JP2004105746A - Mammography apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a mammography apparatus which can carry out various image processing for supporting the diagnosis made by physicians. <P>SOLUTION: The density and luminance of the images are adjusted freely to array and compare images in parallel and the enlargement and the intensifying of the images are automatically carried out to facilitate the detection and detection of the abnormal shades thereof. All from the capture of the images to the outputting thereof are accomplished integrally within the system. Thus, the basic system itself can be regarded as one modality. <P>COPYRIGHT: (C)2004,JPO

Description

The present invention relates to a mammography apparatus for examining a subject's breast.

In examination of mammography (X-ray mammography apparatus) using a combination of a screen and a film which is currently mainly used, image diagnosis of an image (hereinafter, referred to as a mammogram image) taken by mammography in many hospitals includes, for example, the following: It is done in such a procedure.

First, a physician at an examination request department (eg, breast surgery) requests a radiology department to examine a patient (eg, examination by mammography). This request is made by issuing an inspection request form. The test request form contains the patient's ID number, name, date of birth, gender, test request department name, test requesting doctor name, test modality (here, mammography), site, method, test purpose, clinical information Etc. are described.

Next, a radiology technologist performs an examination of the patient (taking a mammogram image by mammography) in accordance with the instructions in the examination request form, and develops the film.

医師 Then, the doctor who performs image reading reads the developed film. Interpretation refers to a process in which a doctor sees an uninterpreted image, determines a diagnosis, and completes an image interpretation report. At this time, an image (film) of a past examination of the patient under examination is often referred to. It is important to use the image of the past examination at the time of image reading in order to improve the quality of image reading. The physician performing the interpretation determines the diagnosis and creates an interpretation report. At this time, the information written by the doctor performing the image reading in the image reading report includes the findings of reading the image, the conclusion, the name of the image reading doctor, the date of image reading, and the like. Then, the interpretation report is sent from the doctor who has performed the interpretation to the doctor in the examination request department.

As the imaging conditions for mammography using a screen / film combination, characteristic X-rays using a Mo (Rh) target and a Mo (Rh) filter are effectively used for the purpose of improving image quality. The X-ray tube voltage is a low tube voltage of 30 kvp or less.

Next, the inspection of mammography without using a screen / film combination will be described. Here, a detection system of mammography using a computed radiography, a slot scan system, a two-dimensional CCD system, or the like will be described.

Computed-Radiography is an X-ray imaging method that uses a plate (imaging plate, IP) coated with a stimulable luminescent material instead of using a conventional film as an X-ray detector. The imaging plate has a very wide dynamic range as compared with the film, and can capture images in a wide dose range. When the imaging plate is irradiated with X-rays, the energy order of the electrons increases the energy order of the electrons, and the X-ray intensity distribution is stored as a latent image. When the laser is subsequently irradiated to excite higher-order electrons, the energy at that time is detected as light. Since this light is proportional to the energy of the X-rays absorbed by the imaging plate, an X-ray image can be obtained electrically (for example, as a digital image).

も の The use of such an imaging plate in a detection system for mammography is described in US Pat. No. 4,721,856 and the like.

イ メ ー ジ ン グ Current imaging plates have various problems. That is, the resolution is poor (the pixel size of the pixel is 100 μm × 100 μm), there are many noises, the IP is scratched when used, and the performance is deteriorated (the IP needs to be replaced after using 100,000 times) There is a problem that the device is expensive.

Next, the case where the slot scan method is used for the detection system of mammography will be described. In the slot scan method, a breast is scanned by irradiating X-rays in the form of a fan beam. X-ray detection uses a detector using a linear CCD. At this time, the influence of scattering (scatter) is reduced by moving the detector in accordance with the irradiation X-ray scan. Although it is a detector using a CCD, it is not a perfect line detector but a semi-area detector having pixels in the width direction. In the semi-area detector, when scanning is performed in accordance with the transfer speed of the CCD charges in the width direction, the charges of the pixels are added by the width, so that the load on the X-ray tube can be reduced.

(4) The detected X-rays are converted into light by an intensifying screen and guided to a CCD by a tapered fiber. For details, the following literature can be referred to.

Yaffe MJ et al: Imaging performance of a prototype scanned-slot digital mammography system, SPIE.Physics of Medical Imaging, 93-103 (1993) It is reported that, unlike the imaging conditions in the case of the screen / film combination, it is appropriate to use a W target and set the X-ray tube voltage to 40 kvp. For details, the following literature can be referred to.

Yaffe M.J. et al: Dynamic range requirements in digital mammography, Medical Physics 20,1621-1633 (1993) At present, the slot scan method has an advantage that a high-quality image can be obtained. However, there are also disadvantages in that the device has mechanical elements, the reliability of the device is low, and the device is relatively expensive.

Next, the case where the two-dimensional CCD system is used for the detection system of mammography will be described. The following are examples of digital detectors using a two-dimensional CCD. That is, there are digital detectors of II-TV system, intensifying screen-lens-CCD system, intensifying screen-tapered fiber-CCD system, and the like.

The II-TV digital detector is for digitizing the light multiplied by II (image intensifier) with a CCD television camera.

At present, there are problems such as (1) low resolution in a large field of view, (2) bulky shape of II hinders, and (3) relatively expensive equipment.

The digital detector of the intensifying screen-lens-CCD system receives the light emitted from the intensifying screen by a lens, condenses the light on a CCD television camera, and digitizes it.

At present, there are problems such as (1) a low resolution in a large field of view and (2) a small amount of light.

(5) The intensifying screen-tapered fiber-CCD system digital detector is for guiding the light emitted from the intensifying screen to the CCD through a tapered fiber and digitizing the light.

At present, there are problems such as (1) a small amount of light, and (2) the apparatus is relatively expensive.

The following articles can be referred to for digital detectors of the intensifying screen-lens-CCD system and the intensifying screen-tapered fiber-CCD system. Roehrig H et al: Digital X-ray Cameras for Real-time Stereotactic Breast Needle Biopsy, SPIE. Physics of Medical Imaging, 213-224 (1993) A detector that overcomes the problems of various detectors as described above. There is a TFT flat panel detector (TFT: Thin Film Transister).

Next, a case where a TFT flat panel detector is used in a detection system of mammography will be described.

The TFT flat panel detector detects the light emitted from the intensifying screen with a photodiode array. For details, refer to the following paper. Antonuk L.E. et al: Large area, Flat-Panel a-Si: H Arrays for X-ray Imaging, SPIE. Physics of Medical Imaging, 18-29 (1993) Next, CAD will be described.

(5) Attempts have been made to analyze images using a computer to detect abnormalities, taking advantage of the characteristics of digital images that image processing is easy using a computer, and has achieved results. This technique is called Computer-Aided Diagnosis (CAD), and is expected to be used for the purpose of improving the accuracy of image diagnosis and reducing the burden on doctors.

The abnormality detection algorithm is introduced in the following literature, for example. (1) Katsuragawa, S. et al: Image feature analysis and computer-aided diagnosis in digital radiography: Classification of normal and abnormal lungs with interstitial disease in chest images.Medical Physics 16,38-44 (1989)
(2) Giger, ML et al: Image feature analysis and computer-aided diagnosis in digital radiography: 3.Automated detection of nodules in peripheral lung fields.Medical Physics 15,158-166 (1988)
(3) Chan, HP et al: Image feature analysis and computer-aided diagnosis in digital radiography: 1. Automated detection of microcalcifications in mammography.Medical Physics 14,538-548 (1987) (4) Kunio Doi et al .: "Computers in digital radiography" Possibility of Assisted Diagnosis ”, Journal of the Radiological Technology Society of Japan, p653-663, 1989. A technique for detecting an abnormality such as a tumor shadow is also disclosed below.

(1) JP-A-02-185240 (2) JP-A-02-152443 (3) JP-A-01-125675 In particular, regarding CAD of breast cancer, US Pat. No. 5,133,020 discloses a doctor on a digital mammogram. A method for discriminating whether the indicated cancer shadow is benign or malignant is described. U.S. Pat. No. 4,907,156 describes a method for detecting microcalcification candidate positions from a digital mammogram.

方法 Also, a method of detecting a candidate position of a tumor shadow is described in the following paper. Yin F.F. et al: Computerized detection of masses in digital mammograms: Analysis of bilateral subtraction images, Medical Physics 18,955-963 (1991) Next, a medical image storage communication system (PACS) will be described.

(4) With the progress of digitization of images, recently, it has become possible to perform this image diagnostic work using a medical image archival and communication system (PACS). PACS is a system for supporting medical doctors in viewing medical images by storing, communicating, and displaying medical images (such as X-ray images, CT images, and MR images) generated in a hospital. The PACS stores the image data sent from the image collection device in a database and transfers the image data from the database to the image workstation when the image is needed. The image workstation transmits the image to a cathode ray tube (CRT). Cathode Ray Tube). The doctor makes a diagnosis by looking at the displayed image. In addition, an interpretation report for recording a diagnosis result can be created and stored on the PACS. According to PACS, there is no need to search for a film, carry a film, or put or remove a film on or from a shark castene.

Many technologies have been disclosed for the system configuration and functions of the PACS. (1) Japanese Patent Application Laid-Open No. 62-121576, (2) Japanese Patent Application Laid-Open No. 63-010269, and (3) Japanese Patent Application Laid-Open No. 013837, (4) JP-A-64-017154, (5) JP-A-02-103668, (6) JP-A-02-119840, and the like.

FIG. 81 is a block diagram showing a schematic configuration of a conventional PACS system.

@PACS has components of network, IA, WS, and DB.

The network performs data communication between each component. The IA collects images from various diagnostic imaging devices. WS displays an image. The DB stores images.

Next, the outline of the interpretation operation in WS will be described.

First, the images of the patient are to be interpreted on the WS in the order of the examination numbers. Here, the order of the examination numbers is the newest order of the examination dates. First, the WS sends a request to transfer an unread image to the DB via the network. The DB retrieves the requested unread image and sends it to the WS via the network. The WS creates an image list from the inspection history according to the order of the inspection numbers. Next, the WS sends a transfer request of the past image to the DB via the network. The DB retrieves the requested past image and sends it to the WS via the network. Then, the WS first displays the transmitted unread image and further displays the transmitted reference (past) image.

マ ン Mammogram images taken by mammography using such a medical image archival communication system (PACS) have been managed, and image diagnosis such as image interpretation has been performed efficiently.

When mammography is used as a modality to diagnose a mammogram image, there are the following problems at the time of diagnosis.

(1) In a mammogram image of a woman with a full mammary gland, there are many regions where the optical density of the mammary gland region is low, and it is difficult to distinguish a microcalcification shadow or a tumor shadow from the region.

(2) The densities of individual images were different when the mammograms were compared and read. When comparing the corresponding parts, accurate comparison diagnosis could not be made if the image density was different.

(3) The user (physician) manually inputs the enlargement instruction on the image and the designation of the emphasized part using a mouse or the like, which is troublesome.

(4) When diagnosing a plurality of images simultaneously, it is troublesome to arrange the images.

(5) In the detection of the abnormal position by the computer, if the result of the abnormal position is superimposed on the original image and output to the screen, the original image becomes invisible and the diagnostic accuracy is lowered.

(6) In some cases, the abnormality detection means cannot be applied to the target image, and if an abnormal result is forcibly issued to an image to which the abnormality cannot be applied, the result becomes unreliable.

(7) Even if it seems that there is no abnormality just by looking at the newest image (current image), the change can be recognized by comparing with the past image. Preparing images for comparison was cumbersome, which reduced diagnostic performance.

As described above, in the conventional example of mammogram image diagnosis, the burden on the doctor who performs image interpretation at the time of diagnosis is large, or the doctor cannot obtain information suitable for diagnosis from the image, and the diagnostic ability is reduced. There was a problem.

Therefore, an object of the present invention is to provide the following mammography apparatus.

(1) Even if the mammary gland is a dense mammogram image, it is possible to easily distinguish a microcalcification shadow or a tumor shadow.

(2) When performing comparative reading of a mammogram image, it is possible to observe the image with the same density range of the image to be compared.

(3) It is possible to automatically perform an enlargement instruction on a mammogram image and designation of an emphasized part.

(4) Automatically arrange mammogram images on the screen.

(5) In the detection of the abnormal position by the computer, an instruction is given so that the result of the abnormal position does not overlap the original screen.

(6) If the abnormal shadow detecting means cannot be applied to the target image, the fact that it cannot be applied is output.

(7) Automatically compare with past images and call attention if there is a change.

The present invention employs the following means to achieve the above object.

A first aspect of the present invention is a mammography apparatus comprising: input means for inputting a mammogram image; and means for enhancing the contrast of a mammary gland region of the mammogram image input by the input means.

According to a second aspect of the present invention, there is provided the apparatus according to the first aspect, wherein the means for enhancing the contrast causes a representative pixel value of the mammary gland region to correspond to the highest luminance. .

A third viewpoint of the present invention is the device according to the second viewpoint, wherein the means for enhancing contrast converts only pixel values in a predetermined range into luminance.

A fourth viewpoint according to the present invention is the device according to the second viewpoint, wherein the means for enhancing the contrast includes each minute pixel when the mammogram image is divided into minute regions as representative pixel values of the mammary gland region. It is characterized by using the highest value among the median values of the area.

A fifth aspect of the present invention is characterized by comprising input means for inputting at least two or more mammogram images, and output means for outputting a mammogram image input by the input means by equalizing the density range. It is a mammography apparatus that performs.

A sixth viewpoint of the present invention is the device according to the fifth viewpoint, wherein the mammogram image input by the input means is an image of the same part photographed from the same direction in the past examination and the present examination. It is characterized by the following.

According to a seventh aspect of the present invention, there is provided input means for inputting a mammogram image, micro area setting means for setting a plurality of micro areas based on a breast outline on the mammogram image input by the input means, Image processing means for performing a predetermined image processing for each of the small areas.

An eighth aspect of the present invention is the apparatus according to the seventh aspect, wherein the image processing means performs at least one of an enlargement process, a contrast enhancement process, and a frequency enhancement process. Things.

A ninth viewpoint of the present invention is the device according to the seventh viewpoint, wherein the minute region setting means sets a plurality of minute regions so as to cover all the object regions on the mammogram image. It is a feature.

A tenth viewpoint of the present invention is the device according to the ninth viewpoint, further comprising a manual operation member for changing a position of the minute region set by the minute region setting means. .

According to an eleventh aspect of the present invention, there is provided an input unit for inputting a mammogram image, a detecting unit for detecting an abnormal shadow from the mammogram image input by the input unit, and a micro area including the abnormal shadow detected by the detecting unit. An image processing device for performing predetermined image processing on an image.

A twelfth viewpoint of the present invention is the device according to the eleventh viewpoint, wherein the position of the center of the minute area is the position where the abnormal shadow is detected.

A thirteenth aspect of the present invention is the apparatus according to the eleventh aspect, wherein the image processing means performs at least one of an enlargement process, a contrast enhancement process, and a frequency enhancement process, and detects a detected abnormality. The content of the image processing is determined according to the type of the image processing.

A fourteenth aspect of the present invention is directed to an input unit for inputting at least two or more mammogram images, a unit for outputting a mammogram image input by the input unit, and an arrangement when the output unit outputs the mammogram image. A mammography apparatus comprising an image arranging means for managing a position and an arrangement direction.

A fifteenth viewpoint of the present invention is the device according to the fourteenth viewpoint, further comprising a unit for storing the arrangement position and the arrangement direction for each doctor.

A sixteenth viewpoint of the present invention is the device according to the fourteenth viewpoint, further comprising a detecting unit for detecting an abnormal shadow from a mammogram image input by the input unit, wherein the image arranging unit is configured to detect the abnormal shadow. The arrangement position and the arrangement direction are determined according to the type of the abnormal shadow detected by the method.

A seventeenth aspect of the present invention is the apparatus according to the fourteenth aspect, wherein the mammogram images input by the input unit are images obtained by a past test and a current test for the same subject. It is.

According to an eighteenth aspect of the present invention, there is provided an input unit for inputting a mammogram image, a detecting unit for detecting an abnormal shadow from the mammogram image input by the input unit, and a marker image indicating a position of the abnormal shadow detected by the detecting unit. And an output unit that outputs the synthesized result without overlapping with the mammogram image.

A nineteenth viewpoint according to the present invention is the device according to the eighteenth viewpoint, wherein the output means arranges a marker image indicating a position of the abnormal shadow detected by the detection means outside the mammogram image. It is characterized by the following.

A twentieth viewpoint of the present invention is the device according to the eighteenth viewpoint, further comprising means for outputting the number of abnormal shadows detected by the detecting means, wherein the output means comprises an identifier for the abnormal shadow. To indicate an abnormal position.

According to a twenty-first aspect of the present invention, input means for inputting a mammogram image, determining means for determining whether or not an abnormal shadow can be detected with respect to the mammogram image input by the input means, and the determining means A mammography apparatus comprising: a detection unit that detects an abnormal shadow from the mammogram image when it is determined that the detection can be performed; and a result output unit that outputs a result of the detection by the detection unit.

A twenty-second viewpoint of the present invention is the device according to the twenty-first viewpoint, wherein the determination unit performs the determination based on the area of the breast of the mammogram image input by the input unit and the inclination of the breast. It is a feature.

According to a twenty-third aspect of the present invention, there is provided an input unit for inputting a first mammogram image and a second mammogram image of the same part taken from the same direction at a different time from the first mammogram image; Detecting means for detecting abnormal shadows from the first and second mammogram images input by the means, and result output means for outputting a detection result only when the abnormal shadows detected by the detecting means are different from each other. A mammography apparatus.

結果 As a result of taking the above measures, the following effects are exhibited.

(1) The mammary gland is solid and dense, so that even in a mammogram image of a woman, for example, in which there are many areas having a low optical density, it is possible to easily distinguish a microcalcification shadow or a tumor shadow.

(2) When comparing and reading mammograms, if the densities of individual images are different, the densities are equalized.

(3) The enlargement instruction on the image and the designation of the emphasized part are automatically performed.

(4) When diagnosing by simultaneously viewing a plurality of images, the images are automatically arranged according to a predetermined rule.

(5) In the detection of the abnormal position by the computer, the result of the abnormal position is specified in the outer frame of the mammogram image.

(6) If the detection means cannot be applied to the target image, the abnormality detection means outputs that the detection means cannot be applied.

(7) The arrangement of the images can be determined according to the doctor's preference, and the comparison between the photographed image and the past image can be easily performed.

According to the present invention, the following mammography apparatus can be provided.

(1) Even if the mammary gland is a dense mammogram image, it is possible to easily distinguish a microcalcification shadow or a tumor shadow.

(2) When performing comparative reading of a mammogram image, it is possible to observe the image with the same density range of the image to be compared.

(3) It is possible to automatically perform an enlargement instruction on a mammogram image and designation of an emphasized part.

(4) Automatically arrange mammogram images on the screen.

(5) In the detection of the abnormal position by the computer, an instruction is given so that the result of the abnormal position does not overlap the original screen.

(6) If the abnormal shadow detecting means cannot be applied to the target image, the fact that it cannot be applied is output.

(7) Automatically compare with past images and call attention if there is a change.

Hereinafter, embodiments of the mammography apparatus according to the present invention will be described with reference to first to fourth embodiments with reference to the drawings. In the first embodiment, a system (referred to as a basic system in this embodiment) that uses digital mammography as a single modality and collectively performs shooting and image output will be described. In the second embodiment, a system in which a network function is applied to a basic system (referred to as a modality system) will be described. In a third embodiment, a system in which PACS is applied to a basic system (referred to as a PACS system) will be described. In the fourth embodiment, other system variations will be described.

FIG. 2 is a perspective view showing the appearance of the basic system 1. In the basic system 1, digital mammography is used as a single modality, and the operations from photographing to image output are collectively performed.

The C arm 5 is configured integrally with the X-ray generation device 2, the compression plate 3, and the X-ray detection device 4, and is rotatable in the direction of arrow 1a, that is, left and right. The compression plate 3 is movable in the direction of arrow 1b, that is, in the up-down direction.

FIG. 1 is a block diagram showing a schematic configuration of the basic system 1. The basic system 1 includes an X-ray generator 2, an X-ray detector 4, an input device 6, a RISI / F (interface) unit 8, an output device 10, a system disk 12, a memory 14, a central controller 16, a barcode reader. The system comprises only one photographing device as in the existing mammography. In addition, since the entire process from capturing an image to outputting the image is performed collectively in the system, the basic system itself can be regarded as one modality.

First, the X-ray generator 2 will be described. The X-ray generator 2 is controlled by the central controller 16. FIG. 3 is a block diagram schematically showing the internal configuration of the X-ray generator 2. The X-ray generation device 2 includes an X-ray tube 20, a high-pressure generation unit 22, an X-ray controller 24, an AEC 30, a filter switching unit 26, a compression pressure control unit 28, a photo sensor 32, and a control panel 34. , A. A function for setting the most suitable imaging condition for each examination; b. And a function of controlling breast compression in association with X-ray irradiation. These two functions a and b will be described respectively.

Regarding the function a for setting the imaging condition most suitable for each examination, the setting of the imaging condition here means the type of filter that defines the X-ray quality, kVp (X-ray tube voltage), mA (X-ray Tube current). First, the imaging conditions are unique information that differs for each patient, that is, the imaging condition determination table that divides the types according to the patient's age, breast hardness, breast thickness, and breast size, and gives the imaging conditions for each type. Decide based on Table 1 shows an example of the photographing condition determination table. Table 1 shows shooting conditions for Type A and Type B, and the other types are omitted.

The patient's age is obtained from the examination request information input by the input device 6 described later. Regarding the hardness of the breast, first, the compression plate 3 is moved with reference to the position of the detector 42 of the X-ray detection device 4, the position x at which the compression plate 3 touches the breast, and the compression plate after a predetermined amount of compression. 3 is measured. The detector 42 will be described later. x is equal to the thickness of the breast when not compressed. Here, the ratio between the compression distance d and the thickness x of the breast when no compression is performed is defined as A value (A value = d / x). Then, the hardness of the breast is determined by the characteristics shown in FIG. That is, the hardness is obtained by giving the value A to a known characteristic curve that gives the hardness of the breast. At this time, the hardness of the breast is roughly divided into three levels of "soft", "medium", and "hard". The size of the breast is determined by optical measurement using the mechanism shown in FIGS. 5 (a) and 5 (b). FIG. 5A is a diagram of a state where the size of the breast is measured by the optical detector 38 and the reflection plate 40 when viewed from the side, and FIG. 5B is a diagram where the state is viewed from above. is there.

(4) Of the light beams 39 emitted from the optical detector 38, the light beam reflected by the reflection plate 40 is detected by the detector 38, whereby the amount of reflected light is measured. Then, the size of the breast is obtained from the characteristics shown in FIG. That is, the size of the breast is obtained by giving the measured light amount to the known characteristic curve. The size of the breast is not limited to the optically obtained method as described above, but may be obtained as follows. That is, the irradiation field size may be input from the operation panel 34, and the irradiation field size may be used as the size of the breast. Then, the size of the breast can be simply obtained. FIG. 6 is a diagram showing the operation panel 34, and “12” × 10 ”” and “10” × 8 ”” can be selected as the irradiation field size. The irradiation field size is not limited to these values.

Regarding the thickness of the breast, the compression thickness is calculated from the position of the compression plate 3 during compression and the position of the detector 42, and this is set as the breast thickness.

By the way, regarding the determination of each parameter of the photographing condition, predetermined rules obtained theoretically and empirically are obtained. That is, with respect to the type of filter that defines the quality of X-rays, it is preferable to use a Mo (molybdenum) filter for normal breasts and use an Rh (logism) filter for breasts with many mammary gland regions. The filter can be switched by the filter switching unit 26 under the control of the AEC 30 described later. With respect to kVp (X-ray tube voltage), a low tube voltage of 30 kVp or less is applied to a normal breast, and a high-contrast image can be captured by X-rays in a low-dose energy region. In addition, a tube voltage greater than 30 kVp is applied to a breast having many mammary gland regions, and X-ray imaging of a high dose energy region is suitable for diagnosis. Regarding mA (X-ray tube current), in order to obtain mAs for three large breasts, it is preferable that not only the energizing time but also the tube current be large. Table 1 is formed based on such rules. The shooting conditions set in accordance with the shooting condition determination table are input to the AEC 30 as thickness / size / hardness data 36.

Here, the AEC 30 will be described. An AEC (Automatic Exposure Control) 30 is for obtaining a control amount for irradiating X-rays with an appropriate dose, and using the obtained control amount for the X-ray controller 24, the filter switching unit 26, the compression pressure control unit 28 To control the exposure. At this time, there are two methods for obtaining a desired control amount. One of them is to destructively read out data of a specific pixel from the detector 42 at regular time intervals during the exposure, and determine an appropriate value for the pixel having the lowest optical density among the data (AEC data). This is a technique for obtaining the amount of X-ray exposure for giving a dose. The irradiation time is controlled by the obtained irradiation amount. This technique is applied when the detector is a flat detector. FIG. 7 shows a data collection point 44 at which a specific pixel is read from the detector 42. The other is to provide an AEC detector 46 comprising an intensifying screen and a photodiode below the data collection point 44 of the detector 42 as shown in FIG. A prescription to collect AEC data without performing. An X-ray exposure amount for giving an appropriate dose to a pixel having the lowest optical density in the output of the AEC detector 46 is obtained. The irradiation time controls the irradiation time.

Next, the function b for controlling breast compression in relation to X-ray irradiation will be described. If the breast is compressed with equal pressure from setting to the end of imaging, the patient may be burdened. Therefore, the compression is appropriately controlled in order to alleviate the compression of the breast as much as possible. That is, the compression is slightly loosened before the photographing, plus pressure is applied immediately before the photographing, an appropriate compression value is set, and the image is released immediately after the photographing is completed. In this way, it is possible to alleviate the pain of the patient.

First, the mechanism for compressing the breast will be described. FIG. 9 is a cross-sectional view of the mechanism for pressing the breast by the pressing plate 3 as viewed from the side. The compression portion 48 is configured by integrating the compression plate 3, the compression plate support portion 49, and the pressure sensor 50. The pressing portion 48 is freely movable in the vertical direction, and is driven by pressing the upper surface of the pressure sensor 50. As a method of driving the compression unit 48, a method of driving by pressing the oil 51 as shown in FIG. 10 is considered. When the breast is pressed by the compression plate 3, the lower hydraulic pressure is released while the breast is sandwiched and the upper part is released. The hydraulic pressure is increased, and the pressure is controlled while controlling the pressure with the pressure sensor 50. To release the breast from compression, release the upper oil pressure and pressurize the lower oil pressure to raise the holding plate. FIG. 11 is a block diagram showing a schematic configuration of such a breast compression mechanism. The control section 52 controls the movable section 54 based on a signal from the pressure sensor 50 and a preset value 56 to drive the compression plate 3. Here, the breast compression mechanism does not depend only on the mechanism as shown in FIG. For example, the compression plate 3 itself may have a function of controlling pressure.

Next, two methods for appropriately controlling the timing of compression so as not to burden the patient will be described. With these methods, the compression pressure control unit 28 controls the above-described breast compression mechanism in accordance with an instruction from the AEC 30. FIG. 12 is a diagram for explaining the first method, and is a diagram showing a process of compressing the breast in relation to X-ray irradiation. Here, FIG. 12A is a timing chart of an X-ray generation signal, FIG. 12B is an emission timing chart of x-ray (X-ray), and FIG. 12C is a timing of pressure for pressing the compression plate 3. FIG. The pressure shown in FIG. 12C is expressed as a percentage (%) when the pressure required during X-ray irradiation is set to 100%.

First, an X-ray technician in charge of imaging gives a compression instruction to the control unit 50 using a console or the like (not shown), and compresses the breast with a pressure actually required at the time of X-ray irradiation. The pressure value at that time is read by the pressure sensor 50 and stored as an appropriate pressure value in a memory (not shown) of the control unit 52 (setting period). Next, the pressure is reduced to 80% of the pressure value stored under the control of the control unit 52, and the process waits (standby period). Then, after the X-ray generation signal (a) is used as a trigger to increase the pressure to 100%, that is, an appropriate pressure value, an x-ray (b) is generated and imaging is performed (during X-ray generation). Immediately after the end of shooting, the compression shall be released completely. Note that the compression rate (here, 80%) in the waiting period can be changed as appropriate.

FIG. 13 is a diagram for explaining the second technique. 13A is a timing chart of an X-ray generation signal, FIG. 13B is an emission timing chart of x-ray (X-ray), and FIG. 12C is a timing chart of pressure for pressing the compression plate 3. is there. The pressure shown in FIG. 13C is represented by a pressure value. First, at the time of setting, an X-ray technician gives a compression instruction to the control unit 50 using a console (not shown) or the like, and appropriately (slightly loosens) the breast to wait (setting and standby period). Then, after the X-ray generation signal (a) is used as a trigger to increase the pressure to a preset set pressure value, an x-ray (b) is generated and imaging is performed (during X-ray generation). Immediately after the end of shooting, the compression shall be completely released. The set pressure value can be changed as appropriate. Next, the X-ray detection device 4 will be described. The X-ray detector 4 is controlled by the central controller 16. FIG. 14 is a block diagram schematically showing the internal configuration of the X-ray detection device 4. The X-ray detection device 4 includes a read time setting device 60, a timing generation device 62, a drive device 64, a detector 42, a read device 68, an A / D converter 70, and a read range setting device 72, It has functions of device control and data reading. In this embodiment, the device (detector 42) for X-ray detection is a TFT flat panel detector. FIG. 15 is a circuit diagram showing a configuration of a TFT flat panel detector (hereinafter, simply referred to as a detector 42). The array 73 is composed of a plurality of cells arranged in a two-dimensional lattice state. One cell includes an FET (a-Si: H) 80 connected to a gate line 76 from the driving device 64 and a data line 78 from the reading device 68, and a sensor (a-Si: H) connected to the FET 80. ) 82 and a capacitor (not shown). The sensor 82 is a photodiode that detects photon photons. An intensifying screen (not shown) is placed on the array 73, and converts the X-rays irradiated on the array 73 into light. Instead of the intensifying screen, a screen coated with a substance having a scintillation function for converting X-rays into light may be used.

The drive device 64 creates a control pulse for detecting a signal based on the read range set by the read range setting device 72 and a timing pulse corresponding to the read time set by the read time setting device 60. To drive the detector 42.

Here, the device control of X-ray detection and data reading in the X-ray detection device 4 will be described. First, the detector 42 performs an initial setting for discharging the electric charge stored in the capacitor of each cell of the array 73. Next, X-rays are emitted to the subject by the X-ray generator 2. The X-ray transmitted through the subject reaches the intensifying screen mounted on the detector 42. The X-rays that have reached the intensifying screen are converted here into light. Photodiodes (sensors 82) located one by one in each cell on the array 73 detect light (photon photons) converted by the intensifying screen and convert the light into an electric signal. The obtained electric signal is temporarily stored in the capacitor as electric charge.

When the X-ray irradiation ends, that is, when the high-voltage generation signal of the X-ray controller 24 changes from ON to OFF, a control pulse generated in the above-described driving device 64 is supplied to the array 73 with the trigger as the trigger. The 73 TFT element (FET 80) is turned on. Then, the reading device 68 reads the charge stored in the capacitor as an analog signal via the data line 78. Here, it is assumed that the reading device 68 performs control such as integration by an operational amplifier and parallel reading. The analog signal read in this manner is A / D converted by the A / D converter 70, and is converted into a 14-bit (16-bit or the like) digital signal for each pixel. In this embodiment, the digital signal having the predetermined bit width is defined as a pixel value. Image data constituted by a matrix of a plurality of pixel values is transferred to the memory 14.

The reading device 68 can change the image reading time according to the driving timing generated by the timing generating device 62. The drive timing is changed by the read time setting device 60. Further, when reading an image in a small irradiation field at the time of the size of the breast and the biopsy, the reading range can be limited for the purpose of efficient image reading. The biopsy will be described later.

(4) The read range is limited by limiting the control line for transmitting a control pulse, that is, the gate line 76 by the read range setting device 72 and the signal line, that is, the data line 78 to be read.

As a post-processing of imaging, when X-rays are not irradiated (when the high-voltage generation signal of the X-ray controller 24 is OFF) after the completion of the image acquisition, dark is again applied to the capacitor of the array 73 for the same time. The time signal is stored. A control pulse for turning on the FET 80 is sent to the detector 24, image data is collected, and the result in the dark is stored in the memory 14. The dark image data is subtracted from the finally collected X-ray image data, and the difference is stored in the memory 14 as a collected image.

By the way, in this embodiment, the case where the TFT flat panel detector is used as the X-ray detection device has been described, but the present invention is not limited to this. For example, by applying a screen-film system and digitizing a photographed film with a digitizer, detection data can be obtained in the same manner as a TFT flat panel detector. In this case, real-time imaging control based on the detection data becomes impossible. An imaging plate may be used as a device for X-ray detection. In this case, the photographing control is similarly impossible. Further, the slot scan method may be applied as a device for X-ray detection. In this case, since the imaging time cannot be set during imaging, pre-exposure is performed first, and imaging conditions including the imaging time are set. It is preferable to keep it. Further, a two-dimensional CCD may be used as an X-ray detection device. In this case, real-time imaging control based on the detector data is possible, and data of the same format as that of the TFT flat panel detector can be obtained as image data (detection data) and stored in the memory.

Next, the input device 6 will be described. The input device 6 has five functions. That is, a. A function for inputting patient information and examination information; b. A function of inputting control of an output screen; c. A function of inputting a radiologist ID, d. A function of selecting image reading and examination modes, e. It has the function of selecting output means. With respect to these functions a to e, the input device 6 will be described. FIG. 16 is a diagram illustrating a screen transition of the operation panel 90. The operation panel is configured by a touch screen.

First, the function a will be described. Function a is for inputting patient information and examination information. A description will be given of a case where the system is connected to the RIS and a case where the system is not connected to the RIS in inputting the information. The RIS is a system for obtaining information from an external system, and will be described later in detail.

First, when there is no information input from the RIS, patient information and examination information are inputted from the examination request information. In this case, since the inspection request information is on paper, the operator inputs it from a keyboard or the like (not shown). The patient information includes a patient name, a patient ID, and the like, and the examination information includes an examination ID, a site, a direction, and the like. Table 2 shows an example of the inspection request information. In Table 2, examination request information on patient ID-880841 and patient name-Yoko Yamako is described.

Next, a case where information is input from the RIS will be described. If information can be input from the RIS, the digitized inspection request information is sent from the RIS via the RISI / F unit 8 and stored in the memory 14. The individual examinations are registered in the order in which they arrive at the memory 14.

検 査 Each test registered as described above is displayed on the operation panel. When the operation panel 90 is configured by a touch panel, the target test can be selected via the touch sensor. FIG. 17 is a diagram showing an examination (patient) list panel displayed on the operation panel, in which the selected examination, that is, the display line of the selected patient name is highlighted.

Next, the function b for inputting the control of the output screen will be described. First, a case where the operation panel 90 is configured by a touch panel will be described. FIG. 18 is a diagram showing an operation panel for performing input for output screen control. Here, FIG. 7A is a diagram illustrating an image selection panel, and FIG. 7B is a diagram illustrating a selection panel of a detailed display ROI. In the image selection panel shown in FIG. 18A, two types of schemas 92, which abstract (deform) the image, are displayed on the operation panel 90, and characters (for example, “CC image”) indicating the parts and directions of the image are displayed. , "ML image") are displayed. When any one of the schemas 92 is touched with a finger or the like, the schema 92 touched by the finger (not shown) is highlighted and an image can be selected. In the selection panel of the detailed display ROI in FIG. 18B, a grid is displayed on the schema 92 and displayed. When the user wants to observe the details of the image, the user touches a part of the displayed grid where the details are to be observed, and the details of the image are displayed on the CRT.

Here, the schema 92 may be one in which the edge of the skin of the subject (breast) in the actual image is detected by using a sobel operator operator and only the edge (breast outline) is drawn.

Next, a case where the operation panel 90 is configured by means other than the touch panel will be described. FIG. 19 is a perspective view of an image selection panel. The image selection panel 94 is constituted by a mechanical switch 95, and selects an image by depressing the switch. FIG. 20 is a perspective view of a panel for selecting a detail display ROI. The selection panel 96 for the detailed display ROI is constituted by a mechanical switch 95 like the image selection panel 94, and by pressing this switch, a part whose details are desired to be observed is selected. Each position of the mechanical switch 95 corresponds to the position of the irradiation field of the displayed image.

Next, the function c for inputting the interpretation doctor ID will be described. When the operation panel 90 is configured by a touch panel, an image reading doctor ID input panel is displayed as shown in FIG. The doctor who performs image interpretation inputs an ID on the ID input panel 98. Next, a function d for selecting a mode of examination and interpretation will be described. As shown in FIGS. 16A to 16C, a mode is selected on the display of each panel. After selecting the mode, the function in each scene can be executed.

Next, the function e for selecting the output means will be described. As shown in FIG. 16D, the image is output to film (“4.1 CRT output”), the image is output to film (“4.2 Film output”), and the image is output to film and CRT (“4.3 CRT output”). An output form such as “film & CRT output”) can be selected.

According to the functions a to e described above, it is possible to cope with the screen and the interpretation style according to the preference of the interpretation doctor.

Next, the case where the present system (basic system) obtains data from another system by using an external system / connection interface will be described in detail. Here, a case in which data is obtained from a RIS (Radiology Information System) via the RISI / F unit 8 will be particularly described.

First, as for data transfer functions and routines from other systems, as described above, digitized inspection request information is sent from an external RIS and converted into a data format that can be processed as information by this system. After that, it is stored in the memory 14. In addition, individual examinations are registered in the examination list in the order in which they arrive at the memory 14. When displayed on the touch panel, a target test (patient) can be selected via the touch sensor as shown in FIG.

Next, as an example of the data structure of the RIS data, the configuration of the inspection request information is the same as that in Table 2 described above. Table 3 shows the structure of the interpretation report as the result of the examination.

Next, the output device 10 will be described. FIG. 22 is a block diagram showing the internal configuration of the output device 10. The output device 10 inputs the processed image data and character / symbol data (hereinafter, referred to as information) composed of character data and screen (symbol) data from the memory 14 and outputs them to the screen of the CRT 100 or the film 102. It has an image reduction / enlargement processing unit 104, a screen creation unit 106, a frame memory 108, an overlay memory 110, a display management unit 112, a D / A conversion unit 114, a barcode generation unit 116, and a laser writing device 118.

The frame memory 108, the overlay memory 110, the display management unit 112, and the D / A conversion unit 114 are dedicated devices for outputting images and information on the screen of the CRT 100, and the barcode generation unit 116 and the laser writing device 118 , A dedicated device for outputting images and information to the film 102.

When an image and information are output on the screen of the CRT 100, that is, when “CRT output” is selected by the operation panel 90 of the input device 6 and an instruction is given to the display management unit 112 to be output, The reduction processing unit 104 performs image processing such as reducing or expanding the image data sent from the memory 14 to a predetermined size, and sends the image data to the screen creation unit 106. The screen creating unit 106 creates a screen by arranging the processed image data at a predetermined position, and writes the screen into the frame memory 108. The character / symbol data is written to the overlay memory 110. Then, the display management unit 112 superimposes the overlay of the predetermined number designated by the central control device 16 on the frame memory 108 and sends the overlay to the D / A conversion unit 114. The D / A converter 114 converts the contents of the frame memory 108, which is a digital signal, into an analog signal (D / A conversion) and outputs the analog signal to the screen of the CRT 100.

When outputting an image and information to the film 102, that is, when selecting “film output” by the operation panel 90 of the input device 6 and giving an instruction to the laser writing device 118 to output the image, the image is reduced / enlarged. The processing unit 104 performs image processing such as reducing or enlarging the image data sent from the memory 14 to a predetermined size, and sends the image data to the screen creating unit 106. Further, the barcode generator 116 generates a barcode based on the predetermined information sent from the memory 14 and sends the barcode to the screen generator 106. The predetermined information for generating a barcode is information unique to an inspection such as an inspection ID and an image number recorded in the inspection request information. The screen creation unit 106 arranges the sent image data at a predetermined position, creates output data by superimposing the image data, the character / symbol data (binarized data), and the barcode, and creates the output data. Send to The laser writing device 118 outputs output data to a film according to an instruction from the central processing unit 16. FIG. 23 is a diagram illustrating an example of the output film 102. The barcode 120 is written on the film 102 at a predetermined position.

Next, the system disk 12 will be described. The system disk 12 stores a control program for realizing the following functions. However, the following functions may be implemented by hardware for the purpose of speeding up.

a. Means for recognizing the mammary gland region to enhance the contrast b. Means for adjusting the density range c. ROI position determining means, shuttle corresponding means d. Image processing means e. Abnormal shadow detecting means applicable determining means f. Abnormal shadow detection means, detection result storage means g. Output screen creation means h. Abnormality detection result output means i. Means for recognizing the photographing direction from the inclination of the arm j. Compression timing adjustment means k. Biopsy puncture status checking means l. Biopsy field-of-view recognition and partial data storage means m. Photographing scene, means for automatically setting photographing conditions by detector (Mote II) n. Means for reading out an image triggered by completion of exposure o. Means for input / output of patient information from RIS, means for outputting identifier p. Means for scaling an image to an arbitrary size q. CRT, film output selection means r. Means for judging the malignancy or benignity of the abnormality and outputting the result s. ROI manual input means t. Overall Control Program First, when the system starts up, the central control unit (CPU) 16 first activates an overall control program (described later), and receives a signal from an input device or the like according to each use situation (described later). Each function is executed in response to an event or the like.

Next, each of the functions a to t will be described.

A. When a histogram of the pixels of the means image for recognizing the mammary gland region and enhancing the contrast is taken, a histogram of a normal breast (breast) has a shape as shown in FIG. 24, and the breast of the breast has a dense breast (dense breast). The histogram is as shown in FIG. Here, in FIG. 25, the anatomical structure to be diagnosed cannot be seen unless the contrast of the region A having a high pixel value is high. Therefore, in order to recognize the anatomical position of the area A, first, a small area (hereinafter referred to as ROI) 122 of n pixels × n pixels as shown in FIG. Among them, a bright ROI (an ROI with a high pixel value) is selected. Next, a look-up table for converting a pixel value into a luminance is displayed so that a representative value (for example, a median value or a median value) of the pixel of the selected ROI 122 is displayed and the output has the highest luminance (brightness). Make changes to enhance contrast. FIG. 27 is a diagram illustrating a relationship between a pixel value and a gray scale (luminance). The slope of the straight line 128 representing the correspondence between the pixel value after contrast enhancement and the gray scale (luminance) is different from the straight line before the change of the lookup table, that is, the straight line 126 representing the correspondence at the time of output from the detector. The look-up table is changed to increase the contrast to enhance the contrast. Here, the enhancement of the contrast may be performed not only when the look-up table is changed but also by changing the pixel value of the image data so that the slope of the straight line 128 is larger than the slope of the straight line 126.

In contrast enhancement, noise may be enhanced if the slope of the straight line 128 is too large. For this reason, it is preferable to limit the degree of noise enhancement.

B. Means for Adjusting Density Range (Matching Image Density) FIG. 28 is a diagram schematically showing a flow until displaying or outputting left and right breast images. The photographed image initially exists in an image memory bank 129 composed of an IC memory, a magnetic disk, or the like. When an instruction to display an image of a specific patient taken from a specific direction is issued, the left and right breast images are first sent to the density equalization processing unit 130 to create a composite image 132. The composite image 132 is obtained by arranging two images of the left and right breasts in order to display or output the left and right breasts as one image. Point. The created composite image 132 is sent to the frame memory 108, the overlay memory 110, and the laser writing device 118, and then displayed on the CRT 100 or output to the film 102. Note that the operation of the output device 10 when the composite image 132 is output is the same as in the case described above, and a description thereof will be omitted.

Here, the concentration equalization processing unit will be described in detail. FIG. 29 is a diagram showing a specific example of the processing of the density equalization processing unit 130, and shows an example of processing for making the average densities in the ROI 133 of the left and right breast images the same. In the present embodiment, a case will be described in which the processing is performed so that the average density of the right image is equal to the average density of the left image. A third average density different from the average density of the image may be used.

First, the average value calculation unit 134 calculates the average values m ₁ and m ₂ of the pixel values of the left image and the right image, respectively, and then obtains the ratio of m ₁ and m ₂ by the division unit 135. Then, the image calculation unit 136 calculates the average density of the right image based on the obtained ratio value so that the average density in the ROI 133 is the same as the average density of the left image, and the left and right image densities are the same. A composite image 132 is created.

The ROI 133 is normally set in advance. However, it is preferable that processing can be performed by receiving not only a standard ROI such as the ROI 133 but also a special ROI (free ROI) given by an operator. . The ROI 133 can be set to a region centered on a portion pointed out by the CAD as a lesion candidate.

As another example of the density equalization processing, in addition to the example in which the average values of the pixels are aligned as described above, the example in which the median value, the mode value, and the histogram in the ROI are aligned is also known.

処理 In addition, the average value of the pixels may be aligned, and the standard deviation of the pixels may be aligned.

c. ROI position determining means, shuttle corresponding means, for example, the position of an ROI for performing enlarged display as image processing can be automatically set and moved.

FIG. 30 is a diagram showing an ROI for enlarged display and a locus of position movement of the center of the ROI. The ROI 133 is composed of 4A pixels × 5A pixels (A is a natural number) of the image. Here, XY coordinates are set, and a contour line 137 obtained by moving the contour 138 of the extracted subject (breast) toward the inside of the breast in the X direction by 3A, a straight line X = 4000-2A, and a straight line Y = 3A , A first closed curve 139 surrounded by a straight line Y = 5000-3A.

Next, while moving the center of the ROI 133 on the first closed curve 139, the image data inside the ROI 133 is enlarged and displayed on the CRT 100 of the output device 10. When the ROI 133 has completed one round of the first closed curve 139, the position movement is temporarily stopped.

Next, a contour obtained by further moving the breast contour 138 by 3A × 2 into the X direction, a straight line X = 4000−2A × 2, a straight line Y = 3A × 2, and a straight line Y = 5000−3A × 2 Create an enclosed second closed curve 140. Similarly to the case of the first closed curve 139, while enlarging the image data inside the ROI 133 while moving the center of the ROI 133 one turn on the second closed curve 140, the image data is output to the CRT 100 of the output device 10. Note that FIG. 30 does not show the second closed curve 140.

処理 The above processing is repeated until the X coordinate value of the leftmost point of the contour becomes smaller than 4000-2A × N (N is a natural number). The movement from the closed curve N to N + 1 is performed linearly. FIG. 31 shows a trajectory when the position of the ROI center is continuously moved.

The outline 137 to be extracted first may be obtained by approximating the breast outline 138 by a polygon, as shown by way of example in FIGS. 32 (a) and 32 (b). The size (determination of the value of A) of the ROI 133 to be displayed is determined by the enlargement ratio. The examiner sets the enlargement ratio before the examination. FIG. 33 shows an example of the case where the enlarged display is performed by the ROI 133 set as described above.

Although the description regarding the determination of the ROI position for the image processing has been described above in the case of performing the enlarged display as the image processing, the same applies to the case of performing other image processing, for example, the contrast enhancement and the like, in the case of the enlarged display. FIG. 34 shows an example in which contrast enhancement is performed. Means for performing various image processing will be described later. In addition, as a method of extracting the breast contour 138 and a method of setting the contour 137, a known method such as automatic extraction may be used. In addition, the examiner can make the setting using the shuttle.

観 察 Observation can be performed by automatically moving the ROI according to the breast shape shown in the mammogram image. FIG. 35 shows the locus of the ROI position movement according to various mammogram images.

D. Image Processing Means The following three types of image processing can be performed by the image processing means.

1. Image processing is performed, such as unsharp masking, to enhance an appropriate frequency region to make it easier to see shadows and the like. Regarding unsharp masking, the following paper can be referred to. Leh-Nien D. loo, "Investigation of basic imaging properties in digital radiography 4.Effect of unsharp masking on detectability of sample patterns", Med.Phys. 12 (2), pp.209-214.
2. Image processing for enhancing the contrast by changing the look-up table as described in the contrast enhancement means is performed.

3.2. The image processing for converting the density range to a certain range is performed in a process before performing all the image processing. As shown in FIG. 36, when the pixel range is A (over exposure) or B (under exposure), the pixel range is converted to the pixel range of C (appropriate exposure).

E. Means for determining whether or not the abnormal shadow detecting means is applicable In the tumor shadow detecting method, an abnormal shadow is detected by calculating a difference between pixel values of left and right breasts. However, this method cannot be applied when the sizes and shapes of the right and left breasts are extremely different. Therefore, in the present embodiment, the following two processes are performed to determine whether the tumor shadow detection method can be applied. If it is determined that application is not possible, the output device 10 outputs a comment to that effect without applying the abnormal shadow detection means.

1. Check the left and right areas of the breast.

画像 As shown in FIG. 37, the image is divided into two areas, an area A and an area B, and the area of the area B is defined as a breast area. Regarding the division of the area, in the histogram of the breast image shown in FIG. 24, the p point (pixel value p) may be used as a threshold for dividing.

面積 The areas obtained for the left and right breasts are compared, and if the difference is, for example, 10% or less of the entire area, it is determined that the tumor shadow detection means can be applied.

2. Check the angle of the breast contour.

38. As shown in FIG. 38, a circle is superimposed on the breast contour (fitting), and the angle formed by a straight line connecting the midpoint 142 of the arc included in the image to the center of the circle and the horizontal line of the image is defined as a contour angle 144. The contour angles obtained for the right and left breasts are compared, and if the angle difference is, for example, 10% or less of the entire angle, the tumor shadow detection means is applied.

Regarding the detection of the contour and the like, a method of using a Sobel operator or the like and then binarizing and extracting the same is known.

f. Abnormal shadow detection means, detection result storage means As means for detecting abnormal shadows, etc., microcalcification shadows and tumor shadows are detected by CAD (computer-aided diagnosis) described above. The means for detecting these abnormal shadows are sequentially applied to the mammogram image, the detection results are described in an abnormality detection result table, and stored in the system disk 12 as, for example, a data file. When the detection results are sequentially output, they are stored in the memory 14 and output. Table 4 shows the abnormality detection result table.

G. Output Screen Creation Means <Management Method for Arranging Mammogram Images on Screen> As the function 1, the output screen creation means can determine the method of arranging images on the screen according to the doctor's preference. In addition, as a function 2, an arrangement method can be determined according to a result of abnormality detection from an image.

FIG. 39 is a diagram showing the types of photographing directions. For example, FIG. 1A shows a case where the right breast is irradiated with X-rays in the vertical direction, in particular, “from top to bottom” (in the direction from the head to the leg of the subject) to perform imaging. I have. At the time of imaging, the breast is pressed and sandwiched perpendicularly to the direction in which the X-rays are emitted.

FIG. 39 shows six types of patterns (a) to (f) for the right breast as the imaging directions. In this embodiment, the imaging directions are two types, that is, up and down and left and right. There are two types of mammogram images for each direction. That is, in the up-down direction, no distinction is made between the “top-down” direction and the “bottom-up” direction, and in the left-right direction, no distinction is made between the “inside-out” direction and the “outside-in” direction. This is not taken into account for the oblique direction (no photographing is performed).

配置 Set the arrangement method on the screen according to the type of mammogram image for each shooting direction. In this embodiment, two CRTs are provided, and different images can be displayed on each CRT. In each CRT, two images are simultaneously displayed on one screen.

FIG. 40 is a diagram showing the type of the method of arranging the image on the screen, FIG. 40 (a) is a diagram showing the type of the arrangement position, and FIG. 40 (b) is a diagram showing the type of the arrangement direction.

As shown in FIG. 7A, the layout positions on the screen include a left layout position L and a right layout position R when the screen is vertically divided, and an upper layout position R when the screen is horizontally divided. There is an arrangement position U and a lower arrangement position D.

As shown in FIG. 3B, there are four types of arrangement directions on the screen, (1) to (4). The doctor holds a preferred arrangement method according to the result of abnormality detection as a table in the memory 14 or the system disk 12 for each type of image (represented by cases 1, 2, and 3). Table 5 shows the contents of the tables held by the three doctors A, B, and C.

FIG. 41 is a diagram showing how images are arranged on the screens of two CRTs on the left and right sides for each type of image (for each case) based on the table of Table 5 held by Doctor A.

FIG. 42 is a diagram showing how images are arranged on the screen of two CRTs on the left and right sides for each type of image (for each case) based on the table in Table 5 held by doctor B.

FIG. 43 is a diagram showing how images are arranged on two CRT screens on the left and right sides for each image type (for each case) based on the table in Table 5 held by the doctor C. Regarding the doctor C, the output is always performed in a fixed arrangement method regardless of the abnormality detection result.

Next, the operation up to outputting to the screen according to the determined arrangement method will be described.

1) The doctor inputs doctor identification information (doctor ID number) before image interpretation.

2) If the input doctor ID number is registered in the table, the central control unit 16 instructs a method of arranging an image to be displayed according to the registered contents. Here, if the doctor ID number is not registered in the table, a default arrangement method (an arrangement method set in advance, for example, the same arrangement method as that of the doctor A) is followed.

3) If the size of the image matrix to be displayed matches the size of the display area matrix of the display device, the image is displayed at the specified arrangement position and arrangement direction. If the image matrix size and the display area matrix size do not match, image data is processed and both ends are cut and displayed in order to match the image matrix size with the display area matrix size.

Regarding the processing of the image data, it is assumed that the image data size is (4000 × 5000) and the matrix size of the display area is (4000 × 5000), for example.

Here, when the display is performed at the arrangement positions “L” and “R”, the matrix size of the area required for display is (2000 × 5000), so that the area is indicated by hatching as shown in FIG. Delete an area.

Further, in the case of displaying at the arrangement positions “U” and “D”, the matrix size of the area required for display is (4000 × 2500), so that the area is indicated by hatching as shown in FIG. Delete an area.

As described above, according to the output screen creating means, the method of arranging the image on the screen can be variously determined according to the doctor's preference or according to the abnormality detection result. Then, an output screen can be created by processing image data.

Note that the shooting direction and the number of images are not limited to the contents of Table 5 described above, and a plurality of images in the oblique direction, such as “from upper left to lower right” and “from upper right to lower left”, are displayed. You may take a picture. Further, the number of display devices is not limited to two. For example, one display unit may be used, or three or more display units may be used and displayed in various arrangement directions.

h. Abnormality detection result output means As a function 1, the abnormality detection result output means can indicate the position of the abnormality detected by the abnormal shadow detection means from outside the image. In addition, as the function 2, the number of detected abnormalities can be indicated. In addition, as the function 3, it is possible to attach identifiers to a plurality of abnormalities, and to clearly indicate each of them.

The abnormality detection result output means satisfies both conflicting demands from the observer (radiographer) who want to refer to the abnormal shadow detection result but do not want to disturb image interpretation.

FIG. 45 is a schematic diagram of a screen in which the result of abnormal shadow detection is shown from outside the image. According to FIG. 45A, a mammogram image 146 showing the detected abnormality (shading) 148 on the screen 145, two markers 147 located outside the mammogram image 146, and the detected abnormality (shading) are shown. The number 149 is displayed. In FIGS. 45A to 45C, the marker 147 is displayed as an arrow. Note that the marker is not limited to the arrow. The markers 147 are positioned outside the mammogram image 146 such that the intersections of the respective markers on the extensions of the arrows are equal to the position of the detected abnormality 148.

When the number of detected abnormalities is plural and the number is relatively large, if the abnormality is indicated by a plurality of markers as described above, the display becomes troublesome.

Therefore, as shown in FIG. 45 (b), the number 149 of abnormalities (shadows) in which the presence of another abnormality is detected is displayed in the corner of the screen while indicating one abnormal position from the outside of the image. Thus, it is understood that the detected abnormality exists in addition to the abnormality indicated by the marker.

(4) As shown in FIG. 45 (c), an identifier 152 such as a number may be displayed near the detected abnormal position.

{Circle around (4)} As shown in FIG. 45 (d), when it is desired to indicate the positions of a plurality of abnormalities at once using a plurality of markers from outside the mammogram image, the markers may be displayed in different shapes or colors.

As shown in FIG. 45 (e), each position of the marker indicating the position of the abnormality (shadow) from the outside of the image is shifted from the coordinates (x, y) in the image of the detected abnormality to the X axis and the Y axis. It can be obtained at the intersections (x, 0) and (y, 0) of the respectively extended perpendicular lines.

<Comparison of CAD result> The main function is to compare the diagnosis result of the past image with the above-mentioned CAD (computer-assisted diagnosis) and the diagnosis result of the current image, and display when there is a difference between the past image and the current image. .

1) The central controller 16 performs CAD processing (abnormality detection) on the current image to obtain a CAD processing result.

2) The central controller 16 searches for a past image from the patient identification information (patient ID).

3) The central control unit 16 compares the CAD processing result of the past image (if the CAD processing result does not exist, executes the CAD processing to obtain the result) with the CAD processing result of the current image.

4) If there is a difference between the two results, the central control device 16 outputs that fact.

5) The doctor inputs a comparative reading command.

6) The central control device 16 outputs the current image and the past image to the display device 10 according to the table shown in Table 6 below. In Table 6, only the table for Case 1 of Doctor A is shown, and the tables for other cases of Doctor A and the tables for other doctors are omitted.

FIG. 46 is a diagram showing a state where the current image and the previous image (past image) are arranged on the screens of two CRTs based on the table of Table 6.

If there is a difference between the two results, the current image and the past image may be displayed without waiting for the doctor to input the comparative interpretation command.

The image obtained by the X-ray detector 4 is temporarily stored in the memory 14 and output from the output device 10. The interpreter makes a diagnosis based on the output.

At this time, as an auxiliary role of image interpretation, in the present system, abnormal shadows are detected, and image processing is automatically performed based on the results, so that abnormal shadows are displayed more clearly. . As image processing, enlargement, contrast adjustment, frequency processing, and the like are performed. Which image processing is to be performed is set in advance by an image reader. When an abnormal shadow is performed, image processing that is automatically set is performed and displayed.

(1) As a display method, first, a display screen after image processing and a standard display screen are set. At this time, a plurality of (for example, two) CRTs are used in accordance with the number of screens, a display screen after image processing is set on one CRT, and a standard display screen is set on another one. Further, a single CRT may be used, and a plurality of screens may be realized by dividing the screen.

標準 In addition, when the image information amount and the screen displayable information amount are the same, the standard screen is displayed as it is, but when the image information amount is larger than the screen displayable information amount, the image information is compressed and displayed. Means for compression include averaging and thinning.

Next, the image that has been subjected to image processing is displayed on the image processing screen. At this time, the position of the detected abnormality is displayed at the center of the screen.

In the case of performing enlargement as image processing, image information may be displayed as it is (when the amount of image information is larger than the amount of image display information), or may be displayed by interpolating information between pixels.

When adjusting the contrast as image processing, the range of pixel values of the displayed image when enlarged is displayed is smaller than that of the standard image, and the difference between the maximum and minimum signals is small. To adjust. FIGS. 47A and 47B are diagrams for explaining the contrast adjustment. FIG. 47A shows the input / output characteristics of the standard image, and FIG. 47B shows the input / output characteristics of the image after the contrast adjustment. FIG. 3C is a diagram illustrating a display example of a standard image, and FIG. 3D is a diagram illustrating a display example of an image after contrast adjustment.

The abnormal shadow appears on the mammogram image due to various factors such as calcification and tumor shape. The abnormal shadow detected by the abnormal shadow detecting means is subjected to image processing according to such various factors, and is then provided for display.

に お い て In the above-described image processing means, the frequency characteristics of the image are changed according to various factors in the frequency processing. For example, when an abnormal shadow appears on an image due to calcification, such a shadow has a relatively high contrast, but since it is a minute shadow, the outline is further enhanced by emphasizing a high frequency band. Be clear. Further, when a tumor appears on an image as an abnormal shadow, such a shadow is judged (interpreted) based on a delicate difference in shading on the image, so that the image is easier to see when the low frequency band is emphasized. As described above, by changing the frequency characteristic of the image, the abnormal shadow can be more clearly displayed.

(4) The range (for example, ROI) of the image displayed on the image processing screen is displayed on the standard image as to where it is on the standard screen.

場合 As shown in FIG. 48 (a), when there are several abnormal shadows, the screen is divided and displayed according to the number. Since image processing is performed on each of the divided screens, the degree of image processing varies depending on each screen. At this time, a number or the like may be given as shown in FIG. 48 (b) in order to make it easy to see where the displayed image is on the standard screen. If the number of abnormal shadows is too large to be displayed, the reader is notified by sound, message, or the like so that all the shadows are not displayed. Regarding the image processing to be performed automatically, since the contents of the image processing can be set in advance by the radiologist, it is also possible to perform image processing other than the above-described image processing.

With the above configuration, it is possible to perform image reading with a quick operation, and to realize excellent lesion detection ability.

I. Means for Recognizing Shooting Direction from Tilt of Arm <Automatic Recognition of Shooting Direction> FIG. 49 is a diagram of the C-arm and the C-arm supporting portion viewed from the side. In the figure, the X-ray generator 2, the compression plate 3, the X-ray detector 4, etc. provided on the C-arm 5 are omitted. The C arm 5 is rotatably attached to the C arm support 154.

According to the automatic recognition of the photographing direction, the input can be simplified by automatically obtaining a part of the accompanying information such as “inspection information” in Table 3 described above. Here, the photographing method is automatically recognized from the inclination of the C-arm 5. That is, as shown in FIG. 49, the inclination angle θ of the C-arm 5 is defined, the inclination angle θ of the C-arm 5 is determined, the content of the accompanying information in the item of the imaging method is determined, and written and stored in the memory 14.

FIG. 50 is a diagram schematically showing processing for automatically recognizing the photographing direction as described above. First, in S1, the rotation angle of the C-arm 5 is recognized using a mechanism that automatically recognizes the rotation angle.

FIG. 51 is a perspective view schematically showing a mechanism for automatically recognizing a rotation angle. As a method of automatically recognizing the rotation angle, first, the first gear 158 is attached to the rotation shaft 156 of the C-arm 5, and the second gear 160 is meshed with the first gear 158. A variable resistor (not shown) is attached to the rotation shaft of the second gear 160 so as to be rotatable in the same manner as the rotation shaft, and the angle recognition unit 162 converts the rotation angle into a resistance value, thereby electrically connecting the variable resistor (not shown). The angle can be recognized. In this case, the rotation angle can be continuously recognized. In addition, a device that converts a rotation angle into an electric signal can be similarly handled.

Next, in S2, the photographing direction is determined from the rotation angle of the C-arm 5 determined in S1.

Here, in S3, the setting of the boundary angle can be set by the input of the technician as the condition for judging the photographing direction. For example, when the boundary angle is θ, as shown in FIG. 52, when the angle θ is “θ = 0 °”, the photographing direction is determined to be “CC”, and the angle θ is “−70 ° <θ <0”. If “゜” or “0 ° <θ <70 °” is satisfied, the photographing direction is determined to be “MLO”, and the angle θ is “−90 ° <θ <−70 °” or “70 ° <θ <90 °”. When the condition is satisfied, the shooting direction is determined to be “MO”. It should be noted that the range of the angle θ and the types of the direction notation characters such as “CC” and “MLO” are merely examples, and are not limited thereto.

(4) Next, the result determined in S4 is written in the item of “shooting method” of the accompanying information. Here, when performing special photographing, it is possible to manually input accompanying information in S5, and it is also possible to make corrections.

As another example of automatic recognition of the rotation angle, as shown in FIG. 53, a second electrode in which a first electrode 164 is provided on a rotation shaft 156 and the upper surface of a disk is divided into several places on the C-arm support 154 side. An electrode (divided electrode) 166 is arranged, and a switching action is caused by the positional relationship between the first electrode 164 and the second electrode 166, thereby mechanically performing angle recognition and determination of a shooting direction. The condition for judging the imaging direction is given by the division angle of the second electrode, and information on the imaging direction is written in the accompanying information according to the switching.

In addition, various mechanisms for switching according to the rotation angle are also included.

In addition, when performing special photography, manual input / correction of accompanying information can be performed in S5.

Determination of left breast or right breast, that is, pressing the “right button” or “left button” (both not shown) of the C-arm 5 for the item “imaged part” in the accompanying information Is automatically written.

{J. Compression timing adjusting means The means for adjusting the timing of compression in association with X-ray exposure has been described in the description of the X-ray generator 2 and will not be described here.

K. Biopsy Inspection Status Confirming Means <Confirming Biopsy Puncturing Status by Ultra-Low Dose X-Ray Imaging> FIG. 54 is a diagram showing a pressure pad used for a biopsy inspection. In the biopsy test, the breast is sandwiched between the pressure pads 168 and a sample (specimen) is collected by puncturing a fine needle (needle) from a window 170 provided on the pressure surface of the pressure pad 168 to the diseased part 172 of the breast.

説明 Details on biopsy test up to sample collection.

First, the breast is sandwiched between the pressure pads 168. At this time, the diseased part 172 is sandwiched so as to be located in the window 170.

Next, imaging is performed with the imaging angle set to “0 °”, and it is confirmed that the diseased part 172 is in the window 170.

Next, as shown in FIG. 55 and FIG. 56, three-dimensional information is obtained by performing photographing with the posture (photographing angle) of the C-arm set to “+ 15 °” and “−15 °”.

Next, the three-dimensional position of the diseased part is calculated from the obtained three-dimensional information, and a double-structure needle 174 is inserted into the calculated position through the window 170.

FIG. 57 is a diagram showing a state where a needle is inserted into a diseased part of the breast.

Next, imaging is performed with the imaging angles set to “+ 15 °” and “−15 °”, and a sample is collected after confirming that the needle is at the center of the diseased part.

後 に After collecting the sample, take a picture again to confirm that the sample of the diseased part has been collected.

際 When inserting a needle into a diseased part, the needle may be bent. If it is possible to confirm whether or not the needle is inserted straight, it is possible to prevent an image from being taken at the time of collecting a sample while the bent needle is inserted, so that unnecessary exposure to the patient can be avoided.

Therefore, before taking an image at the time of sample collection, perform imaging with a low dose of X-rays during the needle insertion process, and confirm whether the needle is inserted in the correct posture. In this case, the photographing is performed with the photographing angles of “+ 15 °” and “−15 °”.

(4) The dose of X-rays at the time of imaging should be small enough to confirm the shape of the needle. Therefore, the dose should be smaller than the dose normally used in X-ray fluoroscopy. After the low-dose imaging confirms that the needle is straight, imaging is performed at the time of sample collection. According to the biopsy puncture status checking means, it is possible to determine by low-dose X-ray imaging whether or not the needle has been punctured straight into the diseased part, so that the biopsy test can be performed appropriately without giving unnecessary invasion to the patient.

{L. FIG. 58 is a diagram showing profile acquisition lines set on the detector. On the surface of the detector 42, 176 is a biopsy irradiation field, and 178 is profile acquisition lines (ad).

In the detector, the profile data of each of the profile acquisition lines 178 is collected before the entire data, and the profile data of the profile acquisition line “a” and the profile acquisition line “c” are acquired as shown in FIG. I do. Then, the position where the image data exists is detected, for example, as a point A by the first derivative of the profile data or the like, and the read range is determined so that only the data in the hatched area (biopsy irradiation field 176) in FIG. 58 is read.

Note that the details of the data reading based on the reading range have been described in the description of the X-ray detection device 2, and thus are omitted here.

M. Automatic setting of photographing conditions by photographing scene and detector (mode) Automatic setting of photographing conditions is performed in principle using Table 1 described above based on measurement results of various conditions as described above.

シ ス テ ム As shown in the operation panel 90 of FIG. 16C, in this system, various system use scenes (photographing scenes) can be selected for each inspection.

In this case, the imaging conditions are different for the normal examination, (1) group examination, (2) biopsy, (3) resected specimen examination, and (4) fluoroscopy. Corresponds to the setting of the shooting conditions.

{N. Since the means for reading out an image triggered by the end of the exposure has been described in the description of the X-ray detection apparatus 2, the description is omitted here.

O. A means for outputting patient information including RIS and a means for outputting an identifier (including a barcode) RIS information (for example, examination request information) can be displayed and viewed. When examination request information is selected by the operation panel 90 in FIG. 16 (examination items of the examination request information are not shown), the request items related to the currently selected examination (eg, patient information and examination information shown in Table 2). ) Is displayed on the screen of the CRT 100 of the output device 10.

P. Means for Enlarging / Reducing an Image to an Arbitrary Size Enlarging / reducing is performed by applying a filter to pixel data of an image. The 1 / n filter is applied when the average value and the maximum value of the pixel values of the n × n matrix are taken assuming n × n, or a predetermined specific matrix element of the n × n matrix is obtained. Apply to cases.

{Q. In the initial operation of the CRT / film output selecting means system, an output method such as "CRT" or "film" can be selected by the operation panel 90 of FIG.

{R. Means for judging whether the abnormality is malignant or benign and outputting the result The means for judging whether the abnormal shadow is benign or malignant is described in US Pat. No. 5,133,020 for tumor shadow. The above can be referred to.

Here, at the time of image interpretation by the doctor, when the doctor instructs the analysis of the shadow (analysis of the abnormality) on the screen as shown in FIG. Whether it is benign or not is output. On the other hand, it outputs whether or not the shadow was pointed out directly by a doctor or the like on the image by the pointing means such as a mouse or the like.

This system has a mouse as one of the input means (instruction means). The mouse is displayed using one surface of the overlay memory 110 of the output device 10, and the position at which the mouse button is clicked is associated with the image as the coordinate position on the screen.

S. The ROI manual input device is a means using a touch panel for outputting a schema, and is omitted here because it is shown in FIG.

t. When the system is started, a screen as shown in FIG. 16A is displayed on the operation panel 90.

(4) The operator can select a process such as “interpretation”, “examination”, “interpretation after inspection”, or “other” by touching the operation panel.

The system disk 12 stores the following data in addition to the control programs having the functions a to t described above. Specific items of each data will be described.

(1) The image and the accompanying information image are data having a maximum matrix size of “6000 × 4800” (2 bytes). FIG. 61 is a diagram showing a coordinate system of image data. In normal photographing, the area of the matrix size of “4800 × 3600” is used.

62. As shown in FIG. 62, the coordinate system of the screen is considered separately for the case of the CRT screen (for example, the matrix size is “2500 × 2000”) and the case of the film (for example, the matrix size is “8500 × 7000”).

(2) As shown in the inspection history table 7, the inspection history is held as information for searching and reading the past image.

 (3) As shown in the inspection request information table 2, it holds the inspection request information obtained from the RIS and the like, and also holds the inspection request information created by manually inputting the paper request information.

(4) Table for arranging images As shown in Table 5, a table for determining how to arrange images by a doctor is held.

(5) Abnormality detection result table As shown in Table 4, the results detected by the abnormal shadow detecting means are held as a table.

(6) At the time of shipment of the reference image data, the detector 42 is irradiated with X-rays for a specified time, and the reference image data is collected and stored.

(4) At the time of maintenance, the difference between the reference data and the image data obtained by trial shooting is detected to detect deterioration of the detector 42 and the like. Next, the memory will be described. The memory 14 is a semiconductor memory that is used for temporarily storing image data, programs and data of the system disk 12, and the like. Writing and reading of data to and from the memory 14 are controlled by the central controller 16.

The central controller 16 controls all operating functions of the system. The operation of the basic system configured as described above is described as “normal examination”, “group examination”, “needle biopsy examination”, “resection / biopsy examination with a scalpel”, “follow-up examination”, “detector deterioration, The maintenance work will be described in the order.

First, the operation in an ordinary examination based on outpatient examination and interpretation will be described. The most common use of mammography in normal hospitals is in the examination and diagnosis of outpatients who visit the hospital because they feel abnormal.

動作 The operation of the system during the examination and interpretation work will be described below.

As described above, when the system is started, the first panel is displayed on the operation panel 90 as shown in FIG.

(5) Select one of the processes of “interpretation”, “examination”, and “others” on the first panel.

と When “interpretation” is selected, an image interpretation doctor ID is input, and after the ID input by the image interpretation doctor, the second panel is output to the operation panel 90 as shown in FIG. The ID of the radiologist is stored in the memory 14, and thereafter the output is made according to the physician's preference until the apparatus (system) is brought down.

Here, it is assumed that the interpreting doctor is set to Y and the ID 9876 is input.

と When “Examination” is selected, a third panel is displayed on the operation panel 90 as shown in FIG.

When "other" is selected, a fourth panel is displayed on the operation panel 90 as shown in FIG. The output conditions are set on this panel.

Here, a case will be described in which “examination” is selected from the first panel, and “ordinary interpretation” (follow-up interpretation and group examination are performed in the same manner) from the second panel.

(1) Input of patient test information For example, if a test request for a certain patient X is transferred from the RIS to the memory 14 of the system as test request information, a list of patients including the patient X is displayed in the operation shown in FIG. Since the examination list is output to the panel 90, the examination technician selects the patient X by touching (touching) the part of the patient X.

(2) Positioning The patient X is positioned (positioned). With regard to the set of imaging devices, it is only necessary to instruct which of the right and left breasts is to be imaged with the button of the arm (designation of the imaging region). The photographing means (photographing method) is also determined by the inclination of the arm. Information on the RIS examination and information on the imaging region, the imaging method, and the like are stored in the image accompanying information.

(3) Breast compression Breast compression is applied by a foot switch (not shown). When the specified pressure (10N) is reached, the compression is stopped.

(4) The imaging conditions are determined based on the imaging condition determination table while the breast is compressed by the imaging condition setting foot switch. In the imaging condition table, for example, “age: 50 years old, hardness: soft, size: small, thickness: 3 cm” is given as information of the patient X. The photographing conditions such as “Filter: Mo, kvp: 28 kvp, mA: 10 mA” are obtained from the photographing condition determination table.

(5) X-ray irradiation X-rays are controlled under the above-mentioned imaging conditions, and X-ray irradiation is performed at the discretion of the engineer. The exposure time is managed by the AEC 30, and imaging is performed with an appropriate mAs value. An appropriate pressure is applied to the patient's breast only during the exposure according to the setting of the technician. For example, if the technician determines that another 1N load is to be applied and inputs that value, a total of 11N pressure is applied to the breast only during the exposure time, and the pressure is released simultaneously with the end of the exposure. The pressure is higher than the ACR standard in advance, and the safety mechanism does not apply any excess pressure.

ここで、フィルムを用いて読影する場合について説明する。 (6) The image data obtained from the storage detector 42 by associating the image with the accompanying information is temporarily stored in the memory 14. Based on this data, image accompanying information is created and stored in the memory 14 in association with the image data. Table 8 shows an example of the image accompanying information.

Here, the case of image interpretation using a film will be described.

(4) There are cases where image interpretation using a film is performed by using the CRT 100 as a supplement, and cases where image interpretation is performed using only a film. When the CRT 100 is used in an auxiliary manner, the output of the film is simply a density correction. These outputs are made sequentially after a set of tests has been performed. The operation inside the system is as follows.

(1) The image data on the image reading memory 14 is read one by one.

(2) Activate the density correction processing function for the density corrected image to correct the exposure to a proper value. The exposure-corrected image data is stored in the memory 14.

(3) CAD processing CAD processing is not performed when the CRT 100 is used in an auxiliary manner.

{Circle over (1)} First, apply abnormal shadow detection means to the image data after the image density correction. As shown in FIG. 63, it is assumed that a microcalcification shadow 180 is detected at a position of coordinates (1000, 1500) and a tumor shadow 182 is detected at a position of coordinates (2000, 3000). The detection result is described in the above-described abnormality detection result table (Table 4) and stored in the memory 14.

(4) Image Processing Image processing is not performed when the CRT 100 is used as a supplement.

(4) ROI data of “1000 × 1000” centered on the coordinates (1000, 1500) and the coordinates (2000, 2000) of the image is extracted from the abnormality detection result table created in the CAD process described above. If the position of the abnormality is included in the ROI, the previously extracted data is used as the ROI data. The ROI data is processed by an image processing function and stored in the memory 14 again. For the microcalcification shadow 180, image processing corresponding to the shadow is performed, such as unsharp masking processing, and for the tumor shadow, a look-up table change is performed.

(5) Screen creation A position where the coordinates (1000, 1500) of the image are converted to the coordinates of the screen based on the abnormality detection result table created in the CAD process described above, that is, a mark indicating the position of the microcalcification shadow is placed on the outer frame of the image. Is set in the position where the coordinates (2000, 3000) of the image are converted to the coordinates of the screen, that is, a mark indicating the position of the tumor shadow is set in the outer frame of the image. Further, as shown in FIG. 64, an image obtained by enlarging the size of one pixel of the ROI data by two times is arranged beside the image. These screen data are sent to the laser writing device 118.

When the CRT 100 is used in an auxiliary manner, the method of arranging images is determined for the radiologist Y according to, for example, Table 6 already described, a screen in which only the images are arranged is created, and the data is sent to the laser writing device 118.

(6) Film printing The screen data obtained by the above-described image processing is sent to the laser writing device 118, and an instruction is given to print on the film. Next, an operation in the case of performing (support) diagnosis using a CRT will be described.

(1) A list of patients whose examination has been completed is displayed on the examination information input operation panel 90. Here, the examination of the patient X is selected.

(2) The image data on the image reading memory 14 is read one by one.

(3) Activate the density correction processing function for the density corrected image to correct the exposure to an appropriate value. The exposure-corrected image data is stored in the memory 14.

(4) CAD processing Apply abnormal shadow detection means to the image data after image density correction. As shown in FIG. 63, it is assumed that a microcalcification shadow 180 is detected at a position of coordinates (1000, 1500) and a tumor shadow 182 is detected at a position of coordinates (2000, 3000). The detection result is described in the above-described abnormality detection result table (Table 4) and stored in the memory 14.

(5) Image Processing Image processing is not performed when the CRT 100 is used as a supplement.

(4) ROI data of “1000 × 1000” centered on the coordinates (1000, 1500) and coordinates (2000, 2000) of the image is extracted from the abnormality detection result table (Table 4) created in the CAD process described above. If the position of the abnormality is included in the ROI, the previously extracted data is used as the ROI data. The ROI data is processed by an image processing function and stored in the memory 14 again. For the microcalcification shadow 180, image processing corresponding to the shadow is performed, such as unsharp masking processing, and for the tumor shadow, a look-up table change is performed.

(6) Screen Creation and Display An initial screen is displayed on the operation panel according to the instruction of the doctor Y. The target image is selected on the initial screen, and the display abnormal shadow detection result and the gaze of the abnormal shadow are displayed.

FIG. 65 is a diagram showing an initial screen displayed on the operation panel.

All the images of the examination are displayed in the preferred arrangement method of the radiologist Y until the examination is completed. Further, an image that needs to be reduced in display is displayed in a reduced size.

The initial screen has a switch that abstracts (deforms) the image, and selects the target image using the switch. In addition, a switch used to display an abnormal shadow detection result and a switch used to gaze (enlarge and emphasize) the abnormal shadow are provided.

As the target image, only the image selected on the operation panel on the initial screen is displayed.

異常 As shown in FIG. 66, the abnormal shadow detection result is displayed so as to overlap the displayed image. The abnormal shadow indication mark is created on the overlay memory at a position of coordinates (1000, 1500) of a mark of microcalcification and at a position of coordinates (2000, 3000) of a tumor shadow. Display them in layers.

(4) The gazing of the abnormal shadow displays the ROI data created by the image processing of (5) based on the priority without reducing the displayed image.

Table 9 is a table showing the priority of gaze of an abnormal shadow.

FIG. 67 is a diagram showing the display of the ROI and the display of the CRT on the operation panel. FIG. 67 (a) shows the display of the CRT, and FIG. 67 (b) shows the display of the operation panel 90.

(4) The operation panel 90 abstracts (deforms) and displays the position of the ROI displayed on the CRT on the image.

Next, the operation in the group examination will be described.

(5) The content of the test at the time of the mass screening is the same as the test flow of the normal test described above. In addition, the diagnosis using only a film is the same as the interpretation using a film in a normal inspection. In the mass screening, the examination and film output are performed together, and the interpretation is performed later.

と す る It is assumed that all inspection results (image data, etc.) are stored on the hard disk. The operation flow of the system in the interpretation work in such a case will be described below.

(1) A list of patients whose examination has been completed is displayed on the examination information input panel. Here, the examination of the patient X is selected.

(2) The image data of the patient X on the image reading memory 14 is read one by one. A density correction processing function is started for the image to correct the exposure to an appropriate value. The exposure-corrected image data is stored in the memory 14. An abnormal shadow detection unit is applied to the corrected image data. As shown in FIG. 63, it is assumed that a microcalcification shadow 180 is detected at a position of coordinates (1000, 1500) and a tumor shadow 182 is detected at a position of coordinates (2000, 3000). The detection result is described in the above-described abnormality detection result table (Table 4) and stored in the memory 14.

(3) Image processing ROI setting The ROI of “1000 × 1000” is set by the ROI position determining means set by the shuttle, and ROI data is obtained in real time.

(4) Image processing The ROI data is processed by the image processing function and stored in the memory 14 again. For the microcalcification shadow 180, image processing corresponding to the shadow is performed, such as unsharp masking processing, and for the tumor shadow 182, a look-up table change is performed.

(5) Screen Creation An initial screen is displayed on the operation panel 90 according to the instruction of the doctor Y. The target image is selected on the initial screen, and the display abnormal shadow detection result, the gaze of the abnormal shadow, and the gaze position by the shuttle are displayed.

(5) As shown in FIG. 65, an initial screen is displayed on the operation panel 90. Until the end of the examination, the images of the examination are all displayed in a preferred arrangement method of the radiologist Y. Further, an image that needs to be reduced in display is displayed in a reduced size.

The initial screen has a switch that abstracts (deforms) the image, and selects the target image using the switch. In addition, a switch used to display an abnormal shadow detection result and a switch used to gaze (enlarge and emphasize) the abnormal shadow are provided.

As the target image, only the image selected on the operation panel on the initial screen is displayed.

異常 As shown in FIG. 66, the abnormal shadow detection result is displayed so as to overlap the displayed image. The abnormal shadow indication mark is created on the overlay memory at a position of coordinates (1000, 1500) of a microcalcification shadow and at a position of coordinates (2000, 3000) of a tumor shadow, and is superimposed on the image by the image display manager. To display. The gaze of the abnormal shadow displays the ROI data created based on the priorities of Table 9 described above without performing reduction or the like with respect to the displayed image.

The gaze position displayed by the shuttle is displayed without reducing the created ROI data designated by the shuttle.

FIG. 67 is a diagram showing the display of the ROI and the display of the CRT on the operation panel. FIG. 67 (a) shows the display of the CRT, and FIG. 67 (b) shows the display of the operation panel 90.

(4) The operation panel 90 abstracts (deforms) and displays the position of the ROI displayed on the CRT on the image.

Next, the operation in the needle biopsy test will be described.

に お い て In the scene where abnormal shadows are found as a result of mammogram interpretation, if necessary by a doctor, a biopsy (biopsy) is performed to determine whether the shadows are malignant or benign. The purpose of this test is to insert a needle into the lesion and remove abnormal cells.

(5) The operation in such a case inspection and image interpretation work will be described below.

In this case, as shown in FIG. 16C, “biopsy” is selected on the third panel of the operation panel 90. In FIG. 16C, “biopsy (perspective)” can be selected. In this case, X-ray fluoroscopy is performed without performing X-ray imaging. Same as inspection.

(1) X-ray irradiation X-rays are irradiated under biopsy conditions.

判断 Judge the small field of view for biopsy and write the image to the memory 14.

Ｘ X-rays are emitted at different angles and stored in the memory 14 in the same manner.

(2) Image reading Two images are taken out from the memory 14.

(3) Creation of Screen for Biopsy Inspection As shown in FIG. 68, a screen in which two images are arranged is created and displayed on the CRT 100.

(4) Shading instruction Shading is instructed for the two images by the mouse, and the instructed positions are stored in the memory 14.

(5) Calculating the puncturing distance from the shadow position The distance is calculated by the biopsy puncturing position calculating means.

(6) Puncture distance output The puncture distance is displayed on the CRT screen or panel. In order to confirm the biopsy puncture status, confirmation imaging is performed using ultra-low dose X-rays. The image is exposed and stored in the memory 14 as in the case of the puncture distance calculation. In addition, the shadow pointing position at the time of puncturing distance calculation is indicated in the overlay memory 110 and is displayed over the image. Next, an operation in a resection / biopsy test using a scalpel will be described.

に お い て In the above-mentioned biopsy (biopsy test), if the lesion is excised with a scalpel, the state of the lesion can be observed most reliably. However, the invasion of the patient is very large.

マ ン When performing such examinations, mammography is mainly used for confirmation work. The operation of the system in the interpretation work will be described below.

選 択 Select “Biopsy” on the third panel of the operation panel 90.

(1) Setting of resected specimen Set the resected specimen.

(2) X-ray irradiation X-rays are irradiated under the imaging conditions of the resected specimen.

(3) Store the image in the memory 14.

(4) Image reading, image reading from the density correction memory 14, and correction of the image density as described above.

(5) CRT display As shown in FIG. 69, an image of the resected specimen 300 is displayed on the CRT 100. Next, the operation in image interpretation for follow-up will be described.

When inspections are being conducted regularly, past inspection data is used for comparison. The operation of the system in such a reading operation will be described below.

Select “Follow-up interpretation” on the second panel of the operation panel 90.

(1) A list of patients whose examination has been completed is displayed on the examination information input panel. Select patient X.

(2) Obtain past test data from the database or PACS.

A past examination of the patient X is selected from the examination history, searched in the database and transferred to the memory 14. It is also assumed that an unread image has already been stored in the memory 14.

(3) Screen Creation When the CRT 100 is used in an auxiliary manner, the way of arranging the images is determined according to Table 5 for the radiologist Y, and as shown in FIG. To the laser writing device 110. Further, the abnormal shadow detection unit may detect an unread image as in the case of normal image reading. Only when no abnormality is detected in the past image and when abnormality is detected in the unread image, the result may be output as shown in FIG.

(5) CRT output or film output (3) The screen created by screen creation is output to the CRT 100 or the film 102.

動作 Next, the operation when performing maintenance work corresponding to detector deterioration will be described.

装置 In order to keep the quality of the mammogram constant at a high level, it is necessary to frequently perform maintenance and inspection of the equipment. The operation of the operation system that can easily perform high-precision maintenance on the detector 42 that affects the imaging performance will be described for the following two cases. The maintenance of the detector 42 includes automatic maintenance performed every time the system is started and maintenance performed by a user (photographing technician) at appropriate intervals.

In the automatic maintenance performed every time the system is started, first, the image data on the detector 42 is reset, and the dark image data is collected. The dark image data is obtained without exposure to X-rays for a certain period of time. After resetting, X-rays are emitted for a certain period of time to collect X-ray exposure data. The difference between the pixel values of the collected X-ray exposure data and the dark data is determined, and a pixel having a certain difference or more is determined to be a flaw. When a flaw is detected, if the flaw is a single flaw, the data of an adjacent pixel is corrected as it is as a pixel value. If the scratch exceeds a certain value, it is judged that the deterioration is large, and a warning mark or the like is displayed on the CRT 100 or the operation panel 90. In the maintenance performed by the user (photographing technician) at appropriate intervals, first, “maintenance” is selected on the fourth panel as shown in FIG. Next, under test conditions, X-rays are test-irradiated, and the obtained data is stored in the memory 14. A reference image is stored in the system disk 12 in advance, and a difference between data obtained by X-ray test exposure and the reference image is obtained. If the pixel has a difference equal to or more than a certain value, it is determined to be a flaw. The correction is performed in the case of a single flaw or the like, and the data of the adjacent pixel is directly used as the value of the pixel. If the scratch exceeds a certain value, it is judged that the deterioration is large, and a warning mark or the like is displayed on the CRT 100 or the operation panel 90. Next, the case where PACS is used will be described.

When information such as patient information or examination information is obtained from an external system, for example, RIS data from the RIS is transferred to the PACS system via the gateway.

汎 用 When reading mammogram images using a general-purpose workstation, the general-purpose workstation has a mammogram reading function as one application.

(Embodiment 2) Next, a second embodiment will be described. In the second embodiment, a system in which a network function is applied to a basic system (referred to as a modality system) will be described.

FIG. 72 is a block diagram showing the device configuration of the modality system. The modality system has a configuration in which a mammography imaging device 210, a digitizer 220, an imager 230, a database 240, and a mammogram interpretation workstation 250 are connected to each other via a local area network (hereinafter abbreviated as LAN) 200. It has become. The LAN 200 has a function of transferring data and commands input and output between the devices at high speed.

The modality system differs from the basic system of the first embodiment in that the image capturing system and the image output system are distributed via a network. Therefore, the output device 10 in the basic system is not provided in the present system. The CRT 260 is simply for confirming the photographed image, and the photographed image is interpreted by the mammogram interpretation workstation 250. The film output of the captured image is performed by the imager 230.

FIG. 73 is a block diagram showing the internal configuration of the mammography imaging apparatus 210. The mammography imaging device 210 includes an X-ray generation device 211, an X-ray detection device 212, an input device 213, an RIS (I / F) unit 214, a memory 215, a ROM 216, an optical disk 217, a LAN I / F unit 218, and a control device 219. The CRT 260 for image confirmation is connected.

The X-ray generator 211 and the X-ray detector 212 are the same as those in the first embodiment. Further, the mammography imaging device 210 includes an optical disk 213 that holds image data and the like obtained by the X-ray detection device 211. This makes it possible to transfer image data off-line without going through the LAN 200.

@Data from the RIS is input to the system by the RISI / F unit 8.

The photographing confirmation CRT 211 confirms an image immediately after photographing and corrects the image density.

FIG. 74 is a block diagram showing the internal configuration of the digitizer 220. The digitizer 220 includes a film feed / laser irradiation control unit 221, a data reading unit 222, an input device 223, a memory 224, a ROM 225, a LAN I / F unit 226, and a control device 227.

(4) The film feed / laser irradiation control unit 221 and the data reading unit 222 digitize data of an analog film that has not been digitized, such as a past image. The digitized data is transferred from the data reading unit 222 to the LAN 200 via the memory 224 and the LAN I / F unit 226.

The input device 223 has a function of inputting identification information for inputting film identification.

FIG. 75 is a block diagram showing the internal configuration of the imager 230. The imager 230 includes a film feed / laser irradiation / film development control unit 231, a data writing unit 232, an input device 233, a memory 234, a ROM 235, a LAN I / F unit 236, and a control device 237.

The imager 230 inputs image data from the LAN 200 and outputs the image data to a film. The image data is sent from the LAN 200 to the data writing unit 232 via the LAN I / F unit 236 and the memory 234. The data writing unit 232 sends image data to the film feeding / laser irradiation / film development control unit 231 to control writing on the film.

(5) The film feed / laser irradiation / film development control unit 231 writes image data to the film by laser, develops the film, and discharges the film. Very high-definition images can be drawn on film. The beam diameter of the laser for writing on the film is arbitrarily changed, and the screen data is written according to the size of the film.

FIG. 76 is a block diagram showing the internal configuration of the database 240. The database 240 includes an optical disk 242, a hard disk 243, a memory 241, a ROM 244, a LAN I / F unit 245, and a control device 246.

The database 240 stores the past image and other inspection images on the hard disk 243 or the optical disk 242 of the optical disk changer. The stored image can be retrieved from the hard disk 243 or the optical disk 242 of the optical disk changer using the ROM 244 with the patient name (patient ID) or the like as a key. The searched image is transferred to the LAN 200 via the memory 241 and the LAN I / F unit 245, and the LAN 200 further transfers the image to an external device.

FIG. 77 is a block diagram showing the internal configuration of the mammogram interpretation workstation 250. The mammogram interpretation workstation 250 includes a LAN I / F unit 251, a system disk 252, an input device 253, a memory 254, a CRT 255, and a control device 256.

The mammogram interpretation workstation 250 has a function equivalent to that of the operation panel 90 described in the first embodiment, a function of inputting an instruction from an operator through a touch screen, and outputs a mammogram image for image interpretation. Has functions.

The system disk 252 is the same as the system disk 12 described in the first embodiment, has various control programs, and executes various functions such as image processing by the control programs.

As described above, according to the second embodiment, since the network function is added to the basic system, the image capturing system and the image output system can be configured separately, and the load in the system can be distributed. . It is also easy to add another device or replace a certain device with a device having higher performance.

(Embodiment 3) Next, a third embodiment will be described.

In the third embodiment, a system in which PACS is applied to a basic system (referred to as a PACS system) will be described.

FIG. 78 is a block diagram showing a device configuration of the PACS system. The PACS system includes a mammography imaging device 280, a gateway 281, a gateway 282, a digitizer 283, an imager 284, a database 285, and a workstation 286.

The mammography imaging device 280, digitizer 283, imager 284, and database 285 are devices equivalent to the modality system described above. On the other hand, the workstation 286 is not a dedicated device for handling a mammogram image, unlike the above-described interpretation workstation 250 of the modality system.

The CRT 287 is a device for confirming an image, and a mammogram image is interpreted by a workstation 286.

Unlike the modality system described above, the PACS system can be connected to another modality 288 via the gateway 281. Information from the RIS 289, such as inspection request information, is once input to the PACS system via the gateway 282.

(Embodiment 4) Next, a fourth embodiment will be described. In the fourth embodiment, other system variations will be described.

FIG. 79 is a block diagram showing a schematic configuration of an abnormality detection (diagnosis support) system. The anomaly detection system digitizes the analog film with a digitizer 260 and detects anomalous shadows with a workstation 262.

The detected abnormal shadow is output to the CRT 268 or the imager 264. With the above configuration, the system becomes simple.

最 も The simplest system that does not indicate the detected abnormal position and simply emits a warning sound is also conceivable.

FIG. 80 is a block diagram showing a schematic configuration of the photographing system. The imaging system includes a mammography imaging device 270, an imager 272, and a CRT 274. The photographing system has only a function of correcting the density of a photographed image and outputting the result, and the handling is the same as that of a conventional screen / film system.

The present invention is not limited to the above-described embodiment, and can be implemented with various modifications. For example, the arrangement of the images is the same when an abnormality is detected in one of the images captured in the “CC” or “ML” direction, for example, when an abnormality is detected in the “CC” image. The “ML” images of the part may be displayed side by side, or, for example, when detected in the “ML” image, the “CC” images of the same part may be displayed side by side.

In displaying the result of detection of an abnormal shadow by CAD, even when an “CC” image or an “ML” image is displayed, if an abnormality is detected, the fact may be output. Further, an image indicating the abnormal shadow may be created next to the original image (mammogram image), and the image may be displayed so as to be superimposed on the original image. In that case, the size of the image to be superimposed is the same as or smaller than the original image. Further, character information indicating an abnormal shadow may be output next to the original image or the processed image.

FIG. 1 is a block diagram showing a schematic configuration of a basic system according to a first embodiment of the mammography apparatus according to the present invention. FIG. 1 is a perspective view showing an appearance of a basic system 1. FIG. 2 is a block diagram schematically showing an internal configuration of the X-ray generator 2. The figure which shows the characteristic for determining the hardness of the breast. The figure for demonstrating the detection of the size of a breast. FIG. 4 is a diagram illustrating an example of an operation panel for selecting a size of a film. The figure which shows the data collection point for AEC in a plane detector. The figure which shows the detector 46 for AEC for collecting AEC data, without performing destructive reading of detector data. Sectional drawing which looked at the mechanism part which presses a breast with the compression board 3 from the side. The figure which shows an example of the drive method of the compression part 48. FIG. 2 is a block diagram showing a schematic configuration of a breast compression mechanism. The figure which shows the process which compresses a breast in connection with X-ray irradiation. The figure which shows the process which compresses a breast in connection with X-ray irradiation. FIG. 2 is a block diagram schematically showing an internal configuration of the X-ray detection device 4. FIG. 2 is a circuit diagram showing a configuration of a TFT flat panel detector. FIG. 9 is a diagram illustrating a screen transition of the operation panel 90. The figure which shows the examination (patient) list panel displayed on the operation panel. FIG. 4 is a diagram showing an operation panel for performing input for output screen control. FIG. 3 is a perspective view of an image selection panel. The perspective view of the selection panel of the detailed display ROI. The figure which shows an image interpretation doctor ID input panel. FIG. 2 is a block diagram showing an internal configuration of the output device 10. FIG. 3 is a diagram illustrating an example of an output film 102. The figure which shows the histogram of a normal breast (breast). The figure which shows the histogram of the breast (dens breast) with a dense mammary gland area. FIG. 4 is a diagram showing a minute area of n pixels × n pixels. The figure showing the relationship between a pixel value and a gray scale (luminance). The figure which shows roughly the flow until the image of right and left breast is displayed or output. FIG. 9 is a diagram showing a specific example of the processing of the density equalization processing unit 130. The figure which shows the ROI for enlarged display, and the locus | trajectory of the position movement of ROI center. The figure which shows the locus | trajectory when the position movement of ROI center is performed continuously. The figure which shows a mode that the breast outline 138 is approximated by a polygon. The figure which shows the example of the enlarged display by the set ROI133. FIG. 9 is a diagram showing an example of contrast enhancement by a set ROI 133. The figure which shows the locus | trajectory of ROI position movement according to various mammogram images. The figure which shows the relationship between a pixel value and a gray scale. The figure which shows a breast area. FIG. 9 is a diagram for obtaining a contour angle 144. The figure which showed the kind of imaging | photography direction. The figure which shows the classification of the arrangement | positioning method of the image on the screen. The figure which showed the mode of arrangement | positioning of the image of doctor A. The figure which showed the mode of arrangement | positioning of the image of doctor B. The figure which showed the mode of arrangement | positioning of the image of doctor C. The figure which shows the size processing of image data. FIG. 7 is a schematic diagram of a screen in which an abnormal shadow detection result is shown from outside the image. The figure which shows a mode that the current image and the previous image (past image) are arrange | positioned on the screen of two CRTs, respectively. FIG. 3 is a diagram for explaining contrast adjustment. The figure which shows the screen which displayed the abnormal shadow. The figure which looked at the C arm and the C arm support part from the side. FIG. 4 is a block diagram schematically showing processing for automatically recognizing a shooting method. The perspective view which shows the outline of the mechanism which recognizes a rotation angle automatically. The figure which shows the determination method of a photography condition. The figure which shows the other example of automatic recognition of a rotation angle. The figure which shows the press pad used for a biopsy inspection. The figure which shows the attitude | position of a C arm schematically. FIG. 3 is an external view showing a posture of a C-arm. The figure which showed a mode that the needle is inserted in the diseased part of the breast. The figure which shows the profile acquisition line set on the detector. The figure which shows the profile acquisition line "a" and the profile acquisition line "c". The figure which shows the screen for a doctor to instruct | indicate the analysis of a shadow (analysis of abnormality). The figure which shows the coordinate system of image data. The figure which shows the coordinate system of CRT and a film. The figure which shows the coordinate of the detected microcalcification shadow and the mass shadow. The figure which shows the screen on which the CAD result and the ROI of the enlarged display were displayed. FIG. 4 is a diagram showing an initial screen displayed on an operation panel. The figure which shows the screen which superimposedly displayed the abnormal shadow detection result on the image. FIG. 4 is a diagram showing a display of an ROI and a display of a CRT on an operation panel. The figure which shows the screen which displayed two images side by side. The figure which shows the image of a resected specimen. The figure which shows the screen which arranged the unread image and the past image. The figure which shows the screen which arranged the unread image and the past image which the abnormal shadow was output. FIG. 6 is a block diagram showing a schematic configuration of a modality system according to a second embodiment of the mammography apparatus according to the present invention. FIG. 2 is a block diagram showing an internal configuration of the mammography imaging apparatus 210. FIG. 2 is a block diagram showing an internal configuration of the digitizer 220. FIG. 2 is a block diagram showing an internal configuration of an imager 230. FIG. 2 is a block diagram showing an internal configuration of a database 240. FIG. 2 is a block diagram showing the internal configuration of a mammogram interpretation workstation 250. FIG. 7 is a block diagram showing a schematic configuration of a PACS system according to a third embodiment of the mammography apparatus according to the present invention. FIG. 13 is a block diagram showing a schematic configuration of an abnormality detection (diagnosis support) system according to a fourth embodiment of the mammography apparatus according to the present invention. FIG. 9 is a block diagram showing a schematic configuration of an imaging system according to a fourth embodiment of the mammography imaging apparatus according to the present invention. FIG. 1 is a block diagram showing a schematic configuration of a conventional PACS system.

Explanation of reference numerals

DESCRIPTION OF SYMBOLS 1 ... Basic system, 2 ... X-ray generator, 3 ... Compression board, 4 ... X-ray detector, 5 ... C arm, 6 ... Input device, 8 ... RISI / F part, 10 ... Output device, 12 ... System Disk, 14: Memory, 16: Central processing unit, 18: Bar code reader, 20: X-ray tube, 22: High pressure generator, 24: X-ray controller, 26: Filter switching unit, 28: Compression pressure control unit, 30 ... AEC, 32 ... Photo sensor, 34 ... Control panel, 36 ... Thickness data, 38 ... Optical detector, 39 ... Light beam, 40 ... Reflector, 42 ... Flat detector, 44 ... Data collection point, 48 ... Compression Part, 49 ... compression plate support part, 50 ... pressure sensor, 52 ... control part, 54 ... movable part, 56 ... set value, 60 ... read time setting device, 62 ... timing generation device, 64 ... drive device, 68 ... read Equipment, 70 A / D converter, 72 readout range setting device, 73 array, 76 gate line, 78 data line, 80 FET, 82 sensor, 90 operation panel, 92 schema, 94 image selection panel 95, mechanical switch, 96, detailed display ROI selection panel, 98, ID input device, 100, CRT, 102, film, 104, image reduction / enlargement processing unit, 106, screen creation unit, 108, frame memory, 110: overlay memory, 112: display management unit, 114: D / A conversion unit, 116: barcode generation unit, 118: laser writing device, 120: barcode, 122: ROI, 124: image data, 126: before conversion , 128: straight line after change, 129: image memory bank, 130: density equalization unit, 132: composite image, 1 3 ROI, 134 average value calculation unit, 135 division unit, 136 image calculation unit, 137 outline unit, 138 breast outline, 139 first closed curve, 140 second closed curve, 145 screen 146: Mammogram image, 147: Marker, 148: Abnormality (shading), 149: Number of detected abnormalities, 150: Other markers, 152: Identifier, 154: C-arm support, S1: C-arm angle recognition processing .., S2... Shooting direction determination processing, S3... Determination condition input processing, S4... Accompanying information writing processing, S5... Manual input / correction processing, 156. 164: first electrode, 166 ... second electrode, 168 ... pressure pad, 170 ... window, 172 ... diseased part, 174 ... needle, 176 ... biopsy irradiation field, 178 ... profile acquisition line , 180: microcalcification shadow, 300: resected specimen.

Claims (7)

Input means for inputting a mammogram image;
Area setting means for setting a plurality of areas based on the outline of the breast on the mammogram image input by the input means,
An image processing means for performing predetermined image processing for each of the set areas. The mammography apparatus according to claim 1, wherein the image processing unit performs at least one of an enlargement process, a contrast enhancement process, and a frequency enhancement process. The mammography apparatus according to claim 1, wherein the area setting means sets a plurality of areas so as to cover all of the object areas on the mammogram image. 4. The mammography apparatus according to claim 3, further comprising an operation unit that changes a position of the area set by the area setting unit. A detection unit that detects an abnormal shadow from the mammogram image input by the input unit,
2. The mammography apparatus according to claim 1, wherein the image processing unit performs a predetermined image process on an image of a region including the abnormal shadow detected by the detection unit. The mammography apparatus according to claim 5, wherein the position of the center of the region is a position where the abnormal shadow is detected. 6. The image processing unit according to claim 5, wherein at least one of an enlargement process, a contrast enhancement process, and a frequency enhancement process is performed, and the content of the image process is determined according to the type of the detected abnormality. The mammography apparatus according to claim 1.

Images