Interface for time-based imaging protocols

Abstract

A display for a contrast enhanced ultrasound (CEUS) examination is disclosed. The display has a user interface with an editable protocol adapted to allow a user to select time-based actions and events for a next CEUS examination on the display, a first time bar display adapted to allow a user to change time-based actions during a CEUS examination and provide a visual indication of the next action on the display, and a second time bar display adapted to allow a user to display images and loops acquired during the CEUS examination on the display. A method of controlling an imaging procedure is also described.

Description

[Technical field]

[0001] Contrast-enhanced imaging, such as contrast-enhanced ultrasound (CEUS) imaging, often requires multiple steps performed in a specific sequence, called a protocol. Known CEUS imaging protocols require timely actions by the operator and are performed manually. For example, once in contrast mode, the operator is required to start contrast injection and begin timing the procedure upon arrival of the first gas bubble in the contrast medium. Just before or just after the incidence angle of the first gas bubble, the operator must begin acquiring images or imaging loops over time, or both.

[0002] After the initial acquisition of an image and / or loop, the operator typically terminates the image / loop acquisition after a designated period of time (e.g., 30-60 seconds). Often, this image / loop acquisition start and end sequence can be repeated at predetermined time intervals to capture images / loops at desired times of contrast circulation. For example, image / loop acquisition can be repeated every 30 seconds to capture a 10 second imaging loop, or to capture 10 images at 10 second intervals.

[0003] During a subject imaging sequence, it may be desirable to freeze the ultrasound transducer so that no ultrasound is transmitted for a period of time to reduce the angle of incidence of contrast bubble destruction. This is done many times during the subject imaging procedure during an image / loop capture sequence.

[0004] Additionally, separate injections of contrast agent may be useful during the imaging procedure. Often, repeat injections are initiated after a predetermined period of time. [Background technology]

[0005] Known imaging protocols such as those described above are performed manually by an imaging system operator, with manual timing to start and end various steps. These imaging protocols often involve a relatively difficult workflow, which requires precision in both imaging and contrast injection timing. As can be appreciated, known methods requiring manual execution of timed sequences of image acquisitions and operations required for some imaging modes, such as contrast-enhanced ultrasound imaging, are difficult and subject to errors in the initiation and termination of image acquisition, resulting in loss of data and / or the need for repeat injections. Summary of the Invention [Problem to be solved by the invention]

[0006] Therefore, what is needed is an apparatus, method and system that overcomes at least the shortcomings of known methods and systems discussed above. [Means for solving the problem]

[0007] According to one aspect of the present disclosure, a display for a contrast enhanced ultrasound (CEUS) examination is disclosed, the display comprising a menu with an editable protocol adapted to enable a user to select time based actions and events for a next CEUS examination on the display, a first time bar display adapted to enable a user to change time based actions during the CEUS examination and provide a visual indication of the next action on the display, and a second time bar display adapted to enable a user to view images and loops acquired during the CEUS examination on the display.

[0008] According to another aspect of the present disclosure, a method of controlling an imaging procedure is disclosed that includes providing a menu with an editable protocol adapted to allow a user to select time-based actions and events for an upcoming contrast-enhanced ultrasound (CEUS) examination on a display, providing a first time bar display adapted to change the time-based actions during the CEUS examination and provide a visual indication of the upcoming action on the display, and providing a second time bar display configured to display images and loops acquired during the CEUS examination on the display.

[0009] According to another aspect of the present disclosure, a tangible, non-transitory computer readable medium is disclosed that stores instructions that, when executed by a processor, cause the processor to: provide a menu with an editable protocol adapted to allow a user to select time-based actions and events for an upcoming contrast-enhanced ultrasound (CEUS) examination on a display; provide a first time bar display adapted to change time-based actions during the CEUS examination; provide a visual indication of the upcoming action on the display; and provide a second time bar display configured to display images and loops acquired during the CEUS examination on the display.

[0010] Representative embodiments are best understood from the following detailed description when read in conjunction with the accompanying drawings. It is emphasized that the various features are not necessarily drawn to scale. In fact, dimensions may be arbitrarily increased or decreased for clarity of illustration. Wherever applicable and practical, like reference numerals refer to like elements. [Brief description of the drawings]

[0011] [Figure 1] 1 is a simplified block diagram of a system for imaging portions of a body, according to a representative embodiment. [Diagram 2]FIG. 1 is a simplified flow diagram of a CEUS protocol, according to a representative embodiment. [Diagram 3] FIG. 1 is a diagram of a display including a menu for generating a CEUS protocol according to a representative embodiment. [Figure 4] 1 is a diagram of a display during real-time acquisition of images according to a representative embodiment. [Diagram 5] 1 is a diagram of a display showing various images / loops collected during an imaging sequence, according to a representative embodiment. [Figure 6] 1 is a flow diagram illustrating a method for imaging a portion of a subject, according to a representative embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0012] In the following detailed description, for purposes of explanation and not limitation, representative embodiments disclosing specific details are described to provide a thorough understanding of the embodiments according to the present teachings. Descriptions of known systems, devices, materials, methods of operation, and methods of manufacture may be omitted to avoid obscuring the description of the representative embodiments. Nevertheless, systems, devices, materials, and methods within the scope of those skilled in the art may be within the scope of the present teachings and used in accordance with the representative embodiments. It is to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting. Defined terms are in addition to the technical and scientific meaning of the defined terms as commonly understood and accepted in the art of the present teachings.

[0013] It should be understood that although terms such as first, second, third, etc. may be used herein to describe various components or components, these components or components should not be limited by these terms. These terms are used only to distinguish one component or component from another component or component. Thus, a first element or component described below can be referred to as a second element or component without departing from the teachings of the inventive concept.

[0014] The terms used herein are for the purpose of describing particular embodiments only and are not intended to be limiting. As used in this specification and the appended claims, the singular forms of the terms "a", "an" and "the" are intended to include both the singular and the plural unless the context clearly dictates otherwise. In addition, the terms "comprises", "comprises", and / or similar terms specify the presence of stated features, elements, and / or components but do not exclude the presence or addition of one or more other features, elements, components, and / or groups thereof. As used herein, the term "and / or" includes any and all combinations of one or more of the associated listed items.

[0015] The present teachings facilitate implementation of imaging protocols using menus, user interfaces and / or GUIs on the display, real-time reminders and warnings provided on the display, and image / loop review on the display. Notably, the real-time reminders and warnings may also be audible. Among other advantages, better control of the imaging procedure, fewer errors during the imaging procedure, and easy review of images / loops acquired during the imaging procedure are achieved.

[0016] FIG. 1 is a simplified block diagram of an imaging system 100 for imaging a region of interest of a subject, according to a representative embodiment.

[0017] With reference to FIG. 1 , the imaging system 100 comprises an imaging device 110 and a computer system 115 for controlling imaging of an area of ​​interest of a patient 105 on a table 106. The imaging device 110 is illustratively an ultrasound imaging system capable of providing a US image scan of an area of ​​interest in the patient 105. Illustratively, the imaging device 110 is of a type commonly used in CEUS imaging procedures and is adapted to provide color Doppler imaging or three-dimensional flow volumetric imaging. CEUS imaging procedures typically include combining contrast imaging modes with standard B-mode. In some cases contrast is combined with flow modes (including color Doppler, but also power Doppler or other approaches). Contrast is also combined with needle visualization modes for biopsy / ablation procedures, and contrast can also be performed in modes that co-register CEUS images with existing data sets from other modalities (e.g., computed tomography (CT), magnetic resonance imaging (MR), and previous ultrasound (US) examinations). In particular, any of these various imaging methods may be two-dimensional (2D) or three-dimensional (3D).

[0018] Computer system 115 receives image data from imaging device 110 and stores and processes the imaging data according to representative embodiments described herein. Computer system 115 includes controller 120, memory 130, display 150 with graphical user interface (GUI) 155, and user interface 160. Display 150 may also include a loudspeaker (not shown) for providing audible feedback.

[0019] The controller 120 interfaces with the imaging device 110 via the imaging interface 111. The memory 130 stores instructions executable by the controller 120. When executed, the instructions cause the controller 120 to allow a user to schedule different steps of a protocol using the GUI 155 and / or the user interface 160, and to selectively retrieve images and / or loops taken at specific times during an exam (e.g., a CEUS exam), as described more fully below. Additionally, the controller 120 may implement additional operations based on executing the instructions, such as instructions or communications with other elements of the computer system 115, including the memory 140 and the display 150, to perform one or more of the processes described above.

[0020] The controller 120 represents one or more processing devices, configured to execute software instructions stored in the memory 130 to perform functions as described in various embodiments herein. The controller 120 may be implemented using any combination of hardware, software, firmware, hardwired logic circuitry, or combinations thereof, such as a field programmable gate array (FPGA), an application specific integrated circuit (ASIC), a general purpose computer, a central processing unit, a computer processor, a microprocessor, a graphics processing unit (GPU), a microcontroller, a state machine, a programmable logic device, or combinations thereof. Furthermore, any processing unit or processor herein may include multiple processors, parallel processors, or both. Multiple processors may be included or combined in a single device or multiple devices.

[0021] The term "processor" as used herein encompasses an electronic component capable of executing a program or machine-executable instructions. References to a computing device with a "processor" should be interpreted to include two or more processors or processing cores, such as in a multi-core processor. A processor may also refer to a collection of processors within a single computer system or distributed among multiple computer systems, such as a cloud-based or other multi-site application. The term computing device should also be interpreted to include a collection or network of computing devices, each of which includes one or more processors. A program has software instructions executed by one or more processors, which may be within the same computing device or distributed across multiple computing devices.

[0022] The memory 130 may include main memory and / or static memory, and such memories may communicate with each other and with the controller 120 via one or more buses. The memory 130 stores instructions used to implement some or all aspects of the methods and processes described herein. The memory 130 may be implemented, for example, by any number, type, and combination of random access memory (RAM) and read-only memory (ROM), and may store various types of information, such as software algorithms, that, when executed by the processor, act as instructions that cause the processor to perform various steps and methods according to the present teachings. Additionally, updates to the methods and processes described herein may be provided to the computer system 115 and stored in the memory 130.

[0023] The various types of ROM and RAM may include any number, type, and combination of computer readable storage media, such as disk drives, flash memory, electrically field programmable gate array read only memory (EPROM), electrically erasable field programmable gate array read only memory (EEPROM), registers, hard disks, removable disks, tapes, compact disk read only memory (CD-ROM), digital versatile disk (DVD), floppy disk, Blu-ray disk, universal serial bus (USB) drive, or any other form of storage media known in the art. Memory 130 is a tangible storage medium that stores data and executable software instructions, and is non-transient while the software instructions are stored. As used herein, the term "non-transient" should be interpreted as a characteristic of a state that persists over a period of time, rather than as a permanent characteristic of a state. The term "non-transient" specifically negates fleeting characteristics, such as the characteristics of a carrier wave or signal, or other formation that exists only temporarily at any place at any time. The memory 130 may store software instructions and / or computer readable code that enable the performance of various functions. The memory 130 may be secured and / or encrypted, or unsecured and / or unencrypted.

[0024] The "memory" is an example of a computer-readable storage medium, and should be construed as possibly being multiple memories or databases. The memory or database may be, for example, multiple memories or databases local to the computer and / or distributed among multiple computer systems or computing devices. A computer-readable storage medium is defined as any medium that constitutes patentable subject matter under 35 USC §101, and excludes any medium that does not constitute patentable subject matter under 35 USC §101. Examples of such media include non-transitory media, such as computer memory devices that store information in a format readable by a computer or data processing system. More specific examples of non-transitory media include computer disks and non-volatile memories.

[0025] User interface 160 may include a user and / or network interface for providing information and data output by controller 120 and / or memory 130 to a user and / or for receiving information and data input by a user. That is, user interface 160 allows a user to input data to schedule, control, or manipulate aspects of the processes described herein, and allows controller 120 to indicate the effect of the user's control or manipulation. User interface 160 may include one or more of a port, disk drive, wireless antenna, or other type of receiver circuitry. User interface 160 may further connect one or more user interfaces, such as, for example, a mouse, keyboard, mouse, trackball, joystick, microphone, video camera, touchpad, touch screen, voice or gesture recognition captured by a microphone or video camera, etc.

[0026] Display 150 may be, for example, a monitor such as a computer monitor, a television, a liquid crystal display (LCD), a light emitting diode (LED) display, a flat panel display, a solid state display, or a cathode ray tube (liquid) display, or an electronic whiteboard. Display 150 may also provide a graphical user interface (GUI) 155 for displaying and receiving information to and from a user.

[0027] As alluded to above and described in more detail below, according to various representative embodiments, various aspects of the imaging protocol may be selectively scheduled by a user to perform specific desired functions during an imaging procedure. Additionally, according to representative embodiments, reminders may be provided to the user during instruction execution of the imaging protocol. Additionally, after an imaging scan is completed, according to representative embodiments, review of acquired images / loops is facilitated by pairing of images / loops to specific points in time of the executed protocol. For purposes of explanation and not limitation, Figs. 2-7 and their description present various aspects of CEUS protocol execution according to the present teachings. It is emphasized that this is merely an exemplary application of various aspects of the present teachings and is not intended to limit the scope of the present teachings.

[0028] 2 is a simplified flow diagram illustrating a protocol 200 for imaging blood flow, according to a representative embodiment. Various aspects and details of protocol 200, and embodiments thereof, are contemplated for use in the above-described imaging system 100. Various aspects of imaging system 100 may not be repeated to avoid obscuring the description of the present representative embodiment.

[0029] Protocol 200 is illustratively a CEUS protocol and includes common steps and operations used in CEUS imaging. Again, application of the present teachings to CEUS imaging is merely exemplary, and various aspects of the present teachings are contemplated for use in other imaging modalities. Additionally, various aspects and details of protocol 200 and the associated methods are common to those described above and may not be repeated to avoid obscuring the description of the present exemplary embodiment.

[0030] As mentioned above, and described more fully below, the various steps in the protocol sequence are implemented using menus on the display 150 (not shown in FIGS. 1 and 2) and the user interface 160 and / or GUI 155. Additionally, instructions stored in memory 130, when executed by the processor of the controller 120, enable selection of various desired steps in the protocol 200, and enable user selection of images and loops via the user interface 160 and / or GUI 155 during and after imaging.

[0031] Protocol 200 begins at 202 with a pre-contrast imaging step that is performed by a user / operator of imaging system 100 on which protocol 200 is being executed. As with all other steps in the protocol, the pre-contrast imaging step may be selected using a menu on display 150 (not shown in FIGS. 1 and 2) using user interface 160 and / or GUI 155.

[0032] After completion of the pre-contrast imaging step at 202, protocol 200 continues with entry of contrast mode at 204, where various settings are adjusted or preset default conditions are selected. Entry into contrast mode at 204 occurs during the scheduling sequence of protocol 200 and may be selected using menus on display 150 (not shown in FIGS. 1 and 2), using user interface 160 or GUI 155, or both.

[0033] The protocol 200 continues with the injection of contrast into the subject or patient at 206. The injection of contrast at 206 is scheduled during the scheduling sequence of the protocol 200. The injection of contrast at 206 is initiated using the user interface 160 of the GUI 155 by selecting injection of contrast from the user interface 160 or a menu on the GUI 155 (not shown in FIGS. 1 and 2), or both. As will be appreciated by those skilled in the art, the injection of contrast and the subsequent appearance of contrast in the arterial or portal or venous circulation triggers certain timers that are used to execute the protocol at certain times. Notably, as will be explained more fully below, these timers can also be set during the scheduling sequence of the protocol. Additionally, as will be explained more fully below, warnings indicating designated times when the operator must take action can be displayed on the display 150 during the imaging scan or can be provided by audio or tactile feedback from the display 150, or by selection of a combination of these options during the scheduling of the protocol 200.

[0034] After completion of contrast injection at 206, the user may choose to activate the contrast timer at 208 using the user interface 160 or GUI 155 to select the timer time and duration from a menu (not shown in FIGS. 1 and 2). Activation of the contrast timer at 208 initiates a custom CEUS protocol. As described more fully below, the various actions and timers used in the custom CEUS protocol may be selected on the display 150 using the user interface 160 or GUI 155, or both.

[0035] After starting the contrast timer at 208, imaging and loop acquisition is performed to ensure the initial arrival of contrast after injection of contrast and the initial arterial phase thereafter. Notably, as described more fully below, the start and end of this contrast timer at 208 may be displayed on the screen or a warning signaling its end may be provided by the display 150, or both. In this manner, a user or operator of the imaging system 100 may start the image acquisition loop at 210. Alternatively, prior to the start of the protocol 200, the user may set a user timer using a menu on the display 150 (not shown in FIGS. 1 and 2) using the user interface 160 or GUI 155. Thus, the user timer for this waiting period after injection of contrast at 208 may be set and started during configuration of the protocol 200 by the user / operator. Illustratively, a user timer for the wait period may be selected by the user / operator using the user interface 160 and / or GUI 155 to select the timer time and duration from a menu (not shown in FIGS. 1 and 2). Further discussion of timer selections and their warnings is provided below in accordance with various representative embodiments. In particular, the user may specify functions such as start acquisition when image / loop, freeze, etc. based on definitions within the user timer sequence and protocol, as described more fully below.

[0036] The duration of the image acquisition loop beginning at 210 is beneficially selectable by the present teachings, as is the acquisition frame rate. The duration of the image acquisition loop beginning at 210 may be selected by the user / operator using the user interface 160 and / or GUI 155 via a selection on a menu (not shown in FIGS. 1 and 2). In particular, contrast studies often have high variability across patients, injections, and lesion types. At a basic level, the purpose of the contrast study is to sample wash-in with an increase in pixel intensity over an initial period resulting from the contrast agent arriving in the imaging plane due to transition within the circulatory system during the arterial phase through peak contrast arrival (the frame where the maximum signal power or pixel intensity occurs within the organ of interest). In this portion of the imaging sequence, a high frame rate is useful to sample fast changes. After this, there is a gradual decay of the agent to sample, which is an increase in pixel intensity over an initial period resulting from the contrast agent arriving in the imaging plane due to passage within the circulatory system. After the arterial phase has been sampled and the user has captured the portal / delay phase performance, frame rate requirements may be relaxed and tradeoffs made to maximize contrast preservation and reduce data size (e.g., by reducing the number of transmissions per second). Thus, as will be appreciated by those skilled in the art, the selected duration of the image acquisition loop in 210 of protocol 200 beneficially allows improved imaging efficiency and accuracy to be implemented by the user / operator.

[0037] Then, after the duration of the loop acquisition at 210, the loop acquisition ends at 212. The duration of the loop acquisition at 210 may be displayed on the screen and / or a warning may be provided by the display 150 signaling the end of the duration of the loop acquisition at 210. In this manner, a user or operator of the imaging system 100 may end the image acquisition loop at 212. Alternatively, a user may set a timer using the user interface 160 or a menu on the GUI 155 (not shown in FIGS. 1 and 2 ) prior to the start of the protocol 200 to end the loop acquisition that begins at 210 and ends at 212. Thus, the timer for this waiting period after the injection of contrast at 208 may be set and started during configuration of the protocol 200 by the user / operator.

[0038] The length of the arterial phase may vary significantly based on the organ, the patient's health, and other factors. The length of time from peak contrast signal to the late phase may also vary significantly based on the organ, the patient, and the lesion. For example, in some patients, the contrast agent may disappear quickly and stop providing any useful signal past a minute or two. In these cases, the protocol 200 may be usefully configured to allow the user / operator to bypass multiple upcoming events in order to proceed to the review / quantification / reporting stage. Similarly, the ideal time to change acoustic properties (e.g., acquisition frame rate, transmission line density, etc.) to preserve contrast agent may not be consistent from patient to patient, but rather may depend on where the user is currently in the wash-in / wash-out sequence. Finally, as discussed more fully below, annotating and marking loops / frames of interest benefits the quantification and reporting that occurs after the examination. These annotations and markings may be performed via the user interface 160 or GUI 155, or both.

[0039] After the end of loop acquisition at 212, the imaging system 100 may enter a freeze mode at 214. Freezing the imaging system stops the transmission of ultrasound to the body. This may be done for several reasons, including, for example, to preserve air bubbles in the contrast agent that may be reduced or eliminated by the ultrasound. Freezing at 214 is generally done when the images that may be collected are not of interest or useful for the particular scan being performed. In certain imaging procedures, the contrast agent level reaches a peak level, after which the level decays over time or reaches a steady state. During these times, it may not be useful to collect images. Furthermore, there are several factors that drive the duration of the freeze, including, but not limited to, the behavior of certain types of lesions with respect to the contrast agent. Thus, the initiation and duration of the freeze at 214 may vary depending on a variety of factors. Thus, the selection of the initiation and termination of the freeze at 214 is beneficially controllable. Notably, freezing and unfreezing may be based on the operator's observation of the image or may be fixed by a protocol. Specifically, in some tissue situations, radiologists set strict protocols that all technicians must follow. This results in a fixed duration so that everything is presented similarly to the radiologist. In other situations, the radiologist / physician may perform the scan and may vary the timing based on observations. Still other situations may be part of a clinical study where adherence to a strict protocol where data collection requires a fixed duration is beneficial.

[0040] The initiation and termination (i.e., duration) of the freezing of the imaging system 100 at 214 may be displayed on the display, or a warning may be provided by the display 150 to signal its termination, or both. In this manner, a user or operator of the imaging system 100 may initiate and terminate the freezing of the imaging system 100 at 214 for a desired period of time by interacting with the display 150 in real time using menus on the user interface 160 or GUI 155 (not shown in FIGS. 1 and 2). Alternatively, a timer may be set by the user using the user interface 160 or GUI 155 prior to the start of the protocol 200. Thus, the timer for this freeze of data collection at 214 may be set and activated during configuration of the protocol 200 by the user / operator.

[0041] After the freeze is finished at 214, another loop acquisition is started at 216. In this way. In either case, the user or operator of the imaging system 100 can start another image acquisition loop at 216. Again, the time to start the next loop acquisition at 216 may be indicated on the display 150, or a warning may be provided by the display 150 to signal its completion, or both. Alternatively, a timer may be set by the user prior to the start of the protocol 200 using a menu on the user interface 160 or GUI 155 (not shown in FIGS. 1 and 2). Thus, this timer for the freeze period may be set and started during configuration of the protocol 200 by the user / operator.

[0042] Then, after the duration of the loop acquisition at 216, the loop acquisition ends at 218. The duration of the loop acquisition (illustratively 30 seconds) may be indicated on the display and / or a warning may be provided by the display 150 signaling the end of the duration. In this manner, a user or operator of the imaging system 100 may end the image acquisition loop at 218. Alternatively, a user may set a timer using the user interface 160 or GUI 155 prior to the start of the protocol 200 to end the loop acquisition started at 216 and ended at 218. Thus, the timer for the image acquisition at 218 may be set and activated during configuration of the protocol 200 by the user / operator.

[0043] After completion of the loop acquisition initiated at 216, the protocol 200 continues to the next stage of the imaging sequence. In particular, at 220 the user / operator can proceed to review the acquired images / loops, select a wash-in loop, or annotate images collected during the scan. As will be described more fully below, the user / operator can perform these functions on the display 150, using the user interface 160 or GUI 155, or both.

[0044] After completing the review and other operations at 220, the protocol proceeds to start quantification at 222. Quantification at 222 typically involves launching an internal or external application that analyzes key CEUS images / loops to determine quantification parameters of interest. For example, it may be useful to consider how the time vs. intensity characteristics differ between pixels in healthy tissue and pixels in a lesion of interest. These analyses are used as additional input to a diagnosis or report. Illustratively, a user can initiate quantification by operating the GUI during review or freeze and selecting from a GUI button that launches a quantification toolset with the current loop as input.

[0045] Finally, once quantification at 222 is complete, protocol 200 proceeds to 224 to report the various findings according to a desired reporting protocol, such as Ultrasound Liver Imaging Reporting and Data System (LIRADS), Thyroid Imaging, Reporting and Data System (TIRADS), or Breast Imaging and Reporting Data System (BIRADS), just to name a few. The selected reporting protocol can be set prior to the start of protocol 200 using menus on display 150 (not shown in FIGS. 1 and 2), and user interface 160 or GUI 155, or both. Additionally, reporting can be customized by the user. For example, the user can use the protocol to select a customized version of the TIRADS report based on differences in Asia, if desired. Rather than reviewing the images at 220, it is desirable to cycle through freezes at 214, proceed to loop acquisition at 216, and end loop acquisition at 218. For example, one may wish to extend the examination in loop increments at 214-218 if the contrast has not washed out and there is an incentive to continue sampling the agent's characteristics (e.g., the lesion shows abnormal decay characteristics or the clinician is uncertain about the classification without further observation). The repetition of the sequence beginning with the freeze at 214 can be done in real time using menus on the display 150 (not shown in Figs. 1 and 2) and the user interface 160 or GUI 155, or both. Notably, a delay before repeating the sequence can be added by the user / operator using the display 150, the user interface 160 or GUI 155, or both. Alternatively, the delay can be set a priori. For example, a default protocol may choose to repeat this sequence until the total elapsed time since injection is on the order of 3 to 5 minutes, which is typical for CEUS washout time frames.

[0046] Alternatively, the user / operator may decide to introduce a second injection of contrast agent as shown. This may be done for one of several reasons, such as when the operator believes that the first set of images / loops is not suitable for analysis. Alternatively, if the user / operator discovers additional lesions during the course of the first examination, additional imaging can be performed to further investigate. Repeating the sequence beginning at 206 can be done in real time using menus on the display 150 (not shown in FIGS. 1 and 2) and the user interface 160 or GUI 155, or both.

[0047] 3 is a first time bar display 300 shown on the display 150, comprising a menu 302 for generating a CEUS protocol, according to a representative embodiment. Various aspects and details of the first time bar display 300 on the display 150 and the menu 302 are common to those described above in connection with FIG. 1 and FIG. 2, and may not be repeated to avoid obscuring the description of this representative embodiment. In particular, the first time bar display 300 is an example of a time bar display adapted to change time-based operations during a CEUS imaging examination and provide a visual indication of the next operation on the display 150. Thus, several operations described in connection with FIG. 2 may be selected during generation of a protocol using the menu 302 of the first time bar display 300. These time-based operations include, but are not limited to, changes in ultrasound settings, including one or more of a change in the number of ultrasound signal transmissions, a pulse repetition interval between successive ultrasound signal transmissions, a frequency of the ultrasound signal, a particular type of ultrasound pulse sequence (e.g., pulse inversion and amplitude modulation), and a frame rate of the captured ultrasound image.

[0048] The menu 302 includes a first submenu 304 and a second submenu 306. The first submenu 304 provides a number of options specific to the imaging properties. In generating a protocol, the user / operator selects an option on the first drop-down menu 305. These options include those described above in connection with FIG. 2, including, but not limited to, pre-contrast imaging, loop acquisition during wash-in, first freeze, first loop acquisition in portal phase, second freeze, second loop acquisition in portal phase, frame rate adjustment and gain. As described above, the menu 302, the first submenu 304, and the first drop-down menu 305 are created by the controller 120 through execution of instructions stored in the memory 130 and are modified using the user interface 160, or the GUI 155, or both. Illustratively, the first and second loop acquisitions in the portal vein phase represent two full imaging loops covering the “portal vein phase” of a liver CEUS exam, which is the period during which contrast agent reaches the liver from the hepatic portal vein. In this example, several 30 second loop acquisitions may occur in the same phase, with the numbering simply being sequential (e.g., Portal 1, Portal 2, Late 1, Late 2 represent two loop acquisitions in the portal phase and two loop acquisitions in the late phase).

[0049] The second drop-down menu 307 includes options for timing of actions, including but not limited to start times, end times, and durations of the various actions described in connection with Figure 2. Additionally, the second drop-down menu 307 may include options for modifying the frame rate (number of transmits per frame) and / or transmit line density to conserve contrast agent, depth, inclusion / exclusion of side-by-side tissue criteria, gain, dynamic range, as well as options for modifying other acoustic characteristics of the acquisition relative to the previous protocol event.

[0050] As described above, the second sub-menu 306 and the second drop-down menu 307 are created by the controller 120 through execution of instructions stored in the memory 130 and are modified using the user interface 160 or the GUI 155, or both.

[0051] In particular, the selection of an option from the first drop-down menu 305 causes a second drop-down menu 307 to provide various options for the selected operation of the first drop-down menu 305. For example, the first time bar display 300 shows the selection of "Loop Acquisition-Wash-In" in the first drop-down menu 305. The selection of "Loop Acquisition-Wash-In" on the first drop-down menu 305 causes various options to appear on the second drop-down menu 307 that are useful for the selected operation of the protocol, which in turn provides the ability to select the imaging mode (3D or 2D), the type of acquisition (loop, image, or both), the duration of the selected operation (in this case loop acquisition-wash-in), and the desired portion of the display 150 to be shown during this portion of the protocol. Other options available to the user in the second drop-down menu 307 include many of those mentioned above, including start and end times, as well as the ability to select warnings and prompts to be presented on the display 150 during execution of the instructions of the particular protocol selected. Illustratively, as described in connection with FIG. 4 below, these warnings and prompts are presented on a display so as to be easily accessible for upcoming operations by a user / operator of imaging system 100.

[0052] 4 is a second time bar display 400 on display 150 during real-time acquisition of images, according to a representative embodiment. Various aspects and details of the second time bar display 400 on display 150 are common to those described above in connection with FIGS. 1-3 and may not be repeated to avoid obscuring the description of this representative embodiment. As alluded to above, the various warnings and prompts presented on the second time bar display 400 on display 150, their timing or duration, or both, are selected by the user / operator during generation of the protocol (e.g., using the first time bar display 300 on display 150), are created by execution of instructions stored in memory 130 by controller 120, and are selected using user interface 160 or GUI 155, or both.

[0053] The second time bar display 400 shows a first screen 402 and a second screen 404 with CEUS images 403 and 407, respectively. The first screen 402 and the second screen 404 further comprise a bar 405 that scrolls based on an event or action trigger and timing specifications for an action to be taken by the user operator. As shown in the first screen 402, a first warning 406 is provided to prompt the user / operator to prepare for the next action at a specified time (e.g., 3 seconds) in the generated protocol. As described above, in addition to the display of the first warning 406, an audio warning, or a tactile warning, or both, may accompany the first warning 406. After passing the first warning 406, a first prompt 408 indicates the appropriate time for the user / operator to activate a timer for the action being taken. In this example, the first warning 406 and the first prompt 408 are used to ensure that the image / loop acquisition begins at a specific time during the imaging scan and is performed according to the generated protocol.

[0054] As shown in the second screen 404, a second warning 409 is displayed to prompt the user / operator to terminate image / loop acquisition at a time specified by the protocol (e.g., using the first time bar display 300 on the display 150) and after a selected duration specified by the protocol. As described above, in addition to the display of the first warning 406, an audio warning, or a tactile warning, or both, may accompany the second warning 409. The second warning 409 indicates an appropriate time for the user / operator to terminate the scan according to the protocol. In particular, another warning (not shown) may be provided to alert the user / operator that the end time of the current acquisition is approaching. In this example, the second warning 409 is used to ensure the image / loop acquisition is terminated according to the generated protocol at a specific time during the imaging scan.

[0055] FIG. 5 is a view 500 on the display 150 with a menu 502 showing various images / loops acquired during an imaging sequence, according to a representative embodiment. Various aspects and details of the view 500 on the display 150 and the menu 502 are common to those described above in relation to FIGS. 1-4 and may not be repeated to avoid obscuring the description of this representative embodiment. In particular, the view 500 is an example of a second time bar display 400 adapted to provide access to images / loops acquired during the execution of a CEUS protocol generated using the first time bar display 300 and the second time bar display 400 described above. Thus, the menu 502 of the first time bar display 300 can be used to select several operations described in relation to FIGS. 2-4 during the generation of the protocol. Moreover, the view 500 is also intended for use in both live imaging setup and post-examination review.

[0056] Menu 502 includes a first submenu 504 and a second submenu 506. As will be described more fully below, the first and second submenus 504, 506 allow a user / operator to review the collection and transitions between actions taken during various steps in a protocol that has been generated as described in connection with Figures 2-3 above.

[0057] The first submenu 504 provides a list of actions to be taken during the protocol selected by the user / operator while generating the protocol. The options provided in the first drop-down menu 505 characterize actions. These options include those described above in connection with Figures 2 and 3, including, but are not limited to, selecting images to be acquired in pre-contrast imaging, loop acquisition during wash-in, first freeze, first loop acquisition in portal phase, second freeze, second loop acquisition in another portal phase, third freeze, loop acquisition during first wash-out, fourth freeze, third loop acquisition during wash-out, and quantification. As described above, the menu 502 and the first drop-down menu 505 are created by the controller 120 through execution of instructions stored in the memory 130 and are modified using the user interface 160 or the GUI 155, or both.

[0058] The second drop-down menu 507 includes a list of various parameters for the selected portion of the CEUS imaging scan of the generated protocol. The second drop-down menu 507 includes timings for various actions including, but not limited to, start times, end times, and durations for the various actions selected using the second drop-down menu 307 described in connection with FIG. 3. As described above, the second sub-menu 506 and the second drop-down menu 507 are created by the controller 120 through execution of instructions stored in the memory 130 and are modified using the user interface 160 or the GUI 155, or both. The view 500 also shows selected images 508, 510 from a number of images 512 collected during the selected portion of the protocol. In particular, the view 500 includes a panel showing a number of images 512 collected during the second loop acquisition selected from the first drop-down menu 505.

[0059] View 500 shows loops acquired in sequence during the entire protocol. Images 512 represent thumbnails from loops taken at the previous step through the current step. In one example, the review bar on the right side of view 500 can be configured to display images in time sequence with appropriate labels (e.g., including separate boxes for each phase, or with a line with timing shown next to the thumbnail and a note as to which step in the protocol it was taken from). In a live imaging setup, the right hand elements in image 512 represent past events in the current and / or previous sequence, and selected images 508, 510 represent live images at the current instance of the scan. In this context, the left side of view 500 represents past / current / upcoming events, with checkmarks indicating what has already been completed.

[0060] The user / operator can select images 508, 510 from the images 512 for further review after completion of the protocol. Notably, the images 512 include the time of their acquisition during the protocol, thus allowing the user / operator to select specific images for further review. By way of example only, the buttons can be used to add an indication that these buttons can be used to navigate the protocol. For example, in a live imaging mode, the button 516 to the left of the trackball circle 514 can be used to repeat the previous protocol element, the top center button 518 of the trackball circle 514 can be used to advance to the next protocol element, and the button 520 to the right of the trackball circle 514 can be used to end the exam and proceed to review. If this display were used in review, the same button assignments could be used to navigate between the loops / images taken in the previous and next protocol elements.

[0061] FIG. 6 is a flow diagram illustrating a method 600 of imaging a subject according to a representative embodiment. Various aspects of the method and details of the flow diagram and accompanying method 600 are common to those described above and may not be repeated to avoid obscuring the description of this representative embodiment. Most notably, the method 600 is contemplated to be stored on a tangible non-transitory computer readable medium that stores not only the method but also instructions that, when executed by a processor, cause the processor to execute the method 600. Finally, although the method 600 is contemplated for use in CEUS imaging, the method 600 may be used in other systems to facilitate imaging protocols using menus, user interfaces and / or GUIs on a display, real-time reminders and warnings provided on a display, and image / loop review on a display.

[0062] At 602, the method begins by providing a user interface with an editable protocol adapted to allow a user to select time-based actions and events for an upcoming contrast-enhanced ultrasound (CEUS) examination on a display.

[0063] At 604, the method includes providing a first time bar display adapted to change a time-based action during the CEUS examination and provide a visual indication of the next action on the display.

[0064] At 606, the method includes providing a second time bar display configured to display images and loops acquired during the CEUS examination on the display.

[0065] As will be appreciated by those of skill in the art having the benefit of this disclosure, the systems and methods of the present teachings provide improvements in imaging protocol implementation, such as those used in CEUS imaging. For example, compared to known methods and systems, various aspects of a protocol, including the initiation, duration, and termination of steps in the protocol, can be facilitated during the generation of the protocol, or during the implementation of the protocol, or both. Furthermore, errors that may arise from human interaction with the imaging system can be reduced, thereby reducing the need to repeat procedures and reducing the time required to complete an imaging procedure. Notably, these advantages are exemplary, and other advances in the field of medical imaging will be apparent to those of skill in the art having the benefit of this disclosure.

[0066] Although methods, systems, and components for implementing imaging protocols have been described with reference to certain exemplary embodiments, it should be understood that the words used are words of description and illustration, rather than words of limitation. Changes may be made within the purview of the appended claims without departing from the scope and spirit of the protocol implementations of the present teachings, as presently stated and as amended.

[0067] The foregoing description of the disclosed embodiments is provided to enable those skilled in the art to practice the concepts described in this disclosure. Therefore, the subject matter disclosed above should be considered as illustrative and not limiting, and the appended claims are intended to encompass all such modifications, enhancements, and other embodiments that fall within the true spirit and scope of the present disclosure. Thus, to the maximum extent permitted by law, the scope of the present disclosure should be determined by the broadest permissible interpretation of the following claims and their equivalents, and should not be limited or restricted by the foregoing detailed description.

Claims

1. A display for contrast-enhanced ultrasound (CEUS) examination, comprising a menu with selectable components of an editable protocol adapted to enable a user to select time-based operations and events of a next CEUS examination on the display, a first time bar display adapted to enable the user to change a time-based operation during the CEUS examination and to provide a visual indication of a next operation on the display, a second time bar display adapted to enable the user to display images and loops acquired during the CEUS examination on the display and a display having the same.

2. The display according to claim 1, wherein the time-based operation has image acquisition and / or loop acquisition, and / or the time-based operation has an ultrasound freeze operation and a non-freeze operation.

3. The display according to claim 1, wherein the selected time-based operation comprises changes to one or more of several ultrasound transmissions, a pulse repetition interval between successive ultrasound transmissions, a frequency of the ultrasound signal, an ultrasound pulse sequence, and a frame rate of captured ultrasound images for an ultrasound setting.

4. The display according to claim 3, wherein the time-based operation comprises changes to one or more of several acoustic transmissions, an acoustic signal frequency, and a frame rate of acquisition for an acoustic setting.

5. The display according to claim 1, wherein the selected time-based operations and events are shown during the CEUS examination.

6. The display according to claim 5, wherein the selected time-based operations and events are emphasized by an audio prompt or a tactile prompt.

7. The display according to claim 1, wherein the second time bar display is adapted to link a specific point within the editable protocol with an image or loop acquired during the CEUS examination.

8. A system for medical imaging, comprising the display according to claim 1.

9. A method for controlling an imaging procedure, the method comprising Providing a menu with an editable protocol adapted to enable a user to select time-based operations and events for a next contrast-enhanced ultrasound (CEUS) examination on a display; Providing a first time bar display adapted to change a time-based operation during the CEUS examination and provide a visual indication of the next operation on the display; Providing a second time bar display configured to display images and loops acquired during the CEUS examination on the display A method comprising. **Claim 10**: The method according to claim 9, wherein the time-based operations include ultrasound freeze and non-freeze controls, and / or the user interface comprises a graphical user interface (GUI) adapted to function with the display. **Claim 11**: The method according to claim 9, wherein the selected time-based operations and events are presented during the CEUS examination. **Claim 12**: The method according to claim 11, wherein the selected time-based operations and events are emphasized by an audio prompt or a tactile prompt. **Claim 13**: The method according to claim 9, wherein the second time bar display is adapted to link a specific point within the editable protocol to an image or loop acquired during the CEUS examination, and / or is adapted to provide an image or loop at a specific time of the CEUS examination by navigating between the second time bar displays. A tangible non-transitory computer-readable medium storing instructions which, when executed by a processor, cause the processor to Provide a menu with an editable protocol adapted to enable a user to select time-based operations and events for a next contrast-enhanced ultrasound (CEUS) examination on a display; Provide a first time bar display adapted to change a time-based operation during the CEUS examination and provide a visual indication of the next operation on the display; Provide a second time bar display configured to display images and loops acquired during the CEUS examination on the display A computer-readable medium for causing the execution. **Claim 15**: The tangible non-transitory computer-readable medium according to claim 14, wherein the time-based operation has image acquisition or loop acquisition, or both, and / or the time-based operation has ultrasonic freeze and non-freeze control.

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