Radiographic collimator with camera and independently controlled shutters

Abstract

A method for facilitating an image-guided procedure includes imaging a patient anatomy with a camera. The imaging of the patient anatomy with a camera produces one or more camera images of the patient anatomy. The method also includes imaging the patient anatomy with an X-ray device. The imaging of the patient anatomy with the X-ray device produces at least one fluoroscopic image of the patient anatomy. The method also includes building and presenting, on a display device, a graphical user interface (GUI) that includes at least portions of the one or more camera images and the at least one fluoroscopic image. The building and presenting includes aligning the one or more camera images and the at least one fluoroscopic image in the GUI.

Description

Attorney Docket No.: 6352.003AWORADIOGRAPHIC COLLIMATOR WITH CAMERA AND INDEPENDENTLY CONTROLLED SHUTTERSCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. provisional application no. 63 / 719,723, filed on November 13, 2024, entitled "Radiographic Collimator with Camera and Independently Controlled Shutters" (attorney docket no. 6352.003P1), which is incorporated herein by reference in its entirety.BACKGROUND

[0002] In radiographic techniques, X-rays are produced in a vacuum tube by accelerating electrons to a target with a high voltage. The high-energy electrons bombard the target, producing X-rays in a conical beam. To prevent off-target X-ray exposure, radiographic collimators (‘beam-limiting devices’) are employed to modify the size and geometry of the X-ray beam to match that of an image detector. For example, in the case of rectangular image detectors, an appropriate collimator could convert the conical beam to a pyramidal, rectangular-shaped beam. Standard collimators accomplish this by utilizing lead shutters that selectively block the edges / outer portions of an X-ray beam to shape the contours of the X-ray field projected on the image detector. To help identify an area of exposure on a target, for instance a patient undergoing a radiographic examination, a light source is provided in the collimator together with an angled mirror to create a light field that is coaxial to the X-ray field. The resulting light field projects light through the space defined by the shutters in a beam that approximates the beam of the X-ray in order to guide a user performing the radiography.

[0003] Traditional X-ray collimators include four shutters arranged in two pairs, where, within each pair of shutters, the two shutters oppose each other. The two pairs are driven by two knobs, where each knob controls a given pair of opposing shutters. The displacement of the shutters of each pair is typically synchronized, such that a first knob controls the pair of shutters that define a field in a first dimension (e.g., a field in the “x” dimension) and a second knob controls the pair of shutters that define a field in a second dimension, such as a dimension that is perpendicular to the first dimension in a common plane (e.g., a field in the “y” dimension). In examples, the first dimension is a horizontal dimension, and the second dimension is a vertical dimension. RotatingAttorney Docket No.: 6352.003AWOa knob results in movement of both opposing shutters of the pair and closes or opens the opposing shutters by an equal amount. Rotating both knobs results in the X-ray field being limited (or expanded) in each of the two dimensions. Notably, the adjusting of a shutter pair adjusts both shutters, so that any change in size of the field along the associated dimension either shrinks or expands the field in that direction by equal amounts on both ends. As such, the X-ray field is collimated in such a way that reduces the X-ray beam in a manner that maintains the central axis of the X-ray beam. In other words, the central axis of the field remains the same regardless of the adjustment made to the knobs, and the only way to change the location, on the X-ray target, that is the center of the exposure area is to move the target, the X-ray source / device (for instance by movement of a housing in which the source is contained), or both.

[0004] In image-guided surgical (or other medical) procedures, it is common to place onto the patient’s skin an object that is visible in a radiographic image in order to register the patient radiographic anatomy (i.e., for instance bones underlying the skin) in order to locate a target region, for example, for an injection. This process often requires the trial and error of repeatedly positioning the object, turning on the X-ray device to expose the patient anatomy, locating the patient anatomy on the radiographic image relative to the object, and repositioning the object until the target region is located.SUMMARY

[0005] Shortcomings of the prior art are overcome and additional advantages are provided herein. In one aspect, a method for facilitating an image-guided procedure is provided. The method includes imaging a patient anatomy with a camera, the imaging the patient anatomy with the camera producing one or more camera images of the patient anatomy. The method also includes imaging the patient anatomy with an X-ray device, the imaging the patient anatomy with the X-ray device producing at least one radiographic image of the patient anatomy. The method further includes building and presenting, on a display device, a graphical user interface (GUI) that includes at least portions of the one or more camera images and the at least one radiographic image. The building and presenting includes aligning the one or more camera images and the at least one radiographic image in the GUI such that first anatomical feature(s) of the patient anatomy as presented in the one or more camera images align with corresponding secondAttorney Docket No.: 6352.003AWOanatomical feature(s) of the patient anatomy as presented in the at least one radiographic image that underly the first anatomical feature(s).

[0006] In one or more embodiments, the camera is a visible light camera, an infrared camera, or a time-of-flight camera.

[0007] In one or more embodiments, the one or more camera images are presented as part of the GUI to have a transparency that can be selectively adjusted by a user.

[0008] In one or more embodiments, the method further includes collimating an X-ray beam in response to displacement of at least one handle of a bounding box also built and presented as part of the GUI.

[0009] In one or more embodiments, the X-ray beam has a central axis, and the X-ray beam is collimated off of the central axis.

[0010] Additional aspects of the present disclosure are directed to systems and computer program products configured to perform the methods described herein. For instance, a system can include at least one memory, and one or more processors in communications with the at least one memory, and the system can be configured to perform method(s), example aspects of which are recited above and herein.

[0011] In a further aspect, a radiographic collimator apparatus is provided. The radiographic collimator can include a camera having a field of view through an aperture of the radiographic collimator apparatus, a plurality of shutters positioned in the field of view of the camera, and a plurality of motors, and each motor of the plurality of motors can be configured to control a different shutter of the plurality of shutters and control movement of the shutter independent of movement of each other shutter of the plurality of shutters.

[0012] In one or more embodiments, the radiographic collimator apparatus includes a housing, and a computer system provided as part of, or coupled with, the housing, the computer system configured to control operation of the camera.

[0013] In one or more embodiments, the computer system is in data communication with an external computing system that displays a graphical user interface that includes at least portions ofAttorney Docket No.: 6352.003AWOone or more camera images captured by the camera and at least one radiographic image created using the radiographic collimator apparatus.

[0014] The present summary is not intended to illustrate each aspect of, every implementation of, and / or every embodiment of the present disclosure. Additional features and advantages are realized through the concepts described herein.BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Aspects described herein are particularly pointed out and distinctly claimed as examples in the claims at the conclusion of the specification. The foregoing and other objects, features, and advantages of the disclosure are apparent from the following detailed description taken in conjunction with the accompanying drawings in which:

[0016] FIGS. 1 and 2 depict example imaging environments incorporating radiographic collimators;

[0017] FIG. 3 depicts a perspective view of an example collimator in accordance with aspects described herein;

[0018] FIG. 4 depicts a perspective view of another example collimator in accordance with aspects described herein;

[0019] FIG. 5 depicts a perspective view of another example collimator in accordance with aspects described herein;

[0020] FIG. 6 depicts a side view of an example collimator in accordance with aspects described herein;

[0021] FIG. 7 depicts a perspective view from below of an example collimator in accordance with aspects described herein;

[0022] FIG. 8 depicts a side view of an example collimator in accordance with aspects described herein disposed in a housing;Attorney Docket No.: 6352.003AWO

[0023] FIG. 9 depicts an example collimator cover incorporating a light component, in accordance with aspects described herein;

[0024] FIG. 10 depicts an example component diagram of a collimator in accordance with aspects described herein;

[0025] FIG. 11 depicts an example user interface displaying a camera image of a patient anatomy aside a fluoroscopic image of the patient anatomy, in accordance with aspects described herein;

[0026] FIG. 12 depicts an example user interface displaying a camera image of a patient anatomy aside a collimated fluoroscopic image of the patient anatomy, in accordance with aspects described herein;

[0027] FIG. 13 depicts an example user interface displaying a camera image of a patient anatomy, in accordance with aspects described herein;

[0028] FIG. 14 depicts an example user interface displaying a camera image of a patient anatomy aligned with a fluoroscopic image of the patient anatomy, in accordance with aspects described herein;

[0029] FIG. 15 depicts an example user interface displaying a camera image of a patient anatomy aligned with the last taken fluoroscopic image of the patient anatomy, in accordance with aspects described herein;

[0030] FIG. 16 depicts an example user interface displaying a collimated camera image of a patient anatomy aligned with a collimated fluoroscopic image of the patient anatomy, in accordance with aspects described herein;

[0031] FIG. 17 depicts an example process for facilitating image guided procedures and related tasks, in accordance with aspects described herein;

[0032] FIG. 18 shows an example computer system to incorporate and / or use aspects described herein; andAttorney Docket No.: 6352.003AWO

[0033] FIG. 19 shows an example conceptual workflow for a video-guided injection in accordance with aspects described herein.DETAILED DESCRIPTION

[0034] As explained above, traditional collimators present challenges, as paired control of horizontal and vertical shutters limits collimating of the X-ray field to strictly “on-axis”, such that the center of the field is fixed. Thus, a physician or user would have to move a patient or the X-ray device if it is desired to establish a different central axis for the area to be collimated, i.e., the area to be collimated is not already centered in the X-ray field. Such workflow to move either is disadvantageous for a physician or user, particularly in applications where moving the patient cannot be easily achieved. Therefore, there is a need for a collimator that is capable of limiting the area of the X-ray field (e.g., centering the exposure) on a desired anatomical region of the patient without requiring movement of the patient or X-ray machine. Moreover, there is a need for a collimator capable of defining the X-ray field with more precision, reducing the size of the X-ray field to a desired minimum size.

[0035] The trial-and-error workflow required to operate current state-of-the-art collimators is cumbersome, and results in increased X-ray exposure to both the physician and patient, increased procedure time, and less accuracy of identifying a target region. Thus, there exists a need for a method that eliminates the guess work of current processes, and that is safer, more accurate, and more efficient in registering a patient anatomy for image-guided procedures.

[0036] Aspects are discussed herein with reference to various exemplary embodiments and to the accompanying drawings. In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the present disclosure, though those skilled in the art will recognize that various aspects may be practiced without these specific details. In other instances, well-known structures are not shown in detail to avoid unnecessary obscuring of aspects described.

[0037] Furthermore, there is no intention to be bound by any expressed or implied theory presented herein. It is also understood that specific devices and processes illustrated in the attached drawings, and described in the following specification, are exemplary embodiments of inventive conceptsAttorney Docket No.: 6352.003AWOdescribed in the appended claims. Hence, specific dimensions and other physical characteristics of embodiments disclosed herein are not to be considered as limiting, unless the claims expressly state otherwise.

[0038] Described herein are aspects (e g., methods, apparatuses, computer systems, computer program products) for facilitating image-guided procedures. For example, aspects provide a novel approach to collimating an X-ray field. Further aspects provide a radiographic collimator that may include selectively, independently controlled shutters. Further, aspects provide a radiographic collimator that can incorporate a camera to capture images of an exposure area from the same perspective from which the area is exposed to X-rays. Further aspects provide a method wherein camera image(s) may be presented on a graphical user interface, for instance a display device, in alignment with a fluoroscopic image to depict surface anatomy of a patient aligned with corresponding patient radiographic anatomy underlying the surface anatomy. In this manner, a user can conveniently view surface anatomy of a patient and any other objects ‘visible’ to the camera and present in the camera image(s) aligned with bone anatomy and any other radiographically-visible anatomy underlying the surface anatomy. This, in turn, can facilitate image-guided procedures, some examples of which are presented herein (by way of example only, and without limitation).

[0039] FIGS. 1 and 2 depict example environments incorporating radiographic collimators. As shown in example environment 100 of FIG. 1, an X-ray tube 110 generates an X-ray beam 130, the shape and size of which may be modified by the collimator 120. As the X-ray beam 130 exits the X-ray tube 110 and before entering the collimator 120, the X-ray beam 130 has a conical shape. As shown in example environment 200 of FIG. 2, entrance shutters 240 may define a first opening 250 disposed at a face of the collimator 220 proximal to the X-ray tube 210. To prevent the circumstance in which the positions of each lead shutter are opened wider than the imaging area defined by an image detector (over-collimation), entrance shutters 240 can be set at a fixed aperture to shape the X-ray beam 230. Any portion of the X-ray beam 230 not blocked by the entrance shutters 240 can pass through the first opening 250 into the collimator 220. A mirror 260 is disposed in the collimator 220 and angled to reflect light from a light source 270 disposed within the collimator 220 and through a set of shutters 280 and a second opening 290 of the collimator 220 distal to the X-ray tube 210. The mirror 260 reflects light from the light source such that theAttorney Docket No.: 6352.003AWOreflected light 274 is coaxial to the X-ray beam 230, which passes through the mirror 260 instead of reflecting off of it. In examples, the set of shutters 280 include lead. The second opening 290 formed between the set of shutters 280 may define the X-ray field and / or the field of reflected light 274 reflected from the light source 270.

[0040] Referring to FIG. 1, the X-ray beam 130 may be directed at an image detector 140. In examples, the image detector 140 may be mounted on a wall stand 142. The image detector 140 may be planar, having a rectangular planar geometry, for example. Other geometries (such as circular) are possible. A patient anatomy may be positioned in front of the image detector 140, between the detector and the X-ray device, such that the patient anatomy is exposed to the X-ray beam. A processing / computer system or device, and / or other type of controller, can be used to control components of the collimator 120, including, for instance, the positioning of the shutters thereof. A user interface of, or in communication with, the controller can be provided and used by a user to control the collimator and its components. An example such user interface is a graphical user interface. In the example of FIG. 1, a housing 126 incorporates a graphical user interface 124 that a user can interact with to control components of the collimator 120 including the shutters and positioning thereof. Here, the graphical user interface 124 and its supporting electronics are integrated onboard into the housing 126 with the collimator 120. A controller (not shown) could also be encompassed within the housing, or could be provided external to the housing and in communication with the user interface 124 via wired and / or wireless communication link(s). As yet another option, both the user interface 124 and the controller could be house external to the housing, by in communication with components included within the housing 126 to control components of the collimator 120 in accordance with aspects described herein.

[0041] In some embodiments, an X-ray filter is used as a beam hardening material to reduce radiation exposure to the patient. In some embodiments, the beam hardening material may comprise copper and aluminum. In some embodiments, beam hardening material includes 0.1mm copper foil and 3.2mm of aluminum. In some embodiments, a pellicle or film mirror may be provided. For instance, an aluminized mylar may be used as a first-layer mirror. The filter material may be incorporated into the mirror substrate or as a separately adjustable feature when using a mylar mirror.Attorney Docket No.: 6352.003AWO

[0042] Aspects described in further detail herein can be incorporated into environments such as those of FIGS. 1 and 2. For instance, in accordance with aspects described herein, a camera can be provided in devices similar to those depicted in FIGS. 1 and 2. For instance, the camera could replace the light source. In some embodiments, a light source is provided along with a camera. In embodiments, the mirror reflects light (entering through the distal opening of the X-ray device) to a sensor of the camera such that the camera ‘sees’ the area that is being exposed to the X-rays when turned on. In other words, the camera has a line-of-sight that reflects off of the mirror and through the opening through which the X-rays pass to an area of exposure, just as the light generated by the light bulb reflects off of the mirror to project light onto the exposure area in the setup of FIGS.1 and 2. The field of view of the camera is similarly coaxial to the X-ray beam, and the space formed between the lead shutters may define the X-ray field, the field of light reflected from the light source if provided, and / or the field of view of the camera.

[0043] FIG. 3 depicts a perspective view of an example radiographic collimator 300 in accordance with aspects described herein. Here, a camera 310 is provided in the collimator 300. The camera 310 has a field of view directed toward a mirror 312, that reflects the field of view of the camera toward an opening 320, such that the field of view of the camera 310 is coaxial with the field of view of an X-ray beam. In embodiments, the X-ray beam has a focal spot location within the collimated area. In some embodiments, the alignment of the camera 310 and mirror 312 may be fixed. In embodiments, the camera 310 may be a live video camera. In some embodiments, camera 310 may be a visible light camera. In some embodiments, the camera 310 may be an infrared camera. In some embodiments, the camera 310 may be a time-of-flight camera, for instance a LiDAR camera. In some embodiments, the depth of field of the camera 310 may range from 30 to 50 inches. In some embodiments, the depth of field of the camera 310 may range from 15 to 25 inches. In some embodiments, the camera 310 may have a resolution of about 2k x 2k (4MP). In some embodiments, the camera 310 may enable digital zooming to increase image magnification. In some embodiments, the field of view of the camera may range from 12in x 12in at 40 inches to 17in x 17in at 72 inches. In some embodiments, the field of view of the camera 310 may range from 12in x 12in at 40 inches to 17in x 17in at 50 inches. In embodiments, the opening 320 defined by a plurality of shutters defines the X-ray field and the field of view of the camera 310.Attorney Docket No.: 6352.003AWO

[0044] FIG. 4 depicts a perspective view of another example collimator, 400, in accordance with aspects described herein. The example collimator 400 of FIG. 4 includes at least one system 413 (a “controller”, for instance a computer system) having (at least) a processing circuit (one or more processors) for executing instructions / program code / logic (such as program code maintained on memory of the system) to perform actions, for instance processes described herein. In embodiments, the system 413 is in communication via wired and / or wireless communication path(s) with one or more external devices, for instance one or more peripheral devices (such as a graphical display device and / or other user interface devices) and / or one or more other external system(s). The system 413 can also include input / output (I / O) devices, for instance Universal Serial Bus (USB) adapters and network adapters and associated USB and Ethernet ports as shown in FIG. 4. In embodiments, the system 413 can control operations or functions of other devices, for instance devices of the collimator 400, such as the camera, including a power state (on and off) of the camera 410, and the operating mode of the camera 410 to capture image(s). The camera 410 has a field of view directed toward a mirror 412, that reflects the field of view of the camera toward an opening 420. In example, the system 413 also controls movement of a plurality of shutters, as described herein. In embodiments, the system 413 can, in real-time, obtain live video and / or images from camera 410 and feed them to a another device, such as a display device or other GUI whether integrated into the system 413 or connected to the system 413 via wired / wireless communication link(s). In other embodiments, the video / images may be fed to an external computer system for display on a display device.

[0045] As noted, the system 413 could control movement of the plurality of shutters. In this regard, in some embodiments the system 413 implements a control protocol for the collimator. In embodiments, the system 413 can control at least one stepper driver, driving at least one stepper motor of the plurality of motors driving movement of the lead shutters. In some embodiments, a plurality of stepper drivers 415 may control a plurality of stepper motors. In an example collimator, at least one stepper driver can be stacked atop the system 413. As shown in FIG. 4, two stepper drivers 415 can be stacked atop each other, and then stacked atop the system 413.

[0046] FIG. 5 depicts a perspective view of another example collimator (500) in accordance with aspects described herein. A camera 510 can be provided in the collimator 500. The camera 510 has a field of view which can be directed toward a mirror 512 that reflects the field of view of theAttorney Docket No.: 6352.003AWOcamera 510 toward a plurality of shutters, such that the field of view of the camera 510 is coaxial with the field of view of an X-ray beam. As shown in FIG. 5, the collimator 500 can include a circular opening 511 configured to receive an end of an X-tube. The collimator 500 can include a plurality of stepper motors 520a-520d for driving the displacement of a plurality of shutters. In embodiments, and as illustrated in FIG. 5, the plurality of stepper motors 520a-520d can be layered in pairs, such that one pair of stepper motors 520a-520b are provided in a layer or plane proximal to the mirror 512, and a second pair of stepper motors 520c-520d are provided in a bottom layer or plane, distal to the mirror. In embodiments, two shutters of the plurality of shutters can be displaced in a first direction, wherein displacement of the two shutters in the first direction results in modification of first dimensions (i.e., “x” dimensions) of the X-ray field. Similarly, in embodiments, two shutters of the plurality of shutters can be displaced in a second direction, different from the first direction, wherein displacement of the two shutters in the second direction results in modification of the second dimensions (i.e., “y” dimensions) of the X-ray field. The first and second directions can correspond to ‘horizonal’ and ‘vertical’ directions of a radiographic image. Accordingly, in some embodiment, the first and second directions are perpendicular to each other. In embodiments, displacement of each shutter of the plurality of shutters is independently driven. In embodiments, the displacement of the plurality of shutters can be driven by a plurality of stepper motors. In embodiments, a stepper motor of the plurality of motors can drive displacement of only one shutter of the plurality of shutters and does not drive displacement of any other shutters of the plurality of shutters. In this manner, there may be a plurality of stepper motors provided and a corresponding number of shutters, where each stepper motor drives displacement of a respective shutter and only that shutter. In some embodiments, the stepper motor may have an axial force of 15N. In some embodiments, the stepper motor may have a load speed of 50 mm / sec. In some embodiments, a configurable positioner 514 could be added to center the collimator 500 with the X-ray beam center.

[0047] FIG. 6 depicts a side view of an example collimator 600 in accordance with aspects described herein. As depicted in FIGS. 5-6, the plurality of stepper motors 620a-620d can be layered in pairs, such that one pair of stepper motors 620a-620b are generally co-planar in the horizontal direction and provided in a first layer / plane proximal to the mirror 612, and a second pair of stepper motors 620c-620d are generally co-planar in the horizontal direction and providedAttorney Docket No.: 6352.003AWOin a second layer / plane, distal to the mirror 612. The camera 610 has a field of view which can be directed toward a mirror 612.

[0048] FIG. 7 depicts a perspective view from below of an example collimator 700 in accordance with aspects described herein. As was shown also in FIGS. 5-6, a pair of stepper motors 720c-720d can be disposed at a bottom layer, distal to the positioning of X-ray tube. In embodiments, a plurality of shutters 730a-730d defines the field of view of a camera 710 and an X-ray field. In embodiments, shutters of the plurality of shutters 730a-730d can be paired such that two shutters are positioned at a layer that is slightly more distal to the X-ray tube, while two shutters can be positioned at a layer that is slightly more proximal to the X-ray tube. As shown in FIG. 7, a first pair of shutters 730a-730b are positioned at the layer more distal to the X-ray tube, and a second pair of shutters 730c-730d are positioned at the layer more proximal to the X-ray tube.

[0049] FIG. 8 depicts a side view of an example collimator 800 in accordance with aspects described herein (for instance as described with reference to FIGS. 2-7) disposed in a housing 850. In embodiments, the housing 850 has an opening 860 that can be wider than the opening defined by the plurality of shutters. In examples, and to provide illumination to the field of view, which may be particularly useful in situations of low lighting, such as when a patient is draped in the operating room and the X-ray device is positioned in the shadow of the patient or operating table, light(s) is / are provided as part of the radiographic collimator 800 and / or the housing 850. The light(s) facilitate proper positioning for the radiographic exposure(s) to occur. In examples, a reference point or target may be placed under the operating table to show the location of the desired position for the X-ray device so it can be repositioned using the lighted camera view of the target. In an embodiment, the light is disposed on, or as part of, an exterior surface of the housing, and may surround opening 860. The light may be or include a plurality of sources of light, and therefore reference to a “light” herein should be understood to include a device that could incorporate multiple light sources. While a circular shape (i.e., ring light) is contemplated, any other appropriate configuration may be used, in examples. The light may include one or more light emitting diodes (LEDs), though any other sources of light are possible. FIG. 9 depicts both unilluminated (901a) and illuminated (901b) states of an example collimator cover 912 incorporating a light component 902 that surrounds opening 910 of the collimator cover 912, in accordance with aspects described herein.Attorney Docket No.: 6352.003AWO

[0050] FIG. 10 depicts an example component diagram of a collimator in accordance with aspects described herein. In some embodiments, the collimator may include integrated control electronics. In some examples, the collimator includes a controller in the form of computer system (such as system 413 as shown in and described with reference to FIG. 4). In some embodiments, the controller for the collimator is located separate from the collimator, for instance as an external computer. As another example, control of the collimator and components thereof can be effected by way of an external computer system or other controller that is connected to and in communication with a system (e.g., 413) via a communication path, for instance a wired and / or wireless, bidirectional communication path. In embodiments, the communication path can be or include network, serial, wireless, ethernet, or universal serial bus (USB) communication path(s), as non-limiting examples. In an embodiment, processing to perform control functions for provision of controls to the collimator or components thereof can be cloud-based, in which commands are generated and sent from an external system to the collimator device via a network-connected system thereof.

[0051] In the specific example of FIG. 10, controller 1002 includes a single board computer (SBC) multi-leaf collimator (MLC) Controller 1003. Controller 1003 can be implemented by any of various single-board computers, such as those developed and offered by Raspberry Pi Holdings, which include a collection of hardware including processing circuit(s), memory, I / O devices, and other hardware (not shown here). Controller includes, e g., as stored in memory for execution by processing circuit(s), program code 1005 for camera control to control camera 1004 connected to the controller 1002, program code 1007 for Server and application programming interface (API) functionality that enables the controller to receive and handle API calls (such as Representational State Transfer (REST) API calls) made to it from external devices, enabling receipt of commands to control the stepper driver(s), activate the camera, provide requested data, and perform other functions, and program code 1009 for providing motor control over the stepper driver 1008 to control stepper motors 1010, of which there are 4 in this example. The controller 1002 also includes an ethernet port (not shown) in this example for ethemet-based communication with an external device (computer 1006 here). User input to device 1006 can provide at least some control of the controller 1002. In embodiments, the controller 1002 can control the on and off of the camera and the capture of images thereby. In embodiments, the controller 1002 can receive and feed live video from camera 1004 to a display device or graphical user interface directly, or, as in the example ofAttorney Docket No.: 6352.003AWOFIG. 10, to system 1006, which can display the live video / images as described herein. In embodiments, the controller 1002 implements the control protocol for the collimator. In embodiments, a graphical user interface can be built by a computer system (e.g., 1002, 1006, or another system) and presented on a display device / monitor, such as a touch screen monitor that is capable of receiving and providing user input to the computer system. For example, graphic user interface can be built to provide a bounding box defining an area of image(s) to be shown. Graphical elements, such as handles on edge(s) of the bounding box, can be used by a user to define the dimensions and / or position of the bounding box. In a specific example, the user interacts with the bounding box handles via the touch screen monitor to modify the border of the bounding box to define dimensions / size / position of the bounding box. In embodiments, the bounding box corresponds to the bounds of the X-ray field to be collimated, and sets parameters, values, or the like that the controller uses or interprets to move the shutters and achieve the desired collimation and therefore the size and position for the resulting exposure.

[0052] In embodiments, example radiographic collimators described herein can be employed in conjunction with aspects described and depicted with reference to FIG. 10 to improve the workflow of image-guided procedures. FIG. 11 depicts an example user interface 1100 displaying a camera image 1112 of a patient anatomy aside a fluoroscopic image 1120 of the patient anatomy, in accordance with aspects described herein. A user introduces a needle 1150 in the area being imaged both radiographically and by the camera to point to a target region 1160 for injection on the patient anatomy. The target region 1160 for injection, by way of non-limiting example, is the proximal interphalangeal joint (PIP) of the patient’s third digit of the right hand. As shown in FIG.11, the field of view of the camera corresponds directly to the X-ray field exhibited by the fluoroscopic image. Thus, the perspective of the X-ray detector and the perspective of the camera (i.e., visible light camera) are coaxially aligned. In embodiments, the field of view of the camera can correspond directly to the X-ray field with a visual area of the same size. In some embodiments, the field of view of the camera has a slightly smaller visual area than an area covered by the X-ray.

[0053] A dashed bounding box 1170 is provided and has handles in its top left and bottom right corners allowing a user to adjust the dimensions of the bounding box 1170, which corresponds to and defines a desired further collimation to the X-ray field. As shown by the bounding box 1170 in FIG. 11, the X-ray field can be collimated off the central axis of the X-ray field as it is currentlyAttorney Docket No.: 6352.003AWOset (which is centered approximated where the tip of the needle 1150 is in the fluoroscopic image 1120). In other words, the X-ray field can be collimated off the central axis such that the collimation produces an adjusted X-ray area that is off-centered or offset from the central axis of the initial X-ray beam. The system is capable of off-center collimating by way of the independent control and displacement of the shutters as described herein. In embodiments, the graphical user interface can allow the user to select if they want the handles 1172 of the bounding box 1170 to stay locked to the central axis of the X-ray field or not. As the bounding box 1170 region is selected by the user, the computing system can signal to the controller. The controller can implement the control protocol to drive appropriate displacement of the shutters via the stepper motors in order to collimate the X-ray field as desired. Using the position of bounding box 1170 currently shown by way of example, the shutter functioning to ‘crop’ the area from the left side of the image will be closed further than its opposing shutter (functioning to crop the area from the right side of the image), and the shutter functioning to crop the area from the top side of the image will be closed further than its opposing shutter (functioning to crop the area from the bottom of the image). The center of the resulting area of exposure will be approximately between the fourth metacarpal and fourth proximal phalange, as opposed to the location of the tip of the needle 1150.

[0054] FIG. 12 depicts an example user interface 1200 displaying a camera image 1210 of a patient anatomy aside a collimated fluoroscopic image 1220 of the patient anatomy, in accordance with aspects described herein. The desired X-ray field was selected by adjusting the bounding box (labeled 1270 in FIG. 12) as described and shown in FIG. 11, and the X-ray field was collimated accordingly as presented in FIG. 12 by appropriate displacement / movement of the independently driven shutters. As shown in FIG. 12, the X-ray exposure can be limited to a smaller target region, relative to the region depicted in FIG. 11, for example, encompassing the target area 1260 for injection. In some embodiments, after the X-ray field is collimated, the full camera image 1210 may still remain visible to the user, as shown in the upper left comer of the display presented in FIG. 12. In embodiments, the camera image 1210 could always be shown with the same cropping as the collimated area.

[0055] FIG. 13 depicts an example user interface 1300 displaying a camera image 1310 of a patient anatomy, in accordance with aspects described herein. A visible light camera captures a live video of the patient anatomy 1340 (right hand here) positioned on an image detector. Advantageously,Attorney Docket No.: 6352.003AWOX-ray exposure is not needed to position the patient anatomy relative to the X-ray. A user introduced a needle 1350 to point to a target region 1360 for injection on the patient anatomy 1340. The target region 1360 for injection, by way of non-limiting example, is the proximal interphalangeal joint (PIP) of the patient’s third digit 1342 of the right hand.

[0056] FIG. 14 depicts a user interface 1400 displaying a camera image 1410 of a patient anatomy aligned with a fluoroscopic image 1420 of the patient anatomy, in accordance with aspects described herein. The alignment / composition of the images may be effected in any desired manner. For instance, in one example, the camera image(s) is / are overlaid fluoroscopic image(s), while in another example, the fluoroscopic image(s) is / are overlaid fluoroscopic image(s). In any case, the opacity of some aligned image(s) can be adjusted to provide visibility of other(s) of the aligned image(s), for instance opacity of image(s) overlying other images can be adjusted to provide visibility of underlying image(s). In some embodiments, the opacity of the camera image(s) may be adjusted in any desired manner, allowing the fluoroscopic image(s) of patient anatomy or the camera image(s) to be most clearly visible. In the aligned images example of FIG. 14, the camera image 1410 is overlaid on a last-taken (i.e., most recently-captured) fluoroscopic image 1420 and the transparency of the camera image 1410 is adjusted in order to more clearly visualize the radiographic anatomy (i.e., bones) of the patient. A user can see both a superimposed image, or collection of images, e.g., as a video, of the patient’s skin, and this is aligned with the radiographic image of bone. By superimposing the camera image onto the radiographic image, the patient’s radiographic anatomy (i.e., bones) can be directly registered to the patient’s surface anatomy (i.e., the patient’s skin as presented in the camera image). The user can also view exactly where on the surface anatomy (e.g., skin) a surgical instrument such as the needle 1450 in this example is to penetrate the surface anatomy to provide the desired positioning for the instrument in performing the procedure. This can eliminate any guessing by the user with regard to the position of the patient’s radiographic anatomy, which is not visible with just camera image(s) alone. It also can eliminate any guessing by the user with regard to a point of insertion, incision, or the like on the surface anatomy, which is not visible with just fluoroscopic image(s). The user can therefore visualize the target area 1460 for injection and subsequently perform an injection (in this example), whilst viewing both the camera image 1410 and the fluoroscopic image 1420 in an aggregated / composited / aligned view of the images. In more complex procedures, the combined fluoroscopic image 1420 and live video can be used to further inform the location of the patient’sAttorney Docket No.: 6352.003AWOradiographic anatomy. For example, if a patient’s bone is broken, a user can identify on the fluoroscopic image 1420 the location of the break and can mark the exact corresponding location on the patient’s skin where the break is located to inform treatment (as the mark will be visible in the camera images later obtained by a collimator apparatus described herein). In embodiments, live video and live fluoroscopy can be used contemporaneously to display and follow the motion of the patient’s joints.

[0057] FIG. 19 depicts an example conceptual workflow for a video-guided injection in accordance with aspects described herein. The example workflow shown in FIG. 16 includes a combination of physical events, software steps referring to processing performed by one or more computer system(s) such as those of or in communication with an apparatus having imaging device(s), X-ray events, and procedural information. In examples, processing of the workflow is performed by a computer system onboard the imaging system and / or remote computer system(s), such as those outside of the clinical or surgical environment or in the cloud, as examples. The example workflow of FIG. 19 can include the physical events, X-ray events, procedural information, and video events, illustrated and described in FIG. 14, in examples. Initially, patient anatomy is roughly aligned with an image detector using live video guidance (1912). The video is shown as image(s) on a display (1914). A bundle of X-ray projections can be acquired as live fluoroscopy. Live fluoroscopy (1916) obtains video images that can be superimposed on a lastimage hold (LIH) image(s) on the display (1918, 1920, 1928), as depicted in the example user interface 1400 shown in FIG. 14. The operator or surgeon places the injection syringe or needle (labeled 1450 in FIG. 14) into a video field of view and aligns it with the target area for injection using the composite fluoroscopic and video image being displayed (1922). As part of this, the workflow can update the live fluoroscopy, for instance with the surgeon moving the imaging device (i.e., by rotating a C-arm to provide cone beam computed tomography (CBCT) calculations to generate a 3D reconstruction of the patient anatomy) to show a better view to the anatomy (1924). If the alignment of the syringe relative to the anatomy and as reflected by the video image and LIH is acceptable, the operator proceeds with performing an injection (1926). During the workflow, captured images and / or corresponding examination videos can be saved to the PACS or EMR (1930) as desired.

[0058] Auto-collimation of the image(s) is also possible. For instance, the user could use a stylus to mark two diagonally-opposite corners of a desired image, or adjust the dimensions of a boundingAttorney Docket No.: 6352.003AWObox as desired. The system can then automatically collimate the image using the LIH image and subsequently superimpose the live video of the syringe over the LIH image on the display. The operator or surgeon can then place the syringe or needle into a video field and align it with the injection site using the composite fluoroscopic and video image. The operator or surgeon may take one fluoroscopic snapshot, and move the imaging device as needed to confirm that the syringe is in the correct position. The surgeon can then proceed to perform an injection, the video of which being superimposed onto the LIH image on the display.

[0059] If during an image-guided procedure as described the surgical tool needs to be repositioned, for instance for an additional procedure (e.g., an injection, an incision), an additional X-ray exposure is not required. For instance, after the initial X-ray exposure is taken, the patient can remain still. The physician can utilize video-guidance mode, wherein the live video and last taken fluoroscopic image are aligned on the graphical user interface, and the initial X-ray exposure can be used to identify the underlying anatomy of the patient when moving the surgical tool to the proper repositioned location. In embodiments, the controller or other system processing or registering image data for presentation on the graphical user interface can detect when the position of the patient in the live video has deviated from the position of the patient in the last taken fluoroscopic image and warn the physician. In embodiments, this system can be configured with thresholds for allowable movement / deviation between the images. In embodiments, this system can be configured to slightly adjust / warp / reposition the fluoroscopic image to match image(s) of a current live video of the anatomy until applicable threshold(s) has been exceeded, before prompting a warning to the physician.

[0060] FIG. 15 depicts a user interface 1500 displaying a camera image 1510 of a patient anatomy aligned with the last taken fluoroscopic image 1520 of the patient anatomy, in accordance with aspects described herein. As shown in FIG. 15, the target region 1560 for injection, by way of nonlimiting example, is the ulnocarpal joint of the patient’s right wrist. The transparency of the camera image 1510 can be adjusted and, as shown in FIG. 15, is displayed in full opacity, such that the radiographic image does not show through the camera image 1510. In embodiments, a button on the graphical user interface could directly toggle the camera image 1510 between full and zero opacity.Attorney Docket No.: 6352.003AWO

[0061] After using video guidance mode to determine the position of the surgical tool relative to the patient’s radiographic anatomy, a user can take a subsequent fluoroscopic image to verify that the position of the surgical tool is correct. When taking a subsequent fluoroscopic image, the user can collimate the X-ray to a smaller region (for instance a region just large enough to capture a relatively small region around the needle tip, in this example) to limit an unnecessary exposure to the patient or user. For example, once the needle is positioned in FIG. 15, the user can limit the X-ray field to verify the position of the needle relative to the patient’s radiographic anatomy. FIG. 16 depicts an example user interface displaying a collimated camera image of a patient anatomy aligned with a collimated fluoroscopic image of the patient anatomy, in accordance with aspects described herein. As shown in FIG. 16, the transparency of the camera image 1610 is adjusted (relative to the example of FIG. 15) such that the radiographic image 1620 and patient’s bones are visible through the camera image. As explained herein with reference to FIG. 15, handles 1572 on the user interface allow a user to adjust dimensions of the bounding box 1570, which corresponds to the X-ray field to be collimated. In FIG. 16, the user selected to collimate the X-ray field to the area bounded by the dotted box off the center axis of the X-ray field. Handles 1672 on the bounding box 1670 can be manipulated by the user, and simultaneously control the displacement of the independently driven shutters of the radiographic collimator. In some embodiments, the bounding box 1670 and / or corresponding X-ray field can be automatically made smaller to focus on a specific point relative to the surgical instrument. For instance, object recognition operating against the camera images could automatically detect that the top of the needle is sufficiently close to the intended injection site, and on the basis of recognizing this, the controller can be directed to further narrow the X-ray field before taking another fluoroscopic image (optionally after seeking and obtaining a confirmation from the user / medical practitioner).

[0062] In accordance with some embodiments, a camera or video system provided with or as part of an X-ray tube housing or collimator and is used as a video overlay for needle guidance and other applications. In some embodiments, a camera and mirror assembly are separate from / an accessory to the collimator. For instance, the separate camera and mirror assembly can be positioned under or above part of the collimator but as an individual component.

[0063] In some embodiments, the collimator is outside the field of view of the camera, allowing for a larger field of view for the camera on account that the collimator is not limiting the field ofAttorney Docket No.: 6352.003AWOview of the camera. This positioning may be more efficient or desirable in terms of image processing and object detection. In this configuration, the camera may be virtually collimated such that only the areas exposed to the X-rays are shown by the images to the user. However, the entire camera area may still be available to apply image processing techniques like object recognition or optical flow. In some embodiments, the collimator does not sit in the field of view of the camera; instead, the camera is positioned between the collimator and the target with a view to the patient anatomy and is offset from the X-ray path extending from the collimator to the anatomy so as to not interfere with the X-ray path.

[0064] In accordance with aspects described herein, and during fluoroscopic procedures including diagnostic, image-guided, and interventional procedures, fluoroscopy can be used to orient the X-ray system to locate the viewing angle or angles relative to the patient to optimally perform the procedure. With a coaxial video function, an optimum, preferred, or desired viewing angle can be obtained using video imaging, reducing radiation exposure.

[0065] It is appreciated that a multitude of radiographic imaging modalities may be utilized to obtain radiographic image(s), including but not limited to fluoroscopy, computed tomography (CT), ultrasound, and magnetic resonance imaging (MRI), in accordance with aspects described herein.

[0066] Video imagery can also be used for automatic body part recognition, automatic collimation based on body parts, needle guidance, artificial intelligence (Al) input, positional feedback, recording a medical procedure for legal documentation, infrared and ultraviolet, camera measuring pulse rate, LiDAR camera, etc.

[0067] In embodiments, Al applications can use a video camera feed to measure an incremental beam-line orientation using image processing or other methods to derive camera position from scene analysis to facilitate three-dimensional image acquisition through Cone Beam Computed Tomography (CBCT) methodologies. For example, the image processing can be optical flow, or simultaneous localization and mapping (SLAM), as examples.Attorney Docket No.: 6352.003AWO

[0068] FIG. 17 depicts an example process for facilitating image-guided procedures and related tasks, in accordance with aspects described herein. The process could be performed by one or more computer systems, such as those described herein.

[0069] Referring to FIG. 17, the process includes imaging a patient anatomy with a camera (1702). In examples, the camera may be a visible light camera, an infrared camera, or a time-of-flight camera. The imaging of the patient anatomy with the camera may produce one or more camera images of the patient anatomy. In examples, the one or more camera images are presented as part of the GUI to have a transparency that can be selectively adjusted by a user. In examples, the X-ray beam has a central axis, and the X-ray beam can be collimated off of the central axis.

[0070] The process continues by imaging the patient anatomy with an X-ray device (1704). The imaging of the patient anatomy with the X-ray device may produce at least one radiographic image of the patient anatomy. The process then builds and presents (1706) on a display device, a graphical user interface (GUI) that includes at least portions of the one or more camera images and the at least one radiographic image. The building and presenting may include aligning the one or more camera images and the at least one radiographic image in the GUI such that first anatomical feature(s) of the patient anatomy as presented in the one or more camera images align with corresponding second anatomical feature(s) of the patient anatomy as presented in the at least one radiographic image that underly the first anatomical feature(s).

[0071] In one example in which aspects of FIG. 17 are iterated, the process returns to 1702 to imaging a patient anatomy with a camera, and the imaging the patient anatomy with the camera produces one or more camera images of the patient anatomy.

[0072] Processes described herein may be performed singly or collectively by one or more computer systems. Such computer systems may be provided as part of a radiographic imaging system as described herein, or may be in communication with such a system, as examples. FIG.18 depicts one example of such a computer system and associated devices to incorporate and / or use aspects described herein. A computer system may also be referred to herein as a data processing device / system, computing device / system / node, or simply a computer. The computer system may be based on one or more of various system architectures and / or instruction set architectures, suchAttorney Docket No.: 6352.003AWOas those offered by Intel Corporation (Santa Clara, California, USA) or ARM Holdings pic (Cambridge, England, United Kingdom), as examples.

[0073] FIG. 18 shows a computer system 1800 in communication with external device(s) 1812. Computer system 1800 includes one or more processor(s) 1802, which are processing circuit(s) such as central processing unit(s) (CPUs), graphics processing unit(s) (GPUs), and / or other types of processors. A processor can include functional components used in the execution of instructions, such as functional components to fetch program instructions from locations such as cache or main memory, decode program instructions, and execute program instructions, access memory for instruction execution, and write results of the executed instructions. A processor 1802 can also include register(s) to be used by one or more of the functional components. The processors of the computer system, whether in the form of CPUs, GPUs, and / or other types of processors, can be arranged and / or leveraged in any of various ways to facilitate high-performance. For instance, certain processing tasks can be offloaded from the CPU(s) to GPU(s) for processing. Additionally or alternatively, processors, whether CPUs, GPUs, or other types, can be arranged for parallel / concurrent processing in some embodiments. In a specific example, processing tasks are offloaded to a group of GPUs for parallel execution on the GPUs of the group. It is also possible for a group of CPUs (which themselves might have multiple cores each) to execute various tasks in parallel.

[0074] Computer system 1800 also includes memory 1804, input / output (I / O) devices 1808, and I / O interfaces 1810, which may be coupled to processor(s) 1802 and each other via one or more buses and / or other connections. Bus connections represent one or more of any of several types of bus structures, including a memory bus or memory controller, a peripheral bus, an accelerated graphics port, and a processor or local bus using any of a variety of bus architectures. By way of example, and not limitation, such architectures include the Industry Standard Architecture (ISA), the Micro Channel Architecture (MCA), the Enhanced ISA (EISA), the Video Electronics Standards Association (VESA) local bus, and the Peripheral Component Interconnect (PCI).

[0075] Memory 1804 can be or include main or system memory (e.g. Random Access Memory) used in the execution of program instructions, storage device(s) such as hard drive(s), flash media, or optical media as examples, and / or cache memory, as examples. Memory 1804 can include, forAttorney Docket No.: 6352.003AWOinstance, a cache, such as a shared cache, which may be coupled to local caches (examples include LI cache, L2 cache, etc.) of processor(s) 1802. Additionally, memory 1804 may be or include at least one computer program product having a set (e.g., at least one) of program modules, instructions, code or the like that is / are configured to carry out functions of embodiments described herein when executed by one or more processors.

[0076] Memory 1804 can store an operating system 1805 and other computer programs 1806, such as one or more computer programs / appli cations that execute to perform aspects described herein. Specifically, programs / applications can include computer readable program instructions that may be configured to carry out functions of embodiments of aspects described herein.

[0077] Examples of I / O devices 1808 include but are not limited to microphones, speakers, Global Positioning System (GPS) devices, cameras, graphics cards or GPUs, imaging devices, detector devices, lights, accelerometers, gyroscopes, magnetometers, sensor devices configured to sense light, proximity, heart rate, body and / or ambient temperature, blood pressure, and / or skin resistance, and activity monitors. An I / O device may be incorporated into the computer system as shown, though in some embodiments an I / O device may be regarded as an external device (1812) coupled to the computer system through one or more I / O interfaces 1810.

[0078] Computer system 1800 may communicate with one or more external devices 1812 via one or more I / O interfaces 1810. Example external devices include a keyboard, a pointing device, a display, and / or any other devices that enable a user to interact with computer system 1800. Other example external devices include any device that enables computer system 1800 to communicate with one or more other computing systems or peripheral devices such as a printer. A network interface / adapter is an example I / O interface that enables computer system 1800 to communicate with one or more networks, such as a local area network (LAN), a general wide area network (WAN), and / or a public network (e.g., the Internet), providing communication with other computing devices or systems, storage devices, or the like. Ethernet-based (such as Wi-Fi) interfaces and Bluetooth® adapters are just examples of the currently available types of network adapters used in computer systems (BLUETOOTH is a registered trademark of Bluetooth SIG, Inc., Kirkland, Washington, U.S.A.).Attorney Docket No.: 6352.003AWO

[0079] The communication between I / O interfaces 1810 and external devices 1812 can occur across wired and / or wireless communications link(s) 1811, such as Ethernet-based wired or wireless connections. Example wireless connections include cellular, Wi-Fi, Bluetooth®, proximity-based, near-field, or other types of wireless connections. More generally, communications link(s) 1811 may be any appropriate wireless and / or wired communication link(s) for communicating data.

[0080] Particular external device(s) 1812 may include one or more data storage devices, which may store one or more programs, one or more computer readable program instructions, and / or data, etc. Computer system 1800 may include and / or be coupled to and in communication with (e.g. as an external device of the computer system) removable / non-removable, volatile / non-volatile computer system storage media. For example, it may include and / or be coupled to a nonremovable, non-volatile magnetic media (typically called a "hard drive"), a magnetic disk drive for reading from and writing to a removable, non-volatile magnetic disk (e.g., a "floppy disk"), and / or an optical disk drive for reading from or writing to a removable, non-volatile optical disk, such as a CD-ROM, DVD-ROM or other optical media.

[0081] Computer system 1800 may be operational with numerous other general purpose or special purpose computing system environments or configurations. Computer system 1800 may take any of various forms, well-known examples of which include, but are not limited to, personal computer (PC) system(s), server computer system(s), such as messaging server(s), thin client(s), thick client(s), workstation(s), laptop(s), handheld device(s), mobile device(s) / computer(s) such as smartphone(s), tablet(s), and wearable device(s), multiprocessor system(s), microprocessor-based system(s), telephony device(s), network appliance(s) (such as edge appliance(s)), virtualization device(s), storage controller(s), set top box(es), programmable consumer electronic(s), network PC(s), minicomputer system(s), mainframe computer system(s), and distributed cloud computing environment(s) that include any of the above systems or devices, and the like.

[0082] Aspects of the present disclosure may be a system, a method, and / or a computer program product, any of which may be configured to perform or facilitate aspects described herein.

[0083] In some embodiments, aspects of the present disclosure may take the form of a computer program product, which may be embodied as computer readable medium(s). A computer readableAttorney Docket No.: 6352.003AWOmedium may be a tangible storage device / medium having computer readable program code / instructions stored thereon. Example computer readable medium(s) include, but are not limited to, electronic, magnetic, optical, or semiconductor storage devices or systems, or any combination of the foregoing. Example embodiments of a computer readable medium include a hard drive or other mass-storage device, an electrical connection having wires, random access memory (RAM), read-only memory (ROM), erasable-programmable read-only memory such as EPROM or flash memory, an optical fiber, a portable computer disk / diskette, such as a compact disc read-only memory (CD-ROM) or Digital Versatile Disc (DVD), an optical storage device, a magnetic storage device, or any combination of the foregoing. The computer readable medium may be readable by a processor, processing unit, or the like, to obtain data (e.g. instructions) from the medium for execution. In a particular example, a computer program product is or includes one or more computer readable media that includes / stores computer readable program code to provide and facilitate one or more aspects described herein.

[0084] As noted, program instruction contained or stored in / on a computer readable medium can be obtained and executed by any of various suitable components such as a processor of a computer system to cause the computer system to behave and function in a particular manner. Such program instructions for carrying out operations to perform, achieve, or facilitate aspects described herein may be written in, or compiled from code written in, any desired programming language. In some embodiments, such programming language includes object-oriented and / or procedural programming languages such as C, C++, C#, Java, etc.

[0085] Program code can include one or more program instructions obtained for execution by one or more processors. Computer program instructions may be provided to one or more processors of, e.g., one or more computer systems, to produce a machine, such that the program instructions, when executed by the one or more processors, perform, achieve, or facilitate aspects described herein, such as actions or functions described in flowcharts and / or block diagrams described herein. Thus, each block, or combinations of blocks, of the flowchart illustrations and / or block diagrams depicted and described herein can be implemented, in some embodiments, by computer program instructions.

[0086] Although various embodiments are described above, these are only examples.Attorney Docket No.: 6352.003AWO

[0087] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and / or “comprising”, when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components and / or groups thereof.

[0088] The corresponding structures, materials, acts, and equivalents of all means or step plus function elements in the claims below, if any, are intended to include any structure, material, or act for performing the function in combination with other claimed elements as specifically claimed. The description of one or more embodiments has been presented for purposes of illustration and description, but is not intended to be exhaustive or limited to in the form disclosed. Many modifications and variations will be apparent to those of ordinary skill in the art. The embodiment was chosen and described in order to best explain various aspects and the practical application, and to enable others of ordinary skill in the art to understand various embodiments with various modifications as are suited to the particular use contemplated.

Claims

Attorney Docket No.: 6352.003AWOCLAIMS1. A method for facilitating an image-guided procedure, comprising:imaging a patient anatomy with a camera, wherein the imaging the patient anatomy with the camera produces one or more camera images of the patient anatomy;imaging the patient anatomy with an X-ray device, wherein the imaging the patient anatomy with the X-ray device produces at least one radiographic image of the patient anatomy;building and presenting, on a display device, a graphical user interface (GUI) that includes at least portions of the one or more camera images and the at least one radiographic image, the building and presenting including:aligning the one or more camera images and the at least one radiographic image in the GUI such that first anatomical feature(s) of the patient anatomy as presented in the one or more camera images align with corresponding second anatomical feature(s) of the patient anatomy as presented in the at least one radiographic image that underly the first anatomical feature(s).

2. The method of claim 1, wherein the camera is a visible light camera, an infrared camera, or a time-of-flight camera.

3. The method of claim 1, wherein the one or more camera images are presented as part of the GUI to have a transparency that can be selectively adjusted by a user.

4. The method of claim 1, further comprising collimating an X-ray beam in response to displacement of at least one handle of a bounding box also built and presented as part of the GUI.

5. The method of claim 4, wherein the X-ray beam has a central axis, wherein the X-ray beam is collimated off of the central axis.Attorney Docket No.: 6352.003AWO6. A computer system for image-guided procedures, comprising:at least one memory; andone or more processors in communications with the at least one memory, wherein the computer system is configured to perform a method for facilitating an image- guided procedure, the method comprising:imaging a patient anatomy with a camera, wherein the imaging the patient anatomy with the camera produces one or more camera images of the patient anatomy;imaging the patient anatomy with an X-ray device, wherein the imaging the patient anatomy with the X-ray device produces at least one radiographic image of the patient anatomy;building and presenting, on a display device, a graphical user interface (GUI) that includes at least portions of the one or more camera images and the at least one radiographic image, the building and presenting including:aligning the one or more camera images and the at least one radiographic image in the GUI such that first anatomical feature(s) of the patient anatomy as presented in the one or more camera images align with corresponding second anatomical feature(s) of the patient anatomy as presented in the at least one radiographic image that underly the first anatomical feature(s).

7. A computer program product, comprising:a computer readable storage medium readable by a processing circuit and storing instructions for execution by the processing circuit for performing a method for facilitating an image-guided procedure, the method comprising:Attorney Docket No.: 6352.003AWOimaging a patient anatomy with a camera, wherein the imaging the patient anatomy with the camera produces one or more camera images of the patient anatomy;imaging the patient anatomy with an X-ray device, wherein the imaging the patient anatomy with the X-ray device produces at least one radiographic image of the patient anatomy;building and presenting, on a display device, a graphical user interface (GUI) that includes at least portions of the one or more camera images and the at least one radiographic image, the building and presenting including:aligning the one or more camera images and the at least one radiographic image in the GUI such that first anatomical feature(s) of the patient anatomy as presented in the one or more camera images align with corresponding second anatomical feature(s) of the patient anatomy as presented in the at least one radiographic image that underly the first anatomical feature(s).

8. A radiographic collimator apparatus, comprising:a camera having a field of view through an aperture of the radiographic collimator apparatus;a plurality of shutters positioned in the field of view of the camera; and a plurality of motors, wherein each motor of the plurality of motors is configured to control a different shutter of the plurality of shutters and control movement of the shutter independent of movement of each other shutter of the plurality of shutters.

9. The radiographic collimator apparatus of claim 8, further comprising a housing, and a computer system provided as part of, or coupled with, the housing, the computer system configured to control operation of the camera.Attorney Docket No.: 6352.003AWO10. The radiographic collimator apparatus of claim 9, wherein the computer system is in data communication with an external computing system that displays a graphical user interface that includes at least portions of one or more camera images captured by the camera and at least one radiographic image created using the radiographic collimator apparatus.

Images