Note: Descriptions are shown in the official language in which they were submitted.
CA 02587804 2007-05-08
MODUI.Aiz MULTI-MODAL TOMOC3RApHIC DETECI'ORAND SYSTEM
1. Technical Field
[00011 The present disclosure relates, in generai, to gamma ray and x-ray
detector systems
and signa,l processing for nuclear medieine gan una cametas, single photon
emission toniograph}r
(SPECr), positron emission tomography (X'E1), x-ray computed tomography (GT),
digital radiobgy,
x iay nwrnrrx~graphy, and other limited field of view gainma ray and x-ray
detection and signal
processing Q,stnunentadon.
II. Related Applications
[0002] The present application is a continuation in part (CIP) of and claims
prioriocyto U.S.
Pat. App]icamion Serial Number 11/074,239, entitled "Breast Diagnostic
Appa:atus for Fused
SPEGT, PET, X-ray CT, and Optical Surface Imaging of Breast Caneer," filed on
March 7,2005,
which is hereby incorporated by reference.
III. Backgraund
100031 'I'his applicatian relates to the field of gamma ray inaging, nuclear
SPECT imaging,
PET krraging, x-ray CT iumaging, digiral radiography (DR) imaging, x-ray
mammography. oPdcal
imaging, optical fluorescence irnaging, small field of view imaging deteccors
and probes, and fused
irniltimodality imaging.
[0004] In breasc iinaging and screening, x-ray mammography is being used as a
screening
tool for women over the age of 40 years. During the screening process, 40% of
women have dense
CA 02587804 2007-05-08
Pater~ApvltQZtia~e
breast or suspicious breast indications for cancer. The radiologists reading
these mammograms have
difficulty reading the dense breast x-ray nrainmograms. A better method is
needed for detecting
cancer in dense breasts. Currently 8 out of 10 biopsies done on these patients
indicate a false
positive from x-ray rnaixunography.
[0005] To improve the detection of brean cancer in women having dense breasu,
a
combination of molecular cellular functional itnages and x-ray density
irrrages of the breast is needed.
Radioisotopes such as Tc-99m Sestamibi and positron isotopes such as FDG-F18
uptake in
cancerous cells more rapidlythan normal cells. Tc-99rriSestamibi molecules
uptake in tlie
rnitochondria of the ceU. Cancerous ceIls have more niitochondrial activity in
comparison to normal
surrounding cells. Simi7arlyFDG F-18 uptake in cancerous cells is due to more
glucose nietabolism.
'I'he breast cancer cells uptake these isotopes more rapidly than the
surrounding nonnal tissue. 'Ihus,
cancerous cells will enut more gamma rays as compared to norrrral cells.
[0006] In order to build a more sensitive and specific breast inraging device,
the device
must have higher spatial resolution and better contrast sensitivity than whole
body imaging systems.
Also the device must provide rhe locacion of the radioisotope distributions
and anatoniical x-ray
density of breast tissues. In addition, the device must provide anatomical
surface imaging of the
breast superimposed with the radioisotope distributions and x-ray density of
breast tissues and micro
calcifications in three dimensions.
[0007] Today, projection x-ray mammography is used to detect breast density by
compressing the breast tissm causing pain in some instances to the patient
undergoing the
manvnogra.phic exam. Once this exam has been completed and a dense breast
indication has been
found, there is not an easy ahernative except to biopsy the breast tissues by
surgery.
[0008] Scintigraphy has been used in conjunction with whole body gamma cameras
wit.h
Tc-99m Sestamibi, but the sensitivity specificity drops below 40% when
cancerous lesions ane less
2
CA 02587804 2007-05-08
PawrA ppl'ieztian
than 2 cm in size. Ultrasound also maybe used in the case of dense breasts but
the procedure is very
operator dependent. Therefore, there is a need for a more sensitive and
specific breast imaging
system which is comforrable for the patient and can provide true three
dimensional information
regarding potential breast cancer at the no.olecular level before anatomical
changes occur. If there is a
positive finding that breast cancer exisus, then the system should provi.de
three dimensional
morphological infonnation regarding the location of the cancer for surgical
biopsy and rapid
therapy.
IV. Sumrnary
[0009] A Inulti-rnodality detection system and method for detecting medically-
related
conditions is disclosed. In sorne respects, the system and naethods rely on at
least two different
modalities for imaging a region of interest including a patient organ such as
the breast, brain, or
other object within the region of interest, The two or more modalities may be
enabled avith
respective detectors as described herein and a respective output of each may
be collected and
fonnied into a conibined (fused) output representative of the plurality of
different -maging modalities
to enable imagine, diagnosis, study, or treatment of the medical condition.
100101 The present disclosure comprehends sixnultaneous application of more
than one
type of rrudical imaging (or imaging modality) to an olgan or portion of a
subject's body. For
example, various imaging niodalities that can be employed by the present
srtems and methods
include gamma detection, X ray detection, SPECI, PET, and other modalities
that are used in
tomographic systems for the purpose of detecting, sensing, generating images,
diagnosing, locating,
and treating a physiological or medical condition. Some conditions
comprehended hereby include
demmtia in its various forms, for example, breast diseases such as breast
cancer, diseases in the
3
CA 02587804 2007-05-08
Paterrt A ppfraxtian
huitxin taead and brain, including neuno-degenerative diseases, P,lzheimer's
disease, Pick's disease,
Huntington's disease, and mnhiple infarct conditions.
100111 The present system and methods provide for simuhaneous or substantially
simuhaneous measurement and detection of a physical event to cause a sensor to
respond thereto.
By proper applicatiion of such a sensor it is possible to construct a detector
apparatas for detecting
the e+rern or phuality of events an image of an underlying physiological
object or feature of the
object, conditiorn, disease, contrast agent, or bodypan or organ may be
obtained. Receiving
additional inforcnation from more than one imaging detector representing more
than one imaging
modality can provide an inxproved and better resolved and more clinicaily rr-
eaningful image of a
subject or condition under investigation.
[0012] Some embodiments of the present disclosuie are directed to a medical
imaging
apparatus, comprising a first detector contributing a first imaging modality
for detecting a medical
condition in a region of interest; a second detector contributing a second
imaging modalityfor
detecting said medical condition in said region of interest, said second
imaging rnodalitybeing
diffcrent than said first imaging modality; and a structural frame supporting
both of said first and
second detectors, said frame ma+*mah+irig a substantiaIlyfixed relative
positioning berween said
detectors with respect to one another while allowing relative motion between
said detectors and said
region of interest.
100131 Other embodiments are directed to a method for generating a multi-modal
image
for detecting a medical condition, comprising imaging a region of interest
using a first imaging
modaGtq for detecting said condition; imaging said region of interest using a
second inaging
modaliryfor detecting said condition; mechanically fixing respective detectors
for said first and
second imaging modalities to a structural support frame so as to
substantiallyfix said respective
detectors with respect to one another while allowing relative motion between
said detectors; and
4
CA 02587804 2007-05-08
PatenrAppliactiai
combining respective outputs of said fkst and second imaging modalities so as
to form a muhi-
modal combined output thereof indicative of said condition.
V. Brief Description of the Urawiags
100141 The present systems and methods can be better Mustrated and understood
in view
of the accompanying drawings, in which:
[00151 FIG,1 dlustrates a top fronral view of an appamtus utilized by a breast
scan system
as descnbed herein;
100161 FIG. 2 ilhutrates a perspective view of an apparatus utilized bya
breast scan system
showing a patienz on a patient table as described hemin;
[00171 FIG. 3 illustra,tes a system block diagram showing an architecture as
descrbed
herein;
[00181 FIG. 4 illustrates a pesspective view of an apparatus showing a patient
tiked to one
side on a patient table as described herein;
(0019) FIG. 5bLStrates a perspective view of a patient on a patient table, and
illu.nra.tes an
upper outer quadrant gatnma curved detector associated with a breast scan
system as described
herein;
[0020] FIG. 6 illusaates an exploded view of an upper outer quadrant gamma
curved
detector shown in FIG. 5;
(00211 FIG. 7 iIlustraties a top p[an view of an upper outer quadrant gannria
curved
detector shown in FIGS. 5 and 6;
CA 02587804 2007-05-08
Pate~Appd'~tian
[0022] FIG. 8 illustrates a perspective view of an upper outeu quadzant gamrna
curved
detector, a central breast curved gamma detector, and a X-ray source and
detector in an imaging
system;
[0023] FIG. 9 illustrates a front elevational view showing a position of the
irnaging
components of FIG. 8 with respect to a patient;
[0024] FIG, 10 illustrates a left end view showing a position of the imaging
components of
FIGS. 8 and 9 with respect to a patient;
[0025] FIG. 11 illustrates a front elevational exploded view of an upper outer
quadrant
gamrm curved detector showing its position with respect to a patient;
[0026] FIG. 12 illustrates a left end exploded view of an upper outer quadrant
gairuna
curved detector showing irs position with respect to a patient at the
beginning of a tomographic
scan;
[00271 FIG. 13 illustrates a left end exploded view of an upper outer quadrant
gamma
curved detector and illustrates its position with respect to a patient
partially through a tomographic
scan;
[0028] FIG. 14 illustrates a left end exploded view of an upper outer quadrant
gamma
curved detector and illustrates its position with respect to a patient at the
end of a tomographic scan;
[0029] FIG. 15 illusuates a perspective view of a central, breast curved
gamnia detector, a
central breast curved coincidence gamma detector, and a X-ray source and
detector as described
herein;
[0030] FIG. 16 illustrates a left end view and a side view of an upper outer
quadrant
gamma curved detector and a central breast curved coincidence ganuna detector
of a breast scan
system as descnbed herein;
6
CA 02587804 2007-05-08
Pate~Ap~
[0031] PIG. 17 illustrates nmicno PET imaging Eies of response produced bya
PET
imaging system as descnbed herein;
[0032] FIG. 18 illustrates a perspective view of a single photon and
coincidence garxuna
decector uu'lized bya breast scan system as descnbed herein;
[0033] FIG. 19 ilhutrates an end view of the single photon and coincidence
garrum
detector shown in FIG. 18;
[0034] FIG. 20 iJlustrates a perspective view of a detector module utilizcd by
the single
photon and coincidence gaaurra detector shown in FIGS. 18 and 19;
[0035] FIG. 21 illuscrxtes a front elevational view of a detector module shown
in FlG, 20
and a perspective view of the pixelated gamrna detector elensents contained
therein;
[0036] FIG. 22 illustrates a front plan view of a patient showing a central
breast scan and
illustrating a representative position of the single photon and coincidence
gamrna detector as
described herein;
[0037] FIG. 23 ilhlstrates an end view of a patient on a patient table showing
an upper
outer quadrant breast scan and a representative position of a single photon
and coincidence gamtm
detector as described herein;
[0038] FIG. 24 ilhustrates a front plan view of a patient showing a X ray scan
of a breast
and representative positions of the X-ray source and detector during a scan;
[0039] FIG. 25 Alustrates an end view showing breast scan data acquisition
orbits and
recoristtuction of radioisotope disnnbutions in a breast utilizing the breast
scan system as descnbed
herein;
[0040] FIG. 26 illtistratss an end view showing breast scan data acquisition
orbits and
reconstcuction of X-ray transmissions in a breast utilixing a bn:ast scan
system as described herein;
7
CA 02587804 2007-05-08
Puter&Appliazrian
[0041] FIG. 27 Mustrates a schematic diagram showing fusing of
muhimodalityiunages by
utilizing a breast scan system as descrnbed herein;
[00421 FIG. 28 illusttates a front elevational view of a patient on a patient
table and
illustrates stereo-tactic biopsy, rninimalty invasive surgery, and ixnage-
guided therapy using
muhimodality images produced by a breast scan system as descnbed herein;
100431 FIG. 29 i[lustrates a perspective view of a rrailti-modal tomographic
modular
irxra.ging detector utilized in some enixxhrwnts hereof;
[0044] FIG. 30 illustrates an exploded component view of a multi moda]
tomographic
modular irnaging detector,
100451 FIG. 31 illustrates a view of an exemplarypbrilated 2D scintillation
cryrtal array;
[0046] FIG. 32 iflusuates a view of a 2D micro channel plate with a 2D matrix
of anodes;
[0047J FIG. 33 MLSttxtes a block diagrm shoa+ing an exemplazy independent
channel
processor cascaded with a multti-modality tomogrxphic modular imaging
detector,
[0048] FIG. 34 iUu,strates a functional block diagmm of an exemplasy
independent channel
event processor for the multi-modality tomographic modular imaging detector,
[0040] FIG. 35 iIlustrates a functional block diagram of an exemplary rnatric
event
processor for the multi modality tornographic rmodular inWing detector,
[0050] FIG. 36 iJiastrates an exemplarycollimation and radiation shielding for
the multi-
modalitytomographic rnodular imaging detector,
[0051] FIG. 37 dlustrates an exemplaryembodirnent of a curved detector
assembly using
the multi-modality tomographic modular detector modules; and
[0052] FIG. 38 illustrates an exemplary coincidence imaging with two curved
detector
asscmblies of a multi-modality tomographic modular deteetor system.
8
CA 02587804 2007-05-08
AatetAppliUtian
VI. Detailed Deseription
[00531 Referring noarto the Figures where the illustrations are for the
purpose of
describing embodiments of the present invention and are not intended to limit
the invention
disclosed herein, FIG. 1 illustrates a top frontal view of an apparatus that
may be utilized by a breast
scan system. As shown in FIG. 2, the patient 10 lies prone and slighrly tihed
to one side to all~.ow full
extension of the bxieast through a left breast hole 8 or right breast hole 7,
The bneast is scanned with
an anatomic specific irnaging central breast curved gamm detector Tfor single
photon emission
compuced tomography (SPEC.'I). Radioisotopes are injected into the patient 10
and emitted
radiation is detected by the central breast curved garruna detector 1. The
breast scan systcm also has
an x-raysource 5 and an x-raydetector 6, The x-ray source 5 transmits x-rays
through the breast of
the patient 10 which are detected bythe x-raydeuctor6. The x-raysource 5 and x-
raydetector 6 are
rotated around the patient's breast on a rotate table 2. Also the central
breast curved gamma detector
1 is mtated around the patient's breast on rotate table 2.
[0054] The upper outer quadrant gamma curved detector 3 can be positioned to
itrrage the
upper oucer quadrant of the breast to the axiDa. The upper outer quadrant
garruna curved detecmr 3
collects radioisotope infortnatiion from the patiern's breast area where the
centtal breast curved
gamma detector I cannot be positioned. The sliding detector carriage 9 allows
the imaging
components to be trarw,slated horizontally from the left breast hole 8 or to
the right breast hole 7,
and vice versa, to image the respective breast.
[0055] In FIG. 2, the patient 10 is shown lying prone and slightlytilted to
one side on
breast insaging patient table 4 and over left breast hole 8. The patient's
breast is cxtended by gravity
for imaging. The patient is injected with a radioisotope which accumulates in
cancerous tissues of
the breast more rapidlythan nonnil tissues, The central breast curved gamma
detector 1 detects
9
CA 02587804 2007-05-08
I'aterAppliazttmi
gamma rays emitted from the radioisotope distnbutions. The central breast
curved gamina detector
1 is designed to anatomieallyfit close to the shape of the central breast to
collect gamma rays being
emitted. The central breast curved gatnma detector 1 is rotated around the
patient's central breast by
rotate table 2. The upper outer quadrant gamma curved detector 3 is positioned
around the patient's
thorax to collect garnrna rays from the upper outer quadrant of the breast co
the axilla. 7he breast
anatomy is a complex imaging atea and the system is designed to image the
entire breast including
the lymph nodes. The upper outer quadrant ganuna curved detector 3 can be
positioned three
dimensionally around the patient's thorax with vertical, horizontal, traverse,
and oscillations to
collect data while being very close to the patient 10.
[0056] As shown, x-ray source 5 and x-ray detector 6 are mounted to the rotate
table 2.
This allows for x-ray micro computed tomography of the breast. The x-ray
sotuce 5, x-ray detecicor
6, and central breast curved gamma detector 1 are all positioned around the
patient's breast on the
Ivtate table 2 to acquire high cssolution single photon enzission cornputed
tomographic (SPECr)
images and x-ray high resolution computed tomograQhy (Cl) images of the
breast. In addition, the
slidmg detector carriage 9 allows imaging of the left breast through the left
breast hole 8 and then
trumlates to right breast hole 7 for repositioning of the patient for right
breast imaging.
100571 Referring now to FIG. 3, the overall architecture and system structure
is shown.
Gamuna rays are detected by either the central brean gamma curved detector(s)
1 and/or the upper
outer quadrant gamrna curved detector 3. These detectors can collect ga.mrrra
rays enutted from
single photon enutting isotopes, such as Tc-99rn, or posiEron emitting
isotopes, such as F-18. When
using the positron ernitting isotopes, coincidence detection is used to
collect and determine the angle
of the pair of 180 degree opposed garrum rays emitted from a positron
annihilation. The central
breast SPEG"r'/PET DAQ block 15 controls and acquires both single photon gamma
rays and
coincidence gamma rays from the central breast gamma curved detectors 1 to
form isotope
CA 02587804 2007-05-08
I'atatApplaa:tion
projection images. The central breast motion contnoller 17 controls the
geometric positioning of the
central breast gamuna curved detectors 1 including, rotation, vertical,
radial, oseillar,e, and tilt
positioning. The upper outer qua,dram SPEGT/PET DAQ block 16 controls and
acquires both
single photon ganima rays and coincidence gamma rays fx+om upper outer
quadrant curved gamma
detector 3 to form isotope projection images.'Ihe upper outer quadrant motion
controIler 18
controls the geometric positioning of the upper outer qvadrant gamma curved
detector 3 including
rotation, vertical, radial, oscillate, and tih positioning.
[0058] As shown, x-ray CI' DAQ 20 interfaees w[th the micro C.'I' a-ray source
5 and x xn-y
detector 6 to acquire projection x-ray images thnough the breast anatatny. The
n-iicro C.T X-ray
source 5 and x-ray detector 6 are positioned bythe x-ray CT motion controller
38 for x-ray micro
CT of breast densities. The x-ray GT DAQ block 20 controls and acquires data
from the micco CI'
x-ray source 5 and the x-ray detector 6. The x-ray CT DAQ 20 controls the x-
ray detector 6 to
generate projection views thmugh the breaast anatomy and form two dimension
frames of attenuated
x-rays. For optical irnages of the breast, optieal breast cameras 11 are
attached to respective micro
CT x ray source 5, x-ray detector 6, cem.ral breasi gamma curved detectors 1,
and upper outer
quadrant gamina curved detector 3. The optical DAQ 21 controls the optical
breast cameras 11 to
generate optical views of the breast for spectral irrrage of the breast at
various wavelengths. The
breast system reconstnuction and control computer 19 controls and coIlects
data from respective
data acquisition (DAO) and motion controilers. SpecificaIly, the projection
gamrrra images,
coincidence gamma images or positron emission tomography (pE'I) images, x-ray
projection images,
and optical iIrrages are processed by the breast Yeconstruction and control
computer 19 to form
micro SPECI'voim-gs, micro PET volumes, micro CT volumes of the breast
anatomical density
and radioactive isotope uptake in breast tissues. Also the breast
reconstruction and control computer
19 geometrically overlays the optical views of the breast in co-registration
with micro SPECT, micro
11
CA 02587804 2007-05-08
Pate~Applioxiip:
PET, and micno C.T three dimensional information. The three dimensional breast
data from the
respective inodalities of micro SPECT, micro PET, micro GT, and optical
surface iznage spectsvsris
are combined together or fused on the breast display and analysis workstation
22.
[00591 Referring now to FIG. 4, the patient 10 may lie on the patient table
slightly tilted to
one side to allow fuD. breast estension by gravity into the left breast hole
8.'ihe patient nray be
disposed in other configurations and positions with respect to the table,
platform, or support
strnu-tuze or member. For example, the patient may be upright, in a standing
or sitting position,
wh~7e the patient's breast is suitably disposed within an imaging negion of
interest that allows imaging
of the breast. The patient and the imaging system and debectors ane thus
oriented in a convenient
and physically cornpatible way to obtain the multi-moda[ images as described
herein, and not
necessasily constrxining the patient or the imaging apparatus to any
parricular absolute or relative
orientation.
[00601 The sliding detector carriage 9 can be positioned interactively by an
operator for
alignment on the center of the left bneast. The scans can then be done on the
left breast, Also shown
is the upper outer quadrant gaz:una curved detector 3 which can be positioned
to image the upper
outer cluadtant of the breast. The upper outer quadrant gamma curved detector
3 can be positioned
by the upper outer quadruYt mtion controller 18 in an elliptical and
oscillatory motion to obtain
enough views io tomogrdphically reconstruct the upper outer quadrant region of
the breast.
10061j In FIG. 5, the patient 10 is shown lying prone and slightlytilted to
one side wirh
her left breast extended into the left breast hole. The centiral br+east
curved gamina detector 1 is
shown mounr,ed to an oscillate positioner 14, a vertical positioner 12, radial
positioner 13, rotate
table 2, and to the sliding detector caniage 9. 'Ihe x-raysource 5 and x-ray
detector 6 are also
maneuvered about the patient's breast vvith their respective vertical
positioners on rotate table 2. The
upper outer quadrant gamina curved detector 3 is positioned around the
patient's breast and thorax.
12
CA 02587804 2007-05-08
PatftAppkb~ran
The upper outer quadrant ganuna curved detector 3 is maneuvered with its
respective oscillate
positioner 14, radial positioner 13, vertical positioner 12, traverse
positioner 39, and sliding detector
carriage 9.
[0062] Referxing now to FIG. 6, the upper outer quadrant gamma curved detector
3 is
shown close to the patiern's chest and upper outar quadrant of the patierns
breast. The upper outer
quadrant gamma curved detector 3 is positioned close to the patient's breast
anatomy via oscillate
positioner 14, radial positioner 13, vertical positioner 12, and transverse
positioner 39 mounted on
sliding detector cartiage 9.
[0063] In FIG. 7, the upper outer quadrant gamma curved detector 3 is shown
being
positioned with coordinmd motion via oscillate positioner 14, radial
positioner 13, vernical
positioner 12, and tiansverse positioner 39 mounted on sliding detector
caniage 9.
[0064] As shown in FIG. 8, the apparatus utilized to obtain nniltiple angular
radioisotopes
views, x rayviews, and optical spectrum views of the breast is illusrsated.
For the central breast scan,
the central breast curved gamma detector 1, x-ray source 5 and x-my detector 6
are rotated around
the breast on rotate table 2. 'I'he central breast curved gamma detector 1 x-
ray source 5 and x-ray
detector 6 have a respective oscillate positioner 14, vertical positioner 12,
and radial positioner 13 to
be moved around the central breast in a coordinated motion to collect anatomic
specific views. The
posidon orbits and respective oscillations of respective components allow the
central breast curved
garnnra detector i to be positioned close to the breast without touching the
breast to improve spatial
resolution of and sensitiviryto radioisotope distnbutions within the breast.
Also geometric and
temporal x-rayviews of the breasc can bc done with x-ray source 5 and x-ray
detector 6 being
positioned via their respective vertical positioners 12, radial positionexs
13, and rotate table 2. The
position of the upper outer quadrant gamma curved detector 3 can be
synchronized with cent.rdl
breast imaging components.
13
CA 02587804 2007-05-08
AateratAppliaaaz
[00651 Referring now to FIG. 9, the system concept is shown from aside
viewwirh the
patient 10 lying pxone and slighttytiled to one side with full breast
extension by gravity. The x ray
source 5 and x ray detector 6 are shown with their respective vertical
positioners 12 and rotate table
2.
[0066] In FIG. 10, the central breast curved gamtna detector 1 is shown
collecting
projection view data of radioisotope distributions while being positioned
close to the breast
anatomy. Also the x-ray source 5 and x-ray detector 6 are also positioned on
cornmon rotate table 2.
An optical breast camera 11 is shown to take temporallysynchionized views of
the breast's optical
reflections, trdnsmissions, and fluorescence at various specttums or
wavelengths. One use of the
optical views is for breast surface registration with respective x ray
transmission and radioisotope
views.
[0067] Referring now to FIGS. 11,12,13,14, variom positions of the upper outer
quadrant gamma curved deteeuor 3 are shown collecting gamma rays from
radioisotope distributions
within the breast and lyiWhnwdes located close to the breast. The upper outer
quadrant area of the
bieast is the location where 50% of cancess occur. FIG. 14 shows views from
the back and left side
of patient; FIG.11 from the left side of patient and breast; FIG. 12 from the
left front side of chest
wall and breast; and FIG. 13 from the left back side of chest wall and breast.
[0068] In FIG. 15, the central breast curved coimcidence gamxna detector 23 is
shown to
allow coincidence detection of positron emitting isotopes, like F- 18. The
cenual breast curved
gainma detector 1 and central breast curved coincidence gamma detector 23 are
operated with
temporal coincidence window between each event eollected on the respective
detector to form a line
of response (LOR) between detector elernents. The central breast curved
coincidence gamma
detector 23 is also rotated on rotate table 2 and can be positioned with its
respective positioners.
Also, the central breast curved coincidence gamma detector 23 can be used for
single photon
14
CA 02587804 2007-05-08
Au~App&~rtiat
gamtna detection and woxic in concert with central breast curved garruna
detector 1 to form SPECI'
inrage projections improving sensitiviny uid specificity of the imaging
system.
10069J Referring now to FIG. 16, an exempLuy cenual breast curved coincidence
gmnma
detector 23 inay be used to operate in coincidence with the upper outer
quadrant gamma curved
detector 3. This allows for positron imaging of the upper outer quadrant for
detection of cancer and
lymph node uptake of radioisotope.
[0070] In FIG. 17, the coincidence licxs of response 24 are shown betwven
respective
breast curved single photon and coincidence gamma detectoss 25. Also the
entire breast voltune can
be isnaged with translation, rotation, oscillating curved ganuna detector
niotion 26.
[0071] As shown in FIG. 18, the breast curved single photon and coincidence
gamma
detector 25 may be comprised of bxeast curved single photon and coincidence
gannma detector
moduk(s) 27, '1 he modules 27 are mounted to fonn an anacomic breast shaped
curved detector. The
breast curved single photon and coincidence gam:xra deteccor module 27 can
efficiently iunage lower
energy single photon emitting isotopes, such as Tc-99m, at 140.5 KeV as well
as 511 KeV
coincidence gamina rays from positron ernitters, such as P-18. DOhen ineaging
positron emitters, two
breast curved single photon and coincidence garntna detectorrs 25 rnay be
operated in coincidence
nzode facing each other, as shown in FIG. 17.
[0072] Refeffing now to FIG. 19, an exeinplarybreast curved singk photon and
coineidence gamma detector 25 is shown and includes a plurality of niukiple
breast curved single
photon and coincidence gamma detector modules 27.
[0073] In FIG. 24, the major components of an exemplary breast curved single
photon
and coincidence gamma detector xnadule 27 are shown. GatrIItta rays and X rays
enter a module 27
via ganuna and coincidence collimator 29. The collimator mechanicalty focuses
garnma rays for a
conmnon set of angles. In an exemplary preferned embodiment, parallel hole
collimation may be
CA 02587804 2007-05-08
PQ=ApphCdt1C11
used to allow imaging of single photon emitting radioisotopes. The collimation
provides the spatial
resolution for SPECT irnagrng. In 511 KeV positron gamma ray imaging, the
collimation acts as an
anti-scatter grid to reduce down-scatter radiation from 511 KeV interaction in
patient. The
collimation may be designed with high resolution pammeters and along with
positioning of the
detector closer to patient provides greatly irnproved spatial resolution and
isotope sensitivity.
Pixelated ganuna detector elements 28 or pixilated scintillation crystals are
used to provide high
resolution iunages. The pixelated array in this eaemplary embodiment are
interposed between the
ganuna and coincidence collimation 29 and low profile mi.cro channel amplifier
30. The pixelated
gamma detector elements 28 convert garnma rays into visible light. The low
profile micro channel
amplifi~er 30 converrs the light to electrons that are amplified. The single
and eoincident gamrra
DAQ electronics 31 convert the amplified electrons from the low profile micro
channel amplifier 30
to digital signals representing geometric position, energy level, and tirne of
ganuna event interaction
with breast curved single photon and coincidence detector module.
[0074] As shown in FIG. 21, an exernplarypixelated ganvria detector elements
28 are
illustrated and a side view of the breast curved single photon and coincidence
gamma detector
module 27 are shown. The pixelated gamma detector elements 28 channel the
scintillation light
down independent channels and allow for high count rate data acquisition with
multiple events
qcciuring withirl the pixelated array. The scpta between the respective pixels
rnay be designed to
allow shaping of light distnbutions for high spatial and energy resolation of
events in pixels with
adaptive weighted positioning algorithms in the single and coincident gaInma
DAQ electronics 31.
[0075] Referring now to FIG. 22, an exemplary breast curved single photon and
coincidence gamma detector 25 is shown positioned ebse to the central breast
anatomy allowing for
generation of tomographic views of the breast. The breast single photon and
coincidence ganaxxn
detector modules 27 may be placed in a curved configtuation to al]ow close
view of the breast
16
CA 02587804 2007-05-08
PaoeraApplinuiaq
witlaout touching the breast. The breast curved single photon and coiricidenee
gamma detector 25
may be geometrically maneuvered by positioners and motion control systexns.
Also shown is a
focused coIIimauon system 29 to view radioisotope distributions.
100761 In FYC',. 23, the breast cumd single photon and coincidence gamma
detector 25 is
shown generating views of the upper outer quadrant of the patient's breast.
Each of the breast single
photon and coincidence detector modules 27 pxnvides a tomgraphic view with
unique rotation and
oscillation about the outer side of the patienc's breast, chest and back while
the patient 10 is lying
pmne on patient table 4 with breast extended via gravity. As nyentioned above,
this represents an
exemplary embodimenz, and other physical absolute and relative orientations of
the patient, her
breast, and the imaging system are possible, such as by imaging the breast wuh
the patient in an
upright, seaoed or standing position, or whik the patient lies on her back
with the unaging detectors
substantially above the patient.
100771 Referring now to FIG. 24, x-ray source 5 and x-ray detecoor 6 are shown
generating a fan/cone beam through a patient's breast. Different views am
shown to illustrate the
exemplary positions of the x ray soluce and detectur around the patient's
breast. The plurality of
views allow reconstraction of x rayviews to form three d'smensional
tomogsaphic slices of the
breast's x raydensiaes.
(00T8] In FIG. 25, exemplaty reconsmicted tomographic images are shown fnom
the use
of progiamunable detector orbits 32, oscillating curved gamma detector orbiu
33 and mconstructed
SPEt,'Y' and PET itnages 34 from oscillating orbits. The programmable orbits
are adjustable to a
patient's size and respective anatomyto obtain optimized spatial resolution
and high sensiuviry
iunages of radioisotope distributions. Unique reconstruction tomographic
processing maybe uulized
to produce high clualitYy imaging with these unique views in space.
17
CA 02587804 2007-05-08
PaMAppG2zda:
[0079] Irt FIG. 26, exernpluyreconstiueted tomographic images are shown from
the
prograncunable detector orbits 32 and x-ray source and detector orbits 35 and
reconstTVCted x-ray
CT image from oscillating orbits 36. I-Iere again, unique reconstruction
tomographic processing may
be uulized to produce high quality imaging with these unique x-ray views in
space.
100$01 Referring now to FIG. 27, an exemplary breast syscem display and
analysis
worktation 22 combines or fuses images obtained from at least a first and a
second icrraging
modalicy. '11m radioisotope tornographie images from single gancuna photon
emitters with micro
SPEG'I', positron emitters with coincident gamrna rays for micro PET, combines
with x-ray density
images from x-ray micro CT and optieal surface vcm for optical surface
spectnum to form fused
images of the breast.
[0081] In FIG. 28, an exeinp]a.ty illustrative biopsy or surgical instrument
40 is shown
being guided into the pat,ient 10 and mechanically positioned with the stereo-
tactic image guided
holder 41. The bneasc system dispkay and analysis workstation 22 genexates
interactive image guide
infonnation to align the stereo-tactic image guided holder 41 while patient 10
is lying prone and
slightlytilted on breast imaging patient table 4. The patient and imaging
apparatus may also be in
other reGtive orientations as discussed above. Also shown are the other basic
multiunodality
irraguq components of x-ray sourice 5, bleast curved single photon and
coincidence gamiraa
detector 25, and rotate table 2 to generate images for biopsy, surgical
removal, or therapy of breast
cancer, The breast cliagnostic apparatus for fused SPEGT, PET, X-ray CT and
Optical Surface
Imaging of the breast descn'bed herein is a unique multinnodality imaging
dcvice to uniquely scan the
patient's entire breast, or subsrantiallythe entire breast, for the presence
of cancer or other medical
conditions.
[0082] FICY. 29 illustrates a dual modality detection module 291 in one
exemplary
configuration. The dual modality detection module 291 is designed to detect
gamma iays (energetic
1$
CA 02587804 2007-05-08
Paae&Applaaxaw
photons) from single photon nuclear isotopes and coincidence photons fnom
posstron emiting
isotopes. The module is constructed to allow configurations of curved detector
arrays for anatonuc
specific unaging. The module contains components to detect the position,
energy, time of the
gamxna ray detected by module for both single photon emission tomography
(SPECI) and positron
envssion tomography (PE'I). Also a set of modules my be configured to perform
coincidence
detection for positxon emission tomography (PE'I).
[0083) FIG. 30 shows some rnain components and assemblies of an exemplary dual
modality detection niodule. The present disclosure can be extended beyond two
modalities, to r.hnee
or more modalities fused for the ixnaging of a medical condition and assisting
the diagnosis or
treatment of the same. The xnodule 301 is conlposed of a collimator 302,
crystal housing radiation
shield 303, pirilated scintillation crystal and optical coupling 304, micro
channel plate aniplifier 305,
amplifier radiation shield housing 306, event processing chamel cards 307, and
event processor
backplane 308.
[00841 The collimator 302 allows for colliznation of ganuna rays for single
photon
emission computed tomography. Also, the collamator 302 maybe used as an anti-
scatoer and out of
field of view radiation shield for positron emission tomography. The
collimator along with the
crystal housing radiation shield 303 and amplifier radiation shield housing
306 reduce the out of field
events and allows focused coUection of ganum rarys within the desiired field
of view. This aspect of
the detector's construction and operation nray be useful for irr,aging
specific sections of anatomy
like the bteast and brain. Other anatomical portions of a body, e.g., the
extremities, may also be
ima.ged using the present detector and system. The pixilated scintillation
crystal and opti.cal coupling
304 absorbs and bloclz the gamma rays and produces low levels of light photons
proportional to
the gamma rays' energy.
19
CA 02587804 2007-05-08
Pute9A ppliauiai
[00$5] The light may be collimated or piped through crystal and optical
coupling to the
micro chanx-el plate amplifier 305. The miero channel plate amplifier 305 or
equivalent position
sensitive low level light amplifier coIlects the light fnam the pixilated
crystal and optical coupling
304 and converts the light into electrons with a photo converter. The
respective electrons are then
amplified by several orders of magnicude and detected by independent detection
channel anodes,
nese anodes wiA have currents proportional to the energy, position, and time
of the detected
gamma ray. The respective two dimensional anode atray on the nnicro channel
plate amplifier 305 or
equivalent position sensitive low level lighL amplifiei are connectcd to the
event processing channel
cards 307.
100861 'Ihe event processing channel cards 307 amplify, integrate, and can
detect the time
of the respective pulse generated by detected gamma ray and perform channel
independent analog
to digital conveTsions. Also the event processing chazxnel cards 307
discriminate pulses for energy
levels and generate accurate tirrung signals for coincidence detection. The
event processing channel
cards 307 are connected to the event processor backplane 308. The event
processor backplane 308
may include several digital signal processors and micro processor to perform
event digital event
position, event energy, event time, and compress event data to be sent to
frame processor.
[0087] It should be understood that the specific application at hand can
detennine the
specific constn3ction and arrangement of che present components of the above
illustraave
embodi.nient. For example, as to the softwware and/or hardware employed in the
present systerm,
the system designer can provide some or a11 of certain features within said
software and/or hardware
and/or finnware. Additionally, the layout of the components can incorporate
some or all of the
above functions and features into a single component or spread them among
several discrete
components. The ciro0its descnbed herein may be integrated onto one or more
separate circuit
boards, wafers, printed circuits, chips, application-specific integrated
circuits ("ASICs") and the lilse.
CA 02587804 2007-05-08
Pao9Appliaztiac
[008$] Referring to FIG. 31, the pi2cilated scintillation crystal and optical
coupling 304 are
shown with FIG. 31(a) showing a perspective and FIG. 31(b) showing a plan view
of the same. 'Ihe
array includes a plurality of scintillation crystals which may be pixelated or
divided into a grid of
discrete elements. The individual scintillation pixels 401 may be configured
into a two dimensional
("2D") matrix forrnat or arrxy, for exampk along Cmesian (or x-y) coordinate
dimensions. The
scintillation pixels 401 are separated with septa rnateria1402. The septa
materia1402 refkcts and
assist in collimting the Ught to the exit end of the scintillation pixels 401.
At the end of scintillation
pixels 401 an optical coupling maybe provided to transferthe light to the
juxtaposed niicro channel
plate amplifier 305 or equivalent position sensitive law kvel light amplifier.
[0089) FIG. 32 shows a micro chaninel plate amplifier 305 or equivaknt
position sensitive
low level light ampl.ifier with independent ehannel anodes 321. The micro
channel plate arnmplifier
305 or equivalent position sensitive low lcvel light amplifier coIlecrs the
light from the pixilated
crystal and optical coupling 304 (see FIG. 30 and converts the light irno
electrons wnch a photo
converter. The respective electrons are then amplified by several orders of
magnitude and detected
by iudependent channel anodes 321. These anodes wil! have currents
proportional to the energy,
positian, and time of the detected gamma ray.''Ilae mspective two dimensional
indepEndent channel
anode 321 array on the micro channel plate amplifier 305 or equivalent
position sensitive low level
light amplifier arie connected to the event processing chuniel cards 307 (see
FIG. 30 as mentioned
previously.
[0090] FIG. 33 sho'ws some exemplary processing stages in an event processing
channel
card 307. The event processing channel cards 307 have independent channel
event processor 331
(see FIG. 33). The independent channel event processors 331 are coupled to a
matrix event
processor 332 (see FIG. 33).
21
CA 02587804 2007-05-08
AatentApp+tutttia:
100911 FIG. 34 shows some maiun processing elements for an exemplary
embodiment of
an independent channel event processor 331. "I'he independent channel event
processors 331 are
connected to the two dimensional independexu channel anode 321 array on the
micr+4 channel plate
amplifier 305 (see FIG. 30 or equivalent position sensitive low level light
amplifier. The independent
channel event processors 331 consist of both analog and digital processing
elemexrts. A channel
preamplifier ("prearnp") 341 maybe coupled to the independent channel anode
321. 'I'he channel
prearnp 341 amplifies the pulse signal and conditions it for event integrator
342 and pulse detection
and trigger 343. An digital offsetlpulsa adjusrment is connected to the
channel preamp 341 and
event integrator 342 to provide canceling out of offsets to zero for event
integrator 342. The event
integrator 342 has an integrator reset 344 to allow for xndependent
asynchronous pulse integrate
reset cycles. The event integrator 342 is connected to the A/D converter 345
to perform analog to
digital conversion of irnegrated pulse amplitude. The event process contro1346
controls the pulse
detection and respective integrate, hold, reset cycle for digitizang of gamma
raypulse. The pulse
detection aad uigger 343 detects a pulse greater than a threshold and
perform.s accurate timing
detection of the pulse wirh respective differentiation or constant fraction
discrimmation
components.
[0092] FIG. 35 illustrates an exeniplaty matrpc event processor 332 (see also
FIG. 33). The
matrix event processor 332 is located event processor backplane 308 (see FIG.
30 and is coupled to
a mukiple independent channel event processors 331. The matrix evern processor
332 allows event
data acquisition and the resulting iurrage formation_ The event processor 332
inchides one or more
digital process elements and/or nucro processors.
[0093] The processing performed by the event processor 332 includes processing
perforrned by the trigger detection processor 351. The trigger detection
processor 351 is coupled to
a respective event process controIler 346 on a plurality of input channels.
'i'be trigger detection
22
CA 02587804 2007-05-08
PatextAppltaxttQl
processor 351 detects an event based upon a time variable or signal, and
contmis which set of the
pturality of channels is to perform the cornesponding event processing, signal
;ntegration, and
analog-to-digital conversion. A 2D event channel selection element 352
determines which set of
channels to sample for the event.
100941 An event "centroidA maybe defined for an event since the event
maytrigger
multiple channels and have enesgy distributed over moultiple charulels.
'Iherefore, a centra[ or typical
or representative channel of a plura,lity of channels can be associated with
an event as being most
representative of that event. The event sample control 354 r.akes the centruid
channels selected
from the 2D event channel selection 352 and generates a synchronization timing
sequence to run
respective integration and analog-to-digital conversion cyeles on selected
centrroid channels for the
event. The timing and control signals frorn the 2D event channel selection 352
are sent the niultiple
independent channel event processors 331 via a nlultiple channel cross point
nn3hiplexer 353. The
muhiple channel cross point multiplexer 353 bi-directionallytrazisfers
respective control signals and
data colleetion informacion to the plurality of channels on the indepen.dent
channel event processor
331.
[0095] DUhen an event is detccted by the t,rigger detection 351, signals are
sent to che time
stamp interface 355 which is coupled through an interface to a common cirne
stamp control process
for generation and :etum of a tixne-of-event output for the event re]ative to
other possible events in
the system. The time stamp i.nterface 355 interacts with an exteraal time
stamp processor and is used
for coincidence detection of events.lhe time stamp interface 355 allows the
event sample control
sequence of sampling to be aborted if the event is not in coincidence with
another event trigger on a
180 degree spatiatlropposed event channel.
[0096] I'he event position processor 356 uses information from each channel of
the
centroid of an event to deoennine the position of a source of a gamma ray
detected bya respective
23
CA 02587804 2007-05-08
PanmApplr,ratian
pixel in pixilated scintillation cxystal and optical coupling 304 (see FIG.
31). The position is
computed as a weighted center of gravity calculation for a closest pixel
position determination. The
event position, energy, and time are determined by the event position
processor 356 and sent to the
serial event input/output ("I/p") interface 357,
[0097) The serial event I/O interface 357 is coupled to a framing processor
for respective
image fomiation and eventually generating a modality, e.g., SPE CI' or PET
image output.
[00981 The detector control process alloovs for cah%ration and general control
of the
muhi- (e.g., dual-) modality detection module 301 (see MG. 30,
[0099] FIG. 36 illustrates another exemplary view of some main components of a
dual
rnodality detection module 361, The collimator 362, crystal housing radiation
shield 363, and
amplifier radiation shield housing 366 can reduce out of field of r-
iew:adiation which could cause
imaging errors. 'I1nse respective shields also provide control temperature
envitroninent for the dual
mvdality detection module 361.
[00100] FIG. 37 iIlustrates an exemplary system having the rnultr (e.g., dual-
) modality
detection modules 371 described above, having juxtaposed posiaons relative to
one other so as to
form an approxixnately curved dual modaliry detector array 374 with a
substantially circular general
profile (approximating a circle) about a certain region of interest ("ROI")
373. In some
errkodiments, the ROI includes or consists of a space for irnaging a patient's
organ or a diseased
body part (e.g., brain, breast, arm, leg, etc.). It can be appreciated that,
with collimators 302 in place,
the individual detection modules 371 take on overlapping lines of sight
covering the ROI 373, The
dual modality detection modules 371 are connect via a base plate 372 and can
be translated and
oscillated as a unit. The base plate provides structural support to fix the
detection modules 371
thereto to provide a common spatial frame of reference. In some embodiments,
the individual
detection modules 371 are rigidly fixed to the support base plate 371 and
therefore the individual
24
CA 02587804 2007-05-08
PaontApp&xtirn
detection modules 371 w+e sparially fixed relative to one another. The base
support plate 371 can be
rotated as a whole and the detection modules 371 ateached to the support plate
372 will rotate along
with it and therefore be moveable with respect to a patient, organ, ROI,
patient support platform,
organ support stnutuir, or the L1se. This allows imaging with the muhiple
modes of imaging
empbyed from a variety of directions as needed. Note that other degrees of
freedom, such as
swiveling, tilting, vibrating, spinaing, spira.l movement, and the like are
available in addition to the
rotation described above to allow a better or substantially full spatial
coverage of the ROI 373 in use
for generating the tomographic images. An arciculated elemcnt can be used to
couple said structural
support frame of the imaging apparatus to the detector elemerux so that they
can move along said
degrees of fneedom. Joints, hinges, motors, lead screws, ball-bearings and
other mechanical and
electromechanical elements can be used to anieulate said movement.
1001011 FIG. 38 iffiistrates a pair of exemplary curved dual modality detector
arrays 380
positioned 180 degrees with respect to one another to form a positron en~ssion
tomography
imaging apparatus according to an excmplary ensbodiment. Ene:gy from 511 KeV
garrnna rays
from a positron annihilation event, traveling along line 383 in opposing
directions, can be detected
by the pair of opposing detectozs 381 and 382. The curved detector arrays 380
can themselves be
rotated about a central axial axis, translated radially, tilted outside a
plane of their curvature (outside
a plane normal to the central axial axis), or oscillated about any given axis
to achieve a mone
complete image coverage according to principles of superposition and
tomographie imaging.
Additionally, the individual detector modules may be rotated, translated,
tilted, and osciilated about
one or mone axes in one or more degx+ees of freedonL Nbtorized apparauu and
actuators can be
used to accomplish the motions described above.
[00102] Enmbodiinents of the present systems and rnethods include a multi-
modality
tomographic modular iurraaging detector comprising at least one 2D pixelated
scintillation crystal
CA 02587804 2007-05-08
PatemApptid~
array, a geometric optical coupling, a compact micro channel amplifier plate
with a 2D matrix of
independent anode charme]s, an independent channel event processing for each
of the anodes, a 2D
matra event processor for gauuna rays spatial, energy, and tune of detection.
[00103] The mu}tif-modalitytomographic specific modular itnaging der.ector may
furtber
include means for deterrn+=+, g a super-resolution with a phualicyof pixels
per anode channel, or
with adaptive weighted position detection.
[00104] 'I'he muhi-rmodalitytomographic specific modular imaging detector can
further
include means for coincidence imaging with two more modnles to perfoim
positrvn emission
tomographic itnaging.
[00I05] The multi-modalitytomographic specific mdular imaging detector modules
may
be further cascaded into a mosaic of subscantially curved detector arraps for
single photon emission
computed tomographic imaging.
[00106] 'lhe mukimmwdaGtytomographic specific modular imaging detector maybe
further
cascaded ;uto a mosaic for dual curved detector arrays to perfornx positron
emission t.omogmphy.
[00107] The muletmodalitytomographic specific modular imaging deteccor maybe
furdher
coupled to amspeetive mechanical collirnators for single photon ennission
tomography.
[00108] The mulc~modality tomographic specific modular irnaging deieetor may
be further
coupled to mechanical anti scatter baffle colliimtois for positron emission
tomography,
[00109] The multi-modalitytomographic specific modular imaging detector maybe
further
coupled to coincidence detection and 21) image histogram processing modules
for image generation.
[001101 The muhi-modality tomographic specific modular iunaging detector may
include a
plurality of translatable and rotatable detector units to perform super
resolution single photon
emission tomography.
26
CA 02587804 2007-05-08
P44entApP&3tian
1001111 The m-ilci-modaktonnographic specific modular imaging detector can be
designed to be cransLuble and rotmble to perform super resolution positron
em,ission tomography.
1001121 Accord.ingly, at [east two imaging modalities (e.g., X-ray and PET; X-
ray and
SPECT; CI'; and others) can be employed to detect a coxnmon condition. The
imaging apparatus
and method can be employed to fuse together or combine the outputs of said
detection rnodalid.es
into a single useful output.
1001131 In some embodiments, the multi-modal detection comprises a first
imaging
modality (e.g., PET or SPECI) for detecting a functional aspect of a subject
or oagan while a second
iznaging modality (e.g., X ray) is used for detecting an a.natomical aspect of
a subject or organ.
[00114] The appazatus descrlbed above allows, in some embodiments, dua~ or
multi-
modality imaging of a patient without irquiring the patuent to move from a
fiust position to a second
position corresponding to the two imaging modalities used. As opposed to some
systems presently
in use that require moving the patient or translating the gurney on which the
patient is placed from a
first rnodaGty imager to a second modality irnager, here, the patient can be
imaged using more than
one modality coupled to a conunon frazneworic while the patient remains
substantially stationary.
This can impror-e the clarity, resolution, and accuracy of the multtmodal
image, and provide greater
comfort and saferyto the paticnt.
[00115] In other embodiments hereof, imaging an organ can be conducted without
rrequiiing physical or nlechaniccal contact between the organ and the imaging
apparatus. For
example, nnblce present imaging systems that often require awoman's breast to
be cornacted or
deformed or pressed by an uncomfortable imaging device, the present system
allows a no- contact
imaging of the breasc, especially if presented within a region of interest
within the present curved
azray detector system.
27
CA 02587804 2007-05-08
PutezAppfrattian
[00116] As discussed above, thcsc components and processors can be implemented
in
software, ha:dware, firmware, or various combinations thereof, and the present
illustrative
demancation of the funccions and block diagrams and components described can,
be accomplished
flexibly in more than one way. For example, one or more additional components
may be
incorporated into the present system, or a single component can be constructed
to perfonrn the
functions of twu or more compon.ents described in the present preferred
ennbodiments.
J001171 The present disclosure is not intended to be limxted by its preferred
embodiments,
and other embodiments are also comprehended and within its scope. Numernus
other
embodiments, modifications and extensions to the present disclosure are
nnended to be covered by
the scope of the present inventions as claimed belaw. This includes
implementation details and
features that would be apparent to those skilled in the an in the mecba-ical,
logical or electmnic
implementation of the systems described herein.
1001181 DVlaat is claimed is:
28
