JP2010194100A - Diagnostic imaging supporting device and method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a diagnostic imaging supporting device and method for quantitatively presenting lung disease or signs thereof based on image data including the lung field of a subject. <P>SOLUTION: The diagnostic imaging supporting device having a display part for displaying a three-dimensional image including a lung region of the subject includes: an input part for inputting the position of at least one thickened part of the subject on the three-dimensional image displayed in the display part; a sectional image generating part for generating a sectional image including the thickened part at the position inputted by the input part; and an evaluation part for evaluating the extent of the thickened part along the chest wall on the sectional image. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an image diagnosis support apparatus for enabling quantitative understanding of lung diseases and signs based on image data including a lung field of a subject. The present invention relates to a technique for efficiently quantifying the degree of disease associated with asbestos accumulation from a three-dimensional image.

  In image diagnosis, it is known that accumulation of asbestos inhaled into a subject appears as an abnormality in the thickness of the lung wall or chest wall. Patent Document 1 discloses, for example, a technique for performing image processing in order to more suitably detect asbestos in a chest X-ray image.

  In addition, asbestos lesions can be diagnosed by a tomogram obtained by an X-ray CT apparatus for plaque and pleural thickening, which are precursors to mesothelioma. Doctors visually diagnose the accumulation of asbestos in the lungs and diseases by measuring abnormalities in the wall thickness of the lung wall and chest wall on the image.

JP 2007-244738 JP 2003-91735 A

  However, doctors using only slice images and only partial wall thickness measurements can only partially identify asbestos-containing diseases, and how much the patient is exposed to asbestos, asbestosis, It is difficult to diagnose whether you have dermatoma.

  An object of the present invention is to provide an image-aided diagnosis for efficiently presenting lung diseases and signs thereof efficiently based on image data including a lung field of a subject, particularly a three-dimensional image. To provide an apparatus.

The above-described object is an image-assisted diagnosis apparatus including a display unit that displays a three-dimensional image including a lung region of a subject.
A cross-sectional image for generating a tomographic image including an input unit for inputting a position of at least one thickened portion of the subject on the three-dimensional image displayed on the display unit, and a thickened portion at the position input by the input unit This is achieved by an image-aided diagnosis apparatus comprising a generation unit and an evaluation unit that evaluates the spread of the thickened portion along the lung wall on the tomographic image.

Further, (1) in an image-assisted diagnosis method comprising a step of displaying a three-dimensional image including a lung region of a subject,
(2) inputting the position of at least one thickened portion of the subject on the three-dimensional image displayed in step (1);
(3) generating a tomographic image including a thickened portion at the position input in step (2);
(4) This is achieved by an image-aided diagnosis method comprising a step of evaluating a spread along the lung wall of the thickened portion on the tomographic image.

  According to the present invention, it is possible to provide an image diagnosis support apparatus and method for enabling quantitative presentation of lung diseases and signs based on image data including a lung field of a subject.

1 is a hardware configuration diagram showing a configuration example of an entire diagnostic imaging support apparatus according to Embodiment 1 of the present invention. 3 is a display example of a three-dimensional image used in the first embodiment. FIG. 3 is a diagram showing a flow of processing in the first embodiment. FIG. 3 is a diagram for obtaining a tomographic image including a thickened portion in the first embodiment. 3 is a display example of a three-dimensional image used in the second embodiment. FIG. 6 is a diagram showing a flow of processing in the second embodiment. FIG. 6 is a diagram for obtaining a tomographic image including a thickened portion in the second embodiment.

  The best mode for carrying out the present invention will be described below with reference to the accompanying drawings. Note that components having the same function are denoted by the same reference symbols throughout the drawings for describing the embodiment of the invention, and the repetitive description thereof is omitted.

  FIG. 1 is a hardware configuration diagram illustrating a configuration example of the entire diagnostic imaging support apparatus according to the first embodiment of the present invention.

  Specifically, the diagnostic imaging support apparatus 10 is an image acquisition unit that acquires, for example, a tomographic image or a three-dimensional image including a lung region of a subject (a three-dimensional image such as a volume rendering described in Patent Document 2). It is connected to a certain medical image photographing device 2 via a network such as LAN3. The medical imaging apparatus 2 has been described as an X-ray CT apparatus as an example, but may be any apparatus that can capture an image of a subject (preferably a plurality of slice images) such as an MRI apparatus or an ultrasonic imaging apparatus.

  The diagnostic imaging support apparatus 10 is a central processing unit (CPU) 11 that is a control unit that mainly controls the operation of each component, and a main memory 12 that stores a control program for the apparatus and serves as a work area when the program is executed. Operating system (OS), peripheral device drive, magnetic disk 13 that stores various application software including programs for processing such as chest wall thickness measurement, and display data Based on the data from the display memory 14 as a display memory 14 that temporarily stores data and a display unit that displays, for example, a tomographic image or a three-dimensional image including the lung field region of the subject acquired by the image acquisition unit A monitor 15 such as a CRT monitor or a liquid crystal monitor for displaying images, a mouse 17 as an input unit for inputting the position of at least one thickened portion of the subject on the three-dimensional image displayed on the display unit, The controller 16 that detects the state of the mouse 17 and outputs signals such as the position of the mouse pointer on the monitor 15 and the state of the mouse 17 to the CPU 11, the keyboard 18, and the above components are connected. It consists of bus 19.

  The CPU 11 reads the program from the magnetic disk 13, loads it into the main memory 12, and executes it.

  In FIG. 1, the magnetic disk 13 is connected as a storage device other than the main memory 12, but an optical disk drive or the like may be connected in addition thereto.

  Next, FIG. 2 is a display example of a three-dimensional image used in the first embodiment, and is displayed on the monitor 15 in FIG. In FIG. 2, 21 is an outer frame of the monitor screen. 22 is a three-dimensional lung image displayed in the center of the monitor screen. The subject's chest is divided into two planes along the subject's body axis, and one of them is operated from the inside of the lung. It is displayed so that a person can observe it. However, in the three-dimensional image of the lung shown by 22, 23 is the spine, 24 is the rib, and 25a and 25b are thickened portions generated along the lung wall. In FIG. 2, 26 also displays a two-dimensional image in an arbitrary direction with respect to the body axis direction (Z direction) of the subject, or 2 in a direction perpendicular to the body axis direction, as will be described later. This is a selection button for selecting whether to display a dimensional image. Reference numerals 27a to 27d are designated points for the operator to observe the inner wall of the lung on a three-dimensional image and input a place where the thickened portion is present.

  Next, the processing flow of the first embodiment will be described with reference to FIG.

(Step 31)
The operator divides the three-dimensional image (the subject's chest (lung field) shown in FIG. 2 into a plane along the body axis by the control by the central processing unit (CPU) 11 according to the present embodiment. Display one of them) and display it on the monitor. That is, the three-dimensional image here is a three-dimensional image in which one of the three-dimensional images of the lung field region of the subject cut along a plane along the body axis is viewed from the inside of the subject.

(Step 32)
On the screen displayed in step 31, the operator observes the inner wall of the lung and designates the position of the thickened portion by specifying the desired location of the thickened portion with designated points 27a and 27b, or 27c and 27d. input. However, the location specified in one thickened portion may be one or two locations. In the case of two places, the right end and the left end on the monitor screen of the thickened portion may be used. Further, the positions of the designated points 27a and 27b or 27c and 27d on the three-dimensional coordinates are such that the designated point designated on the two-dimensional monitor is a predetermined plane (for example, 27a and 27b or 27c and 27d). It is calculated on the assumption that it is located on a plane perpendicular to the screen. For example, in FIG. 4 (a), the specified point 27a is determined as (xa, ya, za), and the specified point 27b is determined as (xb, yb, zb).

(Step 33)
The tomographic image generation unit generates a tomographic image of a desired cross section including the thickened portion from the three-dimensional coordinates of the specified point of the desired portion of the thickened portion specified in step 32 as shown in FIG. 4 (b). However, if the location specified in step 32 is one location, a tomographic image in the direction perpendicular to the body axis direction (Z-axis direction) is generated, and if the location specified in step 32 is two locations, 2 A planar tomographic image including points is generated. A selection button 26 is used to select whether to generate a tomographic image in a direction perpendicular to the body axis direction (Z-axis direction) or a plane tomographic image in an arbitrary direction including two points.

(Step 34)
From the tomogram generated in step 33, a lung field region is extracted and displayed as indicated by 45 in FIG. 4 (b). Specifically, a region having a low CT value may be extracted to extract a region, or a known technique such as region glowing may be used.

(Step 35)
The position of the center of gravity of the lung field extracted in step 34 on the tomographic image is calculated for each of the left and right lung fields. Specifically, the left and right lung fields may be regarded as a rigid body, and the center of gravity position may be obtained by a physical method. The center of gravity of each of the left and right is O ₁ and O ₂ , but FIG. 4B shows only O ₂ on the right side of the screen.

(Step 36)
Further, the two-dimensional positions of both ends on the tomographic image of the thickened portion designated in step 32 are calculated. As for the positions of both ends, there are two places specified in step 32,
If the positions of both ends of the thickened portion are on the two extended lines designated in step 32, the process proceeds to step 42 with the points where the extended lines and the chest wall intersect as the ends of the thickened portion. If there are not two places designated in step 32, or if there are two places, but not both ends of the thickened portion, the positions of both ends of the thickened portion are extracted using step 37 to step 41 described below.

(Step 37)
The CPU 11 extracts the chest wall from the tomographic image by the chest wall extraction unit incorporated inside. As shown in FIG. 4 (b), this chest wall is extracted with the position just inside the ribs 24 as the chest wall. For example, the CPU 11 may extract a rib having a high CT value and connect it by spline interpolation to form a chest wall. Or CPU11 should just determine a threshold value so that the inner side of a rib may be extracted as a chest wall, and should just extract a chest wall by threshold value processing.

(Step 38)
The CPU 11 determines whether or not there is a fat region (reference numeral 46 in FIG. 4) that comes in close contact with the chest wall within the measurement range. The fat region is placed inside the chest wall, sandwiched between plaques and muscles to be diagnosed, and is displayed on an image with a low CT value. Therefore, if the tissue is arranged in order of the CT wall from the lung wall, the region where the CT value is high, the region where the CT value is low, and the region where the CT value is high. (Fat part) is determined. If the fat area does not exist, the CPU 11 proceeds to step 39, and if the fat area exists, the CPU 11 proceeds to step 40.

(Step 39)
At each position along the chest wall, the CPU 11 extracts the thickened portion to the inside by the thickened portion extracting unit, and measures the thickness of the thickened portion along the outer periphery of the chest wall by the thickened portion thickness measuring unit. In this case, the thickness is measured in a direction perpendicular to the chest wall.

(Step 40)
The CPU 11 measures the thickness of the thickened portion excluding the fat region. Specifically, at a position where there is fat, the thickness of the thickened part is measured by the thickened part thickness measuring unit from the innermost position of the fat region. Here, the thickness is also measured perpendicular to the chest wall. Specifically, the CPU 11 subtracts the length of the fat region from the length from the chest wall to the innermost end of the thickened portion to obtain the thickness of the thickened portion. Alternatively, the CPU 11 has the same thickness from the innermost end of the fat region to the innermost end of the thickened portion as the thickness of the thickened portion.

(Step 41)
CPU11 distinguishes the region where the thickened part is thicker than the preset thickness (for example, 5mm, but can be changed by GUI) and other regions, and determines both ends along the lung wall as point A and point B .

(Step 42)
The angle from which O ₁ and O ₂ (the side with the thickened portion) are considered as the center and the point A and the point B is estimated is obtained as θ. Based on the angle θ, the operator evaluates the degree of spread along the lung wall of the thickened portion specified in step 32 by an evaluation unit that evaluates the spread of the thickened portion along the chest wall. That is, here, the spread of the thickened portion along the chest wall is represented by an angle at which both ends of the thickened portion are viewed with respect to the center position on either the left or right side of the lung region.

(Step 43)
It is determined whether or not all thickening parts have been broken. If completed, the process proceeds to step 44. If not completed, the process proceeds to step 33, and the next thickened portion designated in step 32 is started to be broken.

(Step 44)
A list showing the thickened portion specified in step 32 and the spread along the chest wall at an angle from the center of the lung field is displayed on the monitor.

  According to the above embodiment, the operator can know the position in the lung field of the thickened portion in the lung field based on the three-dimensional image of the subject, and further along the chest wall in the axial section of the thickened portion. You can quantitatively know the spread. In particular, according to the present embodiment, since the position of the thickened portion is designated based on the three-dimensional image, it is not necessary to fold all the multi-slice images obtained by the X-ray CT image, and the fold time is shortened. Can be planned.

  Next, FIG. 5 is a display example of a three-dimensional image used in the second embodiment, and is displayed on the monitor 15 in FIG. In FIG. 5, reference numeral 47 denotes an outer frame of the monitor screen. 48 is a three-dimensional lung image displayed in the center of the monitor screen, and is displayed so that an operator can observe the chest of the subject from the outside of the lung without dividing it as shown in Example 1. It is a thing. However, in the three-dimensional lung image indicated by 48, 49 is a lung field, and 50a and 50b are thickened portions generated along the lung wall. In FIG. 5, 51 also displays a two-dimensional image in an arbitrary direction with respect to the body axis direction (Z direction) of the subject, or 2 in the direction perpendicular to the body axis direction, as will be described later. This is a selection button for selecting whether to display a dimensional image. Reference numerals 52a to 52d are designated points for the operator to observe the inner wall of the lung on the three-dimensional image and input a place where the thickened portion is present.

  Next, the processing flow of the second embodiment will be described with reference to FIG.

(Step 53)
The operator creates the three-dimensional image (the subject's chest (lung field) displayed from the outside of the subject) shown in FIG. 5 under the control of the central processing unit (CPU) 11 according to the present embodiment. Displayed on the monitor. That is, the three-dimensional image here is a three-dimensional image obtained by viewing the lung field region of the subject from the outside of the subject.

(Step 54)
On the screen displayed in step 53, the operator observes the outer wall of the lung and inputs the position of the thickened portion through the input unit by designating the desired location of the thickened portion with designated points 52a to 52d. However, the location specified in one thickened portion may be one or two locations. In the case of two places, the right end and the left end on the monitor screen of the thickened portion may be used. Further, the positions of the designated points 52a to 52d on the three-dimensional coordinates are assumed to be, for example, that the designated point designated on the two-dimensional monitor is located on a predetermined plane (a plane perpendicular to the body axis). And calculate. For example, in FIG. 7 (a), the specified point 52a is determined as (xa, ya, za), and the specified point 52b is determined as (xb, yb, zb).

(Step 55)
From the three-dimensional coordinates of the specified point of the desired portion of the thickened portion specified in step 54, the position input by the input unit as shown in FIG. 7 (b) is a tomographic image of the desired cross section including the thickened portion. It is generated by a tomographic image generating unit that generates a tomographic image including a thickened part of the image. However, if the location specified in step 54 is one location, a tomographic image in a direction perpendicular to the body axis direction (Z-axis direction) is generated, and if the location specified in step 54 is two locations, 2 A planar tomographic image including points is generated. A selection button 51 is used to input whether to generate a tomographic image in a direction perpendicular to the body axis direction (Z-axis direction) or a plane tomographic image in an arbitrary direction including two points.

(Step 56)
From the tomogram generated in step 55, a lung field region is extracted and displayed as 66 in FIG. 7 (b). Specifically, a region having a low CT value may be extracted to extract a region, or a known technique such as region glowing may be used.

(Step 57)
The position of the center of gravity of the lung field extracted in step 56 on the tomographic image is calculated for each of the left and right lung fields. Specifically, the left and right lung fields may be regarded as a rigid body, and the center of gravity position may be obtained by a physical method. Although the center of gravity of each of the left and right is O ₁ and O ₂ , only O ₁ on the left side of the screen is shown in FIG. 7 (b).

(Step 58)
Further, the two-dimensional positions of both ends on the tomographic image of the thickened portion designated in step 54 are calculated. As for the positions of both ends, there are two places specified in step 54,
If the positions of both ends of the thickened portion are on the two extended lines specified in step 54, the process proceeds to step 54 with the points where the extended lines and the chest wall intersect as the ends of the thickened portion. If the location specified in step 54 is not two locations, or if there are two locations, but not both ends of the thickened portion, both ends of the thickened portion are extracted using steps 59 to 63 described below.

(Step 59)
The CPU 11 extracts the chest wall from the tomographic image by the chest wall extraction unit incorporated inside. As shown in FIG. 7 (b), this chest wall is extracted with the position just inside the ribs 24 as the chest wall. For example, the CPU 11 may extract a rib having a high CT value and connect it by spline interpolation to form a chest wall. Or CPU11 should just determine a threshold value so that the inner side of a rib may be extracted as a chest wall, and should just extract a chest wall by threshold value processing.

(Step 60)
The CPU 11 determines whether or not there is a fat region (reference numeral 67 in FIG. 7) that comes in close contact with the chest wall within the measurement range. The fat region is placed inside the chest wall, is sandwiched between plaques and muscles to be diagnosed for lesion determination, and is displayed on an image with a low CT value. Therefore, if the tissue is arranged in order of the CT wall from the lung wall, the region where the CT value is high, the region where the CT value is low, and the region where the CT value is high. (Fat part) is determined. If the fat area does not exist, the CPU 11 proceeds to step 61, and if the fat area exists, proceeds to step 62.

(Step 61)
At each position along the chest wall, the CPU 11 extracts the thickened portion to the inside by the thickened portion extracting unit, and measures the thickness of the thickened portion over the outer circumference of the chest wall by the thickened portion thickness measuring unit. In this case, the thickness is measured in a direction perpendicular to the chest wall.

(Step 62)
The CPU 11 measures the thickness of the thickened portion excluding the fat region. Specifically, at a position where there is fat, the thickness of the thickened part is measured by the thickened part thickness measuring unit from the innermost position of the fat region. Here, the thickness is also measured perpendicular to the chest wall. The CPU 11 subtracts the length of the fat portion from the length from the chest wall to the innermost end of the thickened portion to obtain the thickness of the thickened portion. Alternatively, the CPU 11 has the same thickness from the innermost end of the fat region to the innermost end of the thickened portion as the thickness of the thickened portion.

(Step 63)
CPU11 distinguishes the region where the thickened part is thicker than the preset thickness (for example, 5mm, but can be changed by GUI) and other regions, and determines both ends along the lung wall as point A and point B .

(Step 64)
The angle from which O ₁ and O ₂ (the side with the thickened portion) are considered as the center and the point A and the point B is estimated is obtained as θ. Based on the angle θ, the operator evaluates the degree of spread along the lung wall of the thickened portion specified in step 54 by an evaluation unit that evaluates the spread of the thickened portion along the chest wall. That is, here, the spread of the thickened portion along the chest wall is represented by an angle at which both ends of the thickened portion are viewed with respect to the center position on either the left or right side of the lung region.

(Step 65)
It is determined whether or not all thickening parts have been broken. If finished, go to step 66, and if not finished, go to step 55, and start breaking for the next thickened portion specified in step 54.

(Step 66)
The thickened portion designated in step 54 and the spread along the chest wall are displayed on the monitor in a list form, which is expressed by the angle from the center of the lung field.

  According to the above embodiment, the operator can know the position in the lung field of the thickened portion in the lung field based on the three-dimensional image of the subject, and further along the chest wall in the axial section of the thickened portion. You can quantitatively know the spread. In particular, according to the present embodiment, since the thickened portion is specified based on the three-dimensional image, it is not necessary to fold all the multi-slice images obtained by the X-ray CT image, and the fold time can be shortened. .

  The preferred embodiments of the medical image display apparatus according to the present invention have been described above, but the present invention is not limited to such examples. It will be apparent to those skilled in the art that various changes or modifications can be conceived within the scope of the technical idea disclosed in the present application, and these are naturally within the technical scope of the present invention. Understood.

  10 diagnostic imaging support device, 11 CPU, 12 main memory, 13 magnetic disk, 14 display memory, 15 monitor, 16 mouse controller, 17 mouse, 18 keyboard, 19 common bus

Claims (12)

In an image-aided diagnosis apparatus including a display unit that displays a three-dimensional image including a lung region of a subject,
A cross-sectional image for generating a cross-sectional image including an input unit for inputting the position of at least one thickened portion of the subject on the three-dimensional image displayed on the display unit, and a thickened portion at the position input by the input unit An image-assisted diagnosis apparatus comprising: a generation unit; and an evaluation unit that evaluates a spread along the chest wall of the thickened portion on the cross-sectional image.   The image-aided diagnosis apparatus according to claim 1, wherein the spread evaluated by the evaluation unit is represented by an angle at which both ends of the thickened portion are viewed with respect to a center position on either the left or right side of the lung region.   The image-assisted diagnosis apparatus according to claim 1, wherein the position input by the input unit is one place, and the tomographic image is a tomographic image on a plane perpendicular to a body axis of the tomographic image.   The image-assisted diagnosis apparatus according to claim 1, wherein there are two positions input by the input unit, and the tomographic image is a tomographic image on a plane passing through the two positions.   The image-assisted diagnosis apparatus according to claim 1, wherein the evaluation unit includes a chest wall extraction unit that extracts a chest wall from the tomographic image, and a thickening unit extraction unit that extracts a thickening portion associated with the chest wall. .   6. The image-assisted diagnosis apparatus according to claim 5, wherein the chest wall extraction unit extracts the chest wall by connecting positions inside the ribs by spline interpolation on the slice.   The evaluation unit measures the thickness of the thickened portion extracted by the thickened portion extracting unit from the chest wall to the inside by the thickened portion thickness measuring unit, and the length along the chest wall of a portion where the thickness is thicker than a predetermined value. The image assisted diagnosis apparatus according to claim 1, wherein the spread is evaluated.   The evaluation means measures the thickness of the thickened portion extracted by the thickened portion extracting means from the chest wall to the inside, and centered on either the left or right central position of the lung region where the thickness is greater than a predetermined value. The image assisted diagnosis apparatus according to claim 2, wherein the spread is expressed by an estimated angle of view.   The three-dimensional image is a three-dimensional image in which one of the three-dimensional images of the lung field region of the subject cut along a plane along the body axis is viewed from the inside of the subject. The image-assisted diagnosis apparatus described.   The image-assisted diagnosis apparatus according to claim 1, wherein the three-dimensional image is a three-dimensional image obtained by viewing a lung field region of the subject from the outside of the subject. (1) In an image-assisted diagnosis method comprising a step of displaying a three-dimensional image including a lung region of a subject,
(2) inputting the position of at least one thickened portion of the subject on the three-dimensional image displayed in step (1);
(3) generating a cross-sectional image including a thickened portion at the position input in step (2);
(4) An image-assisted diagnosis method comprising a step of evaluating a spread along the lung wall of the thickened portion on the cross-sectional image.   The image-aided diagnosis method, wherein the spread evaluated in the step (4) is represented by an angle at which both ends of the thickened portion are viewed with respect to a center position on either the left or right side of the lung region.

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