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[0001] The present invention relates to methods and systems for imaging a body tissue or organ.
[0002] In the diagnosis of a clinical condition in a body tissue or organ, it is known to obtain a number of biopsies from the tissue or organ. For example, in the diagnosis of prostate or breast cancer, a region of the organ is imaged using ultrasonic radiation. The practitioner obtains a 2D image of the region of the organ and then, based on the image, selects a site in the organ from where a biopsy is to be obtained. A cannula is then introduced into the organ to the site and a biopsy is obtained. The cannula is typically integrated with the ultrasound transducer, and the cannula as well as the site in the image from which the cannula is poised to obtain a biopsy is indicated in the image. After obtaining the biopsy, another 2D image of another region of the organ or tissue may be obtained (by moving the ultrasound transducer) and an additional site of the organ or tissue may be selected for obtaining a biopsy. This process may be repeated several times so as to yield a number of biopsies from different sites of the organ or tissue.
[0003] In this method of obtaining biopsies, it is difficult for the practitioner to visualize in three dimensions the spatial relationship among the biopsy sites. This is due to the fact that each time the practitioner moves the ultrasound transducer to obtain a new image, the practitioner must remember bow the transducer was moved in order to visualize in his mind the spatial relationship between the presently and previously imaged regions and the perspectives from which the regions were imaged. The inability to accurately determinate and record the spatial relationships among the imaged regions often results in biopsies not being obtained from sites where a biopsy should have been obtained.
[0004] The present invention provides a system and method for selecting and recording biopsy sites within a body organ. In accordance with the invention, a three-dimensional image of at least a portion of the organ is obtained using a three-dimensional imaging device such as a three-dimensional ultrasound imaging transducer. The three dimensional image may be analyzed for regions that are suspected of having a predetermined condition such as a malignancy. For example, applicant's co-pending U.S. patent application Ser. No. 09/874,919 filed on Jun. 5, 2001 discloses a method for detecting malignancies in a tissue. The image is processed to produce a grid-like three-dimensional representation of the three-dimensional contour of the organ. This grid representation of the image is displayed on a display screen. The grid representation of the contour allows the interior of the organ to be visualized through the surface. Regions in the image suspected of having a predetermined condition such as malignancy may be indicated in the grid representation. A sub-region of the organ is then imaged. The sub-region may be imaged using either a two-dimensional imaging system such as an ultrasound system having a two-dimensional transducer, or a three-dimensional imaging system. The image of the sub-region, referred to herein as a “sub-image” is displayed on a display screen. The sub-image is analyzed and its position within the grid representation of the organ is determined. This may be done by using one or more reference points that are present in the image of the organ and the sub-image (e.g. a bone feature or artificially inserted clips present in the image and sub-image). Alternatively, this may be done in a calculation based upon the orientation of the transducers relative to the body organ when the image and sub-image were obtained. The sub-image is then indicated in the displayed grid representation of the organ. The sub-image and the grid representation showing the sub-image are thus displayed simultaneously. Regions in the sub-image suspected of having the predetermined condition are preferably indicated in the displayed sub-image.
[0005] The practitioner decides at which sites, if any, in the sub-image, a biopsy is to be obtained. The locations of any biopsies obtained are indicated in the sub-image as well as in the grid-representation.
[0006] Additional sub-images of the organ may then be obtained and displayed. For each sub-image, the position of the sub-image is indicated in, the grid representation. Sites in the sub-image where biopsies were previously obtained are indicated in the sub-image. Sites in the sub-image suspected of having the predetermined condition are preferably indicated in the sub-image. The practitioner then decides at which sites, if any, in this sub-image, a biopsy is to be obtained. The locations of any biopsies obtained are indicated in the sub-image as well as in the grid-representation.
[0007] Since the location of a current-sub-image is indicated in the grid representation together with the locations of any previous sub-regions, the practitioner can select sub-images in an orderly fashion. If sites suspected of having a predetermined condition are indicated in the grid representation and in the sub-images, the practitioner can obtain biopsies from all suspected sites.
[0008] In a preferred embodiment, the transducer used to obtain sub-images has an integrated cannula that is used to obtain a biopsy at a site in a sub-image. The sub-image includes a sign indicative of the site in the sub-image from which the cannula is poised to remove tissue for a biopsy. This allows the practitioner to select a site from which a biopsy is to be obtained based upon the spatial relationship of the site to sites in the image where biopsies were previously obtained. In particular, if suspected sites are indicated in the sub-image, the practitioner can position the cannula to obtain biopsies from the suspected sites.
[0009] The invention thus provides, in one of its aspects, a method for selecting and recording biopsy sites in a body organ comprising:
[0010] a) obtaining a three-dimensional image of a three dimensional region of the organ;
[0011] b) obtaining a first two-dimensional sub-image of a first two-dimensional sub-region of the three-dimensional region;
[0012] c) determining the position of the first two-dimensional, sub-image in the three-dimensional image;
[0013] d) optionally selecting one or more sites in the first two-dimensional sub-image where a biopsy is to be obtained;
[0014] e) indicating in the three-dimensional image any sites at which biopsies were obtained;
[0015] f) obtaining an additional two-dimensional sub-image of an additional two-dimensional sub-region of the organ, the additional two-dimensional sub-region, being included in the three-dimensional region;
[0016] g) determining the position of the additional two-dimensional sub-image in the three-dimensional image;
[0017] h) indicating in the additional two-dimensional sub-image any sites where biopsies have previously been obtained;
[0018] i) optionally selecting one or more sites in the additional two-dimensional sub-image where biopsies are to be obtained;
[0019] j) indicating in the three-dimensional image any sites where biopsies were previously obtained; and
[0020] k) repeating steps f) to j) as required.
[0021] In another of its aspects, the invention provides a system for selecting and recording biopsy sites in a body organ comprising:
[0022] (a) A three-dimensional imaging device providing a three-dimensional image of a three dimensional region of the organ;
[0023] (b) A two-dimensional imaging device providing two-dimensional sub-images of two-dimensional sub-regions of the three-dimensional region;
[0024] (c) One or more display screens for displaying a representation of the three dimensional image and for displaying one or more two-dimensional images;
[0025] (d) Means for selecting one or more sites in a two-dimensional sub-image where a biopsy is to be obtained;
[0026] (e) A processor configured to:
[0027] (i) determine the position of a two-dimensional sub-image in the three-dimensional image;
[0028] (ii) display on a display screen a representation of a three-dimensional image with an indication of the position of a two-dimensional sub-image in the three-dimensional image;
[0029] (iii) display on a display screen one or more two-dimensional sub-images;
[0030] (iv) determine in a three-dimensional image any sites at which biopsies were obtained and indicate in a displayed representation of the three-dimensional image any sites at which biopsies were obtained;
[0031] First Embodiment
[0032]
[0033] A processor
[0034] Referring again to
[0035]
[0036] The shaft
[0037] After a 3D image of the organ has been obtained and a grid representation of the organ generated and displayed, as described above, a 2D sub-image of a planar sub-region of the organ is obtained using the imaging device
[0038] The processor
[0039] Additional 2D sub-images of the organ may then be obtained, as processed as above. For each sub-image, the position of the sub-image in the 3D image is indicated in the grid-representation of the organ. Locations in the sub-image suspected of having the predetermined condition, as well as sites in the sub-image where biopsies were previously performed, are indicated in the displayed image. The site in the sub-image at which the cannula
[0040] Indicating in the grid-representation the site in the organ of each biopsy as the biopsy is obtained insures that biopsies are obtained from all selected sites, and moreover allows the site of each biopsy in the organ to be recorded for future reference. Displaying simultaneously on a displayed sub-image regions suspected of having a predetermined condition, such as malignancy as well as the site where the cannula
[0041] Second Embodiment
[0042]
[0043] The processor
[0044] Since separate imaging devices are used to obtain the 3D image and 2D sub-images, the 3D image obtained by the imaging device
[0045]
[0046] The transducer
[0047] After a 3D image of the organ has been obtained by the 3D imaging device
[0048] The processor
[0049] As in the first embodiment, additional 2D sub-images of the organ may then be obtained, as described above. For each additional 2D sub-image, the change in the location and angular orientation of the transducer
[0050] Indicating in the grid-representation the site in the organ of each biopsy as the biopsy is obtained insures that biopsies are obtained from all selected sites, and moreover allows the site of each biopsy in the organ to be recorded for future reference. Displaying simultaneously on a displayed sub-image regions suspected of having a predetermined condition, such as malignancy as well as the site where the cannula