JP6258084B2 - Medical image display device, medical image display system, and medical image display program - Google Patents

Description

  Embodiments as one aspect of the present invention relate to a medical image display device, a medical image display system, and a medical image display program.

  Various inspection devices (hereinafter referred to as modality devices) used in image diagnosis are indispensable in current medical care because they can inspect the body in a minimally invasive manner. The high-performance modality device has made it possible to acquire high-quality images with high resolution, enabling accurate and precise examinations in diagnostic imaging. For example, an X-ray CT (Computed Tomography) apparatus can acquire three-dimensional information of the internal tissue of a subject with high resolution, and an MRI (Magnetic Resonance Imaging) apparatus can acquire fresh blood containing no contrast medium. There are various imaging methods for each modality device, such as non-contrast angiography (MRA: MR Angiography) for imaging by MRI. In addition, as digitalization of medical images progresses, a hospital system (HIS: Hospital Information System) or radiology information system (RIS), which is an ordering system that processes examination requests from doctors via an electronic network, In addition, a medical image central management system (PACS: Picture Archiving and Communication Systems) that accumulates images acquired by modality devices as electronic data has been developed.

  Thus, with the development of the modality device, it has become possible to observe the inside of the living body easily and in detail. On the other hand, the amount of data that can be acquired is enormous, and many modality devices acquire data in the form of volume data composed of a plurality of images. The volume of the volume data is as large as several thousand images when the whole body is imaged, and the burden on the interpreting doctor who makes a diagnosis by using these data is increasing. Interpretation is an important task for diagnosing diseases and deciding treatment strategies. While early detection is desired, it is not easy to analyze a large amount of medical images and make decisions at an early stage. Therefore, as an invention that supports image diagnosis, a medical image processing apparatus (for example, Patent Document 1) that identifies an anatomical region using a segmentation technique and the like, and determines an abnormal area and its malignancy, There is provided an image analysis apparatus (for example, Patent Document 2) that determines a positional correspondence between images acquired in two different examinations by a structure having periodicity such as a spine.

  Moreover, accuracy is required for interpretation and diagnosis, and in order to make a high-quality diagnosis, it is necessary to accurately grasp an abnormal site or a treatment site in the acquired medical image. However, reading an anatomical part from a medical image requires skilled techniques and knowledge. Therefore, the provision and research of techniques for expressing and constructing the anatomical position of the human body using mathematical techniques are being carried out.

  The anatomical position is a position of a characteristic local structure of the human body that plays an important role in understanding a medical image, and serves as a mark when anatomically mapping the human body. The local structure corresponds to, for example, the anterior arch (nodule) of the first cervical vertebra (cervical vertebra I) in the head, the tracheal bifurcation in the chest, and the right upper kidney in the abdomen. This anatomical position is automatically detected from a medical image acquired by a modality apparatus such as an X-ray CT apparatus or an MRI apparatus by general image analysis, pattern recognition technology, or the like.

Japanese Patent No. 5197029 Japanese Patent No. 5138431

  Interpretation differs depending on the type of examination and the medical condition of the patient. On the other hand, it is necessary to comprehensively interpret a medical image that is performed when creating an interpretation report so as not to overlook the findings. That is, it is necessary to confirm all the slice images that are acquired by several hundreds or thousands of images per person. It is inefficient to interpret such medical images at random from the first image to the last image. In addition, there may be a discrepancy between the part or local structure that is interpreted by the interpreting doctor as necessary and the part or local structure that needs to be confirmed by the examination, or the judgment of the interpreting doctor may be overlooked. is there. In addition, when many parts and local structures must be confirmed, there may be a leakage of interpretation.

  Therefore, there is a demand for a medical image display device that generates an interpretation guide for efficient interpretation based on the anatomical position described above, and performs display that supports the interpretation.

  The medical image display device according to the present embodiment is a medical image display device that receives a medical image composed of a plurality of slice images, and displays the anatomical position indicating a characteristic local structure of a human body as the medical image. An anatomical position detection unit that detects from the above, an interpretation guide generation unit that generates an interpretation guide that guides the interpretation order of the medical image based on the anatomical position, and the guidance that guides the interpretation order of the interpretation guide A display generation unit that generates a display based on an anatomical position and the anatomical position detected from the medical image; and a display unit that displays the display generated by the display generation unit. It is characterized by.

1 is a conceptual configuration diagram illustrating an example of a medical image display apparatus according to an embodiment. The functional block diagram which shows the function structural example which concerns on 1st Embodiment of the medical image display apparatus which concerns on embodiment. 6 is a flowchart illustrating an example of an operation according to the first embodiment of the medical image display apparatus according to the embodiment. The figure explaining the detection method of an anatomical position. The figure explaining the kind of local structure. The figure explaining anatomical position information. 6 is a diagram for explaining an example of a table stored in an interpretation guide table storage unit of the medical image display apparatus according to the embodiment. FIG. The figure explaining the selection method of the examination purpose of the medical image display device concerning an embodiment. 6A and 6B are diagrams illustrating examples of a display condition table and an interpretation target medical image table of the medical image display apparatus according to the embodiment. FIG. 6 is a view for explaining a method for generating an interpretation guide of the medical image display apparatus according to the embodiment. FIG. 6 is a diagram for explaining an example of an interpretation guide of the medical image display apparatus according to the embodiment. The figure explaining the method of specifying the slice image containing the interpretation target AL of the medical image display apparatus which concerns on embodiment. FIG. 6 is a diagram for explaining a display image generation method of the medical image display apparatus according to the embodiment. The figure explaining the 1st display example of the image interpretation guide display in 1st Embodiment of the medical image display apparatus which concerns on embodiment. The figure explaining the 2nd display example of the image interpretation guide display in 1st Embodiment of the medical image display apparatus which concerns on embodiment. FIG. 6 is a diagram illustrating a third display example of interpretation guide display in the first embodiment of the medical image display apparatus according to the embodiment. The figure explaining the functional block diagram which shows the function structural example which concerns on 2nd Embodiment of the medical image display apparatus which concerns on embodiment. 9 is a flowchart illustrating an example of an operation according to a second embodiment of the medical image display apparatus according to the embodiment. The figure explaining the 1st display example in 2nd Embodiment of the medical image display apparatus which concerns on embodiment. The figure explaining the 2nd display example in 2nd Embodiment of the medical image display apparatus which concerns on embodiment. The figure explaining the 3rd display example in 2nd Embodiment of the medical image display apparatus which concerns on embodiment. The figure explaining the 4th example of a display in 2nd Embodiment of the medical image display apparatus which concerns on embodiment. The figure explaining the 5th example of a display in 2nd Embodiment of the medical image display apparatus which concerns on embodiment.

  Hereinafter, an embodiment of a medical image display apparatus will be described with reference to the accompanying drawings.

(overall structure)
FIG. 1 is a conceptual configuration diagram illustrating an example of a medical image display apparatus 100 according to an embodiment.

  As illustrated in FIG. 1, the medical image display device 100 includes a communication control device 10, a storage unit 20, a main control unit 30, a display unit 40, an input unit 50, and a line-of-sight information acquisition unit 60. The medical image central management server 200, the modality device 300, and the HIS / RIS 400 are connected via the communication control device 10 via the electronic network. The communication control apparatus 10 implements various communication protocols according to the network form. Here, the electronic network means the entire information communication network using telecommunications technology. In addition to the hospital basic LAN, wireless / wired LAN and Internet network, telephone communication network, optical fiber communication network, cable communication network and satellite. Includes communication networks. The medical image display apparatus 100 acquires examination data from the medical image central management server 200 or the modality apparatus 300 via an electronic network.

  The medical image central management server 200, the HIS / RIS 400, and the medical image display device 100 may be configured as a system on the cloud.

  The modality apparatus 300 includes various medical image imaging apparatuses such as an X-ray CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, a PET (Positron Emission Tomography) apparatus, and an ultrasonic diagnostic apparatus. Data received by the medical image display device 100 is volume data composed of a plurality of slice images.

  The medical image display apparatus 100 is connected to the HIS / RIS 400. The HIS / RIS 400 is a system that processes examination requests and the like created by doctors called examination orders. From HIS / RIS400, patient ID for uniquely identifying a patient, patient information such as patient name, patient gender and physique, and examination information such as examination type, examination purpose, modality device type, etc. via electronic network You can get it.

  A program stored in the storage unit 20 is executed by the main control unit 30 to detect an anatomical position and generate an interpretation guide for the received volume data.

  The storage unit 20 includes a storage medium such as a RAM and a ROM, and includes a storage medium that can be read by the main control unit 30, such as a magnetic or optical storage medium or a semiconductor memory. You may comprise so that a part or all of the program and data in these storage media may be downloaded via an electronic network. Further, the detection of the anatomical position performed by the medical image display apparatus 100 may be performed using a program or data stored in the storage unit 20 in advance, and may be performed on an external storage device via the communication control apparatus 10. It may be executed using stored data or the like, or may be executed by a program stored in an external storage device or the like.

  The display unit 40 is configured by a general display device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display, and displays an image under the control of the main control unit 30.

  The input unit 50 is configured by a general input device such as a keyboard, a touch panel, a numeric keypad, and a mouse. Moreover, you may provide the input device corresponding to the input by audio | voice, such as a microphone. The input unit 50 outputs an input signal corresponding to an operation such as a user's examination or selection of a display image, image processing, or the like to the main control unit 30.

  The line-of-sight information acquisition unit 60 includes a general video camera including a semiconductor imaging device such as a CCD (Charge Coupled Device) image sensor or a CMOS (Complementary Metal Oxide Semiconductor) image sensor, as well as a personal computer or a mobile device. It is composed of a built-in Web camera, network camera, and the like. The line-of-sight information acquisition unit 60 can be read by the main control unit 30 of the medical image display apparatus 100 that digitally converts the acquired line-of-sight information and stores the converted digital data, in addition to the configuration as the video camera described above. Includes configurations such as storage media.

  Hereinafter, in the “first embodiment”, the interpretation guide generation and display, and in the “second embodiment”, in addition to the first embodiment, the interpretation implementation status and interpretation execution order based on the interpretation guide are described. Each will be explained.

(First embodiment)
The first embodiment relates to generation and display of an interpretation guide.

(1) Configuration FIG. 2 is a functional block diagram illustrating a functional configuration example of the medical image display apparatus 100 according to the embodiment. As shown in FIG. 2, the medical image display apparatus 100 includes an interpretation guide table storage unit 21, a medical image input unit 31, an anatomical position detection unit 32, an interpretation guide generation unit 33, a display generation unit 34, a display unit 40, An input unit 50 is included. The display generation unit 34 includes a display image generation unit 341, an interpretation guide display generation unit 342, and an image preparation unit 343. Of the above configuration, each of the medical image input unit 31, the anatomical position detection unit 32, the interpretation guide generation unit 33, the display generation unit 34, the display image generation unit 341, the interpretation guide display generation unit 342, and the image preparation unit 343 The function is a function realized by the main control unit 30 executing a program stored in the storage unit 20. The display unit 40 has a function realized by the main control unit 30 executing a program stored in the storage unit 20 and a display function.

  The medical image input unit 31 receives medical image data from the medical image central management server 200 and the modality device 300. The medical image input unit 31 receives one or a plurality of medical image data. The medical image data received by the medical image input unit 31 is volume data composed of a plurality of slice images.

  The anatomical position detection unit 32 detects the anatomical position of the input medical image data, and adds information on the detected anatomical position (hereinafter referred to as anatomical position information) to the input medical image data. Give. The input medical image data may be preliminarily provided with anatomical position information. For example, the addition of the anatomical position information to the medical image data may be executed at the timing when the image is acquired by the modality device 300 or may be executed at the timing when the medical image data is stored in the centralized medical image management server 200. . In that case, the detection process of the anatomical position in the anatomical position detection unit 32 and the process of adding the anatomical position information to the medical image data can be omitted. A method for detecting the anatomical position in the anatomical position detection unit 32 will be described later.

  The anatomical position information given to the medical image data may be held in a state associated with the corresponding medical image data in a data format such as XML data or binary data, for example. The received medical image data is data that conforms to the DICOM (Digital Imaging and Communication in Medicine) format, and the anatomical position information may be held as supplementary information in the DICOM standard.

  The interpretation guide generation unit 33 generates an interpretation guide that guides the interpretation order of medical images based on anatomical positions. A method for generating an interpretation guide will be described later.

  The display generation unit 34 has functions of a display image generation unit 341, an interpretation guide display generation unit 342, and an image preparation unit 343, and an anatomical position indicating the interpretation order of the interpretation guide and an anatomical view of the medical image. A display based on the position is generated and displayed on the display unit 40.

  The display image generation unit 341 is based on the local structure (hereinafter referred to as the interpretation target position) corresponding to the anatomical position that guides the interpretation order of the interpretation guide based on the anatomical position detected from the received medical image. Hereinafter, a slice image of a medical image including the interpretation target AL) is generated in the interpretation order of the interpretation guide, and a display image is generated.

  The interpretation guide display generation unit 342 generates an interpretation guide display for guiding the interpretation order of the interpretation guide based on the interpretation target position.

  Based on the interpretation target position, the image preparation unit 343 specifies a slice image including the interpretation target AL to be displayed in the following order from the medical image based on the anatomical position of the received medical image, A slice image including the interpretation target AL to be displayed in the subsequent order is read in advance. The processing of the image preparation unit 343 will be described later.

(2) Operation FIG. 3 is a flowchart illustrating an example of an operation according to the first embodiment of the medical image display apparatus 100 according to the embodiment.

  In ST 101, the medical image input unit 31 receives medical image data from the medical image central management server 200 or the modality device 300.

  In ST103, the anatomical position is detected by the anatomical position detection unit 32 for the received medical image data.

  FIG. 4 is a diagram illustrating a method for detecting an anatomical position. FIG. 4A shows an example of a method for generating the model a5 used for detecting the anatomical position. The model a5 shown in FIG. 4A may be stored in advance in the storage unit 20 of the medical image processing apparatus 100, or may be stored in an external storage device.

  As shown in FIG. 4A, the model a5 used for detecting the anatomical position is generated by general machine learning or pattern recognition. FIG. 4A shows an example in which the model a5 is generated using the image database a1 and the anatomical position correct answer data a2. The image database a1 is a set of volume data obtained by an X-ray CT apparatus or an MRI apparatus for subjects having different body shapes. As illustrated in FIG. 4A, the image database a1 includes not only whole body volume data (image A) but also volume data (images B and C) obtained by imaging a part of the body. The correct anatomical position data a2 is data in which the correct anatomical position is determined in advance by a specialist such as a doctor for each image in the image database a1. As shown in FIG. 4A, the feature extraction unit a3 extracts features from the respective volume data in the image database a1, and generates a model a5 by the learning algorithm a4 using the anatomical position correct answer data a2. . The model a5 shows a method for associating the feature generated as a result of the learning algorithm a4 and extracted from the image database a1 with the anatomical position. The model a5 includes a model using machine learning, for example. In addition, different models may be generated according to sex, age, race, physique, and the like, or a model that can absorb these differences.

  FIG. 4B shows an example of processing executed by the anatomical position detection unit 32. The anatomical position detection unit 32 extracts features of the analysis target image data b1 whose anatomical position is unknown, like the feature extraction unit a3 in FIG. 4A, and uses the already generated model a5. To detect the anatomical position. More specifically, the local structure is detected, and the position of the detected local structure in the medical image is calculated as an anatomical position. The anatomical position information b2 calculated in this way is given to the analysis target image data b1.

  The anatomical position is not limited to the above-described method, and can be detected by a mathematical statistical framework (computational anatomical model) called computational anatomy.

  FIG. 5 is a diagram for explaining the types of local structures. The local structure is a characteristic structure of the human body that plays an important role in understanding medical images, and is sometimes called an anatomical landmark (AL). For example, FIG. 5A shows an example of the local structure of the head and neck. In FIG. 5 (a), the anterior arch (nodule) of the first cervical vertebra (cervical vertebra I), the upper end of the dental process (cervical vertebra II), the right upper surface, the left upper surface, the right eye center, the left eye center, Is illustrated. Similarly, FIG. 5B illustrates the tracheal bifurcation, right apex, left apex, right subscapular angle, left subscapular angle, and left subclavian artery starting point for the local structure of the chest. Yes. FIG. 5 (c) illustrates the right kidney upper pole, the left kidney upper pole, the right kidney lower pole, the left kidney lower pole, the pancreatic head, and the pancreatic tail tip for the local structure of the abdomen. In FIG. 5D, as the local structure of the lower limb, the lateral epicondyle of the right femur, the medial epicondyle of the right femur, the lateral epicondyle of the left femur, the medial epicondyle of the left femur, and the lateral side of the right tibia The condyle, the medial condyle of the right tibia is illustrated. For example, the local structure is defined for the whole body with a granularity as shown in FIG. 5, and a plurality of local structures are defined for various bones, muscles, organs, and the like constituting the human body. An anatomical location is detected for each of these local structures.

  Such an anatomical position is held in association with medical image data as anatomical position information. The anatomical position information may be stored as a database in the storage unit 20 or the like in XML or text format in association with an ID for uniquely specifying a medical image, for example, or medical information as supplementary information of DICOM It may be held together with the image data.

  Anatomical position information includes anatomical position information, part information such as the chest and abdomen to which the local structure corresponding to the anatomical position belongs, and the anatomical position such as the bone system and respiratory system. The body tissue information according to the functional system in the human body of the local structure corresponding to can be included.

  FIG. 6 is a diagram for explaining anatomical position information. The table in FIG. 6A shows an example of anatomical position information. The table showing the anatomical position information in FIG. 6A includes, from the left, the identifier, name, reliability, part, body tissue, patient coordinate system (X axis, Y axis, Z axis) of the anatomical position. ) Position is shown. FIG. 6A illustrates a part of the anatomical position information of the abdomen. 6A, from the left, the identifier (ABDO25.C)), name (center of body of L5), reliability (0.87), part (abdomen), body tissue (bone system), patient coordinates The system (X-axis (-3.1), Y-axis (23.4), Z-axis (90.0)) is shown. Similarly, the second row includes the identifier (ABDO32.C)), name (upper right iliac spine), reliability (0.82), site (abdomen), body tissue (bone system), patient coordinate system (X Axis (-11.1), Y-axis (-54.4), Z-axis (84.1)), 3rd stage is identifier (ABDO39.C)), name (left iliac spine upper surface), reliability (0.83) site, (abdomen), body tissue (bone system), patient coordinate system (X axis (−3.0), Y axis (30.0), Z axis (104.0)) are shown ing.

  The identifier is an ID for uniquely identifying the anatomical position. The name indicates the name of the local structure, and is expressed in terms of anatomical and medical terms. The reliability is a numerical value indicating the accuracy of the anatomical position. Since anatomical positions are data estimated by calculation using machine learning algorithms or pattern recognition, a numerical value indicating how accurately each position is calculated for each anatomical position. Given. In the example shown in FIG. 6A, a numerical value between 0 and 1 is used, and a numerical value closer to 1 indicates higher reliability. The site | part has shown the site | part of the human body to which a local structure belongs, for example, it classifies like a chest and an abdomen. The body tissue is classified according to the function of the local structure, and includes, for example, the nervous system, the bone system, and the respiratory system. In addition to such parts and body tissues, information on organ names and units of anatomical structures such as the heart, lungs, and femur can be included as anatomical position information. The patient coordinate system indicates the anatomical position by the coordinates of the X axis, the Y axis, and the Z axis.

  FIG. 6B is a diagram illustrating the patient coordinate system. As shown in FIG. 6B, the patient coordinate system is a coordinate system in which the patient's left-right direction is the X axis, the patient's dorsal ventral direction is the Y axis, and the patient's head and foot direction is the Z axis. The X axis increases to the right from the patient center, the Y axis increases from the patient center to the dorsal direction, and the Z axis increases from the patient's foot to the head. Such a patient coordinate system is relatively represented by an arbitrary position such as a reference position of the volume data.

  The example of FIG. 6 shows an example of information and data format included in the anatomical position information.

  Returning to the flowchart of FIG.

  In ST 105, the interpretation doctor who is the user inputs the part name, disease name, examination purpose, and the like to be examined via the input unit 50 to the interpretation guide generating unit 33.

  In ST 107, the interpretation guide generation unit 33 generates an interpretation guide corresponding to the input part name, disease name, and examination purpose from various tables stored in the interpretation guide table storage unit 21.

  In ST109, the display generation unit 34 generates a display such as a display image, an interpretation guide display, and a preparation image from the medical image received according to the interpretation guide.

  In ST111, display unit 40 displays the generated various displays.

  First, an interpretation guide generation method in the interpretation guide generation unit 33 will be described with reference to FIGS. The interpretation guide generation unit 33 generates an interpretation guide from various tables stored in the interpretation guide table storage unit 21 based on an input of a medical image inspection request or an inspection purpose of an interpretation doctor or the like.

  FIG. 7 is a diagram illustrating an example of a table stored in the interpretation guide table storage unit 21 of the medical image display apparatus according to the embodiment. FIG. 7 illustrates an example of the interpretation guide extraction table and the interpretation guide table stored in the interpretation guide table storage unit 21.

  FIG. 7A shows an example of an interpretation guide extraction table. The interpretation guide extraction table lists “interpretation guide IDs” for uniquely identifying interpretation guides corresponding to “examination purpose” associated with “part name” and “disease name”. In FIG. 7A, when the site name is “Site A” and the disease name is “Disease A”, the interpretation guide ID corresponding to “Test purpose A” in the first row is “1111”. . The interpretation guide generation unit 33 generates an interpretation guide for inspection purpose A uniquely specified by the interpretation guide ID “1111”. Similarly, the interpretation guide ID corresponding to the “inspection purpose B” in the second row is “2222”, and the interpretation guide ID corresponding to the “inspection purpose C” in the third row is “3333”. . Similarly, when the site name is “site A” and the disease name is “disease B”, the interpretation guide ID corresponding to “test purpose D” in the first row is “4444”, and “test purpose E” in the second row. The interpretation guide ID corresponding to “5555” is shown.

  The interpretation guide extraction table shows “examination purpose” related to “part name” and “disease name”, but may be “organ name” and “disease name”. “Examination purpose” related to “name”, “organ name”, and “disease name” may be indicated.

  FIG. 7B shows an example of an interpretation guide table. In the interpretation guide table, “interpretation target AL”, “interpretation order”, and “priority”, which are local structures corresponding to the interpretation target position, are set. In the interpretation guide corresponding to the interpretation guide ID “1111”, the interpretation target AL is set to “AL2, AL3, AL5, AL6, AL9” and the priority is set to “5, 5, 3, 3, 1” in the order of interpretation. Has been. Similarly, in the interpretation guide corresponding to the interpretation guide ID “2222”, the interpretation target AL is set to “AL5, AL6, AL3, AL4”, and the priority is set to “5, 3, 5, 3”. The priority shown in the example of FIG. 7B is expressed by a numerical value between 1 and 5, and a numerical value closer to 5 indicates a higher priority.

  The interpretation guide generation unit 33 as described above searches various tables stored in the interpretation guide table storage unit 21 based on the input (ST105) such as the part name, disease name, and examination purpose, and generates an interpretation guide ( ST107).

  FIG. 8 is a diagram for explaining a method for selecting an inspection purpose of the medical image display apparatus 100 according to the embodiment.

  FIG. 8A shows an example in which an examination purpose is selected from a part name and a disease name when an interpreting doctor or the like selects a medical image. FIG. 8A illustrates a medical image list D1 in which a list of received medical images is displayed in a table format. FIG. 8A shows a case where the pointer or cursor is placed on the medical image data indicated by the first-stage examination ID “XX-XXX1” of the medical image list D1 by the input from the input unit 50 including a mouse. An example is shown. In the example of FIG. 8A, a part selection menu D2 and an examination purpose selection menu D3 corresponding to the line on which the pointer and cursor are aligned are displayed. The site selection menu D2 displays a list of sites imaged in the selected medical image, and the test purpose list corresponding to the site selected from among the sites is selected for each disease name. Displayed on menu D3. For example, in the example of FIG. 8A, “chest” is selected as the site name in the site selection menu D2, and “emphysema” and “lung cancer” are selected as the “disease name” corresponding to “chest” in the examination purpose selection menu D3. ”,“ Pneumonia ”. In the example of FIG. 8A, a “+” button is displayed next to the display of “pulmonary emphysema” and “pneumonia”, and by pressing this button, the examination purpose corresponding to the selected disease name is displayed. Is displayed in a list. FIG. 8A shows an example in which the examination purpose corresponding to “lung cancer” is displayed by pressing the above “+” button for “lung cancer” shown in the examination purpose selection menu D3. Test purposes corresponding to the disease name "lung cancer" include "lung cancer screening", "lung cancer metastasis test", and "lung cancer close examination". It should be noted that the purpose of these examinations may be hidden when the “-” button next to “lung cancer” is pressed. FIG. 8A shows an example in which the inspection purpose of the medical image to be interpreted is input by selecting the part name and selecting the inspection purpose classified for each related disease name. As described above, when a medical image doctor or the like selects a medical image to start interpretation, a medical image is displayed at the same time as the medical image is displayed by selecting a region name, a disease name, and an examination purpose. Interpretation can be started along the guide.

  Note that the contents shown in the part selection menu D2 and the examination purpose selection menu D3 in FIG. 8A may be specified by directly inputting a character string or the like from the input unit 50 by an interpretation doctor or the like. For example, if “Lung cancer close examination” is entered, the entered wording is analyzed, “Lung cancer” as the disease name, “Fine examination” is identified from “Scrutinized examination”, and “Lung cancer detailed examination” is automatically performed. It may be specified as an inspection purpose. In addition, an examination request, an assumed disease name, a past history, or the like may be acquired from the HIS / RIS 400, and the examination purpose may be automatically specified.

  FIG. 8B shows an example in which a list of examination purposes is displayed by specifying a site name from the anatomical position information of the displayed medical image and selecting a disease name corresponding to the specified site name. Is shown. A slice image D4 is displayed on the left side of the image display screen W1 in FIG. The interpretation guide generation unit 33 specifies the anatomical position corresponding to the slice image D4, and uses the pull-down menu D5 on the right side of the image display screen W1 from the name of the part or organ to which the local structure corresponding to the anatomical position belongs. List of disease names. As described with reference to FIG. 6, the anatomical position information detected for the medical image includes information regarding a part or an organ to which the local structure corresponding to the anatomical position belongs. In the example of FIG. 8B, “pulmonary cancer”, “pneumonia”, and the like as disease names are displayed in the pull-down menu D5 from the name of the region or organ to which the local structure corresponding to the anatomical position corresponding to the slice image D4 belongs. A displayed example is shown.

  Further, in the example of FIG. 8B, the examination purpose corresponding to “lung cancer” selected in the pull-down menu D5 is displayed at the bottom of the pull-down menu D5. In addition, a check box is displayed for each inspection purpose displayed in FIG. 8B, and a plurality of inspection purposes can be selected. When a plurality of inspection purposes are selected, the interpretation guide generating unit 33 generates a plurality of interpretation guides corresponding to the selected inspection purposes. Of the generated interpretation guides, those that have the same interpretation target AL may be displayed on the interpretation guide display, and in the interpretation guide that will be implemented later, the interpretation guide AL will be different from other interpretation targets AL. It may be displayed. When a plurality of interpretation guides are generated, interpretation is guided using the plurality of interpretation guides in order.

  As described above, when the inspection purpose is selected, the interpretation guide generation unit 33 searches the various tables stored in the interpretation guide table storage unit 21 to generate an interpretation guide. As the table searched when generating the interpretation guide, various tables in which display conditions and interpretation targets in interpretation are set are used in addition to the interpretation guide extraction table and the interpretation guide table described with reference to FIG. Hereinafter, the display condition table and the interpretation target medical image table stored in the interpretation guide table storage unit 21 will be described.

  FIG. 9 is a diagram illustrating an example of the display condition table and the interpretation target medical image table of the medical image display apparatus 100 according to the embodiment.

  The table in FIG. 9A shows an example of the display condition table. In the display condition table, display conditions such as gradation values, highlighted anatomical positions, and display speed are set for each interpretation guide ID, which requires changing the display conditions due to the interpretation target AL. . The display condition 1 (display speed) of the first interpretation target AL “AL2” of the interpretation guide ID “1111” in FIG. 9A is “speed 1”, and the display condition 2 (tone value) is “ XX-X1 "is set. Similarly, the display condition 1 (display speed) of the second interpretation target AL “AL3” is “speed 1”, and the display condition 2 (gradation value) is “XX-X2”. The display condition 1 (display speed) for the interpretation target AL “AL5” is “speed 2”, the display condition 2 (gradation value) is “XX-X3”, and the first interpretation target AL “AL6” is displayed. Condition 1 (display speed) is “speed 1”, display condition 2 (tone value) is “XX-X4”, and display condition 1 (display speed) of the fifth interpretation target AL “AL9” is “Speed 2” is set, and “XX-X5” is set in display condition 2 (tone value). “Speed 3” is set for the display condition 1 (display speed) of the first interpretation target AL “AL5” of the interpretation guide ID “2222”, and “XX-X3” is set for the display condition 2 (gradation value). Has been.

  As shown in FIG. 9A, the display condition can be set for each interpretation guide and for each interpretation target AL.

  Display conditions such as gradation values are set in the display conditions. For example, at the time of image interpretation, the gradation value (contrast) of the pixel is adjusted by display settings so that the obtained image data can easily observe the site and local structure for the purpose of diagnosis. The image data acquired by the X-ray CT apparatus has a CT value for each pixel. This CT value is associated with the tissue X-ray attenuation coefficient, and has gradation in a CT value range from -1000 to +1000, where water is 0, air CT value is -1000, and bone is +1000. For example, when observing a lung field, since the lung field has many areas including air, the gradation is observed with a low CT value. At that time, since the heart, the soft tissue of the chest wall, or the bone has a high CT value, the signal is saturated and cannot be observed. As described above, there is a case where the target part or the local structure cannot be observed unless the gradation value is adjusted and observed with the correct contrast.

  Further, the display speed can be changed according to the priority of the interpretation target AL and the inspection purpose. For example, in the case of a health checkup, the number of interpretation points is limited, and interpretation is performed at a relatively fast display speed. On the other hand, in the case of metastasis inspection, precision inspection, etc., there are a wide variety of interpretation points, and detailed interpretation is required, so interpretation is performed at a relatively slow display speed. In this way, efficient interpretation can be supported by changing the display speed in accordance with the difference in inspection purpose. The display speed may be set according to the priority for each interpretation target AL. For example, a slice image corresponding to an interpretation target AL having a high priority can be displayed at a low speed, and a slice image corresponding to an interpretation target AL having a low priority can be displayed at a high speed. In this way, by changing the display speed, it is possible to prompt the user to carefully interpret the slice image including the interpretation target AL.

  In addition to the gradation value, various display conditions such as enlargement / reduction display, rotation, or provision of a frame in the region of the interpretation target AL can be set according to the interpretation target AL.

  By using an interpretation guide generated using such a display condition table, it is possible to guide the interpretation to be performed under the display conditions corresponding to the interpretation target AL. Further, if the display conditions are set so as to be automatically changed, it is possible to save labor for changing the display conditions in interpretation.

  The table of FIG. 9B shows an example of the medical image table to be interpreted. In the interpretation target medical image table, for each interpretation guide ID, “interpretation target medical image” and “modality type” for acquiring the interpretation target medical image are set. In the example of FIG. 9B, “latest, last time” is shown as the medical image to be interpreted of the first-stage interpretation guide ID “1111”, and “CT” is shown as the modality type. The first line of the interpretation target medical image table shows the setting of an interpretation guide for comparing and interpreting the latest medical image and the previous medical image acquired by the X-ray CT apparatus. The second row of the interpretation target medical image table has “latest” as the interpretation target medical image of the interpretation guide ID “2222”, “MMG (mammography: mammography), US (ultrasonography)” as the modality type. It is shown. The second line of the interpretation target medical image table shows the setting of an interpretation guide for comparative interpretation of the latest images acquired by MMG and US. The third row of the interpretation target medical image table indicates “latest, last time, last time” as the interpretation target medical image of the interpretation guide ID “3333” and “MRI” as the modality type. The third line of the interpretation target medical image table shows the setting of an interpretation guide for comparing and interpreting the latest medical image acquired by MRI, the previous medical image, and the previous medical image.

  As described above, depending on the purpose of examination, there may be a case where comparative interpretation is performed in which interpretation is performed while comparing with a medical image acquired in a past examination. For example, when the purpose of examination is “follow-up” of a disease such as cancer, it is necessary to compare and interpret past examination images and latest examination images. In this way, by setting the information of the examination to be compared in the interpretation guide, it is possible to automatically read the medical image to be subjected to the comparison interpretation only by inputting the examination purpose or the like, or the same part of the comparison medical image. And local structures can be displayed sequentially or side by side.

  Also, in image diagnosis, diagnosis is often made comprehensively by examination combining a plurality of modality devices. Therefore, when an interpreting doctor or a doctor examines a case or judges a diagnosis comprehensively, a comparison across modality devices is necessary. When such an examination is performed, the images corresponding to the same interpretation target AL acquired by, for example, mammography and ultrasonic examination may be displayed in order or displayed side by side by the generated interpretation guide. it can.

  Thus, the interpretation guide generation unit 33 can generate an interpretation guide having various settings according to the inspection purpose.

  In FIG. 10, a method for generating an interpretation guide will be described by taking as an example a case where “part A”, “disease A”, and “examination purpose A” are input to the interpretation guide generation unit 33 as interpretation guide extraction conditions.

  FIG. 10 is a diagram illustrating a method for generating an interpretation guide of the medical image display apparatus 100 according to the embodiment. As shown in the upper part of FIG. 10, the interpretation guide extraction conditions are input from the input unit 50 or the HIS / RIS 400.

  The table at the top of FIG. 10 shows the interpretation guide extraction conditions, and shows an example in which “part A”, “disease A”, and “examination purpose A” are input to the interpretation guide generation unit 33. The interpretation guide generation unit 33 uses the interpretation guide extraction conditions “part A”, “disease A”, and “examination purpose A” as keys, and the interpretation guide table storage unit illustrated in FIG. The image interpretation guide extraction table stored in 21 is searched, and the image interpretation guide ID “1111” is acquired. Based on the interpretation guide ID “1111”, the interpretation guide table, display condition table, and interpretation target medical image table stored in the interpretation guide table storage unit 21 are searched, and the search results are summarized as shown in the lower part of FIG. Interpretation guides are generated.

  FIG. 11 is a diagram illustrating an example of an interpretation guide of the medical image display apparatus 100 according to the embodiment. FIG. 11 shows an example of an interpretation guide with an interpretation guide ID “1111” when “part A”, “disease A”, and “examination purpose A” are input.

  The interpretation guide shown in FIG. 11 includes “interpretation target AL”, “interpretation order”, and “priority” corresponding to the interpretation guide ID “1111” of the interpretation guide table, and the interpretation guide ID “1111” of the interpretation target medical image table. "Interpretation target image" and "Modality type" corresponding to "," and "Display condition 1" and "Display condition 2" corresponding to the interpretation guide ID "1111" of the display condition table are respectively shown. In the interpretation target medical image table shown in FIG. 9B, “previous” and “latest” are set as the interpretation target images. In the example of FIG. 11, the previous and latest interpretation target medical images are alternately displayed. An interpretation guide to be interpreted is generated.

  Based on the interpretation guide generated in this way, the display generation unit 34 generates various displays based on the interpretation guide (ST109). In the display generation unit 34, the display image generation unit 341 generates a display image for displaying a slice image of the medical image according to the interpretation order and display conditions of the interpretation target AL. The interpretation guide display generation unit 342 generates an interpretation guide display that guides the interpretation order based on the interpretation target AL of the interpretation guide. The image preparation unit 343 generates a medical image to be displayed next based on the order of the interpretation guide. A preparatory image read in advance is generated.

  Hereinafter, various displays generated by the display generation unit 34 will be described in order.

  First, a method for generating a display image generated by the display image generation unit 341 will be described. The display image generation unit 341 specifies a slice image including the interpretation target AL of the interpretation guide based on the anatomical landmark detected from the received medical image data, and generates a display image arranged in the interpretation order. .

  FIG. 12 is a diagram illustrating a method for specifying a slice image including the interpretation target AL of the medical image display apparatus 100 according to the embodiment. FIG. 12A illustrates medical image data received by the medical image display apparatus 100. In the medical image data shown in FIG. 12A, the interpretation target position of the interpretation guide illustrated in FIG. 11 is indicated by a circle, and the corresponding interpretation target AL is indicated. The interpretation target AL of the interpretation target position indicated by the double circle is “AL2”, the interpretation target AL of the interpretation target position indicated by the black circle is “AL3”, and the interpretation target AL of the interpretation target position indicated by the shaded double circle is The interpretation target AL at the interpretation target position indicated by “AL5” and the shaded circle is indicated by “AL6”, and the interpretation target AL at the interpretation target position indicated by the white circle is indicated by “AL9”. As shown in FIG. 12A, when the slice direction A of the medical image data is the Z axis, the slice image corresponds to the XY plane. The medical image data includes information regarding the imaging conditions as supplementary information. The imaging conditions include information such as pixel size, slice thickness and slice interval, imaging start position and reference position, for example. As described with reference to FIG. 6A, the anatomical position is shown in a coordinate system called a patient coordinate system. If the slice direction A of medical image data is the Z axis, the pixel size, slice thickness, and slice Based on information such as the interval, the patient coordinate system of the anatomical position can be converted into voxel coordinates of medical image data or slice image coordinates and slice numbers.

  FIG. 12B shows a list of slice numbers including the interpretation target AL among the anatomical positions of the medical image data. In the example of FIG. 12B, the slice number of the interpretation target AL “AL2” is 5, the slice number of the interpretation target AL “AL3” is 6, the slice number of the interpretation target AL “AL5” is 16, and the interpretation target. The slice number of AL “AL6” is No. 17, and the slice number of interpretation target AL “AL9” is No. 19. As described above, the display image generation unit 341 can identify the slice image corresponding to the interpretation target AL from the medical image.

  With the above-described method, the display image generation unit 341 specifies a slice image including the interpretation target AL from the received medical images. Hereinafter, a method for generating a display image in which medical images are rearranged in the interpretation order of the interpretation guide based on the slice image including the specified interpretation target AL will be described.

  FIG. 13 is a diagram illustrating a display image generation method of the medical image display apparatus 100 according to the embodiment. In the example of FIG. 11, an interpretation guide for comparing the medical image acquired in the previous examination with the latest medical image is illustrated. In the upper part of FIG. 13, a medical image obtained by the latest examination shown by shading (hereinafter referred to as the latest medical image) and past medical pictures obtained by the previous examination shown by white are shown. Images (hereinafter referred to as previous medical images) are shown.

  The latest medical image slice image and the previous medical image slice image are shown in order in the direction of the arrow indicating the display order on the right side of FIG. A part of each slice image shows a slice image including the interpretation target AL. In the example of FIG. 13, the slice images before and after the slice image including the interpretation target AL are “previous medical image AL2”. “Range”, “Range of latest medical image AL2”, “Range of previous medical image AL3”, and “Range of latest medical image AL3” are displayed side by side.

  As shown in FIG. 13, the display image generation unit 341 uses the upper and lower slice images of the slice image including the interpretation target AL indicated in the interpretation guide as the interpretation target range, and the latest medical image, the previous medical image, Are generated according to the interpretation order of the interpretation guide. The anatomical position shows the position information of the characteristic local structure of the human body, but the region and local structure to be interpreted exist within a certain range centered on the anatomical position, and the spatial spread have. Therefore, the display image generation unit 341 may set a slice image including the interpretation target AL and a certain range including the preceding and succeeding slice images as the interpretation target. The range to be interpreted may be set according to the reliability of the anatomical position information, the priority of the interpretation guide, and the like. For example, a slice image that is an interpretation target range of the interpretation target AL with low reliability of the anatomical position information may set a range that exceeds the other interpretation target AL as the interpretation target range.

  In addition, the display image generation unit 341 may continuously automatically reproduce (cine display) images in which slice images are arranged as display images. When a plurality of interpretation guides are generated, display images may be generated in the order of the generated interpretation guides, the order of interpretation guide IDs, or a preset order.

  The display image generation unit 341 not only controls the display order of slice images along the interpretation guide by the display image as described above, but also controls display speed and display conditions according to the interpretation guide. By the display generated by the display image generation unit 341, the interpreting doctor or the like can save the trouble of searching for a site or local structure to be interpreted. Also, with regard to the parts and local structures that should be comparatively interpreted, the same parts and local structures are automatically displayed on the screen based on the anatomical position without searching for the corresponding parts. Can do. Moreover, even if the acquisition modality devices are different, it is possible to automatically compare and display corresponding parts and local structures based on anatomical positions.

  Next, various displays for guiding the interpretation order of the interpretation target AL based on the interpretation guide by the interpretation guide display generation unit 342 will be described.

  FIG. 14 is a diagram illustrating a first display example of interpretation guide display in the first embodiment of the medical image display apparatus 100 according to the embodiment.

  In the example of FIG. 14A, the slice image D1 and the order display D2 are displayed on the image display screen W1. In the slice image D1, the display image generated by the display image generation unit 341 is displayed according to the order of the interpretation guide. In the order display D2, the inspection purpose and the interpretation target AL of the interpretation guide corresponding to the inspection purpose are displayed in the order indicated in the interpretation guide. In the example of the order display D2 shown in FIG. 14A, the interpretation target AL “AL2” is the first in the interpretation order, “AL3” is the second, “AL5” is the third, “AL6” is the fourth. Fifth, “AL9” is shown. Among them, the second interpretation target AL column is shaded to indicate that interpretation is currently being performed. At that time, a slice image including the interpretation target AL3 is displayed in the slice image D1.

  A slider G3 is displayed below the slice image D1. In the slice image D1, slice images before and after the slice image including the interpretation target AL are displayed as slice images corresponding to the interpretation target AL. The slice image corresponding to the interpretation target AL may be changed in the order of the slice number by moving the slider G3 to the left or right or moving a trackball such as a mouse up or down on the display of the slice image D1. Moreover, after the last slice image is displayed among the plurality of slice images corresponding to the interpretation target AL, the first slice image of the slice image in the next interpretation order may be automatically displayed. In that case, the display of the order display D2 is displayed with emphasis on the display of the interpretation target AL in the order corresponding to the slice image. The same applies when the slider G3 reaches the right end.

  FIG. 14B is a modification of FIG. In FIG. 14B, the anatomical chart is shown in the order display D2, and the position of the interpretation target AL on the anatomical chart is shown. Each interpretation target AL shown in the order display D2 has a number indicating the interpretation order. Furthermore, in the example of FIG. 14B, the label of the second interpretation target AL is shaded, indicating that the interpretation is currently being performed. Similarly to FIG. 14A, a slice image including the second interpretation target AL is displayed in the slice image D1.

  In the example of FIG. 14B, an interpretation area D4 indicated by a one-dot chain line is shown in a part of the slice image D1. The interpretation area D4 indicates an area where a part or local structure corresponding to the interpretation target AL on the slice image exists. Thus, based on the interpretation guide, the range corresponding to the interpretation target AL on the slice image may be highlighted on the screen and displayed on the screen.

  FIG.14 (c) is a modification of FIG.14 (a) and FIG.14 (b). The order display D2 in FIG. 14C is a diagram in which graphics indicating the interpretation target AL are arranged in order from the left in the order of interpretation. The figure indicating the interpretation target AL “AL3” shown second from the left is shaded, indicating that the interpretation target AL is currently being interpreted. As described above, the background of the graphic or the color of the character may be changed according to the interpretation target AL being displayed in the slice image D1.

  Further, a display corresponding to comparative interpretation or comparison by another modality device may be shown below the second interpretation target AL “AL3”. The example of FIG. 14C shows an example in which the previous test and the latest test are compared. Under the figure of the interpretation target AL “AL3” currently displayed, “1 time before” The “latest” figure is shown. The background and the color of characters may change corresponding to the display of the slice image D1 in the same manner as the figure of the interpretation target AL. Further, as indicated by an arrow A, the display of the slice image D1 may be switched according to the selection of the “one time before” and “latest” graphics.

  As shown in FIG. 14, when the slice image corresponding to the interpretation target AL is displayed in the slice image D1, the label of the interpretation target AL corresponding to the order display D2 and the character indicating the local structure are different from other colors. Emphasis may be given by displaying on the screen or by displaying an animation such as blinking, and the interpretation order may be guided to the user.

  FIG. 15 is a diagram illustrating a second display example of the interpretation guide display in the first embodiment of the medical image display apparatus 100 according to the embodiment. FIG. 15 is a modification of FIG.

  FIG. 15A shows a position display D3 indicating the interpretation target position in the medical image beside the slice image D1. The position display D3 shows a bar G1 corresponding to the total number of slices of the medical image, an interpretation target position in the medical image, a mark G2 indicating the range of the interpretation target AL, and a slider G3 indicating the current position of the medical image. Yes. The range of the interpretation target AL may be a range of several millimeters (millimeters) above and below the slice image including the interpretation target AL, or the range may be set according to the reliability of the anatomical position information. Further, the anatomical position information can also include part and organ information, and the range of the interpretation target AL may be determined according to the part and organ to which the interpretation target AL belongs.

  FIG. 15B is a modification of FIG. In the position display D3, a bar G1 corresponding to the total number of slices of the medical image, and a label G4 indicating the interpretation target position and the interpretation target AL name in the medical image are displayed. The label G4 shows a number indicating the interpretation order and the interpretation target AL. The third label G4 is shaded and indicates the interpretation target position corresponding to the slice image D1.

  In this way, in the example of FIG. 15, the interpretation target position and range for the entire medical image are shown together with the interpretation order, so that the user can interpret the interpretation order, the position of the slice image that requires interpretation, and the slice that requires interpretation. The number of sheets can be grasped. This makes it possible to easily grasp the work prospects and progress.

  Finally, display by the image preparation unit 343 will be described. Since the medical image display apparatus 100 according to the embodiment has information on the interpretation order of the interpretation target AL in the interpretation guide, the medical image or slice image to be interpreted next is specified in advance based on the interpretation target AL, and the display unit 40 can be displayed. The image preparation unit 343 specifies a slice image to be interpreted next and displays it on the display unit 40. FIG. 16 shows an example in which the image preparation unit 343 displays a slice image to be read next on the display unit 40.

  FIG. 16 is a diagram for explaining a third display example of the interpretation guide display in the first embodiment of the medical image display apparatus 100 according to the embodiment. In the upper left of FIG. 16, a preparation image D5 is shown in the upper right of the slice image D1. On the lower right side of the slice image D1, the second interpretation target AL “AL3” in the order display D2 is shaded to indicate that it is currently being displayed. The third interpretation target AL in the order display D2 is “AL5”. Therefore, as shown in FIG. 16, the image preparation unit 343 prepares a slice image corresponding to the interpretation target AL “AL5” to be interpreted next based on the interpretation order of the interpretation guide, and displays it on the preparation image D5. . By preparing a slice image corresponding to the next interpretation target AL in advance, it is possible to shorten the image reading time. In addition, when comparing between different modality devices, a dedicated application corresponding to a medical image acquired by the modality device can be started in advance, and the reading time and display time can be improved by using an interpretation guide. Can be shortened.

  As described above, in the first embodiment, an interpretation guide suitable for the inspection purpose is generated, and various displays based on the interpretation guide are generated and displayed. With such various displays, the user can perform interpretation in an interpretation order suitable for the inspection purpose, and can proceed with interpretation in an efficient manner. Further, the interpretation guide display indicating the interpretation order is displayed on the display unit 40, so that the progress of interpretation and the amount of work can be easily estimated. Furthermore, since the slice images corresponding to the interpretation target AL are displayed in order as the display image, it is possible to prevent oversight of the part to be interpreted and the local structure, and to interpret the part and the local structure in an efficient order. it can.

(Second Embodiment)
In addition to the first embodiment, the second embodiment relates to determination of an interpretation implementation status based on an interpretation guide.

(1) Configuration FIG. 17 is a diagram illustrating a functional block diagram illustrating a functional configuration example according to the second embodiment of the medical image display apparatus according to the embodiment. The same components as those in the first embodiment (FIG. 2) are denoted by the same reference numerals and description thereof is omitted. As shown in FIG. 17, in addition to the functional configuration of FIG. 2, a user storage unit 23, an interpretation time storage unit 25, an order determination unit 36, an interpretation implementation status determination unit 37, a user interpretation implementation status generation unit 38, and line-of-sight information acquisition Part 60. Of the above configuration, the functions of the order determination unit 36, the interpretation implementation status determination unit 37, and the user interpretation implementation status generation unit 38 are realized by the main control unit 30 executing the program stored in the storage unit 20. It is. The line-of-sight information acquisition unit 60 corresponds to the function of collecting line-of-sight information using a camera or the like, and the slice number or coordinates realized by the main control unit 30 executing the program stored in the storage unit 20. And a line-of-sight information counting function.

  The order determination unit 36 determines the interpretation execution order based on whether or not the interpretation target AL of the medical image is interpreted according to the interpretation order of the interpretation guide. The order determination unit 36 generates an order determination result display according to the determination result.

  Based on the interpretation target AL of the interpretation guide based on the interpretation target AL of the interpretation guide, the interpretation execution status determination unit 37 determines whether the interpretation target AL of the medical image has been interpreted from the operation content on the medical image, the user's line-of-sight information, and the utterance content of the user. Determine the interpretation status. The interpretation implementation status determination unit 37 generates an interpretation implementation status display according to the determination result.

  The interpretation time storage unit 25 records the start time and end time of the interpretation execution status determination in the interpretation implementation status determination unit, and calculates and stores the interpretation time from the start time and end time.

  The user storage unit 23 stores the interpretation implementation status, interpretation order, and interpretation time for each user.

  The user interpretation implementation status generation unit 38 generates a user interpretation implementation status display indicating the interpretation implementation status for each user from the interpretation implementation status, interpretation order, and interpretation time stored for each user.

(2) Operation FIG. 18 is a flowchart illustrating an example of an operation according to the second embodiment of the medical image display apparatus 100 according to the embodiment. The flowchart according to the second embodiment describes the operation after various displays described in the first embodiment are displayed on the display unit 40.

  In ST201, interpretation of the received medical image is started. In interpretation, a slice image selected by an interpretation doctor or the like is displayed on the display unit 40. Further, in image interpretation, image processing such as enlargement, reduction, rotation, movement, and gradation processing is performed on the displayed slice image, or a finding is input from the input unit 50 including a keyboard or the like. Alternatively, an operation such as selecting a key image corresponding to the finding from the displayed slice images is performed. Note that the input of findings may be performed by the utterance of an interpreting doctor.

  In ST203, the order determination unit 36 determines whether the interpretation is performed according to the interpretation order of the interpretation guide. When the interpretation is performed in the interpretation order, the process proceeds to ST209, and it is determined whether the interpretation is performed. On the other hand, if the order determination unit 36 determines that the interpretation is not performed according to the interpretation order, an order determination result display is generated (ST205), and the generated order determination result display is displayed on the display unit 40 (ST207). ).

  In ST209, the interpretation implementation status determination unit 37 determines whether interpretation has been performed on the interpretation target AL.

  In ST211, based on the interpretation determination result determined by the interpretation implementation status determination unit 37, an interpretation determination result display is generated.

  In ST213, an interpretation determination result display is displayed on the display unit 40.

  In ST215, it is determined whether or not the interpretation is continued. When the interpretation is continued, the processes after ST203 are repeatedly executed. When the interpretation ends, the interpretation implementation status display immediately before the termination is displayed on the display unit 40 (ST217). Whether or not the interpretation is continued is determined based on, for example, the presence or absence of an input operation from the input unit 50, the operation of ending the medical image display device 100, or saving or printing the created interpretation report. The

  Hereinafter, the interpretation order result display generated by the order determination unit 36 and the interpretation implementation status display generated by the interpretation implementation status determination unit will be described.

  FIG. 19 is a diagram for explaining a first display example in the second embodiment of the medical image display apparatus 100 according to the embodiment.

  In the example of FIG. 19 (a), a check box indicating whether or not the interpretation is completed is displayed on each of the interpretation targets AL shown in the order display D2. The interpretation implementation status determination unit 37 generates and displays an interpretation implementation status result display in which a check mark “re” is displayed in the check box as an interpretation implementation status result for the interpretation target AL determined to have been interpreted. In the example of FIG. 19A, the interpretation implementation status determination unit 37 determines that interpretation has been completed for the first interpretation target AL “AL2” in the order display D2, and a check mark is placed in the check box as the interpretation implementation status display. A display showing “re” is shown.

  Further, it may be possible to transition to a slice image including the selected interpretation target AL by providing a link to the interpretation target AL displayed in the order display D2 and pressing the link set for each interpretation target AL. The order determination unit 36 determines that the interpretation order is different when the interpretation target AL being currently interpreted is not completed and the link of the subsequent interpretation target AL is pressed. A message indicating that the interpretation order is different may be generated. For example, in the example of FIG. 19A, the interpretation of the second interpretation target AL “AL3” in the order display D2 has been performed, and the interpretation of “AL3” has not yet been completed. In this state, when the link of the interpretation target AL in the third row or later is pressed, the order determination unit 36 determines that the interpretation order is not in line with the interpretation guide. Further, by moving a trackball such as a mouse up and down on the display of the slice image D1 in FIG. 19A, the slice image including the interpretation target AL corresponding to the next interpretation target AL “AL5” is converted into the slice image. When displayed in D1, the interpretation target AL to be interpreted in the order of the order display D2 is “AL3”, whereas the interpretation target AL displayed in the slice image D1 is “AL5”. The order determination unit 36 determines that the interpretation target AL having an order different from that of the interpretation guide is being interpreted due to such a display difference. The order determination unit 36 may generate a message indicating that the interpretation order is different as the order determination result display.

  FIG. 19B is a modification of FIG. In FIG. 19B, when the interpretation of the interpretation target AL is completed in the order display D2 (a check mark “re” is displayed), the interpretation target corresponding to the next order in accordance with the interpretation order of the interpretation guide. An example in which AL is newly displayed in the order display D2 is shown. FIG. 19B shows an example in which the interpretation of the interpretation target AL “AL2” in the interpretation order No. 1 and the second interpretation target AL “AL3” is completed, and a check mark “Re” is displayed in the check box. Has been. When the next interpretation target AL is “AL5”, when the interpretation of the second interpretation target AL “AL3” is completed and a check mark “Re” is newly displayed in the check box, the interpretation target AL is “AL5”. Is displayed in the order display D2. As described above, the interpretation guide display generation unit 34 may display the next interpretation target AL in the interpretation order D2 based on the completion of interpretation by the interpretation implementation status determination unit 37.

  Further, when all the interpretation targets AL corresponding to the interpretation order are displayed in the order display D2 in advance and the interpretation is completed by the interpretation implementation status determination unit 37, a link of the interpretation target AL corresponding to the next interpretation order is displayed. You may make it activate.

  FIG. 20 is a diagram for explaining a second display example in the second embodiment of the medical image display apparatus 100 according to the embodiment.

  FIG. 20A shows an example in which an interpretation execution status display is added to FIG. 15A of the first embodiment. Similarly to FIG. 15A, the position display D3 includes a bar G1 corresponding to the total number of slices of the medical image, an interpretation target position in the medical image, a mark G2 indicating the range of the interpretation target AL, and the current medical image. A slider G3 indicating the position is shown. The range of the interpretation target AL includes a plurality of slice images. In the example of FIG. 20A, the position in the mark G2 corresponding to the slice image for which the interpretation determination result is completed is indicated by shading. That is, a portion of the mark G2 where no shade is displayed indicates the position of a slice image that has not been interpreted. In addition, the range shown by the shaded area in FIG. 20A is represented by color, brightness, or the like on the display.

  The interpretation implementation status determination unit 37 can determine for each slice image whether interpretation has been performed. For example, the slice image to be interpreted was not displayed, the display time was short, the term related to the local structure included in the slice image to be interpreted was not spoken, and the slice image was selected with a cursor or pointer, Interpretation slice image in which the user's line of sight acquired by the line-of-sight information acquisition unit 60 that has not been subjected to image processing such as enlargement or gradation value change is not located at a predetermined coordinate of the interpretation target slice image Is not selected as the key image, or the interpretation target AL is not described in the findings, the interpretation implementation status determination unit 37 determines that the interpretation target slice image has not been interpreted. The interpretation execution status determination unit 37 interprets the position of the slice image that has not been interpreted among the interpretation target positions, with the position corresponding to the slice image that has not been interpreted in the range within the mark G2 being outlined. Generate a status display. Therefore, when all the slice images corresponding to the range of the interpretation target AL have not been interpreted, the shaded display in the mark G2 is displayed in a skipped manner.

  Although FIG. 20A shows an example in which the interpretation execution status display of the position of the slice image for which the interpretation has been completed is shown, an interpretation implementation status display that indicates the position of the slice image for which the interpretation has not been completed may be generated.

  By such display, the user can grasp the position of the slice image that is not sufficiently interpreted. Further, it may be possible to transition to a predetermined slice image by pressing the area of the mark G2. For example, it may be possible to instantaneously move to the corresponding slice image by pressing the position of the mark G2 corresponding to the slice image that has not yet been interpreted.

  FIG. 20B shows an example in which an interpretation status display is added to FIG. 15B of the first embodiment. The warning mark G5 indicates an interpretation target AL that has not been interpreted. In the example of FIG. 20B, the interpretation target AL currently being interpreted is “AL5”, which is the third interpretation order. The label of the interpretation target AL “AL1” having the first interpretation order is shaded to indicate that the interpretation has been completed. On the other hand, the label of the interpretation target AL “AL2” having the second interpretation order remains blank, and a warning mark G5 is displayed on the right side. In this way, the interpretation implementation status determination unit 37 generates and displays an interpretation implementation status display that distinguishes an interpretation target AL for which interpretation has not been completed from an interpretation target AL for which another interpretation has been completed.

  With such a display, the user can grasp the local structure or part of the interpretation target whose interpretation is not sufficient. Further, by pressing the label of the target AL for which interpretation is not completed, the transition may be made to the first slice image of the interpretation target AL, or to a slice image with insufficient interpretation.

  FIG. 21 is a diagram for explaining a third display example in the second embodiment of the medical image display apparatus 100 according to the embodiment. FIG. 21 is a modification of FIG. 19 or FIG.

  FIG. 21A shows, in a bar graph, the slice image ratio at which the interpretation determination result is completed for each interpretation target AL. The order display D2 shows a check box and a bar graph for each interpretation target AL. On the right side of the bar graph, a line indicating the rate at which interpretation can be determined is shown. For example, when the interpretation completion determination criterion is that 90% or more of slice images including a plurality of slice images including the interpretation target position are displayed, the right line of the bar graph is 90%. Indicates the position. Note that the anatomical position may be set for each interpretation target AL as a reference for completing the interpretation according to the reliability for which the reliability is set. In the example of FIG. 21A, regarding the first interpretation target AL in the ranking display D2, since the bar graph has reached the right line, it is assumed that the interpretation has been completed, and the check mark “re” is displayed in the left check box. Is displayed. Similarly, for the fourth interpretation target AL, since the bar graph exceeds the right line, it is assumed that the interpretation has been completed, and a check mark “re” is displayed in the left check box.

  For the fourth level interpretation target AL, even if the interpretation implementation status determination unit 37 determines that the interpretation has been completed, the interpretation implementation status determination unit 37 combines the determination results of the order determination unit 36. As the interpretation implementation status display, an interpretation implementation status display that does not display a check in the check box may be generated. That is, even if the interpretation is completed, but the interpretation is not performed in the interpretation order, the interpretation completion status display for which the interpretation completion is not performed and the check box is not displayed is generated for the interpretation target AL. May be.

  FIG. 21B is a modification of FIG. FIG. 21B shows an example in which the interpretation status of each interpretation target AL is displayed in three states of “completed”, “under interpretation”, and “not started”. The row indicated by the reproduction mark (triangle) on the order display D2 indicates that it is the interpretation target AL corresponding to the display image. In the example of FIG. 21B, there are two interpretation targets AL whose implementation status is “under interpretation”. One shows a reproduction mark, and the other has no display of a reproduction mark. The interpretation target AL of the line whose interpretation execution status is “under interpretation”, for which the reproduction mark is not shown on the order display D2, is a slice that includes another interpretation target AL before the judgment is made that the interpretation has been completed. Indicates that image interpretation has started.

  In this way, by displaying the progress status of the interpretation and the interpretation execution status display indicating whether or not the interpretation has been completed, the interpretation doctor who is the user, for example, even if there is an interpretation target AL for which the interpretation has been delayed. Therefore, it is possible to easily grasp the place where the interpretation is postponed and to prevent the interpretation from being overlooked.

  FIG. 22 is a diagram illustrating a fourth display example in the second embodiment of the medical image display apparatus 100 according to the embodiment. FIG. 22 shows an example in which the time measured by the interpretation time storage unit 25 is displayed as the interpretation execution status display.

  FIG. 22A shows an example in which the time until the completion of interpretation of each interpretation target AL acquired in the interpretation time storage unit 25 is displayed in the order display D2. In the upper part of the bar graph shown in the order display D2 in FIG. 22A, a number indicating the interpretation order is displayed. The time when the interpretation of the first interpretation target AL in the interpretation order is completed is after the interpretation starts. It is shown that it is “3 minutes 57 seconds”. Further, it is shown that the interpretation time of the interpretation target AL having the second interpretation order is “6 minutes 53 seconds” after the interpretation is started. In the example of FIG. 22A, since the interpretation is being performed for the third interpretation target AL whose interpretation order is, the interpretation completion time is not shown, and an indicator indicated by a triangle is shown on the bar graph indicating the interpretation time. Has been.

  The display shown in the lower part of FIG. 22 (a) may be displayed side by side for each interpretation doctor. For example, the interpretation time in the interpretation that has already been performed using the same interpretation guide may be displayed side by side.

  FIG. 22B illustrates an example in which the interpretation implementation status determination unit 37 determines whether interpretation has been completed for the interpretation target AL according to the interpretation time acquired by the interpretation time storage unit 25 and displays the interpretation implementation status display. Is shown. The interpretation time storage unit 25 measures the time when interpretation is performed for each interpretation target AL. FIG. 22B illustrates an example in which the interpretation implementation status determination unit 37 determines whether interpretation has been completed for the interpretation target AL according to the recommended time. The recommended time may be, for example, an average value or a median value obtained by obtaining the interpretation time of each interpretation target AL from the interpretation implementation status stored for each interpretation doctor, or the number of years of interpretation doctors' interpretation or interpretation. The recommended reading time may be the reading time of a doctor who has performed a large number of cases. In the example of FIG. 22B, since the interpretation time with the first interpretation order has reached the recommended time, the interpretation implementation status determination unit 37 determines that the interpretation is complete, and a check mark “re” is displayed in the check box. Has been. On the other hand, since the interpretation time with the second interpretation order is less than the recommended time, the interpretation implementation status determination unit 37 does not determine that the interpretation is complete, and the check mark “re” is not displayed in the check box. Further, the interpretation time of the interpretation order No. 3 exceeds the recommended time, and interpretation is performed. The portion exceeding the recommended time is indicated by dark shading. Since the interpretation has been performed beyond the recommended time, the interpretation implementation status determination unit 37 determines that the interpretation has been completed, and a check mark “re” is displayed in the check box.

  Thus, the time required for interpretation can be grasped from the interpretation time. In addition, by knowing your own interpretation time with respect to the recommended time, you can identify the interpretation target AL that you took time to work, and consider improving the interpretation method.

  FIG. 23 is a diagram for explaining a fifth display example in the second embodiment of the medical image display apparatus 100 according to the embodiment. FIG. 23 shows an example of the interpretation execution status display for each user generated by the user interpretation implementation status generation unit 38 from the interpretation implementation status and interpretation time for each interpretation doctor stored in the user storage unit 21.

  FIG. 23A shows an example in which interpretation corresponding to a plurality of examination purposes is performed on one medical image. A label indicating the first radiographer is shown next to the inspection purpose. In the example of FIG. 23, the first interpreter of “lung cancer screening” and “lung cancer metastasis examination” is “interpretation doctor A”, and the first interpreter of “lung cancer close examination” is “interpretation doctor B”. Interpretation may be double checked. The second interpreter differs from the first interpreter in terms of points of caution, such as whether there is no viewpoint overlooked by the first interpreter or whether there is an insufficient portion of interpretation by the first interpreter. For example, if the first interpreter is an inexperienced doctor, more careful interpretation is required.

  In the example of FIG. 23 (a), at the lower part of the order display D2, a location where “interpretation physician B” who has performed “detailed examination of lung cancer” has focused interpretation is indicated by the number of stars. Whether or not interpretation has been performed with priority is determined according to the determination result in the interpretation implementation status determination unit 37, the interpretation time acquired in the interpretation time storage unit 25, and the like. For example, the determination may be made comprehensively based on the length of the interpretation time, the number of times of display, the presence or absence of description in the key image or findings, and the like. Further, the length of the interpretation time, the number of times of display, the presence or absence of description in the key image or the findings, and the like may be displayed below the order display D2. In FIG. 23 (a), among the interpretation target ALs “right lung apex”, “left lung apex”, and “tracheal bifurcation” of “lung cancer detailed examination”, there are two stars at “left lung apex”. , One star is displayed in the “tracheal bifurcation”, indicating that the interpretation of the “left lung apex” and “tracheal bifurcation” has been focused.

  FIG. 23B shows an example in which an interpretation execution status display for each interpretation doctor is displayed in a tab format. In the example of FIG. 23B, an interpretation execution status display of “interpretation doctor A” is displayed. In the example of FIG. 23B, interpretation doctor A has completed interpretations of “lung cancer screening” and “lung cancer metastasis examination”. On the other hand, “detailed examination of lung cancer” is being interpreted, and its progress is displayed at the bottom of the sequence display D2. The shaded bar graphs shown next to the interpretation target ALs “right lung apex”, “left lung apex”, and “tracheal bifurcation” of “detailed examination of lung cancer” indicate the progress of the interpretation. The “right lung apex” is a shaded bar graph indicating that the interpretation has been completed. On the other hand, the “left lung apex” is a part of the bar graph and the “tracheal bifurcation” is a white bar. It can be determined that the interpretation of these interpretation targets AL has not been completed.

  In this way, by generating an interpretation status display for each interpreting doctor, it is possible for interpreting doctors, etc., to perform a double check to easily understand how other interpreting doctors have performed interpretation. It is possible to perform an efficient and efficient double check. In addition, since it is possible to grasp for each interpretation doctor how the interpretation was performed, it can be used for reviewing and teaching the interpretation method.

  In this way, in addition to the various displays of the interpretation guide, the interpretation is displayed by displaying the interpretation execution status display that indicates whether the interpretation is being performed, and the order determination result that determines whether the interpretation is being performed in order. It is possible to prevent the oversight of the target site and the local structure and to support efficient interpretation.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. These embodiments and their modifications are included in the scope and gist of the invention, and are also included in the invention described in the claims and the equivalents thereof.

DESCRIPTION OF SYMBOLS 10 Communication control apparatus 20 Memory | storage part 30 Main control part 40 Display part 50 Input part 60 Gaze information acquisition part 21 User memory | storage part 31 Medical image input part 32 Anatomical position detection part 33 Interpretation guide production | generation part 34 Interpretation guide display production | generation part 35 Image preparation unit 36 Order determination unit 37 Interpretation execution state determination unit 38 User interpretation execution state generation unit 39 Interpretation time measurement unit 100 Medical image display device 200 Medical image central management server 300 Modality device 400 HIS / RIS

Claims (17)

A medical image display device for receiving a medical image composed of a plurality of slice images,
An anatomical position detecting unit for detecting an anatomical position indicating a characteristic local structure of the human body from the medical image;
An interpretation guide generating unit for generating an interpretation guide for guiding the interpretation order of the medical images based on the anatomical position;
A display generation unit for generating a display based on the anatomical position for guiding the interpretation order of the interpretation guide and the anatomical position detected from the medical image;
A display unit for displaying the display generated by the display generation unit;
A medical image display device comprising: The interpretation guide includes at least the local structure corresponding to the interpretation target anatomical position and the order of the local structure corresponding to the interpretation target anatomical position;
The medical image display apparatus according to claim 1. An interpretation guide table storage unit for storing a table for generating an interpretation guide;
The interpretation guide table storage unit extracts an interpretation guide that associates an interpretation guide table that lists the interpretation guides for each interpretation ID that uniquely identifies the interpretation guide, an examination purpose of the medical image, and the interpretation guide ID. Remember the table,
The image interpretation guide generating unit generates the image interpretation guide corresponding to the inspection purpose of the medical image based on the image interpretation guide extraction table and the image interpretation guide table;
The medical image display apparatus according to claim 2. The interpretation guide table storage unit includes a display condition table in which a display condition of the anatomical position for guiding the interpretation order of the interpretation guide is set for each interpretation guide ID, and an interpretation target for each interpretation guide ID. A medical image table to be interpreted, in which medical image conditions are set,
The image interpretation guide generating unit generates the image interpretation guide in which a condition based on at least one of the display condition table and the image interpretation target medical image table is added to the image interpretation guide;
The medical image display device according to claim 2, wherein: The display generation unit is a slice image of the medical image including the local structure corresponding to the anatomical position that guides the interpretation order of the interpretation guide based on the anatomical position detected from the medical image. A display image generation unit for generating a display image, which is displayed in the interpretation order of the interpretation guide,
The display unit displays the display image;
The medical image display device according to any one of claims 1 to 4. The display generation unit further includes an interpretation guide display generation unit that generates an interpretation guide display that guides the interpretation order of the interpretation guide based on the anatomical position that guides the interpretation order of the interpretation guide,
The display unit displays the interpretation guide display;
The medical image display apparatus according to claim 5. The interpretation guide display generation unit generates the interpretation guide display in which the local structure corresponding to the anatomical position guiding the interpretation order is displayed in the interpretation order;
The medical image display device according to claim 6. The image interpretation guide display generation unit displays the anatomical position that guides the image interpretation order on an anatomical chart in which the position, appearance, shape, organ, part, and organ of the structure in the human body are represented by illustrations or photographs. Generating the interpretation guide display displayed at a corresponding position;
The medical image display device according to claim 6 or 7. The interpretation guide display generation unit includes a slice range including the local structure corresponding to the anatomical position corresponding to the interpretation order from the medical image based on the anatomical position guiding the interpretation order. And generating the interpretation guide display indicating the slice range for the entire medical image,
The medical image display apparatus according to claim 6, wherein: Whether the local structure corresponding to the anatomical position guiding the interpretation order of the interpretation guide of the medical image is interpreted based on the anatomical position guiding the interpretation order of the interpretation guide. An order determination unit for determining;
The order determination unit generates an order determination result display based on the determination result,
The display unit displays the order determination result display;
A medical image display device according to any one of claims 1 to 9. The interpretation of the medical image based on the anatomical position that guides the interpretation order of the interpretation guide from at least one of the operation content on the medical image, the user's line-of-sight information, and the utterance content of the user. An interpretation implementation status determination unit that determines whether or not the local structure corresponding to the anatomical position guiding the interpretation order of guides has been interpreted;
The interpretation implementation status determination unit generates an interpretation implementation status display based on the determination result,
The display unit displays the interpretation status display;
The medical image display apparatus according to claim 10. An interpretation time storage unit that records a start time and an end time of the interpretation implementation status determination in the interpretation implementation status determination unit, and calculates and stores an interpretation time from the start time and the end time;
The interpretation implementation status determination unit determines the interpretation implementation status based on the interpretation time;
The medical image display apparatus according to claim 10 or 11, characterized in that: A user storage unit that stores the interpretation implementation status, the interpretation order, and the interpretation time for each user;
A user interpretation implementation status display generation unit that generates a user interpretation implementation status display indicating an interpretation implementation status for each user from at least one of the interpretation implementation status, the interpretation order, and the interpretation time stored for each user. When,
Further comprising
The display unit displays the user interpretation implementation status display;
The medical image display device according to any one of claims 10 to 12. The display generation unit, based on the anatomical position that guides the interpretation order of the interpretation guide, the local corresponding to the anatomical position that guides the interpretation order of the interpretation guide to be displayed in the following order The slice image including the structure is specified in advance from the medical image based on the anatomical position detected from the medical image, and the interpretation order of the interpretation guides to be displayed in the subsequent order is guided. An image preparation unit that reads in advance a slice image including the local structure corresponding to an anatomical position;
The display unit displays slice images displayed in the following and subsequent orders;
The medical image display apparatus according to claim 1, wherein: Computer
A medical image display program for receiving a medical image composed of a plurality of slice images,
Anatomical position detecting means for detecting an anatomical position indicating a characteristic local structure of a human body from the medical image;
An interpretation guide generating means for generating an interpretation guide for guiding the interpretation order of the medical images based on the anatomical position;
Display generation means for generating a display based on the anatomical position for guiding the interpretation order of the interpretation guide and the anatomical position detected from the medical image;
Display means for displaying the display generated by the display generation unit;
A medical image display program characterized by functioning as: An interpretation guide display generating means for generating an interpretation guide display for guiding the interpretation order of the interpretation guide based on the anatomical position for guiding the interpretation order of the interpretation guide;
The display means displays the interpretation guide display;
The medical image display program according to claim 15, wherein: A medical image display system that operates on an electronic network that receives a medical image composed of a plurality of slice images,
An anatomical position detecting unit for detecting an anatomical position indicating a characteristic local structure of the human body from the medical image;
An interpretation guide generating unit for generating an interpretation guide for guiding the interpretation order of the medical images based on the anatomical position;
A display generation unit for generating a display based on the anatomical position for guiding the interpretation order of the interpretation guide and the anatomical position detected from the medical image;
A display unit for displaying the display generated by the display generation unit;
A medical image display system comprising:

Images