Medical imaging system

Abstract

The invention relates to an imaging system (100) comprising: an aperture (110) for receiving an object (160) to be imaged; a stage (120) for supporting an object (160) and configured to move longitudinally relative to the aperture (110); a position indicator (130) for indicating a position; and a controller (150). The controller (150) is configured to receive an image of a region of interest (161) of an object (160) on the stage (120) acquired by the imaging system (100). An image is acquired with a stage (120) in a stored first stage position (121) at which a region of interest (161) of the object is at a reference position (111) within the aperture (110). The controller (150) is configured to receive a user input marking an interventional location in the image, determine a puncture location (162), calculate a second table location (122), where the puncture location (162) is marked with a location indicator, and store a third table location, where the table is located more outward (121) of the aperture (110) than in the first location when the table is in the third table location. In this way, the efficiency of the image-guided workflow and the ergonomics of the intervening physician may be improved.

Description

Technical Field

[0001] The present invention relates to an imaging system for medical imaging, in particular to an imaging system for image-guided workflows. The present invention also relates to a computer-implemented method for use in a control console of an imaging system. The present invention also relates to a computer program element and to a computer-readable medium having a computer program element stored thereon. Background Art

[0002] US2017 / 281294A1 describes a marking method and a computed tomography device, the method comprising: scanning a target object to obtain an image of the target object; determining an intervention position on the surface of the target object based on the position of a part of interest in the image of the target object; and marking the intervention position on the surface of the target object.

[0003] US6041249A discloses a computed tomography apparatus equipped with a device for marking a guide path on a patient for a medical instrument (such as a puncture needle) to be used in a medical procedure. The computed tomography apparatus generates a planning image and identifies the guide path within the planning image. A computer uses the planning image and the path identified therein to automatically adjust the position of a light source and, if necessary, the position of a patient table supporting the patient, so that the light beam from the light source is positioned in accordance with the guide path identified in the image.

[0004] US2020 / 057123A1 discloses a system for guiding medical interventions, more specifically, a system for guiding invasive devices (such as biopsy needles) using magnetic resonance, computed tomography, or other types of images. The system employs device guidance operating on the surface of a sphere centered on a selected target.

[0005] Large imaging systems such as magnetic resonance imaging (MRI) or X-ray computed tomography (CT) can provide ultra-clinical imaging for diagnosis and treatment. However, access to the patient is a potential disadvantage of image-guided interventions using such imaging systems, as the area of interest is typically placed in the center of a long, narrow hole during imaging. This can be particularly important for needle interventions (such as biopsies or localized procedures), where reaching inside the imaging system hole can be a challenge. As an example, the surgeon may have to bend down into the hole to check the location of the incision using (real-time) imaging. This can be done by pushing a finger into the potential incision area. After the needle is placed, the location may not be accurate enough and the needle may need to be replaced.

[0006] Therefore, image-guided surgery on patients imaged using imaging systems with bores (such as MRI or CT) can be inefficient and result in unsatisfactory interventionalist ergonomics with uncomfortable and / or impractical working positions. Furthermore, other aspects such as patient throughput and ultimate medical outcomes can also be suboptimal.

[0007] Therefore, there is a need to improve the workflow of such image-guided interventions. Summary of the Invention

[0008] The object of the present invention is to provide an improved image-guided workflow. The invention is defined by the independent claims. Advantageous embodiments are defined in the dependent claims.

[0009] According to a first aspect, an imaging system for medical imaging is provided. The imaging system comprises: an aperture for receiving an object to be imaged; a table for supporting the object and configured to move longitudinally relative to the aperture; a position indicator for indicating a position; and a controller. The controller may, for example, comprise a memory and a processor. The controller is configured to:

[0010] receiving an image of a region of interest of the object on the table acquired by the imaging system, wherein the table is positioned in a stored first table position, wherein in the first table position the region of interest of the object is located at a reference position within the bore;

[0011] receiving user input marking an intervention location in the image;

[0012] determining a puncture location on the object relative to the reference location; and

[0013] A second table position is calculated and stored based on the puncture position, the position indicated by the position indicator and the stored first table position, such that when the table is in the second table position, the puncture position on the object coincides with the position indicated by the position indicator.

[0014] By determining a puncture (or incision, or the like) location on an object (such as a patient) based on user input from an image, and subsequently calculating a second table position that marks that location with a position indicator, workflow efficiency can be improved. The second table position can be determined automatically. When the table moves to the second table position, the puncture location is indicated with a position indicator. Preferably, the table can be moved automatically by a controller, but other options are possible, such as manually or semi-automatically moving the table to the determined coordinates. The second position is preferably such that the puncture location of the object on the table in the second position is outside the aperture of the imaging system. In this way, the user does not have to reach into the aperture to see the indication of the puncture location.

[0015] The controller is further configured to store a third table position, wherein when the table is in the third table position, the table is further outside the bore than in the first position, and wherein a region of interest of an object on the table in the third table position is not at the isocenter of the bore. The third table position is different from the first and second table positions. The third table position may be received, calculated, or adjusted by the controller, for example, based on a user selection or other input, and / or may be predetermined. The third table position may be selected or calculated based on ergonomic parameters such as the user's length, the user's reach, the table height, the length of the object, the length of the instrument, etc. Storing the third table position is advantageous because, for example, the interventionalist has better ergonomic access to the object on the table compared to the first table position because the table is further outside the bore. Furthermore, because the third table position is different from the second table position, the interventionalist's freedom of movement is not restricted by position indicators or associated structures (such as a laser bow). The third table position may be further from the isocenter of the bore than the second table position, for example, to increase freedom of movement. Alternatively, the third table position may be closer to the isocenter of the bore than the second table position. The third table position can be proximal to the first table position, further outside of the bore than the first table position to provide improved ergonomics for the interventionalist when accessing, for example, a puncture site, but close enough that table movement can be advantageously limited and / or eccentric imaging in the third position can be achieved.

[0016] Because the first and third positions are stored, the interventionalist can advantageously switch the table position between the third position for optimal access to the subject (patient) and the first position for optimal imaging of the subject (patient) to check progress during image-guided surgery. Preferably, the table automatically moves between the stored table positions, such as upon command from the interventionalist via a user interface. This improves both workflow efficiency and ergonomics for the interventionalist.

[0017] The reference position inside the aperture may be at or close to the isocenter of the aperture for optimal image acquisition of the region of interest.

[0018] Determining the puncture location relative to a reference location may include receiving user input marking the puncture location. For example, receiving user input of an image with a marked intervention location. As an example, a user may indicate a suitable path between the intervention location and the puncture location. Alternatively or additionally, the controller may translate the marked intervention location in the image to a puncture location on the object relative to the reference location via a computational roadmap of the interior volume of the object on the table. The translation may include calculating an optimal path for an interventional needle, catheter, or similar instrument from a puncture location on the object to an intervention location inside the object based on the imaged volume of the object. Translating the intervention location in the image to determine the puncture location on the object may be based on, for example, anatomical regions that the catheter can pass through or that the catheter needs to avoid. Determination of the puncture location may include using an artificial intelligence algorithm that is capable of learning from previous interventional procedures and / or strategies. The controller may be configured to automatically determine the puncture location or provide suggestions to the user who provided the input.

[0019] Therefore, machine learning or artificial intelligence can be integrated to provide and recommend optimal puncture locations and trajectories to surgeons. Data mining based on a large number of image-guided interventions can be used to determine puncture locations and catheter trajectories used in clinical practice and integrated into artificial intelligence networks (e.g., deep learning networks). Personalized preferences including avoidance of anatomical and physiological regions can be considered. Similarly, machine learning or artificial intelligence can be used to determine appropriate third-party positions, for example based on user, subject, and / or system parameters.

[0020] The position indicator can be a fixed indicator, such as but not limited to a laser (light) bow or bridge, for example positioned near the aperture of the imaging system. Other fixed solutions, such as position indicators attached to the aperture of the imaging system or attached to the wall, floor or roof of the imaging room, etc. are also possible. The position indicator in the form of a laser bridge (light shutter) can be a standard laser bridge (light shutter) commonly used for patient positioning, such as for treatment or treatment planning, or a similar existing laser or other light source attached to or near the imaging system. This is advantageous because it can make it possible to indicate the puncture position on the object in a second position without additional hardware.

[0021] Alternatively, the position indicator can be mobile. Such as, but not limited to, a position indicator attached to a mobile unit such as a robotic device. For example, a robotic device for performing (a portion of) an intervention. The interventional robotic device can be positioned on rails mounted on a table, which allows the interventional robotic device to be moved to the incision and treatment area. Improved positioning of the interventional robotic device can be achieved by using a position indicated by the position indicator that overlaps with the translational incision position of the robotic device. The position indicator can use a laser or other light source to indicate, for example, a point or line on an object on the table.

[0022] The controller may include, for example, a processor and memory. The processor may be a single-core and / or multi-core processing unit, a graphics processing unit, an accelerated processing unit, a digital signal processor, a field programmable gate array, and / or an application-specific integrated circuit, among others. Processing may involve a single device, such as a single controller including a processor, or may be performed by a distributed system having multiple local and / or remote units. The memory may be short-term and / or long-term storage configured to interact with the processor.

[0023] According to an embodiment of the present invention, the controller is configured to calculate and store updated coordinates for the position indicator, such that when the table is in a second table position and the position indicator indicates an updated position using the updated coordinates, the puncture location on the subject coincides with the updated position indicated by the position indicator. This is advantageous when the position indicated by the position indicator can be updated, such as by moving a mobile position indicator and / or changing a target point or line marked by the indicator. For example, by pivoting an indicator mounted on a wall or ceiling. When the position indicated by the position indicator is movable, absolute movement of the patient table can be reduced, accelerating the workflow and providing additional flexibility. As an example, a mobile position indicator of a robotic device can be moved into a bore of an imaging system. For example, the system can have tracks on which the position indicator can be moved relative to the bore and / or the table. When the position indicator on the robotic surgical device can be moved into the bore, the second table position can advantageously be similar to or identical to the first table position, thereby reducing table movement. Likewise, where the robotic surgical device is used to perform (a portion of) an intervention at a second table position, the stored third table position, in combination with the stored first table position, provides a user, such as an interventionalist, with an ergonomic position to, for example, perform additional surgical steps, fine-tune the intervention, switch tables back and forth to verify interventional hand progress and switch imaging, etc.

[0024] According to an embodiment of the present invention, the controller is configured to store a temporary table position, wherein, when the table is in the temporary table position, the region of interest coincides with the position indicated by the position indicator, and wherein the controller is configured to calculate and store a first table position based on the temporary table position and the offset between the position indicated by the position indicator and a reference position. In this way, the system can automatically determine the first table position. The operator can move the table to the temporary table position so that the region of interest the operator wants to image is indicated by the position indicator. This can be very intuitive for the operator because the region of interest is indicated directly below the laser bridge, for example. Once the table is in the correct temporary position, this position can be stored, and the first table position can be automatically determined. The first table position can then be used when imaging the region of interest, because in the first table position, the region of interest of the object is at the reference position within the bore. This helps provide an efficient and intuitive workflow.

[0025] According to an embodiment of the invention, the imaging system is a magnetic resonance imaging system or a computed tomography system.The invention may be particularly advantageous for magnetic resonance imaging systems, since such systems typically have long and narrow bores that are difficult to access.

[0026] According to an embodiment of the present invention, the controller is configured to acquire an off-center image of a subject acquired by the imaging system when the table is in a third table position. The controller is configured to geometrically correct the off-center image. This may be particularly advantageous when the third table position is further outside the relatively long MRI system bore than the first table position to improve access to the subject, but close enough to still allow imaging of a region of interest. When the table is in the third position, the region of interest of the subject on the table is not at the isocenter of the bore, but can still be imaged in this manner. Furthermore, portions of the subject outside the region of interest can also be imaged in the third position, which can be advantageous for positioning a catheter, for example, if the catheter is not in the intended position. Compared to the first table position, access to the subject can be improved in the third table position. Therefore, advantageously, the subject can also be imaged when the table is in the third position. Off-center imaging can result in distortion of the region of interest and signal gaps. By acquiring an off-center image of the subject—i.e., an image in which the imaged portion of the subject is not at the isocenter of the bore—and geometrically correcting the image, surgical procedures can be imaged using geometrically corrected images even when the table is in the ergonomically advantageous third position. Correction for geometrical differences when the table is in the third table position may be fine-tuned based on differences in images acquired in the third table position compared to images acquired in the first table position.

[0027] According to an embodiment of the present invention, the imaging system is a magnetic resonance imaging system, and geometric correction of the decentered image includes correcting for gradient nonlinearity of the magnetic resonance system and / or includes comparing the decentered image with an image acquired using a table at a first table position. Based on, for example, system characteristics, gradient nonlinearity, etc., B0 shimming, limiting image decentering values, etc., can be calculated and set.

[0028] According to an embodiment of the present invention, an imaging system includes a display, and a controller is configured to provide an image on the display. This embodiment is advantageous because the system can directly present an image of a region of interest on the display, allowing a user to provide input. The display can be positioned, for example, on or near the aperture of the imaging system so that it can be viewed while standing next to the imaging system. Alternatively or additionally, the system can include a remotely located display, such as in another room or at another location.

[0029] According to an embodiment of the present invention, the imaging system includes a user interface. The user interface may include, for example, a voice interface, a gesture recognition interface, a touch interface, a mouse, a hand switch, or a foot switch. The user interface can advantageously be used to provide input for, for example, table position, intervention position, selection of imaging parameters, etc. If the system includes a display, the user can interact with, for example, images on the display via the user interface.

[0030] According to an embodiment of the present invention, an imaging system includes a camera directed toward a table, and a controller is configured to update a stored table position and / or a stored position of an object on the table based on images from the camera. The camera may be, for example, a 2D or 3D camera, a camera that records visible and / or infrared radiation, or the like. The camera can advantageously improve workflow efficiency and accuracy by determining the position of an object on the table relative to the table, the position of the table (e.g., relative to an aperture, etc.). As an example, if an object moves on the table, the camera can provide input regarding the change in position. In this manner, workflow accuracy, such as the accuracy of the table position, can be improved.

[0031] According to a second aspect of the present invention, there is provided a computer-implemented method for controlling a console relative to an imaging system comprising an aperture and a position indicator, the method comprising:

[0032] receiving an image of a region of interest of an object on the stage acquired with the imaging system, wherein the image was acquired with the stage positioned in a stored first stage position, wherein in the first stage position the region of interest of the object is at a stored reference position within the bore;

[0033] receiving user input marking an intervention location in the image;

[0034] determining a puncture location on the object relative to the reference location;

[0035] determining a second table position based on the puncture location, a stored location indicated by the position indicator, and the first table position, such that when the table is in the second table position, the puncture location on the object coincides with the location indicated by the position indicator; and

[0036] A third table position is stored, wherein when the table is in the third table position, the table is further outside the aperture than in the first position, and wherein the region of interest of the object on the table in the third table position is not at the isocenter of the aperture.

[0037] According to an embodiment of the present invention, the method further includes:

[0038] storing a temporary stage position, wherein in the temporary stage position the region of interest on the object coincides with the position indicated by the position indicator, and

[0039] A first stage position is determined based on the temporary stage position and an offset between the position indicated by the position indicator and a reference position within the bore.

[0040] According to an embodiment of the present invention, the step of determining a puncture location on the object relative to a reference location includes using a trained artificial intelligence algorithm to perform a roadmap of the internal volume of the object and / or determine the puncture location (based on the intervention location). Determining the puncture location, such as via a translation from the intervention location in the image to the puncture location, can include calculating an optimal path for an interventional needle, catheter, or similar instrument from the puncture location on the object to the intervention location inside the object based on the imaging volume of the object. Translating the intervention location in the image to the puncture location on the object can be based on, for example, anatomical areas that the catheter can pass through or, for example, that the catheter needs to avoid. Determination of the puncture location can include using an artificial intelligence algorithm that can learn from previous interventional procedures and / or strategies. Computational roadmap mapping can, for example, automatically determine the puncture location or provide recommendations about suitable options.

[0041] According to a third aspect of the present invention, a computer program element is provided which, when executed by a controller, is adapted to cause the controller to perform the method as described above.The computer program element may be software available for downloading from a server, for example via the Internet.

[0042] According to a fourth aspect of the invention, there is provided a computer readable medium having a computer program element stored thereon.

[0043] These and other aspects of the invention will be apparent from and elucidated with reference to the embodiments described hereinafter. BRIEF DESCRIPTION OF THE DRAWINGS

[0044] Figure 1 The imaging system is shown schematically.

[0045] Figure 2 The workflow using the imaging system is schematically shown.

[0046] Figure 3 The workflow using the imaging system is schematically shown.

[0047] Figure 4 The positioning of the needle relative to the lesion is shown schematically.

[0048] Figure 5 A flow chart of a computer-implemented method is shown.

[0049] Figure 6A flow chart of a computer-implemented method is shown. DETAILED DESCRIPTION

[0050] The imaging system 100 according to an embodiment of the present invention is Figure 1 Schematically shown in . The imaging system 100 includes an aperture 110, which can be relatively long and narrow so that it can fit within the patient or the portion of the patient to be imaged. An example of one type of imaging system is a magnetic resonance imaging system, in which a long and narrow aperture is typically used to achieve good imaging quality. However, other tomographic imaging systems (such as computed tomography systems, positron emission tomography systems, single photon emission computed tomography systems, combinations of such systems, etc.) can also have long and narrow apertures. In the aperture 110 of the imaging system 100, a reference position 111 is defined. The reference position can be, for example, at the isocenter of the aperture or near the center of the aperture.

[0051] The imaging system 100 includes a table 120. The table can be moved longitudinally into and out of the bore, or closer to or farther from the bore. An object 160 to be imaged (such as a patient to be imaged) can be positioned on the table 120. The table is configured to be positioned in at least a first table position 121, a second table position 122, and a third table position 123 (at least in the first and second positions). Figure 1 Not shown, but in Figure 3 The stage position is defined, for example, by one or more coordinates relative to a reference position 111 in the hole.

[0052] The imaging system includes a position indicator 130 configured to indicate a position 131. The indicated position 131 (such as a center point or center line of the indicated position 131) may also be defined in the same coordinate system as the stage position and the reference position 111. The indicated position may, for example, take the form of a line, a point, a circle, an ellipse, etc. Figure 1 In the schematic diagram of FIG, indicated position 131 is visible on stage 120. However, if an object 160 on the stage is located at position 131, the position indicator will mark position 131 on the object. Indicated position 131 can be fixed in a coordinate system, such as if the position is indicated by a laser bow fixed relative to the imaging system. Alternatively, indicated position 131 can be changed by position indicator 130 so that a position at various coordinates can be indicated. The coordinate system for the position relative to imaging system 100 can be a one-dimensional coordinate system along the longitudinal axis of stage 120. Other coordinate systems are also possible, such as a two-dimensional system in the plane of stage 120.

[0053] The imaging system includes a controller 150. The controller may include, for example, an ASIC, an FPGA, and / or a processor and a memory storing instructions for controlling the processor. Figure 1 In some examples, the imaging system includes a local display 140. In some examples, the imaging system may also include a user interface ( Figure 1 (not shown). The user interface may include, for example, a voice interface, a gesture recognition interface, a touch interface, a mouse, a manual switch, or a foot switch. Such a user interface may be used to provide user input for, for example, table position, intervention position, selection of imaging parameters, etc. In the system including Figure 1 In the case of a display and a user interface in , a user can interact with, for example, an image on the display via the user interface.

[0054] Figure 1 An object 160, such as a patient, is shown on the table 120 in the bore 110. The object 160 has a region of interest 161 that can be imaged by the imaging system 100. Based on the imaging of the region of interest 161 and user input marking the intervention location in at least one image, the controller 150 can determine a puncture location 162 in the coordinate system relative to the reference location 111. When the puncture location 162 is known, a second table position 122 can be determined such that when the table 120 is in the second table position 122, the puncture location 162 is at the location 131 indicated by the position indicator 130. In addition, the controller 150 is configured to store a third table position 123 that provides, for example, Figure 3 Improved working position shown.

[0055] Figure 2 An example of a workflow utilizing the imaging system 100 is shown. Figure 2 The position in is shown with one-dimensional coordinates from the leftmost side of the imaging system 100 and from a reference position 111. In this case, the position indicator 130 is a fixed shutter with a fixed indication position 131.

[0056] exist Figure 2 In FIG. 5 , at (a), the table has moved to a table position having coordinates 600, where the patient's region of interest 161 is below the position 131 indicated by the shutter. Based on the table coordinates and the distance between the reference position 111 and the indicated position 131, as shown in FIG. Figure 2 As shown in FIG800 , at (a), a first stage position 121 may be determined and stored. In this case, the first stage position 121 has coordinates 1400 .

[0057] Then, if Figure 2 As shown, at (b), when the table with the patient has moved to the first table position 121 (having coordinates 1400), the patient's region of interest 161 is located at the reference position 111. The patient has moved further into the bore 110. In this example, the reference position is at the isocenter of the bore 110. With the region of interest 161 at the isocenter of the bore 110, the patient can be imaged by the imaging system 100 to generate one or more images of the region of interest.

[0058] The user (such as an interventional physician) can view and interact with the generated image in the viewing software. Based on the input from the user, the entry point or puncture location 162 can be determined, such as Figure 2 Using the determined puncture position 162 relative to the reference position 111 (here shown as a difference of 55 distance units) and the known coordinates of the shutter relative to the reference position (here -800), the second stage position 122 can be determined (at 655) and stored.

[0059] Figure 2 At (d), the table is shown in a second table position 122. Puncture position 162 is now directly below position 131 indicated by the light barrier, which can help the interventionalist quickly find the correct position and perform an intervention or a portion of an intervention, such as placing a needle at puncture position 162. For simplicity, position 131 is indicated here by a line. However, other indications, such as a point combined with a two-dimensional coordinate system, are also possible.

[0060] Figure 3 Additional steps in the workflow are shown, such as Figure 2 The workflow shown in Figure 3 In FIG, at (a), the table with the patient has moved further out of the bore 110 to a third table position 123. The system may store the coordinates of the third table position (here 240) in memory. This third table position 123 is a potentially more comfortable and ergonomic position for the interventionalist to perform the intervention without having to reach into the bore 110 or be constrained by a position under a shutter. Figure 3 In the schematic diagram of FIG. 1 , the interventional physician or other user places the needle 310 at the puncture site 162 .

[0061] Note that in Figure 3 In the example shown, third position 123 is shown positioned far outside the bore to provide a position with optimal freedom of movement for the interventionalist. However, third table position 123 can be located closer to first table position 121, such as closer to the isocenter compared to second position 122. This can advantageously limit table movement and / or enable off-center imaging. Ergonomics are still improved for the interventionalist, who does not have to reach as far into the bore to access the patient as in first table position 121.

[0062] exist Figure 3In FIG. 1 , at (b), the table has moved back to the first table position 121. In this position, the region of interest 161 (here with the needle 310) can be imaged using the imaging system 100 to check or confirm the progress of the intervention. If a display is present on or near the imaging system 100, the interventionalist can view the images without having to move to a different position. When both the first table position 121 and the third table position 123 are stored, the user of the imaging system 100 can easily switch the table between a comfortable working position and an imaging position. The table can be moved automatically between the first table position 121 and the third table position 123, such as at the command of the user via the user interface.

[0063] As an example, an operator of a magnetic resonance imaging (MRI) system, such as one with a shutter, may define one or more of the following table positions using the system:

[0064] 1. The region of interest at or near the isocenter indicated by the shutter.

[0065] 2. The entry point of the needle indicated in the MRI scan, under the laser (such as the scanner's standard laser or the laser bridge in an MRI-radiotherapy setup).

[0066] 3. The entry point of the needle outside the magnet at a comfortable working position for the interventional operator

[0067] 4. The entry point of the catheter at a location on the patient not covered by the roadmap scan depicting the lesion, at or near the isocenter.

[0068] These positions may be indicated on a touch screen at the magnets, and the operator can use, for example, buttons, gesture control, or voice control to instruct the table to travel to the desired position.

[0069] Figure 4 An example of a portion of a patient's anatomy with a needle entry position or puncture position 162 relative to a lesion 410 to be treated is shown schematically. An interventional radiologist may want to puncture a lesion in an organ such as the liver or kidney. The patient may be moved into the bore of the imaging system (the table is in a first position 121) and a roadmap scan of the region of interest is performed, wherein the roadmap scan shows the location of the lesion 410. Using one or more images from the scan, the best position for entry into the body with a needle, catheter or the like can be planned. The location of the lesion 410 is translated to the puncture position 162. In order to avoid sensitive areas 420, it may not be a straight, shortest trajectory, but for example at an angle, and / or with a curved trajectory, etc. The translation from the interventional position to the puncture position 162, collecting anatomical information to pass through or avoid passing through areas of the patient's anatomy, may utilize artificial intelligence. In a second step, as Figure 4As shown in (b), the table can be moved to a second table position 122 so that the entry point 162 is marked using the position location 131 on the skin.

[0070] As Figure 4 In another step not shown, the patient can be moved further out of the hole (e.g., to the third table position 123) to facilitate skin preparation, application of local anesthesia, creation of a small incision, and placement of the needle. Once the needle is inserted a few millimeters, the patient can be moved back into the scanner (first table position 121), and using imaging, correct placement and orientation can be confirmed. The patient can be moved out again to the working position (third table position 123) to advance the needle in the correct direction based on the information collected from the imaging scan. This process of switching between imaging and working positions can be repeated until the imaging system confirms that the needle has reached the target.

[0071] Several variations of the workflow utilizing the imaging system are conceivable. For example, as described above, the table can be positioned in the third table position 123 in an ergonomic image guidance position that provides an off-center image of the overview image of the region of interest 161. The overview image in such an image guidance position can be geometrically corrected, for example, by taking into account other overview images. In the case of magnetic resonance imaging, the geometric correction can take into account gradient magnet nonlinearities.

[0072] The surgeon's commands, e.g., to scan, reposition the table, switch the table between positions, etc., can be determined by the system using a bore microphone, camera, (foot) switch, touch screen, or the like. The surgeon's commands can be used to guide catheter placement, e.g., via a catheter-guiding robot using such a user interface.

[0073] The catheter position can be tracked and visualized on-screen in / on the bore. The surgeon can initiate scanning by, for example, voice commands or gestures, repositioning the table between initial catheter placement, ergonomic image eccentricity, or isocenter, such as using artificial intelligence-based voice and / or gesture recognition.

[0074] Any part of the workflow may include the use of a catheter-guiding robot, for example, in place of manual catheter placement.

[0075] Figure 5 An example of a computer-implemented method with a flow chart is shown. The computer-implemented method is suitable for controlling a console 120 relative to an imaging system 100 including an aperture 110 and a position indicator 130. The method includes:

[0076] receiving 510 an image of a region of interest 161 of an object 160 on a table 120 acquired with the imaging system 100 , wherein the image was acquired with the table 120 positioned in a stored first table position 121 , wherein in the first table position 121 the region of interest 161 of the object 160 is located at a stored reference position 111 within the bore 110 ;

[0077] receiving 520 user input marking an intervention location in the image;

[0078] determining 530 a puncture location 162 on the object relative to a reference location 111 ;

[0079] determining 540 a second table position 122 based on the puncture position 162, the stored position 131 indicated by the position indicator 130, and the first table position 121, such that the puncture position 162 on the object coincides with the position 131 indicated by the position indicator 130 when the table 120 is in the second table position 122; and

[0080] A third stage position 123 is stored 550 , wherein when the stage is in the third stage position 123 the stage is further outside the aperture 110 than in the first position 121 , and wherein a region of interest 161 of an object on the stage in the third stage position 123 is not at the isocenter of the aperture.

[0081] The third station position 123 may be predetermined and may be Figure 5 One or more other steps of the flowchart in FIG are previously stored 550. When executing the method, the third table position 123 can be received, calculated, or adjusted, for example, based on a user selection or other input. The third table position 123 can be selected or calculated based on ergonomic parameters such as the length of the user, the user's reach, the height of the table, the length of the object, the length of the instrument, etc.

[0082] Figure 6 Shown with Figure 5 An example of a method similar to the method in . However, in this example, the method includes two additional steps.

[0083] The method includes:

[0084] storing 505 a temporary stage position, wherein, in the temporary stage position, the region of interest 161 on the object 160 coincides with the position 131 indicated by the position indicator 130 ;

[0085] determining 507 a first stage position 121 based on the temporary stage position and an offset between a position 131 indicated using the position indicator 130 and a reference position 111 within the bore 110 ;

[0086] receiving 510 an image of a region of interest 161 of an object 160 on a table 120 acquired with the imaging system 100 , wherein the image was acquired with the table 120 positioned in a stored first table position 121 , wherein in the first table position 121 the region of interest 161 of the object 160 is located at a stored reference position 111 within the bore 110 ;

[0087] receiving 520 user input marking an intervention location in the image;

[0088] determining 530 a puncture location 162 on the object relative to a reference location 111 ;

[0089] determining 540 a second table position 122 based on the puncture position 162, the stored position 131 indicated by the position indicator 130, and the first table position 121, such that the puncture position 162 on the object coincides with the position 131 indicated by the position indicator 130 when the table 120 is in the second table position 122; and

[0090] A third stage position 123 is stored 550 , wherein when the stage is in the third stage position 123 the stage is further outside the aperture 110 than in the first position 121 , and wherein a region of interest 161 of an object on the stage in the third stage position 123 is not at the isocenter of the aperture.

[0091] It should be noted that the above embodiments illustrate rather than limit the present invention, and that those skilled in the art will be able to design many alternative embodiments without departing from the scope of the claims. In the claims, any figure signs placed in brackets should not be interpreted as limiting the claims. The word "comprising" does not exclude the presence of elements or steps other than those listed in the claims. The word "a" or "an" before an element does not exclude the presence of multiple such elements. The present invention can be implemented by hardware comprising several different elements and / or by a suitably programmed processor. In a device claim that lists several modules, several of these modules can be embodied by one and the same item of hardware. The measures recited in mutually different dependent claims can be advantageously used in combination.

Claims

1. An imaging system (100) for medical imaging, the imaging system comprising: an aperture (110) for receiving an object (160) to be imaged; a stage (120) for supporting the object (160) and configured to move longitudinally relative to the hole (110); a position indicator (130) for indicating a position (131); and A controller (150) configured to: - receiving (510) an image of a region of interest (161) of the object (160) on the table (120) acquired with the imaging system (100), wherein the image is acquired with the table positioned in a stored first table position (121), wherein in the first table position (121) the region of interest (161) of the object (160) is at a reference position (111) within the bore; - receiving (520) user input marking an intervention location in said image; - determining (530) a puncture location (162) on the object relative to the reference location (111); - calculating and storing (540) a second table position (122) based on the puncture position (162), the position (131) indicated by the position indicator and the stored first table position (121), such that when the table is in the second table position (122), the puncture position (162) on the object coincides with the position (131) indicated by the position indicator (130); and Characterized in that the controller (150) is further configured to: - storing a third table position (123), wherein, when the table is in the third table position (123), the table is further outside the aperture (110) than in the first position (121), and wherein the region of interest (161) of the object on the table in the third table position (123) is not at the isocenter of the aperture.

2. The imaging system according to claim 1, wherein The controller (150) is configured to calculate and store updated coordinates for the position indicator (130) so that when the table is in the second table position (122) and the position indicator (130) indicates an updated position (131) using the updated coordinates, the puncture position (162) on the object coincides with the updated position (131) indicated by the position indicator (130).

3. The imaging system according to claim 1 or 2, wherein: The controller (150) is configured to store (505) a temporary table position, wherein when the table is in the temporary table position, the region of interest (161) coincides with the position (131) indicated by the position indicator (130), and The controller (150) is configured to calculate and store (507) the first stage position (121) based on the temporary stage position and an offset between the position (131) indicated by the position indicator (130) and the reference position (111).

4. The imaging system according to any one of the preceding claims, wherein The imaging system (100) is a magnetic resonance imaging system or a computed tomography system.

5. The imaging system according to any one of the preceding claims, wherein The controller (150) is configured to receive an off-center image of the object (160) acquired by the imaging system when the table (120) is in the third table position (123), and wherein the controller (150) is configured to geometrically correct the off-center image.

6. The imaging system according to claim 5, wherein: The imaging system (100) is a magnetic resonance imaging system, and wherein the geometric correction of the eccentric image comprises correcting for gradient nonlinearities of the magnetic resonance imaging system and / or the geometric correction comprises comparing the eccentric image with an image acquired with the table at the first table position (121).

7. An imaging system according to any one of the preceding claims, wherein: The imaging system includes a display (140), and wherein the controller is configured to provide the image on the display (140).

8. An imaging system according to any one of the preceding claims, wherein: The imaging system includes a user interface.

9. The imaging system according to any one of the preceding claims, wherein: The imaging system includes a camera directed toward the table (120), and wherein the controller (150) is configured to update a stored position of the table and / or a stored position of an object (160) on the table based on images from the camera.

10. A computer-implemented method for controlling a console (120) relative to an imaging system (100) comprising an aperture (110) and a position indicator (130), the method comprising: - receiving (510) an image of a region of interest of an object on the table acquired with the imaging system, wherein the image was acquired with the table positioned in a stored first table position (121), wherein in the first table position (121) the region of interest (161) of the object is at a reference position (111) within the bore; - receiving (520) user input marking an intervention location in said image; - determining (530) a puncture location (162) on the object relative to the reference location (111); - determining (540) a second table position (121) based on the puncture position (162), the stored position (131) indicated by the position indicator (130) and the first table position (121), such that when the table is in the second table position (122), the puncture position on the object coincides with the position (131) indicated by the position indicator (130); and characterized in that - storing (550) a third table position (123), wherein, when the table is in the third table position (123), the table is further outside the aperture (110) than in the first position (121), and wherein the region of interest (161) of the object on the table in the third table position (123) is not at the isocenter of the aperture.

11. The method according to claim 10, wherein: The method further comprises: - storing (505) a temporary stage position, wherein in said temporary stage position said region of interest on said object coincides with said position indicated by means of said position indicator, and - determining (507) the first stage position based on the temporary stage position and an offset between the position indicated by means of the position indicator and the reference position within the bore.

12. The method according to claim 10 or 11, wherein: Determining (530) the puncture location includes roadmapping an internal volume of the object and / or using a trained artificial intelligence algorithm to determine the puncture location.

13. A computer program element which, when executed by a controller, is adapted to cause the controller to perform the method according to claim 10, 11 or 12.

14. A computer readable medium having stored thereon a computer program element according to claim 13.

Images