Specialized tabletops for medical imaging

Abstract

A system of interchangeable specialized tabletops for medical imaging, such as tomographic imaging, is constructed with features that permit improvements in patient imaging and treatment specific to a particular anatomy of interest. Such features include cutaways, holes and removable structures, ramps and integrated devices that allow access to tissues for intervention or imaging under multiple imaging modalities. Such features are also integrated, which aids in the positioning and immobilization of patient tissues and devices relative to those tissues. Structures and methods optimally use multiple tabletops with minimal space requirements, and of show medical imaging uses involving the storage of multiple tabletops.

1 . A tabletop for use in medical procedures comprising a support surface for a patient and engaging elements on 
 a) at least two lateral sides or    b) at the bottom of the tabletop under the support surface    for engaging guiding components that comprise    i) part of an imager,    ii) part of a preparatory station, or    iii) patient transporter,    the tabletop comprising at least one structure selected from the group consisting of:    a supporting structure other than a single extended flat surface that supports specific portions of the human anatomy;    apertures in the structural support surface that allows for body parts to extend through the holes to provide access to those body parts during medical examination or procedures;    apertures in the structural support surface that allows interventional or imaging devices to extend through the holes to gain access to body parts during medical examination or procedures;    structural elements on the tabletop that support specific portions of the human anatomy and are adjustable to fit or accommodate patients or body parts of patients of different dimensions;    adjustable body support elements that are removable, adjustable and replaceable manually;    structural elements such as bridging elements connecting sections of a tabletop, that are removable in order to gain access to patient tissues;    structure that supports, guides and secures interventional medical devices while allowing those devices to be used for medical procedures;    optical or electromagnetic position trackers having a reference component fixed to the tabletop which measures the position of a movable tracked component attached to an interventional or imaging device;    cooling means integral with the tabletop;    pneumatic or hydraulic system for motivating the tabletop or components on the,    fluid drainage paths and connector to a fluid receptor on that fluid path;    controlled pressure bladders for assisting in the comfortable positioning of patients;    pressure controls for the bladders so that they may be inflated or deflated to alter points of support for patients to relieve local stress on the patient;    actuators for attachments to limbs or joints of patients to assist in the manipulation of the limbs or joints during medical procedures or imaging procedures;    remote control system for the actuators;    engaging system on the sides and/or bottom of the tabletop to engage support elements on a transporter, and    latching or locking elements to secure the tabletop to structures on which the tabletop is placed.    
     
     
         2 . The tabletop of  claim 1  wherein the tabletop comprises an elongated patient support surface and an opening in the patient support surface allowing body parts to pass into the opening when a patient's front lies on the patient support surface, the tabletop having engaging guide supports along at least one of a) both lateral longitudinal edges of the tabletop and b) along the bottom of the tabletop, the engaging guide supports allowing the tabletop to be slidably engaged with guides on a system selected from the group consisting of a patient transporter, an imager and a preparatory station.  
     
     
         3 . The tabletop of  claim 2  wherein the opening is positioned on a location of the support surface such that a patient lying on his/her front against the support plane will have body parts exposed and accessible through the opening, the opening comprising at least one of a fixed-size aperture in the support plane, an adjustable aperture in the support plane, or an opening in the support surface that extends to the edge of the support surface.  
     
     
         4 . The tabletop of  claim 3  further comprising at least one elevated arch element on the support surface which can support specific body portions of a patient.  
     
     
         5 . The tabletop of  claim 4  wherein the arch support element is adjustable in at least one dimension of height and width.  
     
     
         6 . The tabletop of  claim 4  wherein the arch support element can be removed or securely positioned by snap engagement or manually controlled clamp engagement.  
     
     
         7 . The tabletop of  claim 2  wherein inflatable/deflatable bladders are present on the support plane to assist in positioning or comforting a patient.  
     
     
         8 . The table top of  claim 2  wherein adjustable limb support elements are secured to the tabletop to support at least one limb of a patient while positioned on the tabletop.  
     
     
         9 . The tabletop of  claim 5  wherein the tabletop has structural elements that engage with receptor structural elements in an MR imager to stabilize the tabletop within the MR imager.  
     
     
         10 . The tabletop of  claim 2  comprising rails, slides or clamping arms suitable for the fixturing of magnetic resonance responsive coils in positions adjustable in at least two degrees of freedom such that the coils may be held motionless in positions close to tissues of the patient, the coils extending above or below the tabletop's surface,  
     
     
         11 . A method of performing an imaging or interventional medical procedure on a patient comprising positioning a patient on the tabletop of  claim 1  and imaging the patient or performing an interventional medical procedure on the patient.  
     
     
         12 . The method of  claim 11  wherein a portion of the patient is allowed to extend downwardly through an aperture in the tabletop and an interventional procedure is performed on the patient through the aperture,  
     
     
         13 . The method of  claim 12  wherein the interventional procedure is performed after the patient is imaged with an imaging technology selected from the group consisting of X-ray imaging, PET, magnetic resonance imaging, ultrasound imaging and computerized x-ray tomography.  
     
     
         14 . The method of  claim 13  wherein remote controlled interventional apparatus is used to perform the interventional procedure, and materials in the interventional apparatus do not interfere with the imaging technology to a degree that prevents functional viewing of the interventional procedure.  
     
     
         15 . The method of  claim 12  wherein the tabletop with a patient thereon is positioned within an imager, images are taken of a region of the patient associated with the portion of the patient, the tabletop with patient is removed from the imager, and an interventional technique is performed on the region of the patient that was imaged.  
     
     
         16 . A method of providing at least one tabletop according to  claim 1  for association with a device that supports the tabletop, the method comprising: 
 a) providing a prep station with at least two tabletops carried on the prep station in slidably removable position,    b) sliding one of the at least two tabletops onto another support element having fitted support for receiving the one of the at least two tabletops and    c) securing the one of the at least two tabletops onto the another support element.    
     
     
         17 . A system for use in medical procedures comprising an imager, a transporter, a tabletop, and a preparatory station comprising: 
 a preparatory station comprising a moveable assembly having multiple ports, each port for acceptance and removal of a tabletop by allowing the tabletop to slide along a guiding system into and out of a port,    the transporter and the imager having a tabletop guiding system that allows a tabletop compatible with the preparatory station to be accepted and guided by the guiding systems on the transporter and imager.    
     
     
         18 . A method of performing a medical procedure on a tabletop according to  claim 1  wherein there is an aperture in the tabletop that extends from a relatively central position on the support surface completely through to an edge of the tabletop, and the procedure comprises prostate biopsy, where a man lies on his back on the support surface, the man's legs slightly splayed and the man's thighs lying directly above the aperture, wherein a physician uses the aperture to gain access to reach between the man's thighs and then inserting a needle into the perineum.  
     
     
         19 . A tabletop for use in medical procedures comprising a support surface for a patient and engaging elements on 
 a) at least two lateral sides or    b) at the bottom of the tabletop under the support surface    for engaging guiding components that comprise    i) part of an imager,    ii) part of a preparatory station, or    iii) patient transporter,    the tabletop comprising:    a supporting element elevated above a support surface for a trunk of a patient, the elevated element supporting specific portions of the human anatomy selected from arms, legs and upper torso, and are adjustable to fit or accommodate patients or body parts of patients of different dimensions;    apertures in the structural support surface that allows for body parts to extend through the holes to provide access to those body parts during medical examination or procedures or apertures in the structural support surface that allows interventional or imaging devices to extend through the holes to gain access to body parts during medical examination or procedures; and    latching or locking elements to secure the tabletop to structures on which the tabletop is placed.    
     
     
         20 . The tabletop of  claim 19  wherein the supporting element elevated above a support surface comprises a support for thighs or hips that may be pivoted to expose areas of a patient to permit access for invasive procedures.