JP6335030B2 - Medical image diagnostic apparatus, ultrasonic diagnostic apparatus, and medical image processing apparatus - Google Patents

Description

  Embodiments as one aspect of the present invention relate to a medical image diagnostic apparatus, an ultrasonic diagnostic apparatus, and a medical image processing apparatus.

  In order to discover breast cancer and other breast abnormalities, diagnosis based on mammography called mammography is performed. Mammography is acquired by a mammogram apparatus (mammography apparatus). The mammography apparatus acquires an image by irradiating X-rays with the breast compressed and thinly stretched. Acquisition of a mammography apparatus using a mammography apparatus has a problem of exposure to X-rays, but can be acquired in a short time and is widely used in breast cancer screening and the like.

  When an abnormal finding is extracted from a breast X-ray image acquired by such a mammography apparatus and an interpretation report is created, an abnormal finding on the breast X-ray image is observed using a diagram schematically showing the breast X-ray image. (For example, patent document 1 etc.) is provided.

JP 2011-24622 A

  In breast cancer inspection using a mammography apparatus, generally, imaging is performed from two directions of the left and right breasts, ie, the MLO (Medio Lateral Oblique) direction and the Cranio Caudal (CC) direction. When a region of interest is recognized in an examination with a mammography apparatus, imaging with another modality apparatus such as an ultrasonic diagnostic apparatus, an MRI (Magnetic Resonance Imaging) apparatus, an X-ray CT (Computed Tomography) apparatus, or a biological tissue examination A close examination is performed by biopsy.

  However, the breast X-ray image acquired by the mammography apparatus is a two-dimensional image acquired by pressing a three-dimensional breast. Therefore, for example, when comparing an image acquired in a close examination and a breast X-ray image, it is necessary to imagine the position of the region of interest based on the breast X-ray images acquired from the MLO and CC directions. In addition, there may be cases where the interpreting doctor who interprets the breast X-ray image acquired by the mammography device differs from the interpreting doctor who interprets the image acquired by the close examination, such as a doctor or laboratory technician performing a close examination. It has been difficult to share the location information of regions with each other.

  Therefore, there is a demand for a medical image diagnostic apparatus and a medical image processing apparatus that can easily grasp position information of a region of interest in a breast X-ray image.

  The medical image diagnostic apparatus according to the present embodiment obtains the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions. A position information specifying unit for specifying, and a schema generating unit for generating a schema indicating the three-dimensional position information of the specified region of interest in a breast model that is a diagram schematically representing the breast. Features.

1 is a conceptual configuration diagram illustrating an example of a medical image diagnostic apparatus according to an embodiment. The functional block diagram which shows the function structural example of the medical image diagnostic apparatus which concerns on embodiment. The flowchart which shows an example of operation | movement of the medical image diagnostic apparatus which concerns on embodiment. The figure explaining the example of the breast X-ray image acquired by the mammography apparatus. The figure explaining the example of the breast model of the medical image diagnostic apparatus which concerns on embodiment. The figure explaining the method of producing | generating a breast model based on the breast X-ray image of the medical image diagnostic apparatus which concerns on embodiment. The figure explaining the example of the breast model produced | generated with the medical image diagnostic apparatus which concerns on embodiment. The figure explaining the alignment method of a breast X-ray image and a breast model in the medical image diagnostic apparatus which concerns on embodiment. The figure explaining the method of specifying the positional information on the region of interest of the breast X-ray image in the medical image diagnostic apparatus according to the embodiment. The figure explaining the depth information of the region of interest of the breast X-ray image in the medical image diagnostic apparatus according to the embodiment. FIG. 6 is a diagram for explaining a method for specifying position information when there are a plurality of regions of interest in a breast X-ray image in the medical image diagnostic apparatus according to the embodiment. The figure explaining the example of the schema in the medical image diagnostic apparatus which concerns on embodiment. The figure explaining the example of sectional drawing of the schema in the medical image diagnostic apparatus which concerns on embodiment.

  Embodiments of a medical image diagnostic apparatus will be described below with reference to the accompanying drawings.

(1) Configuration FIG. 1 is a conceptual configuration diagram illustrating an example of a medical image diagnostic apparatus 100 according to an embodiment. The example of FIG. 1 shows an example in which the medical image diagnostic apparatus 100 is configured as an ultrasonic diagnostic apparatus. The medical image diagnostic apparatus 100 is not limited to an ultrasonic diagnostic apparatus, and may be configured by other modality apparatuses such as an MRI apparatus, an X-ray CT apparatus, and a SPECT (Single Photon Emission Computed Tomography) apparatus.

  A medical image diagnostic apparatus 100 configured by the ultrasonic diagnostic apparatus illustrated in FIG. 1 includes an image processing unit 10, an imaging unit 20, a communication control unit 30, a system control unit 40, a display unit 50, and an input unit 60. It is. Among them, the image processing unit 10 includes a main control unit 110 and a storage unit 120, and the imaging unit 20 includes an ultrasonic probe 210, a transmission / reception unit 220, and a data collection unit 230 that are necessary for imaging of the ultrasonic diagnostic apparatus. It is. For example, when the medical image diagnostic apparatus 100 is configured by an X-ray CT apparatus, the imaging unit 20 includes an X-ray irradiation apparatus, a high-voltage power source, an X-ray detector, a DAS (Data Acquisition System) necessary for imaging by the X-ray CT apparatus. ) And the like.

  The medical image diagnostic apparatus 100 shown in FIG. 1 is connected to a mammography apparatus 200 and a medical image central management server 300 via an electronic network via a communication control unit 30. The communication control unit 30 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 mammography apparatus 200 and the medical image central management server 300 store breast X-ray images, and the medical image diagnostic apparatus 100 acquires the breast X-ray images from the mammography apparatus 200 and the medical image central management server 300 via the electronic network. .

  The image processing unit 10 performs image processing on the breast X-ray image or the collected data collected by the imaging unit 20. The image processing in the image processing unit 10 is processed by executing a program stored in the storage unit 120 by the main control unit 110.

  The imaging unit 20 images a subject according to imaging conditions and collects data. In the example of FIG. 1, the medical image diagnostic apparatus 100 is configured by an ultrasonic diagnostic apparatus, and the imaging unit 20 collects data of an ultrasonic diagnostic image. The ultrasonic diagnostic apparatus collects data by transmitting an ultrasonic wave from the ultrasonic probe 210 into the subject and receiving a reflected wave caused by an acoustic impedance mismatch inside the subject by the ultrasonic probe. The transmission / reception unit 220 performs processing for performing phasing addition on the drive signal for radiating the transmission ultrasonic wave from the ultrasonic probe 210 and the reception signal from the ultrasonic probe 210. The data collection unit 230 collects any one of B-mode data, color Doppler data, and Doppler spectrum based on the received signal obtained from the transmission / reception unit 220 according to the control signal from the system control unit 40.

  The system control unit 40 includes a CPU (Central Processing Unit) and a memory, and comprehensively controls the medical image diagnostic apparatus 100.

  The display unit 50 includes a general display device such as a liquid crystal display or an OLED (Organic Light Emitting Diode) display, and is collected by the schema or the imaging unit 20 and generated by the image processing unit 10 under the control of the system control unit 40. The displayed image data is displayed on the display.

The input unit 50 is configured by a general input device such as a keyboard, a touch panel, a numeric keypad, and a mouse. The input unit 50 outputs an input signal corresponding to selection of a region of interest of the user, image processing, and the like to the system control unit 40.

  The medical image diagnostic apparatus 100 may be configured by a medical image processing apparatus such as a medical image interpretation apparatus or an image display apparatus.

  FIG. 2 is a functional block diagram illustrating a functional configuration example of the medical image diagnostic apparatus 100 according to the embodiment. As shown in FIG. 2, the medical image diagnostic apparatus 100 is mainly composed of an image processing unit 10, an imaging unit 20, and a display unit 50. Among them, the image processing unit 10 includes an image storage unit 121, a breast model storage unit 123, a patient information storage unit 125, a position information specifying unit 111, a schema generation unit 112, a breast model selection unit 113, a breast model generation unit 114, and a cross section generation unit. 115 and an image generation unit 116.

  Of the above configuration, the functions of the position information specifying unit 111, the schema generation unit 112, the breast model selection unit 113, the breast model generation unit 114, the cross-section generation unit 115, and the image generation unit 116 are stored in the storage unit 120 of the image processing unit 10. This is a function realized by the main control unit 110 executing the stored program.

  The image storage unit 121 stores a breast X-ray image obtained by photographing the breast of the subject from two or more directions. A breast X-ray image captured by the mammography apparatus 200 and stored in the medical image central management server 300 may be input to the image storage unit 121, or a breast X-ray image captured by the mammography apparatus 200 may be input. Good. The breast X-ray image is medical image data conforming to the DICOM (Digital Imaging and Communication in Medicine) format, and includes information such as an imaging direction, an imaging angle, and an imaging condition such as MLO and CC as supplementary information. Furthermore, the incidental information can also include a living body length conversion value for obtaining the length of the subject corresponding to one pixel (pixel) of the breast X-ray image. The living body length converted value will be described later.

  The breast model storage unit 123 stores a breast model schematically representing a general breast shape and size. The breast model is for understanding the appearance, shape, size, etc. of the breast, and is represented by an illustration or a photograph. The breast model may be two-dimensional or three-dimensional. The breast model may be downloaded from an external storage device or may directly refer to the external storage device. The breast model will be described later.

The patient information storage unit 125 stores body shape information including chest circumference at the position of the nipple of the subject, chest circumference under the breast, and living body length information indicating the size and shape of the breast. The living body length information may be included in the supplementary information of the breast X-ray image, or may be downloaded from the medical image central management server 300 or a hospital system (not shown) or referred to.

  The position information specifying unit 111 specifies the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions. Further, the position information specifying unit 111 aligns the breast X-ray image and the breast model based on the specific position on the breast X-ray image, and specifies the position information of the specified region of interest as the position on the breast model. . The processing of the position information specifying unit 111 will be described later.

  The schema generation unit 112 generates a schema indicating the position information of the region of interest specified in the breast model, which is a diagram schematically representing the breast. The schema generation unit 112 generates a schema indicating the three-dimensional position information of the region of interest at the position on the breast model specified by the position information specifying unit 111. The schema generation method will be described later.

  The breast model selection unit 113 selects a breast model closest to the subject's breast based on the body shape information of the subject stored in the patient information storage unit 125. A method for selecting a breast model will be described later.

  The breast model generation unit 114 generates a breast model corresponding to the subject's breast based on the body shape information of the subject. An ellipsoidal breast model is generated based on breast X-ray images taken from two or more directions. A method for generating a breast model will be described later.

  The cross-section generating unit 115 generates a cross-sectional view of a desired cross section of the three-dimensional schema when the schema is three-dimensional. A cross-sectional view generated by the cross-section generator 115 will be described later.

The image generation unit 116 generates image data based on the collected data collected by the imaging unit 20 . When the medical image diagnostic apparatus 100 is configured with an ultrasonic diagnostic apparatus as in the example of FIG. 1, an ultrasonic image is generated by performing image processing on a reception signal based on the reflected wave received by the ultrasonic probe 210.

(2) Operation Hereinafter, an operation of the medical image diagnostic apparatus 100 according to the embodiment will be described.

  FIG. 3 is a flowchart illustrating an example of the operation of the medical image diagnostic apparatus 100 according to the embodiment.

In ST 101, a breast X-ray image is input from the mammography apparatus 200 or the medical image central management server 300 to the image storage unit 121. Mammograms taken from two or more directions are input to the medical image diagnostic apparatus 100 according to the present embodiment.

  FIG. 4 is a diagram for explaining an example of a mammogram X-ray image acquired by the mammography apparatus 200. A breast X-ray image is generally imaged from two directions, an inside / outside oblique direction (MLO) and a head-to-tail direction (CC). 4A illustrates an imaging method in the MLO direction, and FIG. 4C illustrates an imaging method in the CC direction. FIG. 4B shows an example of a breast X-ray image taken from the MLO direction, and FIG. 4D shows an example of a breast X-ray image taken from the CC direction.

  As shown in FIG. 4A, in the MLO direction imaging, the compression plate of the mammography apparatus 200 is a compression device provided above the imaging table in order to compress the breast of the subject during imaging. The compression plate is made of a transparent resin, and is supported so as to be able to contact and separate from the imaging table. Then, the breast of the subject can be compressed by moving the compression plate toward the imaging table, and the thickness of the breast can be made thin and substantially uniform. After the breast is sandwiched between the compression plates and stretched thinly, imaging in the MLO direction is performed in a state where the breast is tilted at a predetermined angle from the standing body axis direction indicated by an arrow in FIG. The breast X-ray image is an image integrated by the thickness of the breast crushed by the compression plate, and as shown in FIG. 4A, when photographing in the MLO direction, the X-ray breast image centered on the MLO cross section indicated by the broken line. Is acquired. The imaging angle in the MLO direction varies depending on the position and body shape of the subject's breast, and the angle input or detected in the mammography apparatus 200 at the time of imaging is attached to the image data. Moreover, in addition to the imaging conditions at the time of imaging, the breast X-ray image can be accompanied by living body length information such as the size of the breast.

  FIG. 4C is a diagram for explaining a photographing method in the CC direction. Like the MLO direction, the breast is sandwiched between the compression plates and stretched thinly, and then imaging in the CC direction, which is a cross section perpendicular to the standing body axis direction indicated by the arrow in FIG. For imaging from the CC direction, an X-ray breast image centered on the CC cross section indicated by the broken line in FIG.

  4A and 4C show the imaging methods from the MLO direction and the CC direction, respectively, the imaging direction in the mammography apparatus 200 is not limited to this. For example, imaging can be performed from various directions such as an external caudal direction (XCC; eXaggerated Cranio Caudal) and an inner breast gap (CV; cleavage).

  FIG. 4B shows an example of a breast X-ray image taken from the MLO direction. The arrow shown on the right side of FIG. 4B is parallel to the MLO cross section, and the MLO image of the breast is shown symmetrically. The upper part of FIG. 4B shows the head side, and the lower part shows the foot side. FIG. 4B shows an example in which a region of interest exists in the right (R) MLO image, and MLO_region of interest indicates the region of interest of the MLO.

  FIG. 4D shows an example of a breast X-ray image taken from the CC direction. The arrow shown on the left side of FIG. 4D is parallel to the CC cross section, and a CC image of the breast is shown symmetrically. The upper part of FIG. 4B shows the outside, and the lower part shows the inside. FIG. 4D illustrates an example in which a region of interest exists in the right (R) CC image, and CC_region of interest indicates a region of interest of the CC.

  In the example of FIGS. 4B and 4C, there are regions of interest in each of the MLO and CC, but these images are images taken from the projection direction that can change each time the image is taken. In addition, the image is taken with the breast pressed (that is, with the breast deformed). For this reason, it is difficult to intuitively grasp the three-dimensional position of the region of interest from only conventional breast X-ray images such as the MLO and CC illustrated in FIGS. 4B and 4C. For example, when trying to diagnose a region of interest using an ultrasonic diagnostic apparatus, the three-dimensional position of the region of interest of the breast must be imagined from the position of the region of interest shown in each image. I had to. Further, when there are a plurality of regions of interest, it is necessary to imagine the position while considering the corresponding relationship, and it is difficult to easily grasp the position of the region of interest. Furthermore, it is difficult to share position information constructed in the head of a doctor or the like with other doctors or patients, and it is difficult to easily transmit and share position information of a region of interest.

  Accordingly, the medical image diagnostic apparatus 100 according to the present embodiment generates a schema (hereinafter simply referred to as a schema) indicating position information of a region of interest based on images acquired from two or more directions by the mammography apparatus 200. To solve the above-mentioned problems.

  Hereinafter, returning to the flowchart of FIG. 3, the schema generation method will be described.

  In ST103, the position information specifying unit 111 acquires a breast model. There are three types of breast models to be acquired. A breast model indicating a standard shape of a breast stored in advance in the breast model storage unit 123, a breast size of a subject from a plurality of breast models prepared in advance, and the like. A breast model selected according to the above, and a breast model generated for each subject.

  FIG. 5 is a diagram for explaining an example of a medical image diagnostic apparatus 100 breast model according to the embodiment. As shown in FIG. 5, the breast model is a schematic diagram briefly showing a characteristic structure by omitting the fine internal structure of the breast.

  FIG. 5A shows an example of a two-dimensional breast model. FIG. 5A illustrates a schematic diagram in which the breast is observed from a direction perpendicular to the body axis direction (Y axis in FIG. 5A). In the example of FIG. 5A, the left and right breasts are indicated by circles, and a circle indicating the nipple is shown near the center thereof. Although FIG. 5A shows an example in which the breast is schematically represented by a circle, the breast may be indicated by an ellipse, an arc, or the like, or may be an illustration of the chest illustrated in FIGS. 4A and 4B. Further, as the internal structure of the breast, a mammary gland, a muscle, a lymph gland and the like may be schematically shown.

  FIG. 5B shows an example of a three-dimensional breast model. FIG. 5B illustrates a schematic diagram in which the left and right breasts are represented by a graphic on the hemisphere. In the example of FIG. 5B, a hemisphere is shown, but a mountain shape closer to the shape of a breast may be used.

  The position information specifying unit 111 acquires the breast model illustrated in FIG. 5 from the breast model storage unit 123. Alternatively, the breast model storage unit 123 stores a plurality of breast models illustrated in FIG. 5 according to the size of the breast in advance, and the breast model selection unit 113 determines whether the breast information is included in the patient information storage unit 125 or the incidental information of the breast X-ray image. An appropriate breast model is selected based on the acquired breast size of the subject. The position information specifying unit 111 acquires the selected breast model. The selection of the breast model is based on, for example, the breast size of the subject calculated from the difference between the chest circumference (top bust) and the breast circumference (under bust) of the nipple, which is the body shape information of the subject. Done. Different breast models depending on the cup size are stored in advance in the breast model storage unit 123, and a breast model corresponding to the calculated cup size is selected from a plurality of breast models. In addition to the cup size described above, living body length information such as a breast width and thickness that can be acquired when the mammography apparatus 200 captures an image may be used.

  A breast model may be generated by the breast model generation unit 114. For example, the diameter of the bottom surface of the breast may be calculated from the underbust included in the patient information described above to generate a two-dimensional circular breast model. Furthermore, a hemispherical breast model may be generated based on the height calculated from the difference between the top bust and the underbust. A breast model may be generated based on the breast X-ray image. The breast X-ray image has a living body length converted value, and the actual size of the breast can be measured from the image. The biological length converted value is a value for obtaining the actual length of one pixel (pixel) in the breast X-ray image, and is set to, for example, “one pixel is 1 mm”. Based on this living body length converted value, the actual length can be calculated from the pixel value of the breast X-ray image by the method as described above. As described above, the breast model generated based on the breast X-ray image and the patient information can represent the breast of the subject on the same scale.

  FIG. 6 is a diagram for explaining a method for generating a breast model based on a breast X-ray image of the medical image diagnostic apparatus 100 according to the embodiment. FIG. 6 illustrates a method for generating an ellipsoidal breast model from a breast X-ray image.

  6A shows a breast X-ray image taken from the MLO direction, and FIG. 6B shows a breast X-ray image taken from the CC direction. First, the outline of the breast imaged in each breast X-ray image is extracted. It may be specified by a breast contour user or the like, or may be extracted by general image processing using edge processing or the like. Next, the image is divided into equal intervals. The broken lines shown in FIGS. 6 (a) and 6 (b) are dividing lines when divided at equal intervals from the right side (base of the breast) of each image. The arrows shown in FIGS. 6A and 6B indicate a straight line connecting the intersections of the fourth dividing line and the outline of the breast. MLO_φ4 in FIG. 6 (a) is a straight line connecting the intersections of the fourth division line on the MLO image and the outline of the breast, and FIG. 6 (b) CC_φ4 is the fourth division line on the CC image. It is a straight line connecting the intersections of the breast and the outline of the breast.

  FIG. 6C shows an example in which MLO_φ4 and CC_φ4 are represented on the XY coordinate plane according to the imaging direction. MLO_φ4 and CC_φ4 each intersect with a straight line passing through the nipple, and in the example of FIG. 6C, MLO_φ4 and CC_φ4 intersect at the position of the nipple. As shown in FIG. 6C, an ellipse inscribed in MLO_φ4 and CC_φ4 can be generated. An ellipsoidal breast model can be generated by generating such ellipses for each dividing line and arranging them.

  Although FIG. 6C shows an example in which MLO_φ4 and CC_φ4 intersect each other at the position of the nipple to generate an ellipse, the position of the nipple and the center of the ellipse do not necessarily match. Therefore, the ellipse may be divided into four, and a quarter ellipse may be generated in each region, and a breast model may be generated using a figure obtained by connecting the ellipses.

  FIG. 7 is a diagram illustrating an example of a breast model generated by the medical image diagnostic apparatus 100 according to the embodiment. As described in FIG. 6, FIG. 7A shows an example in which ellipses generated from the respective dividing lines are arranged at the same intervals as the dividing lines.

  FIG. 7B shows a semi-ellipsoid that inscribes or encloses the ellipse shown in FIG. By arranging ellipses in this way, the shape of the breast can be schematically represented. The semi-ellipsoid shown in FIG. 7B is generated based on a breast X-ray image obtained by compressing a breast, so that a breast model that models a compressed breast is generated. . However, even a collapsed shape is sufficient to grasp the positional relationship of the region of interest in the breast. Note that the ellipse generated in FIG. 6C may be deformed into a circle, and a hemispherical breast model may be generated from the circles deformed from the ellipse arranged in accordance with the dividing line.

  When the breast model is acquired as described above, the position information of the region of interest of the breast X-ray image is specified on the breast model. The position information is specified after aligning the breast X-ray image and the breast model. Hereinafter, returning to the flowchart of FIG. 3, a method for specifying position information and a method for generating a schema will be described.

  In ST105, the position information specifying unit 111 performs alignment between the breast X-ray image and the breast model.

  In ST107, the position information specifying unit 111 specifies position information based on the region of interest included in the breast X-ray images in the MLO direction and the CC direction.

  In ST109, the schema generation unit 112 generates a schema indicating the position information of the region of interest in the breast model.

  In ST111, the schema is displayed on the display unit 50.

  FIG. 8 is a diagram illustrating a method for aligning a breast X-ray image and a breast model in the medical image diagnostic apparatus 100 according to the embodiment. The position information specifying unit 111 performs alignment with the breast model based on the position where the specific structure of the breast X-ray image exists. In the example of FIG. 8, the MLO image taken from the MLO direction of FIG. 4B is shown on the left side, and the two-dimensional breast model of FIG. 5A is shown on the right side. The end of the breast and the nipple are extracted as a specific structure of the MLO image. The end of the breast and the nipple may be specified by image processing, or may be specified by the user inputting from the input unit 60. In the example of the left figure of FIG. 8, the position indicated by the broken line of the MLO image is specified as the upper end portion, the position indicated by the one-dot chain line is the nipple, and the position indicated by the two-dot chain line is specified as the lower end portion. . The breast model in the right diagram of FIG. 8 also shows a dashed line, a one-dot chain line, and a two-dot chain line at positions corresponding to the upper end, the nipple, and the lower end of the breast in the MLO image. Since the MLO image is an image acquired in a state tilted by a predetermined angle from the standing body axis direction, the MLO is aligned along the MLO cross-sectional direction tilted by a predetermined angle from the Y axis indicating the standing body axis direction of the breast model. The positions corresponding to the upper end, nipple, and lower end of the breast of the image are specified.

  The position information specifying unit 111 performs alignment by deforming the breast X-ray image so that the breast X-ray image matches the specified position on the breast model. For example, the arrow B shown in the breast X-ray image indicates the distance between the lower end and the nipple. An arrow B 'shown in the breast model corresponds to the arrow B in the breast X-ray image. The breast X-ray image has a living body length converted value, and the actual length of the arrow B can be calculated. FIG. 8 shows an example in which the breast X-ray image is deformed according to the length of the arrow and the position is adjusted.

  FIG. 8 shows an arrow A indicating the distance from the nipple to the upper end of the breast X-ray image and a corresponding breast model arrow A ′. Position alignment may be performed by changing the breast X-ray image in the same manner based on the arrow A. Further, the breast X-ray image may be divided into two parts from the nipple to the upper end part and from the nipple to the lower end part, and may be deformed and aligned.

  Position alignment by the position information specifying unit 111 is also performed on an image in the CC direction. Based on the breast X-ray image whose position is matched with the breast model in this way, the position information of the region of interest is specified on the breast model.

  FIG. 9 is a diagram illustrating a method for specifying position information of a region of interest in a breast X-ray image in the medical image diagnostic apparatus 100 according to the embodiment. FIG. 9 illustrates a state in which the position information specifying unit 111 virtually synthesizes an MLO image and a CC image that are aligned with the breast model into the breast model. The MLO image is an image corresponding to the MLO cross section shown in FIG. The example of FIG. 9 shows an example in which the MLO image is positioned on an MLO cross section that is perpendicular to the XY orthogonal coordinate plane of the breast model and is inclined at a predetermined angle from the standing body axis direction. Similarly, FIG. 9 shows an example in which the CC image is positioned on a plane perpendicular to the XY orthogonal coordinate plane of the breast model on the CC cross section of FIG. Each breast X-ray image shows an MLO_region of interest and a CC_region of interest. A one-dot chain line in FIG. 9 is a line extending perpendicularly to the MLO image from the position of the MLO_region of interest in the MLO image. Similarly, the two-dot chain line in FIG. 9 is a line extending perpendicularly to the CC image from the position of the CC_region of interest in the CC image. A region surrounded by a one-dot chain line and a two-dot chain line indicates three-dimensional position information of the region of interest of the breast. For example, when the breast model is three-dimensional, the above-described position information is the position information of the region of interest on the breast model. For example, the position information of the region of interest may be indicated by coordinates in an XYZ orthogonal coordinate system, or may be indicated by a length from a specific position. Further, since the MLO_region of interest and CC_region of interest have a certain region, the position information on the breast model is indicated by a set of coordinates, a mathematical expression of the contour line of the figure indicating the certain region, the size of the contour line, and the like. Also good. Further, the position information obtained by projecting the three-dimensional position information of the region of interest onto the XY orthogonal coordinate plane may be the position information of the region of interest on the two-dimensional breast model.

  In the example of FIG. 9, two perpendicular lines are extended from the MLO_region of interest and the CC_region of interest, and the region surrounded by the perpendicular is used as the position information of the region of interest, but from the center of the MLO_region of interest and CC_region of interest The position centered on the intersection of the extended perpendiculars may be used as the position information of the region of interest, or the position information of the region of interest may be specified from the outer peripheries of the MLO_region of interest and CC_region of interest. If two or more perpendicular lines or the outer periphery of the region of interest of the breast X-ray image is used, the position information of the region of interest can include information such as the shape and size of the region of interest. In the example of FIG. 9, an example in which position information is specified from a breast X-ray image taken from two directions of MLO and CC is shown, but a breast X-ray image taken from three or more directions may be used. Furthermore, the depth information of the region of interest may be used as position information based on the breast X-ray image.

  FIG. 10 is a diagram illustrating the depth information of the region of interest of the breast X-ray image in the medical image diagnostic apparatus 100 according to the embodiment. The depth information is information indicating the distance from the breast outline to the CC_region of interest. FIG. 10 shows an example in which a straight line is drawn from the CC_region of interest to the breast contour parallel to the Y axis, and the distance from the intersection of the straight line and the contour of the breast to the center of the CC_region of interest is depth information. . Although FIG. 10 illustrates the method of specifying the depth information based on the CC direction image, the depth information may be specified based on the MLO direction image. Further, not the distance from the outline of the breast but the distance from the nipple or the breast end may be calculated.

  As described above, the region of interest can be indicated on the breast model based on the position information specified from the region of interest of the breast X-ray image. 9 and 10, an example in which there is one region of interest has been described. However, when there are two or more regions of interest, position information of the region of interest can be specified by the same method. However, when a plurality of regions of interest are close to each other, it is necessary to specify a correspondence relationship between the regions of interest.

  FIG. 11 is a diagram illustrating a method for specifying position information when there are a plurality of regions of interest in a breast X-ray image in the medical image diagnostic apparatus 100 according to the embodiment. In the example of FIG. 11, there are two regions of interest MLO_region of interest 1 and MLO_region of interest 2 in the MLO image, and two regions of interest CC_region of interest 1 and CC_region of interest 2 in the CC image. Show. Similar to the example of FIG. 9, a perpendicular line is extended from the MLO_region of interest 1, MLO_region of interest 2, CC_region of interest 1 and CC_region of interest 2, and a region of interest exists at a position where each perpendicular line intersects. In the example of FIG. 11, the regions of interest of “1” and “2” are identified between the two perpendiculars of the CC_region of interest 1 and the CC_region of interest 2 of the perpendicular of the region of interest 1. In addition, as for the perpendicular of the MLO_region of interest 2, the regions of interest “3” and “4” are specified between the two perpendicular lines of the CC_region of interest 1 and the CC_region of interest 2. In such a case, if the correspondence relationship between the MLO_region of interest 1 and MLO_region of interest 2 of the MLO image and the CC_region of interest 1 and CC_region of interest 2 of the CC image cannot be determined, the position information of the region of interest is detected redundantly. The Rukoto.

  Therefore, when there are a plurality of regions of interest by specifying the correspondence between the regions of interest of the MLO image and the CC image when the user or the like inputs from the input unit 60 or inputs the region of interest in the X-ray breast image in advance. Even if it exists, position information can be specified. For example, when there are two regions of interest in the MLO image and the CC image as in the example of FIG. 11, if it is specified that MLO_region of interest 1 and CC_region of interest 1 are in a correspondence relationship, the other MLO_region of interest 2 and CC_region of interest 2 are automatically determined.

  As described above, the position information specifying unit 111 specifies position information on the breast model of the region of interest designated in the breast X-ray image (ST107). Based on the position information of the region of interest on the identified breast model, the schema generation unit 112 generates a schema indicating the region of interest on the breast model (ST109).

  FIG. 12 is a diagram illustrating an example of a schema in the medical image diagnostic apparatus 100 according to the embodiment.

  FIG. 12A is an example in which a region of interest is displayed on the two-dimensional breast model shown in FIG. 5A based on the position information specified by the position information specifying unit 111. For example, when a breast X-ray image as shown in FIG. 4 is acquired, a region of interest is specified in the right breast by the method shown in FIG. The position information of the specified region of interest is specified by, for example, the coordinates of the breast model in the XY orthogonal coordinate system, the distance from the breast outline (depth information), and the like. Based on such position information, the schema generation unit 112 displays the region of interest at the specified position on the breast model.

  The region of interest displayed on the breast model may be a symbol as shown in FIG. 12, for example, or may be a shape such as the size or outline of the region of interest included in the position information. In addition, coordinates, depth information, and numerical values such as the major axis, minor axis, and area of the region of interest may be indicated.

  FIG. 12B is an example in which the region of interest is displayed based on the position information specified by the position information specifying unit 111 in the three-dimensional breast model shown in FIG. Similarly to FIG. 12A, the region of interest may be indicated by a graphic, or the three-dimensional shape of the region of interest specified from the position information may be indicated. Similarly to a general three-dimensional image, the region of interest can be observed from various directions by rotating the three-dimensional schema. The cross-section generator 115 can also generate a cross section by cutting the three-dimensional schema at a desired cross section.

  FIG. 13 is a diagram illustrating an example of a cross-sectional view of a schema in the medical image diagnostic apparatus 100 according to the embodiment. FIG. 13 (a) shows the schema of the right breast in FIG. 12 (b). FIG. 13A shows an example in which the schema of the right breast is cut along section A. The cross section A is a cross section including the region of interest, and is a plane parallel to the XY orthogonal coordinate plane. FIG. 13B shows an example of a cut surface when cut along the cross section A. FIG.

  As described above, the medical image diagnostic apparatus 100 according to the present embodiment can generate a cross section cut by the cross section generation unit 115 in that direction by designating a cross section to be observed in the three-dimensional schema. Based on the cross section generated in this way, a slice image having the same cross section as the cross section generated from the three-dimensional schema can be extracted from images captured by an X-ray CT apparatus or MRI. In X-ray CT apparatus and MRI imaging, imaging conditions such as slice thickness and slice interval are attached to the image data. The schema also has information on the size of the subject's breast based on the subject's living body length information and the life length converted value of the breast X-ray. From these pieces of information, it is possible to display a schema and a multi-slice image acquired by an X-ray CT apparatus or an MRI apparatus in conjunction with each other.

  Further, in the breast examination, an examination using an ultrasonic diagnostic apparatus is performed together with a diagnosis using the mammography apparatus 200. Furthermore, there may be a case in which a biological tissue examination or the like is performed in which a needle is inserted into a location corresponding to a region of interest in a breast X-ray image while taking an image with an ultrasonic diagnostic apparatus to obtain cells. In such a case, it is desired to observe the same region of interest as the breast X-ray image with an ultrasonic diagnostic apparatus. Therefore, by displaying the cross section generated from the three-dimensional schema in synchronization with the image data collected by the ultrasonic diagnostic apparatus, a more accurate and efficient inspection can be performed. For example, a position sensor is attached to the ultrasonic probe of the ultrasonic diagnostic apparatus, and alignment with the three-dimensional schema is performed based on the characteristic structure of the subject's breast. By such alignment, the same cross section as the ultrasonic image generated according to the position and inclination of the ultrasonic probe of the ultrasonic diagnostic apparatus can be generated from the three-dimensional schema. Since alignment by length is possible based on the living body length information, positional deviation between the ultrasonic image and the sectional view of the schema hardly occurs. Further, it may be displayed on the three-dimensional schema which section of the breast is being observed by the ultrasonic diagnostic apparatus.

  The medical image diagnostic apparatus 100 according to the present embodiment can easily grasp position information of a region of interest observed in a breast X-ray image by generating a schema. Further, the schema allows the position information of the region of interest to be shared among doctors, medical workers, patients, and the like, and efficient diagnosis and explanation are possible. In addition, since the schema reproduces the breast of the subject based on the breast X-ray image and the living body length information of the subject, the display can be synchronized with other modality devices, and a plurality of diagnostic images can be used. Therefore, it is possible to perform surgery and examination easily and accurately.

  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 Image processing part 20 Imaging part 30 Communication control part 40 System control part 50 Display part 60 Input part 100 Medical image diagnostic apparatus 200 Mammography apparatus 300 Centralized medical image management server 110 Main control part 120 Storage part 210 Ultrasonic probe 220 Transmission / reception part 230 Data collection unit 111 Position information identification unit 112 Schema generation unit 113 Breast model selection unit 114 Breast model generation unit 115 Cross section generation unit 116 Image generation unit 121 Image storage unit 123 Breast model storage unit 125 Patient information storage unit

Claims (17)

A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A schema generation unit that generates a schema indicating three-dimensional position information of the identified region of interest in a breast model that is a diagram schematically representing the breast;
A breast model storage unit for storing a breast model schematically representing a general breast shape ;
Bei to give a,
The position information specifying unit aligns the breast X-ray image and the breast model based on a specific position on the breast X-ray image, and uses the specified three-dimensional position information of the region of interest as the breast model. Identified as the top position,
The schema generation unit generates a schema indicating the three-dimensional position information of the region of interest at the identified position on the breast model.
Medical diagnostic imaging equipment. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A patient information storage unit for storing body shape information including chest circumference at the position of the nipple of the subject, chest circumference at the bottom of the breast, and body length information indicating the size and shape of the breast;
A breast model selection unit that selects a breast model closest to the breast of the subject based on the body shape information of the subject;
A schema generation unit that generates a schema indicating the three-dimensional position information of the identified region of interest in the selected breast model;
The painting Bei,
Medical diagnostic imaging equipment. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A patient information storage unit for storing body shape information including chest circumference at the position of the nipple of the subject, chest circumference at the bottom of the breast, and body length information indicating the size and shape of the breast;
A breast model generation unit that generates a breast model corresponding to the breast of the subject based on the body shape information of the subject;
A schema generating unit that generates a schema indicating the three-dimensional position information of the identified region of interest in the generated breast model;
The painting Bei,
Medical diagnostic imaging equipment. The breast model generation unit generates an ellipsoidal breast model based on a breast X-ray image taken from two or more directions.
The medical image diagnostic apparatus according to claim 3 . The position information specifying unit aligns the breast X-ray image and a breast model corresponding to the breast of the subject based on a living body length conversion value included in the breast X-ray image, and performs the three-dimensional analysis of the region of interest. Identifying position information as a position on the breast model;
The medical image diagnostic apparatus according to any one of claims 1 to 4, characterized in that. The breast model is a diagram composed of two dimensions or three dimensions.
The medical image diagnostic apparatus according to any one of claims 1 to 5, characterized in that. The position information specifying unit specifies, as the three-dimensional position information, a position at which straight lines starting from the corresponding regions of interest included in the breast X-ray images taken from the two or more directions intersect each other.
The medical image diagnostic apparatus according to any one of claims 1 to 6, characterized in that. The position information specifying unit specifies the three-dimensional position information by selecting a correspondence relationship of the regions of interest when the positions where the straight lines starting from the region of interest intersect each other are two or more.
The medical image diagnostic apparatus according to claim 7 . The three-dimensional position information further includes depth information from the outline of the breast to the region of interest.
The medical image diagnostic apparatus according to any one of claims 1 to 8, characterized in that. A display unit for displaying the schema;
A cross-sectional view generator for generating a cross-sectional view of a desired cross-section of the three-dimensional schema when the schema is three-dimensional;
Further comprising
The display unit displays the cross-sectional view;
The medical image diagnostic apparatus according to any one of claims 1 to 9, characterized in that. The medical image diagnostic apparatus according to claim 10 ,
An image generation unit that generates an ultrasonic image by performing image processing on a reception signal based on the reflected wave received by the ultrasonic probe;
The display unit displays the schema and the ultrasound image;
A medical image diagnostic apparatus comprising the ultrasonic diagnostic apparatus. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A schema generation unit that generates a schema indicating three-dimensional position information of the identified region of interest in a breast model that is a diagram schematically representing the breast;
A breast model storage unit for storing a breast model schematically representing a general breast shape;
An image generation unit that generates an ultrasonic image by performing image processing on a reception signal based on a reflected wave received by an ultrasonic probe;
Equipped with a,
The position information specifying unit aligns the breast X-ray image and the breast model based on a specific position on the breast X-ray image, and uses the specified three-dimensional position information of the region of interest as the breast model. Identified as the top position,
The schema generation unit generates a schema indicating the three-dimensional position information of the region of interest at the identified position on the breast model.
Ultrasonic diagnostic equipment. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A patient information storage unit for storing body shape information including chest circumference at the position of the nipple of the subject, chest circumference at the bottom of the breast, and body length information indicating the size and shape of the breast;
A breast model selection unit that selects a breast model closest to the breast of the subject based on the body shape information of the subject;
A schema generation unit that generates a schema indicating the three-dimensional position information of the identified region of interest in the selected breast model;
An image generation unit that generates an ultrasonic image by performing image processing on a reception signal based on a reflected wave received by an ultrasonic probe;
Ultrasonic diagnostic apparatus having a. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A patient information storage unit for storing body shape information including chest circumference at the position of the nipple of the subject, chest circumference at the bottom of the breast, and body length information indicating the size and shape of the breast;
A breast model generation unit that generates a breast model corresponding to the breast of the subject based on the body shape information of the subject;
A schema generating unit that generates a schema indicating the three-dimensional position information of the identified region of interest in the generated breast model;
An image generation unit that generates an ultrasonic image by performing image processing on a reception signal based on a reflected wave received by an ultrasonic probe;
Ultrasonic diagnostic apparatus having a. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A schema generation unit that generates a schema indicating three-dimensional position information of the identified region of interest in a breast model that is a diagram schematically representing the breast;
A breast model storage unit for storing a breast model schematically representing a general breast shape;
Equipped with a,
The position information specifying unit aligns the breast X-ray image and the breast model based on a specific position on the breast X-ray image, and uses the specified three-dimensional position information of the region of interest as the breast model. Identified as the top position,
The schema generation unit generates a schema indicating the three-dimensional position information of the region of interest at the identified position on the breast model.
Medical image processing apparatus. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A patient information storage unit for storing body shape information including chest circumference at the position of the nipple of the subject, chest circumference at the bottom of the breast, and body length information indicating the size and shape of the breast;
A breast model selection unit that selects a breast model closest to the breast of the subject based on the body shape information of the subject;
A schema generation unit that generates a schema indicating the three-dimensional position information of the identified region of interest in the selected breast model;
With,
Medical image processing apparatus. A position information specifying unit for specifying the three-dimensional position information of the region of interest based on the regions of interest corresponding to each other included in the breast X-ray images obtained by imaging the breast of the subject from two or more directions;
A patient information storage unit for storing body shape information including chest circumference at the position of the nipple of the subject, chest circumference at the bottom of the breast, and body length information indicating the size and shape of the breast;
A breast model generation unit that generates a breast model corresponding to the breast of the subject based on the body shape information of the subject;
A schema generating unit that generates a schema indicating the three-dimensional position information of the identified region of interest in the generated breast model;
With,
Medical image processing apparatus.

Images