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Methods and apparatus for preserving orientation information in radiography images
A method for preserving orientation information in an image may comprise: collecting image data, including orientation information inherent to collecting the image data; and embedding in the image data an orientation mark unambiguously identifying when the image data is presented in a correct viewing orientation. Image data is stored in a medium together with data forming an embedded orientation mark which is bilaterally asymmetrical in at least two orthogonal axes. In a variation, the data forming the embedded orientation mark further comprises at least one humanly recognizable text or punctuation character, word or trademark.
This application is a continuation in part of U.S. patent application Ser. No. 10/510,967, entitled "A RADIATION SENSITIVE RECORDING PLATE AND METHOD OF MAKING AND USING SAME," filed Oct. 12, 2004, which is a National Phase filing under 35 U.S.C. § 371 of International Application PCT/US03/11267, entitled "A RADIATION SENSITIVE RECORDING PLATE AND METHOD OF MAKING AND USING SAME," filed Apr. 14, 2003, which claims priority to U.S. patent application Ser. No. 10/392,158, entitled "A RADIATION SENSITIVE RECORDING PLATE AND METHOD OF MAKING AND USING SAME," filed on Mar. 18, 2003, to U.S. Provisional Application Ser. No. 60/372,323, entitled "METHOD FOR INTERNALLY LABELING THE ORIENTATION OF EXPOSURE OF RADIATION-SENSITIVE PLATES BY PRODUCING A RECOGNIZABLE PATTERN WITHIN THE INFORMATION SET PRODUCED BY SUCH EXPOSURE," filed on Apr. 12, 2002, and to U.S. Provisional Patent Application Ser. No. 60/431,282, entitled "A RADIATION SENSITIVE RECORDING PLATE, A METHOD OF MAKING SAME AND A METHOD OF RECORDING AND ORIENTING IMAGES," filed on Dec. 6, 2002, all of which are herein incorporated by reference in their entirety.BACKGROUND
This application relates generally to image processing. More specifically, the application relates to identifying image orientation. Yet more specifically, the application relates to identifying image orientation in medical and dental X-ray shadow-grams.
Images produced in conventional roll-film cameras, on film, are easy to orient correctly because the camera is constructed in such a way that the emulsion of the film always faces the lens. Because of the shapes of film cassettes and cameras, the film cannot be inserted in modern cameras with the emulsion facing away from the lens, so it is always known that the light, or other radiation recorded by the film, struck the film from the emulsion side. Thus, when orienting slides for projection, or film images for viewing on a light box, it is always known to put the emulsion toward the projection lens in the slide projector, or to put the film on the light box with the emulsion towards the viewer. When that is done, the image seen by the viewer, whether projected or viewed on the light box, will have a known defined correspondence with the orientation of the objects in the original scene. Moreover, even if orientation is lost, reorienting based on determining where the emulsion is will reestablish proper orientation.
Likewise, digital images produced using cameras with detectors such as charge-coupled devices (CCDs), complementary metal oxide semiconductor (CMOS), thin film transistor (TFT) and others that are sensitive to exposure from one side only are inherently unambiguous in their original form. The cameras used to produce such images are physically constructed and arranged with a lens or lens mount in a fixed position relative to the detector, so that the direction from which the exposing radiation strikes the detector is always known. CCD and CMOS sensors used in dental digital or direct radiography also are physically constructed and arranged to produce a diagnostic image only when exposed from the proper direction. Such CCD and CMOS sensors include a radiopaque element on the side away from the intended direction of exposure. Laterality of the images may however be reversed by the use of software used to process, display, and them.
The problem is somewhat more complicated for dental or medical diagnostic images produced on conventional film. One common type of dental or medical diagnostic image is a shadow-gram produced by placing a radiographic film on one side of the object to be imaged and a source of radiation to which the film is sensitive on a diametrically opposite side of the object to be imaged. The radiation, for example X-radiation, casts a shadow of the object to be imaged on the film, thus revealing density variations within the object whose shadow has been cast. When a standard orientation of the examined object is used, and the film is viewed from the same side as the radiation source exposing the emulsion, the laterality, i.e. right versus left, of the object is preserved, because the viewer can unambiguously discern right from left side by observing the image alone. However, medical or dental X-ray film can be exposed and viewed from either side because the film is transparent to both X-rays and visible light. To further complicate matters of orientation, an emulsion is often applied to both sides of the film in order to lower the dosage of radiation required to produce the diagnostic image, by increasing the sensitivity of the film. However, film thus constructed cannot be oriented on the basis of which side has an emulsion. Thus, it is desirable to identify from which side the film was exposed to radiation and so indicate the side from which it should be viewed.
Conventionally, and due in part to its high sensitivity to visible light, as well as to X-rays, radiographic film is usually held in an opaque cassette which not only prevents exposure to visible light, but also limits X-ray exposure to one side of the film, only. The side of the cassette through which large format film, such as that used for medical X-ray applications, is exposed often includes radiopaque labels indicating various patient information, including patient name, date of exposure, side of the patient (e.g., left or right arm), etc., for example, which provide a clear indication embedded in the image of the side of the film from which the exposure was made. If such labels are used, reversal of the image by viewing from the side opposite the side of exposing incident rays also causes the label characters to reverse, clearly indicating the reversed orientation of the diagnostic image. Systems also exist (e.g., Planmeca's pantomograph) which incorporate within the film cassette a mechanism which automatically optically imprints on the margin of the film, and therefore the image, pertinent patient, exposure, and orientation data during the exposure of the film. Often physical features, e.g., notches in the edge or corner of the film or keyways that orient the cassette itself to a cassette holder within the apparatus exposing the object, are used to further ensure that a consistent orientation of the film in the cassette and the exposure apparatus, and thus, the relative orientation of film and the image recorded on it to the object, is obtained and retrievable independently of the structure represented in the diagnostic image itself. The "back side" of the cassette is itself at least partially radiopaque over its entire surface, so as to prevent accidental exposure from the wrong side. The spatial orientation of the original form creating the shadow in the image is thus clearly and unambiguously defined. However, this clear and unambiguous outcome relies either upon the mechanical features noted above, or upon the X-ray radiology technician properly loading the cassette and placing the orienting labels, followed by exposing from the correct side. Otherwise, if the positioning of the film or the cassette is improper, the image produced visually reflects the improper orientation and the process and must be repeated.
Some conventional radiographic film cassettes are fitted on each side of the film with intensifying screens which are covered with a layer of fluorescent phosphor. These phosphors, when exposed to X-rays, fluoresce with visible light which is capable of exposing the film contained within the cassette thereby intensifying the X-ray image signal recorded in the emulsion. Since the emulsion is more sensitive to visible light than to X-ray irradiation, and since it is exposed to the fluorescent light from both sides of the film, the latent image recorded is primarily a result of this indirect exposure by visible light rather than by the X-ray photons that have traversed the imaged tissues.
Unlike the large format films described above, dental intraoral films are conventionally provided prepackaged in packets, which may be disposable and which are often flexible. Because intraoral films must be small enough to be positioned within the mouth, there is little room available for the types of labels described above. In the case of conventional silver halide dental intraoral films, proper orientation is identified by a raised or embossed bump on the film and packet that points away from a radiopaque backing in the packet that prevents or limits inadvertent exposure from the wrong side. The bump, which projects from the plane of the film in the direction from which the shadow is cast, is a permanent feature of the film and persists as marker of the orientation in the dimension perpendicular to the plane of the film, providing a method by which the viewer can identify the side of exposure. If an exposure is made from the wrong side, the resulting image is recognizably undiagnostic because of its degradation caused by the radiopaque backing contained within the packet. The radiopaque backing, typically a textured heavy metal foil, causes exposure from the wrong side to appear in the image as a textured pattern, while the embossed feature preserves and identifies the orientation information for the viewer. As with medical X-rays in which a proper outcome is assured by correct loading of the cassette, a proper outcome using intraoral dental films is assured only by correct assembly of the packet at the factory, followed by correct handling by the radiology technician. The degradation of the image evidencing improper exposure orientation of the film, which results in the reversal of the diagnostic image when the bump feature is used to orient the image, is, however, immediately obvious to the viewer, assuring that mistaken identification of features in the image is highly unlikely and traceable. This combination of an orientation feature and a feature preventing exposure from the wrong side is now conventional.
By convention, dental intraoral films are produced in a variety of generally rectangular standard sizes, with rounded corners. Also by convention, when prepared for viewing, they are grouped in an anatomical arrangement in a holder called a mount. Standard mounts hold films in one of two orientations only: with the longer dimension of the film in a horizontal orientation, henceforth in this application referred to as "landscape" orientation; and with the longer dimension of the film oriented vertically, henceforth referred to in this application as "portrait" orientation.
In keeping with conventions of viewing of radiographic images, on film or on a computer monitor, and for nonambiguity and clarity of the descriptions, the frame of reference for principal directions is based on the image plane, itself. Up shall be a direction generally from any point in the image toward a top of the edge of the image, while down is in an opposite direction. With the up direction oriented in a natural fashion for a viewer, left and right correspond to the viewer's left and right. Vertical corresponds to the direction of a line running up and down from any point in the image.
U.S. Pat. No. 4,625,325 describes a method which incorporates both conventional radiographic film and phosphor in the same process with radiopaque material. The device described patented therein includes a film packet, similar to the intraoral dental film packet described above. The device also incorporates a pocket for holding a plate which is inserted by the radiology technician prior to the exposure of the film. The plate, which is coated with a phosphor on the side facing the film and radiation source and which incorporates radiopaque material on the opposite side, is positioned adjacent to the film in the packet. The plate is an image amplifier similar to the intensifying screens used in cassettes described earlier. During the exposure, the film is exposed both by X-rays impinging directly on the film and by the phosphorescence emitted by the plate phosphor stimulated by the same X-rays. Those X-rays which have passed both the film and the phosphor are absorbed by the radiopaque backing, thereby limiting tissue exposure downstream of the recording surfaces. The packet, film and plate are held by a jig in a position such that the film and plate can only be exposed from one side. The phosphor only functions as an amplifier to provide improved signal-to-noise ratio and to lower the radiation dose per exposure. The phosphor film does not function as a storage phosphor holding a latent image, and is not scanned to produce a diagnostic digital image. Furthermore, no issues of image orientation ambiguity from a digital electronic image result from the process, because the image is recorded on conventional radiographic film, as before.
Conventional Phosphor Plate Technology
Radiosensitive phosphor storage plates, hereafter sometimes referred to in this application as PSPs, have recently started displacing conventional radiographic emulsion film for recording medical and dental images. Advantages including superior sensitivity, lack of dependence on toxic chemical processing fluids, relative insensitivity to ambient light, reusability, and the ease of digital data storage and transmission all stimulate the growth of this technology. The image orientation issues noted above with respect to conventional film; however, as well as new image orientation problems, for example resulting from the use of image processing software, manifest themselves in the use of PSPs. As discussed above, the orientation of the image produced by film technology was identified unambiguously by the presence of a three-dimensional object, namely the bump protruding from the film surface toward the object casting the shadow, providing a permanent and absolute reference in a dimension perpendicular to the plane of the film. The other two dimensions, superior-inferior and anterior-posterior are inferred from the anatomical structures in the image. Unlike the image incorporated into a three-dimensional physical object, i.e., the film with a bump, the images produced by existing PSP technologies are stored and displayed as two-dimensional views without a complete, definite, and permanent indicator of the direction of exposure or of viewing. Incomplete references or markers, as discussed below are incorporated into the existing systems; however, none of the systems are unambiguous, permanent, or complete by virtue of their design.
Although the radiosensitive PSPs are sensitive to a specific, diagnostic radiation type, e.g., X-rays, they are substantially insensitive to visible light for the purposes of registering an image. They can be handled in ordinary room light, absent the usual cassette until the time of the exposure. They are, for sanitary and other purposes such as reducing wear and tear on the phosphor, inserted into radiolucent plastic film sleeves before each use. The PSPs are also reusable to produce multiple images over a period of time. Erasure, by prolonged exposure to intense visible light, and repackaging in the disposable radiolucent plastic film sleeves is done by a radiology technician at the point of use, rather than at the point of manufacture.
A scanner, through laser illumination, stimulates the phosphor to emit light in an amount which depends on the amount of prior exposure to X-rays, and which in turn is registered as data signal. Currently, commercially available phosphor-based digital radiology systems use PSPs having a polymer sheet substrate supporting a pastel-colored phosphor layer applied to one surface of the substrate. The other surface of the substrate appears black. For the purpose of this application, the side of the plate which is intended by the manufacturer as the preferred side to be read, e.g., by the scanner, to produce the diagnostic image shall be referred to as the "front side", while the opposite side of the plate and sensitive layer shall be referred to as the "back side" henceforth. For practical reasons related to the current technology, the side of the plate that is generally intended as the side to be scanned ("front side") is also the side on which the sensitive layer is nearer the surface of the plate and is visible, thereby available for excitation by the scanning mechanism. "Front" and "back" should not, however, be taken to mean correct, incorrect, preferred or the like.
Even though the sensitive layer, e.g., phosphor, is available for scanning from one side, the "front side", only, it can be exposed and register a latent image from either side, and in some commercial systems equally well. As a result of the possibility that the shadow recorded by the sensitive layer, e.g., phosphor, could have been cast from either side of the plane of the plate, the recorded latent image as well as the visible image resulting from its scan are ambiguous with respect to their laterality. Thus, when recording bilaterally symmetric structures, e.g., left or right jaw, mirror images result, which can be easily confused since they are not uniquely oriented. Therefore, the two sides of the body (or mouth) can be confused by the viewer of the image, resulting in erroneous diagnosis and/or treatment. As a result, current commercially available PSP systems for dental use, such as those produced by Air Techniques Inc. and Gendex™, provide on each plate detailed explicit instructions to package and expose PSPs in a specific orientation, so as to preserve image orientation.
Some dental PSP systems employ techniques analogous with technology used in conventional emulsion film. For example, Digora® (available from Soredex), system incorporate a slightly radiopaque layer on the "back side" of the plate, which reduces patient irradiation by rays that pass through the plate and into the patient. The radiopacity of the backing is featureless, but the backing degrades an image exposed by irradiation from the "back side."
The conventional Digora® Optime PSP includes a "marker" that produces a visible mark in the image if the imaging plate is exposed "the wrong way around," according to promotional material produced by the Digora® Optime maker, Soredex, GE Healthcare Finland Oy. Significantly, the mark produced in the image by the "marker" of this conventional technology only indicates that the image was produced by radiation rays that pass from the target to be imaged, to the plate, through the back side of the plate, which Soredex considers to be the "wrong" side of the plate. In such a case, if the user knows that the image has not been corrected, i.e. mirrored through a vertical line, then such mirroring can be performed in the viewing software; however, a corrected image that was exposed through the back of the plate is indistinguishable on the basis of the mark from an uncorrected image that was also exposed through the back of the plate. It is still possible for the user to confuse which structure is imaged in a particular image using this conventional system.
Systems such as Scan-X™ (available from Air Techniques Inc.) and Denoptics™ (available from Gendex) each feature a distinctive marker. The markers are distinctively shaped, either a lower case letter "a" opaquely printed over the "front side" of the phosphor or a small open circle evident as an absence of the phosphor in a localized area, respectively. These markers, referred to as front side markers, are incorporated at the time of fabrication of the PSPs by the manufacturer and are constructed in such a way as to always be read from the phosphor by the scanner in a constant fashion independent of any exposure variables. The result of the presence of a marker produced by either of the above variants, i.e. Scan-X and Denoptics, in fabrication is a diminution, or absence, of phosphorescence from the area of the plate so altered, during scanning. This relative lack of signal is reflected in the visible scan image as a distinct shape, i.e., mark, corresponding to the shape and the location of the marker on the PSP.
Any features of such a front side marker that are either asymmetric or placed asymmetrically with respect to a vertical axis of symmetry of the plate, or both, become represented by similarly asymmetric features of a front side mark in the image of the plate following a scan. Furthermore, this mark becomes detectably reversed with respect to its laterality either in respect to its asymmetric location or its internal asymmetry as a result of software horizontal reflection of the scanned image, or both when both exist. As the placement of the source of the radiation during the exposure has no influence over the appearance of the image of such a front side mark, this front side mark is well suited as an indicator of any reversal of laterality of the entire image following the completion of the scan.
For practical reasons, namely because the image produced by each of the commercially available PSP technology systems can be displayed and viewed in one of four orientations only, which orientations correspond to the conventional orientations for emulsion-based radiographic film mounts, and which orientations are separated by steps of ninety degree rotation relative one another, the rotational transformations of the image (and the plate position) in this application will also be confined to ninety degree steps, or multiples thereof. Thus the available set of orientations to consider for any image will be the two "landscape" and two "portrait" possibilities, i.e., one right side up and one up side down for each category.
The configuration shown in
For purposes of illustration a human anatomical structure will be used as an example of the issues of laterality preservation in radiographic imaging of paired or bilaterally symmetric structures. The anatomical structure illustrated in
If the plate were to be consistently exposed from only one side (e.g., "front side"), then a front side mark produced by a front side marker would provide an absolute reference of laterality by eliminating confusion introduced by horizontally flipping of the image. Such reflection results in the displacement in the image of the open circle front side mark from the lower right or the upper left corners of the image to the lower left or the upper right in the images which are in "landscape" orientation. The displacement would be the reverse for "portrait" orientation. Although recommended, and consistent with best practice, such a consistent exposure of the intraoral plate from the sensitive side is not guaranteed either in the loading of the plate into the sleeve or in its placement during exposure itself. (Medical large format PSP systems generally use cassettes which not only hold the plate in desired orientation during exposure but also are loaded and unloaded by the scanner itself during the scanning process. This method of plate handling prevents inadvertent reversal of laterality prior to the creation of the viewable image.)
It should be noted that certain predictable rules of translocation govern a system composed of a radiographic plate, the image it holds, the long and the short axes of symmetry of the plate or its image, and a universe of combinations of two motions, a reflection through a vertical plane perpendicular to that of the image and a 90 degree rotation around an axis perpendicular to the plane of the plate at the intersection of its long and short axes of symmetry.
The reflection of the image within this system can occur through one of two modes. The first mode involves casting the shadow, i.e., registering the image, onto the sensitive layer, e.g., phosphor, from one side of the plate, e.g., "back side", and reading it off the opposite aspect of the sensitive layer, e.g., "front side". Only one instance of this mode may occur per image. This mode of reflection shall henceforth be referred to as "pre-exposure" reflection in this application. The second mode involves the use of an image processing software tool which reflects right-for-left any selected image. The number of instances of this mode of reflection is not theoretically limited. This mode of reflection shall henceforth be referred to as "software" or"post-exposure" reflection in this application.
Rotation has two distinct modes. The first mode is a physical rotation of the plate, together with its markers, relative to the object to be imaged prior to exposure involved in changing the orientation from "landscape" to "portrait", and if continued, back to "landscape". This mode of rotation shall be referred to henceforth in this application as the "pre-exposure" mode of rotation. The second mode of rotation can occur several ways. After exposure, the PSPs, being small, unattached objects are free to be moved and become randomized in orientation. These PSPs are later removed from their sleeves and arbitrarily rotated as to fit into a plate holder mechanism of the scanner, the constraint at this stage being that the "front side" must face the sensor. Once the images are produced on the computer screen, the operator uses the image processor to align the images in proper superior-inferior orientation by rotating them. This software-mediated rotation is limited to multiples of ninety degrees and is the mechanism through which correct "landscape" and "portrait" orientation as well as superior-inferior relationship is achieved as needed. All three of the rotations given above maintain the relationship between the location of the marker and the details of the shadow-gram. They also preserve laterality. The several mechanisms of rotation comprising the second mode of rotation occur after the sensitive layer is exposed and will henceforth in this application be referred to as "post-exposure" mode of rotation. When a "post-exposure" rotation results in a 180 degree rotation, the resulting transformation is equivalent to a reflection of the entire recorded image through a point located at the intersection of the long and the short axes of symmetry of the plate.
Although certain software-mediated manipulations, such as reflection through a line, are sometimes excluded by built-in restrictions within the radiographic software package, other radiographic software is not so limited. Conventionally, general-usage imaging software does allow such operations and also might be used with an image. Therefore, reflection through a line must be considered possible for any image. This type of "software" or"post-exposure" reflection is discussed below, also.
In order to better understand the discussion below in the DETAILED DESCRIPTION of how the structures according to aspects of the invention unambiguously identify correct and incorrect image orientation, first a discussion of possible transpositions of the image is given.
Within the context of this application, the two modes of reflection and two modes of rotation comprise the universe of orientation transformations allowed by the laws of physics and by the graphic functions included in the software of the image processors typically provided with digital radiography systems. For the purposes of this example, and in order to demonstrate the inability of only a conventional front side marker to differentiate various transformations, a marker 3811, as defined earlier, shall be placed in the lower right corner, as viewed from the "front side", of a plate in a "landscape" orientation. In
Suppose, for the purpose of analyzing the images in
- 1. If only one image is available for viewing independently of other patient information, the viewer will not be able to identify the correct orientation of the image, except by making an assumption that it was exposed from the "front side".
- 2. If a radiology technician is consistently making the error of exposing the films from the "back side", unknown to the viewer, the viewer will conclude when comparing images that images (in fact) exposed and oriented correctly are incorrectly oriented (which is not factually correct), thus compounding the problem.
- 3. A disgruntled or incompetent employee can wreak havoc with the records without anyone realizing it, or having a way of tracing the problem by using software to alter the apparent orientation of images in the records.
- 4. A person with fraudulent intent can expose the plate intentionally from the "back side" in order to make the image appear as though it depicts the opposite side of the body.
The analysis of
The analysis of
Direct Radiography or Digital Radiography
An alternate technology which is competing with PSPs to replace conventional film employs electronic sensors. These sensors may use CCD, CMOS, thin-film transistor (TFT), or the like, construction design and are similar to those used in digital cameras and camcorders. The image is recorded by capturing a shadow cast by the radiation which has been attenuated by passage through tissues under examination and then falling onto the sensor. The sensors are constructed in the shape of a parallelepiped with rounded corners for patient comfort and with two opposing roughly rectangular sides that correspond in size and shape to standard dental film. The thickness of the sensor is several millimeters. During use the sensors are typically connected to a computer or other data acquisition device through a direct cable or a wireless data transmission system. Because of the required electronic circuitry and other radiopaque elements, known sensors have only surface capable of recording an image.
Some of the manufacturers incorporate into their sensors features that produce marks within the image. These marks vary in shape but might be a small rectangle in a corner (Schick, Dexis) or the letters "RVG" along one of the edges in a corner (Trophy/Practiceworks/Kodak). After the image is processed and displayed, the marks, when present, appear as part of the image and behave in exactly the same ways as those marks produced by the front side marker in conventional PSPs. That is to say, manipulations such as rotations and reflections of the image change the location and orientation of the mark in precisely the same way as they would if it were a detail of the diagnostic image itself.
These characteristics of sensor-based radiography eliminate one source of orientation error from consideration, namely the pre-exposure mode or reflection of the image. This means that one can conclude unambiguously whether or not the image has been reversed through reflection if one knows which corner of the sensor has the marker. However, the portrait vs. landscape and rotations related to superior-inferior orientation of the image in the mount can still be disorienting and produce confusion regarding the laterality of the image. Such rotations might particularly affect the wireless sensors which do not require a wire fed out between the lips and to the acquisition device. The wired systems generally obey the following rules because of their direct connection and the stiffness of the wire:
- 1. the wire is anterior for posterior "landscape"-oriented sensor placement
- 2. the wire is superior for mandibular anterior "portrait"-oriented sensor placement
- 3. the wire is inferior for maxillary anterior "portrait"-oriented sensor placement
Any other placement, e.g., vertical bitewing, need not follow any particular rule as a matter of wire placement convenience.
As a consequence of the above factors, the orientation issues presented by the sensor-based systems are varied. For example, laterality identification problems vary from absolute lack of orientation clues in images produced by systems without built-in markers, particularly in those situations where wire lead location is noncontributory (e.g., vertical bitewings) to less serious in other configurations. Those with an asymmetrically placed symmetric marker can be traced if one knows the location on the sensor of the marker which yielded the mark in the image, but without that knowledge laterality can be absolutely ambiguous. If the location of the marker producing the mark is absolutely known to lie in the, for sake of argument, lower right corner when in "landscape" orientation of the sensor, then the clues to laterality can be reduced to the following rules:
- 1. If the mark is in the lower right or the upper left in a "landscape" orientation of the image, the image laterality is correct,
- 2. If the mark is in the upper right or the lower left in a "portrait" orientation of the image, the image laterality is correct,
- 3. If the combination of the mark location and image orientation is different in any aspect then the image is reversed,
Similar rules apply, but with the "sensors" being opposite, as may be understood by the skilled artisan, if the marker were known to be in the upper left in "portrait" orientation of the sensor. The tracing of the marks and their indication of the laterality requires knowledge of details which are not naturally obvious, concentration, attention, an innate ability to manipulate objects in space, and time. In a clinical setting these might not be available when needed.
The marker which produces "RVG" logo mark in the corner of the image is significantly easier to use as an orientation clue to laterality because of the chirality of the mark produced by the "RVG" marker. Flipping of an image containing the mark will also flip the mark. When the letters are visible in their natural orientation, this reflection is easily recognized by an observer. However when the letters within the mark are either upside down or the mark is oriented vertically rather than horizontally, the reflected mark is not nearly as clearly recognizable as being reflected; therefore its value as a tool for detecting reversed laterality of the image is diminished.SUMMARY OF INVENTION
A radiation-recording plate can be constructed and arranged to form an image upon exposure from both a front side and a back side. The plate can include a marker detectable in the image after exposure and indicative of which of the front side and the back side the plate is exposed from. The marker may comprise a medium opaque to the radiation coating a region that does not interfere with reading the image when the plate is exposed from either side. The plate may be sensitive to X-radiation, and the medium may comprise one or more of a heavy element, an alloy including a heavy element, a compound including a heavy element or a salt of a heavy element. The medium could be one of Pb, Sn, Bi, I, Cu and Ba. The medium could be a heavy metal suspended in a binder applied to the region. The marker may have asymmetry about at least one axis. The marker may have horizontal asymmetry about a vertical axis relative to a normal image orientation, or the marker may have vertical asymmetry about a horizontal axis relative to a normal image orientation. The marker may further comprise a back side marker whose appearance in an image on the plate indicates exposure from the back side.
The plate may have a layer sensitive to the radiation that is readable only from the front side, the back side marker further comprising at least one of a material that enhances reading the sensitive layer and a material that attenuates reading of the sensitive layer. Such a back side marker may further comprise at least one of a material that enhances exposure of the plate in a defined region and a material that attenuates exposure of the plate in the defined region. The back side marker may further comprise one of a heavy element, an alloy including a heavy element, a compound including a heavy element or a salt of a heavy element. The medium may be one of Pb, Sn, Bi, I, Cu and Ba.
The plate may further comprise a front side marker whose appearance in an image on the plate indicates exposure from the front side. This plate may further have a layer sensitive to the radiation that is readable at least from the front side, the front side marker further comprising at least one of a void defined in the layer sensitive to the radiation, a material that enhances a signal returned in the area of the marker when reading the sensitive layer and a material that attenuates the signal returned in the area of the marker when reading the sensitive layer or a material having some property different from the rest of the layer sensitive to the radiation such as the frequency of the stimulated emission light. The plate may be readable only from the front side by exciting the layer sensitive to the radiation with an excitation wavelength to generate a return signal at a return signal wavelength, the front side marker functionally opaque to at least one of the excitation signal wavelength and the return signal wavelength. The front side marker may further comprise one of a heavy element, an alloy including a heavy element, a compound including a heavy element or a salt of a heavy element. The medium may be one of Pb, Sn, Bi, I, Cu and Ba. The front side marker may further comprise a void defined in the layer sensitive to the radiation.
The marker may have asymmetry about at least one axis and the marker further comprising a front side marker and a back side marker. The marker can have either horizontal asymmetry about a vertical axis or vertical asymmetry about a horizontal axis, relative to a normal image orientation. In this case, the front side marker may further comprise: a region defined to have a shape of an arrow pointed in a first direction when viewed from the front side. The back side marker may further comprise: a region defined to have a shape of an arrow pointed in a second direction different from the first direction when viewed from the front side. The back side marker, whether arrow-shaped or otherwise having a cognizable left-right and/or top-bottom orientation, can be positioned so as to obscure the front side marker when the plate is exposed from the back side and read from the front side. The plate may include another sensitive layer, wherein the back side marker is disposed between the sensitive layer and the other sensitive layer, and the plate further comprising another front side marker relative to the other sensitive layer.
A method of identifying a side from which a radiation-recording plate has been exposed to radiation may comprise: incorporating in the plate, in a position that substantially does not interfere with an image area of the plate, a marker that produces a mark whose appearance in the image identifies which side the plate is exposed from; exposing the plate to the radiation; and observing the image for the identification of the side of the plate exposed. The mark so produced may be observable and understandable to humans or by machines and may be embedded in such a way as to be undetectable without machine assistance. The method may further comprise: arranging the marker to indicate a rotational orientation of the plate; and observing the image for the indication of the rotational orientation of the plate. The method may yet further comprise observing the image using image processing software, the image processing software recognizing the mark and reorienting an image of the plate to have a clinically expected orientation. The method may yet further comprise performing other alterations to the image, such as introducing a visible mark. The method may yet further comprise: storing with the image an indication of whether the image has been reoriented by an odd number of times. The method may also comprise: substituting for the mark a replacement mark indicative of the software having processed the image; storing the image with the replacement mark or eliminating the triggering mark. This method may also further comprise: storing with the image an indication of whether the image has been reoriented by an odd number of times. The indication stored may be a humanly visible mark or a machine-readable mark.
Such a third mark, sometimes referred to herein as a replacement mark, software generated mark, or an orientation confirming mark, can be used with either PSP systems or sensor systems of image capture. In the PSP environment it can be inserted into the image after the presence or absence of a back side marker is detected and the orientation of the image is determined during processing. The presence of this mark, which at least in part might be inserted into the diagnostic image by the processing software, and the recognition of its correct orientation by the viewer, will allow the viewer of the image to confirm that the orientation of the viewed image containing it has not been reversed through either pre-exposure or post-exposure modes of reflection. This would hold true for images that have been rendered as hard copy on paper or film (viewable from either side) or rendered as an image on an electronic monitor by software capable of reflection operation.
In the PSP systems which use both the reflection on detection algorithm and the back side marker as described herein and which apply these capabilities to all plate processing, the front side marker need not be required on the plate itself for unambiguous maintenance of orientation information. The software generated mark in the image obviates the need for the front side mark since it provides more complete and easier to use orientation information than that deduced from the presence of the mark produced by the front side marker and prevents the need for potentially spurious graphics from the image. Furthermore, the processing software, by design, will insert the confirmation mark into the image before the image is rendered for viewing. However the presence of the front side mark might be desirable for other reasons, such as confirmation in the image of the brand of PSP used.
In sensor based systems which use software capabilities described in this application the orientation confirmation mark provides for unambiguous orientation of a diagnostic image without the need for any additional information about the nature of the sensor or any markers associated with it. An alternate method of producing an orientation confirming mark in the image is through constructing the sensor in such manner that multiple recognizably asymmetric marks which possess a recognizable conventional orientation are produced in the latent image or the image file stored by the equipment to which the sensor is connected, prior to software processing. This might include blinding the sensor cells by blocking radiation from reaching them, rendering them incapable of recording the incident radiation, depriving them of connection to the data acquisition device, or otherwise.
Consequently the recognition of the described orientation confirmation mark in the diagnostic image is sufficient to allow for proper orientation of an isolated image with reference to reflection manipulations. For all intraoral, and most other, dental images that is equivalent to identifying the laterality. For medical images in which the direction of the incident ray (e.g., anterior-posterior vs. posterior-anterior) can be identified from the image itself, the anatomical orientation is also confirmed through the use of this method. In systems using plate-holding cassettes such as certain large-format medical PSP systems which ensure that the plate is exposed from only one side, the orientation confirmation mark would immediately indicate the condition of reversed laterality to the viewer of such an image by appearing in the image in reversed orientation.
Desirable characteristics of an orientation-confirmation mark include:
- 1. The mark may possess elements of rotational symmetry but should lack bilateral symmetry. Such a combination of symmetry/asymmetry might render the appearance of the mark in the image indistinguishable to the reader of the image regardless of any of the standard rotational positions that the image might be mounted in, but because of its lack of bilateral symmetry in at least the horizontal axis and the vertical axis, reflections of its image would be readily evident to the reader.
- 2. The mark may incorporate symbols such as letters, digits, and other graphics which generally possess a recognizable, expected orientation. Elements of the mark may further be recognizable as words or text.
- 3. The inclusion of these characters singly, in groupings, overlapping, or separated, and in orientations to one another which do or do not place the recognizable shapes in coincident parallel axes of orientation might constitute the construction of such a mark.
- 4. The mark can be an aggregation of graphics introduced by software with graphics already present in the image as a result of another image processing operation such as the front side mark produced by a marker on a PSP or a mark produced by a built in marker on a sensor. The orientation confirming mark might be a composite of graphics introduced into the diagnostic image during several distinct stages of registering and processing of the radiographic shadowgram including the initial capture of incident radiation.
- 5. The mark can be incorporated into the image once the laterality of the image is determined by program algorithms which might include such considerations as the source of the data (e.g., sensor or plate), the presence or lack of possibility of pre-exposure mode of image reflection, the presence or absence of back side marker shadow, the flipping or reflection of the image if it is deemed to be reversed relative to its expected orientation and appearance, the recognition of own-brand capture device and its characteristics, and others.
- 6. The mark can be inserted into an area of the image which is not of diagnostic value.
- 7. The mark can be opaque or alternatively can change the values of the pixel values of underlying image while preserving an aspect of their relative intensity.
- 8. The mark in a sensor-produced image can consist entirely of elements produced by markers built into the sensor structure which possess the features described herein.
A method of making a radiation sensitive plate having at least one radiation sensitive layer may comprise: providing a film sensitive to the radiation on a first side of the radiation sensitive plate; and applying a suspension of a heavy metal in a binder to a region of a second side of the radiation sensitive layer.
A method for preserving orientation information in an image may comprise: collecting image data, including orientation information inherent to collecting the image data; and embedding in the image data an orientation mark unambiguously identifying when the image data is presented in a correct viewing orientation. Variations of the method are possible, including wherein collecting includes forming in the image data an exposure mark indicative of from which side of an image receptor radiation incident upon a target object was then incident upon the image receptor. The method may further include: detecting the exposure mark; interpreting the exposure mark; and determining a correspondence between the correct viewing orientation of the image data and the interpreting of the exposure mark; and wherein embedding further comprises: orienting the orientation mark according to the determined correspondence. The method may yet further be varied, wherein embedding further comprises rendering the orientation mark substantially inseparable from the image data. In yet a further variation, the method further comprises: including with the image data and embedded orientation mark, validation data from which a determination can be made that the embedded orientation mark and the image data are validly associated and are unaltered after embedding the orientation mark.
According to yet other embodiments of aspects of the invention, image data is stored in a medium together with data forming an embedded orientation mark which is bilaterally asymmetrical in at least two orthogonal axes. In a variation, the data forming the embedded orientation mark further comprises at least one humanly recognizable text or punctuation character. In yet a further variation, the data forming the embedded orientation mark further comprises at least one humanly recognizable word. Another variation has the data forming the embedded orientation mark further comprising at least one humanly recognizable trademark.
The accompanying drawings are not intended to be drawn to scale. In the drawings, each identical or nearly identical component that is illustrated in various figures is represented by a like numeral. For purposes of clarity, not every component may be labeled in every drawing. In the drawings:
A detailed description of various aspects of embodiments of the invention follows. This invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways. Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of "including," "comprising," or "having," "containing," "involving," and variations thereof herein, is meant to encompass the items listed thereafter and equivalents thereof as well as additional items.
According to aspects of embodiments of the invention, exposure of one side of a radiosensitive plate produces one indicator pattern in the image, while exposure of the other side of the radiosensitive plate produces a different indicator pattern in the image. The indicator pattern recorded on the radiosensitive plate becomes a permanent part of a data pattern recorded by the particular exposure. Thus, whether the data set is embodied in the radiosensitive plate, a digital image data file, or a displayed or printed image, the indicator pattern forms a permanent part of the record. The indicator pattern may blanket the image or may be localized. It may render an image exposed through a substrate of the plate unusable, or may only minimally degrade image quality, or may be located so as not to degrade the quality of the image or data set in any way, for example by being small and located outside of a primary image forming area, such as in a corner of a rectangular plate.
Because the means for forming the indicator pattern is a permanent part of the plate, put there at the time of manufacture, no single or repetitive operator act is required to mark plates with their direction of exposure, no protocol to ensure exposure from a particular side of a plate is required, unless an indicator of a type rendering the image unusable when exposed from a "wrong side" is used, and the indication of the direction of exposure is unambiguously embedded in any data set produced from such a plate. No special protocol or specification of protective sleeves is required for image orientation purposes, either, unless an indicator of a type rendering the image unusable when exposed from a "wrong side" is used.
The indicator pattern can further be used to help identify laterality, i.e., "handedness," of an image. Preservation of the laterality of an image may be important because the symmetry inherent in the human body and most higher animal forms makes distinguishing between certain structures, such as a patient's left incisor or hip and the patient's right incisor or hip, difficult independently, i.e. without other sources of identification. In the case of intraoral dental radiographs, laterality is fully defined by the direction of exposure and the structure depicted. This is so because the radiation source for intraoral dental X-rays is always located outside the patient's mouth and the sensitized plate is always located within the patient's mouth.
Several different structures that produce indicator patterns having the characteristics discussed above and which unambiguously identify each of the possible transpositions are now described in detail. There are two independent non-overlapping categories of markers, "front side" markers and "back side" markers.
A "front side" marker is one that produces a mark in an image viewed or scanned from the front side, regardless of the side of exposure, while a "back side" marker is one that produces a mark in an image on a plate exposed from the "back side" and subsequently read from the "front side". In general, the marker patterns can be produced by materials having suitable patterns placed intermediate the plate sensitive layer and the source of exposing radiation. These patterns can alternatively be produced on phosphor storage plates by affecting the excitation and recording the resultant phosphorescence of the phosphor during the scan process, for example, by perforating the phosphor layer, by obscuring it, or by otherwise altering the phosphorescence properties of the phosphor layer, such as using a phosphor with different excitation properties or different phosphorescence properties (e.g., different wavelength of stimulating or emitted energy) For example, materials can, using any suitable process, be coated, printed, painted, laminated, sublimated, bonded, riveted, etc. onto the plate surfaces during the fabrication process. The materials can be selected to partially or wholly block or intensify, e.g. by use of different phosphor, the radiation reaching the plate in the area covered. A common material that blocks X-radiation, and can be usefully applied to the plates in laminated form in paints or in inks, is lead. Other heavy metals or other heavy elements can also be used, in various forms, e.g., foils, grains, etc. of copper, lead, tin, bismuth, barium, etc. Here, heavy metals and heavy elements generally include any element from the fourth row of the periodic table and heavier. One particularly useful material is copper foil having an approximate thickness of about 1 mil or thicker. Such foil is available in adhesive-backed forms which can be laser cut or die cut to desired form and applied to plates during manufacture.
One example of the type of plate to which the principles of the invention are applicable is a dental plate including a plastic substrate onto which is coated a storage phosphor material sensitive to dental X-rays. The plates are produced in large sheets or continuous webs and then die-cut into their final size and shape.
A simple embodiment is now described, in which a plate such as just described, readable from one side, i.e., the "front side", has an indicator pattern-forming material, i.e., a marker, incorporated into such plate on the opposite side of the plane of the sensitive layer from which such plate is read. This is a "back side" marker.
In this embodiment, a mark is printed on the "back side", in one corner thereof. The mark is printed using a lead impregnated paint, or other suitable material. Other suitable constructions are described in greater detail, below. When exposed from the "front side" of the plate, the resulting image includes no mark. However, when exposed from the "back side" of the plate, an unexposed mark is formed in that portion of the image corresponding to the corner of the plate on which the mark is printed. The image produced, including the mark, can take the form of any of the images of
In a second embodiment, both a "front side" marker and a "back side" marker may be present. For example, different patterns of indicator-forming material may be applied to opposite sides of a plate readable from one side. Alternatively, the "front side" marker may be one or more perforations in the phosphor. This embodiment is advantageous in that the indicator pattern formed can unambiguously inform a person reading the resulting image from which direction the plate was exposed, whereas when the plate of the first embodiment is exposed from the direction that produces no indicator pattern, the image is indistinguishable from images produced by PSPs not including any markers or flipped horizontally.
Embodiments of the invention incorporating both a "front side" marker and a "back side" marker can fully indicate the orientation of a structure imaged, even when the position of the radiation source and the radiation sensitive plate relative to the structure is unknown.
If the plate is marked by both a "front side" marker and a "back side" marker, as described in connection with the second embodiment, the direction of exposure of the plate is unambiguously recorded in the image without any intervention or special act by the operator. In addition, the cassette or sleeve in which the plate is placed during exposure can include a radiopaque mark on one or both sides, unambiguously indicating the proper orientation of the cassette or sleeve relative to some absolute reference such as the left side or front of the patient.
Suppose, for the purpose of analyzing the images in
Suppose, for the purpose of analyzing the images in
Suppose, for the purpose of analyzing the images in
Suppose, for the purpose of analyzing the images in
In a third embodiment of the invention, shown in
In extending the method of analysis used in the discussion relating to
The following discussion of
The first mode is "pre-exposure" reflection of the plate, changing whether the plate is exposed from the "front side" or from the "back side". Depending on which initial reflection position a plate has been exposed in, one of group 4001 and 4002 will be the starting point of analysis.
The second mode of manipulation is a physical rotation of the plate prior to exposure involved in changing the orientation from "portrait" to "landscape", and if continued, back to "landscape", and which changes the relationship between the location of the marker and details of the image produced by the shadow-gram. As has been demonstrated in the discussion regarding
The third mode, a rotation of the plate after exposure, when mounted into the scanner or by software once the data has been captured, maintains the relationship between the location of the marker and the details of the shadow-gram. As discussed below, this mode is illustrated by movements between the left and right columns of
The fourth mode is software reflection of the image after capture. This manipulation is illustrated in
A plate having "front side" markers and "back side" markers, exposed from an arbitrary side and then manipulated by image processing software will produce one of the images of
Hypothetical #1
An image scanned from a plate exposed in the conventionally "correct" orientation, that is, with the "front side" marker facing the source of radiation and at the lower edge is shown in image 4003. Software manipulations by rotation or reflection can produce any of images 4004, 4005, or 4006 in group 4001. However, note that the thin, "front side" marker arrow is at the lower edge facing right when the image 4003 is correctly oriented.
Hypothetical #2
An image as scanned from a plate exposed from the "front side", but rotated so that the "front side" marker is at the upper edge producing the scanned image 4004. Again, software manipulation can produce any of the images 4003, 4005 and 4006. When correctly oriented for viewing, this image 4004 has the thin, "front side" marker arrow at the upper edge facing left.
Hypothetical #3
According to this hypothetical, the plate is exposed from the "back side", with the "back side" marker in the lower edge. When scanned, image 4007, with the "back side" marker on the lower right, facing left is produced. Because this image was subject to a pre-exposure reflection, the scanned image 4007 is produced. A software reflection produces the correct image 4009. Although images 4008 and 4010 could also be produced by software manipulation, observe that "correct" image 4009 has the thick, "back side" marker arrow at the lower edge facing right.
Hypothetical #4
According to this last hypothetical, the plate is exposed from the "back side" after being rotated so that the "back side" marker is at the upper edge, producing scanned image 4008. In order to view the image in a "correct" orientation, it is manipulated using software to reflect horizontally the image 4008, to produce image 4010. The corrected image 4010 has the thick, "back side" marker arrow at the upper edge facing left.
A simple rule can be derived from the four foregoing hypothetical using aspects of the third embodiment, whereby any image produced using the embodiment can be quickly and accurately oriented correctly for viewing. For landscape mode images, after orienting an image correctly with respect to superior/inferior parts using rotation, any marker arrow at the top edge of the image should point left, any marker arrow at the bottom edge of the image should point right. The image must, using software, be reflected horizontally to achieve correct orientation if the rule is not met initially.
In a fourth embodiment of the invention, illustrated in
All the possible images 4201-4208 generated by scanning such a plate exposed to a radiation source from the "front side" and from the "back side" are shown in corresponding positions to those of
Furthermore, even if one of the markers should be obscured by the shadow of a clinical structure which is radiopaque, e.g., a metallic filling or crown, the other is present to even in this rare situation provide indication of the laterality of the image.
In a yet another embodiment of the invention, the plate is fitted with two layers of sensitive material, each possessing a small "front side" marker and allowing the mechanism which converts the latent image into a visible diagnostic image to read the plate from either or both sides and producing a recognizable pattern of that marker in such a diagnostic image, and a different indicator-forming marker or material, housed between the two sensitive layers, capable of producing a recognizable pattern, preferably obscuring the image of the "front side" marker as in the foregoing embodiment, readable from either of the sensitive layers if such material lies between a radiation source and that layer.
An example of aspects of this embodiment is shown by the plate 4400 illustrated in
According to further aspects of this embodiment, between the two phosphor film layers lie near the tail ends of each of the four arrows 4401, radiopaque medium deposits 4407 which can cast a shadow onto the phosphor on the side of the plate opposite the source of radiation and the radiographed object. In the landscape orientation (as shown), the above arrangement of arrow-shaped "front side" markers 4401 and internal material 4407 comprising a "back side" marker, any image of an object exposed from and read from the same side of the plate will have proper orientation, as always, as scanned, with the lower edge arrow 4401 pointing to the right and the "back side" marker 4407 shadow absent. On the other hand, as shown in
As seen from the above discussion, PSPs according to the various embodiments described produce images with distinctive markers permanently embedded in the image information. The distinctive markers can be recognized and acted upon by the clinician viewing the images, or can be automatically recognized and acted upon by the image processing software used to view the images. More sophisticated software can first perform the superior/inferior orientation on its own, based on any suitable image processing rules, while less sophisticated software can rely on the operator to first perform the superior/inferior orientation. In order to effect automatic orientation recognition and reorientation, the image processing software would next search the known possible locations of the markers for those particular shapes corresponding to the markers. When one of those shapes is found in one of those possible locations of the markers, a rule for correctly orienting the image is then applied. In the case of the third or fourth embodiments described above, the simple rule set forth above can easily be applied automatically by the software to bring each image immediately into its correct orientation. The software can also be written to replace a marker recognized within an image with one of its own. The substitution would help those using the images recognize that they have been processed and correctly oriented.
Another software enhancement is also possible in connection with aspects of embodiments of the invention. The reflection process performed by the image processing software can modify the file by toggling a "reflection flag" indicative of whether the image has been reflected an odd or even number of times. The reflection flag can be embedded within the image file, can be stored in an independent file, can be part of the image file name, or stored in any other suitable location. The value of the reflection flag can represent one of two states. The reflection process and reflection flag would preferably satisfy the following conditions:
- 1. The reflection process flips the reflection flag state from one to the other, each time a reflection was applied to a given image, thereby tracking the number of reflections, modulo two;
- 2. The image file so processed is modified to include a graphic, text or other indication, that the image has been reflected horizontally (through a vertical axis of reflection); and
- 3. The repeated use of the reflection tool would toggle the reflection flag between the two states each time it is used.
The image processing system would display a correctly oriented image either if the "back side" marker were present and the reflection flag were indicating an odd number of reflection operations, or if the "back side" marker were absent and the reflection flag indicated an even (including zero) number of reflection operations.
In another embodiment of the invention, the image processing system may store validation data along with the image data, as illustrated schematically in
Plates embodying aspects of the invention can be manufactured by any suitable method. The mark to be produced can be of any arbitrary size relative to the size of the PSPs to be produced. In production methods in which one or more PSPs are cut from larger sheets or webs of material coated on one side with phosphor or another radio-sensitive material, placement of the mark can be synchronized with the locations from which the PSPs are cut, may be randomly placed relative to the locations from which the PSPs are cut, or may completely blanket the locations from which the PSPs are cut. Synchronization can be achieved by any suitable method, including those known in the printing arts for aligning printed elements and die cuts.
A small, highly distinctive mark can be placed in a consistent, predetermined location, whereas a blanket pattern used as the mark should also be highly distinctive, so as to distinguish it from patterns likely to be seen in the diagnostic image. Preferable blanket patters are rectilinear or angular, rather than mottled, curved or random, so as to be distinguishable from naturally occurring patterns in the diagnostic image.
As noted above, production of the mark or pattern on the plate can be done using any suitable means of varying the transmission or absorption of the diagnostic radiation.
For example, the substance of the plate which carries the phosphor might be manufactured in such a way that its absorption of the radiation which produces the latent image in the phosphor is not uniform. The non-uniformity can take the form of the desired mark or pattern. Examples of processes capable of producing the desired non-uniformity are now described.
Alternatively, also as noted above, production of the mark or pattern can be done by varying the output of an exposed plate, for example by varying the phosphor type, thickness or presence.
The pattern can be an integral part of the bulk substance of a plate having a non-uniform composition. This can be accomplished by the introduction of a material which would locally increase the extinction coefficient of the radiation and produce a recognizable pattern in the shadow cast on the phosphor when exposed from its side of the phosphor. During manufacture, a radio-opaque material, e.g. heavy metal salt powder of an appropriate particle size, can be added to the material from which the plate is formed. This addition can be performed in such way that the material would not become homogeneous prior to the finishing of the plate for example while the materials are in a semi-flowable state, before hardening into finished sheets.
The pattern can be introduced during the manufacturing of the plate as a modification of the sheet which holds the phosphor of the finished plate. Examples which can be combined as desired, include to hot press, adhere, stamp, print with ink or foil, spray, re-sublimate, dust, inlay, or otherwise deposit, or impress into, the sheet a material of different extinction coefficient than the bulk material of the sheet. This would introduce a recognizable pattern into the shadow cast onto the phosphor when exposed from its side.
As shown in
Another method for producing zones of contrasting radiopacity within the plate is to inlay the substrate of the plate with a full or partial thickness of material possessing a significantly different coefficient of extinction at relevant wavelengths. One way to create a full thickness inlay of this type, as shown in
According to another structure, shown in
According to yet another construction, as shown in
According to yet another embodiment, illustrated in cross-section in
According to yet another construction, as shown in
A variation on the embodiment of
Plate 5000 has a corner region 5001 with two voids 5002 and 5003 formed therein. The voids 5002 and 5003 are positioned, sized and shaped to retain the corner element (
As shown in
For completeness,
According to a simplified embodiment, shown in
As shown in
When an image as shown in
When an image as shown in
Combining the embodiments of
The extent of coverage of the plate with the strips might be limited to a fraction of the plate surface, e.g., along an edge, or might include the entire surface, including the entire diagnostic active area. The strips in this embodiment might be oriented to run at 45 degrees to the long and the short axis of the plate to facilitate use in scanners capable of scanning along either axis. An alternate arrangement of the strips could be perpendicular to the direction of the scan path, as governed by the scanner mount design.
The degree of attenuation might be such that the difference in the appearance of the attenuated zones and the non-attenuated zones would be below detection level of naked eye. That is to say that the shape of the repeated stripes would not be visible on visual examination of the image produced by a back side exposure, and therefore, would not degrade the diagnostic value of the image. However, a linear machine phosphorescence scan of the plate in a direction parallel to one of the axes of the plate, (not unlike the usual method currently used for reading the latent x-ray images), exposed from the back side would yield a repeating pattern, perhaps a square wave, with a period longer by a factor of √{square root over (2)} than the spacing of the diagonal physical strip pattern on the back side of the plate superimposed over the diagnostic image signal level. The amplitude and the wavelength of this wave would be known and its presence or absence could therefore be recognized during the processing. It might also be desirable to incorporate different spacing and width of the stripes as a machine-recognizable reference of the type or format of the plate if such is needed.
In case the pattern of the stripe shaped mark would have to be intense enough to be visible to the naked eye for technical reasons, e.g., to ensure its detection, the same square wave signal, once confirmed, could be subtracted away from the combined signal without significant deterioration of diagnostic image quality if it were to overlap it. Such can be accomplished by multiplying the pixel raw signal value within the areas affected by the mark by a factor which is a function of the extinction coefficient of the material of the marker which produced the mark and the thickness of the material of the marker, both known values.
Various aspects of embodiments of the orientation confirmation mark are next described in a sensor version.
The design of the sensor device produces the appearance of the text "correct" at the opposite edges of any image produced by exposure of this sensor. In each instance the text will be oriented so that the bottom of the letters is near the outside edge. The presence of the mark (the two instances of the text) would identify in the image the producer of the sensor regardless of software used to render the image. The software in this embodiment, on processing the image and confirming its laterality, inserts two more instances of the same text along the remaining two sides of the image. Once again the letters are oriented so that their bottoms are near the edge and their tops are toward the center of the image. When the diagnostic image is rendered using this embodiment of the invention the orientation confirmation mark consists of the four instances of the word "correct" appearing along the edges of the image allowing the viewer of the image a quick and simple confirmation of correct orientation. Should the image be rotated, the anatomical relationships are not altered and the mark still reads "correct" in the four orientations of the text. However if the diagnostic image is reflector, thus reversing the laterality of it, there will not be a single instant of "correct" which will be readable in the normal manner. The mark used might be not necessarily contain English words but clearly needs to use elements recognizable as to their correct orientation. The presence of the second set of words "correct" in this example identifies that indicates that the software processing the image used the algorithm. This embodiment of the orientation confirmation mark also confirms that the image capture device and the processing software were using the present invention methods and can state the brand of the product.
Markers according to various aspects of embodiments of the invention described above can be made by casting low-melt temperature compositions or alloys into suitable shapes in a plate. Low temperature alloys, including eutectic alloys of Sn, Sb, Bi, Pb and/or others are suitable. Other materials and forms of material mentioned above, such as Cu, Cu foil and laminated structures for example, can also be used.
Although described in connection with intraoral dental phosphor storage plates (PSPs), it should now be evident that various aspects of embodiments of the invention can be applied to other medical and dental phosphor storage plates or films susceptible to exposure from either side, but which can only be read or scanned from one side, as well as to sensor generated images (intraoral or camera) which are exposed from one side but viewable from either one side only (printed on paper) or either side (displayed on a monitor with possibility of reflection or printed on film which can be viewed from either side). By use of the embedded confirmation mark, aspects of embodiments of the invention apply to any digital diagnostic radiographic images including photographic images, if processed and stored using any of the aspects disclosed herein or obvious to the skilled artisan in view of this disclosure. These methods and apparatus can also be used in connection with forensics or other applications where laterality and orientation are important for documentary reasons, as well as diagnostic reasons.
The third mark described herein should preferably be non-opaque with respect to the background image, so as to make it more secure.
Having thus described several aspects of at least one embodiment of this invention, it is to be appreciated various alterations, modifications, and improvements will readily occur to those skilled in the art. Such alterations, modifications, and improvements are intended to be part of this disclosure, and are intended to be within the spirit and scope of the invention. Accordingly, the foregoing description and drawings are by way of example only.
1. A method for preserving orientation information in an image, comprising:
- reading image data from an image collecting device, including orientation information inherent to the image data; and
- embedding in the image data an orientation mark based upon the orientation information, the orientation mark unambiguously identifying when the image data is presented in a correct viewing orientation.
2. The method of claim 1, wherein collecting includes forming in the image data an exposure mark indicative of from which side of an image receptor radiation incident upon a target object was then incident upon the image receptor.
3. The method of claim 2, further comprising:
- detecting the exposure mark;
- interpreting the exposure mark; and
- determining a correspondence between the correct viewing orientation of the image data and the interpreting of the exposure mark; and wherein embedding further comprises:
- orienting the orientation mark according to the determined correspondence.
4. The method of claim 2, wherein embedding further comprises rendering the orientation mark substantially inseparable from the image data.
5. The method of claim 4, further comprising:
- including with the image data and embedded orientation mark, validation data from which a determination can be made that the embedded orientation mark and the image data are validly associated and are unaltered after embedding the orientation mark.
6. The method of claim 2, further comprising:
- removing the exposure mark from the image data.
7. The method of claim 1, wherein the orientation mark is bilaterally asymmetrical in at least two orthogonal axes.
8. The method of claim 7, wherein the orientation mark comprises at least one humanly recognizable text or punctuation character.
9. The method of claim 8, wherein the data forming the embedded orientation mark further comprises at least one humanly recognizable word.
10. The method of claim 8, wherein the text or punctuation character includes at least one numeral.
11. The method of claim 7, wherein the orientation mark comprises at least one humanly recognizable trademark.
12. The method of claim 7, wherein the orientation mark possesses radial symmetry whereby the orientation mark would remain readily recognizable when the image is rotated about a point.
13. The method of claim 7, wherein the orientation mark is similarly recognizable when the image is viewed in portrait orientation and in landscape orientation.
|August 1947
|October 26, 1982
|Komaki et al.
|March 25, 1986
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- Digora Intra-Oral Imaging Systems by Soredex, brochure, May 2001.
- D.A.Miles, DDS,MS, FRCD, Understanding Digital Radiography, posted on Internet by dentalproducts.net Originally published in Dec. 2000 Dental Practice Report, http://www.dentalproducts.net/sml/0012/miles0012/miles0012a.asp, Apr. 27, 2002.
- Fujifilm Products, Fuji Computed Radiography, http://home.fujifilm.com/info/products/inform/fuji—radio.html, Apr. 27, 2002.
- Agfa, Radview Phosphor Scanner, http://ndt.agfa.com/bu/ndt/index.nsf/EN/computedradiography.htm, Apr. 27, 2002.
- A/T ScanX™ Digital Imaging System PN73400, Operator's Manual, 2002.
- X-Ray Mass Attenuation Coefficients—BISMUTH, 3 pp., http://physics.nist.gov/PhysRefData/XrayMassCoef/ElemTab/z83.html, Dec. 14, 2002.
- Digora Fmx—Soredex, Technical data, http://www.soredex.com/digora—fmx—data.shtml, Nov. 21, 2002, p. 1 of 2.
- Terry, B.R., DMD et al., Digital Radiography, http://www.rootcanalspecialist.com/digitalradiography.htm, Apr. 27, 2002, p. 1 of 2.
- Digora Fmx—Soredex, Technical data, Aug. 2002.
- Digora Intra-Oral Imaging Systems by Soredex, http://webspace.dialnet.com/preseli.computers—pcs/Digora.htm, Nov. 21, 2002.
- Digora Optime Chairside Digital Imaging Plate System, Digora—optime—lores.pdf, Mar. 2005.
Type: Grant
Filed: Apr 15, 2006
Date of Patent: Jul 21, 2009
Patent Publication Number: 20070081631
Inventor: George W. Kay (Sharon, MA)
Primary Examiner: Courtney Thomas
Attorney: Lowrie, Lando & Anastasi, LLP
Application Number: 11/279,891
International Classification: A61B 6/14 (20060101);


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To understand the pathway of damage that alcohol does to the thyroid, we first need to look at all the key players that are also affected by alcohol. These are the liver, oestrogen, progesterone, prolactin, glycogen and cortisol. There has been many scientifically published articles on how alcohol affects the liver; in basic terms, moderate to high long term consumption of alcohol will most likely result in scarring of the liver which reduces its ability to function as it was designed to. Below we have listed some of the many hormones that are affected by alcohol, what these hormones are supposed to do to keep us well. It is far easier to avoid something that makes us unwell when we understand it's effects.
Some of the liver's role is as follows:
Metabolise excess oestrogen and fat to be excreted
Glycogen synthesis
Convert T4 to T3 (one of the sites in the body where this happens)
Make Thyroid-Binding Globulin (TBG) – TGB is the taxi that takes T4 & T3 to where it is needed in the body
Eliminate toxins
The main hormones of the thyroid that we talk about are Thyroid Stimulating Hormone (TSH), T4, T3 – active and Reverse T3 (RT3) -inactive. TSH is made by the pituitary and stimulates the thyroid to make T4. T4 (Tyrosine & Iodine) is an inactive hormone, it needs to be converted to T3 to be used by the cells and tissues. This conversion takes place in the liver, kidneys and
muscles. T4 can also be converted instead to RT3, this is part of the cycle but T4 to RT3 needs to also be in balance for healthy thyroid function. Thyroid imbalances have a dramatic impact on your weight management, watch the free video here.
Glycogen is made up of many units of glucose joined together & is stored in the liver as a source of energy. Some of its functions are:
Regulate blood glucose levels
Produce glucuronic acid which detoxifies estrogen
This is a naturally occurring hormone, that is generally produced by the ovaries. It can also be produced by the adrenals & special belly fat cells in post-menopausal women. There are also phytoestrogens that come from plants such as soy, and synthetic forms known as xenoestrogens which can be found in a range of products, pesticides, and plastics to name just a few sources. Learn more about Thyroid and menopause here. Some of Oestrogens functions are:
Bring about puberty in girls
Helps control cholesterol
Helps to keep bones strong
Has an effect on brain and emotions
Excess estrogen can inhibit thyroid function
Progesterone is also made in the ovaries and is needed to be in balance with estrogen so the female reproductive system works well. We tend to notice a lack of progesterone rather than an excess, as the majority of PMT symptoms is a result of not having enough of this hormone. In post-menopausal women – the small amount of progesterone that is made in the body is produced by the adrenals, and if the adrenals are overworked it will direct all its resources to making its stress hormones or adrenaline & cortisol. This further compounds the estrogen dominant picture. One of its major function is:
Thickens the lining of the uterus at ovulation, this makes the womb 'warm & fluffy' so that a fertilized egg can implant.
Prolactin is a hormone that is produced by the pituitary. There is a correlation between high prolactin levels and hypothyroid function. Some of its functions are:
To produce breast milk for a baby
Down regulates oestrogen production
Thyrotropin Releasing Factor (TRF)
TRF is produced by the hypothalamus. Some of its functions are:
To stimulate the production of Thyroid Stimulating Hormone (TSH)
To increase production of Prolactin
Cortisol along with Adrenaline is produced by the adrenals. Cortisol is our long lasting stress hormone. Some of its functions are:
Metabolism of protein, carbs and fats to maintain blood glucose levels
Energy production via the blood glucose levels
Long lasting levels of Cortisol in the body promotes the laying down of fat cells so the body survives famine
Cortisol decrease TSH production
Inhibits T4 changing to T3
Increases the conversion of T4 to RT3
High levels of cortisol also impacts of the liver's ability to clear estrogen
So know that we can see all the ways alcohol affects thyroid function, it's a good idea to limit your consumption of alcohol to 1-2 standard drinks up to 4 days a week. Alcohol intake is also linked to poor cholesterol, reflux and poor digestion. What was interesting in doing this research is that if a moderate to heavy drinker gives up alcohol, you can expect their thyroid hormone levels to drop and then after a period (research varied on the length of time) the hormone levels increased and stabilized. So keep a symptoms diary, see a Thyroid specialist, get some thorough testing to treat your health effectively.
References & Resources:

subset: commoncrawl


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Image held here
So there are two distinct things that are interesting here – the visual and what it represents.
(The trajectory runs from attention data > interest cloud > XXL attention profile).
This represents APML: attention profiling mark up language. (APML is a proposed standard that allows users to share their own personal attention profile and compress all forms of attention data into one portable file format that can be traded between 'attention seekers and givers').
The internet is coming up with some intriguing new forms of visual culture to respresent what's been described and imagined as 'the crowd' or 'the masses'. This runs from the conventional idea of the crowd as a stupid-to-dangerous social 'blob' and the dangers of 'groupthink', to optimistic ideas of collective intelligence such as James Suroweicki's The Wisdom of Crowds. It comes back to the old debate of populism. That is, elitism.


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The Communities Project
The Communities Project is aimed at equipping individuals across the country with the background and tools necessary to begin the process of organizing their communities to more effectively combat addiction. Training 2: Developing Goals, Strategies & Tactics, the second of two trainings developed as part of the Communities Project, will focus on the nature of developing goals collaboratively and executing strategies and tactics in order to attain those goals.
Registration Opens September 16th.


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An award-winning reporter who writes for the Miami Herald, Jacqueline Charles is practically the prototype of a successful print journalist. A graduate of the University of North Carolina Chapel Hill, Charles was honored by the National Association of Black Journalists (NABJ) for her coverage of an earthquake in Haiti in the early 2010s. She received a Regional Emmy for the documentary Nou Bouke: Haiti's Past, Present and Future. She's also been a recipient of the sought-after Society of Professional Journalists Delta Sigma Chi Award.
But long before being a recipient of these prestigious accolades, the Turks and Caicos-born, Florida-raised news scribe had made her mark as a journalist of caliber through years of reporting excellence. What are the principles that got her to where she is? Shall we examine them in the Kreyolicious series you've learned to love…the 5 Success Principles We Can Learn From Jacqueline Charles?
Above: Charles (in royal blue) during a panel discussion at the University of North Carolina Chapel Hill. [Photo Credit: Melia Samant]
1. Whatever it is you want to do, start early.
After graduating from Miami Jackson Senior High School, Charles moved to North Carolina to attend the University of North Carolina's School of Journalism—one of the nation's highest ranking schools in the nation. While there, she begun exercising her skills on the staff of The Daily Tar Heel, the campus newspaper. The clips she built at that paper would help her land her first job out of college. While at UNC, Charles carved leadership roles for herself. According to Jordan Nash, Charles was a co-founder of the Carolina Association of Black Journalists and edited the campus' black student publication Black Ink Magazine.
2. When you've committed an error, admit it.
When Charles makes errors on the social media platform Twitter, she quickly tweets retractions and corrections. It's not like any of us humans are infallible. When you admit when you're wrong, you will get the admiration of even your detractors. What's more, folks will put more faith in you, and respect you and your work. You know you've got respect when the sayimg "I won't believe it until I see Jacqueline Charles tweet it," becomes the phrase of the day.
3. Become known for something.
Oh, the beauty of specialization! Jacqueline Charles graduated from the University of North Carolina Chapel Hill with a degree in Mass Communication and Journalism. Journalism school graduates are aplenty, and according to statistics compiled by the UNC School of Journalism, at most graduation ceremonies an average of 400 students leave the university with that dual degree. How was Charles going to make herself the pear among many apples? She took a position at the Miami Herald as a governmental reporter, and went from there. Speaking of which…
4. There's nothing wrong with some career exploration within your field.
Prior to her current specialization as the Caribbean Correspondent, Charles served as a general assignment reporter, an education reporter, and even worked the social affairs beat at one point. So, yes, it's good to explore different areas within your field. You just have to make sure that you're not on a quest for perpetual exploration. You truly don't want to be the person who's always kicking the tires in this and that field, but never seem to make up his or her mind about a field. One must have a degree of stability in one's career.
5. Stay awake for opportunity can come like a thief in the night.
In Charles' case, it was an earthquake in the afternoon. Up to that point, she may not have covered a catastrophe of that magnitude, but armed with her passport and her reporting skills, the Caribbean-focused reporter traveled to Haiti and received an exclusive with Haiti's then-prez Rene Preval, and gave the whole planet on-the-ground views of the happenings. Her intrepid coverage of the earthquake would later earn her Pulitzer Finalist standing.
There you have it folks…the 5 Success Principles We Can Learn from Jacqueline Charles, Reporter and Journalist, as seen by your girl Kreyolicious.
© kreyolicious


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In the Spotlight: U.S. Bank
Thursday, April 30th, 2015
Tags: In the Spotlight
U.S. Bank is actively engaged in developing, strengthening and energizing communities in which they operate. How long has U.S. Bank been in Jackson and in what ways has U.S. Bank been involved in the local community?
U.S. Bank, the fifth largest commercial bank in the United States, has been operating in Jackson, Wyoming, since 2009. Market President Phil Coosaia is a member of the board and chairman emeritus of the St. John's Hospital Foundation, a member of the Teton Science Schools Finance Committee, and chairman of the board of Jackson Hole Public Art. He is also a former board member of the Teton Science Schools. Bayless Sword, private banker, volunteers as a victims' advocate for Victim Services, and for Pet Partners at St. John's Medical Center and River Rock Assisted Living Community with her chocolate lab, Hoback. U.S. Bank has also sponsored many community organizations including Jackson Hole Ski and Snowboard Club, Community Entry Services, Teton Literacy, Rotary, Doug Coombs Foundation, Jackson Hole Snow Devils, Teton Youth and Family Services, JH Air Improvement Resources, Jackson Hole Youth Soccer, Lion's Club, Habitat for Humanity, Moose Hockey, American Cancer Society, and the Grand Teton Music Festival.
U.S. Bank has supported the Foundation's Youth Engagement Initiative since 2011. Tell us how involving youth in Grand Teton aligns with U.S. Bank's interests and mission.
We are fortunate to be a part of the Jackson community and want to give back to our community through volunteering, awarding grants to nonprofit groups, in-kind donations, and partnering with nonprofit organizations. In Jackson, U.S. Bank actively supports Grand Teton National Park Foundation's (GTNPF) Youth Engagement Initiative by acting as a liaison between them and the U.S. Bank Foundation throughout the grant application process. We assist the GTNPF so its questions and concerns are answered in a timely manner. As residents of Jackson Hole, we wholeheartedly support improvements in our local national park so Jackson Hole residents and visitors can continue to enjoy it for generations to come.
U.S. Bank is committed to protecting and conserving natural resources. Can you explain the efforts taken at U.S. Bank to create a more sustainable future for our community?
At U.S. Bank, we believe we can help protect and conserve our natural resources by: developing less resource-intensive business practices; embracing opportunities for financial products and services that incorporate features or benefits for reduced environmental impact; investing in environmentally beneficial business opportunities; and engaging and educating employees and customers. To find out more, please visit usbank.com/environment.
As an organization who is passionate about the environment and the park, what are some of U.S. Bank employees' favorite activities and places to recreate in Grand Teton?
Michael Hodges, private banker, loves going to Jackson Lake and renting a pontoon boat with friends because it's a great way to explore different areas of the park that are inaccessible by foot. Kyle Dowman, private banker, enjoys visiting Phelps Lake for its famous jumping rock. Ginny Knetzger, private banker, likes to hike, especially to Delta Lake for a picnic. Phil Coosaia, market president, spends some of his free time driving the interior loop road, getting to see all of the new improvements throughout the park. Bayless Sword, private banker, enjoys paddleboarding on String and Leigh Lakes and kayaking on the oxbow.
On behalf of the Foundation and park enthusiasts nationwide, thank you U.S. Bank for your continued support of youth programming in Grand Teton National Park!
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Clean Kit
Kit Includes:
- 1x Laundry Stain Remover- Sodium Sesquicarbonate 150g
- 1x EM Probiotic Soap
- 1x Tuff Stuff Stain Remover Soap
- 1x Dr. Bronner's Liquid Soap- 59mL [choice of ONE scent]
- 1x Drying Strap [choice of ONE pattern]
GST included where applicable.
Setting you up for success! This Clean Kit will help you conquer washing your hannahpads and keep them looking like new for longer.
These tried and tested laundry products were carefully selected by the hannahpad team so you know it's good stuff.
The products included are natural, gentle and powerful for washing and stain removal purposes.
Bonus: you'll be helping the environment by greening what's in your pants and in your laundry room.
Vegan-friendly & Cruelty free.
*Tuff Stuff Soap is made with lemon and eucalyptus essential oils. DO NOT USE if you have sensitivity to these ingredients.
**For details about each product please refer to individual product information.