Medical imaging system

Abstract

The present invention relates to an imaging system (100) 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 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 the object (160) on the stage (120) acquired by the imaging system (100). The image is acquired using the stage (120) at a stored first stage position (121), at which the region of interest (161) of the object is located at a reference position (111) within the aperture (110). The controller (150) is configured to receive user input marking the interventional location in an image, determine the puncture location (162), calculate a second stage position (122), wherein the puncture location (162) is marked using a position indicator, and store a third stage position, wherein when the stage is in the third stage position, it is located further out (121) of the orifice (110) compared to being in the first stage position. In this way, the efficiency of the image-guided workflow and the ergonomics of the interventional physician can be improved.

Description

Technical Field

[0001] This invention relates to imaging systems for medical imaging, and more particularly to imaging systems for image-guided workflows. The invention also relates to a method implemented on a computer relative to an imaging system console. Furthermore, the invention relates to computer program units, and to computer-readable media on which computer program units are stored. Background Technology

[0002] US2017 / 281294A1 describes a marking method and a computed tomography apparatus, the method comprising: scanning a target object to obtain an image of the target object; determining an intervention location on the surface of the target object based on the location of a region of interest in the image of the target object; and marking the intervention location 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 medical instruments (such as puncture needles) to be used in a medical procedure. The computed tomography apparatus generates a planning image and identifies the guide path within the planning image. The computer uses the planning image and the path identified thereon to automatically adjust the position of a light source and, if necessary, adjust the position of the patient table supporting the patient so that the light beam from the light source is positioned to align with the guide path identified on the image.

[0004] US2020 / 057123A1 discloses a system for guiding medical interventions, and more specifically, a system for guiding invasive devices (such as biopsy needles) using magnetic resonance imaging, computed tomography, or other types of imaging. The system employs device guidance that operates 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 supra-clinical imaging for diagnosis and treatment. However, access to the patient is a potential drawback of image-guided interventions using such systems, as the area of ​​interest is typically centered in a long, narrow aperture during imaging. This can be particularly important for needle interventions (such as biopsies or local treatments), where reaching the inside of the imaging system aperture can be challenging. For example, a surgeon may have to bend down into the aperture to examine the location of an incision using (real-time) imaging. This can be done by inserting a finger into the potential incision area. After needle placement, the location may not be accurate enough, and a needle replacement may be necessary.

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

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

[0008] The object of this invention is to provide an improved image-guided workflow. This 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 includes: an aperture for receiving an object to be imaged; a stage for supporting the object and configured to move longitudinally relative to the aperture; a position indicator for indicating the position; and a controller. The controller may, for example, include a memory and a processor. The controller is configured to:

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

[0011] Receive user input that marks the intervention location in the image;

[0012] Determine the puncture location on the object relative to the reference position; and

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

[0014] Workflow efficiency can be improved by determining the location of a puncture (or incision or similar) on an object (such as a patient) based on user input of an image, and then calculating a second position that marks that location using a position indicator. The second position can be determined automatically. As the stage moves to the second position, the puncture location is indicated using a position indicator. Preferably, the stage can be moved automatically by a controller, but other options are also possible, such as moving the stage manually or semi-automatically to the determined coordinates. The second position preferably such that the puncture location of the object on the stage 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 also configured to store a third position, wherein, when the stage is in the third position, it is located further out of the aperture compared to the first position, and wherein the region of interest of the object on the stage in the third position is not at the isocenter of the aperture. The third position differs from the first and second positions. The third position can be received, calculated, or adjusted by the controller, for example, based on user selection or other input, and / or can be predetermined. The third position can be selected or calculated based on ergonomic parameters such as user length, user reach, stage height, object length, instrument length, etc. Storing the third position is advantageous, wherein, for example, the interventional physician has better ergonomic access to the object on the stage compared to the first position because the stage is further out of the aperture. Furthermore, since the third position differs from the second position, the interventional physician's degrees of freedom of movement are not limited by position indicators or related structures such as laser bows. The third position can be further away from the isocenter of the aperture compared to the second position, for example, to increase degrees of freedom of movement. Alternatively, the third position can be closer to the isocenter of the aperture than the second position. The third position can be close to the first position, located further out of the aperture compared to the first position, to provide improved ergonomics for the interventional physician when entering, for example, the puncture position, but close enough that table movement can be advantageously restricted and / or off-center imaging can be achieved in the third position.

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

[0017] The reference position inside the hole can be at or near the isocenter of the hole for optimal image acquisition of the region of interest.

[0018] Determining the puncture location relative to a reference location may include receiving user input indicating a marked puncture location. For example, receiving user input for an image of an interventional location with a marked marker. As an example, the user may indicate a suitable path between the interventional location and the puncture location. Alternatively or additionally, the controller may translate the marked interventional location in the image to the puncture location on the object relative to the reference location via a calculated route map of the object's internal volume on the stage. The translation may include calculating the optimal path for the interventional needle, catheter, or similar instrument from the puncture location on the object to the interventional location inside the object based on the object's imaging volume. Translating the interventional location in the image to determine the puncture location on the object may be based on, for example, anatomical areas that the catheter can pass through or that the catheter needs to avoid. The determination of the puncture location may include using artificial intelligence algorithms 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 providing input.

[0019] Therefore, machine learning or artificial intelligence can be integrated to provide and suggest optimal puncture sites and trajectories to surgeons. Data mining of large amounts of image-guided interventional data can be used to determine puncture sites and catheter trajectories used in clinical practice and integrated into AI networks (e.g., deep learning networks). Personalized preferences for avoiding anatomical and physiological areas can be considered. Similarly, machine learning or artificial intelligence can be employed to determine appropriate third-party locations, such as based on user, object, 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, a port location near the imaging system. Other fixed solutions, such as position indicators attached to the port of the imaging system or to the wall, floor, or ceiling of the imaging room, are also possible. Position indicators in the form of laser bridges (shades) can be standard laser bridges (shades) commonly used for patient positioning, such as for treatment or treatment planning, or similar existing lasers or other light sources attached to or near the imaging system. This is advantageous because it allows for indication of the puncture location on an object in a second position without additional hardware.

[0021] Alternatively, the position indicator can be movable. This includes, but is not limited to, position indicators attached to a moving unit such as a robotic device. For example, a robotic device used to perform an intervention (part of an intervention). The interventional robotic device can be positioned on a track mounted on a table, allowing the interventional robotic device to move to the incision and treatment area. Improved positioning of the interventional robotic device can be achieved 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 (FPGA), and / or an application-specific integrated circuit (ASIC), etc. Processing may involve a single device for execution, such as a single controller including the processor, or it may be executed by a distributed system with multiple local and / or remote units. Memory may be short-term and / or long-term memory configured to interact with the processor.

[0023] According to an embodiment of the invention, the controller is configured to calculate and store updated coordinates for the position indicator, such that when the stage is in a second position and the position indicator indicates an updated position using the updated coordinates, the puncture position on the object coincides with the updated position indicated by the position indicator. This is advantageous where the position indicated by the position indicator can be updated, for example, by moving the position indicator and / or changing the target point or line marked by the indicator. This can be achieved, for example, by an indicator pivotally mounted on, for example, a wall or roof. When the position indicated by the position indicator is movable, absolute movement of the patient stage can be reduced, accelerating workflow and providing additional flexibility. As an example, a position indicator for a robotic device can be moved into an aperture in an imaging system. For example, the system can have a track on which the position indicator can move relative to the aperture and / or the stage. When the position indicator on a robotic surgical device can be moved into an aperture, the second stage position can advantageously be similar to or the same as the first stage position, thus reducing stage movement. Similarly, when robotic surgical equipment is used to perform an intervention (part of) at a second position, the stored third position, combined with the stored first position, provides an ergonomic position for users such as interventional physicians to perform additional surgical steps, fine-tune the intervention, switch back and forth between stages to verify the progress of the interventional procedure, and switch imaging, etc.

[0024] According to an embodiment of the invention, the controller is configured to store a temporary stage position, wherein when the stage is in the temporary stage 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 stage position based on the temporary stage 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 stage position. The operator can move the stage to the temporary stage position such that the region of interest that the operator wants to image is indicated by the position indicator. This can be very intuitive for the operator, as the area is directly indicated, for example, under the laser bridge. Once the stage is in the correct temporary position, that position can be stored, and the first stage position can be automatically determined. Then, when the region of interest is imaged, the first stage position can be subsequently used, because in the first stage position, the region of interest of the object is at the reference position within the aperture. This helps to provide an efficient and intuitive workflow.

[0025] According to embodiments 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 because such systems typically have long, narrow apertures that are difficult to access.

[0026] According to an embodiment of the invention, the controller is configured to acquire an off-center image of the object acquired by the imaging system when the stage is in a third position. The controller is configured to geometrically correct the off-center image. This can be particularly advantageous when the third position is further external to the relatively long aperture of the MRI system compared to the first position to improve access to the object, but close enough that imaging of the region of interest is still possible. When the stage is in the third position, the region of interest of the object on the stage is not at the isocenter of the aperture, but it can still be imaged in this way. Furthermore, portions of the object outside the region of interest can also be imaged in the third position, which can be advantageous for positioning, for example, a catheter, such as when the catheter is not in the intended position. Access to the object can be improved in the third position compared to the first position. Therefore, it is advantageous that the object can also be imaged when the stage is in the third position. Off-center imaging can lead to distortion of the region of interest and signal gaps. By receiving an off-center image of the object, i.e., an image in which the imaged portion of the object is not at the isocenter of the aperture, and geometrically correcting said image, the surgery can also be imaged with a geometrically corrected image when the stage is in an ergonomically advantageous third position. The correction for geometric discrepancies when the station is in the third position can be fine-tuned based on the difference between the image acquired in the third position and the image acquired in the first position.

[0027] According to an embodiment of the present invention, the imaging system is a magnetic resonance imaging system, and the geometric correction of the off-center image includes correcting the gradient nonlinearity of the magnetic resonance system and / or includes comparing the off-center image with an image acquired using a stage at a first stage location. Based on, for example, system characteristics, gradient nonlinearity, etc., parameters such as B0 shimming and limiting image off-center values ​​can be calculated and set.

[0028] According to an embodiment of the invention, the 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 the region of interest on the display, allowing the user to provide input. The display can be positioned, for example, on or near an aperture of the imaging system, so that it can be observed when standing next to the imaging system. Alternatively or additionally, the system may include a remotely positioned display, for example, in another room or another location.

[0029] According to embodiments 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 manual switch, or a foot switch. The user interface can be advantageously used to provide input, for example, the selection of stage position, intervention position, imaging parameters, etc. In the case where the system includes a display, the user can interact with, for example, an image on the display via the user interface.

[0030] According to embodiments of the invention, the imaging system includes a camera pointing to a stage, and a controller is configured to update a stored stage position and / or a stored position of an object on the stage 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, etc. The camera can advantageously improve the efficiency and accuracy of a workflow by determining the position of an object on the stage relative to the stage, and the stage position (e.g., relative to a hole, etc.). As an example, for instance, in the case where an object moves on the stage, the camera can provide input regarding changes in position. In this way, the accuracy of the workflow, such as the accuracy of the stage position, can be improved.

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

[0032] Receive an image of the region of interest of an object on the stage, acquired using the imaging system, wherein the image is acquired using the stage positioned in a stored first stage location, wherein the region of interest of the object is located at a stored reference location within the aperture in the first stage location;

[0033] Receive user input that marks the intervention location in the image;

[0034] Determine the puncture location on the object relative to the reference position;

[0035] A second location is determined based on the puncture location, the storage location indicated by the location indicator, and the first location, such that when the device is in the second location, the puncture location on the object coincides with the location indicated by the location indicator; and

[0036] A third stage position is stored, wherein when the stage is in the third stage position, the stage is located further out of the aperture compared to the first stage position, and wherein the region of interest of the object on the stage in the third stage position is not at the isocenter of the aperture.

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

[0038] Store temporary stage locations, wherein, at said temporary stage locations, the region of interest on the object coincides with the location indicated by the location indicator, and

[0039] The position of the first stage is determined based on the position of the temporary stage and the offset between the position indicated by the position indicator and the reference position in the hole.

[0040] According to embodiments of the invention, the step of determining the puncture location on an object relative to a reference location includes using a trained artificial intelligence algorithm to perform roadmap mapping of the internal volume of the object and / or (based on the intervention location) determine the puncture location. Determining the puncture location, such as by translation from the intervention location in an image to the puncture location, may include calculating the optimal path for the 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 may be based on, for example, anatomical areas that the catheter can pass through or that the catheter needs to avoid. The determination of the puncture location may include using an artificial intelligence algorithm capable of learning from previous interventional procedures and / or strategies. Calculating the roadmap mapping may, for example, automatically determine the puncture location or provide recommendations on suitable options.

[0041] According to a third aspect of the invention, a computer program unit is provided that, when executed by a controller, is adapted to cause the controller to perform the method described above. The computer program unit may be software that can be downloaded from a server, for example, via the Internet.

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

[0043] These and other aspects of the invention will become apparent from the embodiments described below. Attached Figure Description

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

[0045] Figure 2 The workflow of using an imaging system is illustrated schematically.

[0046] Figure 3 The workflow of using an imaging system is illustrated schematically.

[0047] Figure 4 The needle's location relative to the lesion is illustrated schematically.

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

[0049] Figure 6A flowchart of a computer-implemented method is shown. Detailed Implementation

[0050] The imaging system 100 according to an embodiment of the present invention is in Figure 1 The diagram is schematically shown. Imaging system 100 includes an aperture 110, which may be relatively long and narrow, allowing it to fit the patient or a site of the patient to be imaged. An example of one type of imaging system is a magnetic resonance imaging system, where a long and narrow aperture is typically used to achieve good image 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.) may also have long and narrow apertures. A reference position 111 is defined within the aperture 110 of imaging system 100. The reference position may be, for example, at or near the center of the aperture.

[0051] Imaging system 100 includes a stage 120. The stage can be longitudinally moved into and out of an aperture, or closer to or further away from the aperture. An object 160 to be imaged (such as a patient to be imaged) can be positioned on stage 120. The stage is configured to be in at least a first stage position 121, a second stage position 122, and a third stage position 123 (in... Figure 1 Not shown in the image, but... Figure 3 The platform can move between (the points in the hole). The platform position is defined, for example, using 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 position 131. The indicated position 131 (such as a center point or centerline of the indicated position 131) can also be defined in the same coordinate system as the stage position and reference position 111. The indicated position can be, for example, in the form of a line, point, circle, or ellipse. Figure 1 In the schematic diagram, the indicated position 131 is visible on the 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. The indicated position 131 can be fixed in a coordinate system, such as if the position is indicated using a laser bow fixed relative to the imaging system. Alternatively, the indicated position 131 can be changed by the position indicator 130, so that the position can be indicated at various coordinates. The coordinate system of the position relative to the imaging system 100 can be a one-dimensional coordinate system along the longitudinal axis of the stage 120. Other coordinate systems are also possible, such as a two-dimensional system in the plane of the stage 120.

[0053] The imaging system includes a controller 150. The controller may include, for example, an ASIC, an FPGA, and / or a processor, as well as memory storing instructions for controlling the processor. Figure 1 In some examples, the imaging system includes a local display 140. In other examples, the imaging system may also include a user interface (…). Figure 1 (Not shown in the image). 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 can be used to provide user input, for example, for selecting the platform position, intervention position, and imaging parameters. In systems including... Figure 1 In the case of a display and user interface, the 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 a stage 120 in orifice 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 interventional location in at least one image, the controller 150 can determine a puncture location 162 in a coordinate system relative to a reference location 111. When the puncture location 162 is known, a second stage location 122 can be determined such that when the stage 120 is in the second stage location 122, the puncture location 162 is at location 131 indicated by the location indicator 130. Furthermore, the controller 150 is configured to store a third stage location 123, which provides, for example,... Figure 3 The improved working position is shown.

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

[0056] exist Figure 2 In (a), the stage has been moved to a stage position with coordinates 600, where the patient's region of interest 161 is below position 131 indicated by the shader. Based on the stage coordinates and distance between the reference position 111 and the indicated position 131, as... Figure 2 As shown in 800, at (a), the first position 121 can be determined and stored. In this case, the first position 121 has coordinates 1400.

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

[0058] Users (such as interventional physicians) can view and interact with the generated images in the software. Based on user input, the entry point or puncture site can be determined, such as... Figure 2 As shown in (c). Using the determined puncture position 162 relative to the reference position 111 (shown here as a difference of 55 distance units) and the known coordinates of the shader relative to the reference position (here -800), the second position 122 can be determined (at 655) and stored.

[0059] Figure 2 The stage in the second position 122 is shown at (d). The puncture position 162 is now located directly below position 131 indicated by the light shield, which helps the interventional physician quickly locate the correct position and perform the intervention or part thereof, such as placing the needle at puncture position 162. For simplicity, position 131 is indicated here by a line. However, indications such as points combined with a two-dimensional coordinate system are also possible, for example.

[0060] Figure 3 Additional steps in the workflow are shown, such as Figure 2 The workflow shown. Figure 3 In the middle, at (a), the patient's station has been further moved out of the orifice 110 to a third station position 123. The system can store the coordinates of the third station position (here, 240) in memory. This third station position 123 is a potentially more comfortable and ergonomic position for interventional physicians to perform interventions without having to extend into the orifice 110 or be restricted by positions below the light shield. Figure 3 In the diagram, the interventional physician or other user places the needle 310 at the puncture site 162.

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

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

[0063] As an example, an operator of a magnetic resonance imaging (MRI) system with a light shield can use the system to define one or more of the following stage positions:

[0064] 1. Region of interest at or near the isocenter, indicated by the shading device.

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

[0066] 3. The needle entry point outside the magnet, positioned in a comfortable working position for the operator.

[0067] 4. The catheter entry point is located at a position not covered by the lesion mapping scan on the patient, and is isocentric or near isocentric.

[0068] These positions can be indicated on a touchscreen at the magnet, and the operator can use, for example, buttons, gesture controls, or voice controls to direct the stage to the desired position.

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

[0070] As Figure 4 Another step, not shown, involves moving the patient further out of the aperture (e.g., to a third position 123) to facilitate skin preparation, administration 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 position 121), and the imaging allows confirmation of correct placement and orientation. The patient can then be moved back to the working position (third position 123) to advance the needle in the correct direction based on information acquired from the imaging scan. This process of switching between the imaging and working positions can be repeated until the imaging system confirms that the needle has reached its target.

[0071] Several variations of the imaging system's workflow can be envisioned. For example, as described above, the stage can be positioned in a third stage position 123 at an ergonomic image-guided location, which is located off-center in the image and provides an overview image of the region of interest 161. The overview image at such an image-guided location can be geometrically corrected, for example, by taking into account other overview images. In the case of magnetic resonance imaging, geometric correction can take into account gradient magnet nonlinearity.

[0072] Surgeon commands, such as scanning, repositioning the stage, and switching stages between positions, can be determined by the system using a punch microphone, camera, (foot) switch, touchscreen, or similar means. These commands can be used to guide catheter placement, for example, via a catheter-guided robot using such a user interface.

[0073] The catheter position can be tracked and visualized on the screen inside / on the orifice. Surgeons can initiate the scan via, for example, voice commands or gestures, and reposition the catheter on the stage between the initial catheter placement position, an ergonomically oriented off-center position, or an isocentric position. This can be achieved using AI-based voice and / or gesture recognition.

[0074] Any part of the workflow may include using a catheter-guided robot, for example, instead of manual catheter placement.

[0075] Figure 5 An example of a computer-implemented method with a flowchart is shown. The computer-implemented method is adapted to a console 120 of an imaging system 100, which includes an aperture 110 and a position indicator 130. The method includes:

[0076] The image of the region of interest 161 of the object 160 on the stage 120 is acquired by the imaging system 100, wherein the image is acquired by the stage 120 positioned in a first storage location 121, wherein the region of interest 161 of the object 160 is located at a stored reference location 111 within the aperture 110 in the first storage location 121.

[0077] Receive user input 520 to mark the intervention location in the image;

[0078] Determine the puncture position 162 on object 530 relative to reference position 111;

[0079] Based on the puncture position 162, the storage position 131 indicated by the position indicator 130, and the first position 121, the second position 122 is determined such that when the station 120 is in the second position 122, the puncture position 162 on the object coincides with the position 131 indicated by the position indicator 130; and

[0080] The storage 550 is a third stage position 123, wherein when the stage is in the third stage position 123, the stage is located further out of the aperture 110 compared to the first stage position 121, and wherein the region of interest 161 of the object on the stage in the third stage position 123 is not at the isocenter of the aperture.

[0081] The third location, 123, can be reserved and can be... Figure 5 One or more other steps in the flowchart are previously stored 550. When the method is executed, the third position 123 can be received, calculated, or adjusted, for example, based on user selection or other input. The third position 123 can be selected or calculated based on ergonomic parameters such as user length, user reach, table height, object length, instrument length, etc.

[0082] Figure 6 It shows the relationship with Figure 5 This is an example of a method similar to the one described in [the previous example]. However, in this example, the method includes two additional steps.

[0083] The method includes:

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

[0085] The first stage position 121 is determined based on the temporary stage position and the offset between the position 131 indicated by the position indicator 130 and the reference position 111 in the hole 110;

[0086] The image of the region of interest 161 of the object 160 on the stage 120 is acquired by the imaging system 100, wherein the image is acquired by the stage 120 positioned in a first storage location 121, wherein the region of interest 161 of the object 160 is located at a stored reference location 111 within the aperture 110 in the first storage location 121.

[0087] Receive user input 520 to mark the intervention location in the image;

[0088] Determine the puncture position 162 on object 530 relative to reference position 111;

[0089] Based on the puncture position 162, the storage position 131 indicated by the position indicator 130, and the first position 121, the second position 122 is determined such that when the station 120 is in the second position 122, the puncture position 162 on the object coincides with the position 131 indicated by the position indicator 130; and

[0090] The storage 550 is a third stage position 123, wherein when the stage is in the third stage position 123, the stage is located further out of the aperture 110 compared to the first stage position 121, and wherein the region of interest 161 of the 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 are illustrative and not limiting of the invention, and those skilled in the art will be able to devise many alternative embodiments without departing from the scope of the claims. Any reference numerals placed in parentheses in the claims should not be construed as limiting the claims. The word "comprising" does not exclude the presence of elements or steps other than those listed in the claims. The words "a" or "an" preceding an element do not exclude the presence of a plurality of such elements. The invention can be implemented by hardware comprising several different elements and / or by a suitably programmed processor. In device claims enumerating several modules, several of these modules may be embodied by a single item of hardware. Measures recited in mutually different dependent claims may be advantageously combined.

Claims

1. An imaging system (100) for medical imaging, the imaging system comprising: a bore (110) for receiving a subject (160) to be imaged; a table (120) for supporting the subject (160) and configured to move longitudinally relative to the bore (110); a position indicator (130) for indicating a position (131); and a controller (150) configured to: receive (510) an image of a region of interest (161) of the subject (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 subject (160) is at a reference position (111) within the bore; receive (520) a user input marking an intervention position in the image; determine (530) a puncture position (162) on the subject relative to the reference position (111); compute and store (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 subject coincides with the position (131) indicated with the position indicator (130); and characterized in that the controller (150) is further configured to: store a third table position (123), wherein when the table is in the third table position (123) the table is more external to the bore (110) compared to in the first position (121), and wherein the region of interest (161) of the subject on the table in the third table position (123) is not at the isocenter of the bore.

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

3. The imaging system of 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 with the position indicator (130), and wherein the controller (150) is configured to compute and store (507) the first table position (121) based on the temporary table position and an offset between the position (131) indicated with the position indicator (130) and the reference position (111).

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

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

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

8. The imaging system of any of the preceding claims, wherein, The imaging system comprises a user interface.

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

10. A computer implemented method for controlling a table (120) relative to an imaging system (100) comprising a bore (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 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 is at a reference position (111) within the bore; receiving (520) a user input marking an intervention position in the image; determining (530) a puncture position (162) on the object relative to the reference position (111); determining (540) a second table position (122) based on the puncture position (162), a 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 with the position indicator (130); and characterized by, storing (550) a third table position (123), wherein when the table is in the third table position (123) the table is more external to the bore (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 bore.

11. The method of claim 10, wherein, The method further comprises: storing (505) a temporary table position, wherein in the temporary table position the region of interest on the object coincides with the position indicated with the position indicator, and determine (507) the first table position based on the temporary table position and an offset between the position indicated with the position indicator and the reference position within the bore.

12. The method of claim 10 or 11, wherein, determining (530) the puncture position comprises roadmapping an internal volume of the subject and / or determining the puncture position using a trained artificial intelligence algorithm.

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

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

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