular procedure. (for example, to ensure that cumulative dose limits are not exceeded). In one embodiment, the multivariate dispersion interpolation procedure currently used is called the "Shepard procedure." Examples of this procedure are described by Shepard, Donald (1968) in “A two-dimensional interpolation function for irregularly-spaced data,” minutes of the 1968 ACM National Conference, pages 517-524.

In step 1035, once the interpolation procedure has been completed, dose estimates are returned to a requesting system (for example, a dose estimation client program that is executed in a computer system in a training facility. images). In the client, a dose administration system tracks equivalent doses of the patient's organs, effective doses, CTDI, DLP, DAP, up to the examination level. This information is also summarized to provide a cumulative follow-up of equivalent doses of organs, effective doses, CTDI, DLP, DAP for the history of a given patient. In addition, the addition of this information is used to provide an institutional presentation of equivalent doses of organs per capita, effective patient doses, CTDI, DLP, DAP. Therefore, the dose estimation service can provide a wide variety of imaging facilities. This same information is available for an imaging facility that runs a local instance of the dose estimation system.

Figure 11 illustrates an example of a computer infrastructure 1100 for a patient dose estimation service system configured to support multiple CT scan providers, in accordance with one embodiment. As shown, a cloud-based provider 1125 that hosts a dose estimation service 1130 receives requests for dose estimates through a network 1120 from the imaging facilities 1105-i_2. In each imaging facility 1105, a CT system 1110 is used to provide imaging services for patients. An imaging / dose client 1115 communicates with the dose estimation service 1130 to request and receive patient dose estimates, where dose estimates are adapted depending on the procedure and the patient. As indicated, the request may include parameters for a CT procedure, the equipment and scanning modality, and a deformed phantom (or the transformations used to deform a phantom) depending on the body morphology of the specific patient.

In the dose estimation service 1130, a simulation library 1135 is used to select simulations to interpolate a number of patient doses using the request data and the modules of a scanner and CT procedures (Figure 11 shows 1140 phantom data / CT system). If good candidate simulations for interpolation are not available, then the 1130 service can add the request to a simulation queue to perform. Monte Carlo simulations are then carried out in response to the request, providing both an estimate of the patient dose for a given patient and an imaging procedure, as well as a new simulation data point to add to the 1125 library .

Advantageously, the embodiments of the invention provide a variety of techniques for estimating radiation doses resulting from X- ray and CT imaging techniques (and others). As described, image registration techniques and / or image segmentation techniques can be used to create a hybrid imaging phantom that more exactly matches the shape and size of an individual's body. In doing so, it improves the accuracy of the dose estimates determined from a simulation. That is, the resulting hybrid phantom provides a much more accurate mathematical representation of a specific patient for use in a dose simulation than unmodified phantoms alone.

Once the transformations are determined, the virtual hybrid phantom can be used to simulate a particular CT procedure for the patient. For example, Monte Carlo simulation techniques can be used to estimate the dose absorbed by an organ for a virtual phantom. These simulation techniques use the virtual phantom (transformed in relation to a specific patient) together with a series of parameters related to the CT scan model and procedure to be performed in order to calculate precise estimates of the dose absorbed by an organ. However, estimating the dose absorbed by an organ using a Monte Carlo simulation may require significant amounts of computation time, much more than that required for

perform a real CT scan. Consequently, in one embodiment, estimates of the determined patient dose for a given procedure can be generated by interpolating between two (or more) previously completed simulations. If there are no "close" simulations available, then the virtual hybrid phantom, the CT scanner and the procedure data can be added to a queue of complete Monte Carlo simulations to be performed. Over time, a large library of simulations allows real-time dose estimates to be provided as procedures are programmed and executed. Doing so allows the cumulative dose amounts to be captured for a given patient, as well as the cumulative dose limits to be observed. In addition, in one embodiment, a SaaS provider is a hosted dose estimation service provided to multiple imaging facilities. In such a case, the service provider may have a vast library of simulations to use in interpreting dose estimates for imaging providers.

Although the foregoing relates to embodiments of the present invention, other additional embodiments of the invention may be conceived without departing from the basic scope thereof, and the scope thereof is determined by the following claims.

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42083410	United States of America	P	2010-12-08
2011001381	Canada	W	2011-12-08

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BR122017007260A2	Brazil	A2	2012-06-14
CA2819331A1	Canada	A1	2012-06-14
CA2993848A1	Canada	A1	2012-06-14
CA3033428A1	Canada	A1	2012-06-14
US2012148131A1	United States of America	A1	2012-06-14
US2012148132A1	United States of America	A1	2012-06-14
US2012150505A1	United States of America	A1	2012-06-14
WO2012075577A1	World Intellectual Property Organization (WIPO)	A1	2012-06-14
AU2011340078A1	Australia	A1	2013-06-27
MX2013006336A	Mexico	A	2013-09-26
EP2648621A1	European Patent Office (EPO)	A1	2013-10-16
KR20130130772A	Republic of Korea	A	2013-12-02
CN103442644A	China	A	2013-12-11
JP2013544605A	Japan	A	2013-12-19
NZ611554A	New Zealand	A	2014-12-24
RU2013127784A	Russian Federation	A	2015-01-20
US8953861B2	United States of America	B2	2015-02-10
US8958617B2	United States of America	B2	2015-02-17
US2015139519A1	United States of America	A1	2015-05-21
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ZA201303796B	South Africa	B	2015-06-24
JP5917552B2	Japan	B2	2016-05-18
AU2011340078B2	Australia	B2	2016-06-30
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BR112013013804A2	Brazil	A2	2016-09-13
EP2648621A4	European Patent Office (EPO)	A4	2016-12-28
KR20170004029A	Republic of Korea	A	2017-01-10
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EP3281586A3	European Patent Office (EPO)	A3	2018-05-16
EP2648621B1	European Patent Office (EPO)	B1	2018-07-04
HK1242946A	Hong Kong, China	A	2018-07-06
HK1242946A1	Hong Kong, China	A1	2018-07-06
EP3150126B1	European Patent Office (EPO)	B1	2018-07-25
KR101889642B1	Republic of Korea	B1	2018-08-17
JP6395911B2	Japan	B2	2018-09-26
DK2648621T3	Denmark	T3	2018-10-22
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ES2689751T3This record	Spain	T3	2018-11-15
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EP3281586B1	European Patent Office (EPO)	B1	2019-04-10
DK3281586T3	Denmark	T3	2019-06-24
KR20190075169A	Republic of Korea	A	2019-06-28
AU2017251773B2	Australia	B2	2019-08-08
EP3524159A1	European Patent Office (EPO)	A1	2019-08-14
AU2017251775B2	Australia	B2	2019-08-29
KR101994055B1	Republic of Korea	B1	2019-09-27
US10438348B2	United States of America	B2	2019-10-08
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RU2016124149A3	Russian Federation	A3	2019-12-12
US10546375B2	United States of America	B2	2020-01-28
US10546376B2	United States of America	B2	2020-01-28
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KR102124956B1	Republic of Korea	B1	2020-06-19
RU2725751C2	Russian Federation	C2	2020-07-03
CA2993848C	Canada	C	2020-09-22
RU2725751C9	Russian Federation	C9	2020-12-21
CA2819331C	Canada	C	2021-01-12
EP3524159B1	European Patent Office (EPO)	B1	2021-01-20
DK3524159T3	Denmark	T3	2021-04-06
ZA201606246B	South Africa	B	2021-07-28
ES2864040T3	Spain	T3	2021-10-13
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CA3033428C	Canada	C	2022-03-22
CN113856066B	China	B	2024-03-19