Angiographic injection using electrocardiogram gating

Abstract

An infusion system is described that receives a first group of one or more signals from one or more sensors indicating a current volume of infusion fluid dispensed from a fluid reservoir at a first time. The infusion system determines, based on the first group of one or more signals, that a difference between a dose volume limit and the current volume of infusion fluid dispensed from the fluid reservoir at the first time is less than a volume of fluid required to complete both a systolic infusion phase and a diastolic infusion phase. The infusion system further controls the infusion system to refrain from performing either the systolic infusion phase or the diastolic infusion phase in response to determining that the difference is less than a volume of fluid required to complete both the systolic infusion phase and the diastolic infusion phase.

Description

[Technical Field]

[0001] [Related Applications] This application claims priority to U.S. Patent Application No. 16 / 996,083, filed August 18, 2020, the contents of which are incorporated herein by reference.

[0002] [Technical field] FIELD OF THE DISCLOSURE The present disclosure relates to fluid injection systems. [Background technology]

[0003] Many medical imaging procedures, such as angiography, involve the injection of a contrast fluid into a patient. Angiography is a procedure used to diagnose and treat conditions of the circulatory system, including abnormalities or restrictions in blood vessels. During angiography, radiological images of the heart or vascular structures are obtained by injecting a contrast fluid into a patient's blood vessels (e.g., coronary arteries) through a catheter. The injected contrast fluid is able to pass through vascular structures that are in fluid communication with the blood vessel into which it is injected. X-rays are directed at the area of ​​the body into which the contrast fluid is injected. The X-rays are absorbed by the contrast fluid, forming a radiographic outline or image of the blood vessels containing the contrast fluid. Contrast injection can also be used in conjunction with other medical procedures, such as optical coherence tomography (OCT) imaging, intravascular ultrasound (IVUS) imaging, computed tomography (CT) imaging, magnetic resonance imaging (MRI), and interventional device procedures / placement. Summary of the Invention

[0004] In general, the present disclosure describes techniques for synchronizing angiographic injection with an electrocardiogram (ECG) to optimize injection fluid usage. For example, an injection system can read data indicative of an ECG and determine when diastole begins. When diastole begins, the injection system begins injecting fluid into the patient according to the diastolic injection phase (e.g., at a first rate corresponding to the diastolic injection phase and for the entire duration of diastole). From that point on in the angiographic session, the injection system determines whether the difference between a dispensed volume limit (e.g., the maximum amount of fluid that can be injected into the patient in one injection) and the current volume of injection fluid already dispensed from the fluid reservoir is large enough to complete both the systolic and diastolic injection phases while adhering to the dispensed volume limit after completion of the previous diastolic injection phase. If the injection system determines that there is a sufficient difference below the dispensed volume limit to complete both the systolic and diastolic injection phases, the injection system proceeds to perform the systolic and diastolic injection phases immediately after completing the previous diastolic injection phase. Conversely, if the infusion system determines that too much infusion fluid has already been administered and that the infusion system cannot complete both the next systolic infusion phase and the next diastolic infusion phase, even if it is below the administration volume limit (e.g., the difference is such that the systolic infusion phase can be completed but not the diastolic infusion phase, or such that neither phase can be completed), the infusion system will refrain from administering either the systolic or diastolic infusion phase.

[0005] The techniques described herein have several advantages. For example, lower pressure during the diastolic phase facilitates the infusion fluid reaching its intended destination within the patient. Thus, infusing infusion fluid at a higher rate during diastole and a lower rate during systole is a more efficient use of infusion fluid. For this same reason, initiating infusion at the beginning of diastole to maximize the benefits of the lower diastolic pressure is the most efficient use of infusion fluid. Additionally, by verifying that a subsequent diastolic injection phase can be completed within the dose volume limit before performing a preceding systolic injection phase, the infusion system will not waste fluid by performing a systolic injection phase when the benefits of the diastolic injection phase cannot be completed. In this way, waste caused by infusing fluid into a patient when a more valuable injection cannot be completed is avoided, and that amount can instead be saved for a future injection. In this way, the techniques described herein maximize the amount of infusion fluid that can be used during diastole while avoiding waste during other phases where the infusion fluid is less useful or during phases where the infusion system is unable to complete the entire injection. The techniques described herein involve injecting fluid throughout diastole and during intermittent systole, but not at other times during the cardiac cycle.

[0006] In one example, the present disclosure relates to an infusion system including a fluid reservoir configured to store an infusion fluid. The infusion system also includes one or more sensors configured to measure a volume of the infusion fluid administered from the fluid reservoir. The infusion system further includes one or more processors configured to receive a first group of one or more signals from the one or more sensors indicating a current volume of the infusion fluid administered from the fluid reservoir at a first time. The one or more processors are also configured to determine, based on the first group of one or more signals, that a first difference between a dosage volume limit and the current volume of the infusion fluid administered from the fluid reservoir at the first time is less than a volume of fluid required to complete both a systolic injection phase and a diastolic injection phase. The one or more processors are further configured to control the infusion system to refrain from performing either the systolic injection phase or the diastolic injection phase in response to determining that the first difference is less than a volume of fluid required to complete both the systolic injection phase and the diastolic injection phase.

[0007] In another example, the present disclosure relates to a method that includes receiving, by one or more processors of an infusion system, a first group of one or more signals from one or more sensors indicating a current volume of infusion fluid dispensed from a fluid reservoir at a first time. The method also includes determining, by the one or more processors based on the first group of signals, that a first difference between a dispense volume limit and the current volume of infusion fluid dispensed from the fluid reservoir at the first time is less than a volume of fluid required to complete both a systolic injection phase and a diastolic injection phase. The method further includes refraining from performing either the systolic injection phase or the diastolic injection phase in response to determining that the first difference is less than a volume of fluid required to complete both the systolic injection phase and the diastolic injection phase.

[0008] In another example, the present disclosure relates to a non-transitory computer-readable storage medium including instructions that, when executed, cause one or more processors of an infusion system to receive a first group of one or more signals from one or more sensors indicating a current volume of infusion fluid dispensed from a fluid reservoir at a first time. The instructions further cause the one or more processors to determine, based on the first group of one or more signals, that a difference between a dispense volume limit and the current volume of infusion fluid dispensed from the fluid reservoir at the first time is less than a volume of fluid required to complete both a systolic injection phase and a diastolic injection phase. The instructions also cause the one or more processors to control the infusion system to refrain from performing either the systolic injection phase or the diastolic injection phase in response to determining that the difference is less than the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase.

[0009] In another example, the present disclosure relates to a non-transitory computer-readable storage medium including instructions that, when executed, cause one or more processors of an injection system to receive two or more injection characteristic inputs, where the two or more injection characteristic inputs include at least an input for a number of images to be taken and image quality. The instructions further cause the one or more processors to determine, based on the two or more injection characteristic inputs, an injection schedule including a first flow rate for the injection fluid during a diastolic injection phase and a second flow rate for the injection fluid during a systolic injection phase. The injection schedule includes an initial diastolic injection phase and one or more systolic / diastolic injection phase pairs, each of the one or more systolic / diastolic injection phase pairs including a full systolic injection phase and a full diastolic injection phase, the injection schedule terminating with a full diastolic injection phase portion of one of the one or more systolic / diastolic injection phase pairs, and the first flow rate during each diastolic injection phase is based at least in part on the image quality input. The instructions also cause the one or more processors to control the infusion system to infuse the infusion fluid from a fluid reservoir of the infusion system into the patient's body according to an infusion schedule.

[0010] The details of one or more examples of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the disclosure will become apparent from the description and drawings, and from the claims. [Brief explanation of the drawings]

[0011] [Figure 1] 1 shows a perspective view of one embodiment of a powered fluid injector in accordance with one or more aspects of the techniques described in this disclosure. [Figure 2] FIG. 2 is a block diagram illustrating a more detailed example of an injection system configured to perform the techniques described herein. [Figure 3A-E] 1 is an exemplary electrocardiogram shown with an injection schedule superimposed thereon according to conventional angiography techniques. [Figure 4] 1 is an exemplary electrocardiogram shown with an angiography injection schedule overlaid thereon, in accordance with one or more techniques described herein. [Figure 5] 1 is a flowchart illustrating an exemplary angiography injection process for an injection system configured to synchronize injection with an electrocardiogram, in accordance with one or more aspects of the techniques described in this disclosure. [Figure 6] 1 is a flowchart illustrating an exemplary angiography injection process for an injection system configured to synchronize an injection schedule with an electrocardiogram, in accordance with one or more aspects of the techniques described in this disclosure. DETAILED DESCRIPTION OF THE INVENTION

[0012] FIG. 1 is a perspective view of one embodiment of a powered fluid injector 100. In operation, the powered fluid injector 100 can inject a volume of fluid into a patient, for example, via a catheter into the patient's blood vessels. The fluid injected by the powered fluid injector 100 can be, for example, a contrast fluid, a non-contrast fluid (e.g., saline solution), or a combination thereof. By injecting a volume of fluid into a patient, the powered fluid injector 100 can facilitate various medical diagnostic and / or interventional procedures, including the collection of image data representative of an anatomical region of interest. These procedures can include, by way of example, optical coherence tomography (OCT) imaging, intravascular ultrasound (IVUS) imaging, computed tomography (CT) imaging, magnetic resonance imaging (MRI), angiography procedures, and interventional device procedures / placements.

[0013] The illustrated powered fluid injector 100 includes a drive assembly housing 102 (also referred to herein as an “injector housing”) and a sleeve 104. The sleeve 104 can be secured to the drive assembly housing 102. For example, the drive assembly housing 102 can include an opening, and the sleeve 104 can be secured to the drive assembly housing 102 at or near such opening. The sleeve 104 can extend from the drive assembly housing 102 and can be configured to receive and hold a reservoir 106 (also referred to herein as a “fluid reservoir”). The reservoir 106 can have an internal reservoir volume containing a fluid and can include a plunger 108 within the internal reservoir volume. The plunger 108 can be made from various components, including a wiper configured to be movable proximally and distally within the fluid reservoir 106, and a ram. The ram extends from the drive assembly housing 102 into the sleeve 104 and is configured to engage the wiper when the fluid reservoir 106 is received and secured within the sleeve 104, and to drive the wiper proximally and distally according to commands received from a controller 110 coupled to the drive assembly housing 102. At least a portion of the drive assembly may be housed within the drive assembly housing 102.

[0014] The drive assembly can be configured to pressurize the fluid within the internal reservoir volume. For example, the drive assembly can be coupled to plunger 108, such as through an opening in drive assembly housing 102, and can drive plunger 108 within the internal reservoir volume. As plunger 108 is driven forward within fluid reservoir 106, the fluid within the internal reservoir volume can be output from fluid reservoir 106 along tubing 109 that leads to a catheter 126 that is inserted into a patient's blood vessel and injects the fluid into the vascular system. In one application of powered fluid injector 100, the output fluid, such as a contrast agent, can be pressurized in the range of 1000-1500 psi (e.g., 1200 psi).

[0015] The illustrated embodiment of the powered fluid injector 100 includes several features that may be useful for pressurizing and delivering fluid during operation. The powered fluid injector 100 may include a controller 110. The controller 110 may include a user interface for various aspects of operation. For example, the controller 110 may be used by a user to set various parameters and / or protocols to be used for a given fluid injection procedure. In one embodiment, a user may interact with the controller 110 to input fluid injection parameters, such as flow rate, injection volume (e.g., maximum), injection pressure limit (e.g., maximum), fluid injection duration, rise time, and / or other injection parameters. In one embodiment, the controller 110 includes a touchscreen panel display, allowing the user to view and modify injection parameters. The controller 110 may also be used to initialize the powered fluid injector 100 (e.g., to prepare a patient for fluid injection) or to initiate certain features or sequences of operation. The controller 110 may also provide status information, including information related to past or currently ongoing injection procedures and any appropriate warnings. Controller 110 may include an image engine with one or more processors to control the operation of powered fluid injector 100. Such processors may also control other components, such as the drive assembly, peristaltic pump 112, if present, and / or any sensors and detectors included in powered fluid injector 100.

[0016] In addition to the controller 110, the illustrated powered fluid injector 100 includes a hand control 113 for user input. The hand control 113 can be coupled to the powered fluid injector 100 and the controller 110 via either a wireless or wired connection. As such, the hand control 113 connects to the drive assembly housing 102. In other embodiments, the hand control 113 can connect directly to the controller 110. The hand control 113 can generate and transmit various signals related to the injection procedure to the controller 110 or other connected components. A user can control the injection procedure by actuating one or more interface components on the hand control 113. For example, a user can use the hand control 113 as a variable speed control to change the fluid flow rate output from the powered fluid injector 100 and / or as a mechanism to start or stop fluid injection. The hand control 113 can include a controller housing sized to be held in one of a user's hands. In other examples, the hand control device 113 can be sized to be held in both hands of a user or to rest on a surface during operation.

[0017] The powered fluid injector 100 may also include one or more components useful for supplying fluids used in an injection procedure. A container 114 may contain a supply of fluid, such as a contrast agent, and may be secured to the powered fluid injector 100 with a holder 116. Fluid from the container 114 may be supplied to the fluid reservoir 106 for use during an injection procedure. For example, fluid from the container 114 may be drawn into the fluid reservoir 106 when the plunger 108 is retracted, thereby refilling the internal reservoir volume. Similarly, if the powered fluid injector 100 includes a peristaltic pump 112, a second container 118 may contain a supply of fluid, such as a flushing medium (e.g., saline solution), and may be secured to the powered fluid injector 100 with a holder 120. If present, the peristaltic pump 112 may receive fluid from the second container 118 and deliver such fluid to the patient. Often, peristaltic pump 112 may be used to deliver a non-contrast fluid, such as saline solution, at a lower pressure than the pressure at which the drive assembly delivers the contrast fluid from fluid reservoir 106. A valve system 124 may be included to selectively place either fluid reservoir 106 or peristaltic pump 112 in communication with the patient.

[0018] As described elsewhere herein, the controller 110 of the powered fluid injector 100 may control various functions of the powered fluid injector 100, which may include administering contrast fluid out through a tube. In some embodiments, the controller 110 may be housed within the display device housing. In some embodiments, the controller may be housed within the injector housing.

[0019] The powered fluid injector 100 may be fluidly and electrically connected to a catheter 126 that is inserted into a patient's blood vessel (e.g., a coronary artery). When so connected, the powered fluid injector 100 may inject contrast fluid (of various concentrations) or administer non-contrast fluid into the patient's vasculature via the injector tubing and catheter 126. In many embodiments, the catheter 126 may include an invasive blood pressure sensor. The blood pressure sensor may be in electrical communication with the controller 110 when the powered fluid injector 100 is connected to the catheter 126. The blood pressure sensor may provide a blood pressure signal to the controller 110 when the catheter 126 is fluidly connected to the powered fluid injector 100 and may not provide a blood pressure signal when the catheter 126 is not fluidly connected to the powered fluid injector 100.

[0020] In accordance with the techniques described herein, the infusion system 100 may be modified to perform one or more of the techniques described herein. For example, the infusion system 100 may receive a first group of one or more signals from one or more sensors configured to read the fluid level in the fluid reservoir 106, the first group of signals indicating a current volume of infusion fluid administered at a first time from the fluid reservoir 106. Based on the first group of one or more signals, the infusion system 100 may determine whether a first difference between a dose volume limit and the current volume of infusion fluid administered at the first time from the fluid reservoir 106 is less than a volume of fluid required to complete both a systolic infusion phase (e.g., injecting infusion fluid into the patient at a reduced rate throughout the patient's contraction) and a diastolic infusion phase (e.g., injecting infusion fluid into the patient at a higher rate throughout the patient's expansion). If the infusion system 100 determines that there is a sufficiently large difference between the dose volume limit and the current volume of infusion fluid dispensed from the fluid reservoir 106, indicating that the infusion system 100 can complete both the next systolic injection phase and the next diastolic injection phase, the infusion system 100 may proceed to perform both the next systolic injection phase and the next diastolic injection phase. Conversely, in response to determining that the first difference is less than the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase, the infusion system 100 refrains from performing either the systolic injection phase or the diastolic injection phase. In other words, if there is not enough fluid such that the infusion system 100 cannot complete both the next systolic injection phase and the next diastolic injection phase while still complying with the dose volume limit, the infusion system 100 will not perform either the next systolic injection phase or the next diastolic injection phase, but instead will stop the injection process upon completion of the previous diastolic injection phase.

[0021] The injection system 100 can also receive inputs that the injection system can use to define an injection schedule that similarly refrains from performing partial systolic or diastolic injection phases if those phases cannot be completed under required criteria. For example, the injection system 100 can receive two or more injection characteristic inputs, such as inputs for the number and image quality of images to be taken. The injection system 100 can also determine an injection schedule based on the two or more injection characteristic inputs, including a first flow rate for the injection fluid during the diastolic injection phase and a second flow rate for the injection fluid during the systolic injection phase. The injection schedule can also include an initial diastolic injection phase and one or more systolic / diastolic injection phase pairs, each of which includes a full systolic injection phase and a full diastolic injection phase. The injection schedule ends with a full diastolic injection phase portion of one of the one or more systolic / diastolic injection phase pairs. The first flow rate during the diastolic injection phase is based at least in part on the image quality input. The infusion system 100 is capable of infusing an infusion fluid from a fluid reservoir of the infusion system into the patient's body according to an infusion schedule.

[0022] Implementing the techniques described herein in a powered fluid injector 100 as described herein provides several benefits. For example, the lower pressure during the diastolic phase facilitates the injectate fluid reaching its intended destination within the patient when injected by the powered fluid injector 100. Thus, injecting the injectate fluid at a higher rate during the diastolic phase and at a slower rate during the systolic phase is a more efficient use of the injectate fluid. For this same reason, initiating the injection at the beginning of the diastolic phase to maximize the benefits of the lower diastolic pressure is the most efficient use of the injectate fluid. Additionally, by verifying that a subsequent diastolic injection phase can be completed within the administration volume limit before performing the preceding systolic injection phase, the powered fluid injector 100 will not waste fluid by performing a systolic injection phase when the benefits of the diastolic injection phase cannot be completed, while also enhancing patient safety by ensuring that the administration volume limit is not exceeded. In this way, waste caused by injecting fluid into a patient when a more valuable injection cannot be completed is avoided, and that amount can instead be saved for a future injection. In this manner, the techniques described herein maximize the amount of injection fluid that can be used during diastole while eliminating waste during other phases where injection fluid is less useful or during phases where the powered fluid injector 100 cannot complete all of the injection.

[0023] Figure 2 is a block diagram illustrating an example of a computing device configured to synchronize an angiography injection schedule with an electrocardiogram, in accordance with one or more aspects of the techniques described in this disclosure. The injection system 100 of Figure 2 is described below as an example of the injection system 100 of Figure 1. Figure 2 illustrates only one specific example of the injection system 100; many other embodiments of the injection system 100 may be used in other examples, may include a subset of the components included in the example injection system 100, or may include additional components not shown in Figure 2.

[0024] 2, the infusion system 100 includes a user interface device (UID) 212, one or more processors 240, one or more communication units 242, one or more input components 244, one or more output components 246, and one or more storage components 248. The UID 212 includes a display component 202. The storage component 248 of the infusion system 100 includes a stage detection module 220, an infusion module 222, and an electrocardiogram data store 226.

[0025] The one or more processors 240 may implement functionality and / or execute instructions for the infusion system 100 to dynamically expand interface elements for applications displayed on the UID 212 of the infusion system 100. That is, the processor 240 may implement functionality and / or execute instructions for the infusion system 100 in accordance with the techniques described herein in a manner that refrains from performing a partial injection in order to synchronize an angiography injection with the patient's electrocardiogram.

[0026] Examples of processor 240 include an application processor, a display controller, an auxiliary processor, one or more sensor hubs, and any other hardware configured to function as a processor, processing unit, or processing device. Modules 220 and 222 can be operated by processor 240 to perform various operations, operations, or functions of injection system 100. For example, processor 240 of injection system 100 can retrieve and execute instructions stored by memory component 248, such that processor 240 can perform the operations described with respect to modules 220 and 222. The instructions, when executed by processor 240, can cause injection system 100 to synchronize angiography injection with the patient's electrocardiogram in accordance with the techniques described herein in a manner that refrains from performing partial injections.

[0027] The stage detection module 220 may perform operations to manage the electrocardiogram data 226, such as to synchronize angiography injection to follow various diastolic and systolic phases present in the electrocardiogram data 226 during a time period defined by the electrocardiogram data 226. For example, the stage detection module 220 of the injection system 100 may receive the electrocardiogram data 226, analyze the electrocardiogram data 226 to separate various diastolic and systolic phases present in the electrocardiogram data, and analyze the diastolic and systolic phases to determine one or more representative characteristics of the diastolic and systolic phases for a particular patient.

[0028] The infusion module 222 of the infusion system 100 can perform operations to control the infusion and various characteristics of the infusion provided by the infusion system 100. For example, the infusion module 222 can control when an infusion begins, when an infusion ends, and various infusion flow rates, in addition to making other decisions regarding fluid infusion, as described throughout this disclosure.

[0029] In some examples, the stage detection module 220 and the infusion module 222 may execute locally (e.g., on the processor 240) to provide functionality related to the infusion system 100. In some examples, the stage detection module 220 and the infusion module 222 may act as an interface to remote services accessible to the infusion system 100.

[0030] One or more storage components 248 within the infusion system 100 may store information for processing during operation of the infusion system 100 (e.g., the infusion system 100 may store data accessed by modules 220 and 222 during execution of the infusion system 100). In some embodiments, the storage components 248 are temporary, meaning that the primary purpose of the storage components 248 is not long-term storage. The storage components 248 on the infusion system 100 may be configured as volatile memory for short-term storage of information and therefore do not retain their contents when power is removed. Examples of volatile memory include random access memory (RAM), dynamic random access memory (DRAM), static random access memory (SRAM), and other forms of volatile memory known in the art.

[0031] In some embodiments, the storage component 248 also includes one or more computer-readable storage media. In some embodiments, the storage component 248 includes one or more non-transitory computer-readable storage media. The storage component 248 may be configured to store a larger amount of information than typically stored by volatile memory. The storage component 248 may also be configured for long-term storage of information as non-volatile memory space and may retain information after power on / off cycles. Examples of non-volatile memory include magnetic hard disks, optical disks, floppy disks, flash memory, or forms of electrically programmable memory (EPROM) or electrically erasable and programmable memory (EEPROM). The storage component 248 may store program instructions and / or information (e.g., data) associated with the modules 220 and 222 and the data store 226. The storage component 248 may include memory configured to store data or other information associated with the modules 220 and 222 and the data store 226.

[0032] The electrocardiogram data 226 may be any data indicative of a patient's electrocardiogram. In some examples, the electrocardiogram data 226 may be numerical data indicative of electrical impulses measured or recorded by multiple electrocardiogram leads, such as the electrocardiogram leads 254. In other examples, the electrocardiogram data 226 may be images of an electrocardiogram that are analyzed through graphical analysis performed by the stage detection module 220. In yet other examples, rather than the electrocardiogram leads 254 being a mechanical part of the infusion system 100, the electrocardiogram leads 254 may be communicatively coupled to the infusion system 100 via a hemodynamic system to facilitate communication therebetween.

[0033] Communication channel 250 may interconnect (physically, communicatively, and / or operationally) each of components 212, 240, 242, 244, 246, 248, and 254 for inter-component communication. In some embodiments, communication channel 250 may include a system bus, a network connection, an inter-process communication data structure, or any other method for communicating data.

[0034] The one or more communication units 242 of the infusion system 100 can communicate with external devices over one or more wired and / or wireless networks by transmitting and / or receiving network signals on one or more networks. Examples of the communication unit 242 include a network interface card (e.g., an Ethernet card, etc.), an optical transceiver, a radio frequency transceiver, a GPS receiver, or any other type of device capable of transmitting and / or receiving information. Other examples of the communication unit 242 may include a shortwave radio, a cellular data radio, a wireless network radio, and a universal serial bus (USB) controller.

[0035] One or more input components 244 of the infusion system 100 can receive input. Examples of input include tactile, audio, and video input. The input components 244 of the infusion system 100, in one example, include a presence-sensing input device (e.g., a touch-sensitive screen, PSD), a mouse, a keyboard, a voice response system, a camera, a microphone, or any other type of device for detecting input from a human or machine. In some examples, the input components 244 may include one or more sensor components 252, one or more position sensors (e.g., a GPS component, a Wi-Fi component, a cellular component), one or more temperature sensors, one or more motion sensors (e.g., an accelerometer, a gyro), one or more pressure sensors (e.g., a barometer), one or more ambient light sensors, and one or more other sensors (e.g., an infrared proximity sensor, a hygrometer sensor, etc.). Other sensors may include a heart rate sensor, a magnetometer, a glucose sensor, an olfactory sensor, a compass sensor, a step counter sensor, to name a few other non-limiting examples.

[0036] The sensor 252 may also include a fluid sensor either in communication with or incorporated within the fluid reservoir 106. In this manner, the sensor 252 may measure the current volume of infusion fluid in the fluid reservoir 106 and may send one or more signals to the infusion module 222 indicative of the determined current volume.

[0037] One or more output components 246 of the infusion system 100 can generate output in a selected manner. Examples of the manner may include tactile notification, audible notification, visual notification, machine-generated voice notification, or other manner. In one example, the output components 246 of the infusion system 100 include a presence-sensitive display, a sound card, a video graphics adapter card, a speaker, a cathode ray tube (CRT) monitor, a liquid crystal display (LCD), or any other type of device for generating output to a human or machine in a selected manner.

[0038] The UID 212 of the infusion system 100 may include a display component 202. The display component 202 may be a screen on which information (e.g., a visual display) is displayed by the UID 212. The display component 202 may also detect objects at and / or near the display component 202, such as a presence-aware display.

[0039] Although shown as an internal component of infusion system 100, UID 212 may also represent an external component that shares a data path with infusion system 100 for transmitting and / or receiving inputs and outputs. For example, in one example, UID 212 represents an embedded component of infusion system 100 (e.g., a screen on a cell phone) that is located within and physically connected to the exterior of infusion system 100. In another example, UID 212 represents an external component of infusion system 100 (e.g., a monitor, projector, etc. that shares a wired and / or wireless data path with infusion system 100) that is located outside and physically separated from the exterior or housing of infusion system 100.

[0040] The UID 212 of the infusion system 100 can detect two-dimensional and / or three-dimensional gestures as input from a user of the infusion system 100. For example, a sensor of the UID 212 can detect user movement (e.g., movement of a hand, arm, pen, stylus, tactile object, etc.) within a threshold distance of the sensor of the UID 212. The UID 212 can determine a two-dimensional or three-dimensional vector representation of the movement and correlate the vector representation to a gesture input having multiple dimensions (e.g., a wave, a pinch, a clap, a pen stroke, etc.). In other words, the UID 212 can detect multi-dimensional gestures without requiring the user to gesture on or near a screen or surface on which the UID 212 outputs information for display. Instead, the UID 212 can detect multi-dimensional gestures made on or near a sensor that may or may not be located near a screen or surface on which the UID 212 outputs information for display.

[0041] Although not necessarily included in all embodiments of the infusion system 100, in some embodiments the infusion system 100 may also include electrocardiogram leads 254. In such embodiments, the electrocardiogram leads 254 may be electrodes configured to be attached to a patient to develop an electrocardiogram of the patient, such as to generate electrocardiogram data 226. The electrocardiogram leads 254 may thus provide the electrocardiogram data 226 to the infusion system 100, enabling the infusion system 100 to perform the techniques described herein in a self-contained environment and in real time. In other examples, the communications unit 242 may receive the electrocardiogram data 226 from another server, system, or database external to the infusion system 100, such as a hemodynamic system coupled to the infusion system 100 and the electrocardiogram leads 254.

[0042] In accordance with the techniques described herein, in some examples, the injection module 222 can control the injection system 100 to perform an initial diastolic injection phase. The injection module 222 can control the injection system 100 in this manner in response to receiving a user input instruction via the input component 244 to initiate a fluid injection process. The phase detection module 220 can then detect the onset of diastole based on the patient's electrocardiogram data 226. In response to the phase detection module 220 detecting the onset of diastole, the injection module 222 controls the injection system 100 to begin injecting injection fluid from the fluid reservoir according to the initial diastolic injection phase.

[0043] After the first diastolic injection phase and after all subsequent diastolic injection phases, the injection module 222 may receive from the sensor 252 a first group of one or more signals indicating the current volume of injection fluid dispensed from the fluid reservoir 106 at a first time. This current volume dispensed from the fluid reservoir 106 may represent the amount of fluid that the injection system 100 has already dispensed into the current patient in the current injection. Based on the first group of one or more signals, the injection module 222 may determine whether a first difference between the dosage volume limit and the current volume of injection fluid dispensed from the fluid reservoir 106 at the first time is less than the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase. The dosage volume limit may be either predefined or user-defined as the maximum amount of injection fluid that may be dispensed from the injection system 100 into the patient during any one injection. Because exceeding this dosage volume limit may have adverse effects on the patient, users of the injection system are encouraged not to exceed this dosage volume limit when imaging a portion of the patient.

[0044] In some examples, the injection module 222 may determine, based on the first group of one or more signals, that a first difference between the dose volume limit and the current volume of injection fluid administered at a first time from the fluid reservoir 106 is not less than the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase. In such examples, in response to determining that the first difference is greater than or equal to the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase, the injection module 222 controls the injection system 100 to perform both the systolic injection phase and the diastolic injection phase.

[0045] When performing the systolic injection phase and the diastolic injection phase, the phase detection module 220 can detect the onset of systole from the patient's electrocardiogram data 226. In response to the phase detection module 220 detecting the onset of systole, the injection module 222 controls the injection system to begin injecting the injection fluid from the fluid reservoir into the patient at a first rate, as defined by the systolic injection phase. The phase detection module 220 can then detect the end of systole and the onset of diastole from the patient's electrocardiogram data 226. In response to the phase detection module 220 detecting the onset of diastole, the injection module 222 controls the injection system 100 to stop injecting the injection fluid according to the first rate and begin injecting the injection fluid from the fluid reservoir at a second rate different from the first rate. The second rate corresponds to the diastolic injection phase and is defined by the diastolic injection phase.

[0046] The first rate of injection during the systolic injection phase may be less than the second rate of injection during the diastolic injection phase. The blood pressure during systole is greater than the blood pressure during diastole. Thus, to take advantage of the relative ease of pushing the injection fluid into the correct location at lower blood pressures compared to higher blood pressures during systole, the injection module 222 may control the injection system 100 to inject fluid at a greater rate during the diastolic injection phase than during the systolic injection phase. For example, the fluid injection rate during systole may be a percentage of the fluid injection rate during diastole. In some examples, the fluid flow rate during systole may be zero. In some examples, the fluid flow rate during systole may vary between the start of systole and the end of systole (e.g., ramping down from a higher diastolic rate at the start of systole to a minimum, then ramping up again toward a higher diastolic rate at the end of systole). Similarly, the fluid flow rate during diastole may vary between the start of diastole and the end of diastole.

[0047] The injection module 222 can calculate the diastolic injection rate for the diastolic injection phase based on a number of factors. These factors can include at least the dose volume limit, the user-defined flow rate, the number of diastolic cycles to be imaged, and the image quality level. For example, if the dose volume limit is 6 mL of fluid and the user desires to be imaged for at least three diastolic cycles, the injection module 222 can adjust the diastolic injection rate so that enough fluid remains at the 6 mL volume limit to complete at least three diastolic injection phases.

[0048] The stage detection module 220 can determine the beginning and end of systole and diastole through analysis of the electrocardiogram data 226. For example, systole occurs when the heart muscle contracts, thereby pushing blood out of the heart. Systole is indicated in an electrocardiogram, such as the examples of FIGS. 3A-3E and 4, by a short, sudden rise in blood pressure, as shown by the peak of the electrocardiogram. Diastole, on the other hand, occurs when the heart muscle relaxes, allowing blood to fill the chambers of the heart. Diastole is indicated in the electrocardiogram by a longer period of relatively steady or gradual slope. The stage detection module 220 can analyze the electrocardiogram data 226 to determine when the patient is experiencing systole and when the patient is experiencing diastole.

[0049] If real-time electrocardiogram data is not available, the stage detection module 220 can determine the patient's previous diastolic and systolic characteristics and use that information in the stage detection aspects of the present disclosure. For example, the stage detection module 220 can determine the patient's average systolic and diastolic lengths based on either numerical or graphical data present in the electrocardiogram data 226. In such an example, the stage detection module 220 can use the average time lengths to determine when to switch between the systolic and diastolic injection stages. For example, after detecting the onset of systole, the stage detection module 220 can determine that an amount of time equal to the average systolic length has elapsed since detecting systole.

[0050] The injection module 222 can also determine the first rate and the second rate based on the electrocardiogram data 226. For example, the injection module 222 can determine that a certain amount of injection fluid should be injected into the patient during the patient's diastole and / or systole. Using the corresponding diastolic or systolic average lengths calculated by the phase detection module 220, the injection module 222 can determine the correct rate for the diastolic injection phase and / or the systolic injection phase by dividing the determined amount of injection fluid to be injected into the patient by the average length of the corresponding phase.

[0051] Conversely, the injection module 222 may determine, based on the first group of one or more signals, that the first difference is less than the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase. In response to determining that the first difference is less than the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase, the injection module 222 may control the injection system 100 to refrain from performing either the systolic injection phase or the diastolic injection phase.

[0052] In one or more additional embodiments, in addition to or instead of the techniques described above with respect to FIG. 2 , the injection module 222 can receive inputs and use those inputs to define an injection schedule that also refrains from performing partial systolic or diastolic injection phases if those phases cannot be completed under required criteria. For example, the injection module 222 can receive two or more injection characteristic inputs, such as the number and image quality of images to be taken. Additional injection characteristic inputs can include a maximum injection flow rate, a dose volume limit, an injection force ratio, an average diastolic length, and an average systolic length. In some examples, the image quality input can specify the flow rate of the injection fluid during the diastolic injection phase, because the flow rate of the injection fluid affects how bright or dark the corresponding image will be. In some examples, the image quality input can be a value on a scale (e.g., 10 being the best quality and 1 being the worst quality) or other subjective image quality input. In such examples, the injection module 222 can determine the flow rate of the injection fluid during the diastolic injection phase based on the image quality input and one or more anatomical characteristics of the patient.

[0053] The injection module 222 can also determine an injection schedule based on two or more injection characteristic inputs, including a first flow rate for the injection fluid during a diastolic injection phase and a second flow rate for the injection fluid during a systolic injection phase. The second flow rate may be a smaller percentage than the first flow rate. The injection schedule can also include an initial diastolic injection phase and one or more systolic / diastolic injection phase pairs, each of which includes a complete systolic injection phase and a complete diastolic injection phase. In some examples, the number of images taken can be correlated to the number of diastolic injection phases (e.g., one image can be taken during each diastolic injection phase). The injection schedule ends with a complete diastolic injection phase portion of one of the one or more systolic / diastolic injection phase pairs. The first flow rate during the diastolic injection phase is based at least in part on the image quality input.

[0054] In some examples, the injection module 222 can further adjust the injection schedule based on a maximum injection limit of the injection fluid so that the total volume of injection fluid administered according to the injection schedule is less than or equal to the maximum injection limit. In doing so, the injection module 222 can remove one or more systolic / diastolic injection phase pairs if the total volume of injection fluid administered according to the injection schedule is greater than the maximum injection limit until the total volume of injection fluid used during the first diastolic injection phase and the remaining systolic / diastolic injection phase pairs is less than or equal to the maximum injection limit. The maximum injection limit can be an organizationally or personally set limit on the amount of injection fluid that can be injected into a patient during an imaging session while still being safe for the patient.

[0055] The injection module 222 can inject the injection fluid from the fluid reservoir of the infusion system into the patient's body according to an injection schedule. In some examples, the injection module 222 can control the infusion system 200 to initiate a pilot injection to increase the fluid pressure within the infusion system 200 before initiating the injection according to the initial diastolic injection phase.

[0056] In some examples, when controlling the infusion system 200 to inject the infusion fluid, during each systolic / diastolic infusion phase pair, the stage detection module 220 can detect the onset of systole from the patient's electrocardiogram. In response to the stage detection module 220 detecting the onset of systole, the infusion module 222 can control the infusion system to begin infusing the infusion fluid from the fluid reservoir into the patient at a second rate. The stage detection module 220 can then detect the end of systole and the onset of diastole from the patient's electrocardiogram. In response to the stage detection module 220 detecting the onset of diastole, the infusion module 222 can control the infusion system 200 to stop infusing the infusion fluid at the first rate and begin infusing the infusion fluid from the fluid reservoir at the first rate. In some examples, when detecting a change between systole and diastole, the stage detection module 220 can receive data representing the electrocardiogram and determine the patient's average systolic length based on the data representing the electrocardiogram. After detecting the onset of systole, the stage detection module 220 may determine that an amount of time equal to the average systolic length has elapsed since detecting systole.

[0057] 3A-3E are exemplary electrocardiograms 300A-300E shown with an overlaid injection schedule according to conventional angiography techniques. The example in FIG. 3A depicts a conventional injection method that delivers a predetermined volume of fluid at a continuous rate. The total volume of fluid is delivered during injection phase 312A without regard to systolic phases 302A-302E or diastolic phases 304A-304D. Injection phase 312A begins at time 310A upon receiving user input (e.g., via a touchscreen or hand control button) to begin, and continues until the amount of injectable fluid injected into the patient reaches a dose volume limit.

[0058] FIG. 3B shows an electrocardiogram 300B with a basic ECG-gated injection. In the example of FIG. 3B, injection begins upon receiving a user-input instruction to begin at time 310B, beginning with diastolic injection phase 312B. This process then reduces the force during systolic phases 302A-302C, sparing contrast injected during systolic injection phases 314B, 318B, and 322B. During diastolic injection phases 316B, 320B, and 324B, the force returns to full force. This allows the user to inject the same amount of contrast over a longer period of time, but still deliver the total volume required (e.g., up to the dose volume limit). These techniques reduce the total volume required from the standard injection parameters. However, systolic injection phases 314B, 318B, and 322B are of less imaging value due to increased blood pressure, as discussed herein. Similarly, injections for partial diastole may have lower imaging value, meaning that diastolic injection phase 312B and diastolic injection phase 324B are not as valuable in an angiography procedure as diastolic injection phase 316B or diastolic injection phase 320B.

[0059] FIG. 3C shows an electrocardiogram 300C with clip-synced injection. In the example of FIG. 3C, injection begins upon receiving a user-input prompt to begin at time 310C, beginning with diastolic injection phase 312C. This process then reduces the force during systole 302A-302C, conserving contrast injected during systolic injection phases 314C, 318C, and 322C. During diastolic injection phases 316C and 320C, the force is returned to full force. However, this mode only delivers contrast for the duration of an equivalent asynchronous injection. For example, if a 3 mL / s injection with a 6 mL dose volume limit takes 2 seconds to fully deliver, this mode reduces the force during systole to deliver contrast for 2 seconds. This reduces the total amount of contrast delivered, but there is still wasted contrast at the leading (312C, 314C) and trailing (322C) ends.

[0060] FIG. 3D shows an electrocardiogram 300D with a delayed and clip-synchronized injection. In the example of FIG. 3D, the injection does not begin despite receiving a user-input prompt to begin at time 310D. Instead, the injection is delayed until the first detected diastole 304A, initiating a diastolic injection phase 312D. This process also reduces the force during systole 302B-302C, conserving contrast injected during systolic injection phases 314D and 318D. Force returns to full force during diastolic injection phases 316D and 320D. The delayed and clip-synchronized mode is the same as the clip-synchronized injection of FIG. 3C, except that the initiation point is delayed until the beginning of the next diastole. This prevents wasted contrast at the beginning of the injection. However, this technique still injects for an asynchronous time period (e.g., 2 seconds) and still allows for wasted contrast at the end of the injection with a systolic injection phase 318D and a partial diastolic injection phase 320D.

[0061] FIG. 3E shows an electrocardiogram 300E with a delayed injection and clip-synchronized injection at a reduced volume. In the example of FIG. 3E, the injection does not begin at time 310E despite receiving a user-input prompt to begin. Instead, the injection is delayed until the first detected diastole 304A, initiating a diastolic injection phase 312E. This process also reduces the force during systole 302B-302C, conserving contrast injected during systolic injection phases 314E and 318E. During diastolic injection phases 316E and 320E, the force is returned to full force. However, this is a manual process controlled by the user of the fluid injection system. For example, the injection system determines whether the next systole 302 or diastole 304 will be completed within the limited time frame available under the delay and clip-synchronized method. If there is insufficient time to complete the next systole 302 or diastole 304, the injection may be stopped. However, this can result in wasted injection fluid in the final phase (eg, diastolic injection phase 320E) if the final injection is systolic (eg, systolic injection phase 318E), and still waste contrast fluid at the end.

[0062] FIG. 4 is an exemplary electrocardiogram shown with an angiography injection schedule overlaid thereon, in accordance with one or more techniques described herein. FIG. 4 shows an electrocardiogram 400 with a synchronized injection optimized in accordance with the techniques described herein. In the example of FIG. 4, the injection does not begin when a user-input instruction to begin is received at time 410; instead, the injection system delays the injection until it detects the onset of diastole 404A. Once the injection system detects the onset of diastole 404A, the injection begins with a first diastolic injection phase 412.

[0063] After the diastolic injection phase 412, the injection system determines whether the difference between the dose volume limit and the current volume of injection fluid administered from the fluid reservoir in the current injection is sufficient to complete both the systolic injection phase 414 (at reduced force) during systole 402B and the diastolic injection phase 416 (at normal force) during diastole 404B. In this example, the injection system determines that the difference is large enough to allow the injection system to complete both the systolic injection phase 414 and the diastolic injection phase 416 while adhering to the dose volume limit. Thus, the injection system performs both the systolic injection phase 414 and the diastolic injection phase 416.

[0064] After the diastolic injection phase 416, the injection system determines whether the difference between the dose volume limit and the current volume of injection fluid injected from the fluid reservoir in the current injection is sufficient to complete both the systolic injection phase 418 (at reduced force) during systole 402C and the diastolic injection phase 420 (at normal force) during diastole 404C. While there may be a sufficient difference to complete the systolic injection phase 418 below the dose volume limit, in the example of Figure 4, the injection system determines that there is an insufficient amount of injection fluid available to complete the diastolic injection phase 420 below the dose volume limit. Thus, the injection system refrains from performing either the systolic injection phase 418 or the diastolic injection phase 420.

[0065] In general, an optimized synchronized injection is essentially a delayed-start and clipped injection, but the clipping is performed differently. Instead of clipping the injection based on equal time, the clipping is performed based on whether the amount of volume already injected into the patient is sufficiently less than the dose volume limit so that the injection system can complete another diastolic injection phase while adhering to the dose volume limit. For example, in the example of FIG. 4, at the start of the last diastolic injection phase 420, the difference between the amount already injected into the patient and the dose volume limit may be only 1.2 mL. Because this is less than the 1.5 mL required in this example to complete the last diastolic injection phase 420, the injection is stopped. Because the last diastolic injection phase 420 is not performed, the last systolic injection phase 418 is also eliminated, since an injection during systole is worthless if a full diastolic injection phase is not subsequently completed. This type of procedure eliminates leading and trailing waste while still capturing the same two full diastolic phases captured in a conventional injection.

[0066] In some examples, the injection system may be operated in fixed or variable mode. In fixed mode, the injection system can operate according to a schedule programmed into the controller. In variable mode, the user can control the injection through the handheld controller. In variable mode, the one or more processors can set a maximum flow rate when the dose volume limit is approached. In this way, the user can be prevented from inadvertently increasing the flow rate during the systolic injection phase or during the partial diastolic phase to the point where the dose volume limit is reached. The maximum flow rate in variable mode during the latter half of the injection procedure can ensure that the injection procedure ends at the end of the diastolic injection phase, thereby minimizing waste.

[0067] Fluid may be injected according to a schedule that includes injecting only during complete diastolic phases (i.e., not fractions of diastolic phases) and intervening systolic phases. In some examples, a user may input a flow rate and a desired number of images to be taken (e.g., one per diastolic cycle). Alternatively, a user may input a desired image quality level instead of a flow rate and allow the system to select an appropriate flow rate based on one or more anatomical characteristics of the patient. For example, using any of these or other characteristics, the injection system may determine an injection schedule that includes an initial diastolic injection phase 412 and a systolic / diastolic injection phase pair that includes a systolic injection phase 414 and a diastolic injection phase 416. In other words, injection phases 412, 414, and 416 may be determined proactively as a schedule, and the injection system may follow that schedule.

[0068] FIGURE 5 is a flowchart illustrating an exemplary angiography injection process for an injection system configured to synchronize injection with an electrocardiogram, in accordance with one or more aspects of the techniques described in this disclosure. The technique of FIGURE 5 may be performed by one or more processors of a device such as the injection system 100 of FIGURE 1 and / or the injection system 100 shown in FIGURE 2. For illustrative purposes only, the technique of FIGURE 5 is described within the context of the injection system 100 of FIGURE 2, although devices having configurations different from that of the injection system 100 may perform the technique of FIGURE 5.

[0069] The infusion module 222 controls the infusion system 100 to perform a first diastolic infusion phase during the patient's diastole (502). The infusion module 222 then measures (504) the volume of infusion fluid dispensed from the fluid reservoir 106 by receiving from the sensor 252 a first group of one or more signals indicative of the current volume of infusion fluid dispensed at a first time from the fluid reservoir 106. The infusion module 222 then determines (506) the difference between the dispense volume limit and the current volume of infusion fluid dispensed from the fluid reservoir 106 and compares (508) the difference to the volume of infusion fluid required to complete both the systolic infusion phase and another diastolic infusion phase.

[0070] The injection module 222 determines, based on the first group of one or more signals, whether the difference is greater than or equal to the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase (510). In response to determining that the difference between the dose volume limit and the current volume of injection fluid administered from the fluid reservoir 106 is greater than or equal to the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase ("YES" branch of 510), the injection module 222 controls the injection system 100 to complete both the systolic injection phase and the diastolic injection phase (512). The injection module 222 then receives a subsequent signal with updated information regarding the volume of fluid administered from the fluid reservoir 106 (504), and the process continues.

[0071] Conversely, in response to determining that the difference between the administration volume limit and the current volume of injection fluid administered from the fluid reservoir 106 is less than the volume of fluid required to complete both the systolic injection phase and the diastolic injection phase ("NO" branch of 510), the injection module 222 controls the injection system to refrain from performing either the systolic injection phase or the diastolic injection phase (514).

[0072] Figure 6 is a flow chart illustrating an exemplary angiography injection process for an injection system configured to synchronize injection with an electrocardiogram, in accordance with one or more aspects of the techniques described in this disclosure. The technique of Figure 6 may be performed by one or more processors of a device such as the injection system 100 of Figure 1 and / or the injection system 100 shown in Figure 2. For illustrative purposes only, the technique of Figure 6 is described within the context of the injection system 100 of Figure 2, although devices having a configuration different from that of the injection system 100 may perform the technique of Figure 6.

[0073] For example, the injection module 222 can receive two or more injection characteristic inputs (602), including an image quality input and a number of images to be taken (e.g., one image per diastolic injection phase). In some examples, the image quality input specifies an injection flow rate. In some examples, the image quality input may be a value on a scale (e.g., 10 being the highest quality and 1 being the lowest quality) or other subjective image quality input. In such examples, the injection module 222 can determine a flow rate of the injection fluid during the diastolic injection phase based on the image quality input and one or more anatomical characteristics of the patient. These injection characteristic inputs can also include a maximum injection flow rate, a dose volume limit, an injection force ratio, an average diastolic length, and an average systolic length. The injection module 222 can determine an injection schedule (604) based on the two or more injection characteristic inputs, including a number of diastolic injection phases equal to the number of images to be taken, a first flow rate for the injection fluid during the diastolic injection phase, and a second flow rate for the injection fluid during each systolic injection phase. The second flow rate may be a smaller percentage than the first flow rate. The injection schedule may also include an initial diastolic injection phase and one or more systolic / diastolic injection phase pairs, each of which includes a complete systolic injection phase and a complete diastolic injection phase. The injection schedule terminates with a complete diastolic injection phase portion of one of the one or more systolic / diastolic injection phase pairs. The first flow rate during each diastolic injection phase is based, at least in part, on the image quality. The injection module 222 may then control the injection system 100 to inject the injection fluid into the patient's body according to the injection schedule (606), terminating the injection upon completion of the last systolic / diastolic injection pair.

[0074] It should be appreciated that, in some examples, certain acts or events of any of the techniques described herein may be performed in a different order, added, combined, or omitted entirely (e.g., not all acts or events described are required to implement the techniques). Furthermore, in some examples, acts or events may be performed simultaneously rather than sequentially, for example, through multithreading, interrupt processing, or multiple processors.

[0075] In one or more examples, the functions described may be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions may be stored on or transmitted as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing device. Computer-readable media may include computer-readable storage media, which correspond to tangible media, such as data storage media, or communication media, including any medium that facilitates transfer of a computer program from one place to another, for example, according to a communication protocol. As such, computer-readable media may generally correspond to (1) non-transitory tangible computer-readable storage media or (2) communication media, such as a signal or carrier wave. Data storage media may be any available medium that can be accessed by one or more computers or one or more processors to obtain instructions, code, and / or data structures for implementing the techniques described in this disclosure. A computer program product may include computer-readable media.

[0076] By way of example, and not limitation, such computer-readable storage media may comprise RAM, ROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and that can be accessed by a computer. Also, any connection is properly referred to as a computer-readable medium. For example, if instructions are transmitted from a website, server, or other remote source using coaxial cable, fiber optic cable, twisted pair, digital subscriber line (DSL), or wireless technologies such as infrared, radio, and microwave, the coaxial cable, fiber optic cable, twisted pair, DSL, or wireless technologies such as infrared, radio, and microwave are included within the definition of medium. However, it should be understood that computer-readable storage media and data storage media do not include connections, carrier waves, signals, or other transitory media, but instead refer to non-transitory tangible storage media. As used herein, disk and disc include compact discs (CDs), laser discs, optical discs, digital versatile discs (DVDs), floppy disks, and Blu-ray discs, where disks typically reproduce data magnetically while discs reproduce data optically with lasers. Combinations of the above should also be included within the scope of computer-readable media.

[0077] The instructions may be executed by one or more processors, such as one or more digital signal processors (DSPs), general-purpose microprocessors, application-specific integrated circuits (ASICs), field-programmable logic arrays (FPGAs), or other equivalent integrated circuits or discrete logic circuitry. Accordingly, the term "processor," as used herein, may refer to any of the foregoing structures or any other structure suitable for implementing the techniques described herein. Additionally, in some embodiments, the functionality described herein may be provided within dedicated hardware and / or software modules configured for encoding and decoding, or incorporated into a combined codec. The techniques may also be implemented entirely in one or more circuit or logic elements.

[0078] The techniques of this disclosure may be implemented in a wide variety of devices or apparatuses, including wireless handsets, integrated circuits (ICs), or sets of ICs (e.g., chipsets). In this disclosure, various components, modules, or units are described to highlight functional aspects of devices configured to perform the disclosed techniques, but do not necessarily require realization by various hardware units. Rather, as described above, the various units may be combined into a codec hardware unit, or may be provided by a collection of interoperable hardware units including one or more processors, as described above, in combination with appropriate software and / or firmware.

[0079] Various examples of the present disclosure have been described. Any combination of the described systems, operations, or functions is contemplated. These and other examples are within the scope of the following claims.

Claims

1. An injection system (100) comprising: a fluid reservoir (106) configured to store an infusion fluid; one or more sensors (252) configured to measure the volume of the infusion fluid dispensed from the fluid reservoir; one or more communication units (242) configured to receive the patient's electrocardiogram data (226) for synchronizing the infusion schedule with the electrocardiogram data; and One or more processors (240) configured to: receiving a first group of one or more signals from the one or more sensors indicative of a current volume of infusion fluid dispensed from the fluid reservoir at a first time; determining, based on the first group of one or more signals, that a first difference between a dose volume limit and the current volume of the infusion fluid administered from the fluid reservoir at the first time is less than a volume of infusion fluid required to complete both a systolic injection phase and a diastolic injection phase of the injection schedule, wherein the dose volume limit is a maximum amount of the infusion fluid that can be infused into the patient in one injection; and in response to determining that the first difference is less than the volume of injection fluid required to complete both the systolic injection phase and the diastolic injection phase, controlling the injection system to refrain from performing either the systolic injection phase or the diastolic injection phase; Equipped with Injection system.

2. 10. The injection system of claim 1, The one or more processors are further configured to: receiving a second group of one or more signals from the one or more sensors indicative of a current volume of infusion fluid administered from the fluid reservoir at a second time prior to the first time; determining, based on the second group of one or more signals, that a second difference between the dose volume limit and the current volume of the infusion fluid administered from the fluid reservoir at the second time is not less than the volume of infusion fluid required to complete both the systolic injection phase and the diastolic injection phase; and in response to determining that the second difference is not less than the volume of injection fluid required to complete both the systolic injection phase and the diastolic injection phase, controlling the injection system to perform both the systolic injection phase and the diastolic injection phase; Injection system.

3. 3. The injection system of claim 2, The one or more processors are further configured to: Detecting a start of systole from the electrocardiogram data of the patient; In response to detecting the onset of the systole, controlling the infusion system to begin infusing the infusion fluid from the fluid reservoir into the patient at a first rate; detecting the end of systole and the beginning of diastole from the electrocardiogram data of the patient; and In response to detecting the onset of the diastole, controlling the infusion system to stop infusing the infusion fluid at the first rate and to begin infusing the infusion fluid from the fluid reservoir at a second rate different from the first rate; Injection system.

4. 4. The injection system of claim 3, The first speed is less than the second speed. Injection system.

5. 10. The injection system of claim 1, the infusion system is communicatively coupled to a hemodynamic system via the one or more communication units; The infusion system receives the electrocardiogram data from a plurality of electrocardiogram leads configured to record the electrocardiogram data. Injection system.

6. 4. The injection system of claim 3, The one or more processors are further configured to: receiving the electrocardiogram data; and determining a mean systolic length for the patient based on the electrocardiogram data; the one or more processors configured to detect the end of the systole and the start of the diastole are further configured, after detecting the start of the systole, to determine that an amount of time has elapsed since detecting the systole equal to the average systolic length. Injection system.

7. 7. The injection system of claim 6, The one or more processors are further configured to determine the first rate and the second rate based on the electrocardiogram data. Injection system.

8. 10. The injection system of claim 1, The one or more processors are further configured to control the injection system to perform an initial diastolic injection phase before the first time. Injection system.

9. 9. The injection system of claim 8, The one or more processors are further configured to: receiving a user-input instruction to initiate a fluid injection process; detecting an onset of diastole based on the electrocardiogram data of the patient; and In response to detecting the onset of the diastole, controlling the infusion system to begin infusing the infusion fluid from the fluid reservoir according to the initial diastolic injection phase; Injection system.

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