RELATED APPLICATION This application claims priority to U.S. Provisional Application No.

62/236,650, filed October 2, 2015, which is incorporated herein by reference.

GOVERNMENT INTEREST

This invention was made with government support under CA134599 and CA172787 awarded by the National Institutes of Health. The government has certain rights in the invention.

BACKGROUND

Breast cancer remains a devastating disease, adversely affecting a large population of women. Chances of developing breast cancer at some time in a woman's life are approximately 1 in 8. Despite more sensitive magnetic resonance imaging (MRI) methods to detect breast lesions and new minimally invasive conservative forms of therapy, there still remains significant room for improvement in both imaging and therapy. MRI-guided high-intensity focused ultrasound (MRgHIFU) has the potential to provide completely noninvasive therapy of localized breast cancer, avoiding the discomfort and potential complications associated with general anesthesia and surgery. MRgHIFU has the potential to improve cosmetic outcomes by avoiding scarring, and possibly allow earlier administration of systemic therapies due to shorter postoperative recovery time. Indeed, a minimally invasive treatment such as MRgHIFU may be the only viable treatment recourse when radiation or chemotherapy limits have been exhausted. A unique capability of MRI is the ability to monitor and assess thermal therapy treatments in near real-time. Unfortunately, as such breast treatment systems continue to improve, patient comfort and support has remained a low priority. SUMMARY

It has been recognized that a typical support apparatus for a patient undergoing such treatments may not comfortably support the patient and position the patient to provide adequate exposure of a breast to the HIFU device. In addition, typical headrests do not provide for height and tilt adjustments for the patient. Typical headrests also do not support the weight of the patient's head during height or tilt adjustments. As a result, the patient must support their own head or a care provider must support the patient's head during such adjustments.

Furthermore, the time required for diagnostic MRI scans is typically one hour, but can be up to two hours for therapeutic intervention or research. Patient stasis is of utmost importance for accurate imaging and artifact reduction during this time. No matter the amount of thought and expense invested in scanner and coil assemblies, an uncomfortable patient will produce inferior images. Accordingly, a comfortable headrest is desirable for both supine and prone patient positions in the MRI scanner. Padding placement and adjustability are considerations for the many different body types of MRI patients. Safety and ease of use for the MRI Technologist are also important requirements. With these specifications in mind, a headrest was designed that is both adjustable and MRI-safe. The design allows the position of the patient's head to be finely adjusted without the patient first lifting his or her head off the headrest pad. The headrest bears the weight of the patient's head even during adjustment. This feature is particularly beneficial for an injured or elderly patient who finds it painful or difficult to lift her head, either forward or backward, while the Technologist makes headrest adjustments.

The present headrest can be constructed with MRI safety in mind. Thus, for example, the headrest device can be substantially free of ferrous components such as ferrous nuts and bolts. Two headrest adjustments can be provided for patient comfort: anterior/posterior movement ("up/down") and superior/inferior movement ("tilt"). While up/down motion can reduce neck fatigue, tilt motion can reduce excessive pressure on the chin or the forehead. To achieve up/down adjustability the headrest device was designed having a scissor-lift configuration (e.g., similar to a car jack). High mechanical advantage and intrinsic position-lock are features of this particular mechanism. Since scissor-lifts are used to raise and lower a heavy load while keeping the load parallel to the ground, the headrest tilt adjustment also includes a novel modification to the scissor mechanism to make the load

nonparallel to the base. A gearing system was also used to alter the scissor hinge point, allowing one scissor arm to move independently from the other. Thus, independent adjustment of up/down and tilt movement can be achieved with this headrest device.

A patient support apparatus for supporting a patient in a prone position with access to a breast can include a base, and a patient interface portion movably supported about the base to alternately position a right breast and a left breast of a patient for therapeutic treatment under the patient interface portion.

In another aspect of the disclosure, a headrest operable with a patient support apparatus can include a base, a movable cushion support member to support a head cushion, and a scissor mechanism coupled to the base and the cushion support member to move the base and the cushion support member relative to one another. The scissor mechanism can have a first scissor member and a second scissor member rotatably coupled to one another about a pivot joint that is movable relative to the first and/or second scissor members. Rotation of the first and second scissor members relative to one another about the pivot joint can facilitate translation of the base and the cushion support member relative to one another in a height adjustment. Moving the pivot joint relative to the first and/or second scissor members can facilitate rotation of the base and the cushion support member relative to one another in a tilt adjustment.

There has thus been outlined, rather broadly, the more important features of the invention so that the detailed description thereof that follows may be better understood, and so that the present contribution to the art may be better

appreciated. Other features of the present invention will become clearer from the following detailed description of the invention, taken with the accompanying drawings and claims, or may be learned by the practice of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a patient support apparatus for use with an ultrasound breast treatment device on an MRI table, in accordance with an example of the present disclosure.

FIGS. 2A-2C illustrate several patient positions using the patient support apparatus of FIG. 1.

FIG. 3 illustrates a patient support apparatus for use with an ultrasound breast treatment device on an MRI table, in accordance with another example of the present disclosure.

FIGS. 4A-4C illustrate schematic top profiles of sectioned and contoured patient interface portion configurations that may be utilized in a patient support apparatus, in accordance with several examples of the present disclosure.

FIGS. 5A and 5B illustrate a patient support apparatus for use with an ultrasound breast treatment device on an MRI table, in accordance with yet another example of the present disclosure.

FIGS. 6A and 6B illustrate a patient support apparatus for supporting a patient's upper body, in accordance with an example of the present disclosure.

FIG. 7 is a cross-sectional view of a curved track that facilitates rotating a patient interface portion of the patient support apparatus of FIGS. 6A and 6B, in accordance with an example of the present disclosure.

FIGS. 8A and 8B illustrate a patient support apparatus for supporting a patient's upper body, in accordance with another example of the present

disclosure. FIGS. 9A and 9B illustrate a patient support apparatus for supporting a patient's upper body, in accordance with yet another example of the present disclosure.

FIG. 10 illustrates a patient support apparatus for supporting a patient's upper body, in accordance with still another example of the present disclosure.

FIG. 1 1 illustrates an isolated view of a headrest of the patient support apparatus of FIG. 1.

FIG. 12 illustrates cross-sectional view of the headrest of FIG. 1 1 .

FIG. 13 illustrates a headrest in accordance with another example of the present disclosure.

FIGS. 14-16 illustrate the headrest of FIG. 13 with certain components removed for clarity in showing interior features of the headrest.

These figures are provided merely for convenience in describing specific embodiments of the invention. Alteration in dimension, materials, and the like, including substitution, elimination, or addition of components can also be made consistent with the following description and associated claims. Reference will now be made to the exemplary embodiments illustrated, and specific language will be used herein to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended.

DETAILED DESCRIPTION

Reference will now be made to certain examples, and specific language will be used herein to describe the same. Examples discussed herein set forth patient support apparatus and systems that can comfortably support a patient and position the patient to provide adequate exposure of a breast to a MRgHIFU device (e.g. described in more detail in the aforementioned related applications), although other breast treatment devices can be used. In addition, a headrest operable with a patient support apparatus is set forth that can provide for individual adjustment of the height and tilt of a head cushion to suit a patient. The headrest can support the weight of the patient's head during such adjustments, eliminating the need for the patient to support his/her own head or for a care provider to support the patient's head during such adjustments. With the general embodiments set forth above, it is noted that when describing a patient support apparatus, or the related methods, each of these descriptions are considered applicable to the other, whether or not they are explicitly discussed in the context of that embodiment. For example, in discussing the patient support apparatus per se, the system and/or method embodiments are also included in such discussions, and vice versa.

It is to be understood that this invention is not limited to the particular structures, process steps, or materials disclosed herein, but is extended to equivalents thereof as would be recognized by those ordinarily skilled in the relevant arts. It should also be understood that terminology employed herein is used for the purpose of describing particular embodiments only and is not intended to be limiting.

It must be noted that, as used in this specification and the appended claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise.

Also, it is noted that various modifications and combinations can be derived from the present disclosure and illustrations, and as such, the following figures should not be considered limiting.

In describing and claiming the present invention, the following terminology will be used in accordance with the definitions set forth below.

As used herein, the term "substantially" refers to the complete or nearly complete extent or degree of an action, characteristic, property, state, structure, item, or result. For example, an object that is "substantially" enclosed would mean that the object is either completely enclosed or nearly completely enclosed. The exact allowable degree of deviation from absolute completeness may in some cases depend on the specific context. However, generally speaking the nearness of completion will be so as to have the same overall result as if absolute and total completion were obtained. The use of "substantially" is equally applicable when used in a negative connotation to refer to the complete or near complete lack of an action, characteristic, property, state, structure, item, or result.

As used herein, "adjacent" refers to the proximity of two structures or elements. Particularly, elements that are identified as being "adjacent" may be either abutting or connected. Such elements may also be near or close to each other without necessarily contacting each other. The exact degree of proximity may in some cases depend on the specific context.

As used herein, a plurality of items, structural elements, compositional elements, and/or materials may be presented in a common list for convenience. However, these lists should be construed as though each member of the list is individually identified as a separate and unique member. Thus, no individual member of such list should be construed as a de facto equivalent of any other member of the same list solely based on their presentation in a common group without indications to the contrary.

Any steps recited in any method or process claims may be executed in any order and are not limited to the order presented in the claims unless otherwise stated. Means-plus-function or step-plus-function limitations will only be employed where for a specific claim limitation all of the following conditions are present in that limitation: a) "means for" or "step for" is expressly recited; and b) a corresponding function is expressly recited. The structure, material or acts that support the means-plus function are expressly recited in the description herein. Accordingly, the scope of the invention should be determined solely by the appended claims and their legal equivalents, rather than by the descriptions and examples given herein.

FIG. 1 illustrates a patient support apparatus 100, in accordance with an example of the present disclosure. The patient support apparatus 100 can be utilized for any suitable purpose, such as any prone procedure where access to a breast is desired. In some cases, the patient support apparatus may be used on an MRI table to allow a patient to be comfortably oriented over an ultrasound breast treatment device. Examples of particularly useful ultrasound breast treatment devices can be found in copending International Application No.

PCT/US 15/35838, June 15, 2015, and entitled, "Therapeutic Ultrasound Breast Treatment" (Attorney Docket No. 00846-U5763.PCT), although other breast treatment devices may be used such as massage tables, oncology tables, breast tomography, radiation oncology, proton beam therapy, etc. Regardless, the patient support apparatus can include a base 1 10 and a patient interface portion 120 supported about the base. The patient support apparatus 100 can also include a headrest 101 configured to provide support to the patient's head during treatment. The headrest 101 can be coupled to the base 1 10 and/or the patient support portion 120.

The patient interface portion 120 can be configured to alternately position a right breast and a left breast of a patient for treatment, such as by a therapeutic ultrasound breast treatment device (not shown), which may be disposed under the patient interface portion. In one aspect, the patient interface portion 120 can include an opening 122 to provide access to the right breast and/or the left breast under the patient interface potion, such as for a therapeutic ultrasound breast treatment device. The patient interface portion 120 can comprise an upper body portion 130 and a lower body portion 140. For treatment of a breast, the opening 122 is located in the upper body portion 130. The upper body portion 130 can be elevated higher than the lower body portion 140. The lower body portion 140 can comprise a wedge or ramp configuration to provide comfortable support for the patient, such as by minimizing stress on the lower back as the patient is lying prostrate on the patient interface portion.

In one aspect, the patient interface portion 120 can comprise a cradle configuration. In this example, the upper body portion 130 of the patient interface portion comprises a "U" cradle configuration in that it is arcuate in a transverse direction 102 and linear in a perpendicular direction 104 (i.e. curved along one axis). The curvature in the patient interface portion 120 can allow the patient to assume a rotated torso position orienting more breast tissue within the treatment device. In another aspect, one side of the patient interface portion 120 can be elevated higher than an opposite side, which can contribute to a rotated torso position exposing more breast tissue in the treatment device. For example, as shown in the figure, the left side 107a of the upper body portion 130 is elevated higher than a right side 107b of the upper body portion.

FIGS. 2A-2C illustrate several patient positions which can be used in connection with treatment using the devices described herein. Patient position can be adjusted based on target tissue location and patient specific considerations. Generally a twisted torso position provides a good balance of comfort and access to target tissue. Notably, treatments using an ultrasound breast treatment device can range from a few minutes to several hours, depending on the complexity of the treatment. Accordingly, patient support apparatuses can be used to provide comfort to a patient, as well as orient target tissue within a desired treatment volume of a receptacle of an ultrasound breast treatment device.

In one aspect, patient alignment adjustments can optionally be made by mounting the ultrasound breast treatment device on a positioning device that is movable under the patient support apparatus.

FIG. 3 illustrates a patient support apparatus 200 in accordance with another example of the present disclosure. The patient support apparatus 200 includes a base 210 and a patient interface portion 220. The patient support apparatus 220 is divided into two separate and individual components, which include separate upper and lower body portions 230, 240 of the patient interface portion 220. The patient interface portion 220 comprises forward extensions 228a, 228b extending forward from opposite sides of the patient interface portion to support the patient's head when alternately treating the right breast and the left breast via an opening 222 in the upper body portion 230. A recess 227 defined by the forward extensions 228a, 228b can accommodate an arm of the patient while using one of the forward extensions 228a, 228b to support the head. An optional handle or hand grip 226 can be coupled to the base 210 and/or the patient interface portion 220 to assist a patient in maneuvering about the patient interface portion. The handle 226 can be oriented along one or both sides of an upper body portion base 214 to aid movement on and off of the apparatus 200. Thus, in addition to curvature in the patient interface portion 220, an ergonomic handle 226 can allow the patient to assume a rotated torso position exposing more breast tissue in an ultrasound breast treatment device.

FIGS. 4A-4C illustrate schematic top profiles of several sectioned and contoured patient interface portion configurations that may be utilized in a patient support apparatus as disclosed herein. In each case, the patient interface portions 320, 420, 520 include forward extensions 328a-b, 428a-b, 528a-b, respectively, that can serve as head supports. The patient interface portions 320, 420, 520 also include openings 322, 422, 522, respectively, for access to a breast treatment device. FIG. 4A illustrates an optional headrest 301 which is independent of the patient interface portion 320 or associated base structure and can be supported by its own base support structure such as those described herein, although non- adjustable or other configurable headrests may be used.

FIGS. 5A and 5B illustrate a patient support apparatus 600 in accordance with another example of the present disclosure. FIG. 5A illustrates a side profile 650 of a patient interface portion 620 of the patient support apparatus 600, which is configured to support the patient in a comfortable position over an ultrasound breast treatment device. For example, the patient's head can be supported at location 652, the patient's torso and/or hips can bend about location 654, the patient's knees can bend at location 656, and the patient's feet can be supported at location 658. FIG. 5B shows one side of the patient interface portion 620 elevated above an opposite lateral side of the patient interface portion to allow the patient to assume a rotated torso position exposing more breast tissue in the treatment device. In addition, this example illustrates optional handles 626a, 626b that can be included in the patient support apparatus 600. Such handles 626a, 626b can be used as a grip to allow the patient to adjust position and/or used as a hand rest during treatment.

FIGS. 6A, 6B, and 8-10 illustrate several examples of patient support apparatuses. These examples are configured to support a patient's upper body and may be utilized with any suitable lower body support, such as those described herein. In general, these examples include patient interface portions that can be movably supported (e.g., rotatable) about bases to alternately position right and left breasts of patients for treatment by therapeutic ultrasound breast treatment devices disposed under the patient interface portions. In addition, one side of the patient interface portions can be elevated higher than an opposite side, which can contribute to a rotated torso position exposing more breast tissue in the treatment devices.

FIGS. 6A and 6B illustrate a patient support apparatus 700, in accordance with an example of the present disclosure. In this example, a patient interface portion 720 can be rotatable relative to a base 710 by moving along or riding on one or more curved rails 712a, 712b disposed on the base 710 in support of the patient interface portion 720. Thus, the patient interface portion 720 can be movable along the curved rail 712a, 712b to facilitate rotation of the patient interface portion relative to the base 710. This can allow the patient to assume a rotated torso position exposing more breast tissue in the treatment cylinder. A detailed cross-sectional view of the rail 712a is shown in FIG. 7.

The patient interface portion 720 can include a movable portion 721 that is movable along the curved track or rail 712a, 712b, such as by sliding on a high grade plastic curved track or rail. The movable portion 721 can define partial profiles or openings 722a, 722b for the left and right breasts, respectively, to easily switch positions for the patient and technician between left and right breast treatment. The patient support apparatus 700 can therefore facilitate simple and smooth transitions between breast treatment sides. The patient interface portion 720 can also include a removable side portion to be disposed adjacent the movable portion 721 to provide support for the patient on the side of the treated breast. The removable side portion can define a portion of an opening for the right breast or the left breast that complements the portion of the opening of the movable portion. For example, as shown in FIG. 6A, the patient interface portion 720 can include a removable side portion 723 to be disposed adjacent the movable portion 721 to provide support for the patient on the left side for treating the left breast. The removable side portion 723 can define a portion 722c of an opening for the left breast that complements the portion 722a of the opening of the movable portion 721 . A similar removable side portion can be provided for supporting the right side of the patient and treating the right breast. In this case, the removable side portion 723 for the left side can be removed and the movable portion 721 can be rotated to the left about the base 710. The removable side portion for the right side can then be placed on the base proximate the right side of the movable portion 721 . Alternatively, the movable portion can define an opening for both of the right breast and the left breast.

In one aspect, the patient interface portion 720 can be configured to provide patient comfort, such as by having a soft pad 724 of foam or other compliant cushion material that conforms to the human body. The pad 724 can be disposed on a support substrate 725, which can be configured to support the pad 724 and interface with the curved track or rail 712a, 712b, as illustrated in FIG. 7.

FIGS. 8A and 8B illustrate a patient support apparatus 800 in accordance with another example of the present disclosure. This example is similar to the patient support apparatus 700 discussed above in that a patient interface portion 820 can be rotatable relative to a base 810 by moving along or riding on one or more curved rails 812a, 812b disposed on the base 810 in support of the patient interface portion 820. The rails 812a, 812b have an elliptical (e.g., circular) cross- sectional shape. It should be recognized that curved rails in accordance with the present disclosure can have any suitable cross-sectional shape or configuration. Rollers 814a, 814b can be included to maintain the patient interface portion 820 on the rails 812a, 812b. In one aspect, the rollers 814a, 814b can facilitate movement of the patient interface portion along the rails 812a, 812b. In addition, the patient interface portion 820 is shown as a movable portion that includes a single elongated or oblong treatment opening 822 that can simultaneously accommodate both right and left breasts.

FIGS. 9A and 9B illustrate a patient support apparatus 900 in accordance with yet another example of the present disclosure. In this example, a patient interface portion 920 can be rotatable relative to a base 910 by being pivotally coupled to the base 910, such as by revolute joints 91 1 a, 91 1 b for rotation about an axis 906. A range of motion for relative rotational movement between the patient interface portion 920 and the base 910 can be limited to properly position the patient for alternately treating the right and left breasts. In one aspect, the relative position of the patient interface portion 920 and the base 910 can be locked during treatment to prevent unwanted movement of the patient interface portion 920. A motor 916 can be included to cause relative rotational movement between the patient interface portion 920 and the base 910 to position the patient for treatment. The patient interface portion 920 is illustrated with two substantially flat or planar sides or segments joined together in a "V" cradle configuration. It should be recognized that a patient interface portion in accordance with the present disclosure can be of any suitable configuration.

FIG. 10 illustrates a patient support apparatus 1000 in accordance with still another example of the present disclosure. In this example, a patient interface portion 1020 can be rotatable relative to a base 1010 by an inflatable bladder 1060 disposed between the base 1010 and the patient interface portion 1020. The inflatable bladder 1060 can be configured to elevate one side of the patient interface portion 1020 higher than an opposite side of the patient interface portion 1020 to facilitate rotation of the patient interface portion 1020 relative to the base 1010. For example, the inflatable bladder 1060 can be inflated asymmetrically, such as by incorporating a wedge configuration for the inflatable bladder. In one aspect, the inflatable bladder 1060 can include multiple inflatable chambers that, when inflated, have a wedge configuration. Alternatively, the patient interface portion 1020 can be shaped at an angle or in a wedge configuration.

FIG. 1 1 illustrates the headrest 101 isolated from the patient support apparatus 100 of FIG. 1 . Although the headrest 101 is shown associated with the patient support apparatus 100, it should be recognized that a headrest disclosed herein can be associated with any suitable patient support apparatus (e.g., supporting a torso and/or lower body of a patient) or used independent of any other patient support apparatus. A cross-section showing the interior of the headrest 101 is illustrated in FIG. 12, with a head cushion 108 omitted. The headrest 101 can include a base 170, a movable cushion support member 180 to support the head cushion 108, and a scissor mechanism 190 coupled to the base 170 and the movable cushion support member 180 to move the base 170 and the cushion support member 180 relative to one another. For example, the base 170 and the cushion support member 180 can move relative to one another in a translational degree of freedom in direction 103 for height adjustment and in a rotational degree of freedom in direction 105 for tilt adjustment.

The scissor mechanism 190 can have a first scissor member 191 and a second scissor member 192 rotatably coupled to one another about a pivot joint 193 (e.g. , about axis 193a). The pivot joint 193 can be located at a midportion of the first scissor member 191 and a midportion of the second scissor member 192. Rotation of the first and second scissor members 191 a, 192 relative to one another about the pivot joint 193 can facilitate translation of the base 170 and the cushion support member 180 relative to one another in direction 103. Thus, the scissor mechanism 190 can function similar to a typical scissor mechanism to cause the base 170 and the cushion support member 180 to translate relative to one another. For example, the first scissor member 191 can be coupled to the base 170 via a joint 171 that provides for a rotational degree of freedom about axis 171 a, and the first scissor member 191 can be coupled to the cushion support member 180 via a joint 172 that provides for a rotational degree of freedom about axis 172a and a translational degree of freedom in direction 172b. In addition, the second scissor member 192 can be coupled to the cushion support member 180 via a joint 173 that provides for a rotational degree of freedom about axis 173a, and the second scissor member 192 can be coupled to the base 170 via a joint 174 that provides for a rotational degreed of freedom about axis 174a and a translational degree of freedom in direction 174b. Thus, relative movement of the second scissor member 192 and the base 170 in direction 174b and/or relative movement of the first scissor member 191 and the cushion support member in direction 172b can cause relative translational movement of the base 170 and the cushion support member 180 in the direction 103.

In one aspect, the pivot joint 193 can be movable relative to the first scissor member 191 and/or the second scissor member 192 to facilitate rotation of the base 170 and the cushion support member 180 relative to one another in direction 105. For example, as illustrated in FIG. 12, the pivot joint 193 is movable relative to the first scissor member 191 in a direction 193b transverse to a longitudinal axis 195 of the first scissor member 191 . By moving the pivot joint 193 relative to the first scissor member 191 in direction 193b, the first scissor member 191 can move in direction 172b relative to the cushion support member 180, causing the cushion support member 180 to rotate about the axes 173a and 172a, resulting in tilting or rotation of the cushion support member 180 relative to the base 170 in direction 105. Thus, by altering or changing the scissor pivot 193 location, the headrest 101 can provide both height and tilt adjustment of the head cushion 108 for a patient. An optional crank handle (not shown) can be oriented at joint 172 in order to facilitate adjustment.

A translation mechanism 194 (e.g., comprising a gear, a chain, a belt, etc.) can be included to cause relative movement of the second scissor member 192 and the base 170 in direction 174b and/or cause relative movement of the first scissor member 191 and the cushion support member in direction 172b. The translation mechanism 194 can be operated by a user via a hand crank 197. A translation mechanism 196 (e.g. , comprising a gear, a chain, a belt, etc.) can be included to cause movement of the pivot joint in direction 193b. The translation mechanism 196 can be operated by a user via a hand crank 198. Alternatively, one or both of the translation mechanisms 194, 196 can be operated by a motor. Operation of the translation mechanisms 194, 196 can facilitate individual adjustment of the height and tilt of the head cushion 108 to suit a patient. In one aspect, the headrest 101 can support the weight of the patient's head during such adjustments, eliminating the need for the patient to support his/her own head or for a care provider to support the patient's head during such adjustments. This can be due to friction in the translation mechanisms 194, 196 and/or to a locking mechanism (not shown).

FIG. 13 illustrates a headrest 201 in accordance with another example of the present disclosure. Certain components have been removed and/or illustrated in cross-section to show the interior of the headrest 201 in FIGS. 14-16. The headrest 201 is similar to the headrest 101 in many respects. For example, the headrest 201 can include a base 270, a movable cushion support member 280 to support a head cushion 208, and a scissor mechanism 290, 290' coupled to the base 270 and the movable cushion support member 280 to move the base 270 and the cushion support member 280 relative to one another (e.g., in a translational degree of freedom for height adjustment and in a rotational degree of freedom for tilt adjustment).

In this case, hand cranks and associated drive mechanisms for causing height and/or tilt adjustment are omitted and instead the headrest 201 includes features that allow a user to manipulate and lock the headrest in a desired position/orientation. For example, as shown in FIG. 14, the headrest 201 can include a height locking mechanism 281 configured to lock a height adjustment of the cushion support member 280 relative to the base 270. Such height adjustment occurs by rotating first and second scissor members 291 , 292 of the scissor mechanism 290 relative to one another, and by rotating first and second scissor members 291 ', 292' of the scissor mechanism 290' relative to one another, as described above. Such mechanisms can be manually operated or moved via a connected actuator and motor assembly. With particular attention to FIG. 14, the height locking mechanism 281 can include a height locking scissor member 282 that, along with the first scissor member 291 , can be coupled to the base 270 via a joint 271 that provides for a rotational degree of freedom about axis 271 a. Like the first scissor member 291 , the height locking scissor member 282 can be rotatably coupled to the second scissor member 292 about a pivot joint 293 having an axis of rotation 293a. The height locking mechanism 281 can also include a height locking arm 283 that, along with the second scissor member 292, can be coupled to the base 270 via a joint 274 that provides for a rotational degreed of freedom about an axis 274a and a translational degree of freedom in direction 274b. Thus, the height locking arm 283 is movable with the second scissor member 292 at the coupling to the base 271 . The height locking scissor member 282 and the height locking arm 283 can be configured to be releasably coupled or locked in relative position to one another. Any suitable mechanism can be utilized to releasably lock the height locking scissor member 282 and the height locking arm 283 to one another, such as a clamp mechanism that operates using a threaded fastener and/or a cam mechanism. For example, the height locking arm 283 can include an opening 284, such as a channel or a slot. The height locking mechanism 281 can also include a user interface 285 (e.g., a knob, lever, etc.) coupled to a rod or shaft that extends through the opening 284 and that is coupled to the height locking scissor member 282. Rotation of the user interface 285 can rotate a threaded fastener and/or a cam, thereby causing the height locking arm 283 to be clamped between the user interface 285 and the height locking scissor member 282. In addition, the headrest 201 can include a tilt locking mechanism 286 configured to lock a tilt adjustment of the cushion support member 280 relative to the base 270. Such tilt adjustment occurs by moving pivot joints 293, 293' relative to the first scissor members 291 , 291 ' of the respective scissor mechanisms 290, 290', and by moving the first scissor members 291 , 291 ' relative to the cushion support member 280, as described above. The tilt locking mechanism 286 can include a tilt locking scissor member 287 that, along with the first scissor member 291 ' of the scissor mechanism 290', can be coupled to the base 270 via a joint (hidden from view) that provides for a rotational degree of freedom about the axis 271 a. Like the first scissor member 291 ', the tilt locking scissor member 281 can be rotatably coupled to the second scissor member 292' of the scissor mechanism 290' about the pivot joint 293' that rotates about the axis 293a. The tilt locking scissor member 287 and the first scissor member 291 ' can be configured to be releasably coupled or locked in relative position to one another. Any suitable mechanism can be utilized to releasably lock the tilt locking scissor member 287 and the first scissor member 291 ' to one another, such as a clamp mechanism that operates using a threaded fastener and/or a cam mechanism. For example, the first scissor member 291 ' can include an opening 288, such as a channel or a slot. The tilt locking mechanism 286 can also include a user interface 289 (e.g., a knob, lever, etc.) coupled to a rod or shaft that extends through the opening 288 and that is coupled to the tilt locking scissor member 287. Rotation of the user interface 289 can rotate a threaded fastener and/or a cam, thereby causing the first scissor member 291 ' to be clamped between the user interface 289 and the tilt locking scissor member 287.

In one aspect, the scissor mechanisms 290, 290' can be mechanically coupled to one another to facilitate uniform movement of the scissor mechanisms when making height and/or tilt adjustments. For example, a translation mechanism 294 (see cutaway in FIG. 15) associated with the joint 274 can be mechanically coupled to a translation mechanism (hidden from view) associated with a joint 274' to facilitate uniform movement of the second scissor arms 292, 292' relative to the base 270 when making height adjustments. In some embodiments, the headrest 201 can include a handle 277 to facilitate transport of the headrest. A shaft (hidden from view) can extend through the handle 277 to mechanically couple the translation mechanism 294 associated with the joint 274 and the translation mechanism associated with the joint 274'. Similarly, a translation mechanism (hidden from view) associated with the pivot joint 293' can be mechanically coupled (e.g., by a shaft 276) to a translation mechanism 296 associated with the pivot joint 293 to facilitate uniform movement of the scissor arms 291 , 291 ' when making tilt adjustments.

A lever or handle 275 can be coupled to the translation mechanism (e.g. , a gear, a chain, a belt, etc.) associated with the pivot joint 293' to facilitate manual user control of the movement of the pivot joint 293' in making tilt adjustments. A user can grasp or manipulate any suitable portion of the headrest 201 in order to make a height and/or a tilt adjustment, such as the cushion support member 280, the height locking arm 283, and/or the user interface 285. Thus, a user can manually control height and/or tilt adjustments by causing the translation

mechanisms to move without the use of hand cranks and associated drive train components.

With particular attention to FIG. 16, the headrest 201 can include a mirror

299 located beneath the movable cushion support member 280 that can enable a user, such as a health care professional, to observe the eyes and position of a patient using the headrest. The mirror 299 can be rotatably adjustable in direction 264 to provide good visibility of the patient's eyes along a clear line of site once height and/or tilt adjustments have been made. For example, as shown in FIG. 16, the mirror 299 can be rotatably coupled to the base 270 at 279. A mirror adjustment arm 261 can be coupled to the mirror 299. The mirror adjustment arm 261 can have openings 262a, 262b (e.g., channels or slots), which can receive pins 263a, 263b, respectively, that are coupled to the base 270. Thus, movement of the mirror adjustment arm 261 relative to the pins 263a, 263b can cause rotation of the mirror 299 about the pivotal coupling 279 in the direction 264. A user interface 265 can facilitate tilting adjustment of the mirror 299 by a user. The user interface 265 can be configured generally as a rod or shaft. The user interface 265 can be coupled to the mirror adjustment arm 261 at one end and slidably coupled to the base 270 at an opposite end via a bushing or bearing 266. Thus, movement of the user interface 265 in direction 267 can cause tilting of the mirror 299 in direction 264.

Furthermore, the headrest can be constructed with MRI safety in mind.

Thus, in one example, the headrest device can be substantially free of ferrous components such as ferrous nuts and bolts. As described previously, at least two headrest adjustments can be provided for patient comfort, including

anterior/posterior movement ("up/down") and superior/inferior movement ("tilt"). While up/down motion can reduce neck fatigue, tilt motion can reduce excessive pressure on the chin or the forehead. To achieve up/down adjustability the headrest device was designed having a scissor-lift configuration (i.e., a car jack). High mechanical advantage and intrinsic position-lock are features of this particular mechanism. Since scissor-lifts are used to raise and lower a heavy load while keeping the load parallel to the ground, the headrest tilt adjustment also includes a novel modification to the scissor mechanism to make the load nonparallel to the base. A gearing system was also used to alter the scissor hinge point, allowing one scissor arm to move independently from the other. Thus, independent adjustment of up/down and tilt movement can be achieved with this headrest device. It is to be understood that the above-referenced embodiments are illustrative of the application for the principles of the present invention. Numerous modifications and alternative arrangements can be devised without departing from the spirit and scope of the present invention while the present invention has been shown in the drawings and described above in connection with the exemplary embodiment(s) of the invention. It will be apparent to those of ordinary skill in the art that numerous modifications can be made without departing from the principles and concepts of the invention as set forth in the claims.