JP2008061766A - Medical diagnosis device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical diagnosis device capable of improving a diagnosis precision. <P>SOLUTION: The medical diagnosis device is provided with an additional information calculation part 16. The additional information calculation part 16 obtains additional information (SUB after correction and a presence probability) which is the information additional to images and information. Since the additional information is obtained on the basis of a measured value quantitatively measured in a first measurement part 14 and a measured value quantitatively measured in a second measurement part 15, when a diagnosing doctor mutually merges the respective measured values which are conventionally turned to individual diagnostic materials as the additional information and makes a medical diagnosis on the basis of not only the respective measured values but also the additional information, the diagnosis precision is improved. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a medical diagnostic apparatus that performs medical diagnosis.

  There is a whole body screening test as a medical diagnostic device. As a method of whole body screening test, there are mainly morphological image diagnosis, functional image diagnosis, biochemical test and the like. Examples of morphological image diagnosis include X-ray CT (Computed Tomography), MRI (Magnetic Resonance Imaging), and ultrasound. Examples of functional image diagnosis include PET (Positron Emission Tomography) and SPECT (Single Photon Emission CT) (see, for example, Patent Document 1). Biochemical tests include, for example, tumor marker tests (see, for example, Patent Document 2 and Non-Patent Documents 1-4). In morphological image diagnosis, X-rays, a magnetic field, and ultrasonic waves are mainly irradiated from the outside to capture a reaction with a subject (for example, a human body) and to image and quantify it. In functional imaging diagnosis, what is emitted from the inside of a subject is mainly captured and imaged and quantified. The biochemical test quantifies and quantifies biological changes in the living body contained in urine and serum.

  As an example of cancer screening using the above-described diagnosis and examination, first, a tumor marker test with a low burden is performed, and a functional diagnosis or a morphological diagnosis is performed on a person who is highly suspected of cancer from the result of the tumor marker test. . In addition, as described in Non-Patent Document 2, there are cases where all of these are performed in a medical checkup or the like, and a biochemical test is sometimes performed. Here, the tumor marker is a biomarker that is an index of biochemical examination, and is mainly specific to a tumor. In the clinical laboratory, the collected blood is applied to an automatic analyzer, and the target tumor marker is examined.

  In addition, as an example of the therapeutic effect determination using the above-described diagnosis and examination, if the tumor marker value once decreased but not found in PET or CT after cancer treatment, suspected cancer metastasis Anticancer drug treatment may be performed.

  In this way, diagnosis is performed using a plurality of examination means as described in Non-Patent Documents 1, 2, and 4, rather than using a single examination means in whole-body screening screening for cancer and determination of therapeutic effect. That is more common. In particular, in the case of a tumor marker, the tumor marker value changes according to individual differences, and varies depending on the physical condition, sleep and meal timing, cigarettes and other diseases. Diagnose in combination with CT.

In addition, by capturing a region of interest including cancer tissue over time and acquiring an image including the cancer tissue, identifying a biomarker of the cancer tissue in the image, and further obtaining a quantitative measurement value, There is also a technique for quantitatively evaluating cancer and temporal changes of cancer (see, for example, Patent Document 3).
Japanese Patent Laid-Open No. 07-113873 International Publication No. WO01 / 020333 Pamphlet JP-T-2005-516634 “Tumor marker”, [online], March 10, 2006, National Cancer Center, Internet <URL: http://www.ncc.go.jp/jp/ncc-cis/pub/diagnosis/010601.html > “Kansai Medical Net: Examination Contents of Cancer Screening and Comprehensive Medical Dock including PET”, [online], Kansai Medical Net, Internet <URL: http://www.k-medicalnet.co.jp/pet/petcourse /index.html> Masatoshi Tanno, “Tumor Marker List”, [online], Tanno Clinic, Internet <URL: http://tanno-holistic-medicine-japan.com/html2/mark.html> “Cancer Test: Tumor Marker Test”, [online], Hakusan Street Clinic, Internet <URL: http://www.hakusan-s.jp/kensa/syuyou/>

  However, the above-described diagnosis and examination have advantages and disadvantages. In particular, it is necessary to combine a plurality of diagnoses and examinations as described above for early cancer detection and treatment effect determination. In particular, the quantitative value of the biochemical test is evaluated in comparison with other diagnoses and tests, and is diagnosed based on the evaluation. That is, diagnostic materials are individually obtained for each examination, and the diagnostician makes an independent judgment and evaluates them. The reason is that the quantitative values obtained by morphological diagnosis do not change very rapidly with respect to time, but the quantitative values obtained by functional diagnosis and biochemical tests are as described above, such as physical condition, sleep and meal timing, and tobacco. This is because it is a value that fluctuates even in other diseases, and the correlation and reliability of quantitative values of both morphological diagnosis and functional diagnosis or biochemical examination, which have large time changes, will be lost over time. .

  This invention is made | formed in view of such a situation, Comprising: It aims at providing the medical diagnostic apparatus which can improve a diagnostic precision.

As a result of intensive studies to solve the above problems, the inventors have obtained the following knowledge.
That is, a biological morphological image typified by CT tomographic images and absorption correction data, or a biological functional image typified by PET tomographic images and PET projection data, and a biological body typified by body fat percentage and blood glucose level Correlation and reliability with basic information or biochemical information represented by tumor marker values are lost over time, so they did not merge with each other, but tried to merge. When the information obtained by the fusion is used as additional information, the additional information also loses its correlation and reliability over time, but the morphological image diagnosis or functional image diagnosis and the examination or If the time difference from the biochemical test for obtaining biochemical information is small, the correlation and reliability of the additional information are not easily lost. In other words, if additional information is obtained by actively merging between the two, it has been found that the diagnostic accuracy can be improved based on the additional information.

The present invention based on such knowledge has the following configuration.
That is, the invention according to claim 1 is a medical diagnostic apparatus that quantitatively measures from at least one of a biomorphic image obtained from morphological image diagnosis and a biofunctional image obtained from functional image diagnosis. First measurement means for obtaining measurement values, second measurement means for obtaining measurement values quantitatively from at least one of the basic biological information and biochemical information, and quantitative measurement by the first measurement means Output means for outputting a plurality of measured values and the measurement values quantitatively measured by the second measuring means, and additional information calculating means for obtaining additional information that is additional information to the image and information The additional information is obtained based on the measurement value quantitatively measured by the first measurement means and the measurement value quantitatively measured by the second measurement means, and is based on each measurement value and the additional information. The It is characterized in carrying out the care diagnosis.

  [Operation and Effect] According to the first aspect of the present invention, the first measuring means, the second measuring means, and the output means are provided. The first measuring unit obtains a measurement value by quantitatively measuring from at least one of a biomorphic image obtained from morphological image diagnosis and a biofunctional image obtained from functional image diagnosis. The second measuring means obtains a measurement value by quantitatively measuring from at least one of the basic biological information and biochemical information. The output means outputs a plurality of measurement values quantitatively measured by the first measurement means and measurement values quantitatively measured by the second measurement means. By outputting each of these measured values, it is used for browsing medical diagnosis. Furthermore, an additional information calculation unit is provided, and the additional information calculation unit obtains additional information that is additional information to the image and the information. This additional information is obtained on the basis of the measurement value quantitatively measured by the first measurement means and the measurement value quantitatively measured by the second measurement means. The diagnosis accuracy can be improved by performing medical diagnosis based on not only each measurement value but also the additional information as the additional information by fusing the respective measurement values.

  In the above-described invention, it is preferable that the output means described above newly outputs additional information (the invention according to claim 2). By outputting additional information anew, it is possible to provide more accurate medical diagnosis.

  In these inventions described above, the output means may be a display means for display output represented by a monitor (the invention according to claim 3), or a printing means for print output represented by a printer. There may be.

  According to the medical diagnostic apparatus of the present invention, it is provided with the additional information calculating means for obtaining additional information that is additional information to the image and information, and this additional information is quantitatively measured by the first measuring means. Since the measurement value is obtained based on the measurement value and the measurement value quantitatively measured by the second measurement means, each measurement value individually made by the diagnostician as a diagnostic material is mutually fused as additional information. By performing a medical diagnosis based not only on the value but also on the additional information, the diagnostic accuracy can be improved.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 is a side view and a block diagram of a PET (Positron Emission Tomography) apparatus according to an embodiment. In the present embodiment, a PET apparatus will be described as an example of a medical diagnostic apparatus, and the biomorphic image, basic biological information, and biochemical information obtained from morphological image diagnosis are supplied to the PET apparatus from outside the PET apparatus. The medical diagnosis is performed by the controller 7 of the PET apparatus. In this embodiment, X-ray CT is taken as an example for morphological image diagnosis, tumor marker examination is taken as an example for biochemical examination, and body fat percentage is taken as an example for basic biological information. explain. Therefore, an external apparatus viewed from the PET apparatus is an X-ray CT apparatus or an automatic analyzer that inspects tumor markers.

  As shown in FIG. 1, the PET apparatus according to the present embodiment includes a top plate 1 on which a subject M is placed. The top plate 1 is configured to move up and down and translate along the body axis Z of the subject M. With this configuration, the subject M placed on the top 1 is scanned from the head to the abdomen and foot sequentially through the opening 2a of the gantry 2, which will be described later. Biological function images such as projection data and tomographic images are obtained.

  In addition to the top plate 1, the PET apparatus according to the present embodiment includes a gantry 2 having an opening 2a, a plurality of scintillator blocks 3a and a plurality of photomultipliers 3b arranged close to each other. . As shown in FIG. 1B, the scintillator block 3 a and the photomultiplier 3 b are arranged in a ring shape so as to surround the body axis Z of the subject M, and are embedded in the gantry 2. The photomultiplier 3b is disposed outside the scintillator block 3a. As a specific arrangement of the scintillator block 3a, for example, two scintillator blocks 3a are arranged in a direction parallel to the body axis Z of the subject M, and many scintillator blocks 3a are arranged around the body axis Z of the subject M. Lined up forms are listed. The scintillator block 3a and the photomultiplier 3b constitute a γ-ray detector 3 for projection data (also referred to as “emission data”) to be described later.

  In this embodiment, a point source 4 and a γ-ray detector 5 for absorption correction data (also referred to as “transmission data”) to be described later are provided. The γ-ray detector 5 for absorption correction data is composed of a scintillator block and a photomultiplier, like the γ-ray detector 3 for projection data. The dotted line source 4 is a radiation source for irradiating a radioactive drug to be administered to the subject M, that is, a radiation of the same kind as the radioisotope (RI) (in this embodiment, γ rays), and is disposed outside the subject M. Has been. In this embodiment, it is embedded in the gantry 2. The dotted line source 4 rotates around the body axis Z of the subject M.

  In addition, the PET apparatus according to the present embodiment includes a table driving unit 6, a controller 7, an input unit 8, an output unit 9, a projection data deriving unit 10, an absorption correction data deriving unit 11, and an absorption correcting unit 12. Unit 13, first measurement unit 14, second measurement unit 15, additional information calculation unit 16, memory 17, and cable 18.

  The controller 7 comprehensively controls each part constituting the PET apparatus according to the present embodiment. The controller 7 includes a central processing unit (CPU).

  The input unit 8 sends data and commands input by the operator to the controller 7. The input unit 8 includes a pointing device represented by a mouse, a keyboard, a joystick, a trackball, a touch panel, and the like. The output unit 9 includes a display unit represented by a monitor, a printer, and the like. The output unit 9 corresponds to the output means in the present invention, and in particular, the monitor corresponds to the display means.

  The memory unit 17 is composed of a storage medium represented by ROM (Read-only Memory), RAM (Random-Access Memory), and the like. In the present embodiment, the biological function image processed by the projection data deriving unit 10 and the reconstruction unit 13, the absorption correction data obtained by the absorption correction data deriving unit 11, and the data transferred from the outside via the cable 18. CT tomographic image, tumor marker value, body fat percentage, variance and average of SUV (Standardized Uptake Value) within the region of interest ROI (Region Of Interest) determined by the first measurement unit 14, and second measurement The positive parameters and tumor existence probabilities obtained by the unit 15 and the corrected existence probabilities obtained by the additional information calculation unit 16 are written and stored in the RAM, and read from the RAM as necessary. The ROM stores in advance a program for performing a medical diagnosis including nuclear medicine diagnosis in various PETs, and the controller 7 executes the program to perform a medical diagnosis according to the program. .

  In the present embodiment, the memory unit 17 has been transferred from the outside via the cable 18 and the PET data memory unit 17 a that temporarily stores the biological function image processed by the projection data deriving unit 10 and the reconstruction unit 13. A CT data memory unit 17b that temporarily stores CT tomographic images, a bio / biochemical information memory unit 17c that temporarily stores tumor marker values and body fat percentage transferred from the outside via the cable 18, and a first A first measurement value memory unit 17d that temporarily stores the dispersion and average of the SUVs in the ROI obtained by the first measurement unit 14, and a first parameter that temporarily stores the positive parameters and the tumor existence probability obtained by the second measurement unit 15. 2 includes a measured value memory unit 17e and an additional information memory unit 17f that temporarily stores the existence probability after correction obtained by the additional information calculation unit 16 (see FIG. 2).

  The projection data deriving unit 10, the absorption correction data deriving unit 11, the absorption correcting unit 12, the reconstruction unit 13, the first measuring unit 14, the second measuring unit 15, and the additional information calculating unit 16 include, for example, the memory unit 17 described above This is realized by the controller 7 executing a program stored in a ROM of a storage medium represented by the above or a command input by a pointing device represented by the input unit 8 or the like.

  The γ-rays generated from the subject M to which the radiopharmaceutical is administered are converted into light by the scintillator block 3a, and the converted light is photoelectrically converted by the photomultiplier 3b and output to an electrical signal. The electric signal is sent to the projection data deriving unit 10 as image information (pixel).

  Specifically, when a radiopharmaceutical is administered to the subject M, two γ rays are generated due to the disappearance of the positron of the positron emission type RI. The projection data deriving unit 10 checks the position of the scintillator block 3a and the incident timing of the γ-ray, and sends it only when γ-rays are simultaneously incident on the two scintillator blocks 3a that are opposed to each other across the subject M. The obtained image information is determined as appropriate data. When γ-rays enter only one of the scintillator blocks 3a, the projection data deriving unit 10 treats them as noise instead of γ-rays generated by annihilation of the positron, and determines that the image information sent at that time is also noise. Reject.

  The image information sent to the projection data deriving unit 10 is sent to the absorption correction unit 12 as projection data. Absorption correction data (transmission data) sent from the absorption correction data derivation unit 11 to the absorption correction unit 12 is applied to the projection data sent to the absorption correction unit 12 to absorb γ rays in the body of the subject M. The projection data is corrected in consideration of the above.

  The point source 4 emits γ rays toward the subject M while rotating around the body axis Z of the subject M, and the irradiated γ rays are used as a scintillator block of the γ ray detector 5 for absorption correction data. (Not shown) converts it into light, and the converted light is photoelectrically converted by a photomultiplier (not shown) of the γ-ray detector 5 and output to an electrical signal. The electric signal is sent to the absorption correction data deriving unit 11 as image information (pixel).

  Absorption correction data is obtained based on the image information sent to the absorption correction data deriving unit 11. The absorption correction data deriving unit 11 uses the calculation representing the relationship between the absorption coefficient of γ-rays or X-rays and the energy, so that the projection data for CT, that is, the distribution data of the X-ray absorption coefficient is converted into the γ-ray absorption coefficient. By converting to distribution data, the distribution data of the γ-ray absorption coefficient is obtained as absorption correction data. The derived absorption correction data is sent to the absorption correction unit 12 described above.

  The corrected projection data is sent to the reconstruction unit 13. The reconstruction unit 13 reconstructs the projection data to obtain a tomographic image taking into account the absorption of γ rays in the body of the subject M. Thus, by providing the absorption correction unit 12 and the reconstruction unit 13, the projection data is corrected based on the absorption correction data and the tomographic image is corrected. The corrected tomographic image is sent to the output unit 9, the first measurement unit 14, the second measurement unit 15, the additional information calculation unit 16, the memory unit 17, and the like via the controller 7.

  Next, the first measurement unit 14, the second measurement unit 15, the additional information calculation unit 16, and the data flow related thereto will be described with reference to FIG. 2. FIG. 2 is a block diagram schematically showing a flow of data related to the first measurement unit 14, the second measurement unit 15, the additional information calculation unit 16, and the like.

  The biological function image processed by the projection data deriving unit 10 (see FIG. 1) and the reconstruction unit 13 is written into the PET data memory unit 17a and temporarily stored. Further, the CT tomographic image transferred from the outside via the cable 18 is written in the CT data memory unit 17b and temporarily stored. A biofunction image is appropriately read from the PET data memory unit 17a, and a biomorphic image typified by a CT tomographic image is appropriately read from the CT data memory unit 17b, and quantitatively calculated from the biofunction image and the biomorphic image. First measurement unit 14 obtains a measurement value. In the present embodiment, the first measurement unit 14 obtains the dispersion and average of SUVs in the ROI as measurement values.

  On the other hand, the tumor marker value and body fat percentage transferred from the outside via the cable 18 are written in the bio / biochemical information memory unit 17c and temporarily stored. The biochemical information typified by the tumor marker value and the biological basic information typified by the body fat percentage are appropriately read out from the biological / biochemical information memory unit 17c, and quantitatively measured from the biological basic information and biochemical information. 2 The measurement part 15 obtains a measured value. In the present embodiment, the second measurement unit 15 obtains a positive parameter or a tumor existence probability as a measurement value.

  The dispersion and average of the SUV in the ROI obtained by the first measurement unit 14 are written in the first measurement value memory unit 17d and temporarily stored. Further, the positive parameter and the tumor existence probability obtained by the second measurement unit 15 are written in the second measurement value memory unit 17e and temporarily stored. The dispersion of the SUV in the ROI is read from the first measurement value memory unit 17d as appropriate, and the probability of tumor existence is read from the second measurement value memory unit 17e as appropriate, and the ROI measured quantitatively by the first measurement unit 14 The additional information calculation unit 16 corrects the existence probability based on the dispersion based on the dispersion of the SUV and the existence probability of the tumor quantitatively measured by the second measurement unit 15 to obtain the existence probability after correction.

  The existence probability after correction obtained by the additional information calculation unit 16 is written in the additional information memory unit 17f and temporarily stored. Thus, the first measuring unit 14 corresponds to the first measuring unit in the present invention, the second measuring unit 15 corresponds to the second measuring unit in the present invention, and the additional information calculating unit 16 in the present invention. It corresponds to additional information calculation means.

  Next, a specific flow of medical diagnosis will be described with reference to FIG. 3, and each value related to medical diagnosis will be described with reference to FIGS. 4 to 7. FIG. 3 is a flowchart showing a flow of a series of medical diagnoses according to the embodiment, FIG. 4 is a list for obtaining positive parameters, and FIG. 5 is a tumor name (malignant disease), a tumor marker name, and an expectation FIG. 6 is a list for obtaining the existence probability of a tumor for each tumor name (malignant disease), and FIG. 7 is a diagram showing the relationship between the body fat percentage and the SUV correction coefficient. It is.

(Step S1) Calculate the existence probability of the tumor based on the tumor marker value The tumor marker value transferred from the outside via the cable 18 is written in the biological / biochemical information memory unit 17c and temporarily stored, and the biological / biochemical The information is read from the information memory unit 17c as appropriate. Based on the tumor marker value, the second measurement unit 15 quantitatively measures to obtain a positive parameter, and further obtains the existence probability of the tumor.

  Specifically, as shown in FIG. 4, measured values (tumor marker values) and reference values are arranged in a list for each tumor marker, and a positive parameter is obtained for each tumor marker based on the tumor marker value and the reference value.

  The reference value is a known value in advance. This positive parameter is a parameter obtained from various statistical clinical data, and is a parameter depending on the site of the tumor. Hereinafter, y is a tumor site (tumor name), z is a tumor marker name (tumor marker name), and this positive parameter is Ry (z). Further, for convenience of explanation, the positive parameter is unique here regardless of the tumor site, and in FIG. 4, the specific value is appropriately assigned between 0.5 and 2.0.

  If the positive parameter is obtained, the probability that it can exist for each tumor site (tumor name) based on the tumor marker names listed in the list for each tumor name (malignant disease) and the expected positive rate as shown in FIG. That is, the probability of existence of a tumor is obtained. Note that the list shown in FIG. 5 is known in advance based on the inspection methods that have become possible through the application of biotechnology.

  Specifically, as shown in FIG. 6, for each tumor name (malignant disease), each expected positive rate (see also FIG. 5) in the tumor marker and each positive parameter (see also FIG. 4) are associated with each other in a list. Thus, the existence probability of the tumor is obtained based on the expected positive rate and positive parameters.

  Each expected positive rate in the tumor marker is Qy, y in the expected positive rate Qy is a tumor site (tumor name), the factor number is n, the factor number parameter is S (n), and the tumor existence probability is Py And Further, as described above, when Ry (z) is a positive parameter, the tumor existence probability Py is expressed by the following equation (1).

Py = (ΣQy × Ry (z)) / S (k) (1)
However, Σ is the sum of 1 to k, and k is determined by the number of types of tumor marker names. For example, as shown in FIG. 6, the existence probability Py of each tumor can be obtained by the above equation (1). The tumor positive parameter Ry (z) and the existence probability Py thus obtained are written and stored in the second measured value memory unit 17e.

(Step S2) Taking ROI in the biological function image On the other hand, the biological function image processed by the projection data deriving unit 10 (see FIG. 1) and the reconstruction unit 13 is written into the PET data memory unit 17a and temporarily stored. Then, the data is appropriately read from the PET data memory unit 17a. Based on the biological function image, the first measurement unit 14 quantitatively measures and takes a region of interest ROI in the biological function image to obtain the dispersion of the SUV in the ROI as in step S3 described later.

  The region of interest ROI may be set manually, for example, by inputting coordinates for setting the region of interest ROI with the input unit 8 (see FIG. 1), or based on the pixel value of the biological function image or the like. It may be automatically set by calculating a region for dividing the region of interest ROI (see FIG. 1).

(Step S3) Calculation of dispersion of SUV in ROI based on biological function image Next, dispersion of SUV (Standardized Uptake Value) in the region of interest ROI is obtained. At this time, the average is also obtained. Here, when the radioactivity concentration actually measured in a specific region of the body is (A) and the whole body average radioactivity concentration when the whole body uniform distribution of the radioactivity is processed is (B), the SUV is the following (2) It is expressed as an expression.

SUV = A / B (2)
That is, SUV is the radioactivity accumulation magnification in a specific region of the body, and SUV can be obtained at a ratio such as (A / B) as in the above equation (2). In addition, (A) in the above formula (2) is represented by (tissue radiation count [cps] / tissue weight [g]), and (B) in the above formula (2) is (administration radiation count [cps] / It is expressed in weight [g]). For example, if the drug is administered without any bias in the body, the SUV is “1”, and if the drug is accumulated in a certain organ, the organ is “1” such as “2” or “3”. It becomes a bigger numerical value. Thus, by using SUV, it is possible to objectively determine the occurrence or metastasis of cancer.

  More specifically, SUV will be described. Based on the radioactivity per unit amount of the radiopharmaceutical, the total amount of radiopharmaceutical administered to the subject M, and the weight of the subject M, the radiopharmaceutical is administered. The whole-body average radioactivity concentration when it is assumed that the sample M is uniformly distributed throughout the body is calculated. That is, by multiplying the radioactivity per unit amount of the radiopharmaceutical by the total amount of the radiopharmaceutical and dividing the multiplied value by the weight of the subject M (that is, B: (administered radiation count [cps] / weight) [G])), Calculate the whole body average radioactivity concentration. Then, an SUV is obtained by using a tomographic image (for PET) as a biological function image in the region of interest ROI as follows.

  That is, the radioactivity (tissue radioactivity) corresponding to one pixel of the tomographic image for PET is divided by the tissue weight corresponding to one pixel (that is, the weight of water corresponding to one pixel), and Calculate tissue radioactivity concentration. Then, the SUV is calculated by dividing the tissue radioactivity concentration of the subject M by the whole body average radioactivity concentration.

  The dispersion of the SUV can be obtained in the region of interest ROI as follows. That is, assuming that the variance in the ROI is σ, the average in the ROI is Avg, and the total number of pixels in the ROI is N, the variance σ is expressed by the following equation (3).

σ = Σ (SUV−Avg) ² / (N−1) (3)
However, the average Avg in the ROI is represented by Avg = Σ (SUV / N), and is an arithmetic average of the SUV in the ROI. The variance σ and average Avg in the ROI obtained in step S3 after step S2 are written and stored in the first measured value memory unit 17d.

  Note that the SUV may be corrected with the basic biological information. In this case, the corrected SUV corresponds to the additional information in the present invention. Therefore, the additional information calculation unit 16 obtains the corrected SUV by correcting the SUV using the biological basic information, and writes and stores the corrected SUV in the additional information memory unit 17c.

  The body fat percentage will be described as an example of basic biological information. The body fat percentage is determined as follows. That is, the height of the subject M is H, the bioelectrical impedance of the subject M is Z, a is a proportional coefficient determined in advance according to gender and age, W is the weight of the subject M, and the subject M When the fat free weight (weight of tissue other than fat) is LBM and the body fat percentage is FAT, the lean body weight LBM is expressed as the following formula (4), and the body fat percentage FAT is )

LBM = a × H ² / Z (4)
FAT = (W−LBM) / W (5)
However, the unit of FAT is [%]. The lean body mass LBM is obtained by the above equation (4), and the body fat percentage FAT is obtained by the above equation (5) using the lean body weight LBM. The body fat percentage FAT data may be written and stored in the bio / biochemical information memory unit 17c via the cable 18 (see FIG. 1), and the body fat percentage FAT may be read and used for SUV correction.

  The additional information calculation unit 16 corrects the SUV using the body fat percentage FAT. An SUV correction function f (FAT) as shown in FIG. 7 is stored in the memory unit 17 in advance. The SUV correction coefficient α is obtained by substituting the body fat percentage into the correction function f (FAT). Then, the SUV is corrected by multiplying the SUV by the correction coefficient α.

  Such a correction function assumes and creates an object model and is optimized by a separate experiment. As is clear from FIG. 7, the correction coefficient is “1” when the body fat percentage is medium (standard), and is smaller than “1” when the body fat percentage is low, and when the body fat percentage is high. Becomes a value larger than “1”. Therefore, for example, in the case of an obese subject M, even if the SUV is calculated to be low due to the influence of body fat, the SUV is multiplied by a correction coefficient larger than “1” corresponding to the body fat percentage, so that it is evaluated low. SUV is corrected appropriately. When the SUV is corrected using the body fat percentage FAT, the variance σ may be obtained by substituting the corrected SUV into the above (3).

(Step S4) Correction of existence probability by dispersion Based on dispersion ρ of SUV in ROI quantitatively measured by the first measurement unit 14 and existence probability Py of the tumor quantitatively measured by the second measurement unit 15 The additional information calculation unit 16 corrects the existence probability Py by the variance σ as follows. A function for correcting the existence probability Py using the variance σ is defined as f (σ), and correction is performed by multiplying the existence probability Py by the function.

  Thus, the existence probability after correction corresponds to the additional information in the present invention. Therefore, the additional information calculation unit 16 corrects the existence probability using the variance σ, and writes and stores the corrected existence probability in the additional information memory unit 17c.

  The PET apparatus according to the present embodiment having the above-described configuration includes the first measurement unit 14, the second measurement unit 15, and the output unit 9. The first measurement unit 14 includes at least one image of a biomorphic image obtained from morphological image diagnosis and a biofunctional image obtained from functional image diagnosis (in this embodiment, a tomographic image for PET as an example of a biofunctional image, Absorption correction data is quantitatively measured from a kind of biological morphological image) to obtain a measured value (in this embodiment, dispersion or average of SUV in ROI). The second measuring unit 15 quantitatively measures from at least one information of basic biological information and biochemical information (in this embodiment, body fat percentage as an example of basic biological information and tumor marker value as an example of biochemical information). Thus, a measurement value (in this embodiment, a positive parameter or a tumor existence probability) is obtained. The output unit 9 (a display unit represented by a monitor or a printing unit represented by a printer) is measured quantitatively by the first measurement unit 14 and quantitatively measured by the second measurement unit 15. The measured values are output to a plurality (display output for monitor, print output for printing). By outputting each of these measured values, it is used for browsing medical diagnosis (for example, see FIG. 8).

  Furthermore, the additional information calculation unit 16 is provided, and the additional information calculation unit 16 obtains additional information (SUV and existence probability after correction in the present embodiment) that is additional information to the image and the information. Since this additional information is obtained based on the measurement value quantitatively measured by the first measurement unit 14 and the measurement value quantitatively measured by the second measurement unit 15, the diagnostician individually diagnoses the additional information. It is possible to improve the diagnostic accuracy by performing medical diagnosis based on not only each measurement value but also the additional information as the additional information by fusing the respective measurement values as materials.

  FIG. 8 shows one mode of output display for medical diagnosis. Each value related to the vicinity of the nipple is displayed and output on the monitor 9a. In FIG. 8, a CT tomographic image is superimposed and superimposed on a PET tomographic image as a biomorphic image. Therefore, the first measuring unit 14 quantitatively measures the CT tomographic image to obtain the CT value.

  In the left region 9L of FIG. 8A, SUV (“SUV (max)” in FIG. 8A)) and CT value (“CT (ave.)” In FIG. 8A)), blood glucose level and body fat The rate, tumor marker name (“SLX”, “CA19-9”, “PSA”, “AFP”, “SCC”, “CFA”, “thyroglobulin”) and the like are displayed. In addition, an image obtained by superimposing a CT tomographic image on a PET tomographic image is displayed in the right region 9R of FIG. 8B.

  The output unit 9 (a display unit typified by a monitor or a printing unit typified by a printer) newly outputs additional information (SUV and existence probability after correction in this embodiment) (displayed in the case of a monitor). In the case of output and printing, print output) is preferable. For example, the superimposed image is displayed in the left region 9L of FIG. In the right region 9R of FIG. 8B, additional information (the existence probability after correction for each malignant disease in FIG. 8B) is displayed. Thus, by outputting additional information anew, it is possible to provide more accurate medical diagnosis browsing.

  The output unit 9 may be a display unit that performs display output, represented by a monitor, or may be a printing unit that performs print output, represented by a printer.

  The present invention is not limited to the above-described embodiment, and can be modified as follows.

  (1) In the above-described embodiments, the PET diagnosis apparatus has been described as an example of the medical diagnosis apparatus. However, the present invention detects a single gamma ray and reconstructs a tomographic image of the subject. It can also be applied to Photon Emission CT equipment.

  (2) In the above-described embodiment, a nuclear medicine diagnostic apparatus represented by a PET apparatus, a SPECT apparatus, or the like, that is, an ECT (Emission Computed Tomography) apparatus has been described as an example of the medical diagnosis apparatus. It can also be applied to automatic analyzers that examine tumor markers. When applied to an X-ray CT apparatus, the external apparatus viewed from the X-ray CT apparatus is a PET apparatus or an automatic analyzer. When applied to an automatic analyzer, the external apparatus is viewed from the automatic analyzer. Becomes a PET apparatus or an X-ray CT apparatus.

  (3) In the above-described embodiment, a device represented by a PET device or the like and an external device represented by an X-ray CT device or an automatic analyzer are connected by a cable 18 (see FIGS. 1 and 2). The medical diagnosis was also performed using the data transferred from the outside via the cable 18, but a plurality of devices such as a PET device, an X-ray CT device and an automatic analyzer were integrated into one medical diagnostic device. You may comprise as. In addition, the PET apparatus is also an external apparatus, and an apparatus for performing medical diagnosis is provided independently, and a plurality of apparatuses such as a PET apparatus, an X-ray CT apparatus, and an automatic analyzer are used as external apparatuses for data via a transmission means such as a cable. May be configured to forward.

  (4) In the above-described embodiment, a device represented by a PET device or the like and an external device represented by an X-ray CT device or an automatic analyzer are connected by a cable 18 (see FIGS. 1 and 2). The medical diagnosis was also performed using the data transferred from the outside via the cable 18, but for the numerical values such as the body fat percentage and the blood glucose level, the numerical values are input from the input unit 8 (see FIG. 1). Then, medical diagnosis may be performed using the input data.

  (5) In the above-described embodiment, the projection data γ-ray detector 3 composed of the scintillator block 3a and the photomultiplier 3b is a stationary type that detects γ-rays while still, but the scintillator block 3a In addition, the photomultiplier 3b may be a rotary type that detects γ rays while rotating around the subject M.

  (6) In the above-described embodiment, the PET apparatus includes the point source 4 (see FIG. 1), and the point source 4 emits the same γ rays as the radiopharmaceutical and transmits through the subject M, so Based on the above, the absorption correction data is obtained as the biological morphological image, but the projection data for CT may be used as the absorption correction data. Since the CT projection data is a morphological image similar to the absorption correction data described in the embodiment, the absorption correction is performed using the CT projection data instead of the absorption correction data described in the embodiment. Is possible. Similarly, medical diagnosis may be performed using the biological function image that has been subjected to absorption correction.

  (7) In the above-described embodiment, the PET apparatus includes the point source 4 (see FIG. 1), and the point source 4 emits the same γ rays as the radiopharmaceutical and transmits through the subject M, so Although the absorption correction data is obtained as a biomorphological image based on this, the absorption correction data may be obtained from CT or the like. Further, it is not always necessary to perform absorption correction. Therefore, a medical diagnosis may be performed using a biological function image that is not subjected to absorption correction.

  (8) In the above-described embodiment, the first measurement unit 14 (see FIG. 1) is configured to display a biomorphic image (in the embodiment, absorption correction data and a CT tomographic image to be superimposed) and a biofunction image ( In the embodiment, the measurement value is quantitatively measured from both of the tomographic images for PET, and a measurement value (in the embodiment, the average or variance of SUVs in the ROI based on the tomographic image after absorption correction) is obtained. (Refer to FIG. 1) is a measurement value (positive parameter or tumor in the example) quantitatively measured from both biological basic information (body fat percentage in the example) and biochemical information (tumor marker value in the example). The additional information calculation unit 16 (see FIG. 1) obtains the measurement value quantitatively measured by the first measurement unit 14 and the measurement value quantitatively measured by the second measurement unit 15. Based on the additional information (in the embodiment, the corrected SUV and existence To determine the probability), but it is not limited to this.

  That is, the first measurement unit 14 quantitatively measures and obtains a measurement value from at least one of the biomorphological image and the biological function image, and the second measurement unit 15 performs at least the basic biological information and the biochemical information. A measurement value is obtained by quantitative measurement from one piece of information, and the additional information calculation unit 16 is quantitatively measured by the measurement value measured by the first measurement unit 14 and the second measurement unit 15. If additional information is obtained based on the measurement value, the type and number of images and information are not particularly limited. Therefore, the first measurement unit 14 may obtain a measurement value by quantitatively measuring only from the biological morphological image, may obtain a measurement value by quantitatively measuring only from the biological function image, A measurement value may be obtained by quantitatively measuring from both the morphological image and the biological function image. Further, the second measuring unit 15 may obtain a measurement value by quantitatively measuring only from the basic biological information, obtain a measurement value quantitatively from only the basic biological information, A measurement value may be obtained by quantitative measurement only from chemical information, or a measurement value may be obtained by quantitative measurement from both basic biological information and biochemical information.

  (9) In the embodiment described above, the second measuring unit 15 quantitatively measures the biochemical information (tumor marker value in the embodiment) to obtain the measurement value (positive parameter or tumor existence probability in the embodiment). In some cases, basic biological information represented by body fat percentage and blood glucose level was not used directly, but quantitatively determined from biochemical information using biological basic information represented by body fat percentage and blood sugar level directly. You may obtain | require the measured value obtained automatically. For example, in the example, as shown in FIG. 7, when there is a correlation between the SUV and the body fat percentage, the SUV is corrected using the body fat percentage. If there is a correlation between the obtained tumor probability and the body fat percentage or blood sugar level, in addition to the variance described above, the body fat percentage or blood sugar level can be used to further correct the tumor existence probability. Good.

  (10) In the above-described embodiments, as the additional information, the SUV corrected by the body fat percentage or the tumor existence probability corrected by the dispersion has been described as an example. However, the additional information is applied to the image and the information. If additional information is obtained based on the measurement value quantitatively measured by the first measurement unit 14 and the measurement value quantitatively measured by the second measurement unit 15, It is not limited.

  For example, a brain substance (hereinafter referred to as “dopamine”) will be described as an example of basic biological information. First, 1) the brain activity is measured by PET or SPECT. In this case, brain activity can be evaluated by obtaining SUV as in the example. In the case of SPECT, cerebral blood flow is mainly measured by SPECT.

  On the other hand, 2) the substance in the brain in blood is measured, or the activity in the brain is measured with an electrode or the like. Since the activity value (dopamine amount) in the brain changes with age (decreases with age), an appropriate dopamine amount is set with respect to age and the like. 3) By taking the ratio between the measured amount of dopamine and the set amount of dopamine, a proportionality constant regarding dopamine excluding age can be obtained. The portion for obtaining the dopamine amount ratio is performed by the second measuring unit 15, and the second measuring unit 15 may quantitatively measure the dopamine amount and obtain the dopamine amount ratio as a measurement value. At this time, when there is a correlation between a measured value (not limited to SUV in particular) obtained by quantitatively measuring a biological function image obtained by PET or SPECT and a dopamine amount ratio, 4) The activity value can be obtained by correcting the measured value using the dopamine amount ratio. This activity value becomes additional information.

  This activity value is a parameter that serves as a standard for determining whether the amount of dopamine is appropriate (both values are balanced with respect to each other) with respect to the value representing the activity in the brain (for example, SUV). If the brain activity is high (high SUV) and the dopamine amount ratio is large, the dopamine amount is appropriate for the value representing the activity in the brain, and the activity value indicates a normal activity value and is normal. Can be determined based on activity values. Conversely, when the brain activity is active (high SUV) and the dopamine amount ratio is small, the activity value indicates an abnormal activity value, and the possibility of brain disease can be determined based on the activity value. Similarly, when the brain activity is not active (low SUV), the dopamine amount is appropriate for the value representing the activity in the brain based on whether the activity value is an abnormal activity value or a normal activity value. Judge whether there is.

  Therefore, in the case of an abnormal activity value, both values are unbalanced from each other, suggesting the possibility of brain disease. Whether it is an overactivity value or an underactivity value, whether the brain activity is local or overall, etc., is a judgment material such as Alzheimer's, Parkinson's, and drug addiction.

FIG. 1 is a side view and a block diagram of a PET (Positron Emission Tomography) apparatus according to an embodiment. It is the block diagram which showed typically the flow of the data regarding the 1st measurement part, the 2nd measurement part, additional information calculation part, and them. It is a flowchart which shows the flow of a series of medical diagnoses concerning an Example. It is a list | wrist for calculating | requiring a positive parameter. It is a list of tumor names (malignant diseases), tumor marker names, and expected positive rates. It is a list | wrist for calculating | requiring the existence probability of the tumor for every tumor name (malignant disease). It is the figure which showed the relationship between a body fat percentage and a SUV correction coefficient. It is an aspect of the output display for medical diagnosis.

Explanation of symbols

DESCRIPTION OF SYMBOLS 9 ... Output part 14 ... 1st measurement part 15 ... 2nd measurement part 16 ... Additional information calculation part

Claims (3)

  A first diagnostic means for obtaining a measurement value quantitatively from at least one of a biomorphic image obtained from morphological image diagnosis and a biofunctional image obtained from functional image diagnosis; A second measuring means for quantitatively measuring from at least one of the basic biological information and biochemical information to obtain a measured value; a measured value quantitatively measured by the first measuring means; and the second measuring means Output means for outputting a plurality of quantitatively measured values and additional information calculating means for obtaining additional information that is additional information to the image and information are provided. A medical treatment characterized in that a medical diagnosis is performed based on each measurement value and additional information obtained based on the measurement value quantitatively measured by the measurement means and the measurement value quantitatively measured by the second measurement means. Cross-sectional devices.   The medical diagnostic apparatus according to claim 1, wherein the output unit newly outputs the additional information.   3. The medical diagnostic apparatus according to claim 1, wherein the output unit is a display unit that performs display output.

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