W \{ Beamformer / Device
Contents
1. qd 1901002 1090101 0 091 JOSS8001d q Ae ds q 001 U S Patent May 22 2007 Sheet 2 of 4 US 7 221 972 B2 Figure 2a 200 x Display message indicating the test protocol and instructing the user to place the transducer in patient s body Display message instructing user to push NEXT key to store image clip 202 204 NEXT pressed Yes Store image clip Display message instructing user to push NEXT key to enter color Doppler 210 NEXT pressed 214 Enter color Doppler U S Patent May 22 2007 Sheet 3 of 4 US 7 221 972 B2 Figure 2b Es 216 Display instruction to adjust pan box location 218 Display instruction to push NEXT to optimize color Doppler 220 NEXT pressed Yes n 222 Optimize color Doppler 224 Display instruction to press NEXT to store image clip 226 NEXT pressed Yes 228 Store image clip 230 Display instruction to press NEXT to enter PVV Doppler NEXT pressed Yes Enter PVV Doppler 234 U S Patent May 22 2007 Sheet 4 of 4 US 7 221 972 B2 Figure 2c Display instruction adiust gate location then push NEXT to optimize PVV imaging parameters 238 236 NEXT pressed Yes Optimize PW imaging parameters Display instruction to press NEXT2. causing that process to execute a sequence of instructions In this sense a macro is any sequence of instructions that can be interpreted by another process causing that process to execute or have executed a sequence of instructions For example a protocol can have a data or image capture segment Each instantiation of capture can be built as a macro such as store image to disk or store clip to VCR Of particular usefulness might be an instantiation of a macro for storing data utilizing parameters for a data type and device type Store lt datatype gt to lt devicetype gt In this way each segment of the protocol can be written as a macro utilizing parameter The protocol itself can then be imple mented as an engine used to drive a series of macros This development is particularly useful in that the engine 1 the protocol controller 160 can be interrupted after execution of a macro the sequence can be marked to indicate where to re enter and the user can run another sequence of macros protocol before returning to the exit point and continuing execution of the original protocol As mentioned above the collection of macros controls one or more of the following imaging system settings the user interface a display area and a system peripheral More specifically the macros can control one or more of the following transmit parameters and settings receive param eters and settings imaging mode imaging paramet
3. at block 242 The protocol con troller 160 may then wait until the NEXT key is pressed as shown at block 244 After the user presses the NEXT key the protocol controller 160 may display the Doppler caliper as shown at block 246 The protocol controller 160 may display a message instructing the user to select peak regurgitant velocity and press the NEXT as shown at block 248 The protocol controller 160 may then wait until the NEXT key is pressed as shown at block 250 After the user presses the NEXT key the protocol controller 160 may capture the image as shown at block 252 The protocol controller 160 allows for the user to diverge from the protocol at any point The user may thereafter reenter the protocol where it was left or reenter at any other point in the protocol Moreover the protocol controller facilitates the automatic labeling of images For example the first clip which is captured in block 208 may be labeled as a B mode A4C view As another example the second clip which is captured in block 228 may be labeled as a color Doppler A4C view of the mitral valve As still another example the next still image may be labeled as a PW of the mitral valve etc As discussed above the protocol controller 160 may execute commands in the stages of the protocol In order to execute a command the protocol controller 160 may use a macro In software the term macro is often used to describe a s
4. may be implemented as a software implemented finite state machine Of course other implementations can be used Finite state machines are known in the art and are described in for example chapter 5 of Dynamic Modeling in Object Oriented Modeling and Design by Rumbaugh Blaha Premerlani Eddy and Lorensen which is hereby incorporated by reference It is preferred that the finite state machine design pattern be implemented in such a way that the finite state machine software allows the protocol controller 160 to implement a state model diagram in a highly configurable way A state model diagram relates events and states When an event is received the next state depends on the current state as well as the event One such event is a single input from user interface 150 Achange of state caused by an event is called a transition A state model diagram is a graph whose nodes are states and whose directed arcs are transitions labeled with event names There can be guards and actions associated with state transitions as well as state entry and state exit actions The finite state machine represents a collection of hierarchical states where only one sub state is current at any time An application can have multiple states by having multiple finite state machines The state model diagram of a given protocol is used to initiate the execution of the application function ality It is driven by events which are due to user actions There can be c
5. state machines created and running concurrently The protocol finite state machines can send events to each other so they can be synchronized FIGS 2a c are a flow diagram 200 of one example of transitioning through the multiple stages of an exemplary protocol for an A4C View Upon starting the protocol the processor 120 may send a message to the display of user interface 150 to display a message indicating the particular test protocol and instructing the user to place the transducer in the appropriate place on the patient s body as shown at block 202 An additional message may be displayed instruct ing the user to push the NEXT key to store the image clip as shown at block 204 As discussed above one aspect of the preferred embodiments is simplifying the transitioning between the multiple stages in a protocol The user may enter a single input such as a single key press in order to transition to the next stage of the protocol Further in the case of a single key press the keyboard may have a single key which is dedicated to the transitioning to the next stage As shown in the flow diagram in FIGS 2a c the dedicated key may be a NEXT key The protocol controller 160 may then wait until the NEXT key is pressed as shown at block 206 When pressed the protocol controller may store the image clip as shown at block 208 Further the protocol controller 160 may display a message instructing the user to press t
6. the invention can take and not as a definition of the invention It is only the following claims including all equivalents that are intended to define the scope of this invention What is claimed is 1 A medical diagnostic imaging system comprising a storage device storing a protocol for performing a medical diagnostic procedure on the medical diagnostic imaging system the protocol partitioned into at least a first stage and a second stage the stages being different from one another an input device a protocol controller operative to transition to the first stage in response to no more than a first single input from the input device and transition from the first stage 15 25 40 45 65 10 to the second stage in the protocol in response to no more than a second single input from the input device the protocol controller operative to configure the medi cal diagnostic imaging system for the first stage and the second stage in the protocol and a display controller operative to display a message prior to the protocol controller configuring the medical diag nostic imaging system for each of the first and second stages in the protocol the message comprising an instruction for an operator to perform in advance of each of the first and second stages and for the operator to enter an input after performing the instruction wherein the first single input and second single input are received to transition to each of the first
7. 2005 Kerby et al 600 443 2002 0035326 Al 3 2002 Kamiyama 2003 0191389 A1 10 2003 Sano et al OTHER PUBLICATIONS Acuson Sequoia 512 Ultrasound System Administrator Manual Megas GP Advanced Applications Image Management System I MLS http www esaote com products ultrasound megas cAdvAppliclmsGP htm 1 page printed Oct 29 2002 Ultrasound Vivid FiVe GE Medical Systems http www gemedicalsystems com rad us products vivid 5 msuvivid5 html 2 pages printed Oct 29 2002 HP Introduced Advanced Diagnostics for HP SONOS 5500 Echocardiography Ultrasound System http www pacificwestmedical com hewlett_packard htm 5 pages printed Oct 29 2002 Sonos 5500 Ultraperformance Upgrade Philips Medical Sys tems http vvvvvv medical philips com main products ultrasound cardiology sonos5500 upgrades 2 pages printed Jul 30 2003 Sonos 5500 Philips Medical Systems http www medical philips com main products ultrasound cardiology sonos5500 1 page printed Sep 3 2004 Sonos 5500 Features and Benefits Philips Medical Systems http www medical philips com main products ultrasound cardiol ogy sonos5500 features 1 page printed Jul 30 2003 Annex X Ultrasound Staged Protocol Data Management 3 pages undated cited by examiner US 7 221 972 B2 Sheet 1 of 4 May 22 2007 U S Patent L OEBH l U Jasn 091
8. United States Patent U5007221972B2 12 ao Patent No US 7 221 972 B2 Jackson et al 45 Date of Patent May 22 2007 54 ULTRASOUND SYSTEM WITH 5 544 654 A 8 1996 Murphy et al 600 443 PROTOCOL DRIVEN USER INTERFACE 5 831 612 A 11 1998 Stoval et al 6 139 498 A 10 2000 Kafsman et al 75 Inventors John I Jackson Menlo Park CA 6 141 398 A 10 2000 He et al US Lewis J Thomas Palo Alto CA 6 148 095 A 11 2000 Prause et al 382 131 US Cynthia L Kerby Carnation 257 s e al 397 er et al 2775 207 L 6 458 081 Bl 10 2002 Matsui et al Li y 2 CA US 6 488 629 B1 12 2002 Saetre et al 600 443 ivermore CA US 6 641 538 B2 11 2003 Nakaya et al 600 458 73 Assignee Siemens Medical Solutions USA Inc Bo 18 2004 Ogasawaravet al Malvern PA US Continued Notice Subject to any disclaimer the term of this OTHER PUBLICATIONS patent is extended or adjusted under 35 U S C 154 b by 319 days Acuson Sequoia 512 Ultrasound System User Manual cover page pp il 184 and 186 189 Apr 1999 21 Appl No 10 892 921 Continued 22 Filed Jul 16 2004 Primary Examiner Francis J Jaworski 65 Prior Publication Data 57 ABSTRACT US 2005 0049506 Al Mar 3 2005 The embodiments described herein relate to stepping Related U S Application Data through the stages of a protocol using an input device and a 63 Continuation in part of ap
9. a protocol for performing a medical diagnostic procedure on the medical diagnostic imaging system the protocol partitioned into at least two sequential stages the stages being different from one another an input device having at least one key a protocol controller operative to transition from one stage to a next stage in the protocol in response to no more than a single input from the key of the input device and operative to confrnure the medical diagnostic imagine system for the next stage in the protocol and a display controller operative to display a message prior to the protocol controller configuring the medical diag nostic imagine system for each of the at least two sequential stages in the protocol the message compris ing an instruction for an operator to perform in advance of each of the at least two sequential stages and for the operator to enter an input after performing the instruc tion wherein the key is dedicated to indicate transitioning to a stage of the protocol during operation of the protocol on the medical diagnostic system and wherein the no more than a single input from the key is received to transition to each stage of the at least two sequential stages 18 The medical diagnostic imaging system of claim 17 wherein the input device comprises a keyboard with a plurality of keys and wherein the key is a dedicated key to indicate transition ing to a stage of the protocol only during operation of the pro
10. a single input from the input device may indicate to the protocol controller to transition to each of the stages of the protocol In one embodiment the same single input such as a stage transition input is received to transition to each stage of the at least two sequential stages Examples of a stage transition input may include a dedicated key on a keyboard a voice input a foot pedal input or a key or button on the ultrasound transducer The protocol controller may receive a signal from the input device indicating that the stage transition 20 25 30 35 40 45 50 55 60 65 2 input has been activated The protocol controller may then execute the transition to the next sequential stage of the protocol In this manner the stage transition input indicates to the protocol controller when to execute the stages of the protocol Rather than the protocol controller requiring com plex input to transition through the stages of the protocol the stage transition input enables a simpler manner such as by the press of a single button in which to indicate to the protocol controller to transition through the next stage of the protocol In another embodiment different single input such as different keys on a keyboard may be used to transition to different stages of the at least two sequential stages Other embodiments are provided and each of the embodiments described herein can be used alone or in combination with one a
11. aged study contains a set of images acquired under specified conditions during two or more time intervals called stages with a consistent set of images called views acquired during each stage of the study The protocol for a staged study dictates the actions a user preferably performs to complete the study A user proceeds through a staged pro tocol exam one stage at a time acquiring images with the capture settings of each stage One example of a staged study is a stress echo ultrasound study which allows a clinician to compare left ventricular motion from a variety of views with and without stressing the heart A typical stress echo protocol consists of the user imaging and capturing clips of the patient s heart while the patient s heart is at its resting heart rate The standard views of the heart that are imaged and captured are Parasternal Long Axis PLAX Parasternal Short Axis PSAX Apical Four Chamber A4C and Apical Two Chamber A2C Next the patient s heart rate is increased to its maximum either by exercise e g treadmill bicycle or with the use of drugs for those patients who are unable to exercise The user will image and capture clips standard views of the patient s heart while the patient s heart rate is at its maximum increase before the heart rate slows down images are typically captured within 60 90 seconds after exercise has stopped The user reviews the captured clips and selects the cli
12. and second stages respectively 2 The medical diagnostic imaging system of claim 1 wherein the first single input and the second single input comprise a same single input and wherein the same single input is received to transition to each stage of the first and second stages 3 The medical diagnostic imaging system of claim 2 wherein the input device comprises keys on a keyboard and wherein the same single input comprises one of the keys on the keyboard 4 The medical diagnostic imaging system of claim 3 wherein the same single input comprises a dedicated key 5 The medical diagnostic imaging system of claim 2 wherein the input device comprises a voice input and wherein the same single input comprises a vocal com mand 6 The medical diagnostic imaging system of claim 2 wherein the same single input comprises a footswitch 7 The medical diagnostic imaging system of claim 2 wherein the protocol controller further is operative to control system parameters of the medical diagnostic imaging system in accordance with the protocol in response to the same single input being activated 8 The medical diagnostic imaging system of claim 7 wherein the protocol controller controls the system param eters of the medical diagnostic imaging system to guide a user through a pre defined series of clip acquisitions 9 The medical diagnostic imaging system of claim 1 wherein the first single innut and the second single input are dif
13. ch clip or start each clip together at the same time Workflow Enable disable to automatically delete unselected clips at end of exam Enable disable to automatically move the system to the next stage of a staged protocol Enable disable to automatically start and stop VCR recording based upon some defined event US 7 221 972 B2 9 Enable disable to automatically save and recall imaging parameters a defined set such as transmit receive set tings imaging mode filters and processing settings etc upon some defined event such as the first vievv of each stage of a staged protocol or at the beginning of a defined acquisition sequence etc Enable disable to automatically transfer specifically defined types of data to specifically defined devices or locations such as transfer clips over the network at the end of each clip capture transfer still images to a CD at the end of exam etc Enable disable annotations or pictograms upon the occur rence of some user or system event Enable disable automatically performing a specific mea surement upon the occurrence of some user or system event Enable disable entry into a specific measurement and or report package upon the occurrence of some user or system event Enable disable system guidance such as a guidance to the user on the next step to perform for a specific type of exam Enable disable to automatically change the imaging mode based upon the occurrence of some user or s
14. egment script or skeleton that can be used by another process preferably repeatedly and in more than one way For example in Excel Microsoft Corporation Red mond Wash one can build a macro preferably in Visual C to perform a sequence of instructions Once built the macro can be used repeatedly with a given spreadsheet or moved easily to another spreadsheet and be used there potentially in a significantly different context Accordingly the term macro means any sequence of instructions that can be interpreted by another process causing that process to execute or have executed a sequence of instructions Macros can be exceedingly useful as building blocks for the protocol controller 160 A macro may be a set of parameter definitions that define specific ultrasound system behavior Each macro or set of parameters can be used as ultrasound preset data values or ultrasound system controlling param eters Every protocol will consist of some set of macros Once a macro has been defined it belongs to a pool of defined macros A new protocol can be created by combining a unique set of macros from this pool of already defined macros The protocol controller 160 itself can then be implemented as an engine used to drive a series of macros Instead of being a set of parameters a macro can be a code snippet That is a macro can be any sequence of instructions 20 40 45 50 65 8 that can be interpreted by another process
15. ers and settings filters and processing specifics signal processing options post processing options frequency harmonic mode pulse repetition frequency frame rate display con trol number of views annotation a user interface page displayed in the display area an active tool displayed in the display area a cursor in the display area a number of views in the display area system control measurements and reports annotations pictograms review and display fea tures user preferences which user interface page is dis played and which tool cursor is active a DICOM device a CD a DVD a VCR an MO drive a printer and a networked device Suitable protocol macros may include a clip capture macro a clip playback macro a workflow macro and an acquisition sequence macro The following are examples of these types of macros Clip Capture Number of clips to capture per clip capture activation 1 2 4 etc Duration length of each clip to be captured in seconds microseconds heartbeats etc R wave trigger clip capture enabled disabled capture clips based on patients heartbeat or not Clip capture delay time a delay time after an r wave trigger occurs to start capturing the clip in microsec onds Clip compression level Clip capture size full screen quarter screen or some other derivative size Clip Playback Clip playback speed Clip playback mode align heartbeats of multiple captured clips or just play ea
16. ferent 10 The medical diagnostic imaging system of claim 9 wherein the input device comprises a keyboard with a plurality of keys and wherein the first singe input and the second single input are different keys on the keyboard 11 The medical diagnostic imaging system of claim 1 wherein the protocol controller automatically labels images generated during the protocol 12 The medical diagnostic imaging system of claim 11 wherein the automatic labeling of images is based on a mode of a stage of the protocol 13 The medical diagnostic imaging system of claim 1 further comprising an output device wherein the protocol controller outputs on the output device a description of a next stage in the protocol 14 The medical diagnostic imaging system of claim 1 wherein the protocol controller is operative to diverge from the protocol based on user input from the input device 15 The medical diagnostic imaging system of claim 1 wherein the protocol comprises multiple branches and wherein the protocol controller is operative to transition to one of the multiple branches in response to no more than a single input from the input device US 7 221 972 B2 11 16 The medical diagnostic imaging system of claim 15 wherein the one of the multiple branches is executed by the protocol controller based on data received by the medical diagnostic imaging system 17 A medical diagnostic imaging system comprising a storage device storing
17. he NEXT key to enter color Doppler as shown at block 210 Color Doppler is a mode of the ultrasound system 100 whereby the system acquires information at multiple times The acquired data may be manipulated to display different velocities in the image using different colors The protocol controller 160 may then wait until the NEXT key is pressed as shown at block 212 When pressed the protocol controller may enter color Doppler as shown at block 214 The protocol controller 160 may display an instruction to the user to adjust the pan box location as shown at block 216 The user may focus on a portion of the image displayed on the screen by adjusting the pan box location Typically the user may use a trackball which may be a part of user interface 150 in order to focus on a portion of the image such as a certain quadrant of the image The protocol controller 160 may further display a mes sage instructing the user to press the NEXT key to optimize the color Doppler imaging parameters as shown at block 218 The parameters to optimize color Doppler imag ing may include gain and scale The protocol controller 160 may then wait until the NEXT key is pressed as shown at block 220 When pressed the protocol controller may opti mize color Doppler as shown at block 222 The protocol controller 160 may display a message instructing the user to press the NEXT key to store an image clip as shown at block 224 The p
18. he protocol controller may designate that different keys should be pressed to transition the stages vvithin the protocol Specifically when transitioning to the first stage of the protocol the 1 key may be pressed vvhen transitioning to the second stage of the protocol the 2 key may be pressed and so on Further rather than using a key such as a dedicated key to transition through the protocol an icon on the display may be used In this embodiment an ultra sound system may provide an icon that represents an auto mated sequence of exam measurement The icon may dis play the name of the currently active measurement and a tool tip that displays the next measurement in the sequence VVhen the user clicks on the icon the user interface 150 may send a signal to the protocol controller 160 indicating a request to transition to the next stage in the protocol The input from user interface 150 may be sent as a signal to the protocol controller 160 indicating the single input The protocol controller 160 may then transition to the next stage in the protocol Moreover the protocol controller 160 may execute the next stage in the protocol as discussed in more detail belovv This type of single input transitioning through the mul tiple stages of the protocol simplifies the operation of ultrasound system 100 Rather than multiple input required to transition a single push of a button for example may be used Moreover the single inp
19. key has been activated User interface may also enable the user to receive data from processor 160 For example visual data from processor 160 may be displayed on a monitor 36 or other type of display device Further aural data from processor 160 may be output using speakers or other audible output devices During an ultrasound examination a sonographer con tacts the transducer probe 105 with a patient and the ultrasound system 100 generates an ultrasound image In general the ultrasound system s processor 120 causes the beamformer 110 to apply a voltage to the transducer 105 to cause it to vibrate and emit an ultrasonic beam into the portion of the patient s body in contact with the transducer 105 Ultrasonic energy reflected from the patient s body impinges on the transducer 105 and the resulting voltages created by the transducer 105 are received by the beam former 110 The processor 120 processes the sensed voltages to create an ultrasound image that is displayed on the display device 130 US 7 221 972 B2 3 The ultrasound system 100 can be used to perform any number of exams or studies of a patient Some studies require a user to follow a defined protocol A protocol is a sequence of steps performed by a user e g a sonog rapher or physician to perform a particular ultrasound study A protocol is often used with a staged study although a protocol can also be used with a non staged study A st
20. key to begin measurements 240 242 244 NEXT Pressed Yes Display Doppler caliper Display instruction to select peak regurgitant velocity and push NEXT 248 NEXT pressed 252 Yes Capture image US 7 221 972 B2 1 ULTRASOUND SYSTEM WITH PROTOCOL DRIVEN USER INTERFACE REFERENCE TO RELATED APPLICATIONS This application is a continuation in part of U S patent application Ser No 10 651 374 filed on Aug 29 2003 now USS Pat No 6 953 433 which is incorporated by reference herein in its entirety BACKGROUND Many ultrasound exams are driven by a rigid protocol The system operator acquires standard views in a fixed order entering different modes color Doppler PW CW M mode in a specific order making specific measurements in a specific order and saving appropriate images and video clips One example of a protocol is a cardiology exam such as a stress echo examination The common practice is to step the user through a pre defined series of clip acquisitions that allow the clinician to compare left ventricular motion from a variety of views with and without stressing the heart Within the industry there are standard pre defined protocols e g two stage exercise stress four stage exercise stress etc The ACUSON Sequoia echocardiography platform offers some degree of user customization of protocol factors such as the number of stages the number of views a
21. l and configuring the medical diazaostie imaging system for the second stage 21 The method of claim 20 wherein the first single input in ii and the second single input in iv are identical 22 The method of claim 21 wherein the first single input and the second single input are a signal from a key dedicated to transitioning through the protocol 23 The method of claim 20 after iii further comprising controlling system parameters of the medical diagnostic imaging system in accordance with the first stage of the protocol
22. nd the clip capture parameters used for each stage view Operating the ultrasound system to step through the protocol properly may be difficult Typically the ultrasound system includes a keyboard with many keys that requires complex input to step through the protocol This complexity limits those who may operate the system properly Specifi cally the operator of the ultrasound system must be familiar with the ultrasound system in order to manipulate the ultrasound system to follow the prescribed protocol and acquire the appropriate clinical data Moreover this com plexity may increase the possibility that the protocol is incorrectly followed Even for an experienced ultrasound system operator the complex input may increase the number of errors in stepping through the protocol Thus this com plexity in running the protocol operating the ultrasound system may limit the usability and reduce the reliability of the ultrasound system SUMMARY The present invention is defined by the following claims and nothing in this section should be taken as a limitation on those claims By way of introduction the embodiments described below relate to stepping through the stages of a protocol using an input device and a protocol controller for a medical diagnostic imaging system The protocol controller may be operative to transition from one stage to a next stage in the protocol in response to no more than a single input from the input device Thus
23. nother The embodiments will now be described with reference to the attached drawings BRIEF DESCRIPTION OF THE DRAWINGS FIG 1 is a block diagram of a medical diagnostic ultra sound imaging system of an embodiment FIGS 2a c are a flow diagram illustrating transitioning through an exemplary protocol DETAILED DESCRIPTION OF THE PRESENTLY PREFERRED EMBODIMENTS By way of introduction the embodiments described below relate generally to protocols used in a medical diag nostic imaging system Although any type of imaging sys tem can be used these embodiments will be illustrated in conjunction with an ultrasound imaging system Turning now to FIG 1 an ultrasound system 100 typically comprises a transducer probe 105 a beamformer 110 a processor 120 a display device 130 a storage device 140 and a user interface 150 The term processor is being used to broadly refer to the hardware components and or software compo nents i e computer readable program code of the ultra sound system 100 that are used to implement the function ality described herein For example user interface 150 may enable the user to enter commands and or information to be sent to processor 120 User interface 150 may comprise any one or any combination of the following a keyboard a mouse a joystick a microphone a footswitch or the like When the user activates a key on the keyboard for example a signal is sent to the processor indicating that a
24. om the user via user interface 150 allows the user to transition from one stage in the protocol to the next stage in the protocol The one input from the user may comprise a press of a single key a press of a pushbutton a press of a footswitch a vocal input e g a specific vocal command such as NEX T or the like In the context of pressing a single key the single key may be a key dedicated to transitioning from one step to the next in the protocol For example the key on the keyboard may always be dedicated to transitioning from one step to the next in the 0 5 25 40 45 50 55 65 4 protocol during any operation of ultrasound system 100 As described below with respect to FIGS 2a c a NEXT key is used to transition The keyboard may have such a NEXT key which during any operation of ultrasound system 100 vvill be interpreted as a request for transition As another example the key may be dedicated only during the operation of the protocol on ultrasound system 100 Specifically one of the keys on the keyboard such as the ESC key may be assigned to be the key to indicate transitioning of the protocol only during operation of the protocol Alternatively the single key may be any key which is available for use on the keyboard For example the protocol controller may designate that the press of any single key may signal transition to the next stage in the protocol As another example t
25. oncurrent finite state machines active at the same time and they can communicate by sending messages which may cause state transitions and actions to be executed The finite state machine model definition is defined in a file using a state model meta language This allows a concise definition of all the information represented in the state model diagram No software coding is required to define the states or their relationships and transitions of the state model diagram The states and some of their relationships and transitions can be changed without having to recompile and re build the software Each protocol has its own set of parameters that are defined by the protocol and get initialized when the protocol finite state machine is created and initialized The param eters define to the system how to perform or respond to certain user actions e g selections The protocol finite state machine knows what state the protocol is in and defines 20 25 30 35 40 45 50 55 60 65 6 the sequences of operations that occur in response to exter nal stimuli e g user actions such as button presses or selections The external stimuli user actions generate system events and the finite state machine s response to an event depends on the state of the finite state machine receiving the event It can include a change of state or the sending of another event The protocol controller 160 can have one or more protocol finite
26. plication No 10 651 374 protocol controller for a medical diagnostic imaging system filed on Aug 29 2003 now Pat No 6 953 433 The protocol controller may be operative to transition from 8 47 055 one stage to a next stage in the protocol in response to no 51 mt CI more than a single input from the input device Thus a AGIB 5 05 2006 01 single input from the input device may indicate to the A61B 8 00 2006 01 protocol controller to transition to each of the stages of the 52 US CI 600 407 600 443 A protocol In one embodiment the same single input such as 2340300 5 a stage transition input is received to transition to each stage 27 7 200005 7 of the at least two sequential stages In another embodiment m ce ore 600 458 different single input such as different keys on a keyboard S lication file f let h hist may be used to transition to different stages of the at least two sequential stages Other embodiments are provided and 56 References Cited each of the embodiments described herein can be used alone or in combination with one another U S PATENT DOCUMENTS 4 796 634 A 1 1989 Huntsman et al 600 457 23 Claims 4 Drawing Sheets Beamformer 105 Processor 160 Protocol Controller 120 100 Display Device 140 Storage Device 150 Interface US 7 221 972 B2 Page 2 U S PATENT DOCUMENTS 6 786 869 B2 9 2004 Hashimoto 6 953 433 B2 10
27. ps he wants to keep The rest of the clips are deleted when the study has ended The standard has been to capture at least four clips of each view and only keep the best clip for each view of each stage Another example of a protocol is an A4C view which is discussed below regarding FIGS 2a c In order to execute the various stages of a protocol the user preferably operates user interface 150 of the ultrasound system 100 In a system which has a keyboard as part of user interface 150 the user may be required to enter a complex sequence of multiple keys in order to execute one stage of the protocol and transition to the next stage in the protocol This requirement to enter multiple keys limits those who may be able to follow the protocol correctly on ultrasound system 100 Specifically a user should be experienced both generally with the ultrasound system 100 and also specifi cally with the protocol in order to step through the protocol properly This experience level may bar others with lesser experience from being able to execute a protocol For example a new user of ultrasound system 100 such as a resident performing an exam during the off hours or a sonographer who is asked to complete a complex research protocol may not be able to operate ultrasound system 100 to execute the protocol properly One aspect of the preferred embodiments is to simplify the transition between the multiple stages of a protocol In one embodiment one input fr
28. rotocol controller 160 may then wait until the NEXT key is pressed as shown at block 226 For example when the user is satisfied with the image presented on the display the user may press the NEXT key to store the image clip as shown at block 228 As discussed in more detail below the protocol may automatically transition to store the image clip after the user presses the NEXT key The protocol controller 160 may display a message instructing the user to press the NEXT key to enter PW US 7 221 972 B2 7 Doppler as shown at block 230 PW Doppler is pulsed wave Doppler which determines velocity information for one localized region The protocol controller 160 may then wait until the NEXT key is pressed as shown at block 232 After the user presses the NEXT key the protocol con troller 160 may transition to the next step and enter PW Doppler as shown at block 234 The protocol controller 160 may display a message instructing the user to adjust gate location and press the NEXT key to optimize PW imaging parameters as shown at block 236 The protocol controller 160 may then wait until the NEXT key is pressed as shown at block 238 After the user presses the NEXT key the protocol controller 160 may optimize PW imaging parameters as shown at block 240 The protocol controller 160 may display a message instructing the user to press the NEXT key to begin measurements as shown
29. tocol 19 The medical diagnostic imaging system of claim 17 wherein the input device comprises a keyboard with a plurality of keys and 5 20 25 30 35 12 vvherein the key is a dedicated key to indicate transition ing to a stage of the protocol during all operations ofthe medical diagnostic system 20 Method for transitioning through a protocol in a medical diagnostic imaging system the method comprising 1 accessing a protocol for performing a medical diag nostic procedure on the medical diagnostic imaging system the protocol partitioned into at least a first stage and a second stage the stages being different from one another 11 displaying a first message comprising an instruction for an operator to perform in advance of the first stage and to input the first single input iii receiving a first single input from an input device in the medical diagnostic imaging system iv in response to no more than the first single input transitioning to the first stage of the protocol and configuring the medical diagnostic imaging system for the first stane v displaying a second message comprising an instruction for an operator to perform in advance of the second stase and to input the second single input vi receiving a second single input from an input device in the medical diagnostic imaging system and vii in response to no more than the second single input transitioning to the second stage of the protoco
30. ut transitioning is particularly beneficial with ultrasound technologies such as TEQ and Doppler TEQ which address image optimization issues that cannot be easily predicted These ultrasound technologies may require additional input other than the single input from the user Because the transitioning between the stages of the protocol is greatly simplified other steps in the protocol which may require more input become more pre dictable In this manner the operation of stepping through the multiple stages of a protocol is simplified and allows even an inexperienced user to operate ultrasound system 100 Further during operation of the protocol the processor 120 may provide data either visual or aural to the user via user interface 150 which describes the current and or next steps The single input enables the protocol controller 160 to transition from one step to the next in the protocol by a single input and automatically control various system parameters in accordance with the protocol to guide the user through a pre defined series of clip acquisitions For example an ultrasound system can be programmed with a series of preset defined protocols e g a two stage exercise stress echo protocol a four stage exercise stress echo pro tocol etc that a user can select for a particular study The protocol may include a series of steps that should be executed in a sequential order Based on the selected pro tocol the ultrasound system a
31. utomatically moves through stages and views moves between imaging and review of US 7 221 972 B2 5 captured images provides automatic movement to the next stage and performs automatic storage and retrieval of each view The ultrasound system would also know how to capture and playback clips and can automate system actions where appropriate such as automatically performing a sys tem transition to help eliminate the number of steps 1 button hits the user must perform thereby reducing the user s workload Further the protocol may include a series of steps oper ated in a sequence As discussed above the single input may execute the series of steps sequentially Alternatively the protocol may include different steps to execute such as different branches For example the protocol may include several branches A branch to the protocol may be executed based on the ultrasound data gathered during a previous executed stage in the protocol In this example if the protocol determines that a specific branch should be executed e g the ultrasound data is analyzed to determine that the specific branch should be executed upon receiving the single input the first step in the specific branch may be executed In this manner even if a protocol includes a complicated tree of steps proceeding through the branches of the tree of steps may be simplified by using the single input to step through the protocol The protocol controller 160
32. ystem event Acquisition Sequence Define a set of imaging acquisition steps where each step would have varying imaging acquisition parameter definitions the system could automatically move through the acquisition steps or could move through the acquisition steps based upon the occurrence of some user system event As noted above each of the embodiments described herein can be used alone or in combination with one another As also noted above these embodiments can be used with image modalities other than ultrasound imaging and the claims should not be limited to any particular type of image modality unless explicitly recited therein Examples of dif ferent types of image modalities that can be used with these embodiments include but are not limited to computed tomography CT magnetic resonance imaging MRT computed radiography magnetic resonance angioscopy color flow Doppler cystoscopy diaphanography echocar diography fluoresosin angiography laparoscopy magnetic resonance angiography positron emission tomography single photon emission computed tomography x ray angiography computed tomography nuclear medicine bio magnetic imaging culposcopy duplex Doppler digital microscopy endoscopy fundoscopy laser surface scan magnetic resonance spectroscopy radiographic imaging thermography and radio fluroscopy It is intended that the foregoing detailed description be understood as an illustration of selected forms that
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