JP2021145736A - Dose management apparatus and program - Google Patents

Abstract

To easily perform determination of image quality of the present state and adjustment of an imaging condition.SOLUTION: A dose management apparatus for managing dose information in capturing a medical image causes a display unit of a client terminal to display a dose information display screen 421. The dose information display screen 421 includes an irradiation information detail region 64 for displaying a first numerical value (a target SD value) indicating image quality set as a target in capturing the medical image; and a second numerical value (a measured SD value) indicating image quality measured from the medial image.SELECTED DRAWING: Figure 8

Description

The present invention relates to dose control devices and programs.

In the medical field, inspection devices (modality) such as CT (Computed Tomography) devices are used. In the CT examination, in order to appropriately control the radiation exposure dose, the radiation dose used in the examination is confirmed and the imaging conditions in the CT apparatus are changed. Generally, the SD value (standard deviation of the CT value) of the region of interest (ROI) specified on the CT image is measured, and according to the magnitude of the image noise expressed by this SD value, It is determined whether or not the irradiation dose to the subject is appropriate, and the imaging conditions of the CT device are adjusted. If the dose is insufficient, the image quality will deteriorate, such as the image becoming grainy. Therefore, it is desirable to suppress the irradiation dose while ensuring sufficient image quality for diagnosis.

For example, an X-ray imaging information management system that analyzes an X-ray image, derives the granularity of the region of interest as an image quality evaluation value, creates a scatter plot that plots the granularity on the vertical axis and the dose on the horizontal axis, and displays it. Has been proposed (see Patent Document 1).

JP 2013-192697

However, in the conventional dose control device, the SD value indicating the target image quality in the inspection device (modality) is controlled as ancillary information of the DICOM format medical image (DICOM image), but it can be obtained by irradiation with radiation. The SD value actually measured was not displayed from the medical image. Therefore, it is difficult to adjust the shooting conditions after comparing the target image quality set at the time of inspection with the actual image quality.

Even in the technique described in Patent Document 1, the target image quality set at the time of inspection is not compared with the actual image quality.

The present invention has been made in view of the above-mentioned problems in the prior art, and an object of the present invention is to easily determine the current image quality and adjust the shooting conditions.

In order to solve the above problem, the invention according to claim 1 comprises a first numerical value indicating an image quality targeted at the time of taking a medical image and a second numerical value indicating an image quality measured from the medical image. It is a dose management device provided with a control unit for displaying on the same screen of the display unit.

According to the second aspect of the present invention, in the dose control device according to the first aspect, the first numerical value and the second numerical value are numerical values indicating granularity.

According to the third aspect of the present invention, in the dose control device according to the second aspect, the first numerical value and the second numerical value are SD values.

The invention according to claim 4 is the dose control device according to any one of claims 1 to 3, wherein the first numerical value is ancillary information of the medical image or when the medical image is taken. This is the information included in the dose information.

The invention according to claim 5 is the dose management device according to any one of claims 1 to 4, wherein the control unit further displays dose information at the time of taking the medical image on the same screen. Let me.

The invention according to claim 6 is the dose management device according to any one of claims 1 to 5, wherein the control unit further displays the imaging conditions at the time of photographing the medical image on the same screen. Let me.

The invention according to claim 7 is the dose management device according to any one of claims 1 to 6, wherein the control unit uses the second numerical value and the dose information at the time of taking the medical image. Based on this, the imaging conditions for the subject related to the medical image are changed.

According to the eighth aspect of the present invention, in the dose management device according to the seventh aspect, the control unit further displays the changed imaging conditions on the same screen.

The invention according to claim 9 includes a transmission unit that transmits the changed imaging conditions to the inspection device in the dose control device according to claim 7 or 8.

The invention according to claim 10 shows the same screen of the display unit as the first numerical value indicating the image quality targeted at the time of taking the medical image and the second numerical value indicating the image quality measured from the medical image on the computer. It is a program for functioning as a control unit to be displayed above.

According to the present invention, it is possible to easily determine the current image quality and adjust the shooting conditions.

It is a system block diagram of the medical information management system in embodiment of this invention. It is a block diagram which shows the functional structure of the dose control apparatus. It is a figure which shows the data structure in the database of the dose management apparatus. It is a figure which shows the folder structure in the image storage area of a dose management apparatus. It is a block diagram which shows the functional configuration of a client terminal. It is a flowchart which shows the data registration process executed in the dose management apparatus. It is a ladder chart which shows the data utilization processing executed in a dose management apparatus and a client terminal. It is a figure which shows the dose information display screen. It is a figure which shows the viewer screen. It is a figure which shows the viewer screen after SD value measurement is performed. It is a ladder chart which shows the imaging condition change processing executed in a dose management apparatus and a client terminal.

Hereinafter, embodiments of the dose control device according to the present invention will be described. The present invention is not limited to the illustrated examples.

FIG. 1 shows a system configuration example of the medical information management system 100.
As shown in FIG. 1, the medical information management system 100 is composed of an examination device 10, a medical image storage device 20, a dose management device 30, a client terminal 40, and the like, and each device includes a LAN (Local Area Network) or a WAN (Local Area Network). It is connected so that data can be transmitted and received via a communication network N such as Wide Area Network). Each device constituting the medical information management system 100 conforms to HL7 (Health Level Seven) and DICOM (Digital Image and Communications in Medicine) standards, and communication between each device is performed according to HL7 and DICOM. The medical information management system 100 may include a plurality of inspection devices 10 and client terminals 40.

The inspection device 10 is a modality such as a CT device, an X-ray imaging device (DR, CR), an ultrasonic diagnostic device (US), and an MRI, and photographs a patient to generate image data of a medical image. The inspection device 10 adds the incidental information to the medical image by writing the incidental information in the header of the image file of the medical image in accordance with the DICOM standard, and generates the DICOM image file. Ancillary information includes patient information, examination information, series information, image information, and the like.

Patient information is information about a patient. Patient information includes patient ID, patient name, date of birth, gender, height, weight, age, BMI, and the like. The patient ID is identification information for identifying the patient.
Inspection information is information about inspection. The inspection information includes an inspection ID, an inspection date, an inspection time, an inspection description, an inspection instance UID, and the like. The inspection instance UID is identification information for identifying the inspection, and uniqueness is guaranteed by the DICOM standard.
Series information is information about the series. Series information includes series instance UID, series number, series date, series time, modality (CT, DR, CR, US, MRI, etc.), series description, and the like. The series instance UID is identification information for identifying a series, and uniqueness is guaranteed by the DICOM standard.
Image information is information about an image. The image information includes a SOP instance UID, an image date, an image time, an image number, and the like. The SOP instance UID is identification information for identifying a medical image, and its uniqueness is guaranteed by the DICOM standard. The image number is a number indicating the shooting order of the tomographic images (CT images) generated in one scan.

In addition, the inspection device 10 generates an RDSR (Radiation Dose Structured Report) as dose information related to the inspection performed by the inspection device 10. RDSR is information conforming to the DICOM standard and is one of the data formats representing dose information. The dose information is information indicating the amount of energy of the radiation radiated to the subject in the radiological examination.
The inspection device 10 transmits the medical image and the dose information to the medical image storage device 20 and the dose management device 30.

The medical image storage device 20 stores and manages the medical image and dose information generated by the examination device 10 for each patient and each examination. Examples of the medical image storage device 20 include a PACS (Picture Archiving and Communication System) and the like.

The dose management device 30 is a computer device that manages dose information at the time of taking a medical image.
FIG. 2 shows the functional configuration of the dose control device 30.
As shown in FIG. 2, the dose management device 30 includes a control unit 31, a communication unit 32, a storage unit 33, a timekeeping unit 34, and the like, and each unit is connected by a bus.

The control unit 31 is composed of a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and the like, and comprehensively controls the processing operation of each unit of the dose management device 30. Specifically, the CPU reads various processing programs stored in the ROM, develops them in the RAM, and performs various processing in cooperation with the programs.

The communication unit 32 is configured by a network interface or the like, and transmits / receives data to / from an external device connected via the communication network N. For example, the communication unit 32 receives a medical image and dose information (RDSR) obtained by photographing a patient from the examination device 10. Further, the communication unit 32 may receive the medical image and the dose information from the medical image storage device 20.

The storage unit 33 is composed of an HDD (Hard Disk Drive), a non-volatile semiconductor memory, or the like, and stores various data. For example, the storage unit 33 has a database 331 and an image storage area 332.

In the database 331, incidental information (header information) of the medical image file stored in the image storage area 332 and irradiation event information (dose information) related to each examination are stored in a searchable manner.
FIG. 3 shows the data structure in the database 331. The database 331 includes a patient information table T1, an examination information table T2, a series information table T3, an image information table T4, and an irradiation event information table T5.

Information about the patient is stored in the patient information table T1. The information in the patient information table T1 is mainly the information acquired from the RDSR, but may be supplemented from the incidental information of the DICOM image, if necessary. The patient information table T1 is associated with a patient ID, patient name, date of birth, gender, height, weight, age, BMI, etc., with the patient key as the primary key.

Information about the inspection is stored in the inspection information table T2. The information in the inspection information table T2 is mainly the information acquired from the RDSR, but may be supplemented from the incidental information of the DICOM image if necessary. The test information table T2 is associated with the patient key (patient to be tested), test date, test time, referral doctor name, test description, test ID, test instance UID, SOP class UID, etc., with the test key as the primary key. Has been done.

The series information table T3 stores information related to the series of incidental information of the DICOM image. In the series information table T3, the series key is used as the primary key, and the test key (test to which the series belongs), series date, series time, modality, station name, series description, doctor name, series instance UID, series number, device serial The number, reception date and time, etc. are associated with each other. The reception date and time is the date and time when the medical image belonging to the series was received.

The image information table T4 stores information related to the image of the incidental information of the DICOM image. The image information table T4 is associated with a series key (series to which the image belongs), a SOP instance UID, an image date, an image time, an image number, an SD value measurement image flag, and the like, with the image key as the primary key. The SD value measurement image flag is a flag indicating whether or not the medical image is the SD value measurement target, is turned off in the initial state in which the medical image is registered, and is the SD value measurement target. Turn it on when you do.

The irradiation event information table T5 stores information on irradiation units (irradiation event information) generated at the time of inspection. The irradiation event information table T5 has an irradiation event key as a primary key, an inspection key (inspection to which the irradiation event belongs), an inspection start date and time, an imaging protocol name, an irradiation event UID, an area dose, a voltage, a current, an irradiation time, and an allocation protocol. , CTDI _vol , scan length, pitch, DLP (Dose Length Product), SSDE value, phantom, rotation speed, target SD value, measured SD value, and the like. The irradiation event UID is identification information for identifying the irradiation event, and uniqueness is guaranteed by the DICOM standard. The target SD value is an SD value (SD value included in DICOM information) set at the time of inspection, and indicates a target image quality. The measured SD value is an SD value measured from a medical image obtained by an examination, and indicates the actual image quality of the medical image.

Image data of medical images and the like are stored in the image storage area 332.
FIG. 4 shows the folder structure in the image storage area 332. Each data is stored in a folder layered in the order of date, patient ID, examination instance UID, and series instance UID.
Specifically, a "date" folder F1 is created for each date when the dose management device 30 receives (acquires) a medical image.
A "patient ID" folder F11 is created for each patient in the lower hierarchy of the "date" folder F1.
A "test instance UID" folder F21 is created for each test in the lower hierarchy of the "patient ID" folder F11.

In the lower hierarchy of the "inspection instance UID" folder F21, "series instance UID" folders F31 and F32 are created for each series.
Medical images 51 and 52 belonging to the corresponding series are stored in the "series instance UID" folders F31 and F32, respectively. The file names of the medical images 51 and 52 are "SOP instance UID" of each medical image.

When a region of interest (ROI) is specified for a medical image selected from a plurality of medical images (CT images) obtained by a CT examination and the SD value in the ROI is measured, the medical image is displayed. An ROI display image is generated that captures the image in the state where the ROI is shown. Specifically, two types of ROI display images, a DICOM image 53 in DICOM format and a bitmap image 54, are generated.
For the ROI display image (DICOM image 53), a new "series instance UID" folder F33 is created in the lower layer of the "inspection instance UID" folder F21 corresponding to the examination to which the medical image whose SD value is measured belongs. Then, the ROI display image (DICOM image 53) is stored in the "series instance UID" folder F33. The ROI display image (DICOM image 53) is accompanied by incidental information (header information) similar to that of the medical image whose SD value is measured. However, the "series instance UID" in the series information and the "SOP instance UID" in the image information are newly generated values for the ROI display image (DICOM image 53).
The ROI display image (bitmap image 54) is stored directly under the "examination instance UID" folder F21 corresponding to the examination to which the medical image whose SD value is measured belongs.

In the image storage area 332, by dividing the folders by date, patient, examination, and series, high-speed access can be realized at the time of file acquisition. Therefore, the folder in which the target medical image is stored and the file of the medical image can be specified by the DICOM information without accessing the database 331.

The timekeeping unit 34 has a timekeeping circuit (RTC: Real Time Clock), and the current time and time is timed by this timekeeping circuit and output to the control unit 31.

The control unit 31 displays a first numerical value indicating the image quality targeted at the time of taking the medical image and a second numerical value indicating the image quality measured from the medical image on the display unit 42 of the client terminal 40 (see FIG. 5). Display on the same screen. The first numerical value is information included in the incidental information (for example, series information, etc.) of the medical image or the dose information (RDSR) at the time of taking the medical image.

The first numerical value and the second numerical value are numerical values indicating the granularity of the medical image. Examples of the numerical value indicating the granularity include an SD value, an SN ratio, and the like.

The control unit 31 displays the dose information at the time of taking the medical image on the same screen as the first numerical value and the second numerical value.
The control unit 31 displays the imaging conditions at the time of capturing the medical image on the same screen as the first numerical value and the second numerical value.

The control unit 31 changes the imaging conditions for the subject related to the medical image based on the second numerical value and the dose information at the time of capturing the medical image. The calculation method (rule) for calculating the imaging conditions suitable for the subject from the second numerical value and the dose information is predetermined, and the control unit 31 calculates the imaging conditions according to this calculation method.
The control unit 31 displays the changed shooting conditions on the same screen as the first numerical value and the second numerical value.
The communication unit 32 transmits the changed imaging conditions to the inspection device 10. That is, the communication unit 32 functions as a transmission unit. The communication unit 32 may transmit the changed imaging conditions to the console that operates and controls the inspection device 10 instead of directly transmitting the changed shooting conditions to the inspection device 10.

In the present embodiment, a case where an SD value is used as the first numerical value and the second numerical value will be described. Hereinafter, the SD value targeted at the time of taking the medical image is referred to as a “target SD value”, and the SD value actually measured from the medical image is referred to as a “measured SD value”.

The client terminal 40 is a computer device such as a PC (Personal Computer) used by a doctor. The doctor browses medical images, dose information, and the like related to the examination on the client terminal 40.
FIG. 5 shows the functional configuration of the client terminal 40.
As shown in FIG. 5, the client terminal 40 includes a control unit 41, a display unit 42, an operation unit 43, a communication unit 44, a storage unit 45, and the like, and each unit is connected by a bus.

The control unit 41 is composed of a CPU, a ROM, a RAM, and the like, and comprehensively controls the processing operation of each unit of the client terminal 40. Specifically, the CPU reads various processing programs stored in the ROM, develops them in the RAM, and performs various processing in cooperation with the programs.

The display unit 42 is configured to include a monitor such as an LCD (Liquid Crystal Display), and displays various screens according to an instruction of a display signal input from the control unit 41.
The operation unit 43 includes a keyboard equipped with cursor keys, character / number input keys, various function keys, and a pointing device such as a mouse, and controls operation signals input by key operations on the keyboard and mouse operations. Output to unit 41.

The communication unit 44 is configured by a network interface or the like, and transmits / receives data to / from an external device connected via the communication network N.
The storage unit 45 is composed of an HDD, a non-volatile semiconductor memory, or the like, and stores various data.

Next, the operation in the medical information management system 100 will be described.
FIG. 6 is a flowchart showing a data registration process executed by the dose management device 30. Here, a case where a CT image is registered as a medical image will be described as an example.

In the inspection device 10, an X-ray CT examination is performed on the subject, and the CT image (tomographic image) and the RDSR are transmitted from the inspection device 10 to the dose control device 30.
The dose management device 30 receives the CT image and the RDSR from the inspection device 10 by the communication unit 32 (steps S1 and S4).

After receiving the CT image from the inspection device 10, the control unit 31 analyzes the incidental information of the CT image for each received CT image (step S2). Specifically, the control unit 31 acquires patient information, examination information, series information, and image information for each item from the incidental information of the CT image.

Next, the control unit 31 saves the file of the CT image for each received CT image in the image storage area 332 of the storage unit 33 (step S3).
Specifically, when the "date" folder corresponding to the reception date of the CT image does not exist in the image storage area 332, the control unit 31 creates the "date" folder corresponding to the reception date. If the "patient ID" folder corresponding to the patient ID included in the patient information of the CT image does not exist in the lower layer of the "date" folder corresponding to the reception date of the CT image, the control unit 31 controls the patient ID. Create a "patient ID" folder corresponding to. The control unit 31 has a "test instance UID" folder corresponding to the test instance UID included in the CT image test information in a lower layer of the "patient ID" folder corresponding to the patient ID included in the CT image patient information. If not, create an "inspection instance UID" folder corresponding to the inspection instance UID. The control unit 31 lowers the "inspection instance UID" folder corresponding to the inspection instance UID included in the inspection information of the CT image, and has a "series instance UID" folder corresponding to the series instance UID included in the series information of the CT image. Is created, and the image data (DICOM image file) of the CT image is stored in this "series instance UID" folder.

After receiving the RDSR from the inspection device 10, the control unit 31 analyzes the received RDSR (step S5). Specifically, the control unit 31 acquires patient information (patient ID, etc.), examination information (examination instance UID, etc.), dose information, and the like from the RDSR for each item.

The control unit 31 registers the incidental information of the CT image and the information acquired by the analysis of the RDSR in the database 331 of the storage unit 33 (step S6).
Specifically, when the patient information table T1 does not have a record corresponding to the patient related to the CT image and RDSR received this time, the control unit 31 generates a new patient key and displays the patient information table T1 in the patient information table T1. Create a record corresponding to the CT image received this time and the patient related to RDSR. The control unit 31 stores the patient information acquired by the analysis of the RDSR in the patient information table T1. Further, the control unit 31 may add the patient information acquired from the incidental information of the CT image to the patient information table T1.

If the inspection information table T2 does not have the CT image received this time and the record corresponding to the inspection related to RDSR, the control unit 31 generates a new inspection key, and the inspection information table T2 contains the CT image received this time. And create a record corresponding to the inspection related to RDSR. The control unit 31 stores the inspection information acquired by the analysis of the RDSR in the inspection information table T2. Further, the control unit 31 may add the inspection information acquired from the incidental information of the CT image to the inspection information table T2.

The control unit 31 generates a new series key, creates a record corresponding to the series related to the CT image received this time in the series information table T3, and stores the series information acquired by analyzing the incidental information of the CT image. .. Regarding the "reception date and time", the control unit 31 stores the current date and time acquired from the timekeeping unit 34 when the CT image is received.

The control unit 31 generates a new image key for each CT image, creates a record corresponding to the CT image in the image information table T4, and stores the image information acquired by analyzing the incidental information of the CT image. do. Here, the "SD value measurement image flag" is turned off.

The control unit 31 generates a new irradiation event key for each irradiation event included in the RDSR received this time, creates a record corresponding to the irradiation event in the irradiation event information table T5, and acquires it by RDSR analysis. Stores irradiation event information (dose information). Further, the control unit 31 may add the information (target SD value, etc.) acquired from the incidental information of the CT image to the irradiation event information table T5. At the time when the irradiation event information is newly registered, there is no value of "measured SD value".
This completes the data registration process.

In the above data registration process, the case where the dose management device 30 receives the CT image and the RDSR from the inspection device 10 has been described, but the dose management device 30 receives the CT image and the RDSR from the medical image storage device 20. May be good. Further, the timing of receiving the CT image and the RDSR from the inspection device 10 or the medical image storage device 20 does not have to be simultaneous.

In addition, the incidental information of the medical image (CT image) may include an irradiation event UID for associating with the RDSR. In this case, the irradiation event UID makes it possible to associate the RDSR (dose information) with the corresponding medical image.

FIG. 7 is a ladder chart showing data utilization processing executed by the dose management device 30 and the client terminal 40.

First, on the client terminal 40, the search screen provided by the dose management device 30 is displayed on the display unit 42.
When the user inputs search conditions (patient, examination, modality, weight, etc.) in the client terminal 40 by operating from the operation unit 43 (step S11), in the dose management device 30, the control unit 31 changes to the storage unit 33. The information matching the search condition is acquired by referring to the database 331 of the above (step S12). The control unit 31 generates a search result list screen and provides it to the client terminal 40 via the communication unit 32.
On the client terminal 40, the search result list screen is displayed on the display unit 42 (step S13).

When the user operates from the operation unit 43 on the client terminal 40 to select an inspection from the list screen (step S14), in the dose management device 30, the control unit 31 causes the database 331 and the image storage area 332 of the storage unit 33 to be selected. From, the data of the selected inspection is acquired (step S15).
Specifically, the control unit 31 identifies the "patient key" associated with the "test key" of the selected test in the test information table T2, and the specified "patient" from the patient information table T1. Acquire patient information (including patient ID) associated with "key". The control unit 31 acquires the inspection information (including the inspection instance UID) associated with the "inspection key" of the selected inspection from the inspection information table T2. The control unit 31 identifies the "series key" associated with the "inspection key" of the selected inspection in the series information table T3, and the series information associated with the specified "series key" ( (Including series instance UID) is acquired. The control unit 31 acquires the image information associated with the "series key" of the series belonging to the selected inspection in the image information table T4. The control unit 31 identifies the "irradiation event key" associated with the "inspection key" of the selected inspection in the irradiation event information table T5, and is associated with the specified "irradiation event key". Acquire irradiation event information (dose information).
Further, the control unit 31 acquires a medical image related to the selected examination from the image storage area 332 based on the "patient ID", the "examination instance UID", and the "series instance UID" related to the selected examination. .. Further, the control unit 31 acquires an ROI display image (bitmap image) from the image storage area 332 based on the "patient ID" and "examination instance UID" related to the selected examination (only if it exists).

Here, the control unit 31 of the dose management device 30 determines whether or not there is a measured SD value corresponding to the selected test (step S16). Specifically, the control unit 31 refers to the irradiation event information table T5 and determines whether or not the "measured SD value" is included in the record associated with the "inspection key" of the selected inspection. ..

If there is a measured SD value corresponding to the selected test (step S16; YES), the control unit 31 of the dose control device 30 displays the medical image, target SD value, measured SD value, and ROI of the selected test. A display screen for displaying an image, dose information, and imaging conditions on the same screen is generated and provided to the client terminal 40 via the communication unit 32.
On the client terminal 40, the medical image, the target SD value, the measured SD value, the ROI display image, the dose information, and the imaging conditions of the corresponding examination are displayed on the same screen of the display unit 42 (step S17).

FIG. 8 shows a dose information display screen 421 displayed on the display unit 42 of the client terminal 40. The dose information display screen 421 includes a patient information area 61, an examination information area 62, an irradiation event list area 63, an irradiation information detail area 64, a medical image area 65, an ROI display image area 66, and the like.

The patient information area 61 displays information about the selected patient for the examination.
Information about the selected test is displayed in the test information area 62.
In the irradiation event list area 63, a list of irradiation events associated with the inspection is displayed. In the initial state, the top irradiation event is selected in the irradiation event list area 63.
In the irradiation information detail area 64, the details (target SD value, measured SD value, dose information, imaging condition) of the irradiation event selected in the irradiation event list area 63 are displayed. In the example shown in FIG. 8, the irradiation time, voltage, current, DLP, CTDI _vol , scan length, phantom, rotation speed, pitch, and target SD value correspond to the dose information, and the irradiation time, voltage, current, DLP, CTDI _vol. , Scan length, phantom, rotation speed, pitch, and target SD value correspond to the shooting conditions, but are not limited to this example.
The items displayed in the patient information area 61, the examination information area 62, the irradiation event list area 63, and the irradiation information detail area 64 can be arbitrarily set from the items on the database 331.

In the medical image area 65, among the medical images related to the selected examination, the medical image whose SD value is to be measured is displayed. If there is no measured SD value corresponding to the selected examination, the medical image area 65 displays a representative image of the selected examination. As a representative image, for example, among the series associated with the selected inspection, an image near the center of the shooting range of the second series (series number: 2) (determined based on the image number) is used. It will be selected automatically.
When there is a measured SD value corresponding to the selected inspection in the ROI display image area 66 (when the ROI display image exists), the ROI display image corresponding to the inspection is displayed. The ROI display image shows the ROI recognizable on the medical image, and also includes the numerical value of the measured SD value. The measured SD value is also displayed in the corresponding event line in the irradiation information detail area 64 and the irradiation event list area 63.

The control unit 31 of the dose management device 30 causes the patient information area 61 to display the “patient information of the selected patient to be examined” acquired from the patient information table T1.
The control unit 31 displays the “inspection information of the selected inspection” acquired from the inspection information table T2 in the inspection information area 62.
The control unit 31 displays a list of “irradiation events associated with the selected inspection” acquired from the irradiation event information table T5 in the irradiation event list area 63.
The control unit 31 displays the details of the irradiation event selected in the irradiation event list area 63 in the irradiation information detail area 64.
The control unit 31 displays in the medical image area 65 a medical image in which the “SD value measurement image flag” is turned on in the image information table T4 among the “medical images related to the selected examination” acquired from the image storage area 332. Let me.
The control unit 31 causes the ROI display image area 66 to display the ROI display image (bitmap image) stored directly under the “inspection instance UID” folder corresponding to the selected inspection in the image storage area 332.

In step S16, if there is no measured SD value corresponding to the selected test (step S16; NO), the control unit 31 of the dose management device 30 will use the medical image, target SD value, and dose information of the selected test. , A display screen for displaying the shooting conditions on the same screen is generated and provided to the client terminal 40 via the communication unit 32.
On the client terminal 40, the medical image, the target SD value, the dose information, and the imaging conditions of the corresponding examination are displayed on the same screen of the display unit 42 (step S18).

When there is no measured SD value corresponding to the selected test, the “measured SD value” of the corresponding event in the irradiation information detail area 64 and the irradiation event list area 63 is blank on the dose information display screen 421 shown in FIG. No image is displayed in the display image area 66. A representative image of the selected examination is displayed in the medical image area 65. The other items of the corresponding event in the irradiation information detail area 64 and the irradiation event list area 63, the patient information area 61, and the examination information area 62 are the same as the dose information display screen 421. When the user presses the SD value measurement button B1 in the ROI display image area 66, the control unit 31 of the dose management device 30 generates a viewer screen corresponding to the selected examination (patient ID, examination instance UID), and the communication unit. It is provided to the client terminal 40 via 32.
On the client terminal 40, the viewer screen is displayed on the display unit 42 (step S19).

FIG. 9 shows a viewer screen 422 displayed on the display unit 42 of the client terminal 40. The viewer screen 422 includes a series selection area 71, a medical image area 72, and the like.
In the series selection area 71, the series 71A and 71B belonging to the selected inspection are displayed.
In the medical image area 72, medical images belonging to the series selected in the series selection area 71 are displayed. In the CT image, a plurality of medical images are displayed in a stack in the medical image area 72. The stack display is to display a plurality of medical images in a superposed state, and the image displayed at the top can be switched so as to turn the page according to the user's operation.

The control unit 31 of the dose control device 30 displays thumbnail images corresponding to each series belonging to the selected examination as series 71A and 71B in the series selection area 71.

On the viewer screen displayed on the client terminal 40, when the user selects a series / image by operating from the operation unit 43 (step S20), in the dose management device 30, the control unit 31 causes the database 331 of the storage unit 33. With reference to the image storage area 332 and the image storage area 332, the data of the selected series / image is acquired, and the selected medical image is displayed on the viewer screen displayed on the display unit 42 of the client terminal 40.

In the viewer screen 422 shown in FIG. 9, the user operates from the operation unit 43 to drag and drop any of the series 71A and 71B displayed in the series selection area 71 to the medical image area 72 for medical use. The series to be displayed in the image area 72 can be selected.

The control unit 31 of the dose control device 30 displays medical images belonging to the selected series in the image storage area 332 based on the "patient ID", "test instance UID", and "series instance UID" of the selected series. The stored folder is specified, the medical images in the folder are read out, and the medical images are displayed in a stack in the medical image area 72.
The user can rotate (switch) the images displayed in the stack with respect to the medical image area 72 by rotating the mouse wheel. When the user stops the rotation of the mouse wheel, the image displayed in the medical image area 72 at that time is selected. The user selects an image suitable for measuring the SD value.

In the client terminal 40, when the ROI is specified by the user operating from the operation unit 43 on the viewer screen on which the selected medical image is displayed (step S21), the control unit 31 of the dose management device 30 is the client terminal. The designated ROI is displayed on the medical image of the viewer screen displayed on the display unit 42 of the 40. For example, the ROI is specified by drawing an ellipse, a rectangle, or the like on a medical image. As the ROI, it is desirable to specify a region such as the liver in which the pixel value is uniform (stable) and is wide to some extent. Further, the ROI may be automatically set by using the function of extracting a predetermined site (organ) from the medical image.

The control unit 31 measures the SD value (measured SD value) from the CT value in the ROI specified on the selected medical image (step S22). The measured SD value is one of the values indicating the distribution of the signal values of the image. The control unit 31 displays the measured SD value (numerical value) in the vicinity of the ROI in the viewer screen displayed on the display unit 42 of the client terminal 40.

FIG. 10 shows an example of the viewer screen 423 in a state where the ROI 73, the measured SD value 74, and the area 75 are shown. The measured SD value 74 is the standard deviation of the CT values in the range included in the ROI 73. The area 75 is the area of the ROI 73.

When the user instructs the exit of the viewer screen or the generation of the capture screen by operating from the operation unit 43, the control unit 31 of the dose management device 30 shows the ROI recognizable on the selected medical image. A ROI display image that captures the image is generated (step S23). Specifically, the control unit 31 generates a DICOM image and a bitmap image as ROI display images. The control unit 31 generates an ROI display image (DICOM image) by adding the same incidental information (header information) as the medical image whose SD value is measured.

The control unit 31 stores the measured SD value and the ROI display image in the storage unit 33 in association with the medical image (step S24). Specifically, the control unit 31 stores the “measured SD value” as the irradiation event data associated with the selected inspection (inspection key) in the irradiation event information table T5. Further, the control unit 31 changes the "SD value measurement image flag" of the medical image in which the SD value is measured to be turned on in the image information table T4. Further, the control unit 31 stores the ROI display image (bitmap image) in the image storage area 332 of the storage unit 33 directly under the “inspection instance UID” folder corresponding to the selected inspection. In addition, the control unit 31 creates a new "series instance UID" folder in the lower hierarchy of the "inspection instance UID" folder corresponding to the selected inspection, and creates a new "series instance UID" folder in the "series instance UID" folder. DICOM image) is stored.
After step S17 or step S24, the data utilization process ends.

FIG. 11 is a ladder chart showing imaging condition change processing executed by the dose management device 30 and the client terminal 40.

When the user instructs the client terminal 40 to change the imaging conditions by operating from the operation unit 43 (step S31), in the dose management device 30, the control unit 31 captures images based on the measured SD value and the dose information. The condition is calculated (step S32).
Specifically, when the dose information display screen 421 (see FIG. 8) is displayed on the display unit 42 of the client terminal 40 and an instruction is given to change the imaging conditions, the control unit 31 of the dose management device 30 changes. , SD value that will be measured from the medical image taken under the changed imaging conditions based on the difference between the target SD value and the measured SD value related to the inspection targeted for display on the dose information display screen 421. The imaging conditions for the subject (patient) related to the medical image are changed so that the image approaches the target SD value. As new imaging conditions, for example, at least one of irradiation time, voltage, current, DLP, CTDI _vol , scan length, phantom, rotation speed, pitch, and target SD value is calculated.

The control unit 31 generates a display screen that displays new shooting conditions on the same screen as the target SD value and the measured SD value, and provides the new shooting conditions to the client terminal 40 via the communication unit 32.
On the client terminal 40, the newly calculated shooting conditions are displayed on the same screen as the target SD value and the measured SD value (step S33). For example, it is displayed on the dose information display screen 421 shown in FIG. 8 with newly calculated imaging conditions added.

When the user confirms the newly calculated imaging conditions on the client terminal 40 and approves the change of the imaging conditions by operating from the operation unit 43 (step S34), the control unit 31 of the dose management device 30 communicates. The newly calculated imaging condition is transmitted to the inspection device 10 via the unit 32 (step S35).
In the inspection device 10, the imaging conditions received from the dose management device 30 are set.
This completes the shooting condition change process.

As described above, according to the present embodiment, the first numerical value (target SD value) indicating the target image quality at the time of taking the medical image and the second numerical value (target SD value) indicating the image quality measured from the medical image (the second numerical value). Since the measured SD value) and are displayed on the same screen, the user can compare the target image quality with the image quality of the actually generated medical image, and can judge the current image quality and the shooting conditions. Can be easily adjusted.

For example, granularity can be used as a numerical value indicating image quality. In particular, by using the SD value, it becomes easy to adjust the imaging conditions of the CT apparatus.

Further, since the first numerical value can be obtained from the incidental information of the medical image or the dose information (RDSR), the first numerical value is not related to whether or not the inspection device 10 corresponds to the output of the RDSR. Can be used.

Further, by displaying the dose information on the same screen as the first numerical value and the second numerical value, it is possible to judge whether or not the dose in the inspection device 10 is appropriate, and the future imaging conditions will be examined. It is possible to easily guess the shooting conditions suitable for this. Therefore, it becomes easy to adjust the shooting conditions from the next time onward.

Further, by displaying the imaging conditions on the same screen as the first numerical value and the second numerical value, it is possible to judge whether or not the dose in the inspection device 10 is appropriate, and the future imaging conditions will be examined. It is possible to easily guess the shooting conditions suitable for this. Therefore, it becomes easy to adjust the shooting conditions from the next time onward.

In addition, since the imaging conditions for the subject related to the medical image are changed based on the second numerical value and the dose information at the time of photographing the medical image, new imaging conditions are set after grasping the current image quality. Can be calculated.
Further, by displaying the changed shooting conditions on the same screen as the first numerical value and the second numerical value, the newly calculated shooting conditions can be presented to the user.
Further, by transmitting the changed imaging conditions to the inspection device 10, it becomes easy to adjust the imaging conditions in the inspection device 10.

The description in the above embodiment is an example of the dose control device according to the present invention, and is not limited thereto. The detailed configuration and detailed operation of each part constituting the device can be appropriately changed without departing from the spirit of the present invention.

For example, in the above embodiment, the case where the target SD value, the measured SD value, and the like are displayed on the display unit 42 of the client terminal 40 has been described, but the target SD value is displayed on the display unit (not shown) included in the dose management device 30. The value, the measured SD value, and the like may be displayed.
Further, when a patient is selected from the operation unit 43 of the client terminal 40, the first numerical value indicating the target image quality in the examination relating to the patient and the second value indicating the image quality measured from the medical image obtained by the examination are shown. May be initially displayed on the same screen of the display unit 42 of the client terminal 40.

Further, in the above embodiment, the case where the SD value is used as the first numerical value and the second numerical value has been described, but it may be an SN ratio or the like, and is not particularly limited as long as it is a numerical value indicating image quality.

In the above description, an example in which the ROM is used as a computer-readable medium in which a program for executing each process is stored has been disclosed, but the present invention is not limited to this example. As other computer-readable media, non-volatile memory such as flash memory and portable recording media such as CD-ROM can be applied. Further, a carrier wave may be applied as a medium for providing program data via a communication line.

10 Examination device 20 Medical image storage device 30 Dose control device 31 Control unit 32 Communication unit 33 Storage unit 34 Timing unit 40 Client terminal 41 Control unit 42 Display unit 43 Operation unit 61 Patient information area 62 Examination information area 63 Irradiation event list area 64 Irradiation information detail area 65 Medical image area 66 ROI display image area 100 Medical information management system 331 Database 332 Image storage area 421 Dose information display screen N Communication network T1 Patient information table T2 Examination information table T3 Series information table T4 Image information table T5 Irradiation Event information table

Claims (10)

A dose management device including a control unit that displays a first numerical value indicating an image quality targeted at the time of taking a medical image and a second numerical value indicating an image quality measured from the medical image on the same screen of the display unit. The dose control device according to claim 1, wherein the first numerical value and the second numerical value are numerical values indicating granularity. The dose control device according to claim 2, wherein the first numerical value and the second numerical value are SD values. The dose management device according to any one of claims 1 to 3, wherein the first numerical value is information included in the incidental information of the medical image or the dose information at the time of photographing the medical image. The dose management device according to any one of claims 1 to 4, wherein the control unit further displays dose information at the time of taking the medical image on the same screen. The dose management device according to any one of claims 1 to 5, wherein the control unit further displays imaging conditions at the time of photographing the medical image on the same screen. One of claims 1 to 6, wherein the control unit changes the imaging conditions for the subject related to the medical image based on the second numerical value and the dose information at the time of photographing the medical image. The dose control device described in. The dose management device according to claim 7, wherein the control unit further displays the changed imaging conditions on the same screen. The dose control device according to claim 7 or 8, further comprising a transmission unit that transmits the changed imaging conditions to the inspection device. Computer,
A program for functioning as a control unit for displaying a first numerical value indicating the target image quality at the time of taking a medical image and a second numerical value indicating the image quality measured from the medical image on the same screen of the display unit. ..

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