WO2015104674A1

WO2015104674A1 - Apparatuses and methods for filtering or screening radiation

Info

Publication number: WO2015104674A1
Application number: PCT/IB2015/050151
Authority: WO
Inventors: Ronny Winshtein
Original assignee: Ronny Winshtein
Priority date: 2014-01-12
Filing date: 2015-01-08
Publication date: 2015-07-16

Abstract

Apparatuses and methods for filtering or screening radiation. Radiation filtering or screening device includes: cross section divided into plurality of defined shaped areas; radiopaque material; controllable mechanism configured to shift portions or members including radiopaque material to cover the cross section according to chosen allocation between portions or members and defined shaped areas, whereby each defined shaped area is selectively and independently covered with chosen thickness or/and amount of radiopaque material, thereby generating chosen variable radiopacity to radiation above the cross section per each defined shaped area. System includes: radiation filtering or screening device, display, and input device. Methods include use of radiation filtering or screening device during imaging procedures. Exemplary applications include: for reducing amount (or/and intensity) of radiation received by a subject, for example, during radiation therapy; and for imaging, and defining shaped portions, of bodily parts, such as organs or/and tissues.

Description

APPARATUSES AND METHODS FOR FILTERING OR SCREENING RADIATION

RELATED APPLICATIONS

This application is related to U.S. Provisional Patent Application No. 61/926,362, filed January

12, 2014, and entitled "SYSTEMS AND METHODS FOR REDUCING UNNECESSARY RADITION EXPOSURE", and to U.S. Provisional Patent Application No. 62/083,214, filed November 22, 2014, and entitled "SYSTEMS AND METHODS FOR FILTERING ELECTROMAGNETIC RADIATION", the disclosures of which are incorporated herein by reference in their entirety. The contents of all of the above documents are incorporated by reference as if fully set forth herein.

FIELD AND BACKGROUND OF THE INVENTION

The present invention, in some embodiments thereof, relates to filtering or screening radiation, and more particularly, but not exclusively, to apparatuses and methods for filtering or screening radiation (i.e., electromagnetic radiation). Some embodiments of the invention are applicable for reducing amount (or/and intensity) of radiation received by a subject, for example, during radiation therapy. Some embodiments of the invention are applicable for imaging, and defining shaped portions, of bodily parts, such as organs or/and tissues.

Radiation emitting devices are generally known and used, for instance, as radiation therapy devices or as radiography imaging devices. A radiation therapy device generally includes a gantry which can be swiveled around a horizontal axis of rotation in the course of a therapeutic treatment. A linear accelerator is located within the gantry for generating a high energy radiation beam for therapy. This high energy radiation beam may be an electron beam, photon (x-ray) beam, proton beam or other heavy particle beam for example. During treatment, the radiation beam is trained on a zone of a patient lying in the isocenter of the gantry rotation. Radiography imaging devices, particularly in fluoroscopy, may be stationary, such as those used in coronary angiography theaters, or may be mobile, in the form of a mobile unit, such as a C-arm unit.

In radiation imaging applications, in order to control the radiation emitted toward a subject (patient), and scattered back toward a radiation administrator (health care provider), a beam shielding device, such as a plate arrangement or multi-leaf collimator, is typically provided in the trajectory of the radiation beam between the radiation source and the subject. An example of a plate arrangement is a set of four plates which can be used to define an opening for the radiation beam. In general, a collimator (commonly used term for radiation screening devices in x-ray machines) is a beam masking apparatus which may include multiple leaves (e.g., relatively thin plates or rods) typically arranged as opposing leaf pairs. The plates are formed of relatively dense and radiation impervious material and are generally independently positionable to delimit the radiation beam.

Imaging techniques involving administering X-rays to subjects is becoming more common due to the increased use of minimally invasive procedures in various fields, such as orthopedics, urology, gynecology, gastroenterology, cardiology, thoracic surgery, neurosurgery and neurology, interventional radiology, vascular surgery, pain management, implantation of tissue and neural pacemakers, etc.. Studies have shown that exposure of healthy tissue to any dosage level of radiation may result in significant sequels including development of secondary tumors and that the frequency of such side effects is related to the dosage level.

In view of the current state of the art, in spite of extensive teachings relating to filtering or screening radiation, for example, with applications directed to reducing amount of radiation administered to, or/and received by, subjects, significant limitations exist. Thus, there is need for developing and practicing improved or/and new techniques for filtering or screening radiation.

SUMMARY OF THE INVENTION

The present invention, in some embodiments thereof, relates to apparatuses (devices, systems, mechanisms) and methods for filtering or screening radiation. Some embodiments of the invention are applicable for reducing amount (or/and intensity) of radiation received by a subject, for example, during radiation therapy. Some embodiments of the invention are applicable for imaging, and defining shaped portions, of bodily parts, such as organs or/and tissues.

According to an aspect of some embodiments of the present invention there is provided a device for filtering or screening radiation, the device comprising: a cross section divided into a plurality of defined shaped areas; radiopaque material; at least one controllable mechanism configured to shift portions or members of the radiopaque material to cover the cross section according to a chosen allocation between the portions or members and the defined shaped areas, such that each defined shaped area can be selectively and independently covered with a chosen thickness or/and amount of the radiopaque material, thereby generating a chosen variable radiopacity to the radiation above the cross section per each defined shaped area.

According to some embodiments of the invention, each defined shaped area defines a volume fillable with one or more of the portions or members of the radiopaque material. In exemplary embodiments, the cross section relates to a radiolucent template. In exemplary embodiments, each defined shaped area defines at least one cell in the radiolucent template. In exemplary embodiments, the radiopaque material includes at least one radiopaque member sized and shaped to cover or at least partially fill at least one cell.

According to some embodiments of the invention, the radiation filtering or screening device further includes: at least one actuator associated with the controllable mechanism and adapted to force a change in a position of the portions or members; and a controller arranged to control at least one actuator according to preset rules. In exemplary embodiments, the radiopaque material includes at least of steel, tungsten, uranium, molybdenum and lead. In exemplary embodiments, the radiopaque material is characterized by an average effective atomic number (Zeff) equal to or greater than 1. In exemplary embodiments, the radiopaque material includes particles of a substance characterized by an average atomic number (Z) equal to or greater than 20. In exemplary embodiments, the substance is tungsten thallium, lead, gold, bismuth, iodine, barium or mercury. In exemplary embodiments, the radiopaque material includes iodine, barium or carbon dioxide. In exemplary embodiments, the members of the radiopaque material include a hinged shutter.

According to some embodiments of the invention, the radiation filtering or screening device further includes: a feeder including at least one port for containing and supplying the portions or members of the radiopaque material; a feeder displacing mechanism adapted for displacing the feeder from and to a facing position in which each port faces a corresponding defined shaped area.

According to some embodiments of the invention, the radiation filtering or screening device is configured to filter or screen x-ray radiation lower than 50 keV, or in a range of between 10 keV and 150 keV, or in a range of between 50 keV and 25 MeV, particularly across a number of the defined shaped areas covered with at least one portion or member of the radiopaque material.

According to an aspect of some embodiments of the present invention there is provided a device for filtering or screening radiation, the device comprising: a radiolucent template including an exterior divided into defined shaped areas; a plurality of actuators, optionally distributed in apposition to the exterior, associated with the defined shaped areas; and radiopaque material.

According to some embodiments of the invention, each of the actuators is changeable between an opened position and a closed position, wherein in the opened position the radiopaque material is forced or is allowed to align in a minimal covering form in apposition to a corresponding defined shape area, wherein in the closed position a selected portion or a number of members including the radiopaque material is forced or is allowed to cover the corresponding defined shaped area. According to some embodiments of the invention, the radiopaque material is in a form of a solid member including a polygonal surface sized and shaped to cover one of the defined shaped areas. In exemplary embodiments, the radiopaque material is in a form of pellets being 5 mm or less in diameter and having smooth outer surface. In exemplary embodiments, the radiopaque material includes a flowable contrast enhancing medium. In exemplary embodiments, the plurality of actuators include a piezoelectric actuator or/and a valve.

According to an aspect of some embodiments of the present invention there is provided a system for filtering or screening x-ray radiation, the system comprising: a radiation filtering or screening device located between a radiation source and a target tissue, and including an exterior configured to lie between the radiation source and a target tissue, the exterior is divided into defined shaped areas; radiopaque material provided in the radiation filtering or screening device; a display configured to display a preliminary radiographic image of the target tissue within a chosen frame; and an input device, connected or connectable to a processor, configured for receiving an input command indicating a first image area within the preliminary radiographic image, the processor is programmed to link the first image area with at least one of the defined shaped areas.

According to some embodiments of the invention, the radiation filtering or screening device includes at least one controllable mechanism configured to shift portions or members of the radiopaque material to cover a cross section according to a chosen allocation between the portions or members and the defined shaped areas, such that each the defined shaped area is selectively and independently covered with a chosen thickness or/and amount of the radiopaque material, thereby generating a chosen variable radiopacity to the radiation above the cross section per each defined shaped area.

According to some embodiments of the invention, the radiation filtering or screening device includes at least one actuator changeable between a first position and a second position in accordance with the input command, wherein in the first position the radiopaque material is forced or is allowed to align in a minimal covering form in apposition to a corresponding defined shape area and in the second position a selected portion or a number of members including the radiopaque material is forced or is allowed to cover the corresponding defined shaped area. In exemplary embodiments, the input device includes voice recognition capturing and the input command includes a preset voice command. In exemplary embodiments, the input device includes gesture recognition capturing and the input command includes a preset gesture command. In exemplary embodiments, the input device includes at least one of: wired gloves, a camera and a controller-based gestured input device. In exemplary embodiments, the input device includes a multi-touch surface and the input command includes a preset multi-touch gesture. In exemplary embodiments, the preset multi-touch gesture includes a finger-touch gesture including at least one of: single tap, multiple-taps, long-press, scroll, pan, pinch- close, pinch-open and rotate. In exemplary embodiments, the input device includes a touchscreen.

In exemplary embodiments, the display is communicative with the radiation filtering or screening device. In exemplary embodiments, the input device includes the display. In exemplary embodiments, the defined shaped areas are arranged as a grid.

According to an aspect of some embodiments of the present invention there is provided a method for filtering or screening radiation, the method comprising: providing a radiation filtering or screening device between a radiation source and a target tissue, the radiation filtering or screening device includes a cross section divided into a plurality of defined shaped areas, a radiopaque material, and at least one controllable mechanism configured to shift portions or members including the radiopaque material to cover the cross section according to a chosen allocation between the portions or members and the defined shaped areas; injecting contrast agent to color the target tissue; sampling a preliminary image representing the colored target tissue and an adjacent non-colored tissue; choosing a first image area within the preliminary image; entering an input command to an input device to link the first image area with at least one of the defined shaped areas; and imaging the target tissue.

According to some embodiments of the invention, the radiation filtering or screening device produces a covering pattern of the radiopaque material in accordance with the input command in which at least one of the defined shaped areas linked to the first image area are kept uncovered by the radiopaque material while other defined shaped areas are covered with the radiopaque material.

According to some embodiments of the invention, choosing includes marking the first image area on a display displaying the preliminary image. In exemplary embodiments, the method further includes producing an electrocardiogram, analyzing a cardiac cycle, and measuring a cardiac cycle interval.

According to some embodiments of the invention, the method further includes superimposing a first image including a blank portion with a second image including a corresponding imaged portion.

All technical or/and scientific words, terms, or/and phrases, used herein have the same or similar meaning as commonly understood by one of ordinary skill in the art to which the invention pertains, unless otherwise specifically defined or stated herein. Methods, materials, and examples described herein are illustrative only and are not intended to be necessarily limiting. Although methods or/and materials equivalent or similar to those described herein can be used in practicing or/and testing embodiments of the invention, exemplary methods or/and materials are described below. In case of conflict, the patent specification, including definitions, will control. Implementation of some embodiments of the invention can involve performing or completing selected tasks manually, automatically, or a combination thereof. Moreover, according to actual instrumentation and equipment of some embodiments of the invention, several selected tasks could be implemented by hardware, by software, by firmware, or a combination thereof, using an operating system.

For example, hardware for performing selected tasks according to embodiments of the invention could be implemented as a chip, as a circuit, or a combination thereof. As software, selected tasks of some embodiments of the invention could be implemented as a plurality of software instructions being executed by a computer using any suitable operating system. In an exemplary embodiment of the invention, one or more tasks of exemplary embodiments of the method or/and system as described herein are performed by a data processor, such as a computing platform for executing a plurality of instructions. Optionally, the data processor includes a volatile memory for storing instructions or/and data. Alternatively or additionally, optionally, the data processor includes a non-volatile storage, for example, a magnetic hard-disk or/and removable media, for storing instructions or/and data. Optionally, a network connection is provided as well. Optionally, a display or/and a user input device such as a keyboard or mouse is provided as well.

BRIEF DESCRIPTION OF THE DRAWINGS

Some embodiments of the invention are herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of embodiments of the invention. In this regard, the description taken with the drawings makes apparent to those skilled in the art how embodiments of the invention may be practiced.

In the drawings:

FIGs. 1 A - 1 C schematically illustrate exemplary image frames as may appear on a display connected to an exemplary radiation filtering or screening system configured and operative as a radiography or fluoroscope type apparatus, in accordance with some embodiments of the invention;

FIGs. 2A - 2B schematically illustrate an exemplary system for filtering or screening radiation (radiation filtering or screening system 100), including an exemplary device for filtering or screening radiation (radiation filtering or screening device 120), in accordance with some embodiments of the invention;

FIG. 3 is a flowchart of an exemplary method for filtering or screening radiation (radiation filtering or screening method 200), including use of the exemplary radiation filtering or screening system, particularly highlighting the step (procedure) [250] of defining screening to radiolucent areas, in accordance with some embodiments of the invention;

FIG. 4 is a flowchart of an exemplary method for filtering or screening (radiation filtering or screening method 300), including use of the exemplary radiation filtering or screening system, particularly highlighting the step (procedure) [340] of defining screening to areas beyond a marker margins, in accordance with some embodiments of the invention;

FIGs. 5A - 5C schematically illustrate frontal views of an exemplary radiation filtering or screening device featuring a multi-leaf type of modality or configuration, and an actual covered area verses a pre-set radiation pattern, in accordance with some embodiments of the invention;

FIGs. 6A - 6C schematically illustrate frontal views of an exemplary radiation filtering or screening device featuring a binary mosaic type of modality or configuration, and an actual covered area verses a pre-set radiation pattern, in accordance with some embodiments of the invention;

FIGs. 7A - 7B schematically illustrate a frontal view of an exemplary pre-set radiation pattern and an isometric view of an exemplary radiation filtering or screening device featuring a shutter-type binary set type of modality or configuration according to the pre-set radiation pattern, in accordance with some embodiments of the invention;

FIG. 8 schematically illustrates a side cut-view of an exemplary singular shutter mechanism, in accordance with some embodiments of the invention;

FIG. 9 schematically illustrates a side cut-view of an exemplary plural shutters mechanism, in accordance with some embodiments of the present invention;

FIG. 10 schematically illustrates an isometric view of an exemplary radiation filtering or screening device, featuring an exemplary binary mosaic type of modality or configuration, in accordance with some embodiments of the invention;

FIG. 11 schematically illustrates an isometric view of an exemplary radiation filtering or screening device, featuring an exemplary binary mosaic type of modality or configuration which includes an exemplary robotic feeder mechanism, in accordance with some embodiments of the invention;

FIG. 12 schematically illustrates a frontal view of an exemplary radiation filtering or screening device, featuring a pinned-type binary mosaic type of modality or configuration, in accordance with some embodiments of the invention;

FIGs. 13A - 13B schematically illustrate isometric views of exemplary radiopaque pins of different shapes, in accordance with some embodiments of the invention; FIGs. 14A - 14B schematically illustrate isometric views of an exemplary radiation filtering or screening device, featuring a pinned-type binary mosaic type of modality or configuration which includes pins feeder mechanism, in accordance with some embodiments of the invention;

FIGs. 15A - 15B schematically illustrate isometric and side cut views, respectively, of an exemplary radiation filtering or screening device, and members thereof, featuring a "multi-radix" type of modality or configuration, in accordance with some embodiments of the invention;

FIG. 16 schematically illustrates side cut view of an exemplary radiation filtering or screening system, featuring a "multi-radix" type of modality or configuration, based on accumulated orbs, in accordance with some embodiments of the invention;

FIGs. 17A - 17C schematically illustrate views of an exemplary radiation filtering or screening device, and portions thereof, featuring a pinching type binary mosaic type of modality or configuration, in accordance with some embodiments of the invention;

FIG. 18A - 18D schematically illustrate views of an exemplary spinning type radiation filtering or screening mechanism, in accordance with some embodiments of the invention;

FIG. 19 schematically illustrate a frontal view of an exemplary radiation filtering or screening device, featuring a shapeable spacer type of modality or configuration, in accordance with some embodiments of the invention;

FIG. 20 schematically illustrate a frontal view of an exemplary radiation filtering or screening device, featuring a multi-balloon cascade type of modality or configuration, in accordance with some embodiments of the invention;

FIGs. 21 A - 21 E schematically illustrate exemplary application of an exemplary radiation filtering or screening system (3100), particularly highlighting an exemplary radiation filtering or screening device (3010) configured to reduce amount of radiation received by a subject, and possible scenarios in a method thereof, in accordance with some embodiments of the invention; and

FIGs. 22A - 22B schematically illustrate an exemplary application of an exemplary radiation filtering or screening system (4106), particularly, highlighting an exemplary radiation filtering or screening device (4100) configured to filter or screen radiation projected from a source towards a target object, in accordance with some embodiments of the invention.

DESCRIPTION OF SPECIFIC EMBODIMENTS OF THE INVENTION

The present invention, in some embodiments thereof, relates to filtering or screening radiation, and more particularly, but not exclusively, to apparatuses (devices, systems, mechanisms) and methods for filtering or screening radiation (i.e., electromagnetic radiation). Some embodiments of the invention are applicable for reducing amount (or/and intensity) of radiation received by a subject, for example, during radiation therapy. Some embodiments of the invention are applicable for imaging, and defining shaped portions, of bodily parts, such as organs or/and tissues.

Some of the following exemplary embodiments may be described in the context of exemplary techniques and means for affecting x-ray radiation targeting a bodily part, such as an organ or tissue, for ease of description and understanding. However, the invention is not limited to the specifically described exemplary apparatuses (devices, systems) and methods, and may be adapted to various clinical applications without departing from the overall scope of the invention. For example, apparatuses and related methods including concepts described herein may be used for filtering or screening other types of electromagnetic radiation, such as, but not limited to: gamma radiation, radio waves, microwaves, actinic radiation, visual light, infrared light, and ultraviolet light.

The terms "radiation", and "electromagnetic radiation", are synonymously used herein, and, in a non-limiting manner, refer to waves of energy associated with electric and magnetic fields resulting from the acceleration of an electric charge. Electromagnetic waves can be characterized by either the frequency or wavelength of their oscillations to form the electromagnetic spectrum, which includes, in order of increasing frequency and decreasing wavelength: radio waves, microwaves, infrared radiation, visible light, ultraviolet radiation, X-rays and gamma rays. Electromagnetic radiation is considered us consisting of massless photons, the elementary particles responsible for all electromagnetic interactions. The energy of an individual photon is quantized and is greater for photons of higher frequency. The effects of electromagnetic energy upon biological systems and living tissues depend both upon the radiation's power and its frequency.

The terms "filtering", and "radiation filtering", are synonymously used herein, and, in a non- limiting manner, refer to fully or partially blocking or removing some or all wavelengths or frequencies in the spectrum of an incoming beam of electromagnetic radiation, such as X-ray. A "filter", a "filtering mechanism", a "radiation filtering or screening device", or a "filtering apparatus", as used herein, in a non-limiting manner, may be configured to selectively block low energy radiation (e.g., lower than 10 keV for X-rays, commonly referred to as "soft X-rays"), or medium energy radiation (e.g., 10 to 100 keV for X-rays, commonly referred to as "hard X-rays") or high energy radiation (e.g., higher than 100 keV for X-rays), or to block most or all of the radiation spectrum of the photon energies passing therethrough. In some embodiments, exemplary radiation filtering or screening devices in accordance with the invention are configured to partially or fully block hard X-ray photon energies mostly within the range of 10 to 150 keV. Filter permeability to radiation may be dependent on the number and density of relevant photon energy "absorbing" atoms that a ray of photons encounters along its path from a radiation source to a target object, therefore, in most cases, it will relate to the material used in the filter, its form/structure and its dimensions.

The terms "screening", "radiation screening", "shielding", "masking", and "collimating", as used herein, in a non-limiting manner, refer to substantially or fully blocking a chosen range of wavelengths or frequencies of electromagnetic radiation. As such, a "screening device" or a "collimator", as used herein, in a non-limiting manner, may be considered a type of a "radiation filtering or screening device" configured to substantially or fully absorbing or blocking electromagnetic radiation at least within a chosen range of energies, for example, X-ray photon energies mostly within the range of 10 to 150 keV. Unlike radiation filtering or screening devices that may allow enough permeability to photon energy within the chosen ranges to provide some imaging (e.g., radiographic) capabilities, screening devices will include materials in densities, forms and dimensions that will substantially block such photon energies to a degree causing imaging to be impractical.

For brevity, without diminishing meaning, of illustratively describing exemplary embodiments of the invention, the phrase "radiation filtering or screening", as used herein, in a non-limiting manner, refers to combination of the preceding described aspects and characteristics of "filtering" or "radiation filtering", as well as the preceding described aspects and characteristics of "screening", "radiation screening", "shielding" or "masking", or "collimating". Additionally, the phrases "radiation filtering or screening device", "radiation filtering or screening system", and "radiation filtering or screening method", respectively, correspond to, and are synonymous with, a device for filtering or screening radiation, a system for filtering or screening radiation, and a method for filtering or screening radiation.

The terms "radiopaque material", or "radiation filtering material", as used herein, in a non-limiting manner, refer to a material provided in a certain form (e.g., solid or fluid), density, quantity, shape or/and dimension that effectively absorbs or block, fully or partially, electromagnetic radiation at least within a chosen range of energies.

Some embodiments of the present invention relate to radiation filtering or screening devices featuring a "matrix screening" type of configuration, and applications thereof for performing two- dimensional (2-D) shaped matrix filtering or screening during radiation imaging, such as fluoroscopy. Implementation of some embodiments of the invention allow selective screening of certain shaped areas in a given fluoroscopy frame according to predefined set of rules or logics, optionally automatically or manually, optionally in real-time or discretely, in view of a continuously changing or moving fluoroscopy shaped target, or/and according to specific demand. Exemplary embodiments of radiation filtering or screening apparatuses of the invention may be connectable to or readily embedded in a radiation/energy emitting systems such as radiography and fluoroscopy systems (e.g. x-ray C-arm systems), or radiation therapy systems (e.g., linear accelerators).

Exemplary embodiments of radiation filtering or screening apparatuses of the invention may be configured to screen or mask specific shaped areas which are subject to change in real-time or in discrete periods during a medical procedure, and the exemplary embodiments of radiation filtering or screening apparatuses include means for immediate adjustability.

Exemplary embodiments of radiation filtering or screening apparatuses of the invention may include a radiopaque material selectively shapeable or distributable according to need. A fluoroscopy system generally produces an image frame, commonly in a rectangular shape which may or may not be further bounded with collimating plates allowing circular or rectangular revised framing of a portion in the general image frame. The image frame contains a target organ or tissue in need for continuous monitoring and observation during a medical procedure, as well as adjacent tissues. In the effort to minimize the overall radiation dose absorbed by adjacent tissues or other unnecessary tissue radiation doses to the target tissues or/and adjacent tissues, some embodiments of the radiation filtering or screening apparatuses disclosed herein, for example, which may be employed in fluoroscopy procedures, are capable of screening or masking most or all areas in the general image frame of tissues adjacent the target tissues, in a continuous or/and discrete pattern.

Radiation filtering or screening device, and exemplary embodiments thereof

According to an aspect of some embodiments of the present invention there is provided a device for filtering or screening radiation, including the following components and functionalities thereof: a cross section divided into a plurality of defined shaped areas; radiopaque material; at least one controllable mechanism configured to shift portions or members of the radiopaque material to cover the cross section according to a chosen allocation between the portions or members and the defined shaped areas, such that each defined shaped area can be selectively and independently covered with a chosen thickness or/and amount of the radiopaque material, thereby generating a chosen variable radiopacity to the radiation above the cross section per each defined shaped area.

In exemplary embodiments, each defined shaped area defines a volume tillable with one or more of the portions or members of the radiopaque material. In exemplary embodiments, the cross section relates to a radiolucent template. In exemplary embodiments, each defined shaped area defines at least one cell in the radiolucent template. In exemplary embodiments, the radiopaque material includes at least one radiopaque member sized and shaped to cover or at least partially fill at least one cell.

In exemplary embodiments, the radiation filtering or screening device further includes: at least one actuator associated with the controllable mechanism and adapted to force a change in a position of the portions or members; and a controller arranged to control at least one actuator according to preset rules. In exemplary embodiments, the radiopaque material includes at least of steel, tungsten, uranium, molybdenum and lead. In exemplary embodiments, the radiopaque material is characterized by an average effective atomic number (Z_eff) equal to or greater than 1. In exemplary embodiments, the radiopaque material includes particles of a substance characterized by an average atomic number (Z) equal to or greater than 20. In exemplary embodiments, the substance is tungsten thallium, lead, gold, bismuth, iodine, barium or mercury. In exemplary embodiments, the radiopaque material includes iodine, barium or carbon dioxide. In exemplary embodiments, the members of the radiopaque material include a hinged shutter.

In exemplary embodiments, the radiation filtering or screening device further includes: a feeder including at least one port for containing and supplying the portions or members of the radiopaque material; a feeder displacing mechanism adapted for displacing the feeder from and to a facing position in which each port faces a corresponding defined shaped area.

In exemplary embodiments, the radiation filtering or screening device is configured to filter or screen x-ray radiation lower than 50 keV, or in a range of between 10 keV and 150 keV, or in a range of between 50 keV and 25 MeV, particularly across a number of the defined shaped areas covered with at least one portion or member of the radiopaque material.

Radiation filtering or screening device, and additional exemplary embodiments thereof

According to an aspect of some embodiments of the present invention there is provided a device for filtering or screening radiation, including the following components and functionalities thereof: a radiolucent template including an exterior divided into defined shaped areas; a plurality of actuators associated with the defined shaped areas; and radiopaque material.

In exemplary embodiments, each of the actuators is changeable between an opened position and a closed position, wherein in the opened position the radiopaque material is forced or is allowed to align in a minimal covering form in apposition to a corresponding defined shape area, wherein in the closed position a selected portion or a number of members including the radiopaque material is forced or is allowed to cover the corresponding defined shaped area. In exemplary embodiments, the radiopaque material is in a form of a solid member including a polygonal surface sized and shaped to cover one of the defined shaped areas. In exemplary embodiments, the radiopaque material is in a form of pellets being 5 mm or less in diameter and having smooth outer surface. In exemplary embodiments, the radiopaque material includes a flowable contrast enhancing medium. In exemplary embodiments, the plurality of actuators include a piezoelectric actuator or/and a valve.

Radiation filtering or screening system, and exemplary embodiments thereof

According to an aspect of some embodiments of the present invention there is provided a system for filtering or screening x-ray radiation, including the following components and functionalities thereof: a radiation filtering or screening device located between a radiation source and a target tissue, and including an exterior configured to lie between the radiation source and a target tissue, the exterior is divided into defined shaped areas; radiopaque material provided in the radiation filtering or screening device; a display configured to display a preliminary radiographic image of the target tissue within a chosen frame; and an input device, connected or connectable to a processor, configured for receiving an input command indicating a first image area within the preliminary radiographic image, the processor is programmed to link the first image area with at least one of the defined shaped areas.

In exemplary embodiments, the radiation filtering or screening device includes at least one controllable mechanism configured to shift portions or members of the radiopaque material to cover a cross section according to a chosen allocation between the portions or members and the defined shaped areas, such that each the defined shaped area is selectively and independently covered with a chosen thickness or/and amount of the radiopaque material, thereby generating a chosen variable radiopacity to the radiation above the cross section per each defined shaped area.

In exemplary embodiments, the radiation filtering or screening device includes at least one actuator changeable between a first position and a second position in accordance with the input command, wherein in the first position the radiopaque material is forced or is allowed to align in a minimal covering form in apposition to a corresponding defined shape area and in the second position a selected portion or a number of members including the radiopaque material is forced or is allowed to cover the corresponding defined shaped area.

In exemplary embodiments, the input device includes voice recognition capturing and the input command includes a preset voice command. In exemplary embodiments, the input device includes gesture recognition capturing and the input command includes a preset gesture command. In exemplary embodiments, the input device includes at least one of: wired gloves, a camera and a controller-based gestured input device. In exemplary embodiments, the input device includes a multi- touch surface and the input command includes a preset multi-touch gesture. In exemplary embodiments, the preset multi-touch gesture includes a finger-touch gesture including at least one of: single tap, multiple-taps, long-press, scroll, pan, pinch-close, pinch-open and rotate. In exemplary embodiments, the input device includes a touchscreen. In exemplary embodiments, the display is communicative with the radiation filtering or screening device. In exemplary embodiments, the input device includes the display. In exemplary embodiments, the defined shaped areas are arranged as a grid. Radiation filtering or screening method, and exemplary embodiments thereof

According to an aspect of some embodiments of the present invention there is provided a method for filtering or screening radiation, including the following steps (procedures): providing a radiation filtering or screening device between a radiation source and a target tissue, the radiation filtering or screening device includes a cross section divided into a plurality of defined shaped areas, a radiopaque material, and at least one controllable mechanism configured to shift portions or members including the radiopaque material to cover the cross section according to a chosen allocation between the portions or members and the defined shaped areas; injecting contrast agent to color the target tissue; sampling a preliminary image representing the colored target tissue and an adjacent non-colored tissue; choosing a first image area within the preliminary image; entering an input command to an input device to link the first image area with at least one of the defined shaped areas; and imaging the target tissue.

In exemplary embodiments, the radiation filtering or screening device produces a covering pattern of the radiopaque material in accordance with the input command in which at least one of the defined shaped areas linked to the first image area are kept uncovered by the radiopaque material while other defined shaped areas are covered with the radiopaque material.

In exemplary embodiments, the step (procedure) of choosing includes marking the first image area on a display displaying the preliminary image. In exemplary embodiments, the method further includes producing an electrocardiogram, analyzing a cardiac cycle, and measuring a cardiac cycle interval.

In exemplary embodiments, the method further includes superimposing a first image including a blank portion with a second image including a corresponding imaged portion. For purposes of better understanding embodiments of the present invention, in the following illustrative description thereof, reference is made to the figures. Throughout the following description and accompanying drawings, same reference numbers refer to same components, elements, or features. It is to be understood that the invention is not necessarily limited in its application to any particular sequential ordering of method steps or procedures, or to particular details of construction or/and arrangement of device, apparatus, or/and system components, set forth in the following illustrative description. The invention is capable of other embodiments or of being practiced or carried out in various ways.

Reference is now made to FIGs. 1A - 1 C which schematically illustrate three image frames on a display 180 connected to an exemplary radiation filtering or screening system 100, for example, configured and operative as a radiography or fluoroscope type apparatus. For illustrative purposes, all three frames show a specific framing of an organ ORG including a vasculature portion with a bifurcation BF and a plurality of branches BR, at a single instance where a guidewire GW is protruding in a chosen branch at bifurcation BF. In some embodiments, the frames are taken during catheterization, optionally cardiac. FIG. 1A shows a regular pre-screened image frame showing a colored organ ORG (e.g., filled with contrast enhancing agent) thereby shown in dark contrast with respect to adjacent tissues illustrated as a light area 112. Guidewire GW is covered with or is connected to or is made from a radiopaque material shown in dark contrast also with respect to colored organ ORG.

In some embodiments, the radiation filtering or screening system 100 can be set manually or/and is configured and operative to automatically filter or screen beam portions targeted at specific areas in an image frame, such as light area 112, in contrast to other substantially areas, such as the dark area captured with colored organ ORG. In exemplary embodiments, the radiation filtering or screening system may be configured and operative to cover substantially all light area 112 (as shown in FIG. 1 B) or preserve margins of light area 112 around the image reflection of organ ORG (as shown in FIG. 1 C), thereby replacing the image reflection of all or part of light area 112 with a screened area 113. In some embodiments, the screened area 113 is defined and shaped according to analyzed sampled frame (such as the image frame of FIG. 1 A) manually, or automatically, optionally in view of a substantial contrast between colored organ ORG and light area 112. Optionally, alternatively or additionally, screened area 113 is defined and shaped using digital subtraction between a first frame where organ ORG is uncolored and a second frame where organ ORG is colored, so that only organ ORG is not subtracted and rest of the frame is subject to screening by the collimator. Optionally, alternatively or additionally, screened area 113 is defined and shaped according to predefined margins about guidewire GW or/and radiopaque marker(s) provided thereon. Optionally, at least part of screened area 113, or margins thereof, is determined manually or/and selectively by a user.

Reference is now made to Figs. 2A - 2B which schematically illustrate radiation filtering or screening system 100, which includes an exemplary radiation filtering or screening device 120. Radiation filtering or screening system 100 includes an x-ray source 130, radiation filtering or screening device 120, a receptor unit 140 including a screen 110 (e.g., a fluorescent screen), and a controller 170 (e.g., a computer with controlling software) for controlling features of any of source 130, radiation filtering or screening device 120, or/and receptor unit 140. Optionally, alternatively or additionally, radiation filtering or screening system 100 includes an x-ray image intensifier or/and a flat-panel detector (not shown). As shown in FIG. 2A, a patient PAT is positioned over a bed 160 located between source 130 and screen 110, whereas radiation filtering or screening device 120 is located between patient PAT and source 130 (radiation filtering or screening device 120 may be adjacent or remote to source 130). In some embodiments, in case of a flat-panel-detector type fluorescent screen, fluorescent screen 110 includes a scintillator layer that converts x-rays into light, behind which is a grid of tiny pixels (usually about 0.1 mm or even less). Each pixel contains thin-film transistor and a photodiode which generates an electrical signal in proportion to the light produced by the scintillator layer. The signals from the photodiodes are amplified and encoded in order to produce an accurate and sensitive digital representation of the x-ray image absorbed by screen 110.

In some embodiments, the pixels grid includes pixels that are clustered into a plurality of pixels clusters. In some embodiments, each cluster of pixels is set or/and analyzed to transfer a single specified electrical or digital signal in relation to the amount of light (e.g., number of absorbed photons over a time frame) absorbed in the cluster. In some embodiments, the single specified signal determines a local radiopacity of radiation filtering or screening device 120. Optionally, the single specified signal is transferred only if the number of absorbed photons over a predetermined time period is above a predetermined threshold value. Optionally, each cluster correlates in shape and or size to a differentiated corresponding portion or area in radiation filtering or screening device 120.

As shown in FIG. 2B, x-ray source 130 includes a body 132 and a rectangle window 134 through which a beam 150 of electromagnetic radiation is projected. Source 130 is configured to produce a single pulse or consecutive pulses of beam 150 with chosen parameters such as intensity, exposure and image average contrast, image rate and exposure rate, field of view and image magnification, or others. Radiation filtering or screening device 120 includes a radiolucent template 122 allowing entrapped radiation absorbing or radiopaque material 124 to be areally shaped, shifted or/and distributed according to need and preserve shaped non-screened area(s) 126. Beam 150 is projected via window 134 and preserves coherent dispersion at its first travel segment 152 until reaching radiation filtering or screening device 120, where some portions of beam 150 cross section are partially or fully blocked by the areas filled or covered with radiopaque material 124 while the other portions of beam 150 cross section are substantially or fully unblocked in non-screened areas 126 of radiolucent template 122, and allowed to advance until reaching patient PAT as filtered beam 154. The filtered beam 154 penetrates partially and travels through patient's PAT body where it is further absorbed in different ratios by soft tissues, hard tissues or/and other materials having different radiopacity, provided along its travel. The portion of beam 150 (as part of its original cross section) that continues its travel from patient PAT to screen 110, namely, beam portion 156, creates a fluoroscopic image that accumulates opacity topography made by radiation filtering or screening device 120 and patient PAT tissues that beam 150 passed through (similarly to as shown in FIG. 1 B or FIG. 1 C).

In some embodiments, radiation filtering or screening device 120 is configured such that it may include different number of discrete regions, each can be selectively (manually or automatically) controlled so that to acquire a chosen radiopacity to an electromagnetic radiation portion passing therethrough. Optionally and additionally, at least one of such regions can be changed in shape, size (area or/and depth with respect to source 130) or/and location, or may be canceled or created as needed.

FIG. 3 is a flowchart of an exemplary (fluoroscopy type) method for filtering or screening radiation (radiation filtering or screening method 200), including use of the exemplary radiation filtering or screening system 100 (including radiation filtering or screening device 120), particularly highlighting the step (procedure) [250] of defining screening to radiolucent areas. At first, the operator targets 210 an organ, such as organ ORG having a vasculature portion (as shown in FIG. 1A). The operator then injects 220 a contrast agent into organ ORG to enhance its contrast with respect to adjacent light areas. Before, after or in parallel to injecting 220, the operator makes 230 a preliminary sampling of patient PAT about the targeted 210 organ ORG vasculature portion. In an exemplary embodiment, sampling making 230 is performed before organ ORG is colored. Optionally, additionally or alternatively, sampling making 230 is performed when organ ORG is substantially colored with contrast agent.

In some embodiments, for example in use of an optional flat-panel detector, controller 170 analyzes 240 the distribution of light areas shown at fluorescent screen 110 in order to determine which shaped area(s) are to be screened using radiopaque material. Optionally, additionally or alternatively, selection can be made, at least in part, manually or/and selectively by the user. In some embodiments, clusters of light sensitive pixels correspond to portions or areas of radiolucent template 122 of radiation filtering or screening device 120, so that a calculated sum of photons or a photons rate, absorbed by a cluster, shall determine if a corresponding portion or area of radiolucent template 122 shall be covered in full, or substantially or completely not, by radiopaque material. In some embodiments, each pixels cluster is shaped according to a corresponding shape (virtual or physical) on radiolucent template 122. Optionally, the cluster shape and the corresponding shape are oppositely (opposably) positioned so that a beam portion traveling through the corresponding shape and through patient PAT will target a specific area portion of fluorescent screen 110 and transformed to photons absorbed substantially of fully by the cluster shape. In some embodiments, if the amount of photons absorbed in the premises of the cluster shape within a chosen time frame is above a predetermined threshold, then a radiopaque material 124 will be forced or allowed to cover the corresponding area on radiolucent template 122 or remain covering it, or/and if the amount of photons absorbed in the premises of the cluster shape within a chosen time frame is less than a predetermined threshold, then a radiopaque material will be forced or allowed to uncover the corresponding area on radiolucent template 122 or remain uncovering it. In some embodiments, the chosen time frame is fixed or preset; optionally it is between 1 millisecond to 1 minute, optionally 10 milliseconds to 1 second, or higher or lower or intermediate. Optionally, at least one cluster shape and corresponding shape are rectangular, optionally square; optionally, cluster shape or corresponding shape includes a side being 0.01 mm to 10 mm in length, optionally 0.1 mm to 1 mm in length, or higher, or lower or intermediate. Optionally, alternatively or additionally, analysis 240 includes digital subtraction angiography.

Following analysis 240, light areas 112 are defined 250 for screening, so that radiation filtering or screening device 120 can be used or is configured to automatically allocate radiopaque material to the chosen screened area 124. After radiation filtering or screening device 120 is set, fluoroscopy can be performed 260. All or some of method 200 steps may be repeated as needed in a continuous or discrete manner, as long as the shaped collimating areas are frequently changed, for example due to movements of target object PAT (e.g., the patient), organ ORG, bed 160, guidewire GW (or any other intrusive artifact traveling in organ ORG) or/and any of radiation filtering or screening system 100 members. Repetition of steps 210-260 or steps 220-260 or steps 230-260 may be performed every approximately 0.1 second, optionally every approximately 1 second, optionally every approximately 10 seconds, or higher, or lower, or in any intermediate value. A single fluoroscopy step may be performed 260 for at least 0.5 second, optionally at least 1 second, optionally at least 10 seconds, optionally at least 1 minute, optionally at least 10 minutes, or more. Frame rate may be at least 1 frame/sec, optionally at least 10 frames/sec, optionally at least 15 frames/sec, optionally at least 24 frames/sec, or higher, or lower, or intermediate.

In some embodiments, each fluoroscopy run 260 (e.g., fluoroscopy performed between two consecutive samplings 230) may include a brightness averaging phase in which total projected radiation characteristics are determined according to total number of absorbed photons compared with the total unscreened projected areas.

FIG. 4 is a flowchart of an exemplary (fluoroscopy type) method for filtering or screening (radiation filtering or screening method 300), including use of the exemplary radiation filtering or screening system, particularly highlighting the step (procedure) [340] of defining screening to areas beyond a marker margins. At first, the operator targets 310 an organ, such as organ ORG having a vasculature portion (as shown in FIG. 1A). The operator then positions 320 or/and advances a radiopaque marker (e.g., guidewire GW) to a chosen location in organ ORG. Afterwards, the operator or controller 170 defines 330 chosen margins about the radiopaque marker, beyond which the areas in the frame are defined 340 for screening so that the corresponding portions of beam 150 are to be selectively blocked by radiopaque material in radiation filtering or screening device 120. After radiation filtering or screening device 120 is set, fluoroscopy sampling can be performed 350. All or some of method 300 steps may be repeated as needed in a continuous or discrete manner, as long as the shaped collimating areas are frequently changed, for example due to movements of patient PAT, organ ORG, bed 160, guidewire GW (or any other intrusive artifact traveling in organ ORG) or/and any of radiation filtering or screening system 100 members.

In some embodiments, radiation filtering or screening system 100, or radiation filtering or screening device 120, includes a radiolucent template with an exterior, a plurality of actuators and a radiopaque material. In some embodiments, each actuator is discretely actuated between an opened position and a closed position. In some embodiments, in the opened position, the radiopaque material is forced to align in a minimal covering form in apposition to a specific segment of the exterior. In some embodiments, in the closed position, the radiopaque material is forced to align in a full covering form in apposition to the specific segment.

A radiopaque material may be in a form of a solid member including a polygonal surface adapted to cover the segment at the closed position. Alternatively, the radiopaque material is in a form of pellets being 5 mm or less in diameter and having smooth outer surface. Alternatively, the radiopaque material includes a flowable contrast enhancing medium. Optionally, the radiopaque material is rotatable from the opened position to the closed position. Alternatively, the radiopaque material is shiftable from a distant location when in the opened position to a closer location when in the closed position. The plurality of actuators may include at least one of a piezoelectric actuator, a valve and a pressure source.

The radiopaque material may be in the form of a flowable material, an elastic or pliable material, a rigid material, either provided as a singular volume or member or as a plurality of members having relative formability between them. Exemplary rigid radiopaque members may include radiopaque pieces of any shape or material and may be provided, for example, as thin paving tiles, as pin-like or spiked elongated bars or/and as hinged shutters. Each single or cluster of radiopaque members may be positionable by a dedicated actuator (e.g., a solenoid, a magnet, an electrical motor, a step motor or a pneumatic or hydraulic actuator) which selectively set the position of the radiopaque member, either maximally or fully obstructing local passage of radiation rays, or minimally obstructing or completely allowing passage thereof. Alternatively, for example in case of a flowable radiopaque material, actuators can be used to allocate the radiopaque material mass or volume in contained areas around chosen shaped boundaries.

In exemplary embodiments, radiation filtering or screening system, for example, including the radiation filtering or screening device, may be provided or/and equipped with operating software or/and controller(s) which operate the actuators according to pre-set rules. The radiation filtering or screening system may configured to automatically determine shaped differentiation between target areas to be collimated with minimal absorbency (including zero absorbency) and adjacent areas to be collimated with maximal absorbency (including full absorbency). Alternatively or additionally, an operator may determine the exact shape of the radiation area by providing a radiation pattern which may optionally be already pixelized or be later translated to a pixelized scheme.

In exemplary embodiments, the radiation filtering or screening device may be set to continuously change the shape of the screened or/and non-screened area(s) by a continuous operation of the actuators. Additionally or alternatively, a feeder connectable with a supply of radiopaque members or radiopaque material quantity may be applied for selectively providing or/and collecting radiopaque material according to the set or pre-set pattern(s). The feeder may be operated to provide or/and collect radiopaque material portions or members either one-by-one, cluster-by- cluster or by changing the entire radiopaque material on the template at-once. Alternatively or additionally, the feeder may be applied to arrange a complete set of radiopaque material members/portions in a stand-by location before, during or/and after a beaming which is screened with another previously arranged complete set of radiopaque material members/portions. Switching between a previous set and a stand-by replacing set may be done by replacing templates (where a first template contains the previous set and a second template contains the replacing set), by repositioning a single template (where a template includes at least two areas, a first area contains the previous set and a second area contains the replacing set) or by using two groups of feeding or actuating means - a first group which collects the previous set from the template and a second group which provides the replacing set on same template.

An aspect of some embodiments of the present invention relates to an electromagnetic radiation filtering or screening device including a radiolucent template having at least one cell configured to contain, partially or/and fully, a sized radiopaque material member or portion/quantity. In some embodiments, at least one actuator is linked with the cell and is adapted to shift or/and allocate at least one radiopaque material member or portion between a first position, in which the at least one member or portion completely covers the cell, and a second position, in which the at least one member or portion completely or partially uncovers the cell. Optionally, additionally or alternatively, the at least one actuator linked with the cell is adapted to shift or/and allocate at least one radiopaque material member or portion between a first position, in which the at least one member or portion partially or completely fills the cell, and a second position, in which the at least one member or portion is substantially of fully absent from the cell. In some embodiments, the radiation filtering or screening device further comprises a controller that is arranged to control the at least one actuator according to continuously programmed/set or pre-set rules.

In some embodiments, the radiation filtering or screening device is adapted for screening radiation rays of radiography (e.g., fluoroscopy) imaging systems or/and for collimating radiation rays of radiotherapy systems.

In some embodiments, at least one cell includes a circular, a rectangular or a hexagonal cross section. In some embodiments, the radiopaque material includes steel, tungsten, uranium, molybdenum or/and lead. In some embodiments, a radiopaque material member includes an elongated body sized to at least partially fill the at least one cell. In some embodiments, at least one radiopaque material member is a hinged shutter or a male part adapted for axial placement in the at least one cell.

In some embodiments, the radiation filtering or screening system further includes a feeder which comprises at least one port for containing or/and supplying the at least one radiopaque material member or/and portion. In some embodiments, the feeder includes or is combined with a feeder displacing mechanism that is adapted for displacing the feeder from and to a facing position in which the at least one port faces the at least one cell. In some embodiments, the feeder includes a second radiolucent template including a plurality of the at least one port each adapted to contain and supply a single member or quantified portion of the radiopaque material, or part thereof, to a single corresponding cell.

In some embodiments, the actuator includes means to transfer the at least one member or quantified portion from the at least one port to the at least one cell.

In some embodiments, the preset rules include a sequence of binary rules for selectively operating or not operating the at least one controller according to a chosen radiation covering scheme.

In some embodiments, the radiation filtering or screening device further comprises a positioning verification mechanism adapted for verifying a chosen position of the at least one member or quantified portion of the radiopaque material. In some embodiments, the positioning verification mechanism includes at least one of an optical visualization device, an electrical sensing device, a mechanical sensing device and an electro-magnetic sensing device.

Referring again to the drawings, FIGs. 5A - 5C schematically illustrate frontal views of an exemplary radiation filtering or screening device featuring a multi-leaf type of modality or configuration 1010 (FIG. 5B) and an actual covered area C1 (FIG. 5C) verses a pre-set radiation pattern P1 (FIG. 5A). Multi-leaf type collimators are used in radiotherapy procedures, having designs specifically tailored for ultra-high-dose projections as needed in radiotherapy. As shown, collimator 1010 includes a housing or frame 1011 incorporating a plurality of slidable leaves, such as leaf 1012. In a common scenario, after a preliminary scanning, the operator sets radiation pattern P1 according to preliminary scanning result analysis. Accordingly, at least some leaves are re-positioned thereby creating a shaped opening which facilitates actual covered area C1 that at least partially, optionally optimally, correlates to the pre-set radiation pattern PL The correlation resolution is determined on the leaves thickness.

It may be difficult or even non-feasible using multi leaf collimators to efficiently cover complex shapes, including a "frame" shapes (an example of which is shown in FIG. 6A), narrow shapes (for example, which corresponds with blood vessel size and contour) and others.

FIGs. 6A - 6C schematically illustrate frontal views of an exemplary binary mosaic radiation filtering or screening device 1100 (FIG. 6B) and an actual covered area C2 (FIG. 6C) verses a pre-set radiation pattern P2 (FIG. 6A). Radiation filtering or screening device 1100 is tagged as "mosaic" as it includes a plurality of small pieces or quantified portions of a radiopaque material which are being selectively deployed for covering a template according to a requested pattern. Such a pattern may be determined according to a cross-sectional shape of at least one target tissue, vessel or/and organ in need for radiation, either in the process of fluoroscopy or of radiotherapy sessions. Radiation filtering or screening device 1100 is further tagged as "binary" as the base template includes a matrix of radiolucent or open holes or cells, each hole/cell may be covered with a mating member/piece or quantified portion of a radiopaque material so that the chosen distribution of the pieces / quantified portions on the template is accomplished by selectively choosing in each cell whether it will or will not be covered or/and filled, thereby allowing local passage of radiation rays therethrough in full or in part, or if such radiation will be absorbed or blocked.

In some embodiments, radiation filtering or screening device 1100 includes a template including a grid 1110, which is optionally partially or fully radiolucent. The template or/and grid 1110 may be made of plastic, glass, polymer, light metal (e.g., aluminum). In some embodiments, grid 1110 includes holes or cells, such as cell 1120, in between vertical and horizontal borders. The cells may be rectangular, circular or in any other shape and configured for covering with mating pieces or quantified portions of the radiopaque material (not shown). Such binary mosaic patterned radiation filtering or screening device allows more shaping possibilities such as pattern P2 which is a "frame" type shape which determines an outer radiation area enclosing a core non-radiation area. Such is the case when there is a need to irradiate a tumor or tissue encircling partially or completely a vital radiosensitive structure or tissue or organ such as a blood vessel, nerve, bronchi, trachea, esophagus, bowel spinal cord, brain tissue, heart, lung, kidney, liver, urethra, etc. Screening resolution is determined according to covering area dimensions of the radiopaque members. In some embodiments, cells or/and radiopaque pieces or quantified portions of different sizes may be used.

Reference is now made to FIGs. 7A - 7B which schematically illustrate a frontal view of an exemplary pre-set radiation pattern P3 and an isometric view of an exemplary shutter-type binary radiation filtering or screening device 1200 set according to the pre-set radiation pattern P3. Radiation filtering or screening device 1200 includes a template 1210 incorporating a plurality of shutter-like radiopaque members, each is secured with a hinge to template 1210 and configured to selectively cover or uncover a different portion of the template. The radiopaque members are presented in a specific binary pattern which resembles pattern P3 whereby some radiopaque members, such as member 1212, cover corresponding portions of template 1210, and other radiopaque members, such as member 1214, are lifted and allow passage of radiation rays through corresponding portions of template 1210. Shutter-like radiopaque members are usually, though not necessarily, relatively thin, therefore will be mostly suited for relatively small doses of radiation, such as in the case of radiography (e.g., fluoroscopy). Thickness will be mostly dependent on forming material, and for example will be 0.5-2 mm, optionally 1 mm, in case of tungsten made radiopaque shutter, or 1 -3 mm, optionally 1.5 mm, in case of lead made radiopaque shutter. In case of shutter-type radiation filtering or screening devices intended for fluoroscopy, radiopaque shutters size may be compensated for lower resolution in view of fewer parts, and for example may be sized to covering areas between 1 mm x 1 mm to 10 mm x 10 mm, optionally 5 mm x 5 mm. Covering areas may be of any shape, including rectangular.

FIG. 8 schematically illustrates a side cut-view of an exemplary singular shutter mechanism, including a radiopaque shutter 1214 coupled to template 1210 with a hinge 1218 and configured to selectively cover or uncover a mating cell or recess 1216. An actuator is connected to radiopaque shutter 1214 or/and hinge 1218 for promoting selective rotational movement according to pre-set rules.

FIG. 9 schematically illustrates a side cut-view of an exemplary plural shutters mechanism, including three levels of radiopaque shutters 1222, 1224 and 1226 hingedly connected to a template 1220. Plural shutters mechanism may be applied for using thinner radiopaque members than in the case of the singular option, for properly obstructing same dose, in this example third the thickness of radiopaque shutter 1214. Once in opened non-obstruction position, thinner shutters will create thinner obstructing lines but in higher amounts in an opposite relation.

In order to avoid a grid pattern, that may partially obstruct the beam passage, though in relatively small and optionally negligible proportions, a different approach for binary collimating mechanism may be used. FIG. 10 schematically illustrates an isometric view of an exemplary binary mosaic radiation filtering or screening device 1300, in accordance with some embodiments of the present invention. Radiation filtering or screening device 1300 includes a radiolucent template 1310 with a grid spaced with plurality of cells holes, such as cell 1314. Some cells are covered with radiopaque pieces such as piece 1312 and other are maintained opened such as cell 1314. The radiopaque pieces are releasably connected or interlocked to template 1310 using passive or active locking means (not shown). The radiopaque pieces are deployed, collected or/and remotely stored using a feeder mechanism 1320 which includes a plurality of actuators, such as actuator 1322, distributed in a grid pattern correspondingly to template 1310. The actuators may be any active connecting, interlocking, forcing/attracting or/and grasping means which may selectively hold or release a radiopaque piece, such as piece 1316, according to tentatively set or prescheduled pre-set rules.

A different approach is shown in FIG. 11 , schematically illustrating an isometric view of a second exemplary binary mosaic radiation filtering or screening device 1400 which includes a robotic feeder mechanism 1420. As opposed to feeder 1320 which is "negative" member to the radiolucent template, containing residuary radiopaque pieces, the robotic feeder 1420 is a rotatable mechanism, containing an excessive amount of radiopaque pieces, such as piece 1430, configured to allocate specific radiopaque pieces onto template 1410. In some embodiments, feeder 1420 comprises at least two areas which are sequentially positionable over template 1410 on feeder 1420 rotation, a first area readily contains radiopaque pieces in a chosen follow-up pattern whereas a second area is ready to collect a complete set of patterned radiopaque pieces once current beaming ends.

A possible binary mosaic radiation filtering or screening device optimized for radiotherapy may be configured to include elongated and thin, pin-like radiopaque members in order to both improve collimating shape resolution and obstruct much intensified doses, as with respect to fluoroscopy collimators. Reference is now made to FIG. 12 which schematically illustrates a frontal view of an exemplary pinned-type binary mosaic radiation filtering or screening device or collimator 1500. Collimator 1500 includes a fenestrated radiolucent template 1510, each fenestration is optionally a through hole shaped and sized to accommodate and connect with at least a portion of a radiopaque pin, such as radiopaque pin 1520. The small diameter radiopaque pins provided in high quantity (optionally at least 100 members, optionally at least 1 ,000 members, optionally at least 10,000 members, optionally at least 100,000 members, or even higher, according to need) allow accurate collimating shapes of different complexities, such as patterns C3 and C4 presented in FIG. 12.

FIGs. 13A - 13B schematically illustrate isometric views of exemplary radiopaque pins of different shapes. In FIG. 13A, a cylindrical shaped radiopaque pin 1520 is presented which comprises an elongated cylindrical body 1522 and two opposing spiked heads 1524 and 1526 positioned at its two bases. Although illustrated as having cylindrical cross sections, the spiked heads may be of any shape. Pin 1520 may be made of steel, tungsten, uranium, molybdenum or lead, and may be produced (e.g., sintered or lathed) out of a single part or a few combined parts. Any of heads 1524 and 1526 may include a magnet or a magnetizable material. FIG. 13B shows a slightly different version for radiopaque pin 1530 which differs from pin 1520 only by its body 1532 having a cubic shape. One advantage of having a rectangular cross-section or other interlacing capable shape is that minimal to non-radiolucent trapped areas is kept in between.

FIGs. 14A - 14B schematically illustrate isometric views of an exemplary pinned-type binary mosaic radiation filtering or screening device or collimator 1600, or at least a portion thereof for demonstrative purposes, which includes a pins feeder mechanism 1610. Collimator 1600 includes a radiolucent template 1650 including a plurality of holes or ports adapted to accommodate intrusion or pinning of a radiopaque pin, such as pin 1520, at one or any of its heads, for example head 1526. Any of template 1650 holes may incorporate an actuator adapted for connecting with or releasing head 1526. Alternatively, connection is made passively using snug fitting, threading, magnets, etc. Alternatively, holes are slightly oversized and radiopaque pins are not affixed to template 1650. Feeder 1610 is applied for positioning or removing radiopaque pins from template 1650 or/and for fixating the pins thereto. Feeder 1610 includes a plurality of recesses or holes such as recess 1612, which may or may not correspond in distribution or/and sizes to holes of template 1650. Actuators, such as actuator 1620, are linked to the recesses for selectively holding or releasing radiopaque pins. Each actuator may be independently activated in a binary fashion according to pre-set rules. In some embodiments, a moving mechanism, such as an arm or slide (e.g., robotic), is connected to feeder 1610 (not shown) and may change its position with respect to template 1650, and for example may move feeder 1610 in between at least two positions including an opposing position in front of template 1650 (as shown in FIG. 14A) and a remote position.

It may be advantageous to select the local obstruction degree in each covered spot or area. This may be accomplished by varying the overall length or thickness of the radiopaque members or/and by choosing between radiopaque materials differentiated by relative radiation absorption or obstruction. This feature may change the type of modality or configuration of such systems from a "binary" type of modality or configuration to a "versatile" or "multi-radix" type of modality or configuration, in the sense that each local selected obstruction may not be considered as a binary variable but rather as one which allow a range of possibilities. Such a modality may be important when there is a need to apply beams of various intensities in different locations such as when there is a need to apply different radiation intensities to a tumor due to expected variations in tumor radio-sensitivities. Such variation in radio-sensitivities may results from spatial heterogeneity of the tumor grade and behavior, degree of tumor hypoxia, fibrous reaction, etc. Functional imaging using PET scan, MRI spectroscopy, or SPECT fused to CT scans is becoming important in tailoring radiotherapy not only to proper anatomic regions but also to escalate the dose to hot or more aggressive, or more resistant tumors spots.

Reference is now made to FIGs. 15A - 15B which schematically illustrate an isometric view and a side cut view, respectively, of an exemplary radiation filtering or screening device 1700, and members thereof, featuring a "multi-radix" type of modality or configuration. Radiation filtering or screening device 1700 includes a radiolucent template portion 1730 having a plurality of inward tunnels such as adjacent tunnels 1732 and 1734. The tunnels may be of same or different dimensions such as diameter or/and length. The tunnels are configured to accommodate radiopaque members or assemblies, such as radiopaque assembly 1710, which include a plurality (in this example, three) of members, such as radiopaque member 1712. As shown, tunnel 1734 incorporates a shorter radiopaque assembly 1720, which is therefore optionally less opaque to radiation rays passage therethrough than radiopaque assembly 1710. The assembled radiopaque members may be interconnected, and even interlocked, or may be loosely adjoined. A feeder (not shown) may be configured to feed or shoot a sequence of radiopaque members in one tunnel or in several tunnels according to a sequential route. Alternatively or additionally, a radiopaque assembly containing a relatively large quantity of members may be provided at least partially in a tunnel and then be broken to a chosen length.

Similarly, in exemplary embodiments, a feeder may be applied to fill volumetric containers, such as tunnels, with pieces or quantified portions of radiopaque material having homogenous or different volumes or/and shapes. FIG. 16 schematically illustrates side cut view of a "multi-radix" radiation filtering or screening device 1800 based on accumulated orbs. Radiation filtering or screening device 1700 includes a radiolucent template portion 1830 having a plurality of inward tunnels such as adjacent tunnels 1832 and 1834. A feeding assembly or mechanism (not shown) is configured to selectively fill (or pass by without filling) each tunnel in a certain pre-set amount of radiopaque orbs, such as orb 1812. As shown, tunnel 1832 is filled with a larger accumulation 1810 of orbs whereas tunnel 1834 if filled with a lesser accumulation 1820 of orbs.

Referring back to FIG. 9, in a similar fashion, radiopaque shutters 1222, 1224 and 1226 may not be positioned as a unitary cluster but rather may be positioned differently according to overall needed thickness.

Reference is now made to FIGs. 17A - 17C which schematically illustrate views of an exemplary pinching type binary mosaic radiation filtering or screening device 1900 and portions thereof. Radiation filtering or screening device 1900 includes a radiolucent casing 1910 having a plurality of opposing pairs of radiolucent members 1912,, each pair 1912, is actuatable to move from an opened position, where the two radiolucent members are maximally distant, to a closed position, where the two members are minimally distant, optionally adjacent, optionally in direct contact, or/and vice versa. The radiolucent casing 1910 may be made from any substantially radiolucent material, for example, plastics, polymer, glass, thin aluminum plates or otherwise. A radiopaque material 1920 is provided in casing 1910 formed of a mass of small radiopaque pellets or flowable solution of metal ions.

Radiopaque pellets may be formed of metal alloy, optionally stainless steel, optionally tungsten, optionally lead. The pellets may be 5 mm or less in diameter, optionally 1 mm or less, optionally 0.5 mm or less. Optionally, the pellets include, optionally covered or coated with a lubricant, optionally a dry lubricant (not shown) such as graphite, molybdenum disulfide, hexagonal boron nitride or tungsten disulfide. Optionally, alternatively or additionally, the pellets are soaked with a fluidic lubricant such as oil (not shown). FIG. 17B shows a segment of radiation filtering or screening device 1900 in cross section having four pairs of radiolucent members 1912i, 19122, 19123 and 19124, all of them positioned in a fully opened position, thereby allowing radiopaque material 1920 to fill the entire space entrapped therebetween. In FIG. 17C, pair 19122 is in a closed position so that radiopaque material is squeezed aside; hence the entire portion of radiation filtering or screening device 1900 at the area of members 19122 becomes substantially radiolucent. In some embodiments, elastic means (not shown) force radiolucent material 1920 to regain a substantially homogenous spread and covering when members 19122 retract back to the opened position.

FIG. 18A - 18D schematically illustrate views of an exemplary spinning type mechanism 2000 for filtering electromagnetic radiation. Mechanism 2000 includes a plurality of rotatable or spinning cylindrical members 2010,, each cylindrical member includes a radiolucent cylindrical body 2012, in which a radiopaque plate 2014, is provided along a diameter thereof and across its entire length. Spinning may be accomplished with mechanical, electrical or electromagnetic means as known in the art. In some embodiments, each member 2010i is rotatable from a first fixed opened position (as shown in FIG. 18D), where plate 2014, is substantially perpendicular with respect to a beam source, to a second fixed closed position (as shown in FIG. 18C), where plate 2014, is substantially horizontal with respect to the beam source. In some other embodiments, members 2010, are continuously spinning whereby each member may be actuated to selectively alter from a first nominal rotation rate, where plate 2014, is subject to reach a perpendicular position in sequence with each beam pulse, to a second altered rotation rate or same rate but with tangential shift of 90°, where plate 2014, is subject to reach a horizontal position in sequence with each beam pulse.

FIG. 19 schematically illustrates a frontal cross sectional view of an exemplary shapeable spacer type radiation filtering or screening device 2100. Radiation filtering or screening device 2100 includes a radiolucent template 2110 encasing a bladder or a membrane 2130 containing a flowable radiopaque material 2132, optionally containing a contrast enhancing agent such as iodine, barium or mercury, or optionally a solution (e.g., heavy liquid) containing ions of metals or other radiopaque materials. A shapeable spacer 2120 is provided in template 2110 that is capable of forming shaped spaces by compressing bladder 2130 aside, as shown in the figure. Spacer 2120 includes a plurality of hingedly interconnected members 2122,, each two connected members is capable of selectively change in angular position therebetween. By using a computerized controller, a chosen spacing shape can be translated to a chosen positioning or/and relative positioning of each member 2122,.

FIG. 20 schematically illustrates a frontal cross sectional view of an exemplary balloons cascade type radiation filtering or screening device 2200. Radiation filtering or screening device 2200 includes a radiolucent template 2210 encasing a flowable radiopaque material 2230 (which may be similar to radiopaque material 2132) and a plurality of evenly spaced expandable radiolucent members 2222i provided in a matrix form. Optionally, the expandable members 2222, are inflatable, optionally expandable from an insignificant dimension to a partially expanded form (denoted in the figure as 2222k) or to a fully expanded form (denoted in the figure as 2222j). By expanding, each expanded member forces radiopaque material 2230 to flow aside thereby creating islands of radiolucent cavities. By selectively inflating and deflating certain members 2222,, continuously changing radiolucent shapes can be formed, surrounded by radiopaque material 2230.

Reference is now made to FIGs. 21 A - 21 E which schematically illustrate exemplary application of an exemplary radiation filtering or screening system 3100, particularly highlighting an exemplary radiation filtering or screening device 3010 configured to reduce amount of radiation received by a subject, and possible scenarios in a method thereof. In radiation filtering or screening system 3100, radiation filtering or screening device 3010 includes an exterior 3012. Radiation filtering or screening device 3010 includes a plurality of radiopaque elements 3014 arranged over exterior 3012, each radiopaque element 3014 is actuatable between a first position (shown in FIG. 21 D) and a second position (shown in FIG. 21 E), wherein radiopaque element 3014 fully covers a portion 3016, of exterior 3012 at the first position, and uncovers at least partially portion 3016, at the second position. A plurality of actuators may be linked to the plurality of radiopaque elements 3014, and distributed in apposition to exterior 3012, wherein each of the actuators may be discretely actuated between the first position and the second position. The radiopaque elements 3014, may be arranged as a grid (as shown). Optionally, at least one of radiopaque members 3014, includes a shutter or a leaf composed of a radiopaque material.

In exemplary embodiments, radiation filtering or screening system 3100 is configured and operative as a radiographic or fluoroscopic type apparatus, for example, based on x-ray imaging. In exemplary embodiments, radiation filtering or screening system 3100 includes a radiation source 31 10 (e.g., an x-ray source), a receptor unit 3160 including a fluorescent screen 3120. Radiation filtering or screening device 3010 may be positioned and located such that exterior 3012 lies between radiation source 3110 and a target tissue 321 O of a subject or patient PAT. In exemplary embodiments, radiation filtering or screening system 3100 may also include a controller 3130 (e.g., a computer with controlling software) for selectively controlling features and operating parameters of components thereof. Optionally, alternatively or additionally, radiation filtering or screening system 3100 includes an x-ray image intensifier or/and a flat-panel detector.

As shown in FIG. 21 A, subject or patient PAT is positioned over a bed 3140 located between source 3110 and fluorescent screen 3120, whereas radiation filtering or screening device 3010 is positioned and located between subject or patient PAT and source 31 10. In exemplary embodiments, radiation filtering or screening device 3010 may be adjacent or remote to source 31 10. Source 3110 is configured to produce a single pulse or consecutive pulses of electromagnetic radiation beam 3150 with chosen parameters such as intensity, exposure and image average contrast, image rate and exposure rate, field of view and image magnification, or others.

In some embodiments, radiation filtering or screening system 3100 also includes an input device 3050 configured and operative to receive an input command linking a first positional parameter with a first image area 3062 related to a preliminary radiographic image 3060. Input device 3050 may include a multi-touch surface, optionally in the form of a touchscreen 3052, and the input commands may be in the form of preset multi-touch gestures, such as finger-touch gestures, optionally at least one of: tapping (e.g., single tap or multiple-taps), long-press, scrolling, pan, pinch-close, pinch-open and rotate. Optionally and alternatively, an input device includes voice recognition capturing and the input commands may be in the form of preset voice commands. Optionally and alternatively, an input device includes gesture recognition capturing and the input commands may be in the form of preset gesture commands. In some such embodiments, an input device may include at least one of wired gloves, a camera and a controller-based gestured input device.

In some embodiments, touchscreen 3052 is handheld and wired or wirelessly communicative with radiopaque elements 301 , either directly or via controller 3130. Touchscreen optionally performs also as a display, communicative with radiography system 3100, and is configured to display captured radiographic images such as preliminary radiographic image 3060.

The positional parameter may include a geometric transformation of at least one radiopaque element 3014,, including but not limited to rotation or/and translation, between the first position and the second position. Optionally, additionally or alternatively, the positional parameter may include a rate of continuous cyclic change between the first position and the second position.

In exemplary embodiments, radiation filtering or screening system 3100 may be programmed to produce a covering pattern 3020 including distinct areas of exterior 3012, including a first area 3022 correlating to said first image area, such that all radiopaque elements 3022, lying fully or mostly over first area 3022 have the first positional parameter. In some embodiments, covering pattern 3020 includes a second area 3024, distinct to first area 3022, such that all radiopaque elements 3024, lying fully or mostly over second area 3024 have a second positional parameter different than the first positional parameter. In Some embodiments, covering pattern 3020 includes a third area 3026, distinct to first area 3022 and to second area 3024, such that all radiopaque elements 3026, lying fully or mostly over third area 3026 have a third positional parameter different than the first positional parameter and the second positional parameter. An exemplary method of use for radiation filtering or screening system 3100 may include at least one of several steps, as presented below, not necessarily in same order. Subject or patient PAT is positioned over bed 3140 and undergoes preliminary steps of treatment preparations, diagnosis and location of target tissue 3210. In exemplary embodiments, radiation filtering or screening system 3100 is provided between radiation source 3110 and target tissue 3210. Optionally, using a catheter, especially in case that target tissue 3210 is part of a blood vessel, contrast agent is injected to color target tissue 3210. A preliminary image 3060 is taken/sampled and presented in touchscreen 3052, as shown in FIG. 21A, representing colored target tissue 3210 and an adjacent non-colored tissue 3220. The operator may then choose first image area 3062, as shown in FIG. 21 B, in order to focus the radiation exposure to target tissue 3210, and to the specific region of the treatment. The operator may then enter the command to capture first image area 3062 optionally by sweeping, tapping or/and pinching with his finger(s) across/along the correlating area/length on touchscreen 3052 over the represented colored target tissue 3210 in preliminary image 3060. By doing so, radiation filtering or screening system 3100 may link the first positional parameter with first image area 3062, or the operator may link them manually.

Following operator's input commands, radiation filtering or screening system 3100 produces covering pattern 3020 (as shown in FIG. 21 C) to exterior 3012 by correlating first area 3022 to first image area 3062, such that all radiopaque elements 3022, lying fully or mostly over first area 3022 are set to the first positional parameter. Covering pattern 3020 may automatically arrange second area 3024 and set all radiopaque elements 3024, lying fully or mostly over second area 3024 to the second positional parameter. Optionally and alternatively, the operator enters manually to touchscreen 3052 a second image area (not shown), correlating with requested second area 3024, or/and a requested second positional parameter linked to radiopaque elements 3024,. Second area 3024 may be determined automatically or manually as a marginal area surrounding first area 3022.

Covering pattern 3020 may automatically arrange third area 3026 and set all radiopaque elements 3026, lying fully or mostly over third area 3026 to the third positional parameter. Optionally and alternatively, the operator enters manually to touchscreen 3052 a third image area (not shown), correlating with requested third area 3026, or/and a requested third positional parameter linked to radiopaque elements 3026,. Third area 3026 may be determined automatically or manually as the remaining area over exterior 3012 other than first area 3022 and second area 3024.

In some embodiments, the positional parameters include different rates of continuous cyclic change between the first (closed) position and the second (opened) position. The first positional parameter may have a first rate being equal to or higher than 5 frames/second, optionally equal to or higher than 10 frames/second, optionally equal to or higher than 20 frames/second, optionally equal to or higher than 30 frames/second, or higher, or lower, or an intermediate value, optionally an infinite rate (i.e., radiopaque elements 3022, are kept static in the second position). The second positional parameter may have a second rate, optionally between 1 frame/second and 5 frames/second. The third positional parameter may have a third rate, optionally equal to or smaller than 1 frame/second, optionally equal to or smaller than 0.1 frame/second, or lower, or higher, or an intermediate value, optionally a null rate (i.e., radiopaque elements 3026, are kept static in the first position).

Target tissue 3210 may then be imaged using radiography system 3100. Beam 3150 is projected from radiation source 3110 towards fluorescent screen 3120. Beam 3150 substantially preserves coherent dispersion at its first travel segment 3152 until exterior 3012, where some of beam portions are substantially or fully absorbed by any of radiopaque elements 301 at the instance it is in the first (closed) position, as shown in FIG. 21 D, according to its preset rate. The filtered beam 3154 penetrates partially and travels through the subject's or patient's body (and target tissue 3210) where it is further absorbed in different ratios by soft tissues, hard tissues or/and other materials having different opacity, provided along its travel. The portion of beam 3150 that continues its travel from the subject or patient PAT to fluorescent screen 3120, namely, beam portion 3156, creates a fluoroscopic image that accumulates opacity topography generated by radiation filtering or screening system 3100 and subject or patient PAT tissues that beam 3150 passed through.

When producing images of multiple image segments or areas differentiated by exposure rates or/and refresh rates, especially of video images, there may be a need to introduce image correction or improvement techniques so that the operator or medical practitioners will not be potentially annoyed with segmented or incoherent images, or with images having blank portions. In some embodiments, image correction, restoration or/and refurbishing means may include gating (in correlation with in interval of a motion cycle) or/and superimposition of images.

In some embodiments, at least one of the first rate, the second rate and the third rate is gated in correlation with a movement cycle acting upon target tissue 3210. The movement cycle may be correlated with a cardiac cycle or/and a respiratory cycle. Optionally, the movement cycle includes at least one recurring stagnant point. Optionally, radiopaque elements 3022,, 3024, or/and 3026, are in a minimally covering position of first area 3022, second area 3024 or/and third area 3026, respectively, at a recurring stagnant point in the movement cycle. In some embodiments, at least one of the first rate, the second rate and the third rate is an integer determined as a product or a division of an interval of the movement cycle. In some embodiments, the method includes at least one of producing an electrocardiogram, analyzing a cardiac cycle and measuring a cardiac cycle interval.

In some embodiments, the step of imaging the target tissue has an imaging rate gated in correlation with at least one of the first rate, the second rate and the third rate.

In some embodiments, the method includes superimposing a first image including a blank portion with a second image including a corresponding imaged portion.

Reference is made to FIGs. 22A-22B are schematic diagrams illustrating application of an exemplary radiation filtering or screening system 4106, particularly highlighting an exemplary radiation filtering or screening device 4100 configured to filter or screen electromagnetic radiation projected from a source 4101 towards a target object 4102. Source 4101 is provided in radiation filtering or screening system 4106, for example, configured to perform a procedure based on fluoroscopy, interventional radiology, or computed tomography. Radiation filtering or screening device 4100 includes a front 4103 adapted for positioning towards source 4101 , a first region 4104 and a second region 4105, both provided about or beyond front 4103 relative to source 4101.

In exemplary embodiments, radiation filtering or screening device 4100 includes a plurality of regions including first region 4104 and second region 4105, and may include at least three regions or more. Optionally, first region 4104 and second region 4105 are discontinuous areas.

FIG. 22A shows an exemplary non-binding situation in which radiation filtering or screening device 4100 is implemented in radiation filtering or screening system 4106. Radiation filtering or screening system 4106 includes source 4101, as well as a receptor unit 4107 including detection means, for example a fluorescent screen 4108, and a controller 4109 (e.g., a processor with controlling program) for controlling parameters of source 4101 , radiation filtering or screening device 4100 and receptor unit 4107. Optionally, alternatively or additionally, radiation filtering or screening system 4106 includes an x-ray image intensifier or/and a flat-panel detector.

As shown in FIG. 22A, target object 4102 (e.g., a subject or patient) is positioned over a bed

4110 located between source 4101 and fluorescent screen 4108, whereas radiation filtering or screening device 4100 is located between target object 4102 and source 4101. In exemplary embodiments, radiation filtering or screening device 4100 may be adjacent or remote to source 4101. In some embodiments, in case fluorescent screen 4108 is a flat-panel-detector type it may include a scintillator layer that converts x-rays into light, behind which is a grid of tiny pixels (usually about 0.1 mm or even less). Each pixel contains thin-film transistor and a photodiode which generates an electrical signal in proportion to the light produced by the scintillator layer. The signals from the photodiodes are amplified and encoded in order to produce an accurate and sensitive digital representation of the x-ray image absorbed by fluorescent screen 4108.

In some embodiments, the pixels grid includes pixels that are clustered into a plurality of pixels clusters. In some embodiments, each cluster of pixels is set or/and analyzed to transfer a single specified electrical or digital signal in relation to the amount of light (e.g., number of absorbed photons over a time frame) absorbed in the cluster. In some embodiments, the single specified signal determines a local radiopacity of radiation filtering or screening device 4100. Optionally, the single specified signal is transferred only if the number of absorbed photons over a predetermined time period is above a predetermined threshold value. Optionally, each cluster correlates in shape and or size to a differentiated corresponding portion or area in radiation filtering or screening device 4100.

As shown in FIG. 22B, source 4101 includes a body 4111 and a rectangle window 4112 through which an electromagnetic radiation 4113 is projected ahead. Source 4101 is configured to produce a single pulse or consecutive pulses of electromagnetic radiation 4113 with chosen parameters such as intensity, exposure and image average contrast, image rate and exposure rate, field of view and image magnification, or others. Radiation filtering or screening device 4100 may include a radiolucent template 4114 allowing entrapped radiation filtering or radiopaque material to be areally shaped, such as according to second region 4105 shape, either by shifting or/and distributing thereof according to need and preserve shaped uncovered regions, such as first region 4104. Beam 4113 is projected via window 4112 and preserves coherent dispersion at its first travel segment 4115 until reaching radiation filtering or screening device 4100. Through radiation filtering or screening device 4100, some of beam portions of first beam segment 4115 are partially or fully absorbed by areas of second region 4105, filled or covered with radiation filtering material, while the other beam portions are substantially less absorbed or fully unabsorbed in the non-covered areas of first region 4104. Beam 4113 then progresses as a collimated beam 4116 beyond radiation filtering or screening device 4100 until reaching target object 4102. The collimated beam 4116 penetrates partially and travels through target object 4102 where it is further absorbed in different ratios by soft tissues, hard tissues or/and other materials having different radiopacity, provided along its travel. The portion of beam 4113 that continues its travel from target object 4102 to fluorescent screen 4108, namely, beam portion 4117, creates a fluoroscopic image that accumulates opacity topography made by radiation filtering or screening device 4100 and target object 4102 tissues through which beam 4113 passed.

In some embodiments, radiation filtering or screening device 4100 further comprises regulator 4118 configured for changing an amount of radiation filtering material 4119 within boundaries of first region 4104, or second region 4105, or both, for altering difference in radiopacity therebetween. In some embodiment, radiation filtering material 4119 is characterized by an average effective atomic number (Zeff) equal to or greater than 1 or equal to or greater than 3 or equal to or greater than 10. When a portion of electromagnetic radiation beam travels through high atomic number particles, it will be absorbed in proportion to amount and concentration thereof. Optionally, radiation filtering material 4119 comprises particles, optionally atoms or ions, of a substance characterized by an average atomic number (Z) equal to or greater than 20, or equal to or greater than 50, such as tungsten/metatungstate, thallium, lead, gold, bismuth, iodine, barium or mercury. Optionally, additionally or alternatively, radiation filtering material 4119 includes a radiocontrast agent such as iodine, barium or carbon dioxide. Optionally, radiation filtering material 4119 includes at least one flat solid, or powdered particles, or a fluid (optionally a heavy liquid or/and a liquid solution).

In some embodiments, any of first and second regions 4104 and 4105 is partly radiolucent if enclosing an amount of radiation filtering material 4119, meaning that it will not fully absorb or screen out radiation even if filled, partially but optionally also to full capacity, with radiation filtering material 4119. Optionally, alternatively or additionally, any of first and second regions 4104 and 4105 is substantially radiolucent if absent of radiation filtering material content, meaning that parts of radiation filtering or screening device 4100 are substantially radiolucent to radiation when not containing any of radiation filtering material 4119. In contrary, any of first and second regions 4104 and 4105 will be substantially radiopaque if filled to a maximal volume with radiation filtering material 4119.

In some embodiments, radiation filtering or screening device 4100 is configured such that it may include different number of discrete regions, each can be selectively (manually or automatically) capped to a different quantity or/and density of the radiation filtering material 4119, so that to acquire a chosen radiopacity to an electromagnetic radiation portion passing therethrough. Optionally and additionally, at least one of such regions can be changed in shape, size (area or/and depth with respect to source 4101) or/and location, or may be canceled or created as needed. In some embodiments, at least one of first and second regions 4104 and 4105 is geometrically changeable in a plane parallel to front 4103. Optionally, alternatively or additionally, at least one of first and second regions 4104 and 4105 is geometrically changeable in a plane normal to front 4103.

Radiation filtering or screening device 4100 may include a processor (possibly as part of controller 4109) programmed to control radiopacity of at least one of the first and second regions normal to the front. The control may be set or preset according to a user input or/and set or preset automatically in real-time according to a user directional attention or/and according to radiopacity distribution within the target object 4102. In some embodiments, the quantity of radiation filtering material 4119 is spatially arranged to cover a chosen shaped area vertically to source 4101 and a chosen depth horizontally to source 4101.

It should be emphasized that in a common procedure there may be a plurality of regions of interest or/and a number of focus areas. A number of regions of interest may be provided in a single image or in a single focus area (e.g., a single, non-continuous area of interest). Optionally, additionally or alternatively, a number of regions of interest may located at different images during a particular session or procedure. For example, during fluoroscopy the physician commonly scan the target object (i.e., the subject or patient, or a specific internal bodily region thereof) at different angles so while the subject or patient lays on the bed the source and the radiation filtering or screening device (optionally affixed thereto) may translate across or/and rotate around the subject or patient, optionally at least with respect to an anteroposterior axis thereof.

In some embodiments, choosing location and shape of the at least one region includes using a user operated input device such as a keyboard, a computer mouse, a multi-touch surface such as a touchscreen, a gesture recognition device, a voice recognition device, or a visual attention capturing device such an eye-gaze tracking device. Optionally and alternatively, choosing of location and shape includes using a captured contrast of the first area of interest with surrounding area portion in the preliminary image, such as measured difference in luminance or/and chromaticity between a first area in a captured image representing the first area of interest and a second area in the captured image representing the surrounding area. The captured contrast may be facilitated by first introducing contrast enhancing material to the first area of interest.

In some embodiments, radiation filtering or screening device 4100 is configured to automatically adjust location of one or more regions upon source 4101 repositioning with respect to the first area of interest. Optionally, alternatively or additionally, radiation filtering or screening device 4100 is configured to automatically adjust the location upon target object 4102 repositioning with respect to source 4101. The latter scenario is common during catheterization procedure under fluoroscopy, when the interventional radiologist moves the bed (and patient lying thereon) relative to the fixed x-ray source. In some embodiments, a second area of interest may be defined within the focus area, followed by allowing an automatic adjustment of the location, accordingly.

In some embodiments, radiation filtering or screening device 4100 is configured such that after choosing one or more regions of interest, upon movement of the source 4101 being affixed to radiation filtering or screening device 100, in relation to target object 4102, first region 4104 or/and second region 4105 automatically change in location or/and shape to correspond to the new relative positioning of radiation filtering or screening device 4100, source 4101 and target object 4102. These changes may be performed real-time by a feed-forward control configured to calculate in-advance assessed relative displacements, velocities and directions of each of the radiation filtering or screening device, source and target object, followed by immediate or simultaneously adjustments in shape or/and location of the first and second regions. Measurement of all vectors can be produced by position or proximity sensors provided on one or more locations.

Each of the following terms written in singular grammatical form: 'a', 'an', and 'the', as used herein, means 'at least one', or One or more'. Use of the phrase One or more' herein does not alter this intended meaning of 'a', 'an', or 'the'. Accordingly, the terms 'a', 'an', and 'the', as used herein, may also refer to, and encompass, a plurality of the stated entity or object, unless otherwise specifically defined or stated herein, or, unless the context clearly dictates otherwise. For example, the phrases: 'a unit', 'a device', 'an assembly', 'a mechanism', 'a component', 'an element', and 'a step or procedure', as used herein, may also refer to, and encompass, a plurality of units, a plurality of devices, a plurality of assemblies, a plurality of mechanisms, a plurality of components, a plurality of elements, and, a plurality of steps or procedures, respectively.

Each of the following terms: 'includes', 'including', 'has', 'having', 'comprises', and 'comprising', and, their linguistic / grammatical variants, derivatives, or/and conjugates, as used herein, means 'including, but not limited to', and is to be taken as specifying the stated component(s), feature(s), characteristic(s), parameter(s), integer(s), or step(s), and does not preclude addition of one or more additional component(s), feature(s), characteristic(s), parameter(s), integer(s), step(s), or groups thereof. Each of these terms is considered equivalent in meaning to the phrase 'consisting essentially of.

Each of the phrases 'consisting of and 'consists of, as used herein, means 'including and limited to'.

The phrase 'consisting essentially of, as used herein, means that the stated entity or item (system, system unit, system sub-unit, device, assembly, sub-assembly, mechanism, structure, component, element, or, peripheral equipment, utility, accessory, or material, method or process, step or procedure, sub-step or sub-procedure), which is an entirety or part of an exemplary embodiment of the disclosed invention, or/and which is used for implementing an exemplary embodiment of the disclosed invention, may include at least one additional 'feature or characteristic' being a system unit, system sub- unit, device, assembly, sub-assembly, mechanism, structure, component, or element, or, peripheral equipment, utility, accessory, or material, step or procedure, sub-step or sub-procedure), but only if each such additional 'feature or characteristic' does not materially alter the basic novel and inventive characteristics or special technical features, of the claimed entity or item. The term 'method', as used herein, refers to steps, procedures, manners, means, or/and techniques, for accomplishing a given task including, but not limited to, those steps, procedures, manners, means, or/and techniques, either known to, or readily developed from known steps, procedures, manners, means, or/and techniques, by practitioners in the relevant field(s) of the disclosed invention.

Throughout this disclosure, a numerical value of a parameter, feature, characteristic, object, or dimension, may be stated or described in terms of a numerical range format. Such a numerical range format, as used herein, illustrates implementation of some exemplary embodiments of the invention, and does not inflexibly limit the scope of the exemplary embodiments of the invention. Accordingly, a stated or described numerical range also refers to, and encompasses, all possible subranges and individual numerical values (where a numerical value may be expressed as a whole, integral, or fractional number) within that stated or described numerical range. For example, a stated or described numerical range 'from 1 to 6' also refers to, and encompasses, all possible sub-ranges, such as 'from 1 to 3', 'from 1 to 4', 'from 1 to 5', 'from 2 to 4', 'from 2 to 6', 'from 3 to 6', etc., and individual numerical values, such as Ί ', Ί .3', '2', '2.8', '3', '3.5', '4', '4.6', '5', '5.2', and '6', within the stated or described numerical range of 'from 1 to 6'. This applies regardless of the numerical breadth, extent, or size, of the stated or described numerical range.

Moreover, for stating or describing a numerical range, the phrase 'in a range of between about a first numerical value and about a second numerical value', is considered equivalent to, and meaning the same as, the phrase 'in a range of from about a first numerical value to about a second numerical value', and, thus, the two equivalently meaning phrases may be used interchangeably. For example, for stating or describing the numerical range of room temperature, the phrase 'room temperature refers to a temperature in a range of between about 20 °C and about 25 °C, and is considered equivalent to, and meaning the same as, the phrase 'room temperature refers to a temperature in a range of from about 20 °C to about 25 °C.

The term 'about', as used herein, refers to ± 10 % of the stated numerical value.

The phrase Operatively connected', as used herein, equivalently refers to the corresponding synonymous phrases Operatively joined', and Operatively attached', where the operative connection, operative joint, or operative attachment, is according to a physical, or/and electrical, or/and electronic, or/and mechanical, or/and electro-mechanical, manner or nature, involving various types and kinds of hardware or/and software equipment and components.

It is to be fully understood that certain aspects, characteristics, and features, of the invention, which are, for clarity, illustratively described and presented in the context or format of a plurality of separate embodiments, may also be illustratively described and presented in any suitable combination or sub-combination in the context or format of a single embodiment. Conversely, various aspects, characteristics, and features, of the invention which are illustratively described and presented in combination or sub-combination in the context or format of a single embodiment, may also be illustratively described and presented in the context or format of a plurality of separate embodiments.

Although the invention has been illustratively described and presented by way of specific exemplary embodiments, and examples thereof, it is evident that many alternatives, modifications, or/and variations, thereof, will be apparent to those skilled in the art. Accordingly, it is intended that all such alternatives, modifications, or/and variations, fall within the spirit of, and are encompassed by, the broad scope of the appended claims.

All publications, patents, and or/and patent applications, cited or referred to in this disclosure are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent, or/and patent application, was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this specification shall not be construed or understood as an admission that such reference represents or corresponds to prior art of the present invention. To the extent that section headings are used, they should not be construed as necessarily limiting.

Claims

What is claimed is:

1. A device for filtering or screening radiation, the device comprising:

a cross section divided into a plurality of defined shaped areas;

radiopaque material;

at least one controllable mechanism configured to shift portions or members of said radiopaque material to cover said cross section according to a chosen allocation between said portions or members and said defined shaped areas, such that each said defined shaped area can be selectively and independently covered with a chosen thickness or/and amount of said radiopaque material, thereby generating a chosen variable radiopacity to said radiation above said cross section per each said defined shaped area.

2. The device of claim 1 , wherein each said defined shaped area defines a volume tillable with one or more of said portions or members of said radiopaque material.

3. The device of claim 1 , wherein said cross section relates to a radiolucent template.

4. The device of claim 3, wherein each said defined shaped area defines at least one cell in said radiolucent template.

5. The device of claim 4, wherein said radiopaque material includes at least one radiopaque member sized and shaped to cover or at least partially fill said at least one cell.

6. The device of claim 1 , further comprising:

at least one actuator associated with said controllable mechanism and adapted to force a change in a position of said portions or members; and

a controller arranged to control said at least one actuator according to preset rules.

7. The device of claim 1 , wherein said radiopaque material comprises at least of steel, tungsten, uranium, molybdenum and lead.

8. The device of claim 1 , wherein said radiopaque material is characterized by an average effective atomic number (Z_eff) equal to or greater than 1.

9. The device of claim 1 , wherein said radiopaque material comprises particles of a substance characterized by an average atomic number (Z) equal to or greater than 20.

10. The device of claim 9, wherein said substance is tungsten thallium, lead, gold, bismuth, iodine, barium or mercury.

11. The device of claim 1 , wherein said radiopaque material comprises iodine, barium or carbon dioxide.

12. The device of claim 1 , wherein said members of said radiopaque material include a hinged shutter.

13. The device of claim 1 comprising:

a feeder comprising at least one port for containing and supplying said portions or members of said radiopaque material;

a feeder displacing mechanism adapted for displacing said feeder from and to a facing position in which each said ports faces a corresponding defined shaped area.

14. The device of claim 1 configured to filter or screen x-ray radiation lower than 50 keV particularly across a number of said defined shaped areas covered with at least one portion or member of said radiopaque material.

15. The device of claim 1 configured to filter or screen x-ray radiation within a range between 10 keV and 150 keV, particularly across a number of said defined shaped areas covered with at least one portion or member of said radiopaque material.

16. The device of claim 1 configured to filter or screen x-ray radiation within a range between 50 keV and 25 MeV, particularly across a number of said defined shaped areas covered with at least one portion or member of said radiopaque material.

17. A device for filtering or screening radiation, the device comprising:

a radiolucent template comprising an exterior divided into defined shaped areas;

a plurality of actuators associated with said defined shaped areas; and

radiopaque material;

wherein each of said actuators is changeable between an opened position and a closed position, wherein in said opened position said radiopaque material is forced or is allowed to align in a minimal covering form in apposition to a corresponding defined shape area, wherein in said closed position a selected portion or a number of members comprising said radiopaque material is forced or is allowed to cover said corresponding defined shaped area.

18. The device of claim 17, wherein said radiopaque material is in a form of a solid member comprising a polygonal surface sized and shaped to cover one of said defined shaped areas.

19. The device of claim 17, wherein said radiopaque material is in a form of pellets being 5 mm or less in diameter and having smooth outer surface.

20. The device of claim 17, wherein said radiopaque material includes a flowable contrast enhancing medium.

21. The device of claim 17, wherein said plurality of actuators include a piezoelectric actuator.

22. The device of claim 17, wherein said plurality of actuators include a valve.

23. A system for filtering or screening x-ray radiation, the system comprising:

a radiation filtering or screening device located between a radiation source and a target tissue, and including an exterior configured to lie between said radiation source and a target tissue, said exterior is divided into defined shaped areas;

radiopaque material provided in said radiation filtering or screening device;

a display configured to display a preliminary radiographic image of said target tissue within a chosen frame; and

an input device, connected or connectable to a processor, configured for receiving an input command indicating a first image area within said preliminary radiographic image, said processor is programmed to link said first image area with at least one of said defined shaped areas.

24. The system of claim 23, wherein said radiation filtering or screening device includes at least one controllable mechanism configured to shift portions or members of said radiopaque material to cover a cross section according to a chosen allocation between said portions or members and said defined shaped areas, such that each said defined shaped area is selectively and independently covered with a chosen thickness or/and amount of said radiopaque material, thereby generating a chosen variable radiopacity to said radiation above said cross section per each said defined shaped area.

25. The system of claim 23, wherein said radiation filtering or screening device includes at least one actuator changeable between a first position and a second position in accordance with said input command, wherein in said first position said radiopaque material is forced or is allowed to align in a minimal covering form in apposition to a corresponding defined shape area and in said second position a selected portion or a number of members comprising said radiopaque material is forced or is allowed to cover said corresponding defined shaped area.

26. The system of claim 23, wherein said input device includes voice recognition capturing and said input command includes a preset voice command.

27. The system of claim 23, wherein said input device includes gesture recognition capturing and said input command includes a preset gesture command.

28. The system of claim 27, wherein said input device includes at least one of: wired gloves, a camera and a controller-based gestured input device.

29. The system of claim 23, wherein said input device includes a multi-touch surface and said input command includes a preset multi-touch gesture.

30. The system of claim 29, wherein said preset multi-touch gesture includes a finger-touch gesture comprising at least one of: single tap, multiple-taps, long-press, scroll, pan, pinch-close, pinch- open and rotate.

31. The system of claim 23, wherein said input device includes a touchscreen.

32. The system of claim 23, wherein said display is communicative with said radiation filtering or screening device.

33. The system of claim 23, wherein said input device includes said display.

34. The system of claim 23, wherein said defined shaped areas are arranged as a grid.

35. A method for filtering or screening radiation, the method comprising:

providing a radiation filtering or screening device between a radiation source and a target tissue, the radiation filtering or screening device comprises a cross section divided into a plurality of defined shaped areas, a radiopaque material, and at least one controllable mechanism configured to shift portions or members comprising said radiopaque material to cover said cross section according to a chosen allocation between said portions or members and said defined shaped areas;

injecting contrast agent to color said target tissue;

sampling a preliminary image representing said colored target tissue and an adjacent non- colored tissue;

choosing a first image area within said preliminary image;

entering an input command to an input device to link said first image area with at least one of said defined shaped areas; and

imaging said target tissue;

wherein said radiation filtering or screening device produces a covering pattern of said radiopaque material in accordance with said input command in which said at least one of said defined shaped areas linked to said first image area are kept uncovered by said radiopaque material while other defined shaped areas are covered with said radiopaque material.

36. The method of claim 35, wherein said choosing includes marking said first image area on a display displaying said preliminary image.

37. The method of claim 35, comprising producing an electrocardiogram, analyzing a cardiac cycle and measuring a cardiac cycle interval.

38. The method of claim 35, comprising superimposing a first image comprising a blank portion with a second image comprising a corresponding imaged portion.