Ulllted States Patent
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`Hanover et al.
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`[19]
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`[11] Patent Number:
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`[45] Date of Patent:
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`6,104,780
`9
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`Au . 15 2000
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`US006104780A
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`5:386/T53
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`......................... .. 378/41
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`5,095,501
`3/1992 Kobayashi.
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`4/1992 Asahina et al.
`5,107,528
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`5,367,554 11/1994 Kobayashi .
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`1/1995 Hf1”aW°°d-
`Siczek ................................... ..
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`Primary Examiner—Craig E. Church
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`Attorney, Agent, or Firm—Thorpe, North & Western, LLP
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`[57]
`ABSTRACT
`Amobile, bi-planar fluoroscopic imaging apparatus has first
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`and second imaging systems disposed on first and second
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`C-arms. The C-arms are preferably disposed on Wheeled
`bases allowing for movement from one place to another.
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`A1t€U1atiV€1Y,
`the. first C-arm is large flfld diSP0S€d
`0I1.a
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`Wheeled base Whlle the Seeend C.-arm IS Smaller and 0115-
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`P95“ 0“ the firs‘ Cfirm 511811 that 1‘ “‘°~S‘S~ {*C°“"°11‘°~r Sends
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`trigger pulses to the imaging systems causing the systems to
`alternate operation. Alternatively, the first and second sys-
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`tems are configured in a master/slave relationship with the
`master system sending triggering pulses to the slave. A
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`display continuously displays the images produced by the
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`imaging. systems such that an image produced by the first
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`system is displayed While the second system operated to
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`produce an image and vis versa. A storage device stored the
`images as they are produced and later delivers the images to
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`the display for viewing.
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`[54] MOBILE BI-PLANAR FLUOROSCOPIC
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`IMAGING APPARATUS
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`[75]
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`[
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`73 Assignee:
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`Inventors: Barry Hanover; Larry Anderton;
`Steven Curtis’ all of
`Lake
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`Utah
`OE
`C Medical Systems Inc., Salt Lake
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`City’ Utah
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`[21] Appl. No.: 08/977,311
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`Filed:
`NOV‘ 24, 1997
`[22]
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`Int. Cl.7 ....................................................... H05G 1/70
`[51]
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`[52] U.s. Cl.
`........................... .. 378/92; 378/101; 378/197
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`[58] Field of Search .................................. 378/41, 42, 92,
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`378/101
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`[56]
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`References Cited
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`U-S- PATENT DOCUMENTS
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`
`
`1/1969 Kok .
`3,424,901
`
`
`12/1970 Andersson.
`3,549,885
`
`
`
`11/1971 Massiot .
`3,617,749
`9/1985 Caugant .
`4,541,293
`
`
`
`11/1989 Koyama .
`4,884,293
`
`
`
`4,887,287 12/1989 Cobben .
`
`
`
`4/1990 Hahn .
`4,918,716
`
`
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`21 Claims, 5 Drawing Sheets
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`116
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`128
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`Page 1 of 12
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`Elekta Exhibit 1005
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`Page 1 of 12
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`Elekta Exhibit 1005
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`U.S. Patent
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`Aug. 15,2000
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`Sheet 1 0f5
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`6,104,780
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`Page 2 of 12
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`Page 2 of 12
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`U.S. Patent
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`Aug. 15,2000
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`Sheet 2 0f5
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`6,104,780
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`116
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`Page 3 of 12
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`U.S. Patent
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`Aug. 15,2000
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`Sheet 3 0f5
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`6,104,780
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`134_
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`Fig3
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`0:...:"‘%_I
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`186"32HF
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`Page 4 of 12
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`Page 4 of 12
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`U.S. Patent
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`Aug. 15,2000
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`Sheet 4 0f5
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`6,104,780
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`STORAGE
`DISPLAY
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`CONTROLLER
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`TRIGGER
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`1ST IMAGING SYSTEM
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`2ND IMAGING SYSTEM
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`Fig. 4
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`240
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`DISPLA Y
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`250
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`STORAGE
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`TRIGGER
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`1 ST SYSTEM
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`MASTER
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`2ND SYSTEM
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`SLAVE
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`14
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`Fig. 5
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`Page 5 of 12
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`Page 5 of 12
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`U.S. Patent
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`Aug. 15,2000
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`Sheet 5 0f5
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`6,104,780
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`Page 6 of 12
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`2
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`In addition, it is often desirable to take X-rays of a patient
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`from a number of different angles, preferably in quick
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`succession and without repositioning the C-arm. Such a
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`configuration is often referred to as bi-planar imaging and
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`allows an object to be viewed in two planes simultaneously.
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`The two X-ray beams emitted from the two X-ray tubes may
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`cross at an iso-center. Bi-planar imaging is useful for check-
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`ing a catheter position, a balloon status or performing a
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`digital subtraction run.
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`Bi-planar imaging may be accomplished in several ways.
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`One way is by using two independent imaging systems, or
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`two C-arms. U.S. Pat. No. 4,884,293 issued Nov. 28, 1989,
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`to Koyama discloses a dual
`imaging system with one
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`imaging system being mounted to the floor and the other
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`being mounted to the ceiling. One disadvantage of this
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`system is that it is permanently mounted to the floor and
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`ceiling. Thus, the system cannot be moved about a hospital
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`as needed. Another disadvantage of this system is that,
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`although the C-arms are coordinated, the imaging systems
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`operate independently of one another. Thus,
`the images
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`produced are not coordinated.
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`Another configuration for obtaining bi-planar imaging is
`slidingly nesting one C-arm in another. U.S. Pat. No. 5,515,
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`416 issued May 7, 1996, to Siczek et al. discloses a dual
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`imaging system with one C-arm being mounted to the floor
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`and the other C-arm being slidingly disposed on the first
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`C-arm. One disadvantage of this system is that the two
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`imaging systems may not be moved independently of one
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`another. Thus, the positioning of the second imaging system
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`is limited by the position of the first. Another disadvantage
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`is that it is permanently mounted to the floor. Thus, it cannot
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`be moved about a hospital. Afurther disadvantage is that the
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`two images must share a common iso-center because they
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`are nested.
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`Another configuration for obtaining bi-planar imaging is
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`disposing the imaging systems in a ring, as opposed to
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`C-arms. U.S. Pat. No. 3,549,885 issued Dec. 22, 1970, to
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`Andersson discloses a dual imaging system with both imag-
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`ing systems being mounted perpendicularly in a rotatable
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`ring. One disadvantage with this system is that the bi-planar
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`images are always disposed at a fixed, perpendicular angle
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`with respect to each other.
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`Another configuration for obtaining bi-planar imaging is
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`disposing the imaging systems on a G-arm, as opposed to
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`C-arms. U.S. Pat. No. 5,095,501 issued Mar. 10, 1992, to
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`Kobayashi discloses a dual imaging system with both imag-
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`ing systems being mounted perpendicularly in a G-shaped
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`arm. Like the ring configuration above, one disadvantage of
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`this system is that the bi-planar images are always disposed
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`at a fixed, perpendicular angle with respect to each other.
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`Furthermore, it is often desirable to view X-rays in real
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`time and to save or store X-rays taken of a patient for later
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`review. It is difficult to operate both imaging systems at the
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`same time because both systems typically operate indepen-
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`dently. In addition, if both systems operate at the same time,
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`the two X-ray beams cause a blurred picture and expose the
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`subject to excessive radiation due to scattering.
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`Therefore, it would be advantageous to develop a mobile,
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`bi-planar imaging system with independently movably
`imaging systems capable of being moved and capable of
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`various bi-planar angles. It would also be advantageous to
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`develop a bi-planar imaging system with a control system to
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`automatically operate the imaging systems by alternately
`operating each imaging system. It would also be advanta-
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`geous to develop a bi-planar imaging system capable of real
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`time display and real time storage of images.
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`6,104,780
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`1
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`MOBILE BI-PLANAR FLUOROSCOPIC
`
`
`IMAGING APPARATUS
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`BACKGROUND OF THE INVENTION
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`1. Field of the Invention
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`The present invention relates to a mobile, bi-planar x-ray
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`imaging apparatus. More particularly, the present invention
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`relates to a x-ray imaging apparatus having two imaging
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`systems each disposed on two,
`independently movable
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`C-arms with a control system in communication with both
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`imaging systems such that they alternate taking x-rays.
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`2. Prior Art
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`It is often desirable to take X-rays of a patient from a
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`number of different positions, preferably without the need
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`for frequent repositioning of the patient. It is preferable that
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`the X-ray support structure not unduly encumber the space
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`immediately surrounding the patient to enable a physician to
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`treat or otherwise attend to the patient without the need to
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`repeatedly remove and replace the X-ray equipment. Mobile
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`C-arm X-ray diagnostic equipment has been developed to
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`meet these needs and has become well known in the medical
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`art of surgical and other interventional procedures.
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`AC-arm refers generally to an elongate C-shaped member
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`terminating in opposing distal ends of the “C” shape. An
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`X-ray source and an image receptor are typically mounted at
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`or near the distal ends, respectively, of the C-arm in oppos-
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`ing orientation, with the C-arm supported in a suspended
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`position. The space within the C-shape of the arm provides
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`room for the physician to attend to the patient substantially
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`free of interference from the X-ray support structure. The
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`support structure usually rests upon wheels which enable the
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`C-arm to be wheeled from room to room, and along the
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`length of a patient while the physician operates or examines,
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`ensuring that devices such as cardiac catheters, long bone
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`nails, etc. are properly positioned during the procedure.
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`The C-arm is usually mounted so as to enable rotational
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`movement of the arm in two degrees of freedom, i.e. about
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`two perpendicular axes in a spherical motion. More
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`specifically, the C-arm is slidably mounted to the support
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`structure to enable orbiting rotational movement of the
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`C-arm about its center of curvature, thereby permitting the
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`X-ray source and the image receptor to be selectively
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`oriented vertically, horizontally, or somewhere in between.
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`The C-arm is also laterally rotatable, i.e. in a perpendicular
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`direction relative to the orbiting direction to enable selec-
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`tively adjustable positioning of the X-ray source and recep-
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`tor relative to both the width and length of the patient. The
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`spherically rotational aspects of C-arm apparatus allow the
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`physician to take X-rays of the patient at an optimal angle as
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`determined with respect to the particular anatomical condi-
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`tion being imaged.
`Designers and manufacturers of C-arm equipment are
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`faced with a number of challenges. The support structure
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`used to support and rotate a C-arm in its various suspended
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`positions must be strong enough to withstand tremendous
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`torsional,
`tensile and compressive stresses. The support
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`structure must also be heavy enough and have a large
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`enough footprint to avoid tipping over upon lateral rotation
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`of the C-arm, which causes the center of gravity to shift
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`dramatically. There have been previous attempts to provide
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`C-arm support structure to solve the problems mentioned
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`above. Exemplary of such prior art attempts is U.S. Pat. No.
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`4,955,046 (issued to Siczek et al. on Sep. 4, 1990) which
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`discloses a C-arm apparatus. A wheeled support cart
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`includes a rotatable L-arm upon which a C-arm is slidably
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`mounted. The L-arm thus provides rotational movement of
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`storing the first frame of the second system; and then
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`repeating the steps of operating the systems and displaying
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`and saving the images. The image of one system is displayed
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`continuously while the other system operates to produce an
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`image.
`These and other objects, features, advantages and alter-
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`native aspects of the present invention will become apparent
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`to those skilled in the art from a consideration of the
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`following detailed description taken in combination with the
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`accompanying drawings.
`DESCRIPTION OF THE DRAWINGS
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`3
`OBJECTS AND SUMMARY OF THE
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`INVENTION
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`It is an object of the present invention to provide a mobile
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`bi-planar imaging system that is capable of various bi-planar
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`angles.
`It is another object of the present invention to provide a
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`bi-planar imaging system with a control system for auto-
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`matically operating the imaging systems in an alternating
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`sequence.
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`It is yet another object of the present invention to provide
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`a bi-planar imaging system with real time display and real
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`time image storage.
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`These and other objects and advantages of the present
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`invention are realized in a mobile, bi-planar imaging appa-
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`ratus having first and second imaging systems disposed on
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`first and second C-arms and having a controller to cause the
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`imaging systems to alternately operate to produce a series of
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`sequential images. The first imaging system has a first X-ray
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`source and a first image receptor disposed on opposing ends
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`of a first C-shaped arm. The second imaging system likewise
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`has a second X-ray source and a second image receptor
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`disposed on opposing ends of a second C-shaped arm. The
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`first and second C-arms are preferably movably disposed on
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`wheeled bases. Thus, the apparatus may be moved about a
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`facility, such as a hospital, and moved about a patient.
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`Alternatively,
`the first C-arm is large and moveably
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`disposed on a wheeled base. The second C-arm is small and
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`movably disposed on the first C-arm such that it may nest
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`within the first C-arm.
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`Alternatively,
`the first C-arm is large and moveably
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`disposed on a first wheeled base. The second C-arm is small
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`and also moveably disposed on a second wheeled base.
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`The apparatus also has a controller coupled to the first and
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`second imaging systems to cause the imaging systems to
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`alternate operation. The imaging systems will typically be
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`positioned such that the X-ray beams produced will cross. If
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`operated at the same time, the crossing beams may cause
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`blurred images and excessive radiation exposure to the
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`patient. Therefore, the controller alternates the operation of
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`the image systems. The controller may be an external
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`controller or the imaging systems may be configured in a
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`master/slave relationship. The controller, or master, sends a
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`triggering pulse causing the imaging system to operate.
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`The apparatus also has a display for displaying the images
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`produced by the imaging system. The display may be two
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`monitors each displaying images from the first and second
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`systems, respectively, or may be a single monitor displaying
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`images from both systems simultaneously, such as a split
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`screen. The display displays the images from the two
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`systems continuously. Thus, an image produced by the first
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`system is displayed while the second system is operating.
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`Likewise, an image produced by the second system is
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`displayed while the first system operates.
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`The apparatus has a storage device coupled to the first and
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`second imaging systems for storing images as they are
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`produced. The storage device later delivers the images to the
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`display for viewing.
`The process of the present invention includes the steps of
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`providing first and second imaging systems for producing
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`images in first and second planes; operating the first system
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`to produce an image defining a first frame of the first system;
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`displaying the first frame of the first system; storing the first
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`frame of the first system; operating the second system to
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`produce an image defining a first frame of the second
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`system; displaying the first frame of the second system;
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`FIG. 1 is a side elevational view of a preferred embodi-
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`ment of the mobile, bi-planar imaging system of the present
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`invention.
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`FIG. 2 is a side elevational view of an alternative embodi-
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`ment of a mobile, bi-planar imaging system of the present
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`invention.
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`FIG. 3 is a top view of an alternative embodiment of a
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`mobile, bi-planar imaging system of the present invention.
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`FIG. 4 is a block diagram of a preferred embodiment of
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`the mobile, bi-planar imaging system of the present inven-
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`tion.
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`FIG. 5 is a block diagram of an alternative embodiment of
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`the mobile, bi-planar imaging system of the present inven-
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`tion.
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`FIG. 6 is a graph showing the operation of the bi-planar
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`imaging system of the present invention.
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`DETAILED DESCRIPTION OF THE
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`INVENTION
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`Reference will now be made to the drawings in which the
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`various elements of the present invention will be given
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`numerical designations and in which the invention will be
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`discussed so as to enable one skilled in the art to make and
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`use the invention.
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`A preferred embodiment in accordance with the present
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`invention is illustrated in FIG. 1 wherein is shown a mobile,
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`bi-planar X-ray apparatus, generally designated at 10. The
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`apparatus 10 has a first imaging system 12 and a second
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`imaging system 14. The imaging systems 12 and 14 have
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`first and second C-arms 16 and 18, respectively, terminating
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`in opposing upper and lower distal ends. The C-arms 16 and
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`18 preferably have a uniformly circular C-shape, but may
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`alternatively comprise any arc-shaped member.
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`The C-arms 16 and 18 are held in a suspended position by
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`first and second support structures or carriage, generally
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`designated at 20 and 22, respectively, which includes first
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`and second support arms 24 and 26 mounted upon first and
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`second wheeled bases 28 and 30. The support arms 24 and
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`26 provide for rotational movement of the C-arms 12 and 14
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`about an axis of lateral rotation 32 and 34.
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`The wheeled bases 28 and 30 enables transport of the
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`C-arms 12 and 14 from a first location to a second location.
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`It is often highly advantageous to be able to move X-ray
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`equipment from one room to another conveniently. The
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`mobile nature of the apparatus 10 as provided by the
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`wheeled bases 28 and 30 offers the advantage of increased
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`access by patients in many different rooms of a hospital, for
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`example.
`The support arms 24 and 26 are slidably mounted to the
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`outer circumference of the C-arms 12 and 14 and the support
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`structures 20 and 22 include structure and mechanisms
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`necessary to enable selective, sliding orbital motion of the
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`Page 8 of 12
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`C-arms about an axis of orbital rotation 36 and 38 to a
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`selected position. The axis 36 and 38 preferably coincides
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`with a center of curvature of the C-arms 12 and 14 and with
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`the axis of lateral rotation 30 and 32. It will be appreciated
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`that the sliding orbital motion causes the C-arms 12 and 14
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`to move through various points of attachment to the support
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`arms 24 and 26. The support structures 20 and 22 further
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`include mechanisms known in the art for laterally rotating
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`the support arms 24 and 26 selectable amounts about an axis
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`of lateral rotation 30 and 32 to a selected lateral position.
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`The combination of sliding orbital motion and lateral rota-
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`tion enables manipulation of the C-arms in two degrees of
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`freedom, i.e. about two perpendicular axes. This provides a
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`kind of spherical quality to the movability of the C-arms 12
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`and 14—the sliding orbital motion and lateral rotation
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`enable an X-ray source coupled to the C-arm to be moved to
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`substantially any latitude/longitude point on a lower hemi-
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`sphere of an imaginary sphere about which the C-arm is
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`moveable.
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`The imaging systems 12 and 14 include first and second
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`X-ray sources 40 and 42 and first and second image recep-
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`tors 44 and 46 as known generally in the X-ray diagnostic
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`art, mounted upon opposing locations, respectively, on the
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`C-arms 12 and 14. The first X-ray source 40 and the first
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`image receptor 44 are referred to collectively as the first
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`imaging system 12. Likewise, the second X-ray source 42
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`and the second image receptor 46 are referred to collectively
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`as the second imaging system 14. The image receptors 44
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`and 46 can be an image intensifiers or the like. The orbital
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`and laterally rotational manipulation of the C-arm enables
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`selective positioning of the imaging systems 12 and 14 with
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`respect to the width and length of a patient located within
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`interior free space 48 of the C-arms 12 and 14. The sliding
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`orbital movement of the C-arms cause the imaging systems
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`12 and 14 to move along respective arcuate movement paths.
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`It is preferred that the axis of lateral rotation 32 and 34
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`pass through the center of curvature 36 and 38 of the C-arms
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`12 and 14 in a substantially horizontal orientation, although
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`such is not required. As noted above, the C-arms 12 and 14
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`may embody any suitable arc-shaped member, although a
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`uniformly circular C-arm having a single center of curvature
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`is preferred. However, an arc-shaped member having mul-
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`tiple centers of curvature may be used with the present
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`invention, in which case it is preferred that the axis of lateral
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`rotation 32 and 34 coincide with the center of curvature of
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`the portion of the arc-shaped member to which the support
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`arms 24 and 26 is attached for a given position of the
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`arc-shaped member.
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`Although applicant has referred to the attachment of the
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`support arms 24 and 26 to the C-arms 12 and 14 as a “point
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`of attachment”, it will be appreciated that in practice, the
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`support arm is essentially attached to the C-arm over an area
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`and not a point, although a “point” may be a large area or a
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`small site. The phrase “point of attachment” as used herein
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`shall refer generally to some central point within the area of
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`attachment. The central point of attachment preferably coin-
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`cides with a geometric centroid of the area of attachment. It
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`is also to be understood that the phrase “slidably mounted”
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`as used herein shall include any suitable mounting of the
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`C-arms 12 and 14 to the support arms 24 and 26 which
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`enables an orbital, circulating-type motion of the C-arms
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`about the axis 36 and 38. The phrase “slidably mounted” is
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`thus not to be limited to literal sliding action but may include
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`stepped advancement achieved with notched structure,
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`geared advancement, or any other suitable advancement
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`means.
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`An alternative embodiment in accordance with the present
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`invention is illustrated in FIG. 2 wherein is shown a mobile,
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`6
`bi-planar X-ray apparatus, generally designated at 100. The
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`apparatus 100 has a first imaging system 112 and a second
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`imaging system 114. The imaging systems 112 and 114 have
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`first and second C-arms 116 and 118, respectively, termi-
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`nating in opposing upper and lower distal ends. The C-arms
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`116 and 118 preferably have a uniformly circular C-shape,
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`but may alternatively comprise any arc-shaped member.
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`The first C-arm 116 is held in a suspended position by a
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`support structure or carriage, generally designated at 120,
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`which includes a support arm 124 mounted upon a wheeled
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`base 128. The support arm 124 provides for rotational
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`movement of the C-arm 112 about an axis of lateral rotation
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`132. The wheeled base 128 enables transport of the C-arms
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`112 and 114 from a first location to a second location.
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`The support arm 124 is slidably mounted to the outer
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`circumference of the first C-arm 112 and the support struc-
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`ture 120 includes structure and mechanisms necessary to
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`enable selective, sliding orbital motion of the C-arm about
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`an axis of orbital rotation 136 to a selected position. The
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`support structure 120 further includes mechanisms known in
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`the art for laterally rotating the support arm 124 selectable
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`amounts about an axis of lateral rotation 132.
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`The second C-arm 118 is held in a suspended position by
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`a support structure 122, which includes a support arm 126
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`mounted on the first C-arm 116. The support arm 126
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`provides for rotational movement of the C-arm 118 about an
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`axis of lateral rotation 134. The support arm 126 is slidably
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`mounted to the outer circumference of the second C-arm 118
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`and the support structure 122 includes structure and mecha-
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`nisms necessary to enable selective, sliding orbital motion of
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`the C-arm about an axis of orbital rotation 138 to a selected
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`position. The support structure 122 further includes mecha-
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`nisms known in the art for laterally rotating the support arm
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`126 selectable amounts about an axis of lateral rotation 132.
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`As shown in FIG. 2, the C-arms 116 and 118 will often share
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`a common axis of orbital rotation 136 and 138. The axis of
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`orbital rotation, however, may be different for each C-arm.
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`The first C-arm 116 has a larger diameter than the second
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`C-arm 118. In addition, the second C-arm 118 is pivotally
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`the
`and slidably disposed on the first C-arm 116. Thus,
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`second C-arm 118 may nest within the first C-arm 116.
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`The imaging systems 112 and 114 include first and second
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`X-ray sources 140 and 142 and first and second image
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`receptors 144 and 146, mounted upon opposing locations,
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`respectively, on the C-arms 112 and 114. The orbital and
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`laterally rotational manipulation of the C-arm enables selec-
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`tive positioning of the imaging systems 112 and 114 with
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`respect to the width and length of a patient located within
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`interior free space 148 of the C-arms 116 and 118. The
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`sliding orbital movement of the C-arms cause the imaging
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`systems 112 and 114 to move along respective arcuate
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`movement paths.
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`An alternative embodiment in accordance with the present
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`invention is illustrated in FIG. 3 wherein is shown a mobile,
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`bi-planar X-ray apparatus, generally designated at 150. The
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`apparatus 150 has a fi aging system 152 and a second
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`imaging system 154. The imaging systems 152 and 154 have
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`first and second C-arms 156 and 158, respectively, termi-
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`nating in opposing upper and lower distal ends. The C-arms
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`156 and 158 preferably have a uniformly circular C-shape,
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`but may alternatively comprise any arc-shaped member.
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`The first C-arm 156 is held in a suspended position by a
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`support structure or carriage, generally designated at 160,
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`which includes a support arm 164 mounted upon a wheeled
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`base 168. The wheeled base 168 enables transport of the
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`C-arm 156 from a first location to a second location.
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`Page 9 of 12
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`6,104,780
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`7
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`The second C-arm 158 is held in a suspended position by
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`a support structure or carriage, generally designated at 170,
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`which includes a support arm 174 mounted upon a wheeled
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`base 178. The wheeled base 178 enables transport of the
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`C-arm 158 fro