JP2012245329A - Image processing apparatus, radiographic image radiographing system, image processing program, and image processing method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an image processing apparatus which facilitates confirming a target in second radiographic images obtained from the radiographic image detector by irradiating a subject with radiation from predetermined angles; an radiographic image photographing system, an image processing program, and an image processing method.SOLUTION: The radiographic images obtained by radiographing using tomosynthesis are reconstructed to generate a tomographic image using a tomographic image generator 66. The tomographic image with a radiographed target, and the two-dimensional images (stereo radiographic images at ±15°) are displayed on a display 82. When a user indicates a target area including a target on the tomographic image, the locations of the areas on the two-dimensional images corresponding to the indicated target area are computed and then displayed to overlay the image of the target area in the tomographic image on the corresponding areas in the two-dimensional images. When the user indicates the location of the target, the corresponding locations on the two-dimensional images are computed and then displayed to show the corresponding areas on the two-dimensional images.

Description

  The present invention relates to an image processing apparatus, a radiographic image capturing system, an image processing program, and an image processing method, and more particularly to an image processing apparatus, a radiographic image capturing system, an image processing program, and an image for displaying a radiographic image on a display means. It relates to the processing method.

  For the purpose of medical diagnosis, a radiation image is captured by a radiation image capturing apparatus by irradiating a subject of a subject who is a patient with radiation. 2. Description of the Related Art There is known a technique for grasping the position, shape, etc. of a subject, such as a tumor or a calcification, which is an affected part of a subject using a photographed two-dimensional radiation image and a three-dimensional radiation image.

  For example, in Patent Document 1, in IVR (interventional radiology: catheter surgery under fluoroscopy), a viewpoint position of a three-dimensional image is calculated based on positional information of support means in fluoroscopy, and the calculated viewpoint A technique for synthesizing and displaying a three-dimensional X-ray image from a position and a fluoroscopic image is described. Patent Document 2 acquires a two-dimensional X-ray image of an object to be inspected, obtains a diagnostically related structure from a three-dimensional image, calculates a composite projection image, A technique for superimposing and displaying X-ray images formed under the same geometric condition is described. Patent Document 3 describes a technique for superimposing a Latham image, which is a two-dimensional image obtained by projecting a three-dimensional image on a plane, on an X-ray fluoroscopic image.

JP 2002-336235 A JP 2008-119527 A JP 2008-29692 A

  In general, in a biopsy (biopsy, biopsy) in which a part of an affected area of a patient is collected, a positional relationship between a target (tissue such as an object of interest) and a biopsy needle is obtained using a two-dimensional image (stereo image). Checking is done. However, in the case of using a two-dimensional image, for example, the three-dimensional position of the target, particularly the position in the direction in which radiation is irradiated (see the z-axis direction in FIG. 1) may be unknown, and confirmation may be difficult. .

  In addition, when using a three-dimensional image (reconstructed tomographic image), since the contrast is strong in the portion where the biopsy needle is photographed, an artifact may occur in the three-dimensional image, and confirmation may be difficult. .

  On the other hand, as described above, although there is a technique for performing confirmation by displaying a three-dimensional radiation image and a two-dimensional radiation image, confirmation of the positional relationship between the target and the biopsy needle that the user wants to confirm is performed. It may be difficult to do above.

  The present invention provides an image processing apparatus, a radiographic image capturing system, and a radiographic image capturing system capable of easily confirming an object of interest in a second radiographic image acquired from the radiographic image detector by irradiating radiation from a predetermined angle. An object is to provide an image processing program and an image processing method.

In order to achieve the above object, an image processing apparatus according to claim 1 is configured to emit radiation from different angles with respect to a subject on the radiation image detector from a radiation irradiation unit provided facing the radiation image detector. A plurality of first radiation images that are irradiated and photographed at each angle by the radiation image detector are acquired from the radiation image detector, and the radiation of the subject is acquired based on the acquired plurality of first radiation images. A tomographic image generating means for generating the tomographic image reconstructed with reference to the detection surface of the image detector; a tomographic image in which the object of interest in the subject generated by the tomographic image generating means is imaged; and the radiation irradiation A second radiation image acquired from the radiation image detector by irradiating the subject on the radiation image detector from a predetermined angle from a predetermined angle and displaying And when the designated area is designated in the tomographic image displayed on the display means, the corresponding area of the second radiation image corresponding to the designated area is calculated, and the calculated correspondence The display processing means is controlled to display an image of the designated area on the area, and when the object of interest is designated in the tomographic image, the second radiation image corresponding to the position of the object of interest is displayed. Control means for calculating a corresponding position and controlling the display processing means to display the calculated corresponding position.

Radiation image detection by irradiating radiation from the radiation irradiator to the subject on the radiation image detector at different positions while moving the radiation irradiator provided facing the radiation image detector to multiple positions. A plurality of first radiation images are taken by the instrument. The tomographic image generation means acquires a plurality of first radiographic images from the radiographic image detector, and reconstructs the detection surface of the radiographic image detector of the subject based on the acquired plurality of the first radiographic images. A tomographic image is generated. The display processing means is predetermined for a tomographic image that is a three-dimensional image obtained by capturing an object of interest in the subject generated by the tomographic image generating means, and a subject on the radiation image detector from the radiation irradiation unit. The second radiation image, which is a two-dimensional image acquired from the radiation image detector by irradiating radiation from the selected angle, is displayed on the display means.

In this way, by displaying the three-dimensional image and the two-dimensional image on the display means, the user can select a designated area including a target of interest on the three-dimensional image, for example, a target from which a tissue is to be collected by biopsy. The position can be indicated. Since the designated region and the target position can be designated on the three-dimensional image, the designated region and the three-dimensional position of the target, in particular, the position in the direction perpendicular to the radiation detector can be easily obtained.

  Further, in the present invention, when the designated area is designated in the tomographic image displayed on the display means, the control means calculates a corresponding area of the second radiation image corresponding to the designated area, and on the calculated corresponding area. When the display processing means is controlled to display the image of the designated region in an overlapping manner and the object of interest is designated in the tomographic image, the corresponding position of the second radiation image corresponding to the position of the object of interest is calculated, and the calculated correspondence The display processing means is controlled to display the position.

As described above, since the image of the designated area can be displayed on the corresponding area on the two-dimensional image or the position of the object of interest can be displayed, the user can irradiate the radiation from a predetermined angle. The object of interest can be easily confirmed in the second radiation image acquired from the radiation image detector.

  Further, according to the present invention, as in the image processing apparatus according to claim 2, the second radiographic image is such that a biopsy needle inserted into the subject is taken in order to collect the object of interest. can do.

  In the image processing apparatus according to the third aspect of the present invention, the second radiographic image can be a pair of radiographic images for positioning.

  In the image processing apparatus according to the fourth aspect of the present invention, the subject can be a breast.

  The radiographic image capturing system according to claim 5, wherein the radiographic image is detected by irradiating a subject on the radiographic image detector from a different angle from a radiation irradiation unit provided facing the radiographic image detector. A radiographic image capturing apparatus that captures a plurality of radiographic images for each angle by a device, a tomographic image generated from the plurality of radiographic images captured by the radiographic image capturing apparatus, and the generated tomographic image and the subject 5. The apparatus according to claim 1, wherein a radiation image is emitted from a predetermined angle and the second radiation image captured by the radiation image capturing apparatus is displayed on a display unit. An image processing apparatus.

  The image processing program according to claim 6, wherein the computer irradiates radiation from a different angle to a subject on the radiation image detector from a radiation irradiation unit provided opposite to the radiation image detector. A plurality of first radiographic images taken at each angle by the image detector are acquired from the radiographic image detector, and the radiographic image detector detects the subject based on the acquired plurality of first radiographic images. A tomographic image generating unit configured to generate the tomographic image reconstructed on the basis of a plane; a tomographic image generated by the tomographic image generating unit; and the subject on the radiation image detector from the radiation irradiation unit in advance. Display processing means for displaying on a display means a second radiation image obtained by irradiating radiation from a predetermined angle and acquired from the radiation image detector; When a designated area is designated in the tomographic image displayed on the means, a corresponding area of the second radiation image corresponding to the designated area is calculated, and an image of the designated area is overlaid on the calculated corresponding area. If the object of interest is specified in the tomographic image, the corresponding position of the second radiation image corresponding to the position of the object of interest is calculated, and the calculated correspondence It is for functioning as control means for controlling the display processing means to display the position.

  The image processing method according to claim 7, wherein the subject on the radiation image detector is moved from the radiation irradiation unit at each position while moving the radiation irradiation unit provided facing the radiation image detector to a plurality of positions. A plurality of first radiographic images captured by the radiographic image detector by irradiating radiation from different angles with respect to the radiographic image detector, based on the acquired plurality of the first radiographic images, A tomographic image generation step for generating the tomographic image reconstructed with reference to a detection surface of the radiological image detector of the subject, a tomographic image generated by the tomographic image generation step, and the radiation image detection from the radiation irradiation unit A second radiation image acquired from the radiation image detector by irradiating the subject on the vessel with a predetermined angle and displayed on the display means. And when the designated area is designated in the tomographic image displayed on the display means, the corresponding area of the second radiation image corresponding to the designated area is calculated, and the calculated corresponding area If the object of interest is specified in the tomographic image, the corresponding position of the second radiation image corresponding to the position of the object of interest is controlled. And a control step of controlling the display processing step so as to display the calculated corresponding position.

  As described above, according to the present invention, it is possible to easily confirm the object of interest in the second radiation image acquired from the radiation image detector by irradiating radiation from a predetermined angle. An effect is obtained.

It is a top view which shows an example of a structure of the radiographic imaging apparatus of this Embodiment. It is a figure which shows an example of the structure at the time of imaging | photography of the radiographic imaging apparatus of this Embodiment. It is explanatory drawing for demonstrating at the time of imaging | photography of the radiographic imaging apparatus of this Embodiment. It is a block diagram which shows an example of a structure of the radiographic imaging system of this Embodiment. It is a flowchart which shows an example of the flow of the biopsy test | inspection (biopsy) of the target substance in the test subject's breast performed using the radiographic imaging system of this Embodiment. In the radiographic imaging device of this Embodiment, it is explanatory drawing for demonstrating imaging | photography of the radiographic image which irradiated the radiation from the angle of +/- 15 degree. 7 is an explanatory diagram for explaining a specific example in which a tomographic image of a target area image is displayed in an overlay manner on a two-dimensional image displayed on a display 82 of a display device 80 by the image processing apparatus of the present embodiment. FIG. FIG. 5 is an explanatory diagram for explaining a specific example in which the target position indicated on the tomographic image is displayed on the two-dimensional image displayed on the display 82 of the display device 80 by the image processing apparatus of the present embodiment. is there. A specific example in which the tomographic image of the target region image is displayed as an overlay on the two-dimensional image of the target tissue sampled by the biopsy needle displayed on the display 82 of the display device 80 by the image processing apparatus of the present embodiment. It is explanatory drawing for demonstrating. It is a flowchart which shows an example of the flow of the biopsy test | inspection (biopsy) of the object of interest in a test subject's breast performed using the conventional general radiographic imaging system. It is explanatory drawing for demonstrating a specific example which designates a target on the two-dimensional image displayed on the display 82 of the display apparatus 80 by the conventional general image processing apparatus. It is explanatory drawing which showed the state of the distribution area | region which calcified and distributed.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. Note that this embodiment does not limit the present invention.

  As shown in FIGS. 1 to 3, the radiographic image capturing apparatus 10 of the present embodiment captures the breast N of the subject W with radiation (for example, X-rays) in the standing state where the subject W stands. An apparatus, for example, called mammography. In the following, when the subject W faces the radiographic image capturing apparatus 10 at the time of imaging, the near side near the subject W is defined as the front side of the radiographic image capturing apparatus 10, and the subject W faces the radiographic image capturing apparatus 10. The far side away from the subject W in this case is the rear side of the radiographic imaging device 10, and the left-right direction of the subject W when the subject W faces the radiographic imaging device 10 is the left-right direction of the radiographic imaging device 10. (See each arrow in FIGS. 1 to 3).

  Moreover, the imaging target of the radiographic image capturing apparatus 10 is not limited to the breast N, and may be, for example, another part of the body or an object. The radiographic image capturing apparatus 10 may be an apparatus that captures the breast N of the subject W in a sitting position in which the subject W is sitting on a chair (including a wheelchair) or the like. Any device may be used as long as the breast N of the subject W can be separately photographed while standing.

  As shown in FIG. 1, the radiographic image capturing apparatus 10 includes a measurement unit 12 having a substantially C-shaped side view provided on the front side of the apparatus, and a base unit 14 that supports the measurement unit 12 from the rear side of the apparatus. ing.

  The measuring unit 12 presses the breast N between the imaging surface 22 on which the planar imaging surface 20 that contacts the breast N of the subject W in the standing state is formed and the imaging surface 20 of the imaging table 22. , And a holding unit 28 that supports the imaging table 22 and the compression plate 26.

The compression plate 26 is provided with a biopsy hand unit 38 for collecting necessary tissue from the biopsy site of the breast N. The compression plate 26 is provided with a rectangular opening 34 for tissue collection using the biopsy hand unit 38. The biopsy hand unit 38 includes a post unit 36 supported by a biopsy needle driving unit (a biopsy unit 44, which will be described in detail later) disposed on the imaging table, and an arm unit 37 having one end connected to the post unit 36. . A biopsy needle 40 is attached to the other end of the arm portion 37. An opening (not shown) for aspirating and collecting the tissue at the biopsy site of the breast N is provided at the distal end of the biopsy needle 40. The biopsy needle 40 is inserted in the direction along the surface of the compression plate 26 (direction parallel to the compression plate 26, the xy axis direction in FIG. 1) and the breast N by the biopsy hand unit 38 (the compression plate 26). Can be moved in the direction intersecting (FIG. 1, z-axis direction). In the present embodiment, the biopsy needle 40 is moved by the biopsy hand unit 38, so that the biopsy needle 40 passes through the opening 34 of the compression plate 26 toward the imaging surface 20 from the z-axis. It is configured so that it can be inserted in the direction.

  The measurement unit 12 is provided with a radiation source 30 such as a tube (see FIG. 4), a radiation irradiation unit 24 that irradiates radiation for inspection from the radiation source 30 toward the imaging surface 20, and a holding unit 28. Is provided with a support part 29 that is separated and supports the radiation irradiation part 24.

  The measuring unit 12 is provided with a rotating shaft 16 that is rotatably supported by the base unit 14. The rotation shaft 16 is fixed with respect to the support portion 29, and the rotation shaft 16 and the support portion 29 rotate together.

  The holding portion 28 can be switched between a state in which the rotation shaft 16 is connected and rotates integrally, and a state in which the rotation shaft 16 is separated and idles. Specifically, gears are provided on the rotating shaft 16 and the holding portion 28, respectively, and the meshing state and the non-meshing state of the gears are switched.

  Note that various mechanical elements can be used for switching between transmission and non-transmission of the rotational force of the rotating shaft 16.

  The holding unit 28 supports the imaging table 22 and the radiation irradiation unit 24 so that the imaging surface 20 and the radiation irradiation unit 24 are separated from each other by a predetermined distance, and the interval between the compression plate 26 and the imaging surface 20 is variable. The compression plate 26 is slidably held.

  The imaging surface 20 with which the breast N abuts is made of carbon, for example, from the viewpoint of radiolucency and strength. A radiation detector 42 for detecting radiation that is irradiated with radiation that has passed through the breast N and the imaging surface 20 is disposed inside the imaging table 22. The radiation detected by the radiation detector 42 is visualized and a radiation image is generated.

  The radiographic image capturing apparatus 10 of the present embodiment is an apparatus that can perform imaging from a plurality of directions at least on the breast N as a subject. 2 and 3 respectively show the posture of the radiation image capturing apparatus 10 at the time of imaging and the position of the radiation irradiation unit 24 at the time of imaging. As shown in FIGS. 2 and 3, the imaging is performed by supporting the radiation irradiating unit 24 and inclining the support unit 29 that supports the imaging table 22 via the holding unit 28.

  As shown in FIG. 3, in the radiation imaging apparatus 10, when imaging (tomosynthesis imaging) is performed on the breast N from a plurality of directions, the rotation shaft 16 idles with respect to the holding unit 28 and presses against the imaging table 22. When the plate 26 does not move and the support portion 29 rotates, only the radiation irradiation portion 24 moves in an arc shape. In the present embodiment, as shown in FIG. 3, the imaging position is moved from the angle α by a predetermined angle θ, and imaging is performed at N positions where the radiation irradiation unit 24 is located at P1 to PN.

  In the radiographic image capturing apparatus 10 of the present embodiment, both CC (Cranio & Caudal: head-to-tail direction) imaging and MLO (Mediolital-Oblique: internal and external oblique direction) imaging are performed on the breast N. It is a device that can During CC imaging, the posture of the holding unit 28 is adjusted so that the imaging surface 20 faces upward, and the radiation irradiation unit 24 is positioned above the imaging surface 20 so that the radiation unit 24 is positioned upward. The posture is adjusted. Thereby, radiation is irradiated from the radiation irradiation unit 24 to the breast N from the head side to the foot side of the standing subject W, and CC imaging is performed. In MLO imaging, generally, the posture of the holding unit 28 is adjusted in a state where the imaging table 22 is rotated 45 ° or more and less than 90 ° compared to CC imaging, and the side wall angle of the imaging table 22 on the front side of the apparatus is adjusted. Positioning is performed so that the axilla of the subject W is applied to the part 22A. Thereby, the radiation is irradiated from the radiation irradiation unit 24 to the breast N from the axial center side of the body of the subject W to the outside, and MLO imaging is performed.

  A chest wall surface 25 is formed on the surface of the imaging table 22 on the front side of the apparatus so that the chest portion below the breast N of the subject W abuts at the time of imaging. The chest wall surface 25 is flat.

  In FIG. 4, the block diagram of an example of a structure of the radiographic imaging system 5 of this Embodiment is shown.

  The radiographic image capturing system 5 of the present embodiment includes a radiographic image capturing device 10, an image processing device 50, and a display device 80.

  The radiographic imaging device 10 includes a radiation irradiation unit 24, a radiation detector 42, an operation panel 43, a biopsy unit 44, an imaging device control unit 46, and a communication I / F unit 48.

  The imaging device control unit 46 has a function of controlling the overall operation of the radiographic imaging device 10, and includes a memory including a CPU (Central Processing Unit), a ROM (Read Only Memory), and a RAM (Random Access Memory), HDD (Hard Disk Drive), a non-volatile storage unit including a flash memory or the like. The imaging device control unit 46 is connected to the radiation irradiation unit 24, the radiation detector 42, the operation panel 43, the biopsy unit 44, and the communication I / F unit 48.

  When receiving an irradiation instruction from the operator through the operation panel 43 (exposure switch), the imaging apparatus control unit 46 is provided in the radiation irradiation unit 24 according to an imaging menu (described in detail later) set based on the specified exposure condition. Radiation is applied to the imaging surface 20 from the received radiation source 30.

  The radiation detector 42 receives the irradiation of the radiation carrying the image information, records the image information, and outputs the recorded image information. For example, a radiation sensitive layer is disposed, and the radiation is converted into digital data. And output as an FPD (Flat Panel Detector). When the radiation is irradiated, the radiation detector 42 outputs image information indicating a radiation image to the imaging device controller 46. In the present embodiment, the radiation detector 42 receives image radiation that has passed through the breast N to obtain image information indicating a radiation image.

  The operation panel 43 has a function for setting various operation information such as exposure conditions and posture information, various operation instructions, and the like.

  The exposure conditions set on the operation panel 43 include information such as tube voltage, tube current, irradiation time, and posture information. The posture information specified on the operation panel 43 includes information representing a photographing position (photographing posture, angle) when photographing the breast N from a plurality of directions.

  It should be noted that these operation conditions, various operation information such as posture information, various operation instructions, and the like may be set by an operator through the operation panel 43, or other control devices (RIS: Radiology Information System, It may be obtained from a radiation information system, a system that manages information such as medical treatment and diagnosis using radiation), or may be stored in advance in a storage unit.

  When various types of information are set from the operation panel 43, the imaging apparatus control unit 46 emits radiation from the radiation irradiation unit 24 according to the imaging menu set based on the various types of information set (breast N). Radiation images are taken by irradiation. When imaging from a plurality of directions, the imaging device control unit 46 adjusts the posture of the holding unit 28 so that the imaging surface 20 faces upward, and the radiation irradiation unit 24 is positioned above the imaging surface 20. The attitude of the support portion 29 is adjusted to the position. Then, as shown in FIG. 3, the imaging device control unit 46 rotates the support unit 29 to move the radiation irradiation unit 24 in an arc shape from the angle α to the angle θ, and based on the imaging conditions, the radiation irradiation unit 24. The radiation X is individually irradiated at a different angle with respect to the imaging surface 20 from the radiation source 30 provided in FIG. Thereby, N radiation images are obtained.

  The biopsy unit 44 has a function of driving the biopsy hand unit 38. The biopsy unit 44 drives the biopsy hand unit 38 in accordance with an instruction from the imaging device control unit 46 and holds the biopsy needle 40 in a state where it is moved to a predetermined position.

  The communication I / F unit 48 is a communication interface having a function for transmitting and receiving a radiographic image and various information captured between the radiographic image capturing apparatus 10 and the image processing apparatus 50 via the network 49. .

  The image processing device 50 has a function of generating a reconstructed tomographic image from the radiographic image acquired from the radiographic image capturing device 10.

  The image processing apparatus 50 includes a CPU 52, a ROM 54, a RAM 56, an HDD 58, a communication I / F unit 60, an image display instruction unit 62, an instruction reception unit 64, a tomographic image generation unit 66, and a storage unit 68. These are connected to each other via a bus 69 such as a control bus or a data bus so that information can be exchanged.

  The CPU 52 controls the image processing apparatus 50 as a whole. Specifically, the CPU 52 performs control by executing a program 55 stored in the ROM 54. In the present embodiment, the program 55 is stored in advance. However, the present invention is not limited to this. The program 55 is stored in a recording medium such as a CD-ROM or a removable disk, and the ROM 54 or the like is recorded from the recording medium. It may be installed on the ROM 54 or the like from an external device via a communication line such as the Internet. The RAM 56 secures a work area when the CPU 52 executes the program 55. The HDD 58 stores and holds various data.

  The communication I / F unit 60 is a communication interface having a function for transmitting and receiving a radiographic image and various information captured between the image processing apparatus 50 and the radiographic image capturing apparatus 10 via the network 49. .

  The image display instruction unit 62 has a function of instructing the display 82 of the display device 80 to display a radiation image (tomographic image and two-dimensional image, details will be described later).

  The display device 80 according to the present embodiment has a function of displaying captured radiographic images (tomographic images and two-dimensional images), and includes a display 82 and an instruction input unit 84 on which radiographic images are displayed. It is configured. In addition, the instruction input unit 84 has a function for a user (for example, a doctor) who wants to collect an object of interest such as calcification or a tumor to input an instruction related to display of a radiation image. , Keyboard, mouse and the like. In this embodiment, a person who collects or diagnoses an object of interest such as a tumor by a radiographic image taken by a doctor or the like is called a user, and a tissue to be collected for biopsy such as calcification or tumor is defined as a user. It is called a matter of interest.

  The instruction receiving unit 64 has a function of receiving an instruction from the user input by the instruction input unit 84 of the display device 80.

  The tomographic image generation unit 66 has a function of reconstructing a tomographic image from a plurality of radiation images obtained by tomosynthesis imaging and generating a tomographic image parallel to the imaging surface 20. In this embodiment, “parallel” is used, but it also includes substantially parallel.

  The tomographic image generation unit 66 generates a tomographic image from a plurality of radiation images I photographed at the positions P1, P2, P3,. The position at which the object of interest is projected on the radiation image differs depending on the imaging angle at which the radiation source 30 emits radiation from each position. Therefore, the tomographic image generation unit 66 acquires imaging conditions when the radiographic image is captured from the radiographic image capturing apparatus 10, and based on the imaging angle included in the imaging conditions, the object of interest between the plurality of radiographic images is acquired. The movement amount is calculated, and a tomographic image is reconstructed based on a known reconstruction method.

  The storage unit 68 is for storing various types of information, such as a so-called large-capacity hard disk. The present embodiment also has a function of temporarily storing a radiographic image acquired from the radiographic image capturing apparatus 10 and a tomographic image generated by the tomographic image generation unit 66.

  Next, the operation of the radiation image capturing system 5 of the present embodiment will be described with reference to the drawings.

  First, radiographic image capturing in the radiographic image capturing apparatus 10 of the present exemplary embodiment will be described. When radiographing is performed, the radiographic imaging device 10 executes imaging according to the imaging menu when the imaging menu is set.

  When the radiographing apparatus 10 receives radiographing instructions for radiographing the breast N from a plurality of directions, the posture of the holding unit 28 is adjusted so that the radiographing surface 20 faces upward as shown in FIG. At the same time, the posture of the support unit 29 is adjusted so that the radiation irradiation unit 24 is positioned above the imaging surface 20.

  The subject W brings the breast N into contact with the imaging surface 20 of the radiographic imaging device 10. In this state, the radiographic imaging device 10 moves the compression plate 26 toward the imaging surface 20 when the operator gives an operation instruction to start the compression to the operation panel 43.

  In this state, the radiation imaging apparatus 10 according to the present embodiment rotates only the support unit 29 when an imaging instruction for imaging (tomosynthesis imaging) is performed on the breast N from a plurality of directions on the operation panel 43. Then, the radiation irradiation unit 24 is moved in an arc shape, and the imaging position is moved from the angle α by a predetermined angle θ as shown in FIG. 3, and the radiation irradiation unit 24 is positioned at N positions P1 to PN. Radiation is applied based on the imaging conditions. Also, when an imaging instruction for CC imaging (when radiation is applied from 0 °) is input, radiation is applied from a predetermined angle (eg, 0 ° or ± 15 °) for positioning and confirmation. When a shooting instruction for shooting (stereo shooting or the like) is input, radiation is applied based on the shooting conditions at a predetermined angle. The radiation individually irradiated from the radiation irradiation unit 24 reaches the radiation detector 42 after passing through the breast N.

  When radiation is irradiated, the radiation detector 42 outputs image information indicating the irradiated radiation image to the imaging device controller 46, respectively. As described above, when radiation irradiation is performed at N positions P1 to PN of the radiation irradiation unit 24, image information of N radiation images is output to the imaging device control unit 46. .

  The imaging device control unit 46 outputs each input image information to the image processing device 50. Note that, as described above, when the radiation irradiation unit 24 is irradiated with radiation at N locations P1 to PN, the CPU of the imaging device control unit 46 stores the image information of the N radiation images. The image is output to the image processing apparatus 50.

  The image processing apparatus 50 reconstructs a tomographic image from N radiation images obtained by tomosynthesis imaging input from the radiographic imaging device 10, and a reconstructed tomographic image and a radiation image (2 by CC imaging or stereo imaging). Radiographic image display processing for displaying the two-dimensional image on the display 82 of the display device 80 is performed. In this embodiment, a tomographic image reconstructed from a radiographic image obtained by tomosynthesis imaging is a three-dimensional image, while a radiographic image obtained by CC imaging or stereo imaging is converted into a two-dimensional image ( It is also referred to as a 2D image).

  Next, a biopsy test (biopsy) of an object of interest in the breast N of the subject W performed using the radiographic imaging system 5 of the present embodiment will be described in detail. FIG. 5 shows a flowchart of an example of a workflow of a biopsy test (biopsy) performed using the radiographic image capturing system 5 of the present embodiment.

  First, in step 100, tomosynthesis imaging is performed on the breast N of the subject W by the radiographic image capturing apparatus 10, and a plurality of radiographic images are output to the image processing apparatus 50. In the next step 102, the image processing device 50 generates a tomographic image based on the plurality of input radiation images and displays it on the display 82 of the display device 80. At this time, in addition to the tomographic image, a two-dimensional image may be displayed.

  In the present embodiment, the display of the radiation image on the display 82 of the display device 80 is executed by the CPU 52 processing the image display processing control program 55 stored in the ROM 54. By executing the program 55, the CPU 52 functions as a display processing unit and a control unit.

  From the tomographic image displayed on the display 82, the user uses the instruction input unit 84 to instruct a target (interest of interest) for which tissue is to be collected. The method of instruction is not particularly limited. For example, the target of the tomographic image displayed on the display 82 is instructed by using a mouse or a touch pen to indicate the target on the image, or the region including the target is instructed. That's fine. In the present embodiment, as a specific example, a case where a target area 90A including a target TGA and a target area 90B including a target TGB are instructed is illustrated (see FIG. 7).

  In the next step 104, when the instruction receiving unit 64 receives a user instruction, the target (target area) is specified and the three-dimensional position of the target (target area) is calculated. In the present embodiment, the position of the target in the z-axis direction is calculated based on the slice thickness when the tomographic image is reconstructed and the position of the tomographic image (for example, what number).

  In the next step 106, the breast N of the subject W into which the biopsy needle 40 is inserted is sterilized and anesthetized, and in the next step 108, the biopsy needle 40 is inserted into the breast N of the subject W. In this embodiment, the user inserts the biopsy needle 40 into the breast N here.

  In the next step 110, photographing before piercing (puncture) is performed. The radiographic image before piercing may be taken by taking a two-dimensional image. In the present embodiment, for example, as with a stereo image, a radiographic image (2) taken by irradiating radiation from an angle of ± 15 ° is used. (Dimensional image) is taken (see FIG. 6).

  In the next step 112, the tomographic image in which the target is imaged and the two-dimensional image imaged in step 110 are displayed on the display 82 of the display device 80, and the target specified in step 104 on the two-dimensional image. The tomographic image of the area is displayed as an overlay. A specific example of the overlay display displayed on the display 82 of the display device 80 is shown in FIG.

  In the present embodiment, a ± 15 ° two-dimensional image (± 15 ° image) corresponding to the regions 90A and 90B indicated by the instruction input unit 84 on the breast image NG of the breast N shown in the tomographic image. The position of the upper corresponding area is calculated. Further, as shown in FIG. 7, target area images 90GA and 90GB, which are images of the target areas 90A and 90B in the tomographic image, are overlaid on the calculated corresponding areas. The overlay display of the target area images 90GA and 90GB may be always overlaid. For example, the overlay may be performed by the user inputting an instruction by right-clicking the mouse that is the instruction input unit 84 of the display device 80 or the like. It is good to switch the presence or absence of display.

  Here, the case where the target region image in the tomographic image is displayed in an overlay manner is shown, but the present invention is not limited to this. For example, as shown in FIG. The target or position may be shown on a two-dimensional image of ± 15 °.

  The user confirms the positions of the target TGA and TGB from the ± 15 ° image in which the target areas TGA and TGB displayed on the display 82 are overlaid. Since the breast N, the shape of the affected area, or the like may change due to the influence of anesthesia, in this embodiment, imaging is performed before piercing, and the user confirms the position of the target (TGA, TGB). . As a result of the user's confirmation, when it is determined that there is a problem with performing the piercing as it is, such as when the position of the target is largely shifted, re-insertion of the biopsy needle 40, adjustment of the insertion angle, etc. What is necessary is just to perform a predetermined process. On the other hand, if it is confirmed that the biopsy can proceed, in the next step 114, piercing is performed, and after the biopsy needle 40 is inserted to the target position, in the next step 116, imaging after piercing is performed. In the present embodiment, imaging after piercing is performed in the same manner as radiographic imaging before piercing, and is displayed on the display 82 of the display device 80.

  The user confirms the positional relationship between the opening of the biopsy needle 40 and the target TGA from which the tissue is sampled by using the ± 15 ° image in which the target areas TGA and TGB displayed on the display 82 are displayed in an overlay manner. Even if the biopsy needle 40 has reached the target TGA, if the position of the opening is not appropriate, the tissue may not be sufficiently collected. Therefore, the user checks whether the positional relationship between the opening of the biopsy needle 40 and the target TGA from which the tissue is collected is appropriate for collecting the tissue. As a result of confirmation by the user, if it is determined that the positional relationship is not appropriate for tissue collection, a predetermined process such as adjustment of the insertion position of the biopsy needle 40 or re-piercing may be performed. Good. On the other hand, if the user determines that the result is appropriate, the process proceeds to the next step.

  In the next step 118, a range in which the user acquires the tissue is determined from the biopsy needle 40 and the target position, and the target tissue is collected based on the determination.

  In the next step 120, stereo imaging (± 15 °) is performed with the target tissue collected by the biopsy needle 40 to obtain a two-dimensional image. In the next step 122, the tomographic image in which the target is imaged, The two-dimensional image obtained by photographing the biopsy needle 40 and the target in step 120 is displayed on the display 82 of the display device 80, and the tomographic image of the target region specified in step 104 is displayed on the two-dimensional image in an overlay manner. A specific example of overlay display displayed on the display 82 of the display device 80 is shown in FIG. FIG. 9 shows a case where the tissue of the target TGA is collected. In the present embodiment, as shown in FIG. 9, a biopsy needle 40 in which a tomographic image and target area images 90GA and 90GB are displayed in an overlay manner is photographed on the display 82 (see FIG. 9, biopsy needle image 40G). Two-dimensional images (± 15 ° images) are displayed. In this display as well, the presence / absence of overlay display may be switched according to a user instruction.

  The user confirms that a desired target has been collected from the ± 15 ° image in which the target areas TGA and TGB displayed on the display 82 are displayed in an overlay manner. As a result of confirmation by the user, when it is determined that tissue collection is not appropriate, a predetermined process such as adjustment of the insertion position of the biopsy needle 40 or re-piercing may be performed. On the other hand, if the user determines that it is appropriate as a result of the confirmation, in the next step 124, the biopsy needle 40 is removed from the breast N of the subject W, and predetermined processing such as hemostasis / disinfection is performed. End the biopsy.

  As described above, when a biopsy is performed using the radiographic imaging system 5 of the present embodiment, the image processing apparatus 50 acquires and acquires the radiographic image captured by tomosynthesis imaging by the radiographic imaging apparatus 10. The radiographic image is reconstructed, and a tomographic image generation unit 66 generates a tomographic image. The image processing device 50 causes the display 82 of the display device 80 to display a tomographic image of the target imaged and a two-dimensional image (± 15 ° stereo imaged image). When the target area including the target on the tomographic image is designated by the user, the position of the area on the two-dimensional image corresponding to the designated target area is calculated, and the tomographic image is displayed on the corresponding area on the two-dimensional image. The target area image is displayed as an overlay. When the target position is instructed, the corresponding position on the two-dimensional image is calculated and displayed to indicate the corresponding position on the two-dimensional image. In the present embodiment, such a tomographic image and a two-dimensional image are displayed before piercing and after a target tissue is collected in a biopsy.

  As described above, in order to display the tomographic image and the two-dimensional image, the region (or position) corresponding to the region (or position) designated by the user on the tomographic image is overlaid on the two-dimensional image. The user can easily check the target on the two-dimensional image. In particular, the target was taken together with the biopsy needle 40 in a state where the biopsy needle 40 was inserted and the target tissue was collected (or collected). Since the area (or position) corresponding to the area (or position) designated by the user on the tomographic image is overlaid on the two-dimensional image (stereoscopic image), the opening of the biopsy needle 40, the target, It is possible to easily check whether the positional relationship is appropriate.

  Further, since the region including the target or the position of the target is indicated by the tomographic image, the target can be appropriately designated by the user, and the three-dimensional position of the target can be easily acquired.

  As described above, in general, in the biopsy of the breast N, the position of the target is specified using the radiographic image obtained by stereo imaging, and the position of the target and the position of the biopsy needle are confirmed. Is going. A flow of such a general biopsy workflow is shown in FIG. 10 for correspondence with the workflow of the present embodiment (see FIG. 5). Steps 1000 to 1024 of the general biopsy workflow shown in FIG. 10 correspond to steps 100 to 124 of the biopsy workflow of the present embodiment, respectively. In the workflow shown in FIG. 10, a target is specified from an image obtained by stereo shooting (see steps 1000 to 1004). In this case, for example, as shown in FIG. 11, a two-dimensional radiation image captured by irradiating radiation from 0 ° (scout imaging) and a stereo image (± 15 ° image) are displayed on the display device. . When the user selects a target on the minus 15 ° image, the position corresponding to the selected target is shown on the + 15 ° image. However, since the position of the target in the z-axis direction is unknown here, FIG. As shown in FIG. 4, the position where the target exists is indicated by, for example, a dotted line. Based on the display, the user confirms the position of the target and the positional relationship between the opening of the biopsy needle and the target. As described above, when selecting a target on a two-dimensional radiographic image, when the target is calcified or the like and is distributed in a cluster (see FIG. 12), a three-dimensional position (from which the target tissue is to be collected (see FIG. 12) It is difficult to specify the distribution area. In addition, in the stereo image (± 15 °), the position of the corresponding target must be taken into account, which takes time and may reduce the efficiency of the biopsy workflow. On the other hand, in the present embodiment, since the position of the target is specified on the tomographic image that is a three-dimensional image reconstructed from the radiographic image obtained by tomosynthesis imaging, the target can be efficiently targeted, and two-dimensional Since the user can check the image by displaying it on the image, the efficiency of the workflow can be improved.

  The display method for displaying the tomographic image as an overlay on the two-dimensional image is not particularly limited. For example, a translucent tomographic image may be superimposed on the two-dimensional image, Different colors may be displayed in an overlapping manner. Further, in the present embodiment, as the two-dimensional image, a stereo image that is irradiated with radiation from ± 15 ° and photographed by the radiation image capturing apparatus 10 is used. However, the present invention is not limited thereto, and radiation is irradiated from other angles. You may make it use the two-dimensional image image | photographed by doing it.

  In the present embodiment, the case where the present invention is applied to generation of a tomographic image of a radiographic image captured by mammography has been described, but the present invention is not limited to this, and is captured by another radiographic image capturing device. The present invention may be applied to generation of a tomographic image of a radiographic image.

  Moreover, the radiation used for radiographic imaging is not particularly limited, and X-rays, γ-rays, and the like can be applied.

  In addition, the configurations of the radiographic image capturing system 5, the radiographic image capturing device 10, the image processing device 50, and the display device 80 described in the present embodiment are merely examples, and can be used depending on the situation without departing from the gist of the present invention. Needless to say, it can be changed.

  The biopsy flow and the image generation processing flow described in this embodiment are also examples, and it goes without saying that they can be changed depending on the situation without departing from the gist of the present invention.

5 Radiographic Imaging System 10 Radiographic Imaging Device 50 Image Processing Device 66 Tomographic Image Generation Unit 80 Display Device N Breast W Subject

Claims (7)

A plurality of first images captured at different angles by the radiation image detector by irradiating the subject on the radiation image detector with radiation from different angles from a radiation irradiation unit provided facing the radiation image detector. One tomographic image is acquired from the radiation image detector, and based on the acquired plurality of first radiation images, the tomographic image that generates the tomographic image reconstructed on the basis of the detection surface of the radiation image detector of the subject Image generating means;
The tomographic image in which the object of interest in the subject is generated generated by the tomographic image generation unit, and the subject on the radiation image detector is irradiated with radiation from the radiation irradiation unit from a predetermined angle. Display processing means for causing the display means to display the second radiation image acquired from the radiation image detector;
When a designated area is designated in the tomographic image displayed on the display means, a corresponding area of the second radiation image corresponding to the designated area is calculated, and an image of the designated area is calculated on the calculated corresponding area. When the object of interest is specified in the tomographic image, the corresponding position of the second radiation image corresponding to the position of the object of interest is calculated and calculated. Control means for controlling the display processing means to display the corresponding position;
An image processing apparatus.   The image processing apparatus according to claim 1, wherein a biopsy needle inserted into the subject in order to collect the object of interest is captured in the second radiation image.   The image processing apparatus according to claim 1, wherein the second radiographic image is a pair of radiographic images for positioning.   The image processing apparatus according to claim 1, wherein the subject is a breast. Radiation is irradiated from different angles to a subject on the radiation image detector from a radiation irradiation unit provided opposite to the radiation image detector, and a plurality of radiation images are captured at each angle by the radiation image detector. A radiographic image capturing device,
The radiographic imaging device generates a tomographic image from a plurality of radiographic images taken by the radiographic imaging device, and radiates radiation from the generated tomographic image and a predetermined angle to the subject. The image processing apparatus according to any one of claims 1 to 4, wherein the second radiation image is displayed on a display unit.
Radiographic imaging system equipped with. Computer
A plurality of first images captured at different angles by the radiation image detector by irradiating the subject on the radiation image detector with radiation from different angles from a radiation irradiation unit provided facing the radiation image detector. One tomographic image is acquired from the radiation image detector, and based on the acquired plurality of first radiation images, the tomographic image that generates the tomographic image reconstructed on the basis of the detection surface of the radiation image detector of the subject Image generating means;
The tomographic image generated by the tomographic image generation means and the radiation image is acquired from the radiation image detector by irradiating the subject on the radiation image detector from the radiation irradiation from a predetermined angle. Display processing means for displaying two radiation images on the display means;
When a designated area is designated in the tomographic image displayed on the display means, a corresponding area of the second radiation image corresponding to the designated area is calculated, and an image of the designated area is calculated on the calculated corresponding area. When the object of interest is specified in the tomographic image, the corresponding position of the second radiation image corresponding to the position of the object of interest is calculated and calculated. Control means for controlling the display processing means to display the corresponding position;
Image processing program to make it function. A plurality of first images captured at different angles by the radiation image detector by irradiating the subject on the radiation image detector with radiation from different angles from a radiation irradiation unit provided facing the radiation image detector. One tomographic image is acquired from the radiation image detector, and based on the acquired plurality of first radiation images, the tomographic image that generates the tomographic image reconstructed on the basis of the detection surface of the radiation image detector of the subject An image generation process;
The tomographic image generated by the tomographic image generation step, and the radiation image is acquired from the radiation image detector by irradiating the subject on the radiation image detector from the radiation irradiation from a predetermined angle. A display processing step of displaying two radiation images on a display means;
When a designated area is designated in the tomographic image displayed on the display means, a corresponding area of the second radiation image corresponding to the designated area is calculated, and an image of the designated area is calculated on the calculated corresponding area. When the object of interest is specified in the tomographic image, the corresponding position of the second radiation image corresponding to the position of the object of interest is calculated and calculated. A control step of controlling the display processing step to display the corresponding position;
An image processing method comprising:

Images