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WO1997014352A1 - Coloscopie tomographique assistee par ordinateur - Google Patents

Coloscopie tomographique assistee par ordinateur

Info

Publication number
WO1997014352A1
WO1997014352A1 PCT/US1995/014634 US9514634W WO9714352A1 WO 1997014352 A1 WO1997014352 A1 WO 1997014352A1 US 9514634 W US9514634 W US 9514634W WO 9714352 A1 WO9714352 A1 WO 9714352A1
Authority
WO
WIPO (PCT)
Prior art keywords
colon
cross
data
sectional
recited
Prior art date
Application number
PCT/US1995/014634
Other languages
English (en)
Inventor
Carl G. Coin
Original Assignee
Coin Carl G
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US08/300,943 priority Critical patent/US5458111A/en
Priority claimed from US08/300,943 external-priority patent/US5458111A/en
Application filed by Coin Carl G filed Critical Coin Carl G
Priority to CA002234767A priority patent/CA2234767A1/fr
Priority to NZ330208A priority patent/NZ330208A/xx
Priority to EP95939881A priority patent/EP0973433A1/fr
Priority to AU41539/96A priority patent/AU718433B2/en
Priority to PCT/US1995/014634 priority patent/WO1997014352A1/fr
Publication of WO1997014352A1 publication Critical patent/WO1997014352A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/48—Diagnostic techniques
    • A61B6/481—Diagnostic techniques involving the use of contrast agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/02—Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
    • A61B6/03—Computed tomography [CT]
    • A61B6/032—Transmission computed tomography [CT]

Definitions

  • the present invention relates to a safe and effective method for examining a colon which is generally non-invasive, substantially rapid, and which provides a continuous unobstructed view of the internal surface of the colon wall that facilitates detection and diagnosis of abnormalities in the colon anatomy.
  • colonoscopy which consists of a direct endoscopic examination of the colon with a flexible tubular structure known as a colonoscope which has fiber optic capabilities at one end thereof.
  • the colonoscope is inserted through the patient's anus and directed along the length of the colon, thereby permitting direct endoscopic visualization of the colon polyps and tumors and in some cases, providing a capability for endoscopic biopsy and polyp removal.
  • colonoscopy is time-consuming, expensive to perform, and requires great care and skill by the examiner, thorough patient preparation including purgatives and enemas, and usually a moderate anesthesia.
  • colonoscopy is an extremely invasive procedure, there is a significant risk of injury to the colon and the possibility of colon perforation and peritonitis, which can be fatal.
  • Another standard procedure for examining the colon involves a "barium enema" followed by a fluoroscopic and radiographic examination.
  • a solution of barium sulfite alone or mixed with air is first injected into the patient's colon by means of an enema, and then a fluoroscopic and radiographic examination of the colon is performed.
  • This examination requires detailed observation by a radiologist, who must palpate the patient's abdomen and repeatedly reposition the patient for the taking of a first set of x-rays. After these initial x-rays are completed, the patient evacuates the barium mixture and additional x-rays are taken.
  • the total examination procedure can be of considerable duration, lasting from 20 minutes to 1-1/2 hours, and is very uncomfortable and demanding both for the patient as well as the radiologist and x-ray technician.
  • the patient may experience numerous difficulties such as problems retaining the barium mixture, pain associated with palpation, and colon spasms.
  • the colon It is also possible for the colon to become impacted with barium, leading to severe constipation and interference with later diagnostics, thereby requiring the barium to be fully purged using powerful and sometimes dangerous laxatives. This purging of the barium may also in rare instances result in colon perforation with barium peritonitis, which is a lifetime debilitating and potentially fatal complication.
  • the present invention is directed towards a generally non- invasive method of colon examination in which the patient's colon is first inflated with gas, and then a plurality of cross-sectional images of the colon are taken preferably by CT scanning along the longitudinal axis of the abdomen.
  • a set of projection data obtained from the scanning and corresponding to each cross- sectional image is stored in computer memory.
  • These sets of data are processed by a first computer program that reconstructs a three-dimensional model of the entire colon.
  • Data corresponding to the reconstructed three-dimensional model of the colon are also stored in computer memory.
  • a second computer program processes the original sets of data and the three-dimensional model data to reconstruct, for successive thin segments along the length of the
  • Another object of the present invention is to provide a method of examining a colon which minimizes the significant discomfort usually experienced by the patient during a conventional colon examination procedure.
  • a further object is to provide a method of examining a colon which is generally non-invasive so as to minimize any health risks associated with the examination procedure.
  • Figure 1 is a front perspective view of a colon.
  • Figures 2A through 2F illustrate a plurality of cross- sectional images produced by the method of the present invention for the like-numbered segments indicated in Figure 1.
  • Figure 3 shows an exploded view of a portion of the colon with a cursor positioned adjacent a selected colon segment depicted in
  • Figure 4 is a view taken along lines 4—4 of figure 3 of a cross-sectional image produced by the method of the present invention for the colon segment adjacent the cursor in Figure 3.
  • Figures 5 and 5A-5F illustrate standard prior art cross- sectional images of the colon produced by CT scanning.
  • the method of the present invention requires initially that the patient's colon be filled with a gaseous contrast agent, which preferably can be ambient air, carbon dioxide, xenon or nitrous oxide. If xenon or nitrous oxide is selected, a topical anesthetic effect will be produced.
  • the gas is injected into the colon by means of a pump having an enema tip that is inserted into the patient's rectum.
  • the purpose of inflating the colon is two-fold. First, the colon normally sits within the abdomen in a collapsed configuration, which does not permit accurate viewing of its true internal structure. After being filled with gas, as shown in Figure 1, the colon assumes a defined shape which facilitates examination of its internal wall surfaces.
  • the gas acts as a contrast agent that is extremely distinguishable from structures such as water, fat and tissue surrounding the gas.
  • the x-ray absorption values for gas as designated in Hounsfield Units ( H.U. ) along the Hounsfield Scale of x-ray absorption values, are at the extreme low end of the scale at approximately -1000 H.U., compared to fat in the colon wall which has a value of about -100 H.U., water which has a value of 0, and bone, which is very dense and has a value of 1000 H.U.
  • Gas therefore acts as an effective contrast agent when utilized in conjunction with transmission imaging of a body as by computed tomographic ("CT") scanning.
  • CT computed tomographic
  • multiple cross- sectional images of the entire colon are taken along the longitudinal axis of the patient's abdomen, preferably by CT scan employing helical scan imaging.
  • a magnetic resonance imaging apparatus may be utilized to obtain the cross- sectional images.
  • This CT scanning produces sets of projection data corresponding to standard cross-sectional images of the colon taken generally along the longitudinal axis of the abdomen, with 5 the sets of data being transmitted to computer memory for storage therein. Representative illustrations of such cross-sectional images are shown in Figures 5A - 5F.
  • a first computer program processes the sets of projection data to reconstruct a three- dimensional model of the colon, as shown in Figure 1.
  • this reconstructed three-dimensional model will be a model of the gas-filled lumen of the colon.
  • This first reconstruction program requires that an initial, representative prior art cross-sectional image of the colon obtained by the CT scanning be displayed on a display means such as a high resolution video monitor.
  • a cursor is positioned on the lumen of the displayed prior art cross- sectional image through the use of input means such as a mouse or keyboard.
  • the cursor comprises a small circle having a diameter preferably in the range of 5-20 millimeters.
  • This outlined circle on the lumen of the displayed prior art cross-sectional image provides the starting point for this first program, which operates to join together sections that are contiguous with the displayed prior art cross-sectional image and which are in the same range of x-ray absorption values as gas, to form a three-dimensional model of the colon.
  • the three-dimensional model will actually be a model of the gas-filled lumen of the colon.
  • data representing the reconstructed three-dimensional colon model are also stored in computer memory.
  • a second computer program processes the initial sets of data and the three-dimensional model data to reconstruct, for successive thin segments along the length of the entire colon, cross-sectional images which provide a precise simulation of images of the interior of the colon along its length similar to that which would be viewed by colonoscopy.
  • This second program functions by selecting contiguous thin colon segments along the length of the entire colon and reconstructing for each segment the one cross- sectional view thereof which is perpendicular to the longitudinal axis of the colon lumen.
  • the thickness of these segments will be selectively variable by the user and preferably will be in the range of 1-10 millimeters.
  • this second program evaluates and processes the data stored in computer memory using the parameters of smallest cross- sectional diameter, area and circumference as applied to each segment to reconstruct the one desired cross-sectional image for that segment which is perpendicular to the longitudinal axis of the colon lumen. Data representing each of the desired cross-sectional images is then stored in computer memory, for subsequent retrieval and viewing of the images.
  • the program also preferably includes the capability to reconstruct the tissue surrounding the periphery of the lumen of each cross-sectional image, at a tissue thickness that can be selectively varied by the user.
  • the resultant reconstructed images produced by the second program will enable a visualization of both the internal and the external wall surfaces for each cross-sectional image.
  • the examining physician can retrieve each reconstructed cross-sectional image individually from memory for display on the video monitor and if desired, for taking a photograph thereof.
  • the physician displays the three-dimensional model of the colon on the monitor, positions the cursor adjacent the selected colon segment, as shown in Figure 3, and then uses the keyboard to input the appropriate display instruction to the computer, whereby the selected reconstructed cross-sectional image is displayed on the same monitor and replaces the view of the three-dimensional model.
  • the user can return to the view of the three-dimensional model by inputting the appropriate instructions to the computer.
  • the method of the present invention may also include the capability for
  • the program preferably allows the physician to view the reconstructed cross-sectional images in the consecutive sequential order of the sections along the length of the colon, generally in the manner of flipping through the pages of a book.
  • the reconstructed images produced by the present invention provide a visualization of the colon as if it were a tube that had been straightened out and viewed from either end by multiple, consecutive contiguous thin axial sections. This is because each reconstructed cross-sectional image is correctly angled in perpendicular relation to the longitudinal axis of the colon lumen.
  • a physician will be able to readily detect polyps and tumors as small as 2 millimeters which intrude into the lumen of each cross-sectional image and which provide anatomic evidence of an abnormality in the colon.
  • a polyp which intrudes into the colon lumen will be viewed as a roughly perpendicular protrusion to the internal colon wall and will show more precisely its true pathologic relation to the colon wall than would be shown by prior art images of the colon produced by CT scanning because such images are oblique and distorted.
  • the reconstructed cross-sectional images produced by the present invention can therefore assist the physician in determining the gross pathologic significance of a polyp or tumor.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Radiology & Medical Imaging (AREA)
  • Molecular Biology (AREA)
  • Biophysics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Physics & Mathematics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pulmonology (AREA)
  • Theoretical Computer Science (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Ultra Sonic Daignosis Equipment (AREA)

Abstract

La présente invention concerne un procédé généralement non invasif d'examen du colon consistant d'abord à gonfler d'un gaz le colon du patient puis à prendre, le long de l'axe longitudinal de l'abdomen, une pluralité d'images en coupe du colon par imagerie par tomographie assistée par ordinateur. Des fichiers de données correspondant à chaque image de coupe sont stockés dans la mémoire de l'ordinateur, puis traités par un premier programme informatique qui reconstruit un modèle tridimensionnel de la totalité du colon, les données correspondant au modèle de colon tridimensionnel reconstruit étant également stockées dans la mémoire de l'ordinateur. Un second programme informatique traite les fichiers originaux de données et le modèle tridimensionnel de façon reconstruire, suivant la longueur de tout le colon sur une suite de segments de faible épaisseur, une image de coupe correspondant à chacun des segments perpendiculaire à l'axe longitudinal de la lumière du colon. Ces images reconstruites, qui fournissent une simulation exacte de l'intérieur du colon tel qu'il se présenterait à la coloscopie, peuvent être récupérées de la mémoire et visualisées pour examen au moyen d'un écran vidéo conventionnel, ce qui permet au médecin de déceler toute anomalie anatomique de la paroi du colon susceptible de signaler la présence d'une anomalie telle qu'un polype ou une tumeur.
PCT/US1995/014634 1994-09-06 1995-10-16 Coloscopie tomographique assistee par ordinateur WO1997014352A1 (fr)

Priority Applications (6)

Application Number Priority Date Filing Date Title
US08/300,943 US5458111A (en) 1994-09-06 1994-09-06 Computed tomographic colonoscopy
CA002234767A CA2234767A1 (fr) 1995-10-16 1995-10-16 Coloscopie tomographique assistee par ordinateur
NZ330208A NZ330208A (en) 1995-10-16 1995-10-16 Computed tomographic colonscopy
EP95939881A EP0973433A1 (fr) 1995-10-16 1995-10-16 Coloscopie tomographique assistee par ordinateur
AU41539/96A AU718433B2 (en) 1995-10-16 1995-10-16 Computed tomographic colonscopy
PCT/US1995/014634 WO1997014352A1 (fr) 1994-09-06 1995-10-16 Coloscopie tomographique assistee par ordinateur

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US08/300,943 US5458111A (en) 1994-09-06 1994-09-06 Computed tomographic colonoscopy
CA002234767A CA2234767A1 (fr) 1995-10-16 1995-10-16 Coloscopie tomographique assistee par ordinateur
PCT/US1995/014634 WO1997014352A1 (fr) 1994-09-06 1995-10-16 Coloscopie tomographique assistee par ordinateur

Publications (1)

Publication Number Publication Date
WO1997014352A1 true WO1997014352A1 (fr) 1997-04-24

Family

ID=25680131

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1995/014634 WO1997014352A1 (fr) 1994-09-06 1995-10-16 Coloscopie tomographique assistee par ordinateur

Country Status (4)

Country Link
EP (1) EP0973433A1 (fr)
AU (1) AU718433B2 (fr)
CA (1) CA2234767A1 (fr)
WO (1) WO1997014352A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002093496A1 (fr) 2001-05-15 2002-11-21 Koninklijke Philips Electronics N.V. Analyse d'un ensemble pluridimensionnel de donnees

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4391280A (en) * 1980-04-04 1983-07-05 Miller Roscoe E Enema apparata improvements relating to double contrast studies
US5023072A (en) * 1988-08-10 1991-06-11 University Of New Mexico Paramagnetic/superparamagnetic/ferromagnetic sucrose sulfate compositions for magnetic resonance imaging of the gastrointestinal tract
US5322070A (en) * 1992-08-21 1994-06-21 E-Z-Em, Inc. Barium enema insufflation system
US5383456A (en) * 1992-12-18 1995-01-24 The Ohio State University Research Foundation Radiation-based laparoscopic method for determining treatment modality

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4405505A1 (de) * 1994-02-21 1995-08-31 Siemens Ag Computertomograph

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4391280A (en) * 1980-04-04 1983-07-05 Miller Roscoe E Enema apparata improvements relating to double contrast studies
US5023072A (en) * 1988-08-10 1991-06-11 University Of New Mexico Paramagnetic/superparamagnetic/ferromagnetic sucrose sulfate compositions for magnetic resonance imaging of the gastrointestinal tract
US5322070A (en) * 1992-08-21 1994-06-21 E-Z-Em, Inc. Barium enema insufflation system
US5383456A (en) * 1992-12-18 1995-01-24 The Ohio State University Research Foundation Radiation-based laparoscopic method for determining treatment modality

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002093496A1 (fr) 2001-05-15 2002-11-21 Koninklijke Philips Electronics N.V. Analyse d'un ensemble pluridimensionnel de donnees
US7266228B2 (en) 2001-05-15 2007-09-04 Koninklijke Philips Electronics N.V. Multi-dimensional data set analysis and modeling with improved feature detection

Also Published As

Publication number Publication date
EP0973433A4 (fr) 2000-01-26
AU4153996A (en) 1997-05-07
AU718433B2 (en) 2000-04-13
CA2234767A1 (fr) 1997-04-24
EP0973433A1 (fr) 2000-01-26

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