DE102013215454A1 - Method and device for patient positioning - Google Patents

Abstract

The invention relates to the positioning of a patient (4) in a gantry (1) of a medical device for examination or treatment. In this case, a patient positioning device (2) is used for positioning the patient (4) in the gantry (1), which comprises at least two sections (211, 212, 213) which can be tilted relative to one another about at least one axis (231, 232). In order to position the patient (4) in the gantry (1), a tilting of the at least two sections (211, 212, 213) relative to one another is performed. The invention enables a higher efficiency in the positioning of the patient (4) in the gantry (1).

Description

The invention relates to a method of a patient positioning device and a medical device for positioning a patient in a gantry.

For a suitable examination or treatment of patients irradiation devices are often used in medical technology, which irradiate target areas of a patient with electromagnetic radiation or particles. A widespread diagnostic procedure is computed tomography. Computed tomography devices typically include a gantry having a stationary portion and a portion rotatable about a system axis of the gantry relative to the stationary portion. The rotatable member is in the form of a drum, on which components of the computed tomography apparatus, such as e.g. the X-ray source, the X-ray detector, a control system, etc. are arranged. During operation of the computed tomography apparatus, these components are rotated about a patient, which is usually arranged along the system axis in a measuring field, in order to obtain images from different directions. The images or projections taken from different directions are then reconstructed into a 3-dimensional image of the examined tissue.

For certain examinations of patients, the gantry is tilted or swiveled with the X-ray measuring system about a substantially horizontally extending tilting axis arranged at right angles to the system axis relative to a base or to a base. The tilt angle is typically a maximum of +/- 30 ° from the starting position.

Examples of such studies are spiral scans of the head and spine. Tilting in head shots reduces the dose to the radiation-sensitive eye tissue. Spiral scans of the spine partially involve dynamic adjustment of the angle of incidence to the spine so that the spine is as perpendicular to the rotating gantry as possible throughout the scan.

The structure of a tiltable CT gantry is for example in the Scriptures US 2010/0067652 A1 described. A variant for a tilt bearing about a tilt axis discloses the DE 102011002619 A1 , The procedure for shooting by means of a tilted CT gantry is for example in the US 6,751,283 B2 described. For commercially available CTs now tipping by +/- 30 ° to the standard design belongs, such as the Somatom Spirit of Siemens AG. Tiltable gantries have been proposed, for example, for therapy, such as from US 2012/0324648 A1 can be seen, which describes a PET system.

An examination by computer tomography is typically characterized by a comparatively short examination time (in the range of seconds) and a comparatively much longer preparation time (in the range of minutes). This is all the more true if tipping the gantry is required for the examination. To ensure an efficient workflow it is necessary to keep the preparation time for recording with tiltable gantrys as short as possible. It is an object of the invention to make a contribution to this.

This object is achieved in each case by a method according to claim 1, a patient positioning device according to claim 6 and a medical device according to claim 14.

A method is proposed for positioning a patient in a gantry of a medical device (preferably a diagnostic device, such as a computed tomography or MRI scanner) for examination or treatment. Positioning a patient is understood to mean transporting the body or a body part of the patient into a receiving or treatment position. According to the invention, a patient positioning device is used for positioning the patient in the gantry, which comprises at least two sections which can be tilted relative to one another about at least one axis. For the positioning of the patient in the gantry a tilting of the at least two sections is made to each other.

According to one embodiment of the method, not only a positioning in a gantry, but also a positioning in a gantry is made. For this purpose, the patient positioning device is designed for translation in the horizontal direction and is moved in this horizontal direction for transporting the patient into the gantry. Transporting the patient into the gantry should also be understood to mean the transport of a body region of the patient to be examined from outside the gantry into the gantry.

According to one embodiment, the patient positioning device comprises at least three (preferably three or four) sections which can be tilted relative to one another about at least two (preferably two or three) parallel axes, and the at least three sections are tilted relative to one another.

To produce a patient examination position, provision may be made for the gantry to be tilted about an axis and the gantry for positioning the patient to be tilted in a receiving or treatment position about this axis.

According to one embodiment, a translation in the horizontal direction before the tilting of the at least two sections to each other and possibly the tilting of the gantry is made. Preferably, the patient positioning device is configured such that the translation direction and tilt axes are mutually orthogonal.

The invention also includes a patient positioning device for positioning a patient of a gantry which comprises at least two sections which can be tilted relative to one another about at least one axis and which is designed with a tilting mechanism for tilting the tiltable sections relative to one another. Preferably, the patient positioning device is also designed for translation in the horizontal direction such that the patient positioning device is movable into the gantry by translation in this horizontal direction. The preferred embodiment is the at least one tilt axis for tilting the tiltable portions orthogonal to this horizontal direction for movement of the patient positioning device into the gantry. It can also be provided that not the entire patient positioning device but only a support on which the patient is positioned can be moved by translation of this horizontal direction into the gantry. This embodiment is characterized by the characterization of the patient positioning device as being moveable by translation in this horizontal direction into the gantry.

The patient positioning device can also be designed for translation in the vertical direction, so as to ensure an adaptation to the gantry height or to facilitate the ascent by the patient.

According to one embodiment, the patient transport device comprises at least three (preferably three or four) to each other about at least two (preferably two or three) orthogonal axes tiltable sections. The different tilt axes are preferably parallel to each other. Preferably, the sections are also adapted in terms of number and length according to the (average) human anatomy. That For example, the tilting axes are positioned approximately where a human body has tilting axes (for example, for flexing of the torso, tilting of the thigh and lower leg relative to each other, or twisting of the foot position). In one embodiment, the patient positioning device is tiltable such that the shape of a chair or wheelchair results. The tilting mechanism of the patient positioning device can be realized with inflatable cushions. Another alternative, which may also be used in combination with inflatable cushions, is designed for a wheeled patient positioning device. The wheels are connected by connecting elements with the tiltable sections at connecting positions (usually not all wheels with the same section, whereby only a change in height would be feasible). The patient device is also designed for tilting at least two sections by changing at least one horizontal distance between the wheel and the associated connection position.

The patient positioning device may be configured as a gantry dockable patient transport device.

The invention also includes a medical device which is formed with a patient positioning device according to the invention and a tilting gantry. This gantry can form a closed ring and belongs, for example, to a computer tomograph or an MRI scanner.

The subject invention is explained in more detail below in the context of embodiments with reference to figures. Show it

1 FIG. 2: a medical arrangement with a patient positioning device according to the invention and a tilting gantry, FIG.

2 : schematic pictures to explain inventive principles,

3 : three pictures of a medical line behind 1 which illustrate the sequence of a method according to the invention,

4 : a schematic representation which explains a further variant of the method according to the invention,

5 FIG. 5 shows partial subfigures showing a first realization of a tilting functionality of the patient positioning device, FIG.

6 a second implementation of a tilting functionality of the patient positioning device, and

7 : Another illustration of the second implementation of a tilting functionality.

1 shows a CT gantry 1 which with a base 11 and a drum 12 is formed. The drum 12 is not only for a rotation for shooting from different directions, but also for a tilt about an axis perpendicular to the axis of rotation of the drum 12 educated. The CT gantry 1 also has a docking interface 3 on, by means of which a patient transport device 2 can be docked. The patient transport device 2 is by means of wheels 221 and 222 to the CT gantry 1 moved and over the docking interface 3 at the CT gantry 1 fixed. The patient transport device 2 has the shape of a patient chair, but could also be designed as a patient bed with a substantially horizontal reclining position of the patient. The patient 4 sits on one with four sections 211 . 212 . 213 . 214 formed edition, which also for the purpose of transporting the patient 4 in the gantry 1 as from the patient transport device 2 can be releasably formed. In 1 are the sections 211 . 212 . 213 . 214 the edition chosen so that one for the patient 4 as pleasant positioning possible. This is realized primarily by selecting the length of each section 211 . 212 . 213 . 214 which for supporting the patient's back (section 214 ), for the realization of a seat (section 213 ), to support the legs (section 212 ) or to support the feet (Section 211 ) are configured.

2 shows several relevant elements for patient positioning or transport. At the top of the figure is a patient 4 indicated schematically, on a flat couch board 23 is positioned. As shown there, the location of this chaise board can 23 be changed to realize a vertical position, a tilted position or a horizontal position of the patient. Among other things, the invention is based on the consideration that a support or couch formed from sections which can be tilted towards one another both a more pleasant transport and a more effective positioning of the patient 4 allowed. This is indicated in the middle figure chain. The patient 4 will now be of four tiltable couch sections 231 . 232 . 233 and 234 supported. With these figures is shown how the patient 4 can be brought from a sitting position to a lying position, wherein in the lying position, the sections 231 . 232 . 233 and 234 a horizontal lying surface 23 form. At the bottom of the figure is an overall arrangement with patient transport device 2 which on wheels 271 and 272 is movable, as well as a gantry 1 shown. The patient transport device 2 includes four support sections 231 . 232 . 233 and 234 which the patient 4 assist in a sitting position. There is also an interface 23 intended. This patient transport device 2 will go in the direction 58 on an interface 31 the gantry 1 moved, passing through the two interfaces 32 and 31 a coupling of the patient transport device to the gantry 1 is feasible. The gantry 1 is in turn with a base 11 and a tiltable drum 12 educated.

3 shows how with the help of the tiltable support sections 211 . 212 . 213 the patient 4 can be transferred to a treatment position. In the figure, three partial figures are shown, which correspond to different times in the preparation of the treatment position. This is the patient 4 each on one of three sections 211 . 212 and 213 formed support (wherein the sections may be formed of a support and a pad resting thereon). By two tilting joints or tilting axes 231 and 232 are the sections 211 to 213 tilted to each other. The patient is in a gantry 1 examined, the gantry turn from a base 11 and a tiltable drum 12 is formed. In the left picture is by the arrow 51 indicated that the patient is first moved in a horizontal direction in the gantry. In the middle picture it is shown how a treatment position is realized by three cooperating movements. The tilt joint 231 was in the vertical direction 52 lifted, which leads to a flexion of the patient's legs. The joint 232 , which is located in the hip area of the patient 4 was, was - as by the arrow 53 indicated - lowered in the vertical direction, so that there is a tendency of the patient's upper body, which is supported by the fact that the joint 232 opposite end of the section 213 is raised (movement 54 ). At the same time the drum becomes 12 the gantry tilted (movement 55 ). By interaction of the various degrees of freedom of the overall system (tilting axes in the region of the popliteal fossa and hip area as well as vertical raising or lowering and tilting degree of freedom of the drum 12 ) assumes a desired examination position. This can be adjusted as needed during the examination. In particular, it can be provided that there is a patient advancement during the examination, which is for the realization of a scan area of the patient 4 in the course of the scan is required. This is illustrated in the right picture. There is the patient upper body in relation to the drum 12 slightly shifted, which corresponds to a scan feed. This displacement is in part realized by the horizontal movement of the support on which the patient is located. At the same time tilting positions of the support and the gantry ( 1 ) changed. These adjustments are made according to the requirements of the scan, eg to take into account the curved shape of the spine of the patient (scan direction orthogonal to the spine).

In 4 another variant is shown schematically. The patient 4 is again on one of three sections 211 . 212 and 213 formed base, which by means of two joints 231 and 232 allows a Verkippbarkeit the sections to each other. In addition, there are four different positions of a computer tomograph 1 which with source 14 and detector 13 is formed, indicated. The patient pad is in the horizontal direction 51 movable. In addition, it is provided that the gantry can be raised and lowered in the vertical direction (arrow 56 ). In addition, the CT gantry is tiltable. The four positions of the gantry shown 1 correspond to different times of an investigation. During the examination, the patient is moved in the horizontal direction and the vertical position of the gantry is adjusted according to the scan to be performed. Due to the vertical adjustment of the gantry, fewer adjustments to the position of the patient support (in particular vertical adjustment) must be made. As a result, the patient is less moved and thus relieved.

In 5 It is shown how a tilting mechanism for tilting the individual sections of the patient support can be realized. The tilting is accomplished according to the implementation shown in the figure by pneumatic cushion. On the left side of the figure, three sub-figures are arranged among themselves, illustrating the principle. The patient 4 lies on one of three sections 211 . 212 and 213 formed support, which two joints or tilt axes 231 and 232 includes. Below the section 211 is a first inflatable pillow 251 arranged. Below the joint 232 is a second inflatable pillow 252 intended. Both pillows lie on a support 24 , The two pillows 251 and 252 are formed with a plurality of chambers which are independently inflatable. In the middle picture are the chambers 2511 and 2512 of the pillow 251 inflated. On the other hand, there is a third chamber 2511 of the pillow 211 not yet filled. At the pillow 252 are all three chambers 2521 . 2522 and 2523 inflated. The inflating of the chambers thus provides an erection of the upper body of the patient 4 and bending his legs. In the lower picture is also the last chamber 2511 of the pillow 251 filled with air or other suitable gas, resulting in a further uprighting of the upper body. A mechanism for air or gas filling the cushion is schematically outlined in the other two sub-figures in the middle above and bottom right. The patient support shown in the left three images is part of a patient transport device which contains an air or gas filled container 254 includes. From this container lead gas pipes 255 and 253 to the pillows 251 respectively. 252 , These lines each include a valve 2552 respectively. 2532 for controlling the gas inlet into the individual chambers of the cushions 251 and 252 , each with individual lines 2551 respectively. 2513 with the valves 2552 respectively. 2532 are connected. The adjustment of the valves 2552 and 2532 For example, it is made such that the individual chambers of the pillows fill one after the other so as to realize a more controlled tilting. In the figure below right is shown as by reducing the volume of the gas container 254 Gas in the pillows or cushions 2511 . 2512 . 2513 and 2521 . 2522 and 2523 is pressed, and so the patient is brought from a lying position to a semi-sitting position. In this case, a motor may be provided (not shown in the figure), by means of which on the container 254 Pressure is applied so that the gas is pumped into the cushions.

Another realization possibility for a mechanism for tilting of support sections shows 6 , 6 In the upper left corner, there is a lying board consisting of three sections in three different positions, which represent an increasing ( 54 , respectively. 54 ' ) correspond to the front part of the lounger. The individual sections are with 211 . 212 . 213 respectively. 211 ' to 213 ' and 211 '' to 213 '' designated. The idea with this realization is that a change of the lying position can be achieved by the position of the wheels. This is schematically arranged on the right side. There it is shown that in the vertical direction (reference numerals 57 ) the position of the support 24 by a corresponding movement of the support struts 261 respectively. 262 can be changed. The lower endpoints of the support struts 261 respectively. 262 are transferred by reducing the distance in a horizontal movement (see position 24 ' . 261 ' and 262 ' as well as position 24 '' . 261 '' and 262 '' ). In the middle of a plan view of the bedstead formed of three sections is shown. This again consists of three sections 211 . 212 and 213 , The axis 231 ' corresponds to the position 231 in the couch shown above. Below four different positions of a patient transport device are shown. The three sections are shown in each case 211 . 212 and 213 as well as the tilting axle 231 , The support formed by three sections is by means of two connecting struts 261 and 262 with the wheels 271 respectively. 272 connected. The four figures indicate how by changing the distance of the wheels 271 and 272 and the relative position of the connecting struts 261 and 262 different tilting positions of the existing from the three sections edition can be realized.

In 7 is again indicated by two positions that not only the tilt position, but also the vertical positions can be changed (see arrow 57 ). The couch position 23 corresponds here to the positions 271 and 272 the wheels as well as the positions 261 and 262 of the Connecting struts. By changing the distance of the wheels (reference numeral 59 ) will be new wheel positions 271 ' and 272 ' achieved which the positions 261 ' and 262 ' correspond to the connecting struts, whereby the table top to the position 23 ' is raised.

The invention has been illustrated here by means of exemplary embodiments, which represent only exemplary realization possibilities of the invention. Other embodiments will be readily apparent to those skilled in the art through routine action.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 2010/0067652 Al [0005]
• DE 102011002619 A1 [0005]
• US 6751283 B2 [0005]
• US 2012/0324648 A1 [0005]

Claims (16)

Method for positioning a patient ( 4 ) in a gantry ( 1 ) of a medical device for examination or treatment, in which a) a patient positioning device ( 2 ) for positioning the patient ( 4 ) in the gantry ( 1 ) which at least two mutually about at least one axis ( 231 . 232 ) tiltable sections ( 211 . 212 . 213 ) and b) for the positioning of the patient ( 4 ) in the gantry ( 1 ) a tilting of the at least two sections ( 211 . 212 . 213 ) is made to each other. Method according to claim 1, characterized in that - the patient positioning device ( 2 ) is designed for translation in the horizontal direction, and - the patient positioning device ( 2 ) for transporting the patient ( 4 ) in the gantry ( 1 ) is moved in this horizontal direction. Method according to claim 1 or 2, characterized in that - the patient positioning device ( 2 ) at least three axes parallel to each other about at least two ( 231 . 232 ) tiltable sections ( 211 . 212 . 213 ), and - a tilting of the at least three sections ( 211 . 212 . 213 ) is made to each other. Method according to one of claims 1 to 3, characterized in that the gantry ( 1 ) is designed for tilting about an axis and for the positioning of the patient ( 4 ) is tilted to a receiving or treatment position. Method according to one of claims 2 to 4, characterized in that the translation in the first direction before the tilting of the at least two sections ( 211 . 212 . 213 ) is made to each other Patient positioning device ( 2 ) for positioning a patient ( 4 ) in a gantry ( 1 ), which - at least two mutually tiltable by at least one orthogonal to the first axis axis sections ( 211 . 212 . 213 ), and - a tilting mechanism for tilting the tiltable sections ( 211 . 212 . 213 ). Patient positioning device according to claim 6, characterized in that - the patient positioning device ( 2 ) is designed for translation in the horizontal direction such that the patient positioning device ( 2 ) by translation in this horizontal direction into the gantry ( 1 ) is movable. Patient positioning device according to claim 6 or 7, - the patient positioning device ( 2 ) is designed for a translation of a patient in the vertical direction. Patient positioning device according to one of claims 6 to 8, characterized in that the patient transport device ( 2 ) At least three mutually orthogonal to each other at least two axes ( 231 . 232 ) preferably in parallel tiltable sections ( 211 . 212 . 213 ). Patient positioning device according to one of claims 6 to 9, characterized in that the sections ( 211 . 212 . 213 ) are adjusted in terms of number and / or length according to the human anatomy. Patient positioning device according to one of claims 6 to 10, characterized in that the tilting mechanism with inflatable cushion ( 251 . 252 ) is realized. Patient positioning device according to one of claims 6 to 11, characterized in that - the patient positioning device ( 2 ) Bikes ( 271 . 272 ), - the wheels ( 271 . 272 ) by connecting elements ( 261 . 262 ) with the tiltable sections ( 211 . 212 . 213 ) are connected to connection positions, and - the patient device ( 2 ) for tilting at least two sections ( 211 . 212 . 213 ) is configured by changing at least one horizontal distance between the wheel and the associated connection position. Patient positioning device according to one of claims 6 to 12, characterized in that the patient positioning device ( 2 ) than to the gantry ( 1 ) dockable patient transport device is configured. A medical device comprising - a patient positioning device ( 2 ) according to one of claims 6 to 13, and - a tilting designed gantry ( 1 ). Medical arrangement according to claim 14, characterized in that the gantry ( 1 ) forms a closed ring. Medical arrangement according to one of claims 14 or 15, characterized in that it's the gantry ( 2 ) of a computed tomography or magnetic resonance tomograph.

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