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| United States Patent | 5609152 |
| Link to this page | http://www.wikipatents.com/5609152.html |
| Inventor(s) | Pellegrino; Anthony J. (New Fairfield, CT);
Stoller; Milton (West Hartford, CT);
DeFreitas; Kenneth F. (Patterson, NY);
Camarra; David D. (Fairfield, CT);
Scandura; Anthony M. (Scotland, CT);
Schutz; Richard F. (Brewster, NY);
Storm; Jeffrey R. (North Bend, WA) |
| Abstract | A patient-supporting table for performing prone stereotactic mammographic
biopsy procedures having a platform with an aperture positioned so as to
divide the platform into two supporting portions is disclosed. Each of the
supporting portions of the platform are sufficient to support at least a
patient's torso and legs. The supporting portions of the platform enable a
patient's breast to be pendulantly presented in two different orientations
with respect to the aperture which further enables 360.degree. access to a
pendulantly presented breast by stereotactic mammography and biopsy
apparatus which have rotation ranges substantially less than 360.degree.
but more than 180.degree. relative to the aperture. |
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Title Information  |
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Drawing from US Patent 5609152 |
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Prone position stereotactic mammography needle biopsy apparatus and
method for using the same |
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| Publication Date |
March 11, 1997 |
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| Filing Date |
February 15, 1995 |
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| Parent Case |
CROSS REFERENCE TO RELATED APPLICATION
This is a divisional application of U.S. Ser. No. 08/185,690 filed Jan. 24,
1994 now U.S. Pat. No. 5,426,685 issued on Jun. 20, 1995, which is a
divisional application of U.S. Ser. No. 07/957,275 filed Oct. 6, 1992 now
U.S. Pat. No. 5,289,520, issued on Feb. 22, 1994, which is a
continuation-in-part of co-pending application Ser. No. 07/799,412, filed
Nov. 27, 1991, now abandoned. The disclosures of the above listed parent
applications are hereby incorporated by reference. |
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Title Information |
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References |
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Public's "Guesstimation" of Royalty Value
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Market Review |
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Technical Review |
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Claims |
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What is claimed is:
1. A patient-supporting table for performing prone stereotactic
mammographic biopsy procedures, the table comprising:
a platform having a first end, a second end, and a breast-receiving
aperture permitting pendulant presentation of a patient's breast
therethrough, wherein the breast-receiving aperture is positioned on the
platform so as to divide the platform into a first supporting portion
extending from the first end to the breast-receiving aperture for
supporting at least a patient's torso and legs in a first patient position
and a second supporting portion extending from the second end to the
breast-receiving aperture for supporting at least a patient's torso and
legs in a second patient position.
whereby supporting a patient on the first supporting portion of the
platform in the first patient position enables the patient's breast to be
pendulantly presented in a first orientation through the breast-receiving
aperture of the platform and whereby supporting a patient on the second
supporting portion of the platform in the second patient position enables
the patient's breast to be pendulantly presented in a second orientation
through the breast-receiving aperture of the platform.
2. The patient-supporting table of claim 1 further comprising a concave
torso depression surrounding the aperture in the platform.
3. The patient-supporting table of claim 1, wherein the first supporting
portion of the platform is provided with an extensible and retractable
footrest, and the second supporting portion of the platform is provided
with an extensible and retractable footrest.
4. A prone stereotactic mammographic biopsy apparatus for performing
stereotactic X-ray guided breast biopsies comprising:
a base;
a pedestal extending upwardly from the base:
a platform supported by the pedestal, the platform having a first end, a
second end, and a breast-receiving aperture permitting pendulant
presentation of a patient's breast therethrough, wherein the
breast-receiving aperture is positioned on the platform so as to divide
the platform into a first supporting portion extending from the first end
to the breast-receiving aperture for supporting at least a patient's torso
and legs in a first patient position and a second supporting portion
extending from the second end to the breast-receiving aperture for
supporting at least a patient's torso and legs in a second patient
position;
a positionable ledge extending outwardly from the pedestal below the
patient-supporting platform;
means for obtaining stereotactic X-ray images of the patient's breast
pendulantly presented through the breast-receiving aperture in the
patient-supporting platform, the means being supported by the positionable
ledge;
means for compressing the pendulantly presented breast, the means being
supported by the positionable ledge; and
means for guiding a biopsy needle into the pendulantly presented and
compressed breast, the means being supported by the positionable ledge;
whereby supporting a patient on the first supporting portion of the
platform in the first patient position enables a patient's breast to be
pendulantly presented through the breast-receiving aperture in a first
orientation with respect to the breast-receiving aperture and means for
obtaining stereotactic X-ray images, means for compressing the breast and
means for guiding a biopsy needle, and whereby supporting a patient on the
second supporting portion of the platform in the second patient position
enables the patient's breast to be pendulantly presented through the
breast-receiving aperture in a second orientation with respect to the
breast-receiving aperture and means for obtaining stereotactic X-ray
images, means for compressing the breast and means for guiding a biopsy
needle.
5. The apparatus of claim 4, further comprising a concave torso depression
surrounding the aperture in the platform.
6. The apparatus of claim 4, wherein the first supporting portion of the
platform is provided with an extensible and retractable footrest, and the
second supporting portion of the platform is provided with an extensible
and retractable footrest.
7. The apparatus of claim 4, wherein the pedestal includes means for
adjusting the height of the platform relative to the base.
8. The apparatus of claim 4, wherein the means for obtaining stereotactic
X-ray images, means for compressing the pendulantly presented breast and
means for guiding a biopsy needle have a range of rotation relative to the
breast-receiving aperture of at least 180.degree. and less than
360.degree. as measured from an axis extending from the first end of the
platform to the second end of the platform.
9. A method for using a prone stereotactic guided needle breast biopsy
apparatus to sample an area of interest in a breast, the method comprising
the steps of:
(a) providing a prone stereotactic guided needle breast biopsy apparatus,
the apparatus further comprising:
a base,
a pedestal extending upwardly from the base,
a platform supported by the pedestal, the platform having a first end, a
second end, and a breast-receiving aperture pertaining pendulant
presentation of a patient's breast therethrough, wherein the
breast-receiving aperture is positioned on the platform so as to divide
the platform into a first supporting portion extending from the first end
to the breast-receiving aperture for supporting at least a patient's torso
and legs in a first patient position and a second supporting portion
extending from the second end to the breast-receiving aperture for
supporting at least a patient's torso and legs in a second patient
position,
a positionable ledge extending outwardly from the pedestal below the
platform,
means for obtaining stereotactic X-ray images of the patient's breast
pendulantly presented through the breast-receiving aperture in the
platform, the means being supported by the positionable ledge,
means for compressing the pendulantly presented breast, the means being
supported by the positionable ledge, and
means for guiding a biopsy needle into the pendulantly presented and
compressed breast, the means being supported by the positionable ledge,
wherein supporting a patient on the first supporting portion of the
platform in a first patient supporting position enables the patient's
breast to be pendulantly presented through the breast receiving aperture
in a first orientation with respect to the breast-receiving aperture, the
means for obtaining stereotactic X-ray images, the means for compressing
the breast and the means for guiding a biopsy needle by positioning, and
whereby supporting a patient on the second supporting portion of the
platform in a second patient supporting position enables the patient's
breast to be pendulantly presented through the breast-receiving aperture
in a second orientation with respect to the breast-receiving aperture, the
means for obtaining stereotactic X-ray images, the means for compressing
the breast and the means for guiding a biopsy needle;
(b) determining the approximate location of the area of interest in a
patient's breast;
(c) determining whether the first orientation or the second orientation of
the pendulantly presented breast enables biopsy needle access to the area
of interest with a minimal needle path length from the needle guiding
means;
(d) positioning the patient on the platform to enable biopsy needle access
to the area of interest with a minimal needle path length from the needle
guiding means in accordance with the determination in step (c);
(e) compressing the pendulantly presented breast so as to obtain a
compressed pendulantly presented breast;
(f) imaging the compressed pendulantly presented breast so as to obtain
stereotactic images of the area of interest therein;
(g) determining the three dimensional location of the area of interest from
the stereotactic images thereof obtained in step (f); and
(h) inserting a biopsy needle into the compressed pendulantly presented
breast at the three dimensional location determined in step (g) so as to
obtain a sample of breast tissue in the area of interest.
10. A method for using a prone stereotactic guided needle breast biopsy
apparatus to sample an area of interest in a breast, the method comprising
the steps of:
(a) providing a prone stereotactic guided needle breast biopsy apparatus,
the apparatus further comprising:
a base,
a pedestal extending upwardly from the base,
a platform supported by the pedestal, the platform having a first end, a
second end, and a breast-receiving aperture permitting pendulant
presentation of a patient's breast therethrough, wherein the
breast-receiving aperture is positioned on the platform so as to divide
the platform into a fast supporting portion extending from the first end
to the breast-receiving aperture for supporting at least a patient's torso
and legs in a first patient position and a second supporting portion
extending from the second end to the breast-receiving aperture for
supporting at least a patient's torso and legs in a second patient
position,
a positionable ledge extending outwardly from the pedestal below the
platform,
means for obtaining stereotactic X-ray images of the patient's breast
pendulantly presented through the breast-receiving aperture in the
platform, the means being supported by the positionable ledge,
means for compressing the pendulantly presented breast, the means being
supported by the positionable ledge, and
means for guiding a biopsy needle into the pendulantly presented and
compressed breast, the means being supported by the positionable ledge,
wherein supporting a patient on the first supporting portion of the
platform in a first patient supporting position enables the patient's
breast to be pendulantly presented through the breast receiving aperture
in a fast orientation with respect to the breast-receiving aperture, the
means for obtaining stereotactic X-ray images, the means for compressing
the breast and the means for guiding a biopsy needle by positioning, and
whereby supporting a patient on the second supporting portion of the
platform in a second patient supporting position enables the patient's
breast to be pendulantly presented through the breast-receiving aperture
in a second orientation with respect to the breast-receiving aperture, the
means for obtaining stereotactic X-ray images, the means for compressing
the breast and the means for guiding a biopsy needle;
(b) determining the approximate location of the area of interest in a
patient's breast;
(e) determining whether the first orientation or the second orientation of
the pendulantly presented breast enables biopsy needle access to the area
of interest from the underside of the breast;
(d) positioning the patient on the platform to enable biopsy needle access
to the area of interest from the underside of the breast in accordance
with the determination made in step (c);
(e) compressing the pendulantly presented breast so as to obtain a
compressed pendulantly presented breast;
(f) imaging the compressed pendulantly presented breast so as to obtain
stereotactic images of the area of interest therein;
(g) determining the three dimensional location of the area of interest from
the stereotactic images thereof obtained in step (f); and
(h) inserting a biopsy needle into the compressed pendulantly presented
breast at the three dimensional location determined in step (g) so as to
obtain a sample of breast tissue in the area of interest from the
underside of the breast. |
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Claims |
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Description |
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This invention relates to a patient-supporting table and associated
equipment for X-ray mammography and stereotactic needle biopsy of breast
tissue suspected to contain lesions requiring radiographic evaluation.
RELATED ART
Since the publication of an article entitled "Stereotaxic Instrument for
Needle Biopsy of the Mamma" by Jan Bolmgren et al, published in the
American Journal of Roentgenology Vol. 129, Page 121 in July 1977, needle
biopsy of breast lesions to minimize unnecessary surgical invasion of the
patient's tissue has achieved increasing acceptance. Guidance of the
biopsy needle by stereotactic X-ray exposures traditionally required
development of the two X-ray film images and their comparison to determine
the X, Y and Z coordinates of the lesion in question. Insertion of the
biopsy needle via a carefully placed needle guide directed toward the
lesion site could be verified only by additional stereo X-ray film
exposures.
Mammograms made while the patient sits erect before the X-ray equipment may
introduce unavoidable patient movement and resulting inaccuracy, while
conventional tables supporting the patient in the prone position with the
breast depending through a suitable aperture in the table generally
require a patient's arms to be raised, tensing arm muscles, straining or
distorting the breast tissue and again introducing inaccuracies. In
addition, relatively flat and rigid tables often impose undue stress and
discomfort on the patient's joints and vertebra, inducing undesired
restless movements.
SUMMARY OF THE INVENTION
The unique prone position mammography tables of the present invention
provide comfortable support for the prone patient, with a front edge
portion being removable, permitting the patient's arm and shoulder to be
lowered to more normal positions and thus minimizing patient discomfort
and involuntary movements, leaving the patient normally relaxed during the
procedure. In addition, a central concave torso depression formed in these
tables exposes the maximum volume of breast tissue for X-ray examination.
Furthermore, the central concave torso depression encircling the
breast-receiving aperture is positioned at the center of a
longer-than-normal table having an extensible footrest at each end, which
is supported by a rear pedestal opposite the removable front edge portion.
The X-ray tube and the biopsy needle guide are thus afforded access to the
patient's pendulant breast from all possible angles, over a range of more
than 360.degree..
With this invention, accurate placement of the biopsy needle is further
achieved via electronic imaging of the tissue X-rayed utilizing charge
coupled devices or CCDs, with computer enhancement software designed to
increase the sharpness of contrast between portions of the image most
indicative of particular lesion structures of possible interest. This
CCD-based imaging system offers such advantages in visualization and
differentiation of nonpalpable lesions that contrast resolution and system
sensitivity exceed that available with conventional screen or film X-ray
mammography, often permitting definitive diagnosis of equivocal findings
without the need for biopsy. Visualization capabilities are further
increased by electronic image processing techniques to enhance contrasts.
Delays in film development and evaluation are eliminated by the systems of
the present invention, providing virtually instant confirmation of proper
biopsy needle placement, reducing patient discomfort during this critical
phase of the procedure.
This virtually real time imaging of the stereotactic X-ray images, and
their computer enhancement, are preferably facilitated by an optical
system interposed in the position normally occupied by the X-ray film
cassette. This preferred optical system employs a phosphor screen exposed
to the arriving X-rays passing through the breast tissue, and the image
created on the phosphor screen by the arriving X-rays is reflected by a
mirror surface provided by a pellicle reflector, comprising an extremely
thin sheet of select optical grade nitrocellulose, on the order of five to
nine microns in thickness, stretched like a drumhead over a black anodized
flat metal frame and bonded to the precision lapped edge of the frame. The
X-radiation passes directly through this thin film to the phosphor screen,
while the visible light image of the phosphor screen is reflected from the
film's underside directly toward the camera lens, due to a reflective
coating of metallic material such as aluminum silicate, deposited on the
underside of the thin film. Suitable coatings produce up to nearly sixty
percent reflectance, depending upon wavelength. In a preferred embodiment,
a second flat mirror surface redirects the reflected image, thereby
producing a compact folded optical system conveniently enclosed in a
light-tight housing occupying very little more space than conventional
X-ray film cassettes and associated film holder structures. The preferred
camera is Peltier cooled, and incorporates a rectangular CCD format with
one thousand or more pixels along each orthogonal edge.
The comfortable table for | | |
