JP2001299741A - Radiodiagnostic instrument and method for stabbing stab needle using the apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a radiodiagnostic instrument with which, for the work of stabbing a stab needle, the work may be easily performed without impairing its accuracy. SOLUTION: The radiodiagnostic instrument of the present invention has an input means for indicating and inputting the position of starting stab on an image for a stab needle for an image of a subject P reflected on a tomographic image and a laser marker for indicating the stab position on the subject corresponding to the position of starting stab on the image based on the results of indicating and inputting the position of starting stab on the image by the input means. Since this instrument makes it possible that the stab position at which the stab needle is to be stabbed for an actual subject is automatically indicated merely by indicating and inputting on the tomographic image, the accuracy of the stabbing work is secured.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a radiation diagnostic apparatus and a method for puncturing a puncture needle using the apparatus.

[0002]

2. Description of the Related Art Conventionally, a method has been practiced in which a tomographic image of a subject is acquired by an X-ray CT apparatus, and a puncture needle for tissue collection or the like is punctured based on the tomographic image. This is because the tomographic image of the subject appearing on the screen (particularly, the image of the target part such as the affected part) and the image of the needle material are simultaneously checked, and the actual subject is grasped while grasping the positional relationship between the two. Is a type of operation for performing a puncture operation of a puncture needle with respect to. In this case, focusing on a technique for specifying the puncture start position of the puncture needle on the surface of the body of the subject, the technique in the related art specifically includes, for example, the following means.

[0003] First, a lead member 100 or the like woven into a mesh is mounted on a subject P as shown in FIG. The mounting of the lead member 100 is performed at a location that approximately matches the location of the subject P where the puncture needle is to be punctured. Next, the subject P with the lead member 100 mounted thereon is
Irradiation with X-rays generated by an X-ray tube (not shown)
As shown in (1), an image 100 'of the lead member shown together with the tomographic image 101 of the subject P is obtained. Then, based on the tomographic image 101, if the target of the affected part W or the like to be punctured by the puncture needle is determined, the position X of the image 100 'of the lead member, which will reach the affected part W or the like, is determined (FIG. 6 (see dotted line). Finally, the image 100 of the lead member
While checking the position X defined above and the position corresponding to the position X in the lead member 100 actually mounted on the subject P, the position at which puncturing of the puncture needle should be started is confirmed. At the same time, puncture work is performed.

[0004]

However, in the above-described conventional method, the operation of comparing the lead member image 100 'with the actual lead member 100 on the image is performed by the surgeon's eye. I relied on it. Therefore, the tomographic image 10
Performing the puncturing operation while associating the position X appearing on the upper part 1 with the actual position requires some skill and was not always easy. Under such circumstances, it has been generally difficult in the past to accurately specify a puncturing start position and perform subsequent accurate puncturing.

[0005] The present invention has been made in view of the above circumstances, and a purpose thereof is to perform a puncture operation of a puncture needle, and to perform a radiological diagnosis capable of easily performing the operation without impairing its accuracy. It is to provide a device.

[0006]

The present invention employs the following means in order to solve the above problems.

In other words, the radiation diagnostic apparatus according to the first aspect reconstructs a tomographic image of the subject based on the result of the radiation emitted from the radiation source being detected by the radiation detector via the subject. In the diagnostic device, for the image of the subject projected on the tomographic image screen, input means for indicating and inputting a puncture start position on the image of the puncture needle,
Indicating means for indicating a puncture position on the subject corresponding to the puncture start position on the image based on an instruction / input result of the puncture start position on the image by the input means. is there.

The radiation diagnostic apparatus according to claim 2 is
2. The apparatus according to claim 1, wherein the indicating means is configured to be rotatable in substantially the same manner as a rotation orbit of the radiation source and the radiation detector configured to be rotatable around the subject. It is characterized by.

The radiation diagnostic apparatus according to a third aspect of the present invention is the radiographic apparatus according to the second aspect, wherein a predetermined position about the center coordinate of the tomographic image with respect to the coordinates of the puncture start position on the tomographic image is set. And a calculating means for calculating the rotation angle of the instructing means from the rotation angle.

[0010] In particular, the radiation diagnostic apparatus according to claim 4 or 5 is characterized in that, in the apparatus according to any one of claims 1 to 3, the indicating means is a laser transmitter or a projector. Furthermore, a radiation diagnostic apparatus according to claim 6 is the radiation diagnostic apparatus according to any one of claims 1 to 5, wherein the input unit is displayed on the tomographic image screen and can be arbitrarily moved on the screen. With a pointer
A predetermined input operation can be performed after the pointer is positioned at a desired point on the tomographic image screen.

According to a seventh aspect of the present invention, there is provided a radiation diagnostic apparatus, wherein a radiation source and a radiation detector are rotatably disposed around the subject so as to face each other while sandwiching the subject, and the radiation emitted from the radiation source is provided. Based on the result detected by the radiation detector via the subject, in a radiation diagnostic apparatus that reconstructs a tomographic image of the subject, for the image of the subject projected on the tomographic image screen, An input means for instructing and inputting a puncture start position on the image of the puncture needle, and configured to be rotatable around the subject in substantially the same manner as the rotational trajectory of the radiation source and the radiation detector, and puncturing the subject Indicating means for indicating the puncture position of the needle; and determining a rotation angle of the puncture start position coordinate on the tomographic image on the tomographic image from a predetermined position centered on the center coordinate of the tomographic image; Calculating means for calculating a rotation angle of the indicating means so that the indicating means indicates the puncturing position of the subject corresponding to the puncturing start position on the image from the degree. It is.

The puncture method using the radiation diagnostic apparatus according to claim 8 irradiates radiation emitted from a radiation source to a subject, and detects the radiation passing through the subject with a radiation detector. A step of obtaining a tomographic image related to the subject, and a step of instructing and inputting a puncture start position on the image of the puncture needle with respect to the image of the subject projected on the tomographic image screen by an input unit. Automatically pointing the puncture position on the subject corresponding to the puncture start position on the image based on an instruction / input result of the puncture start position on the image based on an instruction / input result. is there.

[0013]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a schematic diagram illustrating a configuration example of an X-ray CT apparatus (radiation diagnostic apparatus) according to an embodiment of the present invention. In FIG. 1, the X-ray CT apparatus includes an X-ray tube (radiation source) 1 and an X-ray detector (radiation detector) 2. These are arranged to face each other as shown in the figure, and both rotate as shown by arrows in the figure. That is, the X-ray tube 1 and the X-ray detector 2 are arranged so as to sandwich the subject P during X-ray exposure to the subject P, which is a normal state of use of the present apparatus.

The subject P is placed (rested) on a top plate 3 configured to be movable in a direction perpendicular to the plane of FIG. The top plate 3 is provided on a bed (not shown), and is movable on the bed in the body axis direction (the direction perpendicular to the paper surface of FIG. 1). The subject P is in a state where the top plate 3 exists on the other side (or the near side) in FIG. 1, that is, in a state where the X-ray tube 1 and the X-ray detector 2 are pulled out from a portion facing each other.
The subject P is set in advance on the top plate 3 and, at the time of X-ray exposure, the subject P is inserted into the near side (or the back side) in FIG. 1 together with the top plate 3 to detect the X-ray tube 1 and X-rays. It is to be arranged between the container 2.

The X-ray tube 1 is connected to an X-ray generator 1a including a high-voltage power supply and the like. Further, the X-ray detector 2 includes, for example, a large number of detection elements arranged in the CH direction (for example, 500
To 1000 ch). The X-ray emitted from the X-ray tube 1 is applied to the subject P in a fan shape as shown by the dotted line in FIG. In this case, a “slice position” for the subject P is defined as a portion where the fan shape and the subject P intersect (or a position where the fan shape “cuts” the subject P, so to speak).

X-rays that have passed through the subject P absorb more or less due to the presence or absence of an organ or the like, and as a result, an intensity distribution is generated for the transmitted X-rays. X-ray detector 2
Then, X-ray information having such an intensity distribution, that is, X-ray information including information inside the subject P is detected and acquired.

Then, as described above, the X-ray tube 1 and the X-ray detector 2 rotate around the subject P, so that the X-ray information on the slice position is obtained in multiple directions. After being changed to an electric signal in the detection element, the electric signal is sent to the image processing unit 4 via the data collection unit 8 and the preprocessing unit 9.

The data collection unit 8 is connected to the X-ray detector 2 and receives the electric signal from the X-ray detector 2.
In the data collection unit 8, the output signal, which is an electric signal, is amplified by an amplifier, and the amplified signal is serially transmitted by a multiplexer in units of a channel defined for the detection element. It is converted into a digital signal by the D converter.

Then, as shown in the block diagram of FIG. 2, the pre-processing unit 9 converts this digital signal into “raw projection data” (hereinafter, referred to as “raw projection data”) by an appropriate calibration process.
After that, the data is transmitted to the image processing unit 4 via the memory M.

The image processing section 4 reconstructs a tomographic image of the subject P based on the projection data thus received. Then, the reconstructed tomographic image is displayed on the image display unit 5 connected to the image processing unit 4.

On the other hand, the X-ray tube 1 and the X-ray detector 2 are electrically connected via a slip ring (not shown), so that the X-ray tube 1 and the X-ray detector 2 are connected.
This means that, while continuously rotating around the subject P, X-ray information in multiple directions about the subject P required for reconstruction of one tomographic image can be continuously collected. The data collection unit 8 is connected to the X-ray detector 2 via the slip ring.
Is connected to

According to such continuous rotation, for example, the projection data at the same slice position can be continuously obtained, and the tomographic image can be continuously displayed on the image display unit 5. According to the continuous display of the tomographic images, for example, it is possible to track a change in the tomographic images due to inflow or outflow of the contrast agent administered to the subject P from time to time. In particular, according to this method, when performing the puncture operation according to the present invention, it is also possible to track the progress of the puncture needle in the subject P from time to time. Such a technique is known as a so-called “dynamic scan”.

As another example, the X-ray tubes 1 and X
By moving the top plate 3 in synchronization with the continuous rotation of the line detector 2, the projection data is acquired while the slice position of the subject P is changed in a spiral shape, and the projection data of the subject P is acquired.
It is also possible to obtain a tomographic image over a wide range (in the body axis direction). Such a technique is known as a so-called “helical scan”.

In the X-ray CT apparatus according to the present embodiment, the case where the above-mentioned "dynamic scan" or the like is performed is referred to as operation or operation in the "perspective mode". On the other hand, for example, an X-ray tube 1 and an X-ray detector 2
Is rotated to the minimum (usually once) to reconstruct a tomographic image is referred to as a “photographing mode”. In this “photographing mode”, the change of the tomographic image that changes every moment as described above is not tracked, but it is possible to acquire a higher spatial resolution, that is, a denser and finer tomographic image.

The acquisition and display of the ever-changing tomographic image in the "perspective mode" are specifically performed, for example, as follows. That is, during the continuous rotation of the X-ray tube 1 and the X-ray detector 2, the projection data sequentially sent from the data acquisition unit 8 and the preprocessing unit 9 is stored in the memory M, and the memory M In this configuration, every time the projection data required to form at least one tomographic image is sequentially accumulated, the projection data is sent to the image processing unit 4 (or read from the memory M). Acquisition and display of a real-time tomographic image of the subject P
(Confirmation) can be performed.

That is, in this case, the reconstruction of the tomographic image and the display thereof are performed in the memory M by at least one.
The X-ray detector 2 is implemented as soon as projection data necessary to construct a single tomographic image is accumulated.
Since the acquisition of X-ray information, data collection and pre-processing, and its accumulation in the memory M are continuously performed in the image display unit 5, a so-called “cine image” image (tomographic image) is displayed on the image display unit 5. It will be displayed continuously.

In such a case, it goes without saying that the higher the speed of the reconstruction processing in the image processing unit 4, the better. In order to realize the high-speed processing, for example, the image processing unit 4 is configured by a plurality of processors to perform parallel processing, or the “number of views” to be reconstructed is reduced or the image is to be reconstructed. What is necessary is just to perform the processing of selecting the said detection element suitably, thinning them out, etc. Here, the “view number” is the number of projection data collected by the X-ray tube 1 and the X-ray detector 2 per rotation, and is, for example, 900 views / 1 rotation. Further, when the detection elements to be reconstructed are, for example, "thinned out" as described above, it is preferable to appropriately perform interpolation processing on the thinned out part when displaying.

A "reconstruction rate" is a ratio of the number of revolutions of the X-ray tube 1 and the X-ray detector 2 (or the time required for one revolution) to reconstruct a tomographic image.
For example, the X-ray tube 1 and the X-ray detector 2
For one rotation of, one tomographic image may be reconstructed.

Furthermore, in such a "perspective mode", the number of continuous rotations of the X-ray tube 1 and the X-ray detector 2 is set to a value, or the above-mentioned "necessary for forming at least one tomographic image". How to define the projection data is basically free in the present invention. For example, the continuous rotation speed is “50 times”, and the projection data forming one tomographic image is “all angles (0 to 360 °) relating to the subject P” or “half angle thereof (0 to 180 °). , Etc., and the acquired projection data.

However, the “continuous rotation speed” has a generally preferable upper limit because of the heat resistance of the X-ray tube 1 and the requirement of minimizing the exposure to the subject P. I do.

As shown in FIG. 2, the image display section 5 of the present embodiment is provided with an input means 6 constituted by, for example, a mouse or the like. When this mouse is used, as shown in FIG. 4 referred to below, the pointer 6a displayed on the image by the mouse is used.
Is arbitrarily moved, and a button or the like attached to the mouse is clicked on a point to be designated, so that (the coordinates of) the designated point is input. As described in detail in the following description of the operation, such an input means 6 is provided with a puncture needle provided for tissue collection, drug injection, and the like for the subject P displayed on the image display unit 5. The puncture start position A on the image is used as a means for instructing / inputting.

Further, the image display unit 5 is operated by the input means 6.
Is supplied to the arithmetic processing unit 7 as shown in FIG. This arithmetic processing unit 7
Is the puncture start position A on the image on the image by the input means 6
, The rotation angle from a predetermined position centered on the center coordinate of the tomographic image screen is calculated based on the instruction / input position.

On the other hand, like the X-ray tube 1 and the X-ray detector 2, the X-ray CT apparatus has a laser marker (pointing means) 1 constructed and arranged to rotate around the subject P.
0 (see FIG. 1) and laser marker rotating means 10a (see FIG. 1 or 2) which is a driving source for operating the laser marker 10 as described above. In the present embodiment, as shown in FIG. 1, the laser markers 10
It is in a form that three units are provided around it. Also,
More specifically, as the laser marker 10, for example, a laser oscillator with a weak output, such as various semiconductor lasers, may be used.

The laser marker 10 is used to indicate the actual puncture start position on the subject P based on the input of the puncture start position A on the image by the input means 6 (described in detail below). ), Also used for confirming a tomographic image acquisition position (slice position) by the X-ray tube 1 and the X-ray detector 2.

The operation of each component described above is controlled and controlled by a central control unit C. In particular, the central control unit C in the present embodiment is operated by the arithmetic processing unit 7. Based on the rotation angle with respect to the puncture start position A on the image, the rotation angle or the position of the laser marker 10 with respect to the subject P is calculated and determined so as to correspond to the rotation angle, and the marker 10 is actually changed via the laser marker rotation means 10a. Drive.

In this embodiment, the arithmetic processing unit 7 is integrally formed with the central control unit C as shown in FIG. 2, but the arithmetic processing unit 7 and the central control unit C It goes without saying that the configuration may be such that they are provided separately.

In the following, the operation and effect of the X-ray CT apparatus having the above configuration will be described based on an example of a work procedure according to a flowchart shown in FIG.

First, the subject P is set on the top 3 which is drawn out of a portion facing the X-ray tube 1 and the X-ray detector 2. It is arranged between the X-ray tube 1 and the X-ray detector 2. Then, as shown in step S1 in FIG. 3, the operation or operation of the present apparatus in the “perspective mode” described above is performed, and while rotating the X-ray tube 1 and the X-ray detector 2 integrally,
For example, a tomographic image 50 relating to the subject P as shown in FIG. 4 is acquired.

Next, as shown in step S2 in FIG. 3, the surgeon uses the acquired tomographic image 50 to insert a puncture needle for tissue collection, injection of a drug or the like into the affected part of the subject P. Check the image of W. Subsequently, the puncture start position A on the image of the surface of the subject P suitable for the puncture needle to reach the diseased part W is designated and input using the input means 6 (step S3 in FIG. 3).

More specifically, when the mouse is used as the input means 6, as shown in FIG. 4, the pointer 6a is moved on an image or a screen and the pointer 6a is moved.
When a is located at a desired location to be input, that is, at the point of the puncture start position A on the image, the user clicks a button with a mouse or the like to input (the coordinates of) the puncture start position A on the image. What should I do?

When the puncture start position A on the image is instructed / input, for example, as shown by a dotted line in FIG. 4, "indication display" which is the most suitable position where the puncture needle is located is automatically made. If it is configured to appear, it is convenient for designating and inputting the puncture start position A on the image. However, in this configuration, the surgeon does not necessarily have to indicate and input a portion where the dotted line in FIG. 4 penetrates the surface of the subject P on the image. As described above, such a display is merely useful as a "reference", and selection of an instruction / input position by the pointer 6a is basically free.

In connection with this, as shown in FIG. 4, a dashed line connecting the tip of the pointer 6a 'and the image of the affected part W penetrates the image of the affected part W as the pointer 6a' moves. It is also conceivable to adopt a configuration in which the user moves while standing. In such a configuration, a state of how the puncture needle penetrates according to the position of the pointer 6a (estimated penetrating state) is confirmed on the tomographic image 50, and the puncture start position on the image is confirmed. A can be determined. That is, when there is an organ or the like that the puncture needle does not want to penetrate, the puncture start position A on the image may be determined based on the dashed line display in FIG. 4 that avoids such an organ or the like. Good. However, such a display is still a guide like the above.

Further, a configuration in which the above two examples are combined may be envisaged. In this case, the dotted line display in FIG. 4 and the dashed line display in FIG. 4 are not only different from each other in the display form of the “line” as described above, but also are displayed in different colors from each other. The configuration is more convenient. And in such a form,
Matching the line display “moved and displayed as the pointer moves” with the line display “most suitable as the position where the puncture needle is (should be) located” is tentative in determining the preferred puncture start position A on the image. Will be a measure of

As described above, when the puncturing start position A on the tomographic image 50 is designated and input on the tomographic image 50, as shown in step S4 in FIG. Of the puncture start position A on the image. In FIG. 4, an angle θ between a vertical straight line (hereinafter, referred to as a perpendicular line) p passing through the center coordinate O and a straight line q passing through the center coordinate O and the puncturing start position A on the image corresponds to the rotation angle. I do. At this time, the “predetermined position” is specifically the “position where the perpendicular line p exists”. The calculation relating to the rotation angle θ is automatically performed in the calculation processing unit 7.

Next, as shown in step S5 in FIG. 3, an angle at which the laser marker 10 should rotate is obtained based on the obtained rotation angle θ. That is, it is necessary to dispose the laser marker 10 so that the laser light emitted from the laser marker 10 hits the actual part P of the subject corresponding to the puncture start position A on the image designated and input on the tomographic image 50. Find the rotation angle. The calculation of the rotation angle of the laser marker 10 is performed by the central control unit C. At this time, the central control unit C calculates the rotation angle in consideration of the current position of the laser marker 10 and other mechanical arrangement relations with peripheral devices, for example. Then, the central control unit C, based on the calculation result,
The laser marker 1 is transmitted via the laser marker rotating means 10a.
0 is actually moved / positioned (step S6 in FIG. 3).

As a result of the above processing, the puncture start position A on the image on the tomographic image 50 and the part indicated by the laser marker 10 on the actual object P are the same on the tomographic image 50 and the actual object This means that there is a positional correspondence on the P body table. Here, it goes without saying that the latter, that is, the part indicated by the laser beam on the actual subject P is indicated as the actual puncturing position. The operator starts the actual puncturing operation on the site designated in this way (see step S7 in FIG. 3). Thereafter, the operation or operation of the present apparatus in the above “perspective mode” is further continued to acquire and display a tomographic image that momentarily informs the puncture state of the puncture needle, and perform the work while confirming this. What should I do?

As described above, in the X-ray CT apparatus according to the present embodiment, the puncture on the actual subject P is automatically performed only by instructing / inputting the puncture start position A on the tomographic image 50. The part to be performed is indicated by the laser marker 10. Therefore, as in the prior art, for example, the operator visually illuminates the corresponding position between the actual mesh-shaped lead member and the image of the lead member as a guide, and the like, which requires some skill, is no longer necessary. Thus, it is possible to easily specify the actual puncture position on the subject P. In addition, accurate puncturing operation can be performed at all times.

As the input means 6, in addition to the form using a mouse or the like, the puncturing start position A on the image can be determined by using the same pointer as described above using a keyboard, or by using a keyboard to coordinate values. May be directly input numerically. The image display unit 5
A touch panel type may be applied to the apparatus, and a configuration may be adopted in which an input can be directly made on the screen using a finger pressure or an input pen. In addition, it goes without saying that various configurations can be considered as the input means in the present invention.

In the above description, three laser markers 10 are prepared and used not only as an instruction means for indicating the actual body surface puncturing position of the subject P but also for confirming a tomographic image obtaining position (slice position). However, the present invention is not particularly limited to the above-mentioned number or shared form. That is, for example, a form in which “one laser marker 10 is specially provided exclusively for the puncturing position indicating means” is naturally within the scope of the present invention.

Further, the present invention is not limited to the mode using the "laser" marker 10 as the indicating means, but may use a light projector instead. In addition, even if other than these, for example, if there is no problem such as causing a failure or pain to the subject P, basically what is used as the indicating means according to the present invention may be used. Of course it is good.

Further, the example of the arithmetic processing in the arithmetic processing unit 7 and the central control unit C has only a meaning as one of the most effective examples as far as this embodiment is concerned. That is, the present invention is not limited to the method of calculating the rotation angle between the center coordinates of the tomographic image 50 and the puncturing start position A on the image, and calculating the rotation angle of the laser marker 10 from the rotation angle. For example, the laser marker 10 as the pointing means in the above-described embodiment is configured to rotate similarly to the X-ray tube 1 and the X-ray detector 2, but may be configured to be able to move more independently. The calculation for determining the puncture start position A on the image may be performed so as to be suitable for the independent movement mode.

For example, when the laser marker 10 is installed in such a manner as to move horizontally and transversely on the subject P, the coordinate values related to the horizontal movement suitable for the movement are given by:
The puncturing start position A on the image designated and input on the tomographic image 50 may be obtained.

[0053]

As described above, according to the radiation diagnostic apparatus of the present invention and the puncturing method using the apparatus, conventionally, when determining the puncturing start position, the puncturing start position is determined by visual judgment of an operator or the like. Although this was performed by comparing the image on which the tomographic image was projected with the actual subject, etc., the configuration including the input means, the instruction means, and the like according to the present invention enabled the puncture of the desired image on the tomographic image screen. Since the actual puncturing position on the subject is instructed only by determining the starting position, the puncturing starting position is automatically specified, and of course, the puncturing operation is performed more easily and more accurately. be able to.

[Brief description of the drawings]

FIG. 1 is a schematic diagram illustrating a configuration example of an X-ray CT apparatus according to an embodiment.

FIG. 2 is a block diagram illustrating a configuration example of an X-ray CT apparatus according to the embodiment.

FIG. 3 is a flowchart illustrating an example of a work procedure relating to a puncture needle puncturing method using the X-ray CT apparatus according to the present embodiment.

FIG. 4 shows an X-ray CT apparatus shown in FIG. 1 and FIG.
FIG. 9 is an explanatory diagram showing a state in which a puncturing start position on the image is designated and input on the tomographic image screen.

FIG. 5 is an explanatory view showing an outline of a lead member to be attached to a subject in a conventional puncturing method.

FIG. 6 is an explanatory diagram illustrating a state where a puncture start position of a puncture needle is temporarily specified on a screen on which a tomographic image relating to a subject and a lead member shown in FIG. 5 are displayed in a conventional puncture method. .

[Explanation of symbols]

 Reference Signs List 1 X-ray tube (radiation source) 1a X-ray generator 2 X-ray detector (radiation detector) 3 Top plate 4 Image processing unit 5 Image display unit 6 Input unit 6a Pointer 7 Arithmetic processing unit 10 Laser marker (instruction unit) 50) tomographic image C central control means P subject A puncturing start position on image

Claims (8)

[Claims] 1. A radiation diagnostic apparatus for reconstructing a tomographic image related to a subject based on a result of radiation emitted from a radiation source being detected by a radiation detector via the subject. Input means for instructing / inputting a puncture start position on the image of the puncture needle with respect to the projected image of the subject; and puncturing on the image based on an instruction / input result of the puncture start position on the image by the input means. An instruction unit for indicating a puncture position on the subject corresponding to a start position. 2. The apparatus according to claim 1, wherein the indicating unit is configured to be rotatable in substantially the same manner as a rotation orbit of the radiation source and the radiation detector configured to be rotatable around the subject. The radiation diagnostic apparatus according to claim 1. 3. A rotation angle from a predetermined position about the center coordinates of the tomographic image with respect to the coordinates of the puncturing start position on the image on the tomographic image is determined, and the rotation angle of the pointing means is determined from the rotation angle. 3. The radiation diagnostic apparatus according to claim 2, further comprising an arithmetic unit for performing an arithmetic operation. 4. The radiation diagnostic apparatus according to claim 1, wherein said indicating means is a laser oscillator. 5. The radiation diagnostic apparatus according to claim 1, wherein said indicating means is a light projector. 6. The input means has a pointer displayed on the tomographic image screen and arbitrarily movable on the screen, and the pointer is located at a desired point on the tomographic image screen. The radiation diagnostic apparatus according to any one of claims 1 to 5, wherein a predetermined input operation can be performed above. 7. A radiation source and a radiation detector are rotatably arranged around the subject so as to face each other while sandwiching the subject, and radiation emitted from the radiation source passes through the subject via the subject. In a radiation diagnostic apparatus that reconstructs a tomographic image of the subject based on a result detected by a detector, a puncture start position on the image of a puncture needle with respect to the image of the subject projected on the tomographic image screen Input means for instructing and inputting a command; and an instruction for instructing a puncture position of a puncture needle with respect to the subject so as to be rotatable around the subject in substantially the same manner as the rotational trajectory of the radiation source and the radiation detector. Means for determining a rotation angle of the puncture start position coordinates on the image on the tomographic image from a predetermined position centered on the center coordinates of the tomographic image; A radiation diagnostic apparatus, comprising: a calculating unit that calculates a rotation angle of the instructing unit so as to indicate the puncturing position of the subject corresponding to the upper puncturing start position. 8. A step of irradiating a subject with radiation emitted from a radiation source and acquiring a tomographic image of the subject based on a result of detecting radiation passing through the subject with a radiation detector; For the image of the subject displayed on the tomographic image screen, the puncture start position on the image of the puncture needle is indicated by the input means.
Inputting, and at least a step of automatically indicating a puncture position with respect to the subject corresponding to the puncture start position on the image based on an instruction / input result of the puncture start position on the image by an instruction unit. A puncture method for a puncture needle using the radiation diagnostic apparatus described above.