US3365575A - Breast x-ray apparatus with means to accurately position the body of a patient - Google Patents

Description

Jan. 23, 1968 P. STRAX BREAST X--RAY APPARATUS WITH APPARATUS WITH MEANS TO ACCURATEIJY POSITION THE BODY OF A PATIENT Filed 1380.. 10, 1964 v v MIMI] ENTOR, PHILIP STRAX ATTORNEYS United States Patent s ass s75 annasr X-RAY APPARATUS wrrn MEANS To lg cgaa'rmv restricts Tun noun or A i NT Philip Strax, Great Neck, N.Y., assignor to Charles &

ABSTRACT UP THE DESCLOSURE There is disclosed in the instant application a mobile breast X-ray unit adapted to expedite the taking of X- ray pictures of breasts and therefore equipment which makes it possible to take mass X-rays, as for example, in an X-ray clinic.

Furthermore, the invention disclosed provides for the mounting of all equipment on a single mobile dolly with the tube screen and camera on a common vertical axis and with a means for varying the height of a stand on which the patient stands so that the breast support member located on the same vertical axis properly supports a breast, whereupon the camera may be moved into position to gently press the breast between a radiation shiel ing cone on the camera and the support surface.

This invention relates to medical X-ray equipment, and more particularly to an apparatus and method for X-ray examination to detect breast cancer and related types of breast growths and defects.

Breast cancer is today the most prevalent form of cancer afilicting Women in the United States. It has long been known that when detected early in its development, it can be more successfully treated. X-ray examination is a principal method for detecting breast cancer in its early stages.

The conventional breast-X-ray examination technique is to first position the patient in vertical and prone positions on an examination table. The X-ray sensitive film pack is located beneath the patients breast. The X-ray tube used to sensitize the film is movably positioned above the patient and table. After the patient is positioned on the table with her breast above the film, the X-ray tube is then moved into position and located to focus the X-ray image of the patients breasts on the film. Proper positioning of the X-ray tube and patient relative to the table and film requires time and skill. It may also cause considerable inconvenience to the patient. The energies used involve large generators and heavy stationary equipment. For these reasons conventional techniques do not lend themselves to mass breast X-ray work of a large number of patients on an expedited examination schedule as, for example, in a mobile breast X-ray clinic.

Because of the importance of early detection in breast cancer treatment, doctors and public health authorities have sought a mass X-ray technique whereby large numbers of Women could be examined quickly, simply and inexpensively. The apparatus and method disclosed herein meet these requirements.

In my invention an X-ray tube, fluorescent screen, camera and patient platform are all mounted on a single ice mobile dolly. The tube, screen and camera are disposed along a vertical axis. The patient simply walks up to and steps onto the platform and positions alternately each breast between the tube and the screen and camera below the screen. The X-ray tube is then energize-d to emit X- rays through the patients breast and onto the fluorescent screen. The screen is thus sensitized to produce an image of the breast. This image is simultaneously photographed on film located in the camera below the screen.

The platform on which the patient stands is vertically adjustable to permit raising or lowering of the patient with respect to the screen and tube to correctly position the patients breasts relative to the screen and tube. The tube assembly may be lowered to gently compress the patients breast between a radiation shielding cone on the tube and a table directly above the screen so as to flatten the patients breast above the screen. This shields the patient from stray radiation and equalizes breast density for better film detail.

Because the patient simply walks up and stands in position for the X-ray examination, and due to the fact that the tube need only be lowered slightly to compress the patients breast for each picture, the machine embodied in this invention is particularly well suited for mass X-ray use.

It is therefore a principal object of my invention to provide a means and method for quickly and conveniently X-raying patients for breast cancer on a mass patient basis.

It is another object of my invention to provide a simple and convenient method and means for positioning a patient relative to a vertically disposed X-ray tube, screen and camera arrangement for breast X-ray examination.

It is another object of my invention to provide a method and means for positioning a patient and the patients breast for X-ray examination, wherein the pav tients breast is gently compressed so as to spread the breast for an optimum field of examination.

It is another object of my invention to provide a method and means for producing X-rays of the breast with a minimum of radiation dose. This is possible because of the efliciency of the screen fluorescence by the X-ray beam and the efiiciency of the camera in reproducing this image on photographic film.

Other objects of my invention not at this time more particularly enumerated will be apparent from the accompanying description and drawing, which is a side elevation in partial section of an apparatus embodying my invention.

Referring to the drawing, my apparatus is preferably mounted on mobile dolly it which rolls about on the floor on wheels 12.

X-ray tube 14 is pivotally mounted to pinion 15 about a horizontal axis in Y-shaped yoke 16. Base 17 of yoke 16 is journalled into mounting block 18 to permit free rotation about a horizontal axis perpendicular the axis of pinion 15. Mounting block 13 is movably attached to upright 24) which is rigidly gussete-d to platform 10. Block 13 is tracked in guide 19 which is mounted on upright 2t} and may be raised or lowered relative to upright 28 by a variety of conventional drives, such as an electric motor driven worm and rack arrangement. This mounting arrangement permits the necessary freedom of movement required for initially setting up and aiming tube 14 and compressing the p-atients breast as explained below.

Also mounted to upright is control panel 21 having control knobs 22 which control the output and elevation of tube 14.

Tie specific design of X-ray tube 1- 2 and control panel '21 used in my apparatus is not a part of my invention. Any of a variety of conventional tubes and panels might be used. Tube 14 should be adapted for projecting of the X-ray beam along a substantially vertical axis. It should also be relatively light, since this contributes to the stability of the complete apparatus.

Attached directly to the bottom of tube 14 is radiation shielding cone 22, which prevents the scatter of X-rays to other parts of the patients body while the X-ray examination is made. Cone 22 is made of suitable shielcing material such as lead or copper and preferably shaped with a flattened surface 23 on the side facing the patient being examined and a fiat 24- at the base of the cone. Flat 23 is shaped so as to permit the patient to rest her upper chest against it while fiat 24 gently presses down on the patients breast during the examination.

Another principal element of my apparatus is the fluorescent screen and camera unit generally designated 30, which is mounted and rigidly positioned on platform 10 by stanchions 31.

The top exterior of unit is breast support table 32 on which the patients breast is positioned for the X-ray examination. Table 32 is made of thin material which does not impede the passage of radiation from X-ray tube 14. While a flat surface is shown, any suitable breast positioning surface may be used for table 32. As pointed out above, tube 14- and cone 22 are lowered during the examination to gently compress the patients breast between fiat 24 and table 32. This spreads the breast, enlarges the examination field for each breast and provides more even density.

Directly below table 32 is an X-ray sensitive fluorescent screen 33 which fiuoresces when sensitized by X-rays emitted by tube 14. By this means a luminous image of the breast being examined is produced on screen 33.

This image on screen 33 is photographed by camera 34 which is positioned directly below screen 33. Camera 34 focuses the image and positions the film used for each X-ray picture in a conventional way. At one side of camera 34 is roll-film magazine 36 which holds fresh film, and on the opposite side is roll-film magazine 38 which holds the exposed film. The film travels from magazine 36 to and through housing 46 below and in line with th screen 33, table 32 and tube 14, at which location the film is exposed. The exposed film then returns to magazine 38.

Screen 33 and camera 34 may be conventional X-ray equipment. Preferably camera 34 is adapted for mass breast survey work, that is, one which can hold a long unperforated X-ray roll-film having room for four to five hundred exposures. Magazines 36 and 38 are preferably mounted on the outside of camera 34 in a way to facilitate convenient removal and reloading. Similarly, screen 33 is preferably one which is adapted to mass breast survey examination, having the capability of producing sharp images on a large number, repetitive basis with a minimum of upkeep.

As pointed out above, tube 14, table 32, screen 33 and camera 34 are positioned at a substantially fixed distance relative to each other when properly set for each examination. Tube 14 may be raised or lowered and adjusted slightly by pivoting about pinion 15 to align the axis of radiation emanating from tube 14, but this does not appreciably vary its distance from table 32, screen 33 and camera 34. These distances are selected to obtain sharp focus of the X-ray image of the patients breast when it is positioned on table 32. Thus, once these distances are calculated, tube 34, table 32 and camera 34 remain in a fixed position and need not be adjusted for each examination. Means to compensate for the difference in height of the patients being examined are provided, as will now be explained.

Directly adjacent camera housing 30 and mounted on platform It? is pedestal 42, on which the patient stands while the X-ray picture is being taken. Pedestal 42 is provided with a power supply (not shown) which raises or lowers pedestal 42 to the desired height. It is not material Whether this power supply is hydraulic, pneumatic or electrical, so long as it can raise or lower pedestal 42 through a full traverse of about one foot. In this way, the patients position may be adjusted relative to X-ray tube 14, screen 33 and camera 34 to permit the patient to conveniently position her breasts on table 32.

In operation the patient approaches and stands on pedestal 42. The operator then raises or lowers pedestal 42 by varying the appropriate control on panel 21 to locate the patient so that she may conveniently position each breast on table 32. The desired power output is then set by the operator by adjusting the appropriate control on panel 21. The patient then rests one breast on table 32 with her upper chest against flat surface 23 of cone 22. The operator then lowers tube 14 and cone 22 until the breast to be examined is gently compressed between flat 24 of cone 22 and table 32. The operator then energizes tube 14 to make the exposure, and camera 34 photographs the image on screen 33 and automatically advances the exposed portion of the film to magazine 38, and fresh film is automatically loaded into position for the next exposure from magazine 36. The operation may then be repeated for the next exposure. Care must be taken to positively identify each exposure with each patient. There are many ways well known in the radiography art for doing this.

While this description has dealt primarily with one specific embodiment of my invention, it should be understood that modifications and improvements which would be apparent to those skilled in the art can be made to the apparatus disclosed herein and still be within the scope of my invention. For example, conventional fluoroscopic examination might be substituted for the disclosed X-ray camera arrangement. Furthermore, the X-ray tube, tluorescent screen and camera of my apparatus might be mounted to a wall rather than on an upright post connected to a dolly, and the movable patients platform positioned in front of that Wall. Alternatively, these units may be mounted coaxially on axes other than vertical. Therefore, while this description has concentrated on a preferred embodiment of the invention, it will be unde stood that the disclosed invention is not to be limited by the foregoing description but solely by the claims granted.

What is claimed is:

1. A breast X-ray device comprising in combination (a) an X-ray source and housing for such source,

(b) an X-ray cone connected to and depending downwardly from the X-ray housing,

(0) an X-ray transparent lateral breast support surface spaced below the X-ray cone,

(i) said cone having at its lower end an X-ray transparent lateral surface which conforms generally to the shape of said breast support surface,

(d) photofiuorographic camera means breast support surface,

(e) patient lift stand adjacent to the above claimed elements for positioning a patient and thereby a patients breast to the height of the breast support surface, and

(f) means for mounting the above claimed elements,

comprising (i) means for aligning and maintaining alignment of the X-ray source, X-ray cone and lower surface, breast support surface and phototluorographic camera means on a substantially vertical axis,

below said (ii) means for varying the distance of the X-ray source housing and cone above the breast support surface along said axis an amount sufiicient to gently compress and spread a patients breast between the cones lower lateral surface and the breast support surface in the close position of such varying means and to release the breast from all restraint in the open position of such distance varying means, and

(iii) means for modifying the height of said patient lift stand relative to said breast support surface.

2. A breast X-ray device as claimed in claim 1 wherein said mounting means further comprises a mobile dolly on which all of said elements are mounted.

3. A breast X-ray device as claimed in claim 1 wherein said mounting means comprises a vertical upright having vertical guide means on which the X-ray source and cone are movably mounted, said breast support surface and photofluorographic camera means being positioned relative to said upright so as to be aligned with the X-ray source and cone through the full traverse of such source and cone on the guide means.

References Cited UNITED STATES PATENTS 1,074,120 9/1913 Hutton 250-58 2,953,683 9/1960 Guntert 250-65 3,150,260 9/1964 Smith 25050 OTHER REFERENCES RALPH G. NILSON, Examiner.

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