JP2011101759A - Medical image display system and program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To enable a radiogram interpreting doctor to easily recognize whether or not a change in an abnormal shadow candidate requires urgency. <P>SOLUTION: In a medical image display system 100, the control part 31 of an image server 3 calculates a change value (difference value) between the feature quantity of an abnormal shadow candidate detected from the medical image of a radiogram interpreting object and the feature quantity of an abnormal shadow candidate detected from the medical image of a past inspection, on the basis of the CAD information of the medical image of the radiogram interpreting object selected by the operation part 42 of a radiogram interpreting terminal 4 and the CAD information of the medical image of the past inspection on the same inspection condition of the same patient, and when determining that the change quantity exceeds a predetermined threshold, warning information warning to that effect is transmitted to the radiogram interpreting terminal 4 by a communication part 34. When receiving the warning information from the image server 3 by a communication part 44, the control part 41 of the radiogram interpreting terminal 4 outputs the warning information by a display part 43 or the like. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a medical image display system and program.

  In recent years, with an increase in the incidence of breast cancer in women, interest in breast cancer screening has increased. In breast cancer screening, a doctor interprets a medical image obtained by photographing a breast to diagnose the presence or absence of an abnormality. However, the number of interpretation doctors who perform diagnosis is insufficient, and there is a problem that diagnosis is delayed.

  In order to improve such a problem, an abnormal shadow candidate detection apparatus (automatic shadow candidate detection device) that automatically detects abnormal shadow candidates indicating the characteristics of a lesion such as breast cancer from a medical image for the purpose of improving diagnostic accuracy or improving the efficiency of diagnostic work ( A CAD device (Computer-Aided Detection) has been developed.

  For example, in Patent Document 1, the type of abnormality and the degree of abnormality are detected for the collected medical images, and an additional inspection is required when the type of abnormality is a specific type and the degree of abnormality is within a predetermined range. A technique for outputting that is described.

JP 2001-187044 A

  By the way, as one of the interpretation methods, so-called comparative interpretation is performed in which a medical image to be interpreted and a medical image acquired by a past examination are interpreted side by side in order to grasp temporal changes of abnormal shadow candidates. It has been broken.

  When performing comparative interpretation, the doctor searches the database for medical images of past examinations that have the same patient and the same examination conditions (same site, same side (left and right), same direction) as the medical images to be interpreted, To select a medical image to be displayed as a comparison target. After selecting the comparison target medical image and displaying it on the display unit, the doctor changes the abnormal shadow candidate in the interpretation target medical image and the comparison target medical image (for example, the size and number of abnormal shadow candidates). Change) is visually observed, and it is determined whether or not the change requires urgency.

  However, this comparative interpretation work is complicated and requires considerable time and skill. The abnormal shadow candidate detection result information obtained by the CAD device is used to determine whether or not an additional examination is necessary as in Patent Document 1, or an interpreting doctor interprets an abnormal shadow candidate in an individual medical image. However, it is not used effectively as a support for comparative interpretation between a plurality of medical images.

  An object of the present invention is to enable an interpretation doctor to easily grasp whether a change in an abnormal shadow candidate requires urgency.

In order to solve the above problem, a medical image display system according to claim 1 is provided.
Storage means for associating and storing a medical image, examination information including patient information relating to the medical image, examination date and examination conditions relating to the medical image, and detection result information of abnormal shadow candidates detected from the medical image; ,
Operation means for selecting a medical image to be interpreted from medical images stored in the storage means;
The detection result information about the medical image to be interpreted selected by the operation means and the detection result information about the medical image of the past examination with the same patient and the same examination condition as the medical image to be interpreted are read from the storage means. Based on the read detection result information, the amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination Control means for calculating whether the amount of change exceeds a predetermined threshold;
The amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted by the control means and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination exceeds a predetermined threshold. Output means for outputting the warning information to warn that when it is determined that,
Display means for displaying the medical image to be interpreted;
Is provided.

The invention according to claim 2 is the invention according to claim 1,
The display means displays and outputs the warning information together with the medical image to be interpreted as the output means.

The invention according to claim 3 is the invention according to claim 1 or 2,
The display unit displays the medical image of the past examination side by side on the medical image to be interpreted.

The invention according to claim 4 is the invention according to claim 2,
In the case where a plurality of medical images of the past examination under the same patient and the same examination conditions as the medical image to be interpreted are stored in the storage means, the control means has a past whose examination date is closest to the medical image to be interpreted. The medical image of the past examination at the time when the amount of change exceeds the threshold is calculated by calculating the amount of change and comparing the amount of change with the threshold. Is determined as a medical image to be displayed side by side with the medical image to be interpreted,
The display means displays the medical image of the past examination determined by the control means along with the warning information along with the medical image to be interpreted.

The invention according to claim 5 is the invention according to claim 2,
The operation means includes a past examination to be displayed side by side with the medical image to be interpreted in the case where a plurality of medical images of the past examination having the same patient and the same examination conditions as the medical image to be interpreted are stored in the storage means. Of medical images can be selected,
The control means calculates a change amount between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted and the feature amount of the abnormal shadow candidate detected from the selected medical image of the past examination, Determine whether the amount of change exceeds a predetermined threshold,
The display means displays the selected medical image of the past examination side by side on the medical image to be interpreted, and is selected from the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted by the control means. When it is determined that the amount of change from the feature value of the abnormal shadow candidate detected from the medical image of the past examination exceeds a predetermined threshold, the warning information for warning that effect is displayed. .

The invention according to claim 6 is the invention according to any one of claims 1 to 5,
The operation means is configured to be able to set the type and threshold value of the feature amount for each user,
The control means performs the determination using a feature amount type and a threshold set for the logged-in user.

The program of the invention described in claim 7 is:
Computer
A storage unit that stores a medical image, patient information regarding the medical image, inspection information including an inspection date and an inspection condition regarding the medical image, and detection result information of an abnormal shadow candidate detected from the medical image in association with each other. Operation means for selecting a medical image to be interpreted from among stored medical images;
The detection result information about the medical image to be interpreted selected by the operation means and the detection result information about the medical image of the past examination with the same patient and the same examination condition as the medical image to be interpreted are read from the storage means. Based on the read detection result information, the amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination Control means for calculating whether or not the amount of change exceeds a predetermined threshold;
The amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted by the control means and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination exceeds a predetermined threshold. Output means for outputting the warning information to warn to that effect when it is determined that
Display means for displaying the medical image to be interpreted;
To function as.

  According to the present invention, it is possible for an interpretation doctor to easily grasp whether a change in an abnormal shadow candidate requires urgency.

It is a figure which shows the example of whole structure of the medical image display system in this Embodiment. It is a block diagram which shows the functional structure of the image server of FIG. It is a figure which shows the example of a data storage of the judgment criteria setting table memorize | stored in the memory | storage part of FIG. It is a block diagram which shows the functional structure of the image interpretation terminal of FIG. FIG. 8 is a diagram illustrating a flow of medical image display processing executed by the image interpretation terminal and the image server in FIG. 1 in the first embodiment. In the medical image display process of FIG. 5, when the difference value between the feature value of the abnormal shadow candidate detected from the interpretation target image and the feature value of the abnormal shadow candidate detected from the comparison target image exceeds the threshold, It is a figure which shows an example of the screen displayed on a display part. In 2nd Embodiment, it is a figure which shows the flow of the medical image display process B performed by the interpretation terminal of FIG. 1, and an image server.

[First embodiment]
(Configuration of Medical Image Display System 100)
First, the configuration of the first embodiment will be described.
FIG. 1 shows a system configuration of a medical image display system 100 according to the first embodiment.
The medical image display system 100 is a system that captures a medical image, detects an abnormal shadow candidate from the medical image, and provides detection result information to the interpretation doctor together with the medical image.

  As illustrated in FIG. 1, the medical image display system 100 includes an image generation device 1, an abnormal shadow candidate detection device 2, an image server 3, and an image interpretation terminal 4. These devices 1 to 4 are connected to each other through a communication network N constructed in a medical institution such as a LAN (Local Area Network) so that data can be transmitted and received between them. The DICOM (Digital Imaging and Communication in Medicine) standard is applied to the communication network N.

Hereinafter, each component apparatus 1-4 is demonstrated.
The image generation apparatus 1 captures a human body and generates digital data of the captured image (medical image). For example, CR (Computed Radiography), FPD (Flat Panel Detector)
), CT (Computed Tomography), MRI (Magnetic Resonance Imaging), cassette-dedicated readers, film digitizers, and other modalities are applicable. In the present embodiment, it is assumed that breast image data is generated by applying a breast-specific CR that performs X-ray imaging of the left and right breasts as the image generation apparatus 1.

  The image generation apparatus 1 is an apparatus that complies with the above-mentioned DICOM standard, and can input various information attached to the generated medical image, for example, patient information and examination information from the outside, and can also automatically generate the information. it can. The patient information includes information such as patient identification information (for example, patient ID) for identifying the patient, patient name, sex, date of birth, and the like. The inspection information includes inspection identification information (for example, inspection ID), inspection date, inspection conditions (inspection site, laterality (left, right), direction (for example, vertical direction (CC), oblique direction) (MLO)), modality type, etc. The image generating apparatus 1 adds the above patient information, examination information, UID (Unique ID) for identifying the image as header information to the generated medical image. To the abnormal shadow candidate detection device 2 and the image server 3 via the communication network N. If the DICOM standard is not complied with, the accompanying information is transmitted to the image generation device 1 using a DICOM conversion device (not shown). It is also possible to make it input.

  The abnormal shadow candidate detection device 2 is a computer that performs image analysis of a medical image supplied from the image generation device 1 and performs detection processing of an abnormal shadow candidate. The abnormal shadow candidate detection device 2 includes a storage unit such as a CPU (Central Processing Unit), a RAM (Random Access Memory), and an HDD (Hard Disk Drive), and a communication unit such as a LAN card. The storage unit of the abnormal shadow candidate detection device 2 stores a detection algorithm detection algorithm corresponding to the type of abnormal shadow to be detected. The CPU of the abnormal shadow candidate detection device 2 is stored in the storage unit. In cooperation with the detection program, an abnormal shadow candidate is detected from each medical image input via the communication unit. For example, mass candidates in the breast image and shadow candidates of the microcalcification cluster are detected.

  As an abnormal shadow candidate detection algorithm, a known algorithm can be applied. For example, as an algorithm for a tumor shadow candidate in a breast image, a method using an iris filter disclosed in Japanese Patent Laid-Open No. 10-91758, a method using a Laplacian filter (Journal of the Institute of Electronics, Information and Communication Engineers (D-II) , Vol. J76-D-II, no. 2, pp. 241-249, 1993), etc. are applicable. In addition, as a detection algorithm for micro-calcification cluster shadow candidates, for example, Morphology filter (The Institute of Electronics, Information and Communication Engineers (D-II), Vol.J71-D-II, no.7, pp.1170-1176, 1992), Laplacian filter (The Institute of Electrical, Information and Communication Engineers Journal (D-II), Vol. J71-D-II, no. 10, pp. 1994-2001, 1998) Applicable.

  When the abnormal shadow candidate detection process by the detection algorithm is completed, the abnormal shadow candidate detection device 2 generates detection result information (hereinafter referred to as CAD information) of the abnormal shadow candidate. The CAD information includes, for example, presence / absence of abnormal shadow candidates, character information indicating the number of detected abnormal shadow candidates, position information of each detected abnormal shadow candidate area (contour), and representative points of each detected abnormal shadow candidate ( For example, information on a plurality of items such as position information of the center of gravity) is included. Then, the abnormal shadow candidate detection device 2 adds the header information of the detection source medical image to the generated CAD information, and transmits it to the image server 3 by the communication unit.

  The image server 3 includes an image DB 351, stores the medical image generated by the image generation device 1 in association with the CAD information received from the abnormal shadow candidate detection device 2, and manages input / output thereof. To do.

FIG. 2 shows a functional configuration example of the image server 3.
As shown in FIG. 2, the image server 3 includes a control unit 31, an operation unit 32, a display unit 33, a communication unit 34, and a storage unit 35, and each unit is connected by a bus 36.

The control unit 31 includes a CPU, a RAM, and the like. The CPU of the control unit 31 reads out various programs such as a system program and a processing program stored in the storage unit 35, expands them in the RAM, and executes various processes according to the expanded programs.
For example, the control unit 31 performs server side processing of medical image display processing (see FIG. 5) described later and functions as a control unit.

  The operation unit 32 includes a keyboard provided with character input keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key press signal pressed by the keyboard and an operation signal by the mouse. To the control unit 31 as an input signal.

  The display unit 33 includes, for example, a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), and displays various screens according to instructions of display signals input from the control unit 31.

  The communication unit 34 is configured by a LAN card or the like, and transmits / receives data to / from an external device connected to the communication network N via a switching hub.

  The storage unit 35 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. The storage unit 35 stores various programs as described above. In addition, the storage unit 35 stores an image DB (Data Base) 351 for storing medical images captured from the image generation apparatus 1 and CAD information captured from the abnormal shadow candidate detection apparatus 2.

The image DB 351 has an image management table that stores management information regarding each medical image stored in the image DB 351. In the image management table, management information for each medical image is stored as one record. The management information includes UID, patient information, examination information, file information (file name of medical image and file name of CAD information corresponding thereto, file storage location, update date, file size, etc.).
When a medical image is received from the image generation apparatus 1, the received medical image is stored in the image DB 351, and management information is created based on the received medical image header information by the control unit 31, Stored in the image management table. When the CAD information from the abnormal shadow candidate detection device 2 is received, the received CAD information is stored in the image DB 351, and a record in which the CAD information and the UID match from the image management table by the control unit 31. The file name and storage location of CAD information are additionally written in the retrieved record. In this way, in the image DB 351, the medical image and the detection result information of the abnormal shadow candidate detected from the medical image are stored in association with each other so as to be searchable.

The storage unit 35 stores login information 352 such as an interpreting doctor ID and a password for each interpreting doctor who is a user who uses the interpreting terminal 4.
Furthermore, the storage unit 35 stores a determination criterion setting table 353. The determination criterion setting table 353 is a medical image display process to be described later. An abnormal shadow candidate detected from a medical image to be interpreted (hereinafter referred to as an image to be interpreted) and a medical image to be compared (hereinafter referred to as a comparative medical image). This is a table that stores, for each interpretation doctor, judgment criteria for judging whether or not there is a significant change that should be warned between abnormal shadow candidates detected from the FIG. 3 shows an example of the criterion setting table 353. As shown in FIG. 3, in the determination criterion setting table 353, the interpretation doctor ID, the type of feature value of the abnormal shadow candidate used as the determination criterion for whether to perform warning, and the threshold value used as the determination criterion are associated with each other. Is remembered. The types of feature quantities used for the determination criteria include, for example, the number of detected abnormal shadow candidates, the area of detected abnormal shadow candidates, and the like. It is also possible to set a plurality of judgment criteria.

  The above determination criteria can be set for each interpretation doctor who is a user by an input operation of the operation unit 32 or the operation unit 42 of the interpretation terminal 4. Here, the type of feature value to be emphasized differs depending on the type of lesion. For example, the change in the number of detections is important for any lesion, but the change in the area of the shadow is important for determining the progress especially when the type of the lesion is a tumor shadow. Moreover, the type of lesion specialized in each doctor is usually different. Therefore, it is preferable to set a judgment standard for each interpretation doctor, so that a judgment standard suitable for a lesion handled by the interpretation doctor can be used. The setting information input from the operation unit 32 or the operation unit of the interpretation terminal 4 is stored in the determination criterion setting table 353 in association with the interpretation doctor ID authenticated at the time of login.

  Returning to FIG. 1, the interpretation terminal 4 acquires the medical image designated by the operation of the interpretation doctor and the CAD information corresponding thereto from the image server 3 and displays it.

FIG. 4 shows a functional configuration example of the image interpretation terminal 4.
As shown in FIG. 4, the interpretation terminal 4 includes a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, and a storage unit 45, and each unit is connected by a bus 46.

The control unit 41 includes a CPU, a RAM, and the like. The CPU of the control unit 41 reads out various programs such as system programs and processing programs stored in the storage unit 45, expands them in the RAM, and executes various processes according to the expanded programs.
For example, the control unit 41 executes an interpretation terminal side process of a medical image display process to be described later.

  The operation unit 42 includes a keyboard having character input keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key pressing signal pressed by the keyboard and an operation signal by the mouse. Are output to the control unit 41 as an input signal.

  The display unit 43 includes, for example, a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), and displays various screens according to instructions of a display signal input from the control unit 41.

  The communication unit 44 is configured by a network interface or the like, and transmits / receives data to / from an external device connected to the communication network N via a switching hub.

  The storage unit 45 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. The storage unit 45 stores various programs as described above. In addition, the storage unit 45 stores image processing parameters (a lookup table defining a gradation curve used for gradation processing, an enhancement degree of frequency processing, and the like) for adjusting a medical image to an image quality suitable for diagnosis. is doing.

(Operation of Medical Image Display System 100)
Next, the operation of the medical image display system 100 will be described.
FIG. 5 shows a flowchart of a medical image display process executed by the image server 3 and the image interpretation terminal 4 in the first embodiment. The server side process of the medical image display process is executed in cooperation with the control unit 31 and the program stored in the storage unit 35. The interpretation terminal side process of the medical image display process is executed in cooperation with the control unit 41 and the program stored in the storage unit 45.

  First, in the interpretation terminal 4, the interpretation doctor ID and password as the user ID are input by the operation unit 42 from the login screen displayed on the display unit 43, and when the login is instructed, the interpretation doctor ID and password are transmitted by the communication unit 44. Is transmitted to the image server 3 (step S1). In the image server 3, when the interpretation doctor ID and password are received by the communication unit 34, user authentication is performed, and an authentication result is notified to the interpretation terminal 4 (step S2).

When the authentication is permitted by the user authentication, the image interpretation terminal 4 selects the image to be interpreted in accordance with the operation of the operation unit 42, and a request for acquiring the image to be interpreted selected by the image server 3 by the communication unit 44 is made. It is transmitted (step S3).
Specifically, in step S <b> 3, first, a search screen is displayed on the display unit 33 in response to an operation by the operation unit 42. When a search condition (patient ID, examination site, laterality, etc.) is input by the operation unit 42 on the search screen, the input search condition and search request are transmitted to the image server 3 by the communication unit 44. In the image server 3, the management information of the medical image that matches the search condition is searched from the image management table of the image DB 351, the list data of the medical image that matches the search condition is created and transmitted to the interpretation terminal 4 by the communication unit 34. Is done. In the interpretation terminal 4, when list data is received by the communication unit 44, an image selection screen based on the list data is displayed on the display unit 43. In the image selection screen, for example, a list having items such as an examination ID, a patient ID, a patient name, an examination date, a modality type, an examination site, a laterality, and a direction is displayed in examination units, The medical image to be selected can be selected via the operation unit 42. When an interpretation target image is selected by operating the operation unit 42, an acquisition request for the selected interpretation target image is transmitted to the image server 3 by the communication unit 44.

  In the image server 3, when the acquisition request for the interpretation target image is received by the communication unit 34, the image data of the requested interpretation target image and the CAD information corresponding to the interpretation target image are retrieved from the medical image DB 351 and read out. (Step S4).

  Next, in the interpretation terminal 4, the comparison target image used for comparative interpretation of the interpretation target image is selected in accordance with the operation of the operation unit 42, and the acquisition request for the comparison target image selected by the image server 3 by the communication unit 44 is selected. Is transmitted (step S5).

In the image server 3, when the communication unit 34 receives the acquisition request for the comparison target image, the image data of the requested comparison target image and the CAD information corresponding to the comparison target image are retrieved from the medical image DB 351 and read out. (Step S6). Then, based on the CAD information read in step S4 and the CAD information read in step S6, the feature amount of the abnormal shadow candidate detected from the image to be interpreted and the abnormal shadow candidate detected from the comparison image. An amount of change from the feature amount (here, a difference value) is calculated (step S7).
In step S7, first, the determination criterion setting table 353 is referred to, and setting information corresponding to the interpretation doctor ID of the logged-in interpretation doctor is read from the interpretation terminal 4. Then, the setting information is referred to, the type of feature amount corresponding to the logged-in interpretation doctor is acquired, the acquired feature amount of the abnormal shadow candidate detected from the interpretation target medical image, and the comparison target medical feature A difference value from the acquired type of feature amount of the abnormal shadow candidate detected from the image is calculated.
For example, when “detection number” is set as the type of feature quantity, “detection number” in the CAD information of the comparison target image is subtracted from “detection number” in the CAD information of the image to be interpreted, and the difference in the detection number A value is calculated.
For example, when “area” is set as the type of feature amount, first, the position of the interpretation target image and the comparison target image are associated using a known technique. For example, as disclosed in Japanese Patent Application Laid-Open No. 2009-82564, a polar coordinate system having a nipple as an origin is set for each of an image to be interpreted and a comparison target image, and a distance from the nipple and an angle from a predetermined reference line are set. The matching position is set as a corresponding position in both images. Next, each abnormal shadow candidate in the interpretation target image is associated with each abnormal shadow candidate in the comparison target image. For example, abnormal shadow candidates whose positions coincide with each other in a polar coordinate system or within a predetermined range are specified as corresponding abnormal shadow candidates. Then, the area of each abnormal shadow candidate (for example, the number of pixels in the region of the abnormal shadow candidate is defined as the area) from the information of the area (contour) of each abnormal shadow candidate in the CAD information of the interpretation target image and the CAD information of the comparison target image. Is calculated, the area of each abnormal shadow candidate in the comparison target image is subtracted from the area of each abnormal shadow candidate in the image to be interpreted, and a difference value is calculated.

  Next, the calculated difference value is compared with the threshold value of the setting information, and if it is determined that the difference value exceeds the threshold value as a result of the comparison (step S8; YES), the image to be interpreted, its CAD information, and the comparison object The image and its CAD information, and warning information indicating that a predetermined feature amount exceeds the threshold value are transmitted to the image interpretation terminal 4 by the communication unit 34 (step S9). Note that if the type of feature quantity is area and there are multiple abnormal shadow candidates, it is determined that the difference value exceeds the threshold if there is an abnormal shadow candidate whose difference value exceeds the threshold. The As a result of the comparison, if it is determined that the difference value does not exceed the threshold (step S8; NO), the image to be interpreted and its CAD information, and the image to be compared and its CAD information are transmitted to the image interpretation terminal 4 by the communication unit 34. (Step S10).

  In the image interpretation terminal 4, when the image to be interpreted is received by the communication unit 44, the received image to be interpreted and the image to be compared are displayed on the display unit 43 (step S11). When the warning information is included in the information received from the image server 3 (step S12; YES), the warning information is further displayed on the display unit 43 (step S13).

  FIG. 6 shows an example of a screen displayed on the display unit 43 in step S13. As shown in FIG. 6, the image to be interpreted and the image to be compared are displayed side by side on one screen, and the feature amount of the abnormal shadow candidate detected from the image to be interpreted and the abnormal shadow candidate detected from the image to be compared are displayed. If the difference value of the feature amount exceeds the threshold value, a dialog D that warns that is displayed. In FIG. 6, a dialog D that is displayed when the feature amount is “number of detections”, the threshold value is 1, and the difference value is 3 is shown as an example. As described above, when the difference value between the feature amount of the abnormal shadow candidate detected from the interpretation target image and the feature amount of the abnormal shadow candidate detected from the comparison target image exceeds the threshold value, the dialog D indicating that is displayed. Therefore, the interpretation doctor can easily grasp whether or not the change of the abnormal shadow candidate is urgent. Further, when urgency is required, the dialog D enables the interpreting doctor to increase his / her attention to interpreting the patient.

  When an instruction to change the comparison target image is input by the operation unit 42 (step S14; YES), the process returns to step S5. When an instruction to change the image to be interpreted is input by the operation unit 42 (step S15; YES), the process returns to step S3. When log-off is instructed by the operation unit 42 (step S16; YES), log-off is performed (step S17), and the medical image display process ends.

[Second Embodiment]
Next, a second embodiment of the present invention will be described.
Since the configuration of the second embodiment is the same as the configuration of the first embodiment, a description thereof will be omitted, and the operation of the second embodiment will be described.

  FIG. 7 shows a flowchart of medical image display processing (referred to as medical image display processing B) executed by the image server 3 and the image interpretation terminal 4 in the second embodiment. The server side process of the medical image display process B is executed in cooperation with the control unit 31 and the program stored in the storage unit 35. The interpretation terminal side process of the medical image display process B is executed in cooperation with the control unit 41 and a program stored in the storage unit 45.

  First, in the interpretation terminal 4, the interpretation doctor ID and password as the user ID are input by the operation unit 42 from the login screen displayed on the display unit 43, and when the login is instructed, the interpretation doctor ID and password are transmitted by the communication unit 44. Is transmitted to the image server 3 (step S21). In the image server 3, when the interpretation doctor ID and password are received by the communication unit 34, user authentication is performed, and the result of authentication is notified to the interpretation terminal 4 (step S22).

When the authentication is permitted by the user authentication, the image interpretation terminal 4 selects the image to be interpreted in accordance with the operation of the operation unit 42, and a request for acquiring the image to be interpreted selected by the image server 3 by the communication unit 44 is made. It is transmitted (step S23).
The specific processing in step S23 is the same as that described in step S3 in FIG. 5 of the first embodiment, and thus description thereof is omitted.

  In the image server 3, when the acquisition request for the interpretation target image is received by the communication unit 34, the image data of the requested interpretation target image and the CAD information corresponding to the interpretation target image are retrieved from the medical image DB 351 and read out. (Step S24).

  Next, in the image server 3, a medical image (referred to as a past image) of a past examination (examination having a past examination date from the interpretation target image) of the same patient and the same examination condition (same part, same side, same direction) as the interpretation target image ) Is retrieved (step S25). If no past image exists as a result of the search (step S26; NO), the process proceeds to step S33, and the image to be interpreted and its CAD information are transmitted to the interpretation terminal 4 by the communication unit 34 (step S33). . If a past image exists as a result of the search (step S26; YES), 1 is set in the counter n (step S27), and the nth (examination date is closest to the image to be interpreted) among the searched past images. The CAD information of the n-th past image is read from the image DB 351 (step S28).

  Next, based on the CAD information read in step S24 and the CAD information read in step S28, the feature amount of the abnormal shadow candidate detected from the image to be interpreted and the abnormal shadow detected from the nth past image. A change amount (here, a difference value) from the candidate feature amount is calculated (step S29). Since the calculation of the difference value is the same as that described in step S7 of FIG. 5 of the first embodiment, the description thereof is omitted.

  Next, the calculated difference value is compared with the threshold value of the setting information, and when it is determined that the value of the difference value does not exceed the threshold value as a result of the comparison (step S30; NO), the counter n is incremented by 1 (step S31), it is determined whether n> the number of past images retrieved (the number of past images retrieved in step S25) (step S32). If it is determined that n> the number of retrieved past images is not satisfied (step S32; NO), the process returns to step S28. When it is determined that n> the number of retrieved past images (step S32; YES), the image to be interpreted and its CAD information are transmitted to the interpretation terminal 4 by the communication unit 34 (step S33).

  On the other hand, if it is determined as a result of the comparison that the value of the difference information exceeds the threshold (step S30; YES), the nth past image is determined as the comparison target image (step S34), and the image to be interpreted and its interpretation image The CAD information, the comparison target image and its CAD information, and warning information indicating that the predetermined feature amount exceeds the threshold value are transmitted to the image interpretation terminal 4 by the communication unit 34 (step S35).

  In the interpretation terminal 4, when an interpretation target image or the like is received by the communication unit 44, it is determined whether or not a comparison target image has been received (step S 36). If it is determined that the comparison target image has been received (step S36; YES), the received interpretation target image and comparison target image are displayed on the display unit 43 together with warning information (step S37).

  In step S37, the image to be interpreted and the image to be compared are displayed side by side on the display unit 43, as in the screen example shown in FIG. The comparison target image is a past image at the time when the amount of change in the feature amount of the abnormal shadow candidate from the interpretation target image exceeds a predetermined threshold among the past images of the same patient as the interpretation target image. . As shown in FIG. 6, the examination date when the image is acquired is displayed at the top of each image. Further, a warning dialog D indicating that the difference value between the feature amount of the abnormal shadow candidate detected from the interpretation target image and the feature amount of the abnormal shadow candidate detected from the comparison target image exceeds a predetermined threshold value. Is displayed.

  In this way, since the past image at the time when the amount of change in the feature amount of the abnormal shadow candidate from the image to be interpreted exceeds a predetermined threshold value is automatically displayed side by side with the image to be interpreted, It is possible to easily grasp from which point in the past the shadow candidate has changed remarkably and whether the change is urgent. For example, if the comparison target image when the area exceeds the threshold is for an inspection one year ago, urgency is required, but if it is for an inspection 15 years ago, it may be determined that urgency is not required. it can. Further, it is not necessary for the image interpretation doctor to search for, select and display a medical image retroactively to the past examination, and it is possible to improve the efficiency of the image interpretation work.

  On the other hand, if it is determined that the comparison target image has not been received (step S36; NO), the received interpretation target image is displayed on the display unit 43 (step S38).

  When an instruction to change the image to be interpreted is input by the operation unit 42 (step S39; YES), the process returns to step S23. When log-off is instructed by the operation unit 42 (step S40; YES), log-off is performed (step S41), and the medical image display process B ends.

  As described above, according to the medical image display system in the first embodiment, the control unit 31 of the image server 3 includes the CAD information of the medical image to be interpreted selected by the operation unit 42 of the interpretation terminal 4 and Based on the CAD information of the medical image of the past examination under the same examination condition of the same patient selected as the comparison target, the feature amount of the abnormal shadow candidate detected from the medical image of the interpretation target and the medical image of the past examination were detected. If the amount of change (difference value) from the feature amount of the abnormal shadow candidate is calculated and it is determined that the amount of change exceeds a predetermined threshold, the communication unit 34 interprets warning information that warns that effect. Transmit to terminal 4. When receiving the warning information from the image server 3 by the communication unit 44, the control unit 41 of the image interpretation terminal 4 outputs the warning information by the display unit 43 or the like.

Therefore, if the amount of change in the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted and the amount of change in the feature amount of the abnormal shadow candidate detected from the medical image in the past examination to be compared exceed the threshold Therefore, the interpretation doctor can easily grasp whether or not the change of the abnormal shadow candidate in the medical image to be interpreted and the medical image of the past examination is urgent. The warning can be output, for example, by displaying the warning information together with the medical image to be interpreted.
Further, when the medical image to be interpreted and the medical image of the past examination selected as the comparison target by the operation of the operation unit 42 are displayed side by side, the amount of change in the feature value of the abnormal shadow candidate detected from both images is changed. When the threshold value is exceeded, an interpretation doctor can easily know whether the change in the abnormal shadow candidate from the time of the selected past examination is urgent or not. It becomes possible.

  Further, according to the medical image display system in the second embodiment, the control unit 31 of the image server 3 has the same patient and the same examination condition as the medical image to be interpreted selected by the operation unit 42 of the interpretation terminal 4. When a plurality of medical images of past examinations are stored in the image DB 351, the image DB 351 sequentially starts from the CAD information of the medical image to be interpreted and the CAD information of the medical image of the past examination having the closest examination date to the medical image to be interpreted. Is calculated from the feature value of the abnormal shadow candidate detected from the medical image to be interpreted and compared with the threshold, and the medical image of the past examination when the variation exceeds the threshold Are determined as medical images to be displayed side by side with the medical image to be interpreted. Then, the medical image to be interpreted and CAD information, the determined medical image and CAD information of the past examination, and the warning information are transmitted to the interpretation terminal 4. The control unit 41 of the image interpretation terminal 4 arranges the determined medical image of the past examination on the medical image to be interpreted and displays it on the display unit 43 together with the warning information.

  Therefore, the image interpretation doctor can easily grasp whether the abnormal shadow candidate has changed remarkably compared with the past time point and whether the change is urgent. In addition, the medical image to be interpreted and the medical image of the past examination that can confirm significant changes in this and the abnormal shadow candidate are automatically displayed side by side, so the interpreting doctor searches the medical image retroactively to the past examination. And the operation of selecting and displaying is not required, and the interpretation work can be made efficient.

In addition, the description content in the said embodiment is a suitable example of this invention, and is not limited to this.
For example, in the above embodiment, it has been described that the image server 3 is provided with functions as storage means and control means, and the interpretation terminal 4 is provided with functions as output means, display means, and operation means. The means may be provided in one apparatus, or the storage means may be provided in the image server 3 and the interpretation terminal 4 may be provided with functions as a control means, an operation means, an output means, and a display means. In any case, each storage unit of the image server 3 and the image interpretation terminal 4 stores a program for realizing the function installed in the own device, and each program is controlled by the cooperation of the control unit and the program. The function is executed. In the above embodiment, the abnormal shadow candidate detection device 2 has been described as a separate device from the image server 3. However, the image server 3 includes a detection program for the abnormal shadow candidate detection device 2, and It may be configured to detect an abnormal shadow candidate.

  In the above embodiment, the case where the output unit is the display unit 43 and the warning information is displayed and output from the display unit 43 has been described as an example. However, the interpretation terminal 4 includes a voice output unit for outputting voice. It is good also as a structure and it is good also as a structure which outputs warning information from an audio | voice output part.

  Moreover, in the said embodiment, although demonstrated using the breast image as an example, a site | part is not limited to a breast.

  In the above embodiment, the warning information is displayed on the screen for displaying the image to be interpreted and the image to be compared side by side. However, it is not always necessary to display the image to be compared at the time of warning. For example, the warning information may be displayed or output by voice while the image to be interpreted is displayed.

  In the above description, an example in which a hard disk, a semiconductor nonvolatile memory, or the like is used as a computer-readable medium of the program according to the present invention is disclosed, but the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. A carrier wave is also applied as a medium for providing program data according to the present invention via a communication line.

  In addition, the detailed configuration and detailed operation of each device constituting the medical image display system can be changed as appropriate without departing from the spirit of the present invention.

DESCRIPTION OF SYMBOLS 100 Medical image display system 1 Image generation apparatus 2 Abnormal shadow candidate detection apparatus 3 Image server 31 Control part 32 Operation part 33 Display part 34 Communication part 35 Storage part 36 Bus 351 Image DB
352 Login information 353 Judgment criteria setting table 4 Interpretation terminal 41 Control unit 42 Operation unit 43 Display unit 44 Communication unit 45 Storage unit 46 Bus

Claims (7)

Storage means for associating and storing a medical image, examination information including patient information relating to the medical image, examination date and examination conditions relating to the medical image, and detection result information of abnormal shadow candidates detected from the medical image; ,
Operation means for selecting a medical image to be interpreted from medical images stored in the storage means;
The detection result information about the medical image to be interpreted selected by the operation means and the detection result information about the medical image of the past examination with the same patient and the same examination condition as the medical image to be interpreted are read from the storage means. Based on the read detection result information, the amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination Control means for calculating whether the amount of change exceeds a predetermined threshold;
The amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted by the control means and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination exceeds a predetermined threshold. Output means for outputting the warning information to warn that when it is determined that,
Display means for displaying the medical image to be interpreted;
A medical image display system comprising:   The medical image display system according to claim 1, wherein the display unit displays and outputs the warning information together with the medical image to be interpreted as the output unit.   The medical image display system according to claim 1, wherein the display unit displays the medical image of the past examination side by side on the medical image to be interpreted. In the case where a plurality of medical images of the past examination under the same patient and the same examination conditions as the medical image to be interpreted are stored in the storage means, the control means has a past whose examination date is closest to the medical image to be interpreted. The medical image of the past examination at the time when the amount of change exceeds the threshold is calculated by calculating the amount of change and comparing the amount of change with the threshold. Is determined as a medical image to be displayed side by side with the medical image to be interpreted,
The medical image display system according to claim 2, wherein the display unit displays the medical image of the past examination determined by the control unit along with the warning information along with the medical image to be interpreted. The operation means includes a past examination to be displayed side by side with the medical image to be interpreted in the case where a plurality of medical images of the past examination having the same patient and the same examination conditions as the medical image to be interpreted are stored in the storage means. Of medical images can be selected,
The control means calculates a change amount between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted and the feature amount of the abnormal shadow candidate detected from the selected medical image of the past examination, Determine whether the amount of change exceeds a predetermined threshold,
The display means displays the selected medical image of the past examination side by side on the medical image to be interpreted, and is selected from the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted by the control means. When it is determined that the amount of change from the feature value of the abnormal shadow candidate detected from the medical image of the past examination exceeds a predetermined threshold, the warning information for warning that effect is displayed. The medical image display system according to claim 2. The operation means is configured to be able to set the type and threshold value of the feature amount for each user,
The medical image display system according to any one of claims 1 to 5, wherein the control unit performs the determination using a feature amount type and a threshold set for a logged-in user. Computer
A storage unit that stores a medical image, patient information regarding the medical image, inspection information including an inspection date and an inspection condition regarding the medical image, and detection result information of an abnormal shadow candidate detected from the medical image in association with each other. Operation means for selecting a medical image to be interpreted from among stored medical images;
The detection result information about the medical image to be interpreted selected by the operation means and the detection result information about the medical image of the past examination with the same patient and the same examination condition as the medical image to be interpreted are read from the storage means. Based on the read detection result information, the amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination Control means for calculating whether or not the amount of change exceeds a predetermined threshold;
The amount of change between the feature amount of the abnormal shadow candidate detected from the medical image to be interpreted by the control means and the feature amount of the abnormal shadow candidate detected from the medical image of the past examination exceeds a predetermined threshold. Output means for outputting the warning information to warn to that effect when it is determined that
Display means for displaying the medical image to be interpreted;
Program to function as.

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