JP2011234864A - X-ray diagnostic apparatus and control program for generating support data - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an X-ray diagnostic apparatus capable of generating support data effective for insertion of a guide wire.SOLUTION: A 3D image data generating section 73 generates 3D contrast image data of blood vessels and guide wire image data on the basis of projection data collected by X-ray imaging of a blood vessel region in which a contrast medium is administered and a guide wire is inserted. A CTO image data generating section 74 generates 3D CTO image data of a chronic total occlusion region (CTO region) on the basis of volume data of the blood vessel region previously collected by the X-ray CT apparatus. Meanwhile, an entry route estimating section 76 generates entry route data indicating the optimum entry route of the guide wire in the CTO region by accumulative operation of voxel values. A data compositing section 77 generates support data by compositing the image data of the guide wire, the contrast image data of the blood vessels, the CTO image data and the data of the entry route.

Description

  The present invention relates to an X-ray diagnostic apparatus and a control program for generating support data, and in particular, can obtain support data effective for blood vessel diagnosis and treatment by superimposing guide wire image data on blood vessel region image data. The present invention relates to a possible X-ray diagnostic apparatus and a control program for generating support data.

  Medical image diagnosis using an X-ray diagnostic apparatus, an MRI apparatus, or an X-ray CT apparatus has made rapid progress with the development of computer technology, and is indispensable in today's medical care. In particular, the X-ray imaging diagnosis of the circulatory region, which has been progressing with the development of the catheter technique, is intended for the entire arteries and veins including the cardiovascular system. Usually, the X-ray of the vascular region to which a contrast medium has been administered. This is performed by observing fluoroscopic image data collected by photographing.

  An X-ray diagnostic apparatus for the purpose of diagnosing a circulatory region mounts an X-ray generation unit and an X-ray detection unit (hereinafter collectively referred to as an imaging system), a holding unit that holds the imaging system, and a patient. X from the optimum direction with respect to the diagnosis / treatment target region (blood vessel region) of the patient by moving the above-described top plate and the C-arm provided on the holding portion in a desired direction. Line photography is possible.

  In IVR (interventional radiology) in which various intravascular devices such as catheters are inserted into blood vessels under observation of fluoroscopic image data collected by such an X-ray diagnostic apparatus, the operation of the intravascular devices is performed. The perspective road map method has been applied in order to perform this safely and easily. In the fluoroscopy roadmap method, first, first image data (reference image data) in which a blood vessel region is highlighted by performing X-ray imaging from a predetermined direction on a diagnosis / treatment target site of a patient to which a contrast medium is administered. ), And then the second image data (fluoroscopic image data) in which the intravascular device is highlighted by performing X-ray imaging from the same imaging direction on the diagnosis / treatment target region where no contrast agent is present. Collect in near real time. Then, by combining the obtained fluoroscopic image data and reference image data, road map data (support data) effective for insertion of the intravascular device is generated (for example, see Patent Document 1).

JP 2000-342565 A

  When inserting an intravascular device into a blood vessel under observation of fluoroscopic image data, the safety and efficiency in inserting the intravascular device are greatly improved by inserting the guide wire prior to the insertion of the intravascular device. Can do. However, when a guide wire is inserted into a blood vessel region (hereinafter referred to as a CTO (chronic total occlusion) region) that is substantially completely occluded using the road map data described in Patent Document 1 described above, a contrast agent is used. Is not flowed into the CTO region, it is impossible to obtain information on the CTO region in the perspective image data.

  On the other hand, it is possible to obtain detailed information in the CTO region in the image data collected by the X-ray CT apparatus or MRI apparatus, but considering the operability of the apparatus and the real-time property of the displayed road map data. Therefore, it is difficult to apply to normal IVR.

  The present invention has been made in view of the above-described conventional problems, and an object of the present invention is to provide a guide wire with respect to the occlusion portion prior to insertion of an intravascular device used for diagnosis and treatment of the occluded blood vessel region. X-ray diagnosis that enables generation of assistance data effective for insertion of a guide wire by combining guide wire image data with a guide wire highlighted, contrasted blood vessel image data with a blood vessel highlighted, etc. An apparatus and a control program for generating support data are provided.

  In order to solve the above-described problem, the X-ray diagnostic apparatus according to the first aspect of the present invention provides an occlusion region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast agent is administered. A wire image data generating means for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data in the X diagnostic apparatus for generating support data for supporting the insertion of the guide wire; Based on the projection data, contrast blood vessel image data generating means for generating contrast blood vessel image data indicating a blood vessel to which the contrast agent has been administered, and the support wire data by synthesizing the guide wire image data and the contrast blood vessel image data. A data synthesizing unit for generating and a display unit for displaying the support data are provided.

  In addition, the X-ray diagnostic apparatus of the present invention according to claim 2 supports the insertion of a guide wire into an occlusion region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast medium has been administered. In the X diagnostic apparatus for generating support data for performing, based on the projection data, wire image data generation means for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data, Contrast-enhanced blood vessel image data generating means for generating contrast-enhanced blood vessel image data indicating a blood vessel to which the contrast agent has been administered, and CTO image data in the CTO region based on volume data collected in advance by another medical image diagnostic apparatus CTO image data generating means, the guide wire image data, the contrasted blood vessel image data, and the CTO image And data combining means for generating the assist data data synthesized and is characterized in that a display means for displaying the assistance data.

  On the other hand, the support data generation control program of the present invention according to claim 12 inserts a guide wire into an occlusion region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast agent has been administered. A wire image data generation function for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data for the X diagnostic apparatus that generates support data for supporting the projection data; and the projection data A contrast blood vessel image data generating function for generating contrast blood vessel image data indicating a blood vessel to which the contrast agent has been administered, and data for generating the support data by combining the guide wire image data and the contrast blood vessel image data A synthesis function and a display function for displaying the support data are executed.

  According to a thirteenth aspect of the present invention, there is provided a control data generation control program for inserting a guide wire into a blockage region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast medium has been administered. A wire image data generation function for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data for the X diagnostic apparatus that generates support data for supporting the projection data; and the projection data A contrast blood vessel image data generation function for generating contrast blood vessel image data indicating a blood vessel to which the contrast agent has been administered based on the CTO image in the CTO region based on volume data collected in advance by another medical image diagnostic apparatus A CTO image data generation function for generating data, the guide wire image data, and the contrast blood vessel image data And it is characterized by performing the data combining function to generate the assistance data by combining the CTO image data, a display function of displaying the assistance data.

  According to the present invention, when a guide wire is inserted into an occluded portion prior to insertion of an intravascular device used for diagnosis or treatment of a blocked blood vessel region, the guide wire image data or blood vessels in which the guide wire is highlighted are displayed. By combining the highlighted contrast blood vessel image data and the like, it is possible to generate support data effective for guidewire insertion. For this reason, it becomes possible to perform the diagnosis and treatment for the occluded portion safely and efficiently, and the burden on patients and doctors can be reduced.

1 is a block diagram showing the overall configuration of an X-ray diagnostic apparatus according to an embodiment of the present invention. The block diagram which shows the specific structure of the X-ray imaging part with which the X-ray diagnostic apparatus of the Example is provided. The block diagram which shows the specific structure of the assistance data production | generation part with which the X-ray diagnostic apparatus of the Example is provided. The figure which shows typically the guide wire image data and the contrast blood vessel image data which are produced | generated by the three-dimensional image data production | generation part of the Example. The figure for demonstrating the CTO area | region which the CTO area | region detection part of the Example detects based on the continuity of contrast blood vessel image data. The figure for demonstrating the optimal approach path | route of the guide wire set by the accumulation calculating part and approach path | route data generation part of the Example. The figure which shows the specific example of the treatment assistance data produced | generated by the data synthetic | combination part of the Example. The figure which shows the other specific example of the treatment assistance data produced | generated by the data synthetic | combination part of the Example. The figure which shows the specific example of the 1st holding | maintenance part provided in the X-ray diagnostic apparatus of the Example, and the 2nd holding | maintenance part. The flowchart which shows the production | generation procedure of the treatment assistance data in the Example.

  Embodiments of the present invention will be described below with reference to the drawings.

  The X-ray diagnostic apparatus of the present embodiment described below is a three-dimensional guide wire image based on projection data collected by X-ray imaging of a blood vessel region of a patient to which a contrast medium is administered and a guide wire is inserted. Data and contrast blood vessel image data are generated. Next, three-dimensional CTO image data of a completely occluded region (CTO region) is generated based on the volume data of the blood vessel region acquired in advance by an X-ray CT apparatus, and the guide wire is optimally entered in the CTO region. The approach route data indicating the route is generated by the cumulative calculation of the voxel values with respect to the blood vessel traveling direction. Then, the obtained guide wire image data, contrast blood vessel image data, CTO image data, and approach route data are combined to generate support data (treatment support data) effective for the treatment of the CTO region.

  In the following embodiments, a case where a guide wire is inserted into the CTO region prior to insertion of an intravascular device such as a balloon catheter or a DCA (directional coronary atherectomy) catheter for the purpose of treating the CTO region will be described. However, the present invention is not limited to this. For example, prior to insertion of an intravascular device such as a small-diameter ultrasound probe for the purpose of diagnosing a CTO region by applying intravascular ultrasound imaging (IVUS) or the like. The guide wire may be inserted as described above.

  Although the case where the CTO image data and the approach route data are generated based on the volume data collected in advance by the X-ray CT apparatus will be described, the volume data collected by another medical image diagnostic apparatus such as an MRI apparatus is used. CTO image data and approach route data may be generated.

(Device configuration)
The configuration of the X-ray diagnostic apparatus according to the embodiment of the present invention will be described with reference to FIGS. FIG. 1 is a block diagram showing an overall configuration of the X-ray diagnostic apparatus, and FIG. 2 is a block diagram showing a specific configuration of an X-ray imaging unit provided in the X-ray diagnostic apparatus. FIG. 3 is a block diagram showing a specific configuration of the support data generation unit provided in the X-ray diagnostic apparatus.

  The X-ray diagnostic apparatus 100 shown in FIG. 1 performs X-ray irradiation in a fluoroscopic mode and a main imaging mode on a treatment target region of a patient 150 to which a contrast agent is administered, and detects X-rays transmitted through the treatment target region. Then, the X-ray imaging unit 1 that generates projection data and the three-dimensional data (volume data) of the treatment target region of the patient 150 that is collected in advance by three-dimensional CT imaging using an X-ray CT apparatus installed separately are stored. The image information storage unit 6 generates perspective image data based on the projection data collected by the X-ray imaging in the fluoroscopic imaging mode, and the projection data and X-ray CT apparatus collected by the X-ray imaging in the main imaging mode. The support data generation unit 7 that generates the treatment support data based on the volume data collected in advance by the above, and the above-described support data generation unit 7 Display unit 8 for displaying visual image data and treatment support data, input of patient information, setting of X-ray imaging conditions including X-ray irradiation conditions, setting of treatment support data generation conditions, setting of threshold values, input of various command signals A first imaging system having an X-ray generation unit 2a and an X-ray detection unit 3a, which will be described later, provided in the X-ray imaging unit 1, an X-ray generation unit 2b, and an X-ray detection A holding unit (not shown) that holds each of the second imaging systems having the unit 3b, the top plate 10 on which the patient 150 is placed, the holding unit to which the first imaging system and the second imaging system are attached, A moving mechanism unit 11 that moves the top board 10 on which the patient 150 is placed in a predetermined direction, and a system control unit 12 that comprehensively controls each unit described above are provided.

  As shown in FIG. 1, the X-ray imaging unit 1 includes an X-ray generation unit 2a and an X-ray detection unit 3a that constitute a first imaging system, and an X-ray generation unit 2b and an X-ray that constitute a second imaging system. The detection unit 3b, the projection data generation unit 4, and the high voltage generation unit 5 have a function of generating projection data based on X-rays transmitted through the patient 150.

  FIG. 2 is a block diagram illustrating a specific configuration of each of the above-described units provided in the X-ray imaging unit 1, and the X-ray generation unit 2 (2a and 2b) includes a CTO region that is substantially completely closed. An X-ray tube 21 that irradiates a treatment target site with X-rays and an X-ray diaphragm 22 that forms an X-ray weight (cone beam) for the X-rays emitted from the X-ray tube 21 are provided. The X-ray tube 21 is a vacuum tube that generates X-rays. The thermoelectrons generated from a heated cathode (filament) are accelerated by a DC high voltage supplied from the high voltage generator 5 and collide with a tungsten anode to cause X-rays. Is generated. On the other hand, the X-ray restrictor 22 is used for the purpose of reducing the exposure dose to the patient 150 and improving the image quality of the image data, and restricts the X-rays radiated from the X-ray tube 21 to a predetermined irradiation region (upper part). Compensation filters that prevent halation by selectively reducing scattered rays, lower blades that reduce leakage dose by moving in conjunction with diaphragm blades, and X-rays that have passed through a medium with low absorption (Not shown).

  The X-ray detector 3 (3a and 3b) has an I.D. I. There are a method using (image intensifier) and a method using a flat detector. Furthermore, the flat detector has a method of directly converting X-rays into electric charges, and a method of converting them into light and then converting them into light. is there. The flat panel detector 31 capable of directly converting X-rays into electric charges is configured by two-dimensionally arranging minute detection elements, and each of the detection elements senses X-rays and charges according to an incident X-ray dose. A photoelectric film to be generated, a charge storage capacitor for storing charges generated in the photoelectric film, and a TFT (thin film transistor) for reading out the charges stored in the charge storage capacitor at a predetermined timing are provided. Then, the charges generated in the respective detection elements by the X-rays transmitted through the patient 150 are sequentially read out by the driving pulse supplied from the gate driver 32.

  Next, the projection data generation unit 4 includes a charge / voltage converter 41 that converts charges read in parallel in units of rows or columns from the flat detector 31 included in the X-ray detection unit 3 into a voltage, An A / D converter 42 that converts the output of the charge / voltage converter 41 into a digital signal, and a parallel / serial converter 43 that converts the digitally converted parallel signal into a time-series serial signal (projection data). I have.

  On the other hand, the high voltage generator 5 includes a high voltage generator 52 that generates a high voltage applied between the anode and the cathode in order to accelerate thermionic electrons generated from the cathode of the X-ray tube 21, and the system controller 12. Is provided with an X-ray control unit 51 for controlling the tube current, tube voltage, irradiation time, irradiation timing, and the like in the high voltage generator 52 based on the X-ray irradiation conditions supplied from.

  Returning to FIG. 1, the image information storage unit 6 stores the treatment target region of the patient 150 collected by three-dimensional CT imaging using an X-ray CT apparatus (not shown) and supplied via a network or a large-capacity storage medium. Is stored in advance as supplementary information on the position information of the imaging region.

  Next, a specific configuration and function of the support data generation unit 7 shown in FIG. 1 will be described with reference to FIGS. As shown in the block diagram of FIG. 3, the support data generation unit 7 includes a projection data storage unit 71, a perspective image data generation unit 72, a three-dimensional image data generation unit 73, and a CTO image data generation unit 74. An area image data generation unit 75, an approach route estimation unit 76, and a data synthesis unit 77 are provided.

  The projection data storage unit 71 includes, for example, a first imaging system having an X-ray generation unit 2a and an X-ray detection unit 3a and a second imaging system having an X-ray generation unit 2b and an X-ray detection unit 3b, for example. Projection data in the main shooting mode collected from two orthogonal directions is stored as position information of the imaging system as supplementary information, and is further collected using either the first imaging system or the second imaging system. The projection data in the fluoroscopic mode is stored.

  The fluoroscopic image data generation unit 72 performs interpolation processing, filtering processing, and the like on the projection data in the fluoroscopic imaging mode stored in the projection data storage unit 71 as necessary to generate fluoroscopic image data. In this embodiment, when the guide wire is inserted into the CTO region of the patient 150, the guide wire is inserted until the distal end of the guide wire reaches the front end of the CTO region. This is performed under observation of fluoroscopic image data collected for a region (blood vessel region).

  On the other hand, the three-dimensional image data generation unit 73 uses the first imaging system and the second imaging system, and for example, the front direction (y-axis direction in FIG. 1) and the side direction (see FIG. 1) of the patient 150 supine on the top board. By reconstructing the projection data in the main imaging mode collected from the x-axis direction (1), simple three-dimensional image data of the guide wire (guide wire image data) and a simple three-dimensional image of the contrasted blood vessel region It has a function of generating data (contrast blood vessel image data), and includes a reconstruction processing unit 731, a wire image data generation unit 732, and a contrast blood vessel image data generation unit 733 as shown in FIG. 3.

  The reconstruction processing unit 731 performs preprocessing such as noise removal processing on the projection data in two different directions read from the projection data storage unit 71, and then performs reconstruction processing using an interpolation process and a back projection method. To generate volume data.

  On the other hand, the wire image data generation unit 732 sets a threshold value α1 for the purpose of extracting guidewire information for the volume data obtained by the above reconstruction process, and extracts voxels having voxel values larger than the threshold value α1. To do. Then, the obtained voxel is subjected to filtering processing for the purpose of noise removal and contour enhancement to generate guide wire image data.

  Similarly, the contrast blood vessel image data generation unit 733 sets a threshold value α1 and a threshold value α2 (α2 <α1) for the purpose of extracting contrast blood vessel information for the volume data obtained by the above reconstruction process, Contrast-enhanced blood vessel image data is generated by extracting voxels having voxel values larger than the threshold value α2 and smaller than the threshold value α1.

  FIG. 4 schematically shows guide wire image data and contrast blood vessel image data generated by the three-dimensional image data generation unit 73. FIG. 4A shows volume data generated by reconstruction processing. A voxel Bx of the contrasted blood vessel Bo included in Vx and a voxel Gx of the guide wire Go inserted into the contrasted blood vessel Bo are shown. On the other hand, FIG. 4B shows a guide wire Go having voxels larger than the threshold value α1 extracted from the volume data Vx, and FIG. 4C is extracted from the volume data Vx. A contrasted blood vessel Bo having voxels larger than the threshold value α2 and smaller than the threshold value α1 is shown.

  In this way, by setting the threshold value α1 and the threshold value α2 for the volume data Vx, the voxel Gx corresponding to the guide wire Go and the voxel Bx corresponding to the contrasted blood vessel Bo are extracted, and predetermined processing is performed on these voxels. Three-dimensional guide wire image data and contrast blood vessel image data are generated. 4 (a) and 4 (c), the occlusion Ao caused by calcification of the blood vessel wall, plaque deposition, etc. existing near the tip of the guide wire Go inserted into the contrasted blood vessel Bo. It also shows about.

  Returning to FIG. 3, the CTO image data generation unit 74 includes a CTO region detection unit 741, a CTO volume data extraction unit 742, a soft region detection unit 743, a rendering processing unit 744, and a CTO image data storage unit 745.

  The CTO region detection unit 741 compares, for example, the contrast vessel image data by comparing the pixel value of the contrast vessel image data supplied from the contrast vessel image data generation unit 733 of the three-dimensional image data generation unit 73 with a predetermined threshold β1. The continuity in the blood vessel running direction is measured, and the front end portion and the rear end portion of the CTO region are detected based on the measurement result.

  FIG. 5 is a diagram for explaining a CTO region detected based on the continuity of contrast-enhanced blood vessel image data, and severe occlusion (complete occlusion) due to the above-mentioned calcification or plaque on the inner wall surface of the blood vessel. When it occurs, the blood inflow to the occluded portion substantially stops, so that the contrasted blood vessel Bo in the occluded portion Ao of the contrasted blood vessel image data disappears.

  On the other hand, in a normal blood vessel connected to the back of the obstruction, almost no blood flows in through the obstruction, but blood flows in through the collateral circulation that is newly formed around the obstruction. The contrasted blood vessel Bo is also shown behind the indicated obstruction Ao. Accordingly, for example, the inner diameter of the contrasted blood vessel Bo or the rate of change thereof is measured with respect to the blood vessel running direction, and the front end portion and the rear end portion of the CTO region are detected by comparing the obtained measurement result with a predetermined threshold value. be able to.

  Returning to FIG. 3 again, the CTO volume data extraction unit 742 reads out the volume data of the patient 150 collected by the separately installed X-ray CT apparatus and stored in advance in the image information storage unit 6 of FIG. Volume data (CTO volume data) corresponding to the CTO area detected by the CTO area detection unit 741 is extracted from the volume data.

  The soft region detection unit 743 sets a threshold γ for the CTO volume data extracted by the CTO volume data extraction unit 742, and replaces a voxel value (CT value) smaller than the threshold γ with a predetermined voxel value. In this case, the above-described CTO region has a relatively small CT value such as a calcification region or the like (hereinafter referred to as a hard region) in which a guide wire cannot be inserted and has a large CT value. There is a plaque region or the like (hereinafter referred to as a soft region) that can be inserted. Therefore, the soft region is identified by replacing the voxel value of the soft region extracted by comparing the voxel value of the CTO volume data with the threshold value γ with a predetermined voxel value that is significantly different from the voxel value of the hard region.

  On the other hand, the rendering processing unit 744 includes, for example, a volume data correction unit, an opacity / color tone setting unit, and an arithmetic processing unit (not shown).

  The volume data correction unit applies the voxel value of the CTO volume data including the voxel value of the soft region replaced with the predetermined value by the soft region detection unit 743 to the preset line-of-sight vector for three-dimensional display and the blood vessel boundary surface. Correction is performed based on the inner product value with the normal vector, and the opacity / color tone setting unit sets opacity and color tone based on the corrected voxel value. The arithmetic processing unit performs rendering processing on the CTO volume data supplied from the soft region detection unit 743 based on the opacity and color tone to generate three-dimensional CTO image data. The CTO image data is stored in the CTO image data storage unit 745. By performing rendering processing on the CTO volume data in which the voxel value of the soft region is replaced with a predetermined value, CTO image data in which the soft region is highlighted can be obtained.

  Next, the blood vessel region image data generation unit 75 includes a misregistration detection unit 751, a misregistration correction processing unit 752, and an image data synthesis unit 753.

  The misregistration detection unit 751 extracts volume data (contrast blood vessel volume data) of the contrast blood vessel region supplied from the contrast blood vessel image data generation unit 733 of the three-dimensional image data generation unit 73 and CTO volume data extraction of the CTO image data generation unit 74. The CTO volume data supplied from the unit 742 is received, and the contrast vessel volume data and the CTO volume data are subjected to, for example, pattern matching processing by cross-correlation calculation, and the positional deviation of the CTO volume data with respect to the contrast vessel volume data is determined in voxel units. Detect with.

  On the other hand, the misregistration correction processing unit 752 corrects the position and size of the CTO volume data with respect to the contrast blood vessel volume data based on the above-described misregistration detected by the misregistration detection unit 751. Then, the image data synthesis unit 753 shifts the position of the guide wire image data supplied from the wire image data generation unit 732 of the three-dimensional image data generation unit 73 and the contrast blood vessel image data supplied from the contrast blood vessel image data generation unit 733. Image data in a wide range of blood vessel regions including the CTO region (hereinafter referred to as blood vessel region image data) is generated by synthesizing the CTO image data after positional deviation correction supplied from the correction processing unit 752.

  Next, the approach route estimation unit 76 includes a wire tip detection unit 761, an accumulation calculation unit 762, and an approach route data generation unit 763.

  The wire tip detection unit 761 is guided wire image data supplied from the wire image data generation unit 732 of the three-dimensional image data generation unit 73 by the same procedure as the CTO region detection unit 741 provided in the CTO image data generation unit 74. The continuity of the guide wire image data in the blood vessel running direction is measured by comparing the pixel value of the image and the threshold value β2, and the position coordinates of the guide wire tip are detected based on the measurement result.

  On the other hand, the cumulative calculation unit 762 receives the CTO volume data supplied from the CTO volume data extraction unit 742 and, based on the detection result of the position coordinates, the position of the tip end portion of the guide wire placed near the front end portion of the CTO region. Is set for the CTO volume data. Then, a cumulative voxel value in the blood vessel traveling direction is calculated with the reference point as the start point and the rear end of the CTO region as the end point.

  Next, the approach route data generation unit 763 sets the route with the minimum accumulated voxel value as the guide wire optimum approach route, and creates approach route data indicating the optimum approach route.

  FIG. 6 shows a specific example of the optimum approach route set by the cumulative calculation unit 762 and the approach route data generation unit 763. Here, for simplification of explanation, the CTO volume data displayed two-dimensionally is shown. The case where the tip end portion of the guide wire is close to the voxel a31 is shown.

  That is, as shown in FIG. 6, when the distal end portion of the guide wire comes close to the voxel a31 of the CTO volume data, the cumulative calculation unit 762 selects the most from the voxels a22, a32, and a42 adjacent to the voxel a31 in the blood vessel traveling direction. The voxel a22 having a small voxel value is selected, and then the voxel a23 having the smallest voxel value is selected from the voxels a13, a23, and a33 adjacent to the voxel a22. The same procedure is repeated until a voxel at the rear end of the CTO region is selected, and voxels are based on the voxel a31 whose guide wire tip is close and the voxels a22, a23, a34,. By selecting a route that minimizes the cumulative value, it is possible to set an optimal approach route that facilitates insertion of a guide wire.

  Next, the data composition unit 77 shown in FIG. 3 adds an approach route data generation unit 763 of the approach route estimation unit 76 to a wide range of blood vessel region image data supplied from the image data composition unit 753 of the blood vessel region image data generation unit 75. Treatment support data is generated by superimposing (synthesizing) the approach route data supplied from.

  FIGS. 7 and 8 show specific examples of treatment support data generated by the data synthesizer 77 for the purpose of inserting a guide wire into the CTO region. The tip of the guide wire is arranged at the front end of the CTO region. FIG. 7 shows the treatment support data in this case, and FIG. 8 shows the treatment support data newly generated when the distal end portion of the guide wire is inserted into the approximate center of the CTO region under the observation of the treatment support data. .

  The treatment support data includes guide wire image data and contrast blood vessels generated by the three-dimensional image data generation unit 73 based on projection data collected by X-ray imaging before or during insertion of the guide wire into the CTO region. Generated by the approach path estimation unit 76 based on the CTO image data generated by the CTO image data generation unit 74 based on the image data, the volume data collected in advance by the X-ray CT apparatus, and the guide wire image data and the CTO volume data It is obtained by synthesizing the entered approach route data.

  When generating CTO image data, a soft region that has a relatively small CT value detected by the soft region detection unit 743 of the CTO image data generation unit 74 and is easy to insert a guide wire is highlighted in the CTO image data. The Therefore, the validity of the approach route data generated by the approach route estimation unit 76 can be confirmed by comparing the soft region indicated in the CTO image data with the approach route data superimposed on the CTO image data.

  Returning to FIG. 1, the display unit 8 includes a data conversion unit (not shown) and a monitor, and the data conversion unit supplies the fluoroscopic image data supplied from the fluoroscopic image data generation unit 72 of the support data generation unit 7 in the fluoroscopic imaging mode. In addition, the treatment support data supplied from the data synthesis unit 77 of the support data generation unit 7 in the main photographing mode is converted into a predetermined display format, and further, conversion processing such as D / A conversion and television format conversion is performed to perform the monitor. To display.

  The input unit 9 is an interactive interface including input devices such as a display panel, a keyboard, a trackball, a joystick, and a mouse, and includes an imaging mode selection function 91 for selecting a fluoroscopic imaging mode and a main imaging mode, and contrast blood vessel information And threshold value α1 and threshold value α2 for the purpose of extracting guide wire information, threshold value β1 and threshold value β2 for the purpose of detecting the CTO region and detecting the tip of the guide wire, and threshold value γ for the purpose of detecting the soft region in the CTO region. And a threshold setting function 92 for setting the above. Also, input of patient information, setting of X-ray imaging conditions including X-ray irradiation conditions, setting of treatment support data generation conditions, input of various command signals, and the like are performed using the above-described display panel and input device.

  Next, the moving mechanism unit 11 shown in FIG. 1 moves the top board 10 in the body axis direction of the patient 150 (z direction in FIG. 1) and the direction perpendicular to the body axis (x direction and y direction in FIG. 1). The first holding unit, the X-ray generation unit 2b, and the X-ray detection unit to which the first imaging system having the top plate moving mechanism 111 and the X-ray generation unit 2a and the X-ray detection unit 3a are attached. A holding unit moving mechanism 112 for moving a second holding unit (none of which is shown) to which the second imaging system having 3b is attached around the patient 150, the top plate moving mechanism 111, and the holding unit moving A moving mechanism control unit 113 that controls the mechanism 112 is provided.

  That is, the moving mechanism control unit 113 is a drive for moving the first holding unit and the second holding unit around the patient 150 based on a control signal supplied from the input unit 9 via the system control unit 12. A signal is supplied to the holding unit moving mechanism 112 to set the X-ray irradiation position and the X-ray irradiation direction. Similarly, the movement mechanism control unit 113 supplies a drive signal generated based on the control signal supplied from the system control unit 12 to the top board movement mechanism 111 to set and update the imaging region for the patient 150.

  FIG. 9 shows a specific example of the first holding unit and the second holding unit provided in the X-ray diagnostic apparatus according to the present embodiment. For example, the floor-standing type holding unit 15a (first holding unit) is shown. Part) and a ceiling traveling type holding part 15b (second holding part). In other words, the X-ray diagnostic apparatus 100 capable of performing X-ray imaging from two directions simultaneously includes an X-ray generator 2a and an X-ray generator 2a and an X-ray generator 2a arranged with a patient 150 (not shown) on the top as shown in FIG. An X-ray generation unit 2a and an X-ray detection that comprise a first imaging system having a line detection unit 3a and a second imaging system having an X-ray generation unit 2b and an X-ray detection unit 3b. The part 3a is attached to both ends of a C arm 81a provided in the floor-standing holding part 15a.

  On the other hand, the X-ray generation unit 2b and the X-ray detection unit 3b constituting the second imaging system are provided in the ceiling traveling type holding unit 15b that can slide in the longitudinal direction and the lateral direction along the ceiling traveling rail 82. Attached to both ends of the Ω arm 81b. Then, by using a combination of the first imaging system attached to the C arm 81a and the second imaging system attached to the Ω arm 81b, X-ray imaging in two different directions of the patient 150 can be performed substantially simultaneously. Is possible.

  Next, the system control unit 12 in FIG. 1 includes a CPU and a storage circuit (not shown), and various information input / selected / set by the input unit 9 is stored in the storage circuit. Then, the CPU comprehensively controls the above-described units of the X-ray diagnostic apparatus 100 based on these pieces of information, and generates fluoroscopic image data for the purpose of arranging the guide wire tip with respect to the front end of the CTO region. Treatment support data for the purpose of inserting a guide wire into the CTO region is generated.

(Procedure for generating treatment support data)
Next, a procedure for generating treatment support data in this embodiment for the purpose of inserting a guide wire into the CTO region will be described with reference to the flowchart of FIG.

  Prior to the generation of treatment support data, a doctor, an examiner, or the like (hereinafter referred to as an operator) who operates the X-ray diagnostic apparatus 100 inputs patient information in the input unit 9 and then includes X-ray irradiation conditions. Setting of X-ray imaging conditions, setting of treatment support data generation conditions, threshold α1 for the purpose of extracting contrast blood vessel information and threshold α2 for the purpose of extracting guidewire information, threshold for the purpose of detecting the CTO region The threshold β2 is set for the purpose of detecting β1 and the tip end of the guide wire, and the threshold γ is set for the purpose of detecting the soft region in the CTO region. These input information and setting information are stored in the system control unit 12. It is stored in the circuit (step S1 in FIG. 10).

  When the above initial setting is completed, the operator administers a contrast medium into the blood vessel of the patient 150 (step S2 in FIG. 10), and the first imaging having the X-ray generation unit 2a and the X-ray detection unit 3a. After the system is arranged at a predetermined position, the fluoroscopic imaging mode is selected and an imaging start command is input at the input unit 9. Then, when this command signal is supplied to the system control unit 12, X-ray imaging in a fluoroscopic mode using the first imaging system is started. However, the above-described X-ray imaging may be performed using the second imaging system having the X-ray generation unit 2b and the X-ray detection unit 3b.

  That is, the system control unit 12 supplies the X-ray irradiation conditions read from its own storage circuit and an instruction signal for generating X-rays to the X-ray control unit 51 of the high voltage generation unit 5 and receives this instruction signal. The X-ray control unit 51 controls the high voltage generator 52 based on the X-ray irradiation conditions to apply a high voltage to the X-ray tube 21 of the X-ray generation unit 2a. The X-ray tube 21 to which the high voltage is applied irradiates the patient 150 with X-rays in a fluoroscopic mode through the X-ray diaphragm 22 for a predetermined period, and the X-rays transmitted through the patient 150 are behind the X-ray tube 21. It is detected by the flat detector 31 of the provided X-ray detector 3a.

  At this time, the photoelectric film of the detection elements arranged two-dimensionally in the flat detector 31 receives X-rays transmitted through the patient 150 and accumulates signal charges proportional to the X-ray transmission amount in the charge storage capacitor. When the X-ray irradiation is completed, the gate driver 32 supplies a drive pulse to the TFT of the flat panel detector 31 based on the clock pulse supplied from the system control unit 12 and accumulates the signal charge stored in the charge storage capacitor. Are read sequentially.

  The read signal charge is converted into a voltage by the charge / voltage converter 41 of the projection data generation unit 4 and further converted into a digital signal by the A / D converter 42, and then the parallel / serial converter 43. Are temporarily stored as projection data for one line in the buffer memory. Next, the parallel / serial converter 43 reads the projection data stored in its own buffer memory serially in line units, and sequentially stores them in the projection data storage unit 71 of the support data generation unit 7.

  On the other hand, the fluoroscopic image data generation unit 72 of the support data generation unit 7 reads out the projection data in the fluoroscopic imaging mode stored two-dimensionally in the projection data storage unit 71. The projection data is subjected to interpolation processing, filtering processing, and the like to generate fluoroscopic image data and display it on the monitor of the display unit 8.

  Next, the operator inserts a guide wire into the blood vessel of the site to be treated under the observation of the fluoroscopic image data displayed in real time on the display unit 8, and places the distal end in the vicinity of the front end of the CTO region (FIG. 10). Step S3).

  Next, the operator selects the main imaging mode and inputs an imaging start command at the input unit 9, and the system control unit 12 that has received this command signal performs X-ray imaging by the same procedure as in the above-described fluoroscopic mode. The unit 1 is controlled to perform X-ray imaging in the main imaging mode using the first imaging system and the second imaging system. Then, the projection data in the main shooting mode collected almost simultaneously from two different directions is stored in the projection data storage unit 71 with the position information of the imaging system as supplementary information.

  On the other hand, the reconstruction processing unit 731 of the three-dimensional image data generation unit 73 performs noise removal and interpolation processing on the above-described projection data read from the projection data storage unit 71, and then performs reconstruction processing to which the back projection method is applied. To generate volume data.

  Next, the wire image data generation unit 732 sets a threshold value α1 for the purpose of extracting the guide wire information supplied from the system control unit 12 in the volume data supplied from the reconstruction processing unit 731. The voxel value is set from the threshold value α1. Extract voxels with Then, the obtained voxel is subjected to filtering processing for the purpose of noise removal and contour enhancement to generate guide wire image data.

  Similarly, the contrast blood vessel image data generation unit 733 extracts the above-described threshold value α1 supplied from the system control unit 12 to the volume data supplied from the reconstruction processing unit 731 and the threshold value α2 for the purpose of extracting contrast blood vessel information ( α2 <α1) is set, and contrast vessel image data is generated by extracting voxels having voxel values smaller than the threshold α1 and larger than the threshold α2 (step S4 in FIG. 10).

  When the generation of the contrast blood vessel image data is completed, the CTO region setting unit 741 of the CTO image data generation unit 74 stores the contrast blood vessel image data supplied from the contrast blood vessel image data generation unit 733 of the three-dimensional image data generation unit 73. By comparing the pixel value and the threshold value β1 supplied from the system control unit 12, the continuity in the blood vessel traveling direction of the contrast blood vessel image data is measured, and based on the measurement result, the front end portion and the rear end portion of the CTO region are determined. It detects (step S5 in FIG. 10).

  On the other hand, the CTO volume data extraction unit 742 reads the volume data of the patient 150 collected by the separately installed X-ray CT apparatus and stored in the image information storage unit 6 in advance, and the CTO region is extracted from the obtained volume data. Volume data of the CTO area detected by the detection unit 741 is extracted.

  Then, the soft region detection unit 743 compares the voxel value (CT value) included in the volume data of the CTO region extracted by the CTO volume data extraction unit 742 with the threshold value γ supplied from the system control unit 12, thereby performing the CTO. A soft region in the region is detected, and the voxel value of the soft region having a voxel value smaller than the threshold γ is replaced with a predetermined voxel value (step S6 in FIG. 10).

  Next, the rendering processing unit 744 calculates a voxel value of the CTO region in which the voxel value of the soft region is replaced with a predetermined value, and a predetermined line-of-sight vector for 3D display and a normal vector for the blood vessel boundary surface and the like. Correction is performed based on the inner product value, and opacity and color tone are set based on the corrected voxel value. Then, the CTO volume data supplied from the soft region detection unit 743 is subjected to rendering processing based on the opacity and color tone described above to generate three-dimensional CTO image data, and the obtained CTO image data is converted into a CTO image. The data is stored in the data storage unit 745 (step S7 in FIG. 10).

  Next, the positional deviation detection unit 751 of the blood vessel region image data generation unit 75 performs the contrast blood vessel volume data supplied from the contrast blood vessel image data generation unit 733 of the three-dimensional image data generation unit 73 and the CTO of the CTO image data generation unit 74. The CTO volume data supplied from the volume data extraction unit 742 is received, and pattern matching processing is performed on the contrast vessel volume data and the CTO volume data to detect a positional shift of the CTO volume data with respect to the contrast vessel volume data. The misregistration correction processing unit 752 corrects the position and size of the CTO volume data with respect to the contrast blood vessel volume data based on the above-described misregistration detected by the misregistration detection unit 751.

  Next, the image data synthesis unit 753 shifts the position of the guide wire image data supplied from the wire image data generation unit 732 of the three-dimensional image data generation unit 73 and the contrast blood vessel image data supplied from the contrast blood vessel image data generation unit 733. A wide range of blood vessel region image data including the CTO region is generated by synthesizing the corrected CTO image data supplied from the correction processing unit 752 (step S8 in FIG. 10).

  On the other hand, the wire tip detection unit 761 of the approach route estimation unit 76 includes the pixel value of the guide wire image data supplied from the wire image data generation unit 732 of the three-dimensional image data generation unit 73 and the threshold value supplied from the system control unit 12. The continuity in the blood vessel traveling direction of the guide wire image data is measured by comparing with β2, and the position coordinate of the guide wire tip portion indicated in the blood vessel region image data is detected based on the measurement result (FIG. 10). Step S9).

  Next, the cumulative calculation unit 762 receives the CTO volume data supplied from the CTO volume data extraction unit 742, and based on the detection result of the position coordinates, the cumulative calculation unit 762 A reference point indicating the position is set for the CTO volume data. Then, a cumulative voxel value in the blood vessel traveling direction is calculated with the reference point as the start point and the rear end of the CTO region as the end point.

  Next, the approach route data generation unit 763 sets the route with the minimum accumulated voxel value as the guide wire optimum approach route, and creates approach route data indicating this optimum approach route (step S10 in FIG. 10). .

  When the generation of the approach route data is completed, the data composition unit 77 adds the approach route estimation unit 76 to the wide range of blood vessel region image data supplied in time series from the image data composition unit 753 of the blood vessel region image data generation unit 75. The treatment route data supplied from the approach route data generation unit 763 is superimposed to generate treatment support data, and various conversion processes are performed on the treatment support data and displayed on the monitor of the display unit 8 (FIG. 10 step S11).

  Next, the operator inserts a guide wire into the CTO region while observing the treatment support data displayed on the display unit 8 (step S12 in FIG. 10), and in parallel with the insertion of the guide wire, the above steps S4 to S4 are performed. By repeating Step S11, treatment support data based on guidewire image data indicating the state of the guidewire being inserted and entry route data newly generated starting from the tip of the guidewire is displayed on the display unit 8. The When the passage of the distal end portion of the guide wire with respect to the CTO region is confirmed by observation of the treatment support image data, the insertion of the guide wire into the CTO region is terminated.

  According to the embodiment of the present invention described above, a guide wire image in which the guide wire is highlighted when the guide wire is inserted into the occluded portion prior to insertion of the intravascular device used for treatment of the occluded blood vessel region. The treatment support data effective for the insertion of the guide wire can be generated by synthesizing the data, contrasted blood vessel image data in which the contrasted blood vessels are highlighted, and the like.

  Also, CTO image data of the CTO region (completely occluded region) is generated based on the volume data collected in advance by the X-ray CT apparatus, and this CTO image data is combined with the above-described contrast blood vessel image data and guide wire image data. Thus, by generating a wide range of blood vessel region image data including the CTO region, it is possible to accurately grasp the state of the guide wire inserted into the CTO region.

  Further, entry route data indicating an optimum entry route for insertion of the guide wire is generated based on the voxel value of the CTO volume data, and the entry route data is superimposed on the CTO image data of the blood vessel region image data and displayed. Thus, the guide wire can be inserted safely and easily.

  Further, by extracting voxels having a relatively small voxel value (CT value) from the voxels constituting the CTO volume data, the CTO image data in which the soft region is emphasized is generated, and the above-described approach to the CTO image data is generated. The validity of the approach route data can be confirmed by displaying the route data superimposed. For this reason, the safety | security and operativity of guide wire insertion with respect to a CTO area | region can further be improved.

  Further, according to the above-described embodiment, the three-dimensional guide wire image data and contrast blood vessel image data displayed in real time are simply generated based on projection data collected by X-ray imaging in two different directions. Therefore, these image data can be obtained with a relatively small exposure dose.

  For the above reasons, it is possible to safely and efficiently perform treatment on the occluded blood vessels of the patient, and the burden on patients and doctors can be reduced.

  As mentioned above, although the Example of this invention has been described, this invention is not limited to the above-mentioned Example, It can change and implement. For example, in the above-described embodiment, a case where a guide wire is inserted into the vascular occlusion portion prior to insertion of an intravascular device such as a balloon catheter or a DCA catheter for treating the vascular occlusion portion has been described. For example, guide wire insertion is performed prior to insertion of an intravascular device for the purpose of diagnosing a vascular occlusion by application of intravascular ultrasound imaging (IVUS) or the like. It doesn't matter.

  Moreover, although the case where the CTO image data is generated based on the volume data collected in advance by the X-ray CT apparatus has been described, the CTO image data is obtained using the volume data collected by another medical image diagnostic apparatus such as an MRI apparatus. May be generated.

  Furthermore, the case where the tip of the guide wire is arranged with respect to the front end of the CTO region under the observation of the fluoroscopic image data collected in the fluoroscopic mode has been described. However, the three-dimensional contrast blood vessel image data collected in the main radiographic mode is described. The above-described arrangement may be performed under the observation.

  On the other hand, the image data synthesizing unit 753 of the blood vessel region image data generating unit 75 in the above-described embodiment is supplied from the guide wire image data and contrast blood vessel image data and the CTO image data generating unit 74 supplied from the three-dimensional image data generating unit 73. The supplied CTO image data is combined to generate blood vessel region image data, and the data combining unit 77 combines the blood vessel region image data and the approach route data supplied from the approach route estimation unit 76 to generate treatment support data. Although the case where the data is generated has been described, it is possible to generate the treatment support data by combining at least two of the guide wire image data, the contrast blood vessel image data, the CTO image data, and the approach route data in the data combining unit 77. Good.

  Further, when generating treatment support data by synthesizing at least guide wire image data and CTO image data, a distal end marker indicating the position of the distal end portion of the guide wire may be added to the front end portion of the CTO image data. In particular, it is possible to accurately grasp the insertion start position of the guide wire with respect to the CTO region by adding the tip marker to the blood vessel cross section shown at the front end of the CTO image data.

DESCRIPTION OF SYMBOLS 1 ... X-ray imaging part 2a, 2b ... X-ray generation part 3a, 3b ... X-ray detection part 4 ... Projection data generation part 5 ... High voltage generation part 6 ... Image information storage part 7 ... Support data generation part 71 ... Projection data Storage unit 72 ... perspective image data generation unit 73 ... three-dimensional image data generation unit 731 ... reconstruction processing unit 732 ... wire image data generation unit 733 ... contrast blood vessel image data generation unit 74 ... CTO image data generation unit 741 ... CTO region detection Unit 742 ... CTO volume data extraction unit 743 ... soft region detection unit 744 ... rendering processing unit 745 ... CTO image data storage unit 75 ... blood vessel region image data generation unit 751 ... position deviation detection unit 752 ... position deviation correction processing unit 753 ... image Data synthesis unit 76 ... approach route estimation unit 761 ... wire tip detection unit 762 ... cumulative calculation unit 763 ... approach route data generation unit 77 ... data synthesis unit ... display unit 9 ... input unit 10 ... ceiling plate 11 ... moving mechanism section 12 ... system control unit 100 ... X-ray diagnostic apparatus

Claims (13)

In an X diagnostic apparatus for generating support data for supporting insertion of a guide wire into an occlusion region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast agent is administered,
Wire image data generating means for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data;
Contrast blood vessel image data generating means for generating contrast blood vessel image data indicating a blood vessel to which the contrast agent has been administered based on the projection data;
Data synthesizing means for synthesizing the guide wire image data and the contrasted blood vessel image data to generate the support data;
An X-ray diagnostic apparatus comprising display means for displaying the support data. In an X diagnostic apparatus for generating support data for supporting insertion of a guide wire into an occlusion region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast agent is administered,
Wire image data generating means for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data;
Contrast blood vessel image data generating means for generating contrast blood vessel image data indicating a blood vessel to which the contrast agent has been administered based on the projection data;
CTO image data generation means for generating CTO image data in the CTO region based on volume data collected in advance by another medical image diagnostic apparatus;
Data synthesizing means for synthesizing the guide wire image data, the contrasted blood vessel image data, and the CTO image data to generate the support data;
An X-ray diagnostic apparatus comprising display means for displaying the support data.   An approach route estimation unit that estimates an optimum approach route of the guide wire in the CTO region and generates approach route data based on the obtained estimation result, and the data synthesis unit adds the approach route to the CTO image data. The X-ray diagnostic apparatus according to claim 2, wherein the support data is generated by superimposing data.   The approach path estimation means includes wire tip detection means for detecting the tip position of the guide wire based on the guide wire image data, and the accumulated voxels of the CTO region with respect to the blood vessel traveling direction obtained from the tip position as a starting point. The X-ray diagnostic apparatus according to claim 3, wherein an optimum approach path of the guide wire in the CTO region is estimated based on a value.   A misregistration correction that corrects a position and a size of the CTO image data with respect to the contrasted blood vessel image data based on a detection result obtained by detecting a misalignment between the CTO image data and the contrasted blood vessel image data. The X-ray diagnosis apparatus according to claim 2, further comprising a processing unit, wherein the synthesizing unit generates the support data using the corrected CTO image data.   The X-ray diagnosis apparatus according to claim 5, wherein the positional deviation detection unit detects the positional deviation by pattern matching processing between the CTO image data and the contrasted blood vessel image data.   Wire tip detecting means for detecting the tip position of the guide wire based on the guide wire image data is provided, and the data synthesizing means is configured to store the CTO image data corresponding to the tip position detected by the wire tip detecting means. The X-ray diagnostic apparatus according to claim 2, wherein a predetermined marker is added to the position.   3. The CTO image data generation unit generates the CTO image data in which a soft region in the CTO region detected by comparing a voxel value of the volume data with a predetermined threshold is highlighted. The X-ray diagnostic apparatus described.   The CTO image data generation means detects the CTO region based on the continuity of the contrast-enhanced blood vessel image data, and extracts a volume in the CTO region extracted from the volume data collected in advance by another medical image diagnostic apparatus. The X-ray diagnostic apparatus according to claim 2, wherein the CTO image data is generated by processing data.   Reconstruction processing means for reconstructing projection data collected by the X-ray imaging with respect to a plurality of directions to generate volume data is provided, and the wire image data generation means is three-dimensional based on the volume data. The said guide wire image data is produced | generated, and the said contrast blood vessel image data production | generation means produces | generates the said three-dimensional contrast blood vessel image data based on the said volume data. X-ray diagnostic equipment.   The wire image data generation means and the contrast blood vessel image data generation means generate the guide wire image data and the contrast blood vessel image data by extracting voxels having a predetermined range of voxel values from the volume data. The X-ray diagnostic apparatus according to claim 10. For an X diagnostic apparatus that generates support data for supporting insertion of a guide wire into an occlusion region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast medium has been administered.
A wire image data generation function for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data;
Contrast-enhanced blood vessel image data generation function for generating contrast-enhanced blood vessel image data indicating a blood vessel to which the contrast medium has been administered based on the projection data;
A data synthesis function for synthesizing the guidewire image data and the contrasted blood vessel image data to generate the support data;
A control program for generating support data, wherein a display function for displaying the support data is executed. For an X diagnostic apparatus that generates support data for supporting insertion of a guide wire into an occlusion region (CTO region) based on projection data obtained by X-ray imaging of a blood vessel to which a contrast medium has been administered.
A wire image data generation function for generating guide wire image data indicating the guide wire inserted into the blood vessel based on the projection data;
Contrast-enhanced blood vessel image data generation function for generating contrast-enhanced blood vessel image data indicating a blood vessel to which the contrast medium has been administered based on the projection data;
A CTO image data generation function for generating CTO image data in the CTO region based on volume data collected in advance by another medical image diagnostic apparatus;
A data synthesis function for synthesizing the guide wire image data, the contrasted blood vessel image data, and the CTO image data to generate the support data;
A control program for generating support data, wherein a display function for displaying the support data is executed.

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