JP3495327B2 - Image acquisition devices, databases and workstations - Google Patents

Description

Detailed Description of the Invention

[0001]

TECHNICAL FIELD The present invention analyzes image of a patient.
An image that has the function of recognizing the presence or absence of abnormality and the degree of progress
For collection devices, databases and workstations
It

[0002]

2. Description of the Related Art Generally, diagnostic imaging is performed by the following procedure. (1) An image acquisition request is sent to the radiology department from an inspection request department (for example, internal medicine) that requests image diagnosis. This request is made by issuing an inspection request form. This examination request form includes the patient ID number, patient name, date of birth, sex, examination request department name, examination requesting doctor name, examination modality (X-ray imaging device, X-ray computer tomography device, magnetic resonance imaging). Device), inspection site, inspection method, inspection purpose, clinical information.

(2) The inspection request form is conveyed to an appropriate inspection technician in the radiology department, and the inspection technician collects images according to the contents of the inspection request form.

(3) An image interpretation doctor interprets the image and creates an image interpretation report according to the image interpretation result. At this time, a past image of the patient or a past image interpretation report is often referred to. This interpretation report includes information such as findings and conclusions of the interpretation doctor.

(4) This image interpretation report is sent to the doctor in charge and is utilized for determining the treatment policy of the doctor in charge.

By the way, in recent years, with the digitization of images, a medical image archiving communication system (hereinafter abbreviated as "PACS": Picture Archiving Commu).
(Nication System) is in the popularization system.

This PACS is a system that solves the problems of the search time, the complexity of film management, and the lack of storage space due to the conventional film management system. It is a system equipped with functions for storing, retrieving, communicating, and displaying various images such as resonance images.

Regarding this PACS, Japanese Patent Laid-Open No. 62-1
No. 21576, No. 63-10269, No. 64-13837, No. 64-17154.
JP-A No. 02-103668, JP-A No. 02-103668
It is disclosed in many documents such as -11840.

One of them is the function of inputting an image (I
A) A function of analyzing an image and extracting a feature amount (WS-
(ANA) and a function to display images and overlays (WS-
OUT) is added.

The function of analyzing the image and recognizing the presence or absence of an abnormality and the degree of progress of the abnormality is the computer-aided diagnosis (C
It is called AD: Computer-Aided Diagnosis), which utilizes the characteristic that a digital image can be easily processed by a computer, and analyzes the image with a computer to mainly determine the presence or absence of abnormality and its degree. This is a function for automatic diagnosis.

Regarding this computer-aided diagnosis, JP-A-02-185240 and JP-A-02-1524 are available.
No. 43, Japanese Patent Laid-Open No. 01-125675, etc.,
It is described in many publications as listed below.

(1) Katsuragawa, S .; et
al: Image feature analysis
and computer-aided diagnostics
-Isin digital radiography:
Classic-ation of normal
and abnormal normal swint int
erstial disease in chest
images. Medical Physics 16,38-
44 (1989).

(2) Giger, M. et al. L. et al:
Image feature analysis and
computer-aided diagnostics-is
internal radiography: 3. A
automat-ed detection of nod
ules in peripheral long pie
lds. Medical Physics 15.158-166 (1
988).

(3) Chan, H .; P. et al: I
image feature an-alysis and
computer-aided diagnostic
n digital radiography: 1. Au
tomated detection of microc
alifications imnammograp
hy. Medical Physics 14.538-548 (198
7). (4) Kunio Doi et al .: "Possibilities of computer-aided diagnosis in digital radiography", Journal of Japan Society for Radiation Technology, p653-663, 1989.

By the way, the image interpretation work is performed in the following procedure. An uninterpreted image of a patient is sent from the database to the workstation in response to the instruction to start the interpretation. At this time, the workstation uses the examination history of the same patient to list the image numbers of past images of the patient, and sends these image numbers to the database as search information. The database searches based on this search information and sends multiple images to the workstation. The workstation holds these images in image memory. However, in general, the image memory capacity is small,
Normally, only about 5 images can be held, so 5 images are sent from the database for the time being, and the rest of the images are waited on the database side.

At the start of image interpretation, an uninterpreted image is displayed on the workstation and a list of image numbers of the past images is displayed on the workstation. When the radiogram interpreter designates a desired image number to be referred to from this list, the image of this image number is displayed on the workstation in response to this designation.

An image interpretation doctor reads an uninterpreted image while referring to past images. By repeating such a procedure, the interpretation work is advanced. Further, as images referred to for image interpretation, there are typical images of cases (hereinafter referred to as “typical case images”) in addition to the past images described above. In order to call this typical case image, search information such as an arbitrary examination modality, examination site, disease name, and disease site is input from the workstation by the image interpretation doctor and sent to the database as search request information. The database side searches for typical case images that match the search request information and sends them to the workstation. This typical case image is displayed on the workstation and is used as a reference for image interpretation together with past images.

The following problems arise in such an image interpretation work. First, the past image specified by the doctor
If the image is not sent to the workstation and is waiting in the database, a sufficiently long waiting time is required until the image arrives from the database and is displayed.

Secondly, since it is left to the radiogram interpretation doctor to select a past image to be referred to from the list and to designate it, the labor of selection and designation is required. Third,
In order to call the typical case image, it is required to enter the search information such as the examination modality, the examination site, the disease name, and the disease site.

Fourthly, even if the unread image is observed, the disease name may not be identified in some cases, and in this case, the typical case image could not be retrieved. Further, the inspection work for collecting images also has the following problems.

That is, as a result of image interpretation of an image collected by a certain examination, the image may not be suitable for image interpretation due to problems such as contrast and photographing position. In this case, of course, a request for additional inspection is issued. The need for additional examination is judged at the time of image interpretation. Interpretation is often performed several days after the end of the examination due to the limitation of the doctor's processing ability. Therefore, the subject needs to return to the hospital several days from the previous examination day for the additional examination and undergo the additional examination, which is a burden.

[0022]

SUMMARY OF THE INVENTION The present invention has been made to address the above-mentioned circumstances, and its purpose is to provide past images or typical case images to be referred to for interpretation without operator intervention. It is an object of the present invention to provide a reference image preparation support device that can prepare and prepare for image interpretation.

Another object of the present invention is to improve the inspection efficiency by executing the CAD processing on the image obtained by the inspection immediately after the inspection is completed and instructing the necessity of the additional inspection based on the result. It is to provide an image acquisition device capable of achieving the following.

[0024]

SUMMARY OF THE INVENTION According to the present invention, an image is different depending on the type of abnormality and the range from the mildest to the severest.
A means to detect the usual degree of progress and the type of abnormality is specified
And the degree of progress is the lightest and the heaviest.
It is provided with means for outputting that an additional inspection is necessary when the temperature falls within a predetermined range excluding frequency, and means for determining the inspection condition of the additional inspection based on the type and progress of the abnormality.

(Operation) According to the present invention, the degree of progress of abnormality is at least the mildest or
Automatically determines that no additional inspection is required when the severity is severe.

[0026]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment according to the present invention will be described below with reference to the drawings. FIG. 1 shows a medical image archiving communication system (PACS: Picture Archiving C).
It is a figure which shows the schematic structure of communication system.

The network (NW) 5 is a transmission line for image communication between the respective devices, and an optical fiber is used as a transmission medium for speeding up. Although a ring type local area network is adopted here, it goes without saying that other types such as a star type may be used.

The network 5 includes a system manager (SM) 1 and a plurality of types of image acquisition devices (IA) 2.
a, 2b, the database (DB) 3, and the workstations (WS) 4A, 4B are connected to each other and can be mutually linked by a communication protocol.

An inspection order system 7 is connected to the network 5 via a gateway 6. The inspection order system 7 includes an input means such as a keyboard. Inspection request information for requesting the collection of images is input from the inspection order system 7.
Table 1 shows an example of this inspection request information.

[0030]

[Table 1]

The image acquisition devices 2a and 2b are image acquisition devices such as an X-ray imaging device, an ultrasonic diagnostic device, an X-ray computer tomography device, and a magnetic resonance imaging device. The image collecting devices 2a and 2b add the generated images to
Image numbers are attached in the order of occurrence and accompanying information as unique information about the image is attached to the database 3 according to the instruction of the system manager 1.
Table 2 shows an example of this accompanying information.

[0032]

[Table 2]

The system manager 1 is constructed as shown in FIG. Control bus (SM-CBUS) 1 which is a transmission path for various control information and data in the system manager 1
i is a network interface (SM-NWI
F) Connected to the network 5 via 1h. The control bus 1i has a control device (SM-CTRL) 1a, a system disk (SM-SD) 1b, an inspection ID number issuing device (SM-EIDI) 1c, and an inspection request information storage device (SM).
-EOIM) 1d, inspection history storage device (SM-EHM) 1
e, an image interpretation report storage device (SM-IDRM) 1f, and an information retrieval device (SM-SRCH) 1g are connected.

The control unit 1a includes a CPU and a system memory and controls the overall operation of the system manager 1. The system disk 1b is, for example, a magnetic disk, stores a program for operating the respective units of the system manager 1 in association with each other, and supplies the program to the control device 1a when the power is turned on. The inspection ID number issuing device 1c issues the inspection ID numbers in the order of arrival of the inspection request information from the inspection order system 7. The inspection request information storage device 1d stores the inspection request information together with the inspection ID number. The inspection history storage device 1e stores all the inspection history created by the workstations 4A and 4B to date. The image interpretation report storage device 1f stores all image interpretation reports created up to now by the workstations 4A and 4B. Table 3 shows an example of this image interpretation report.

[0035]

[Table 3]

The information retrieval device 1g retrieves various information stored in the inspection request information storage device 1d, the inspection history storage device 1e, and the image interpretation report storage device 1f in response to the retrieval requests from the workstations 4A and 4B. .

The database 3 is constructed as shown in FIG. A control bus (DB-CBUS) 3i which is a transmission line of various control information in the database 3 and an image bus (DB-IBUS) 3j which is a transmission line of data are networked via a network interface (DB-NWIF) 3h. Connected to 5. The control bus 3i and the image bus 3j include a control device (DB-CTRL) 3a, a system disk (DB-SD) 3b, an examination directory storage device (DB-DIR) 3c, and an information retrieval device (DB-SRC).
H) 3d, optical disk device for image storage (DB-IOD)
3e, magnetic disk device for image storage (DB-IHD) 3
f, block memory (DB-BLKM) 3g, input device (DB-INPUT) 3k, image input device (DB-II)
NPUT) 3m is connected.

The control device 3a includes a CPU and a system memory and controls the operation of the entire database 3. The system disk 3b is, for example, a magnetic disk, stores a program for operating the respective units of the system manager 1 in association with each other, and supplies the program to the control device 3a when the power is turned on. The inspection directory storage device 3c stores an inspection directory as management information of the images stored in the image storage optical disk device 3e. Table 4 shows an example of this inspection directory.

[0039]

[Table 4]

The information retrieval device 3d retrieves the examination directory in response to the retrieval information from the workstations 4A and 4B. The optical disk device 3e for image storage uses the large-capacity optical disk as a storage medium, and the image collecting devices 2a, 2
The images (including accompanying information) collected in b, typical case images of various cases, and overlay data are stored. The image storage magnetic disk device 3f temporarily stores input / output information to / from the image storage optical disk device 3e using a magnetic disk as a storage medium. The block memory 3g uses a semiconductor memory as a storage medium to temporarily store images and attached information. The input device 3k is, for example, a keyboard or a touch screen, and is an input unit for inputting various commands and accompanying information. The image input device 3m is, for example, a digitizer for reading a film, and mainly reads a typical case image.

The workstation 4A is constructed as shown in FIG. Since the workstation 4B has the same configuration as the workstation 4A, its description is omitted.

A control bus (WS-CBUS) 4k which is a transmission line of various control information in the workstation 4A and an image bus (WS-IBUS) 4l which is a transmission line of data.
Is the network interface (WS-NWIF)
It is connected to the network 5 via 4j. Control bus 4
A control device (WS-CTRL) is provided on k and the image bus 41.
4a, system disk (WS-SD) 4b, input device (WS-INPUT) 4c, character display device (WS-CD)
ISP) 4d, CAD processor (WS-CADP) 4
e, image storage device (WS-IM) 4f, image frame memory (WS-IFM) 4g, image display manager (WS-IDM) 4h, information retrieval device (WS-SRC)
H) 4 m, reference priority information creation device (WS-MKP)
4n, an inspection history creation device (WS-MKH) 4p are connected. Further, a plurality of image display devices (WS-IDISP) 4i, here four, are connected to the image display manager.

The control device 4a includes a CPU, a system memory and the like, and controls the overall operation of the workstation. The system disk 4b uses a magnetic disk as a storage medium and stores a program relating to related operations of each part of the workstation 4A, abnormality detection means selection information, and various reference order rules. The reference order rule is a rule for determining the priority order of referring to past images and typical case images. This program is sent to the control device 4a when the power is turned on. Anomaly detection means selection information is shown in Table 5 below, and Table 6-
Table 11 shows an example of various reference order rules.

[0044]

[Table 5]

[0045]

[Table 6]

[0046]

[Table 7]

[0047]

[Table 8]

[0048]

[Table 9]

[0049]

[Table 10]

[0050]

[Table 11]

The input device 3c is, for example, a keyboard or a touch screen, and is an input means for inputting various commands and image interpretation reports. The character display device 4d is, for example, a CRT (cathode ray tube) display or a liquid crystal panel display, and mainly displays character information such as inspection request information, inspection history, and interpretation report.

The CAD processing device 4e has a computer-aided diagnosis function (CAD: Computer-Aided Diagnosis), detects various abnormalities in an unread image, and creates an abnormal data table. An example of this abnormal data table is shown in Table 12 below.

[0053]

[Table 12]

The CAD processing device 4e includes a plurality of types of abnormality detecting means. The abnormality detecting means includes (a) means for detecting a shadow of interstitial disease of the lung in a front view of a plain X-ray image of the lung, and (b) a front view of a plain X-ray image of the chest in a front view of the lung. There is a means for detecting a shadow, and (c) a means for detecting a shadow of microcalcification of a breast in a breast X-ray image. Further, the CAD processing device 4e includes an anatomical section recognition means. This anatomical section recognition means
It is recognized which of the anatomical divisions of the organ to be inspected the abnormality detected by the abnormality detecting means belongs to. The anatomical division means, for example, in the case of a lung part, each region in which two left and right lungs are vertically divided into three equal parts, and each region is referred to as an “upper left lung field”, a “left middle lung field”, and a “left middle lung field”, respectively. These are referred to as "lower left lung field", "upper right lung field", "right middle lung field", and "lower right lung field".

There are various means for specifying this.
Here, the method disclosed in JP-A-1-125675 is adopted. Incidentally, the anatomical division of the lungs should be properly divided based on the positional relationship with the tip of the rib, but it is difficult to recognize the tip of the rib with a computer, so in the above method, Generally, the fact that the lower clavicle is located at the central position of the upper lung field and the upper edge of the diaphragm coincides with the lower edge of the lung field makes it easier to recognize the image from the lower edge of the clavicle and the upper part of the diaphragm. Based on the positional relationship of the edges,
Recognize the range of each section on the image. By collating the center position of the abnormality with the coordinates on the image that specify each area, the anatomical section corresponding to the position of the abnormality can be specified.

The CAD processing device 4e collectively outputs the determination result of the abnormality detecting means and the area where the abnormality exists in the abnormality data table. The image storage device 4f uses a magnetic disk as a storage medium and handles examination request information, examination history, image interpretation report, uninterpreted image, typical case image, incidental information, overlay display information, abnormal data table, which is handled during workstation startup. The priority information is temporarily stored. The reference priority information is priority order information to be referred to for past images or typical case images determined by the reference priority information creation device 4n based on the image reference preparation rule. The image frame memory 4g uses a semiconductor memory as a storage medium to temporarily store an image.

The image display manager 4h is constructed as shown in FIG. An overlay unit 44 is connected to the image bus 41 via the image memory 42. An overlay unit 44 is also connected to the control bus 4k via a control unit 40, an overlay data creation unit 41, and an overlay memory 43 in this order. The overlay unit 44 is connected to the image display device 4i via the display memory 45 and the D / A converter 46 in this order.

The uninterpreted image, the past image, and the typical case image are input from the image bus 4l and sent to the overlay section 44 via the image memory 42. Further, overlay display information regarding the uninterpreted image is input from the control bus 4l, is sent to the overlay data creation unit 41 via the control unit 40, and is created as overlay data (an image indicating an abnormality). This overlay data is sent to the overlay unit 44 via the overlay memory 43a. In the overlay section 44, the unread image and the overlay data are combined to create a combined image, which is displayed on the image display device 4i via any of the display memory 45 and the D / A converter 46. In addition, past images and typical case images are respectively passed through the overlay unit 44,
The data is sent to separate display memories 45, and the D / A converter 4
6 is displayed on the image display device 4i.

Returning to FIG. 4, the information retrieval device 4m inputs various information stored in the image storage device 4f into the input device 4.
Search based on the search information entered from b. The inspection history creation device 4p updates the inspection history by adding the inspection information regarding the uninterpreted image sent to the workstation 4A to the old inspection history that does not include the inspection information of the uninterpreted image. As the inspection information, necessary information is selected from the inspection request information and the accompanying information. Table 13 shows an example of the inspection history.

[0060]

[Table 13]

The reference priority information creation device 4n determines the priorities of past images and typical case images to be referred to when interpreting the uninterpreted image based on various image reference rules, and refers to them according to the determined contents. Create priority information. The reference rule is the image reference rule when an abnormality is detected in the CAD processing result in the past examination of the same patient as the uninterpreted image, the CAD reference in the past examination of the same patient as the uninterpreted image. There are image reference rules when no abnormality is detected in the processing result, and image reference rules for typical case images.

Next, the operation of this embodiment having the above configuration will be described. Upon installation, a plurality of types of typical case images are input in advance from the image input device 3m of the database 3 and stored in the image storage optical disc 3e via the image storage magnetic disc 3f. In addition, each incidental information of a plurality of types of typical case images is input to the input device 3 of the database 3.
It is input from k and stored in the image storage optical disk 3e via the image storage magnetic disk 3f. A specific example of this accompanying information is shown in Table 14 below.

[0063]

[Table 14]

Next, the flow from generation of an inspection request to generation of an image and storage of the image on the image storage optical disk 3e will be described. First, the inspection request information is input through the inspection order system 7 to make an inspection request. A specific example of this inspection request information is shown in Table 15 below.

[0065]

[Table 15]

The examination request information includes individual information about the patient, examination information for instructing the examination site and examination method necessary for imaging, clinical information of the patient, and the already given disease name. Note that the clinical information of the patient is input only when the differential diagnosis is already confirmed when the relevant test is requested, and therefore the information may not exist in some cases.

This inspection request information is sent to the system manager 1 via the network 5 and transferred from the system manager 1 to an appropriate image collecting device 2a. In the image collecting device 2a, an image is generated by an inspection engineer according to the instruction of the inspection request information, and an image is generated. This image is attached with accompanying information, is sent to the database 3 via the network 5, and is stored in the image storage optical disc 3e via the image storage magnetic disc 3f. A specific example of this accompanying information is shown in Table 16 below.

[0068]

[Table 16]

Further, under the instruction of the system manager 1, the image and the accompanying information are sent to the workstation 4A via the network 5 together with the inspection request information and stored in the image storage device 4f. The inspection history creation device 4q
This examination history is updated by adding the information extracted from the incidental information of the examination and the examination request information to the examination history of the patient stored in the image storage device 4f. A specific example of this updated inspection history is shown in Table 17 below.

[0070]

[Table 17]

The updated inspection history is returned to the image storage device 4f and stored therein. Further, the uninterpreted image is sent from the image storage device 4f to the CAD processing device 4e, and the CAD process is executed. In the CAD processing device 4e, as described above, (a) means for detecting the shadow of interstitial disease of the lung in the front image of the chest simple X-ray image, and (b) in the front image of the chest simple X-ray image. There are provided three types of abnormality detecting means: a means for detecting a shadow of a nodule of the lung, and (c) a means for detecting a shadow of a microcalcification of a breast in a breast X-ray image. The CAD processing device 4e uses the abnormality detection means selection information to specify the type of abnormality that can be detected for this image, and selects the abnormality detection means according to the result. Here, the examination site is the chest, the examination method is simple imaging,
Since the imaging direction is P → A, the abnormality detecting means capable of detecting the pulmonary interstitial disease and the abnormality detecting means capable of detecting the lung nodule are selected. Anomaly detection processing is performed on the original image by the selected anomaly detection unit, and the presence or absence of an anomaly, the type of the anomaly (determined when the anomaly detection unit is selected), the position of the anomaly, the degree of the anomaly, the anatomy The area in which the abnormal segment exists is determined. This determination result is stored in the image storage device 4
f, and is added to the abnormal data table. Thereby, the abnormal data table is updated. Table 18 below shows a specific example of this updated abnormal data table.

[0072]

[Table 18]

The information newly added to this abnormal data table is the information of reference numbers 1 and 2. After the above-described processing, an image interpretation doctor inputs an instruction to start image interpretation from the input device 4c of the workstation 4. In response to this, the oldest uninterpreted image is determined as the first image interpretation target. It is assumed that the first image interpretation target is the uninterpreted image of the examination ID number; 108801 described above.

The unread image is sent from the image storage device 4f to the image display manager 4h and displayed on one of the image display devices 4i. At this time, the reference priority information generation device 4n generates reference priority information. The process of creating this reference priority information will be described below.

First, the abnormal data table and the examination history of the same patient as the uninterpreted image are sent from the image storage device 4f to the reference priority information creation device 4n. Then, all the inspection ID numbers of this inspection history are extracted. At least 1
It is determined whether or not one inspection ID number exists in the abnormal data table. The existence of the inspection ID number in the abnormality data table means that an abnormality is found by the CAD process in the inspection of the inspection ID number.

As a result of this judgment, at least one inspection I
If the D number exists in the abnormal data table, the following processing 1
~ Process 4 and process 6 are sequentially executed. If they do not exist, process 5 and process 6 are sequentially executed.

Process 1 In process 1, the order of priority is determined using the image reference rules shown in Table 6. Therefore, this image reference rule is sent from the image storage device 4f to the reference priority information creation device 4n. The abnormal data table and the inspection history are also stored in the image storage device 4
It is sent from f to the reference priority information creation device 4n.

Then, using the abnormal data table and the inspection history,
The inspection region, modality, abnormality type, and abnormal position of the uninterpreted image are extracted. Similarly, the examination region modality, the abnormality type, and the abnormal position are extracted for each past examination, and the identity with the examination region or the like of the uninterpreted image is determined. As a result of this determination, a past examination having the same examination site and the like as the unread image is selected.

For each of the selected past examinations,
The test history is used to determine if clinical information is present. The clinical information is the information that the doctor in charge enters into the test information as a comment when a characteristic item such as the administration of a drug or a change in symptoms occurs at each test stage. In many cases, the examinations marked with are very important for image interpretation.

As a result of this determination, all the examinations for which clinical information exists are targeted for the prioritization of this processing 1.
All of these tests are prioritized based on the content of clinical information and the date of the test. First, as shown in (a) of the image reference rule shown in the table, the examination having the clinical information of “change in symptom” acquires the first priority. Then, as shown in (b) of the image reference rule shown in the table, an examination having clinical information that does not have this content is assigned a higher priority order from the newest examination date to the first priority order. To earn. The priority order information thus obtained is written in the reference priority order information.

Explaining with a specific example, at least in the examination history of Table 17, there is no examination having clinical information. Therefore, in the processing 1, there is no examination that acquires the priority.

Processing 2 In processing 2, the priority order is determined using the image reference rules shown in Table 7. Therefore, this image reference rule is sent from the image storage device 4f to the reference priority information creation device 4n. The abnormal data table and the inspection history are also stored in the image storage device 4
It is sent from f to the reference priority information creation device 4n. In the process 2, the presence or absence of clinical information is not a factor in determining the priority, unlike the process 1. In the process 2, all the past examinations that are the same as the examination region, modality, abnormality type, and abnormality position of the uninterpreted image are prioritized. All inspections that meet this identity will get priority based on the context of their inspection dates. That is, as shown in (a) and (b) of the image reference rules shown in Table 7, the oldest inspection, that is, the oldest inspection is the first inspection in the process 2.
Get priority. Other tests get higher priority, with older ones following first priority. The priority of the process 2 obtained in this way is arranged lower than the priority of the process 1, and is written in the reference priority information.

Specifically, the inspection I in the inspection history of Table 17
D; 100902 inspection conforms to (a) of the image reference rule shown in Table 7, and inspection ID; 103541 inspection,
It conforms to (b) of the image reference rules shown in Table 7. Therefore, since there is no inspection compatible with the process 1, the process 2
In each of the steam inspections conforming to the image reference rules (a) and (b) in Table 7, the first reference priority information is set as shown in Table 19.
And the second priority.

[0084]

[Table 19]

Processing 3 In processing 3, the priority order is determined using the image reference rules shown in Table 8. Therefore, this image reference rule is sent from the image storage device 4f to the reference priority information creation device 4n. The abnormal data table and the inspection history are also stored in the image storage device 4
It is sent from f to the reference priority information creation device 4n. In the process 3, the past examination in which the unread image and the examination region are the same
Subject to priority. The order of priority among the targeted inspections is from (a) to (a) of the image reference rule inspection shown in the table.
As shown in (c), it is determined based on the examination date and the type of modality. Here, the newest examination among the examinations by the X-ray tomography apparatus obtains the first priority in the process 3. Subsequent to this examination, the newest examination in the examination by the X-ray computed tomography apparatus (CT) and the newest examination in the examination by the magnetic resonance imaging apparatus (MR) acquire higher priority in turn. The priority order of the process 3 thus obtained is arranged in the lower order of the priority order of the process 2 and is written in the reference priority order information.

Specifically, since there is no examination that meets the image reference rules shown in Table 8 in the examination history of the patient, no examination is written in the reference priority information in process 3.

Processing 4 In processing 4, the priority order is determined using the image reference rules shown in Table 9. Therefore, this image reference rule is sent from the image storage device 4f to the reference priority information creation device 4n. The abnormal data table and the inspection history are also stored in the image storage device 4
It is sent from f to the reference priority information creation device 4n. In the process 4, the past examinations having the same examination site are targeted for priority. The priority in this target inspection is
As shown in (a) to (f) of the image reference rules shown in Table 9, it is determined based on the anteroposterior relationship between the type of abnormality of the unread image and the inspection date. Further, different modalities are determined in advance for each type of abnormality in the uninterpreted image. Therefore,
In the process 4, the type of abnormality of the uninterpreted image is specified from the abnormality data table, and the latest examination is selected from the examinations using the modality corresponding to this abnormality type. The priority order of the process 4 thus obtained is arranged in the lower order of the priority order of the process 3, and is written in the reference priority order information.

Specifically, since there is no examination that meets the image reference rules shown in Table 9 in the examination history of the patient, no examination is written in the reference priority information in process 3.

Process 5 As described above, in Process 5, in the abnormal data table, all the examination ID numbers of the examination history of the patient do not exist, in other words, in any of the past examinations of the patient, CA.
When no abnormality is found by the D process, the process 1 to the process 4 are immediately executed without executing them. Process 5
Are prioritized using the image reference rules shown in Table 10. Therefore, this image reference rule is sent from the image storage device 4f to the reference priority information creation device 4n.
The past examination request information of the patient and the examination history of the patient are also sent from the image storage device 4f to the reference priority information creation device 4n. In process 5, all tests for the patient are targeted for priority. As shown in (a) to (h) of the image reference rule inspection shown in Table 10, the priorities among the inspections to be performed are as follows. It has priority over past examinations where the uninterpreted image and the examination site differ. Further, the past examination having the same modality as the uninterpreted image has priority over the past examination having the different modality. In addition, newer inspection date inspections take precedence over older inspection date inspections. According to these rules, the priority order in process 5 is determined.
Similar to the process 1, the priority of the process 5 obtained according to these three criteria is written in the reference priority information as the first priority.

Specifically, since at least one examination ID number of the examination history of the patient is present in the abnormal data table, it is not executed.

Process 6 Process 6 is a process for setting the priority order of typical case images, and is always executed subsequent to Process 4 or Process 5. In the process 6, the priority order is determined by using the image reference rule shown in Table 11. Therefore, the image reference rule is stored in the image storage device 4f to the reference priority information creation device 4n.
Sent to. Further, the abnormal data table and the inspection request information of the uninterpreted image are also sent from the image storage device 4f to the reference priority information creation device 4n. In the process 6, first, it is determined whether or not the inspection ID of the uninterpreted image is present in the abnormal data table, that is, whether or not an abnormality is found in the uninterpreted image by the CAD process. Here, the inspection ID of the uninterpreted image does not exist in the abnormal data table,
That is, when no abnormality is found in the uninterpreted image by the CAD processing, this processing 6 ends at that point.

On the other hand, when the examination ID of the uninterpreted image is present in the abnormal data table, the priority order is determined for a plurality of types of typical case images according to the typical case image reference rules shown in the table. This determination process is performed as follows. First, in the typical case image retrieval device 4q, according to the typical case image reference rule (a), the CAD of the uninterpreted image is CAD.
When the processing result is cancer and the size of the cancer is 1 cm or more, the first priority in the processing 6 is set to the typical case image in which the examination site and the modality are the same as the uninterpreted image and the benign discrimination is performed. To do. A specific example of a plurality of typical case images for which the first priority is set is shown in FIG. This first
Following priority, (b) and (c) of the typical case image reference rules
Accordingly, the typical case images having the same type of abnormality as the uninterpreted image are targeted for priority ordering. Table 20 shows specific examples of the accompanying information of the typical case image in which the type of abnormality is the same as that of the uninterpreted image (interstitial lung disease).

[0093]

[Table 20]

There are two types, case 5 and case 10.
Among these, the second priority in the process 6 is set to the typical case image (case 5) in which the abnormal position is the same as the abnormal position, and the typical case image (case 10) in which the abnormal position is different from the uninterpreted image is processed 6 The third priority in is set. The priority of the process 6 thus obtained is sent to the reference priority information creation device 4n, arranged below the priority of the process 4 or 5, and written in the reference priority information. This process 6
When the typical case image according to is written in the reference priority information, a “case” tag indicating that it is a typical case image is added. Table 21 shows a specific example of the reference priority information created in this way.

[0095]

[Table 21]

This reference priority information is the information retrieval device 4m.
Sent to. Examination ID included in this reference priority information
The request for calling the reference image of is sent from the information search device 4m to the database 3. In response to the call request, a plurality of reference images having the inspection ID are sent from the database 3 to the image storage device 4n and stored therein. The image storage device 4n has a small storage capacity and can store only six images as described above. There is one set of two unread images, and two images are included in each examination ID of priorities 1 and 2, so a total of four references included in each examination ID of priorities 1 and 2 are referenced. The image is first sent to the image storage device 4n and stored therein. Remaining inspection I
The image of D is transferred from the image storage optical disk device 3e of the database 3 to the image storage magnetic disk device 3 so that the call request from the workstation 4 can be quickly responded to.
moved to f.

When an instruction to display past images is input from the input device 4c, past images without case tags are displayed in order from the highest priority according to the reference priority information. It is sent from the storage device 4n to the image display manager 4h and is displayed on the image display device 4i other than the image display device 4i displaying the unread image. At this time, a plurality of reference images may be sent to the image display manager 4h and displayed on different image display devices 4i according to the number of image display devices 4i. When an instruction to display a past image is input again from the input device 4c, a lower-order past image of the currently displayed priority is displayed from the image storage device 4n according to the reference priority information. It is sent to the display manager 4h and displayed on the image display device 4i. By thus repeatedly inputting the instruction to display the past image, a plurality of past images are switched and displayed according to the priority order of the reference priority order information.

When an instruction to display a typical case image is input from the input device 4c, typical case images with case tags are sequentially attached in order from the highest priority according to the reference priority information. The image data is sent from the image storage device 4n to the image display manager 4h and displayed on the image display device 4i other than the image display device 4i displaying the unread image. Switching the display to the typical case image with lower priority,
This is performed by re-inputting an instruction to display the typical case image.

Interpretation is performed with reference to this reference image, and an interpretation report is created. The image interpretation report is stored in the image storage device 4f, and the image interpretation is completed. In this way, according to the present embodiment, the priority order of the reference images is determined based on the CAD processing result, so that the doctor who interprets the image does not need to select the reference image from the list, and the doctor who interprets the image does not read The reference image can be referred to even if the abnormal type of can not be determined. In addition, since the reference images with the highest priority are transferred from the database to the workstation and are stored there, the reference image designated by the image interpretation doctor is not retained in the workstation as in the past, and therefore The frequency of direct calls to the database is reduced, and therefore the image interpretation work can be efficiently performed.

In this embodiment, four image display devices are used in the above description, but the number of image display devices is not limited to four and may be more or less than four. Regarding the array of a plurality of simultaneously displayed images, a side photo is generally arranged next to the front photo, but it may be displayed in another array. Further, in the above description, the finding information is treated as an image interpretation report, but it may be other information including an finding other than the image interpretation report. In the above description, the priority is determined according to the reference rule, but the priority may be determined according to another reference rule as long as the rule reflects the CAD processing result. Further, the typical case images may be selectively displayed according to the designation of the image interpretation doctor without setting the priority order.

Next, the second embodiment will be described. The present embodiment relates to the image collecting apparatus of FIG. 1 of the previous embodiment. A specific configuration of this image acquisition device is shown in FIG. The other parts are the same as those in FIGS.

In FIG. 7, 2A is a control bus which is a transmission line for various control signals, and 2B is an image bus which is a transmission line for image data. This control bus 2
A and the image bus 2B include a control device 2C, a system disk 2D, an X-ray generator 2E, an X-ray imaging device 2F, an image storage device 2G, a CAD processing device 2H, a next inspection condition determining device 2I, an input device 2J, and the like. The display device 2K is connected.

The control device 2C includes a system memory such as a CPU and a semiconductor memory, and controls the overall operation of the image acquisition device. The system disk 2D stores a basic program necessary for controlling the operation of the entire image acquisition device, and supplies the basic program to the control device 2C when the power is turned on. The X-ray generator 2E includes a high-voltage power supply, and applies a high voltage to the X-ray imaging device 2F according to an instruction from the controller 2C. The X-ray imaging device 2F is a device that includes an X-ray tube, an image intensifier, a TV camera, an analog / digital converter, and the like, and captures an X-ray image of a subject and outputs the image as a digital signal. Image storage device 2
G uses, for example, a semiconductor memory or a magnetic disk as a storage medium, and temporarily stores the digital image data output from the X-ray imaging apparatus 2F. The CAD processing device 2H is the same as the CAD processing device shown in FIG. 4 of the first embodiment, and executes the CAD processing on the digital image output from the X-ray imaging apparatus 2F, and outputs the abnormal data table. Is output. The next inspection condition determining device 2I determines the necessity of the additional inspection using the abnormal data table of the CAD processing device 2H, and sets the inspection condition (imaging condition) of the additional inspection when the additional inspection is necessary. . The input device 2J is a keyboard, a mouse, or a touch screen, and is used to input a command and various information of an inspection engineer. The display device 2K is a CRT display or a liquid crystal panel,
Display images and various text information.

Next, the operation of the image collecting apparatus having such a configuration will be described. The inspection request information is sent to the X-ray imaging apparatus 2F. The examination engineer starts, for example, a plain chest X-ray image according to the examination request information. Prior to the start of this inspection, the following preparations are made. First, imaging conditions such as tube current, tube voltage, and exposure time are set from the input device 2J. These imaging conditions are determined by the inspection technician based on the physical characteristics of the subject such as age, sex, and body thickness.
For example, the tube current is set to 200 mA, the tube voltage is set to 80 kV, and the exposure time is set to 0.1 sec. In addition, the posture of the subject with respect to the X-ray tube and the image intensifier of the X-ray imaging apparatus 2F is set so that X-rays are emitted from the back of the subject according to the examination site and the examination direction of the examination request information. .

When the above-mentioned preparation is completed, X-rays are actually exposed and photographing is performed. The image data thus obtained is output as digital image data via the analog / digital converter.

This image data is immediately transferred to the CAD processor 2
It is sent to H and is subjected to CAD processing there. This CAD
As a result of the processing, the CAD processor 2H outputs an abnormal day or a table. As described in the first embodiment, this abnormality data table includes information on presence / absence of abnormality, type of abnormality, position of abnormality (region where abnormality exists), and degree of progress of abnormality.

This abnormal data table is sent to the next inspection condition determining device 2I. The next inspection condition determining device 2I determines the necessity of the additional inspection and determines the inspection condition (imaging condition) of the additional inspection when the additional inspection is necessary. The procedure will be described. FIG. 8 is a flowchart showing a procedure of determining the necessity of the additional inspection by the next inspection condition determining device 2I and determining the inspection condition (imaging condition) of the additional inspection when the additional inspection is necessary, and FIG. 8 is a detailed flowchart of block A, and FIG. 10 is a detailed flowchart of block B in FIG.

As shown in FIG. 8, the next inspection condition determining device 2
In I, it is determined whether or not an abnormality is detected by the CAD processing device 2H (S1). This determination is made based on whether or not the inspection ID exists in the abnormal data table.
The existence of the inspection ID in the abnormal data table means that the CAD
The abnormality is detected by the processing device 2H, and the absence of the inspection ID in the abnormality data table indicates that the CAD processing device 2H has not detected the abnormality.
If No in S1, that is, if no abnormality is detected in the collected image, the process proceeds to S4, and it is determined that the next inspection (additional inspection) is unnecessary. According to this determination, a message "no next inspection" is displayed on the display device 2K. If Yes in S1, that is, if an abnormality is detected in the collected image, the process proceeds to the determination step in S2. By S2, it is determined whether the type of the abnormality is a specific type, here, pulmonary interstitial disease. Here, if it is a pulmonary interstitial disease, the process proceeds to the zygote A, and if it is not a pulmonary interstitial disease, the process proceeds to the determination step of S3. By S3, it is determined whether the type of the abnormality is another specific type, here, a lung nodule. Here, if it is a lung nodule, go to the zygote B, and if it is not a lung nodule, proceed to S4 and determine that the next examination (additional examination) is unnecessary. According to this determination, a message "no next inspection" is displayed on the display device 2K.

FIG. 9 is a flow chart showing the processing procedure following the connector A of FIG. Here, first, the determination step of S8 is executed. In the determination step of S8, it is determined whether or not the degree of the abnormality (here, pulmonary interstitial disease) is included in a predetermined range. Here, when the degree of the abnormality is included in the predetermined range, the process shifts to S9, and it is determined that the next inspection (additional inspection) is unnecessary. According to this determination, as shown in FIG. 11, a message of the detected abnormal type “pulmonary interstitial disease” and “no next examination” is displayed on the display device 2K. On the other hand, when the degree of the abnormality is included in the predetermined range in S9, it is determined that the additional inspection is necessary, and the routine proceeds to the inspection condition selection routine for the additional inspection. This predetermined range is set to a range of 5 to 7 here. The range of abnormalities that can be detected by CAD processing is 1 to
10 (1 is the lightest and 10 is the most severe). The reason for judging that the next inspection (additional inspection) is unnecessary because the degree of the abnormality is not included in the predetermined range is as follows. In other words, the detection of the abnormal degree of 4 or less may include an element of erroneous detection in the CAD process, and even if the additional inspection is performed, the erroneous detection is likely to occur again. Judge that the inspection is unnecessary. Further, for anomalies with an abnormal level of 8 or more, the image interpretation doctor can clearly confirm the existence of the anomaly in the image interpretation work, and therefore it is determined that no additional examination is necessary. Therefore, it is influential that the degree of abnormality is included in this predetermined range due to the possibility of intervening uncertain factors such as erroneous detection as to whether or not there is an abnormality, and it is clear that the image-reading doctor is required to perform image-reading work. It is not always possible to confirm the presence of abnormalities, and it is highly profitable to change the inspection conditions and re-inspect.

Yes in S8, that is, the degree of the abnormality is
When it is included in the predetermined range, the process proceeds to the determination step of S11. In S11, it is determined whether or not the abnormal position is a specific position. This particular location is here the right lung field. When the result of S11 is Yes, that is, when the abnormal position is not the right lung field but the left lung field, S12 is executed, and the imaging direction in the inspection conditions of the additional inspection is R suitable for imaging the left lung field.
Set to L. If No in S11, that is, if the abnormal position is the right lung field, S13 is executed, and the imaging direction in the inspection conditions of the additional inspection is L → that is suitable for imaging the right lung field.
Set to R. When the imaging direction in the inspection condition of the additional inspection is determined in S12 or S13, the process proceeds to the determination step of S14. In S14, it is determined whether or not the tube voltage of the inspection is a predetermined value, here 120 kV. This determination is for avoiding the possibility that an error occurs in the degree of abnormality due to the CAD processing, resulting in a decrease in the contrast of the image due to the tube voltage being too high, in the additional inspection. Therefore, in the case of No in S14, the inspection condition of the additional inspection is set to a tube voltage of, for example, 90 kV, which is slightly lower than the tube voltage of the inspection. According to this tube voltage, the tube current is set to 200 mA, and the exposure time is set to 0.2 sec, for example. On the other hand, also in the case of Yes in S14, similarly, the inspection condition of the additional inspection is set to a tube voltage of, for example, 115 kV which is slightly lower than the tube voltage of the inspection. In accordance with this tube voltage, the tube current is set to 200 mA, and the exposure time is set to 0.15 sec, for example. The test condition selection routine for such an additional test is repeatedly executed for all pulmonary interstitial diseases. The inspection condition of the additional inspection thus obtained is displayed on the display device 4K together with the message "Next inspection is present" as shown in FIG. 12, and the additional inspection according to this inspection condition is called for.

If S2 is No, S3 is executed. S
At 3, it is determined whether the abnormal type is another specific type, here, a lung nodule. If Yes in S3, that is, if the type of abnormality is a lung nodule, another inspection condition selection routine is executed. This routine is shown in FIG. First, in S17, it is determined whether or not the size of the abnormal shadow is a predetermined diameter, here 5 cm or less. When the result in S17 is No, that is, when the size of the abnormal shadow exceeds the predetermined diameter, it is determined that the existence of the abnormality is almost confirmed.
The process proceeds to S18, where it is determined that the additional inspection is unnecessary. According to this determination, a message “no next examination” is displayed together with the detected abnormality type “pulmonary nodule” and the display device 4
Displayed in K. On the other hand, if Yes in S17, that is, if the size of the abnormal shadow is equal to or smaller than the predetermined diameter, it is determined that the presence or absence of abnormality including the possibility of false detection is fluid, and additional inspection is necessary. After S19, the inspection conditions for the additional inspection are set.

In S19, it is determined whether or not the abnormal position exists in a specific area, here, the mediastinum area. If No here, the process proceeds to S20, and if Yes, the process proceeds to S26. In S20, it is determined whether or not the abnormal position is a specific position, here the right lung field.

[0113] No in S20, that is, when the abnormal position is not in the right lung field but in the left lung field, S21 is executed, and the imaging direction in the inspection conditions of the additional inspection is R suitable for imaging in the left lung field.
→ Set to L. If Yes in S20, that is, if the abnormal position is the right lung field, S22 is executed, and the imaging direction in the inspection conditions of the additional inspection is set to L → R suitable for imaging the right lung field. . When the imaging direction in the inspection conditions of the additional inspection is determined in S21 or S22, the process proceeds to the determination step of S23. In S23, it is determined whether or not the tube voltage of the inspection is a predetermined value, here 120 kV.
This determination is for avoiding the possibility that an error occurs in the degree of abnormality due to the CAD processing, resulting in a decrease in the contrast of the image due to the tube voltage being too high, in the additional inspection. Therefore, in the case of No in S23, the inspection condition of the additional inspection is set to a tube voltage of, for example, 90 kV which is slightly lower than the tube voltage of the inspection. According to this tube voltage, the tube current is set to 200 mA, and the exposure time is set to 0.2 sec, for example. On the other hand, also in the case of Yes in S23, similarly, the inspection condition of the additional inspection is set to a tube voltage of, for example, 115 kV which is slightly lower than the tube voltage of the inspection. Depending on this tube voltage, the tube current is, for example, 200 mA, and the exposure time is, for example, 0.15 sec.
Set to.

On the other hand, if Yes in S19, that is, if the abnormal position exists in a specific region, here, in the mediastinum region, S
26 is executed. In S26, the tube voltage of the inspection is 120
It is determined whether or not it was kV. Here, when No,
That is, when the tube voltage of the inspection is not 120 kV, the imaging direction of the additional inspection is set to P → A in S28, and subsequently, in S29, the tube voltage of the additional inspection is 120 kV, the tube current is 100 mA, and the exposure time is Set to 0.06sec.

Yes at S26 (the tube voltage of the inspection is 12
If it is 0 kV), the inspection condition for the additional inspection is set in S24, S25 or S29, and then S30 is executed. S3
0 is a step for setting inspection conditions for magnified imaging.
The inspection conditions for the additional inspection by magnified imaging set here are: imaging direction; P → A, tube voltage; 120 kv, tube current; 1
00 mA, exposure time: 0.06 sec, imaging position: abnormal position.

The inspection conditions of the additional inspection set in S24, S25, or S29 and the inspection conditions of the enlarged photographing are displayed on the display device 4K together with the message "Next inspection is present". Invoke additional inspections, including.

As described above, according to this embodiment, the image is CAD processed immediately after the image is collected, the necessity of the additional inspection is determined based on the processing result, and when the additional inspection is necessary, The inspection condition of the additional inspection can be set and displayed to the inspection engineer. Therefore, the technician performs the additional examination according to this display, and the image-reading doctor can always read a good image. Therefore, the delay due to the re-request of the examination is avoided, and the efficiency of the work from the start of the examination to the end of the interpretation is improved. Can be realized.

In the above description, the inspection conditions for the additional inspection are only displayed, but the X-ray generator and the X-ray imaging device may be set according to the inspection conditions. In this case, adjustment of the imaging position and imaging angle is performed by moving the examination table on which the subject is mounted to an appropriate position while fixing the subject as in the digestive organ diagnostic device, or by using the circulatory organ diagnostic device. The subject may be moved while the imaging device is stationary, or a combination of these two methods may be performed. Further, in the above description, the CAD processing device and the next inspection condition determining means are incorporated in the image collecting device, but these are incorporated in an external work station or a database, and the images collected by the image collecting device are sent to them. Then, the next inspection condition determined may be received and displayed. Further, in the present embodiment, the online PACS does not have to be the online PACS, and the offline PACS does not have to be the form of the PACS. Further, the present embodiment is equipped with a film digitizer, and a film photographed by an X-ray analog photographic device is inputted from this film digitizer, and this image is a target for the judgment of the necessity of the next inspection and the setting of the inspection conditions. May be Further, in the above description, the chest simple X-ray image is described as the target image for determining whether the next inspection is necessary or not and setting the inspection conditions, but the present invention is not limited to this, and other types of images, For example, it may be a breast X-ray image, a stomach X-ray image, a tomographic image by an X-ray computer tomography apparatus, an MR image by a magnetic resonance imaging apparatus, or the like. Furthermore, in the above description, the medical image is described as the target of the determination of the necessity of the next examination and the setting of the examination condition, but the present invention is not limited to this, and other examination data, such as an electrocardiogram and an electroencephalogram. Graph data, numerical data obtained by an automatic chemical analysis device, or the like.

Next, a third embodiment will be described. Similar to the second embodiment, this embodiment also presents the presence / absence of the next inspection and its inspection condition to the technician immediately after the end of the inspection to reduce the accuracy of the images to be collected and the labor of re-inspection.
The image inspection apparatus according to this embodiment has the same configuration as that of FIG. 7 according to the second embodiment. However, unlike the second embodiment, this embodiment uses a next inspection condition setting table created in advance to determine the necessity of the next inspection and the inspection conditions for the next inspection. Therefore, this next inspection condition setting table is created in advance and stored in the image storage device 2G of FIG. This next inspection condition setting table shows the necessity of the next inspection for various combinations of the type of abnormality detected by the CAD processor 2H, the size of the abnormality, the abnormal position, and the inspection direction.
It is a table in which the inspection direction of the next inspection and the inspection conditions of the next inspection (imaging mode such as magnified imaging, tube voltage, tube current, and imaging time) are associated with each other. Table 23 shows an example of a lung nodule.

[0120]

[Table 22]

[0121]

[Table 23]

The operation for determining the necessity of the next inspection and its inspection condition using this next inspection condition setting table will be described below with reference to the flowchart of FIG. In step (S1), the laboratory technician obtains the examination request information and performs a simple chest X-ray of the subject.
X based on the physical characteristics of the subject (age, sex, body thickness, etc.)
Imaging conditions such as tube voltage and tube current of the line generator 2E are set. For example, in the case of chest X-ray photography of an adult male, a tube voltage of 80 kV and a tube current of 200 mA are set. Also,
The examination direction is, for example, placing the X-ray tube behind the subject,
The X-ray imaging apparatus 2F is arranged at a position facing the X-ray tube, that is, on the abdomen side of the subject, and P-> A is set from the back surface to the abdomen.

In step (S2), X is set under this condition.
The line is exposed and the image is collected. The collected images are sent to the image storage device 2G via the image bus 2A,
It is temporarily stored there. Then, step (S3)
Under the control of the control device 2C, this image is C
It is sent to the AD processing device 2H and is subjected to CAD processing there.

The CAD processing result is supplied to the next inspection condition determining means 2I. At this time, the next inspection condition determination table corresponding to the type of abnormality according to the CAD processing result is
It is supplied from the image storage device 2G to the next inspection condition determining means 2I according to an instruction from the control device 2C. In step (S4), the next inspection condition determining unit 2I sets the abnormality degree (or the size of the shadow), the diseased site (or the abnormal position), the inspection direction, and the tube voltage in the CAD processing result to the next inspection condition. Check the decision table to determine the need for the next inspection. Here, if the next inspection is not required, the process ends. On the other hand, if it is determined that the next inspection is required, step (S5) is executed.

The next inspection condition determination table is also used in step (S5). The inspection direction of the next inspection and the inspection conditions of the next inspection (the imaging mode such as enlarged imaging, the tube voltage, the tube current, the imaging time) corresponding to the conditions of the CAD processing result described above are read from the next inspection condition determination table. For example,
If the abnormal type is “pulmonary nodule”, Table 23 is used. Then, in the CAD processing result, for example, if the size of the abnormality is “1 cm” and the abnormal positions are in the mediastinum region and the right lung field, the next inspection is necessary for both, and the inspection direction and the inspection mode are P. -> A magnified picture at A, tube voltage 120k
V, tube current 100mA, imaging time 0.06sec next inspection, inspection direction is side L-> R, tube voltage 90k
The result that the next inspection of V, tube current 200 mA, imaging time 0.2 sec is required is obtained. When step (S5) ends, the process returns to step (S2), and the same processing is repeated until there are no more images.

The collation result thus obtained is displayed on the display device 2.
Displayed in K. The inspection technician sets the inspection conditions according to the displayed contents, and executes the next inspection promptly, that is, while the subject does not need to come out again.

In the same manner, the necessity of the next inspection is determined for the images collected in this re-inspection, and the inspection condition for the next inspection is determined if necessary. This re-inspection is repeated until finally a determination result that the next inspection is unnecessary is obtained.

As described above, also in this embodiment, the same effect as that of the second embodiment can be obtained. It is needless to say that the present invention is not limited to the above-described embodiments and can be variously modified and implemented without departing from the scope of the invention.

[0129]

According to the present invention, improves test査効rate.

[Brief description of drawings]

FIG. 1 is a diagram showing an overall configuration of a PACS of a first embodiment.

FIG. 2 is a diagram showing a configuration of a system manager of FIG.

FIG. 3 is a diagram showing a configuration of a database shown in FIG.

FIG. 4 is a diagram showing a configuration of the workstation of FIG.

5 is a diagram showing a configuration of the image display manager of FIG.

FIG. 6 is a diagram showing a plurality of typical case images that have been benign distinguished.

FIG. 7 is a diagram showing a configuration of an image collecting apparatus according to a second embodiment.

8 is a flowchart showing a procedure for determining the next inspection condition by the next inspection condition determining means in FIG.

9 is a flowchart following the zygote A of FIG. 8;

FIG. 10 is a flowchart following the zygote B of FIG.

FIG. 11 is a diagram showing a display screen of a display device when there is no next inspection.

FIG. 12 is a diagram showing a display screen of the display device when there is a next inspection.

FIG. 13 is a flowchart showing the flow of processing according to the third embodiment.

[Explanation of symbols]

1 ... System manager, 2a, 2b ... Image collection device, 3 ... database, 4A, 4B ... work station, 5 ... network, 6 ... Gateway, 7 ... Inspection order system, 4a ... Control device, 4b ... system disk, 4c ... input device, 4d ... Character display device, 4e ... CAD processing device, 4f ... Image storage device, 4g ... Frame memory for images, 4h ... Image display manager, 4i ... image display device, 4j ... network interface, 4k ... control bus, 4l ... Image bus, 4m ... Information retrieval device, 4n ... Reference priority information creation device, 4p ... Inspection history creation device, 4q ... Typical case image retrieval device.

Front page continued (72) Inventor Takehiro Ema 1385-1, Shimoishigami, Otawara-shi, Tochigi Prefecture Toshiba Medical Engineering Co., Ltd. (56) References JP-A-5-130986 (JP, A) JP-A-2-185240 ( (58) Fields investigated (Int.Cl. ⁷ , DB name) A61B 6/00-6/14

Claims (5)

(57) [Claims] 1. A means for collecting images, the type of abnormality and the least severe to the most severe of the images.
Means for detecting the degree of progress of the abnormality within the range, and when the type of the abnormality is a specific type and the degree of progress falls within a predetermined range excluding the mildest and the severest , an additional inspection An image acquisition apparatus comprising: a unit that outputs that the additional inspection is necessary; and a unit that determines the inspection condition of the additional inspection based on the type and progress of the abnormality. 2. The images acquired by the image acquisition device are different depending on the type of abnormality and the range from the mildest to the most severe.
A means for detecting a normal degree of progress, and the type of the abnormality is a specific type, and when the degree of progress falls within a predetermined range excluding the mildest and the severest , an additional inspection is required. And a means for determining the inspection condition of the additional inspection based on the type and degree of progress of the abnormality. 3. The images acquired by the image acquisition device are different depending on the type of abnormality and the range from the mildest to the most severe.
A means for detecting a normal degree of progress, and the type of the abnormality is a specific type, and when the degree of progress falls within a predetermined range excluding the mildest and the severest , an additional inspection is required. And a means for determining the inspection condition of the additional inspection based on the type and degree of progress of the abnormality. 4. The image acquisition apparatus according to claim 1, wherein the inspection condition of the additional inspection is determined according to the type of the abnormality. 5. The image acquisition apparatus according to claim 1, wherein the inspection condition of the additional inspection is determined according to the degree of progress of the abnormality.