CA2121585A1 - Teleradiology system - Google Patents
Teleradiology systemInfo
- Publication number
- CA2121585A1 CA2121585A1 CA002121585A CA2121585A CA2121585A1 CA 2121585 A1 CA2121585 A1 CA 2121585A1 CA 002121585 A CA002121585 A CA 002121585A CA 2121585 A CA2121585 A CA 2121585A CA 2121585 A1 CA2121585 A1 CA 2121585A1
- Authority
- CA
- Canada
- Prior art keywords
- data
- digital data
- radiologist
- personal computer
- high speed
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04N—PICTORIAL COMMUNICATION, e.g. TELEVISION
- H04N1/00—Scanning, transmission or reproduction of documents or the like, e.g. facsimile transmission; Details thereof
- H04N1/00127—Connection or combination of a still picture apparatus with another apparatus, e.g. for storage, processing or transmission of still picture signals or of information associated with a still picture
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H30/00—ICT specially adapted for the handling or processing of medical images
- G16H30/20—ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
-
- H—ELECTRICITY
- H04—ELECTRIC COMMUNICATION TECHNIQUE
- H04N—PICTORIAL COMMUNICATION, e.g. TELEVISION
- H04N2201/00—Indexing scheme relating to scanning, transmission or reproduction of documents or the like, and to details thereof
- H04N2201/0077—Types of the still picture apparatus
- H04N2201/0086—Image transceiver
Abstract
A teleradiology system for sending the raw data from a complete patient study to a remote location for a radiologist to make a final diagnosis. The system consists of two segments, a sending segment and a receiving segment. The sending segment consists of a universal floppy disk reading unit capable of reading raw data from a radiological device, (e.g., CAT Scanner, Nuclear Medicine Imaging device, Magnetic Resonance Imaging device, and the like) a personal computer, and a high speed modem. The receiving segment consists of a high speed modem to receive the data from the sending segment, a personal computer to control the receiving and manipulation of the data, and a high resolution monitor to view the images. The segments communicate through the modems and over existing telephone systems. At the remote location, the radiologist has the raw data and the capability of utilizing true windowing functions and true density values.
Description
W~ g3/1062~ PCI/US92~098S9 , ~ 2121~8~
TELERADIOLOGY SYSTEM
BACRGRQU~ID OF THE INVENTION
Field of the Inventlon The present invention relates generally to a system for data acquisition and transmissisn. More particularly, the present invention relates to transmitting radiological images from a base radioIogy site to a remote site. ~
Teleradiology involves the transmission of digitized radiological images to an off-site or receive location for medical diagnosis purposes. The most common transmission site is a hospital; the usual recelve site is the doctor's home or office.
When a patient or trauma victim is brought into a hospital, the patient may undergo one or more radiological processes.
Current radiologica~l processes include CAT or CT Scan (Computerized Axial Tomography), Magnetic Resonance Imaging (MRI), Nucl~ear Medicine Imaging (NMI~, Ultrasound and X-ray. Depending on schedules, work-load,~ emergencies, budget constraints, et.c., a.radiologist may not be~available in the hospital at any gi~en time;~to read the image(s). With teleradiologyl a radiologist can Z0 ~ expand the~territory covered by reviewing transmitted images at -~ a~ r~emote office or site. Most frequently, the images are transmitted~over~standard telephone lines. However, with the advent of cellular tel~ephones, digital cellular radio, fiber opt~lcs,~and satelll~te~communications, transmission medium is no 25~ ong~ér~limited t;o-~standard telephone llnes.
In~;practice,~an~lmaging or radiologlcal device scans the traumatized tissuè. ~The raw digitized data is conYerted to a video~signal and~dlsplay~ed on the associated monitor or display device.~ Most imaging or radiological devices ~tilize a means for 30 ~ ;~ storing the raw~data~.- Further, most~lmaging devices compress the raw data before it;is stored. The most common storage devices are disc~drives (either 8~inch, 5.25 inch or~ 3.5 inch), tape drives ~ ~or laser disc drlves. The storage medium is for archival i-~ purposes.
A radiological cross-sectional scan of a particular area of a patient's body is called a "slice". The slices are typically five (5) millime~ers apart. A collection of slices is called a study. Although it may contain any number of slices, a typical study usually contains from 20 to 40 slices.
~'::
q WO g3/1062:. 2 1 2 1 ~ ~ ~ PCr/US92/Og8~9 "
A data matrix ma-y be used to depict each slice. The most common data matrix consists of 256 by 256 available data points.
However, the matrix size can vary. For example, the Elscint CT
Scan, model no. 1800, allows the operator to choose from three S different-matrix sizes, namely 256 x 256; 340 x 340; and 512 x 512. Each point within the matrix may be given a density value.
A density value represents the density of the material found at a specific point within a~slice.
; Most CT scanners~employ the Houndsfield scale to assign lO~ a;numeric value;~to each denslty value. The Houndsfield scale ranges~from minus 1000 to 3095. Air is assigned the numerical vàlue of mlnus lOOO,~water~ lS asslgned the value of zero, and bon,e s~assigned dens1ty va~lùes~from 200 and up.
When viewlng a~slice,~the radiologist is not looking at the entire~ range~ of~ the~ Houndsfleld scale. Before a slice is '~ displayed, the radiologist designates a "window". The window is a~narrowlng,filter.;~ In~some instances,~the wlndow blocks as much as~98~of~the~raw~data.~A~tissue window would be defined to check for~internal~bleeding~and~;a~bone window would be defined to check for'~bone~fractures~
For~example~ f~soft~tissue lS of~particular interest, the ',`~ ra~ ologist~de~flnes~a~w~indow~ranging from~zero to 100. In this exàmple~ any~density value~below zero appears as black on the CRT
screen~and~any~;density~va~lue~above 100 appears white. Density 25~ a~l~e~s~w}thin the~d,e~f~lned~ra~nge~appear~as~shades of gray.
Nuclear-Medicine Imaging devices use an analogous system to ~,,~ count~;~,the~ radioactive~particl~es. ~The~ method of injecting a radio~active~ dye i~to~ a~patient and~measuring the radioactive parti`cles~given~off~,~as~the~radioactive~mater~ial decays, is known 30:~ 'to~-those~skllled~in~-the~art. An NMI~device "counts" or detects `~ , thé`number of radioactive~particles emitted. The count starts at zero and continues upwards.
Displaying~all~of~,the informatlon~at once~, i.e., viewing soft ~ t~lss,ue ~wlndows~;simultaneously ~with bone windows, would be '"~ 35~ `virtually useless~si'nce there would be too many shades of gray for "
he~human eye to;disti`nguish between.
Description of the;Prior Art he typicaI teleradiology system utilizes available hardware and software to; transfer video data from an imaging or , 2 ''~
:
,i WOg3~1062~ PCT/US92/09859 i 212158~
radioloqical device tO a remote viewing device. All known prio~
art teleradiology systems capture the filtered analog video signal ~ generated by the radiology equipment and convert it to digital 3~: data by using a video digitizer or frame grabber. The frame grabber is usually connected to the video output jack of the radiological device's monitor. The frame grabber digitizes the : ~ :
analog video siqnal and forwards the digitized, data to the teleradiology transmit computer. The digitized data is then ;~ transmltted to the;remote location using a modem and standard telephone equipment. At the receiving site, the digitized video data lS received~by a second modem and converted back to a video slgnal and dlsplayed on the remote CRT for the radiologist.
When the radiology equipment produces a plain film, e.g., an X~-ray~ negatlve,~a~sll~ghtly;different procedure is required. The ~film~ls placed on;a~light~box. ~A video camera is pointed at the light box and the video signal from the video camera is connected to~the~frame grabber.~ The~dlgitized data lS then sent to the base site~teleradiology~compu;ter~for transmission to the remote site.
Again,~ prior~ art~te~leradiology systems~tr~ansmit the digitized ~ video~signa1 to the remote location.
In~thè~normal~;~operation of a priQr art~teleradiology system, an`operator or~techniclan~located at the base~or transmit site, establishes~ a communlcatlon~ nk with the~remote site. The c,~ ,radiologis~t convey~s~to~the technician the d~esired windows and ~25~ s ~ s~for~vlewing.~ The~technl~cian~rev;lews the patient study by ,,v~e~}ng~the~;radio~ogy~ device's monltor.; The technician, in accordance~with,the~doctor~'s~ instructlons~ selects a~window and a^~sl~ice~ The~,;raw~ digital data associated~ with the slice is filteréd~through~the~selected~window~ As a resu`lt of this 30~ fi~ltràtion~ raw data~is~lost. The~filtered data is then converted to ~ an ~analog video~signal and displayed on the radiological device's monitor~or CRT screen.~ The operator views that slice on the~screen~ and dec1des~whether to transmit that particular image to~the remote site. I~f the technician decides that the slice is 35 ~ ;ta~ be~transmitted, the~frame qrabber~of the teleradiology system is instructed to digitize the displayed image. The frame grabber -~ responds by taking a digitized "snap-shot" of the image shown on ,~ the~ radiological~devl;ce's display screen. The digitized data is then stored within~the teleradiology system~s transmit computer.
The operator ~hen~repeats this process for each desired slice ' ,~
,~:
WO93/1~25 21~ 15 ~ 5 PCT/US92t09859 until the sludy is complete. This is a time consuming process.
Furthermore, raw data has been lost since it has been filtered, converted into an analog video signal and then reconverted into a digital signal.
5After completing the collection of filtered data, the technician advises the doctor that the desired study is ready for transmission to the remote site. The doctor at ,the remote site prepares to receive the information. The computér modems connect I to establish a link and the data is transferred. The doctor will l0review the filtered data on the remote screen and may be able to make a preliminary diagnosis at this point. If the radiologist requires additional information, usually the same study using~a 1.~
different window, the doctor contacts ~he technician with instructions to set the new window and transmit the study.
15The prior art teleradiology devices do not allow the - radiologist at the remote site to control the true filtering or the true windowing of~ the images. Only a portion of the information available at the time the initial window is selected at the hospital can be sent to the remote site. If the 20 ~ radlolog1st wants ~to view the study with a different window filtering, the radiologist must instruct a technician at the hospita1 to refilter the study. After the frame grabber digitizes the~ signal and stores it within the base computer, it is transm1tted to the remote site.
~; ;25 ~ ~The technician must instruct the sending unit to digitize each~ sl1ce as it 1s~displayed on the base radiological device's RT. ~I'he process needlessly occupies the technician's valuable time~. Further, it 1ncreases the time before the radiologist has acGess to the information needed to make a diagnosis. This delays ~ the treatment of the patient.
. ...... ~
After receiving the requested data, the radiologist views the images, ma~es a preliminary diagnosis and instructs the hospital about the prescribed treatment. Usually, the radiologist at the remote site cannot make a final diagnosis on existing teleradiology systems since the raw da~a is not transmitted. At a later time, usually the next day, the radiologist will go to the base site and will review the study again with all available data to make a final diagnosis.
Since prior teleradiology systems only use the video signal, valuable information is no~ transmitted to, or viewed by the :
:`~
~i WO93/1062~ 212 1 ~ g S PCT/US92/09859 , radiologist at the remote site. In prior art teleradiology systems, the doctor at the remote location can usually do no more than to look for gross abnormalities, such as fractures.
SU ~ Y OF THE INVENTION
5A teleradiology system is provided which includes a means for reading the raw data from the radiological device's storage medium, a means for ~studying the raw data, a means for transmitting the study~ to a remote location, a means for a ~ receiving the data, a means for viewing the data and a means for `~ lO filtering and manlpulating the entire study.
The present invention utilizes the radiological device~s ` ~; storage medium and transmits the complete test data file without ~ ~ ~ any~flltering. Generally, only one transmission is needed under `~the~present inventlon. The present invention does not derive its data from the'ana}og video signal displayed on the base site maglng~device.
S~inoe the complete raw data file is transmitted, the ~ radiologist at the remote site has complete control of the data '~fi~ltration, i.e., true w~indowlng capability, without requiring the ~ 2~0~ sub~sequent~intervention~of~a~technician~at the transmitting site.
-~?~S~ince~the present~ invention trans~mits the complete file of d'ensity~values to the radiologist, the radiologist can move a cursor~onto~a~point ~of the displayed slice and obtain an exact adout~'-of the denslty~value at that~point without possible loss 25~ o~f~ i'nformation due~ to~ f'iltra~tion or~signal conversion. This ability~`'is~invalua~ble~when different~types~of~information appear -~si~ilar~'on~the~screen, such as in the case of a bone and a tumor.
Ancil;lary~pat~ient~data,~such as the~name, date, bed position, etc.~, ~1S also transmitted with the study.~ Since the present ~1nventlon allows~the~ radiologist to mak;e a final diagnosis from the remote site, valuable time is saved and the patient receives treatment sooner. '~
Slnce the present invention does not require a frame grabber, a significant savings can be realized over prior teleradiology systems. The present invention also has the ability to save the studies at the receiving station or remote site for future viewing.
It is the object of the present invention to provide the diagnosing physician with the raw unfiltered test data.
'~' 5 ::
~, W093/10625 ~A. ~ PCT/US92/09859 It is a further object to provide the raw data in a more rapid manner.
Another object of the present invention is to provide a teleradiology device with improved image fidelity.
A further object of the present invention is to provide an improved teleradiology system at a lower cost than those presently on the market.
`~ Still another object of the present invention is to provide l~ true windowing functions and true density measurement capability.
Other objects and advantages of the present invention will be apparent from the reading of the following detailed description ~ of the presently preferred embodiment.
;~
BRIEF DE8C~IPTION OF THE DRA~INGS
Figure 1 is a block diagram of the teleradiology system in j: :
accordance with the present invention.
Figure 2 is a flow~diagram of the main functions performed by the transmission segment in accordance with the present invention.
Figure 3 is a~flow diagram of the main functions performed ~ by~the receiver segment in accordance with the present invention.
DETAILED DESCRIPTION OF T~E PRBFERRED EM~ODI~ENT
-. ~
With reference to Figure 1, the preferred embodiment is comprlsed of two segments or systems: a sending or transmitting unit ~and a receiving unit. The sending unit 10 is located 25 5~ ~proximate~ to the radiology equipment or device 5~ The t~leradiology sending ~unit 10 and~ radiological device 5 are ; usually located at a base site or hospital. The radiological device can be a CT Scanner, Magnetic Resonance Imaging device, Nuclear Medicine Imaging device, Ultrasound device, X-ray and the like. The receiving unit 30 is located at the remote site where the~radiologist is located. Typically, this site is in the radiologist's home or officP.
The sending unit 10 utilizes the same platform media 12 of ~- ~
.: the radiological equipment 5. The platform media 12 can be any - ~ -35 type of electronic data storage medium. In the preferred embodiment, the platform media 12 may be a diskette (8 inch, 5.25 inch or 3.5 inch disk), tape drive or laser disk. The compressed raw digital data is stored on platform media 1~ by the ~` WO93/1~25 2 1 2 1 S ~ 5 PCT/US92~09859 ,~ radiological device 5. The data from platform media 12 is input ;;~ to the teleradiology system via a reading device 14. The preferred reading device 14 depends on the type of storage medium utilized by the radiological device and is most often a universal floppy disk reader or a nine-track tape reader. An example of the ~, universal floppy disk reader is model no. FDD8532 manufactured by Flagstaff Engineering; an example of the nine-track tape is model no. 3201 manufactured by Overland Data.
A sending means 16 is connected to the reading device 14.
The sending means 16 is typically an IBM PC or an IBM compatible computer with at least 640k of memory. The preferred embodiment of the sending means 16 is a Zeos computer, model no. 386 SX-20.
The operator at the base location can view the data from reading device 14 and store it in sending means 16, if so desired.; 15 Sending means }6 is pre~erably a computer system since this permits-on-site review and since computers are commonly available.s3 A transmitting means 18, for example a high speed modem model Courier HST manufactured~ by U.S. Robotics, is connected to the ~ computer 16 for~ transmltting the unfiltered raw data. Since `~;~ 20~ compressed data is being transmitted, the transmission time is greatly reduced over prior teleradiology systems. The sending ~ modem 18 transm1ts the unfiltered raw data to receiving means 38.
;~ The~ receiving means 38 may also be a high speed modem manufactured by U.S. Robotics, model Courier HST. The receive modem 38 lS connected to a processing means or receive computer 36.~ The preferred embodiment employs an IBM PC or an IBM
compatible, with 6~40k~of memory as the processing means 36. An example of an IBM compatible is Texas Instruments ~odel Travelmate WIN-SX. After the study is transmitted, the transmission is terminated automatically. The receive computer 36 decodes the study and sounds an alarm to alert the radiologist that the study lS now ready to be viewed.
Receive computer 36 decompresses the unfiltered raw data and can process it in the same manner as would be possible at the base 3S site. A high resolution monitor 32 allows the radiologist to view the study at the~remote site with all of the image fidelity as is available at the base site. In the preferred embodiment, the monitor 32 is available from Fast Micro as model Fast Data 14"
white VGA monochrome monitor.
, , ~ ' .
.~ wo g3/1~2~ 2 ~ 2 1 5 8 5 PCT/US92/098S9 .~
At this point, the radiologist has all of the i~formation that would be available at the hospital or base site.
Accordingly, a final diagnosis can be made at this point. The radiologist would then provide the instructions for the proper treatment- and care of the patient to the personnel at the base site.
~`~ If it is desired to transmit data on plain film, e.g., X-ray negatives, a digital scanner lS, such as model no. Scan Jet II
manufactured by Hewlett Packard may be used. In this instance a digital scanner is connected directly to the sending computer 16.
This is shown in phantom~in Figure 1.
In either of the above examples, the radiologist c~n manipulate the data in virtually any manner desired without any further intervention by personnel at the base site. For example, the radiologist can vlew~each consecutive slice in the appropriate order. Further, multiple slices can be viewed simultaneously.
True windowing capabillty is available to the radiologist at the remoté location. Reconstructions, where the radiologist can view the~study from any cross-sectional angle, are also available.
20 ~ The radiologist can place a cursor on the screen, move the cursor to a precise position on the slice and obtain the exact ~ density value at tha~t position.
; ~ W;1th prior art teleradlology devices, the radiologist must be~in;constant communication with a technician at the hospital.
;2~ The~radiol~ogist first;relays instructions to the technician and the~technician would~then have to call up the desired image, store them,~image by image, and~then transmit them to the remote site.
` With the preferred~system the entire raw dat~ file is sent n one transmission. The radiologist at the remote location can ~ 30~ instantaneously access~the complete study and has true windowing `~ capability. Virtually all of the capabiIities one has at the base ' site can be reproduced at the remote site.
With respect to Figure 2, the raw data is read by the sending ~-~ computer 16 off of~the universal floppy disk reader 14 and stored internally. A communication link is established between the sending computer 16 and the receiving computer 36. The raw study data is then transmitted to the remote facility.
The radiological device usually compresses the data as a means of decreasing the number of diskettes needed to store the data. The present invention takes advantage of the data ~ .
~ WO93/10625 PCT/US92/09859 ~ - 21215~5 compression which allows all of the unfiltered, raw data produced by the radiological device to be transferred to the remote site in substantially the same transmission time as the prior art transmission. However, the present invention eliminates the technician time previously expended in preparing the data for transmission. In addition, physician time in instructing the technician in preparlng the data is eliminated '~herefore, the physician has all of~the data substantially simultaneously with the completion of the~ patlent interrogation.
lO ~ With respect; to Figure 3, the receiving unit 30 first establishes a communlcat~lon link with the sending unit lO. The raw~data is transferred~ from~the ~sending unit to the receiving unit and stored in received computer 36. The receive computer 36'd~ecompresses~the~raw data and makes it available at the remote site~in~a~format~comparab~le to the original radiological device's format. The radiologist at the receive site can select a ~ particular~wlndow and a particular study to view. The radiologist `~ can~manipulate the~study~through the use of the receive computer 36~and~'control~the~true~wl~ndow~values.
20 ~ With the~preferred~ device,~ the radiologist can view eight different slices simultaneoùsly. At this level of viewing, only l6~-shades~of;gray~are~;provided ln the d1splay. In order to ;~ provide~ a~screen~compatlble with that~at the base site, a high fidelity~mode is also provided. This mode allows the radiologist ~''~'25~ to~view~a~selected imag~e~or~portion~of an image on the full video scree~n~ with~maxlmum~gray~scaling and image quality. Typically, the gray'~sca~ling~'at~the~;base site is 64 shades of gray. Thus the present~-invention~provi~des~base site fldelity and the ability to - view~multiple s;lices~s~imultaneously. Various windowing techniques ~ 30~ can~be employed to~a;ssist~the ra'diologlst in making the diagnosis.
;'~ Further, the~abili`ty to preserve ancillary data from the radiological device,~such as the patient name, bed position, and 'the~like, can be dlsplayed. ~ ' ^~ In the preferred; embodiment, the modem interface was '35 ~ developed using~DataStorm~Technology's Procom Plus programming anguage running under~the Microsoft DOS operating system. The sending and recei~ving unit software was developed using Microsoft ''-"'~ Quick Basic language (version 4.5) also running under the '"~ Microsoft DOS operating system.
* " *! *
', ~ ; 9 ,:
TELERADIOLOGY SYSTEM
BACRGRQU~ID OF THE INVENTION
Field of the Inventlon The present invention relates generally to a system for data acquisition and transmissisn. More particularly, the present invention relates to transmitting radiological images from a base radioIogy site to a remote site. ~
Teleradiology involves the transmission of digitized radiological images to an off-site or receive location for medical diagnosis purposes. The most common transmission site is a hospital; the usual recelve site is the doctor's home or office.
When a patient or trauma victim is brought into a hospital, the patient may undergo one or more radiological processes.
Current radiologica~l processes include CAT or CT Scan (Computerized Axial Tomography), Magnetic Resonance Imaging (MRI), Nucl~ear Medicine Imaging (NMI~, Ultrasound and X-ray. Depending on schedules, work-load,~ emergencies, budget constraints, et.c., a.radiologist may not be~available in the hospital at any gi~en time;~to read the image(s). With teleradiologyl a radiologist can Z0 ~ expand the~territory covered by reviewing transmitted images at -~ a~ r~emote office or site. Most frequently, the images are transmitted~over~standard telephone lines. However, with the advent of cellular tel~ephones, digital cellular radio, fiber opt~lcs,~and satelll~te~communications, transmission medium is no 25~ ong~ér~limited t;o-~standard telephone llnes.
In~;practice,~an~lmaging or radiologlcal device scans the traumatized tissuè. ~The raw digitized data is conYerted to a video~signal and~dlsplay~ed on the associated monitor or display device.~ Most imaging or radiological devices ~tilize a means for 30 ~ ;~ storing the raw~data~.- Further, most~lmaging devices compress the raw data before it;is stored. The most common storage devices are disc~drives (either 8~inch, 5.25 inch or~ 3.5 inch), tape drives ~ ~or laser disc drlves. The storage medium is for archival i-~ purposes.
A radiological cross-sectional scan of a particular area of a patient's body is called a "slice". The slices are typically five (5) millime~ers apart. A collection of slices is called a study. Although it may contain any number of slices, a typical study usually contains from 20 to 40 slices.
~'::
q WO g3/1062:. 2 1 2 1 ~ ~ ~ PCr/US92/Og8~9 "
A data matrix ma-y be used to depict each slice. The most common data matrix consists of 256 by 256 available data points.
However, the matrix size can vary. For example, the Elscint CT
Scan, model no. 1800, allows the operator to choose from three S different-matrix sizes, namely 256 x 256; 340 x 340; and 512 x 512. Each point within the matrix may be given a density value.
A density value represents the density of the material found at a specific point within a~slice.
; Most CT scanners~employ the Houndsfield scale to assign lO~ a;numeric value;~to each denslty value. The Houndsfield scale ranges~from minus 1000 to 3095. Air is assigned the numerical vàlue of mlnus lOOO,~water~ lS asslgned the value of zero, and bon,e s~assigned dens1ty va~lùes~from 200 and up.
When viewlng a~slice,~the radiologist is not looking at the entire~ range~ of~ the~ Houndsfleld scale. Before a slice is '~ displayed, the radiologist designates a "window". The window is a~narrowlng,filter.;~ In~some instances,~the wlndow blocks as much as~98~of~the~raw~data.~A~tissue window would be defined to check for~internal~bleeding~and~;a~bone window would be defined to check for'~bone~fractures~
For~example~ f~soft~tissue lS of~particular interest, the ',`~ ra~ ologist~de~flnes~a~w~indow~ranging from~zero to 100. In this exàmple~ any~density value~below zero appears as black on the CRT
screen~and~any~;density~va~lue~above 100 appears white. Density 25~ a~l~e~s~w}thin the~d,e~f~lned~ra~nge~appear~as~shades of gray.
Nuclear-Medicine Imaging devices use an analogous system to ~,,~ count~;~,the~ radioactive~particl~es. ~The~ method of injecting a radio~active~ dye i~to~ a~patient and~measuring the radioactive parti`cles~given~off~,~as~the~radioactive~mater~ial decays, is known 30:~ 'to~-those~skllled~in~-the~art. An NMI~device "counts" or detects `~ , thé`number of radioactive~particles emitted. The count starts at zero and continues upwards.
Displaying~all~of~,the informatlon~at once~, i.e., viewing soft ~ t~lss,ue ~wlndows~;simultaneously ~with bone windows, would be '"~ 35~ `virtually useless~si'nce there would be too many shades of gray for "
he~human eye to;disti`nguish between.
Description of the;Prior Art he typicaI teleradiology system utilizes available hardware and software to; transfer video data from an imaging or , 2 ''~
:
,i WOg3~1062~ PCT/US92/09859 i 212158~
radioloqical device tO a remote viewing device. All known prio~
art teleradiology systems capture the filtered analog video signal ~ generated by the radiology equipment and convert it to digital 3~: data by using a video digitizer or frame grabber. The frame grabber is usually connected to the video output jack of the radiological device's monitor. The frame grabber digitizes the : ~ :
analog video siqnal and forwards the digitized, data to the teleradiology transmit computer. The digitized data is then ;~ transmltted to the;remote location using a modem and standard telephone equipment. At the receiving site, the digitized video data lS received~by a second modem and converted back to a video slgnal and dlsplayed on the remote CRT for the radiologist.
When the radiology equipment produces a plain film, e.g., an X~-ray~ negatlve,~a~sll~ghtly;different procedure is required. The ~film~ls placed on;a~light~box. ~A video camera is pointed at the light box and the video signal from the video camera is connected to~the~frame grabber.~ The~dlgitized data lS then sent to the base site~teleradiology~compu;ter~for transmission to the remote site.
Again,~ prior~ art~te~leradiology systems~tr~ansmit the digitized ~ video~signa1 to the remote location.
In~thè~normal~;~operation of a priQr art~teleradiology system, an`operator or~techniclan~located at the base~or transmit site, establishes~ a communlcatlon~ nk with the~remote site. The c,~ ,radiologis~t convey~s~to~the technician the d~esired windows and ~25~ s ~ s~for~vlewing.~ The~technl~cian~rev;lews the patient study by ,,v~e~}ng~the~;radio~ogy~ device's monltor.; The technician, in accordance~with,the~doctor~'s~ instructlons~ selects a~window and a^~sl~ice~ The~,;raw~ digital data associated~ with the slice is filteréd~through~the~selected~window~ As a resu`lt of this 30~ fi~ltràtion~ raw data~is~lost. The~filtered data is then converted to ~ an ~analog video~signal and displayed on the radiological device's monitor~or CRT screen.~ The operator views that slice on the~screen~ and dec1des~whether to transmit that particular image to~the remote site. I~f the technician decides that the slice is 35 ~ ;ta~ be~transmitted, the~frame qrabber~of the teleradiology system is instructed to digitize the displayed image. The frame grabber -~ responds by taking a digitized "snap-shot" of the image shown on ,~ the~ radiological~devl;ce's display screen. The digitized data is then stored within~the teleradiology system~s transmit computer.
The operator ~hen~repeats this process for each desired slice ' ,~
,~:
WO93/1~25 21~ 15 ~ 5 PCT/US92t09859 until the sludy is complete. This is a time consuming process.
Furthermore, raw data has been lost since it has been filtered, converted into an analog video signal and then reconverted into a digital signal.
5After completing the collection of filtered data, the technician advises the doctor that the desired study is ready for transmission to the remote site. The doctor at ,the remote site prepares to receive the information. The computér modems connect I to establish a link and the data is transferred. The doctor will l0review the filtered data on the remote screen and may be able to make a preliminary diagnosis at this point. If the radiologist requires additional information, usually the same study using~a 1.~
different window, the doctor contacts ~he technician with instructions to set the new window and transmit the study.
15The prior art teleradiology devices do not allow the - radiologist at the remote site to control the true filtering or the true windowing of~ the images. Only a portion of the information available at the time the initial window is selected at the hospital can be sent to the remote site. If the 20 ~ radlolog1st wants ~to view the study with a different window filtering, the radiologist must instruct a technician at the hospita1 to refilter the study. After the frame grabber digitizes the~ signal and stores it within the base computer, it is transm1tted to the remote site.
~; ;25 ~ ~The technician must instruct the sending unit to digitize each~ sl1ce as it 1s~displayed on the base radiological device's RT. ~I'he process needlessly occupies the technician's valuable time~. Further, it 1ncreases the time before the radiologist has acGess to the information needed to make a diagnosis. This delays ~ the treatment of the patient.
. ...... ~
After receiving the requested data, the radiologist views the images, ma~es a preliminary diagnosis and instructs the hospital about the prescribed treatment. Usually, the radiologist at the remote site cannot make a final diagnosis on existing teleradiology systems since the raw da~a is not transmitted. At a later time, usually the next day, the radiologist will go to the base site and will review the study again with all available data to make a final diagnosis.
Since prior teleradiology systems only use the video signal, valuable information is no~ transmitted to, or viewed by the :
:`~
~i WO93/1062~ 212 1 ~ g S PCT/US92/09859 , radiologist at the remote site. In prior art teleradiology systems, the doctor at the remote location can usually do no more than to look for gross abnormalities, such as fractures.
SU ~ Y OF THE INVENTION
5A teleradiology system is provided which includes a means for reading the raw data from the radiological device's storage medium, a means for ~studying the raw data, a means for transmitting the study~ to a remote location, a means for a ~ receiving the data, a means for viewing the data and a means for `~ lO filtering and manlpulating the entire study.
The present invention utilizes the radiological device~s ` ~; storage medium and transmits the complete test data file without ~ ~ ~ any~flltering. Generally, only one transmission is needed under `~the~present inventlon. The present invention does not derive its data from the'ana}og video signal displayed on the base site maglng~device.
S~inoe the complete raw data file is transmitted, the ~ radiologist at the remote site has complete control of the data '~fi~ltration, i.e., true w~indowlng capability, without requiring the ~ 2~0~ sub~sequent~intervention~of~a~technician~at the transmitting site.
-~?~S~ince~the present~ invention trans~mits the complete file of d'ensity~values to the radiologist, the radiologist can move a cursor~onto~a~point ~of the displayed slice and obtain an exact adout~'-of the denslty~value at that~point without possible loss 25~ o~f~ i'nformation due~ to~ f'iltra~tion or~signal conversion. This ability~`'is~invalua~ble~when different~types~of~information appear -~si~ilar~'on~the~screen, such as in the case of a bone and a tumor.
Ancil;lary~pat~ient~data,~such as the~name, date, bed position, etc.~, ~1S also transmitted with the study.~ Since the present ~1nventlon allows~the~ radiologist to mak;e a final diagnosis from the remote site, valuable time is saved and the patient receives treatment sooner. '~
Slnce the present invention does not require a frame grabber, a significant savings can be realized over prior teleradiology systems. The present invention also has the ability to save the studies at the receiving station or remote site for future viewing.
It is the object of the present invention to provide the diagnosing physician with the raw unfiltered test data.
'~' 5 ::
~, W093/10625 ~A. ~ PCT/US92/09859 It is a further object to provide the raw data in a more rapid manner.
Another object of the present invention is to provide a teleradiology device with improved image fidelity.
A further object of the present invention is to provide an improved teleradiology system at a lower cost than those presently on the market.
`~ Still another object of the present invention is to provide l~ true windowing functions and true density measurement capability.
Other objects and advantages of the present invention will be apparent from the reading of the following detailed description ~ of the presently preferred embodiment.
;~
BRIEF DE8C~IPTION OF THE DRA~INGS
Figure 1 is a block diagram of the teleradiology system in j: :
accordance with the present invention.
Figure 2 is a flow~diagram of the main functions performed by the transmission segment in accordance with the present invention.
Figure 3 is a~flow diagram of the main functions performed ~ by~the receiver segment in accordance with the present invention.
DETAILED DESCRIPTION OF T~E PRBFERRED EM~ODI~ENT
-. ~
With reference to Figure 1, the preferred embodiment is comprlsed of two segments or systems: a sending or transmitting unit ~and a receiving unit. The sending unit 10 is located 25 5~ ~proximate~ to the radiology equipment or device 5~ The t~leradiology sending ~unit 10 and~ radiological device 5 are ; usually located at a base site or hospital. The radiological device can be a CT Scanner, Magnetic Resonance Imaging device, Nuclear Medicine Imaging device, Ultrasound device, X-ray and the like. The receiving unit 30 is located at the remote site where the~radiologist is located. Typically, this site is in the radiologist's home or officP.
The sending unit 10 utilizes the same platform media 12 of ~- ~
.: the radiological equipment 5. The platform media 12 can be any - ~ -35 type of electronic data storage medium. In the preferred embodiment, the platform media 12 may be a diskette (8 inch, 5.25 inch or 3.5 inch disk), tape drive or laser disk. The compressed raw digital data is stored on platform media 1~ by the ~` WO93/1~25 2 1 2 1 S ~ 5 PCT/US92~09859 ,~ radiological device 5. The data from platform media 12 is input ;;~ to the teleradiology system via a reading device 14. The preferred reading device 14 depends on the type of storage medium utilized by the radiological device and is most often a universal floppy disk reader or a nine-track tape reader. An example of the ~, universal floppy disk reader is model no. FDD8532 manufactured by Flagstaff Engineering; an example of the nine-track tape is model no. 3201 manufactured by Overland Data.
A sending means 16 is connected to the reading device 14.
The sending means 16 is typically an IBM PC or an IBM compatible computer with at least 640k of memory. The preferred embodiment of the sending means 16 is a Zeos computer, model no. 386 SX-20.
The operator at the base location can view the data from reading device 14 and store it in sending means 16, if so desired.; 15 Sending means }6 is pre~erably a computer system since this permits-on-site review and since computers are commonly available.s3 A transmitting means 18, for example a high speed modem model Courier HST manufactured~ by U.S. Robotics, is connected to the ~ computer 16 for~ transmltting the unfiltered raw data. Since `~;~ 20~ compressed data is being transmitted, the transmission time is greatly reduced over prior teleradiology systems. The sending ~ modem 18 transm1ts the unfiltered raw data to receiving means 38.
;~ The~ receiving means 38 may also be a high speed modem manufactured by U.S. Robotics, model Courier HST. The receive modem 38 lS connected to a processing means or receive computer 36.~ The preferred embodiment employs an IBM PC or an IBM
compatible, with 6~40k~of memory as the processing means 36. An example of an IBM compatible is Texas Instruments ~odel Travelmate WIN-SX. After the study is transmitted, the transmission is terminated automatically. The receive computer 36 decodes the study and sounds an alarm to alert the radiologist that the study lS now ready to be viewed.
Receive computer 36 decompresses the unfiltered raw data and can process it in the same manner as would be possible at the base 3S site. A high resolution monitor 32 allows the radiologist to view the study at the~remote site with all of the image fidelity as is available at the base site. In the preferred embodiment, the monitor 32 is available from Fast Micro as model Fast Data 14"
white VGA monochrome monitor.
, , ~ ' .
.~ wo g3/1~2~ 2 ~ 2 1 5 8 5 PCT/US92/098S9 .~
At this point, the radiologist has all of the i~formation that would be available at the hospital or base site.
Accordingly, a final diagnosis can be made at this point. The radiologist would then provide the instructions for the proper treatment- and care of the patient to the personnel at the base site.
~`~ If it is desired to transmit data on plain film, e.g., X-ray negatives, a digital scanner lS, such as model no. Scan Jet II
manufactured by Hewlett Packard may be used. In this instance a digital scanner is connected directly to the sending computer 16.
This is shown in phantom~in Figure 1.
In either of the above examples, the radiologist c~n manipulate the data in virtually any manner desired without any further intervention by personnel at the base site. For example, the radiologist can vlew~each consecutive slice in the appropriate order. Further, multiple slices can be viewed simultaneously.
True windowing capabillty is available to the radiologist at the remoté location. Reconstructions, where the radiologist can view the~study from any cross-sectional angle, are also available.
20 ~ The radiologist can place a cursor on the screen, move the cursor to a precise position on the slice and obtain the exact ~ density value at tha~t position.
; ~ W;1th prior art teleradlology devices, the radiologist must be~in;constant communication with a technician at the hospital.
;2~ The~radiol~ogist first;relays instructions to the technician and the~technician would~then have to call up the desired image, store them,~image by image, and~then transmit them to the remote site.
` With the preferred~system the entire raw dat~ file is sent n one transmission. The radiologist at the remote location can ~ 30~ instantaneously access~the complete study and has true windowing `~ capability. Virtually all of the capabiIities one has at the base ' site can be reproduced at the remote site.
With respect to Figure 2, the raw data is read by the sending ~-~ computer 16 off of~the universal floppy disk reader 14 and stored internally. A communication link is established between the sending computer 16 and the receiving computer 36. The raw study data is then transmitted to the remote facility.
The radiological device usually compresses the data as a means of decreasing the number of diskettes needed to store the data. The present invention takes advantage of the data ~ .
~ WO93/10625 PCT/US92/09859 ~ - 21215~5 compression which allows all of the unfiltered, raw data produced by the radiological device to be transferred to the remote site in substantially the same transmission time as the prior art transmission. However, the present invention eliminates the technician time previously expended in preparing the data for transmission. In addition, physician time in instructing the technician in preparlng the data is eliminated '~herefore, the physician has all of~the data substantially simultaneously with the completion of the~ patlent interrogation.
lO ~ With respect; to Figure 3, the receiving unit 30 first establishes a communlcat~lon link with the sending unit lO. The raw~data is transferred~ from~the ~sending unit to the receiving unit and stored in received computer 36. The receive computer 36'd~ecompresses~the~raw data and makes it available at the remote site~in~a~format~comparab~le to the original radiological device's format. The radiologist at the receive site can select a ~ particular~wlndow and a particular study to view. The radiologist `~ can~manipulate the~study~through the use of the receive computer 36~and~'control~the~true~wl~ndow~values.
20 ~ With the~preferred~ device,~ the radiologist can view eight different slices simultaneoùsly. At this level of viewing, only l6~-shades~of;gray~are~;provided ln the d1splay. In order to ;~ provide~ a~screen~compatlble with that~at the base site, a high fidelity~mode is also provided. This mode allows the radiologist ~''~'25~ to~view~a~selected imag~e~or~portion~of an image on the full video scree~n~ with~maxlmum~gray~scaling and image quality. Typically, the gray'~sca~ling~'at~the~;base site is 64 shades of gray. Thus the present~-invention~provi~des~base site fldelity and the ability to - view~multiple s;lices~s~imultaneously. Various windowing techniques ~ 30~ can~be employed to~a;ssist~the ra'diologlst in making the diagnosis.
;'~ Further, the~abili`ty to preserve ancillary data from the radiological device,~such as the patient name, bed position, and 'the~like, can be dlsplayed. ~ ' ^~ In the preferred; embodiment, the modem interface was '35 ~ developed using~DataStorm~Technology's Procom Plus programming anguage running under~the Microsoft DOS operating system. The sending and recei~ving unit software was developed using Microsoft ''-"'~ Quick Basic language (version 4.5) also running under the '"~ Microsoft DOS operating system.
* " *! *
', ~ ; 9 ,:
Claims (19)
1. A teleradiology system characterized by:
means (14,16) for collecting raw digital data from a radiological device at a first location;
means (18) for transmitting the raw digital data, as collected, to a second location;
means (38) for receiving the transmitted digital data at the second location;
means (36) for processing the received digital data; and means (32) for converting the processed digital data into at least one video image.
means (14,16) for collecting raw digital data from a radiological device at a first location;
means (18) for transmitting the raw digital data, as collected, to a second location;
means (38) for receiving the transmitted digital data at the second location;
means (36) for processing the received digital data; and means (32) for converting the processed digital data into at least one video image.
2. The system of claim 1 wherein the collecting means (14,16) is a personal computer.
3. The system of claim 1 wherein the transmitting means (18) is a high speed modem.
4. The system of claim 3 wherein the collecting means (14,16) is a personal computer.
5. The system of claim 1 wherein the receiving means (38) is a high speed modem.
6. The system of claim 5 wherein the transmitting means (18) is a high speed modem.
7. The system of claim 6 wherein the collecting means (14,16) is a personal computer.
8. The system of claim 1 wherein the processing means (36) is a personal computer.
9. The system of claim 8 wherein the collecting means (14,16) is a personal computer.
10. The system of claim 9 wherein the transmitting means (18) is a high speed modem.
11. The system of claim 10 wherein the receiving means (38) is a high speed modem.
12. The system of claim 11 wherein the converting means (32) is a high resolution monitor.
13. The teleradiology system of claim 1 wherein the converting means (32) is a high resolution monitor.
14. The system of claim 13 wherein the collecting means (14,16) is a personal computer.
15. The system of claim 13 wherein the transmitting means (18) is a high speed modem.
16. The system of claim 13 wherein the receiving means (38) is a high speed modem.
17. The system of claim 13 wherein the processing means (36) is a personal computer.
18. The system of claim 1 characterized by:
a radiological device (5) for interrogating a patient at the first location, for generating the raw digital data, and for storing the raw digital data on a platform media (12), wherein the collecting means (14,16) reads the raw digital data from the platform media (12).
a radiological device (5) for interrogating a patient at the first location, for generating the raw digital data, and for storing the raw digital data on a platform media (12), wherein the collecting means (14,16) reads the raw digital data from the platform media (12).
19. A teleradiology method which comprises the steps of:
collecting raw digital data from a radiological device at a base site;
transmitting the raw digital data to a remote site;
receiving the raw digital data at the remote site;
processing the received digital data; and converting the processed data into at least a video image.
collecting raw digital data from a radiological device at a base site;
transmitting the raw digital data to a remote site;
receiving the raw digital data at the remote site;
processing the received digital data; and converting the processed data into at least a video image.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US792,785 | 1991-11-15 | ||
| US07/792,785 US5291401A (en) | 1991-11-15 | 1991-11-15 | Teleradiology system |
Publications (1)
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|---|---|
| CA2121585A1 true CA2121585A1 (en) | 1993-05-27 |
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ID=25158060
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| US (1) | US5291401A (en) |
| EP (1) | EP0641507A1 (en) |
| AU (1) | AU3137693A (en) |
| CA (1) | CA2121585A1 (en) |
| WO (1) | WO1993010625A1 (en) |
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| US5432871A (en) * | 1993-08-04 | 1995-07-11 | Universal Systems & Technology, Inc. | Systems and methods for interactive image data acquisition and compression |
| US6226418B1 (en) | 1997-11-07 | 2001-05-01 | Washington University | Rapid convolution based large deformation image matching via landmark and volume imagery |
| US6408107B1 (en) | 1996-07-10 | 2002-06-18 | Michael I. Miller | Rapid convolution based large deformation image matching via landmark and volume imagery |
| US6009212A (en) * | 1996-07-10 | 1999-12-28 | Washington University | Method and apparatus for image registration |
| US6115486A (en) * | 1996-11-06 | 2000-09-05 | Quinton Instrument Company | Teleradiology system for the storage and transmission of angiographic and related image sequences |
| US6708184B2 (en) | 1997-04-11 | 2004-03-16 | Medtronic/Surgical Navigation Technologies | Method and apparatus for producing and accessing composite data using a device having a distributed communication controller interface |
| US5970499A (en) * | 1997-04-11 | 1999-10-19 | Smith; Kurt R. | Method and apparatus for producing and accessing composite data |
| IL122361A0 (en) * | 1997-11-29 | 1998-04-05 | Algotec Systems Ltd | Image compression method |
| DE19835215C2 (en) * | 1998-08-05 | 2000-07-27 | Mannesmann Vdo Ag | Combination instrument |
| ATE439806T1 (en) * | 1998-09-14 | 2009-09-15 | Univ Leland Stanford Junior | DETERMINING THE CONDITION OF A JOINT AND PREVENTING DAMAGE |
| US7239908B1 (en) * | 1998-09-14 | 2007-07-03 | The Board Of Trustees Of The Leland Stanford Junior University | Assessing the condition of a joint and devising treatment |
| US9289153B2 (en) * | 1998-09-14 | 2016-03-22 | The Board Of Trustees Of The Leland Stanford Junior University | Joint and cartilage diagnosis, assessment and modeling |
| US7184814B2 (en) * | 1998-09-14 | 2007-02-27 | The Board Of Trustees Of The Leland Stanford Junior University | Assessing the condition of a joint and assessing cartilage loss |
| US6633686B1 (en) | 1998-11-05 | 2003-10-14 | Washington University | Method and apparatus for image registration using large deformation diffeomorphisms on a sphere |
| US6381029B1 (en) | 1998-12-23 | 2002-04-30 | Etrauma, Llc | Systems and methods for remote viewing of patient images |
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| US6712856B1 (en) | 2000-03-17 | 2004-03-30 | Kinamed, Inc. | Custom replacement device for resurfacing a femur and method of making the same |
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| ATE426357T1 (en) | 2000-09-14 | 2009-04-15 | Univ Leland Stanford Junior | ASSESSING THE CONDITION OF A JOINT AND PLANNING TREATMENT |
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| JP4056918B2 (en) * | 2003-04-03 | 2008-03-05 | ジーイー・メディカル・システムズ・グローバル・テクノロジー・カンパニー・エルエルシー | Image generation program generation method, image generation program provision device, and image generation program provision system |
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| US4910609A (en) * | 1984-06-07 | 1990-03-20 | Raytel Systems Corporation | Teleradiology system |
| US4748511A (en) * | 1984-06-07 | 1988-05-31 | Raytel Systems Corporation | Teleradiology system |
| EP0293083A3 (en) * | 1987-04-30 | 1990-07-18 | Corabi International Telemetrics, Inc. | Remote transmission diagnostic system |
-
1991
- 1991-11-15 US US07/792,785 patent/US5291401A/en not_active Expired - Fee Related
-
1992
- 1992-11-13 AU AU31376/93A patent/AU3137693A/en not_active Abandoned
- 1992-11-13 WO PCT/US1992/009859 patent/WO1993010625A1/en not_active Application Discontinuation
- 1992-11-13 CA CA002121585A patent/CA2121585A1/en not_active Abandoned
- 1992-11-13 EP EP92925249A patent/EP0641507A1/en not_active Withdrawn
Also Published As
| Publication number | Publication date |
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| WO1993010625A1 (en) | 1993-05-27 |
| EP0641507A1 (en) | 1995-03-08 |
| US5291401A (en) | 1994-03-01 |
| AU3137693A (en) | 1993-06-15 |
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