JP2011110173A - Medical image system and program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To identify the kind of additional information added to a medical image. <P>SOLUTION: In generating a printing image by adding to a medical image a layer image of an annotation showing the position of the annotation and a layer image of a CAD result showing the position of an abnormal shadow candidate, identification information (letters CAD, or the like) for identifying that a result is a CAD result is added corresponding to the CAD result. The generated printing image is printed on a film by a film output device. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

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

  In recent years, the incidence of breast cancer in women has been increasing. Breast cancer is a disease with a high cure rate if detected early, and regular screening is recommended for early detection. In order to improve the detection rate of breast cancer, it is said that it is effective to perform overreading on an X-ray image of the breast. Overreading means that a second doctor interprets a medical image obtained by imaging a patient after the first doctor interprets it. However, at present, in breast cancer screening, the number of doctors who interpret breast images is absolutely insufficient, and it is actually impossible to perform sufficient screening.

  Under such circumstances, computer-aided diagnosis (CAD) has appeared due to the development of computer technology. This function is a function that analyzes a digitally taken medical image (mainly a CR image), adds an annotation to a region that appears to be a lesion, displays it on a display, and helps a doctor interpret the image. For a breast image, an abnormal shadow candidate region that may be a lesion such as a tumor or microcalcification is detected. The effectiveness of CAD has been confirmed in digital image diagnosis, and products are provided by various manufacturers.

  By the way, when interpretation is performed with a medical image displayed on the display, the performance of the display does not reach the gradation expression performance of the film. Therefore, there has been proposed a technique in which a CAD result indicating the position of an abnormal shadow candidate is also printed when a mammography image is output on a film (see Non-Patent Document 1).

Hiroshi Fujita, “Current Status of Mammography CAD System Present Status of Mammography CAD System”, MEDICAL IMAGING TECHNOLOGY, Japan Society for Medical Image Engineering, January 2003, Vol. 21, No. 1, p.27-33

  However, the CAD result is only for diagnosis support, and it cannot be said that it has a diagnostic significance as much as the annotation added to the medical image as a result of diagnosis by the doctor. When additional information such as annotations, CAD results, etc. is added to the medical image output on the film, it is actually added by diagnosing a lesion by a doctor, or added by CAD results I couldn't judge it.

  In particular, in the medical image, the outline display of the abnormal shadow candidate area displayed based on the CAD result and the circular annotation added by the doctor are very similar. When interpretation is performed on the display, since it is possible to select whether or not to display the CAD result outline display and annotation individually, the difference between the two can be easily determined. On the other hand, when both the outline display of CAD results and annotations are printed on a recording medium such as a film, it is very difficult to distinguish between them.

  The present invention has been made in view of the above-described problems in the prior art, and an object thereof is to make it possible to identify the type of additional information added to a medical image.

  In order to solve the above-described problem, the medical image system according to claim 1 adds a plurality of types of additional information illustrating a predetermined position on the medical image to the medical image and adds the additional information to the medical image. Control means for generating an image for printing by adding identification information for identifying the type of the additional information in association with at least one type of additional information of the plurality of types of additional information to the medical image And printing means for printing the generated printing image on a recording medium.

  According to a second aspect of the present invention, in the medical image system according to the first aspect, the additional information corresponding to the identification information illustrates the position of the abnormal shadow candidate detected from the medical image.

  According to the third aspect of the present invention, the computer adds a plurality of types of additional information illustrating a predetermined position on the medical image to the medical image, and the plurality of types of additional information added to the medical image. Control means for generating a printing image by adding identification information for identifying the type of the additional information in association with at least one type of additional information of the medical image, and the generated printing image Is a program for causing the printer to function as an output means for outputting to a printing apparatus.

  According to a fourth aspect of the present invention, in the program according to the third aspect, the additional information corresponding to the identification information illustrates the position of the abnormal shadow candidate detected from the medical image.

  According to the first and third aspects of the invention, the type of additional information added to a medical image can be identified.

  According to the second and fourth aspects of the present invention, the additional information illustrating the position of the abnormal shadow candidate can be distinguished from other additional information.

1 is a system configuration diagram of a medical image system. It is a block diagram which shows the functional structure of a CAD apparatus. It is a block diagram which shows the functional structure of an image server apparatus. It is a block diagram which shows the functional structure of a client terminal. It is a figure for demonstrating the production | generation method of the layer image of a CAD result. It is a figure for demonstrating the production | generation method of the image for printing. It is a flowchart which shows the image generation process for printing performed in a client terminal.

Hereinafter, an embodiment of a medical image system according to the present invention will be described with reference to the drawings.
FIG. 1 shows a system configuration of the medical image system 100. As shown in FIG. 1, a medical image system 100 includes a modality 10, a CAD device 20, an image server device 30, a client terminal 40, and a film output device 50 that perform data communication via a network N such as a LAN (Local Area Network). It is connected and configured. The DICOM (Digital Imaging and Communications in Medicine) standard is applied to the network N.

  The modality 10 images a patient, generates a medical image data file (hereinafter referred to as an image file) D1 (see FIG. 2), and transmits the image file D1 to the CAD device 20 and the image server device 30, respectively. To do. As the modality 10, a CR (Computed Radiography) device, a DX (Digital X-Ray) device, or the like is used.

  The CAD device 20 receives an image file D1 of a medical image from the modality 10, performs image analysis of the medical image, and detects abnormal shadow candidates. Then, the CAD device 20 generates a CAD result file D2 indicating the position of the detected abnormal shadow candidate.

  FIG. 2 shows a functional configuration of the CAD device 20. As shown in FIG. 2, the CAD device 20 includes a control unit 21, an operation unit 22, a display unit 23, a communication unit 24, a ROM (Read Only Memory) 25, and a storage unit 26. It is connected.

  The control unit 21 includes a CPU (Central Processing Unit), a RAM (Random Access Memory), and the like, and comprehensively controls the processing operation of each unit of the CAD device 20. Specifically, the CPU reads various processing programs stored in the ROM 25 or the storage unit 26 in accordance with an operation signal input from the operation unit 22 or an instruction signal received by the communication unit 24 and stores the processing program in the RAM. The program is developed in the formed work area, and various processes are performed in cooperation with the program.

  The operation unit 22 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 22 controls operation signals input by key operations or mouse operations on the keyboard. To 21.

  The display unit 23 is configured by an LCD (Liquid Crystal Display), and displays various screens based on display data input from the control unit 21.

  The communication unit 24 is an interface that transmits and receives data to and from external devices such as the modality 10 and the image server device 30.

  The ROM 25 is configured by a nonvolatile semiconductor memory or the like, and stores a control program, parameters and files necessary for executing the program, and the like.

  The storage unit 26 is configured by a hard disk or the like and stores various data. Specifically, the storage unit 26 stores a detection program for detecting abnormal shadow candidates according to a detection algorithm corresponding to the type of abnormal shadow. The storage unit 26 stores an image file D1 and a CAD result file D2.

  The control unit 21 detects an abnormal shadow candidate from the medical image in cooperation with the detection program stored in the storage unit 26, and generates a CAD result file D2. The position of each abnormal shadow candidate included in the CAD result file D2 may indicate a region (contour) of each abnormal shadow candidate in the medical image, or a representative point (for example, the center of gravity) of each abnormal shadow candidate May be shown. For example, the CAD device 20 detects abnormal shadow candidates such as a tumor and microcalcification from the breast image.

  As an abnormal shadow candidate detection algorithm, a known algorithm can be applied. As an algorithm for detecting a tumor in a breast image, for example, a method using an iris filter, a Laplacian filter, or the like is applicable. As a detection algorithm for microcalcification, for example, a method using a morphological filter, a Laplacian filter, a triple ring filter, or the like can be applied.

  The control unit 21 transmits the CAD result file D2 to the image server device 30 via the communication unit 24.

  The image server device 30 is configured by PACS (Picture Archiving and Communication System), stores the image file D1 received from the modality 10, and provides the image file D1 etc. in response to a request from an external device such as the client terminal 40. To do.

  FIG. 3 shows a functional configuration of the image server device 30. As shown in FIG. 3, the image server device 30 includes a control unit 31, an operation unit 32, a display unit 33, a communication unit 34, a ROM 35, and a storage unit 36, and each unit is connected by a bus 37.

  The control unit 31 includes a CPU, a RAM, and the like, and comprehensively controls the processing operation of each unit of the image server device 30. Specifically, the CPU reads various processing programs stored in the ROM 35 or the storage unit 36 in accordance with an operation signal input from the operation unit 32 or an instruction signal received by the communication unit 34, and stores it in the RAM. The program is developed in the formed work area, and various processes are performed in cooperation with the program.

  The operation unit 32 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse. To 31.

  The display unit 33 is configured by an LCD, and displays various screens based on display data input from the control unit 31.

  The communication unit 34 is an interface that transmits and receives data to and from external devices such as the modality 10, the CAD device 20, and the client terminal 40.

  The ROM 35 is configured by a nonvolatile semiconductor memory or the like, and stores a control program, parameters and files necessary for executing the program, and the like.

  The storage unit 36 is configured by a hard disk or the like and stores various data. Specifically, the storage unit 36 stores the image file D1 received from the modality 10, the CAD result file D2 received from the CAD device 20, and the annotation file D3 received from the client terminal 40 in association with each other. Is done.

  The CAD result file D2 includes information indicating the position of the abnormal shadow candidate detected from the medical image of the associated image file D1. The annotation file D3 includes information indicating the position of the annotation added when the interpreting doctor interprets the medical image of the associated image file D1.

The control unit 31 acquires the image file D1 from the modality 10 via the communication unit 34. In addition, the control unit 31 acquires the CAD result file D2 obtained by analyzing the image file D1 from the CAD device 20 via the communication unit 34. Then, the control unit 31 stores the acquired image file D1 and CAD result file D2 in association with each other in the storage unit 36.
When the annotation file D3 is received from the client terminal 40 via the communication unit 34, the control unit 31 further stores the annotation file D3 in the storage unit 36 in association with the image file D1 and the CAD result file D2. .

  When there is an acquisition request for the image file D1 from the client terminal 40, the control unit 31 reads out the requested image file D1 from the storage unit 36 and transmits it to the client terminal 40. Further, when the CAD result file D2 associated with the image file D1 exists in the storage unit 36, the control unit 31 further reads out the CAD result file D2 from the storage unit 36 and transmits it to the client terminal 40. . When the annotation file D3 associated with the image file D1 exists in the storage unit 36, the control unit 31 further reads the annotation file D3 from the storage unit 36 and transmits it to the client terminal 40.

  The client terminal 40 is a device for displaying a medical image based on the image file D1 acquired from the image server device 30, reading the medical image, and issuing a print instruction for the medical image. It is composed of a PC (Personal Computer) or the like.

  FIG. 4 shows a functional configuration of the client terminal 40. As shown in FIG. 4, the client terminal 40 includes a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, a ROM 45, a storage unit 46, and a memory 47, and each unit is connected by a bus 48.

  The control unit 41 includes a CPU, a RAM, and the like, and comprehensively controls processing operations of each unit of the client terminal 40. Specifically, the CPU reads various processing programs stored in the ROM 45 or the storage unit 46 in accordance with an operation signal input from the operation unit 42 or an instruction signal received by the communication unit 44, and stores it in the RAM. The program is developed in the formed work area, and various processes are performed in cooperation with the program.

  The operation unit 42 is a functional unit that receives an operation instruction from the user. The operation unit 42 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 42 controls operation signals input by keyboard operation or mouse operation. 41 is output.

  The display unit 43 is configured by an LCD, and displays various screens based on display data input from the control unit 41.

  The communication unit 44 is an interface that transmits and receives data to and from an external device such as the image server device 30.

  The ROM 45 is constituted by a nonvolatile semiconductor memory or the like, and stores a control program, parameters and files necessary for executing the program, and the like.

  The storage unit 46 is configured by a hard disk or the like and stores various data. For example, in the storage unit 46, an image viewer program 461 for displaying a medical image on the display unit 43 when interpretation is performed, or a printing image for generating a printing image when outputting a medical image to film. A generation program 462 is stored.

  The memory 47 is composed of a semiconductor memory or the like, and stores data being processed. Specifically, the memory 47 stores an image file D1, a CAD result file D2, an annotation file D3, and the like acquired from the image server device 30.

  The control unit 41 transmits an acquisition request for the image file D1 of the medical image stored in the storage unit 36 to the image server device 30 through the communication unit 44 in cooperation with the image viewer program 461. The image file D1 of the medical image is acquired from the image server device 30. At this time, when the CAD result file D2 associated with the image file D1 exists in the image server device 30, the control unit 41 acquires the CAD result file D2 via the communication unit 44. Based on the image file D1, the control unit 41 displays a medical image on the display unit 43. If the CAD result file D2 exists, the control unit 41 displays an abnormal shadow candidate on the medical image based on the CAD result file D2. The position of is illustrated. Then, interpretation is performed, and annotation is drawn on the medical image based on an operation from the operation unit 42 of the interpretation doctor as necessary. The control unit 41 transmits information indicating the position of the annotation as an annotation file D3 to the image server device 30 via the communication unit 44.

  The control unit 41 generates a printing image in cooperation with the printing image generation program 462. Specifically, the control unit 41 transmits an acquisition request for the image file D1 of the medical image stored in the storage unit 36 to the image server device 30 via the communication unit 44, and the image server device 30. To obtain an image file D1 of a medical image. At this time, when the CAD result file D2 associated with the image file D1 exists in the image server device 30, the control unit 41 acquires the CAD result file D2 via the communication unit 44. When the annotation file D3 associated with the image file D1 exists in the image server device 30, the control unit 41 acquires the annotation file D3 via the communication unit 44.

The control unit 41 generates a print image based on the image file D1, the CAD result file D2, and the annotation file D3 acquired from the image server device 30.
The control unit 41 adds a plurality of types of additional information (annotations and CAD results) illustrating a predetermined position on the medical image to the medical image, and at least of the plurality of types of additional information added to the medical image. Identification information for identifying the type of the additional information is added to the medical image in association with any one type of additional information to generate a print image.
The control unit 41 outputs the generated printing image to the film output device 50 via the communication unit 44.

  Based on the annotation file D3, the control unit 41 generates an annotation layer image illustrating the position of the annotation added by the doctor through diagnosis. The annotation layer image is transparent data except for the annotation position. Further, the control unit 41 generates a CAD result layer image illustrating the positions of the abnormal shadow candidates detected by the CAD device 20 based on the CAD result file D2. The layer image of the CAD result is data indicating transparency except for the position of the abnormal shadow candidate.

  When generating the layer image of the CAD result, the control unit 41 first surrounds the CAD result C1 as shown in FIG. 5B based on the position information of the CAD result C1 shown in FIG. A rectangular area C2 is calculated. Then, as shown in FIG. 5C, the position for printing the identification information is determined, for example, in the upper right area C3 of the rectangular area, and the characters “CAD” are added as the identification information.

As shown in FIG. 6, the control unit 41 generates an image for printing by superimposing the annotation layer image and the CAD result layer image on the medical image.
5 and 6, the abnormal shadow candidate region (outline) is illustrated as the position of the abnormal shadow candidate (outline display), but the representative point of the abnormal shadow candidate may be indicated by a mark.

Next, the operation will be described.
FIG. 7 is a flowchart showing print image generation processing executed in the client terminal 40. This process is realized by software processing in cooperation with the CPU of the control unit 41 and the print image generation program 462 stored in the storage unit 46.

  First, an image file D1 of a medical image to be printed is selected by a user's operation from the operation unit 42, and the selected medical image is transmitted to the image server device 30 by the communication unit 44 under the control of the control unit 41. An acquisition request for the image file D1 of the image is transmitted. Then, the control unit 41 acquires the image file D1 of the medical image from the image server device 30 via the communication unit 44 and loads it onto the memory 47. At this time, when the CAD result file D2 and the annotation file D3 associated with the image file D1 exist in the image server device 30, the control unit 41 sends the CAD data from the image server device 30 via the communication unit 44. The result file D2 and the annotation file D3 are acquired and loaded onto the memory 47.

  Next, the control unit 41 generates a print image (bitmap data) based on the medical image file D1 (step S1).

  Next, the control unit 41 determines whether or not the annotation file D3 exists on the memory 47 (step S2). If the annotation file D3 exists on the memory 47 (step S2; YES), the control unit 41 generates an annotation layer image based on the annotation file D3 (step S3). Then, the control unit 41 adds an annotation layer image to the print image (step S4).

  When the annotation file D3 does not exist on the memory 47 in step S2 (step S2; NO), or after step S4, the control unit 41 determines whether or not the CAD result file D2 exists on the memory 47. (Step S5). When the CAD result file D2 exists on the memory 47 (step S5; YES), the control unit 41 generates a layer image of the CAD result based on the CAD result file D2 (step S6).

  Next, the control unit 41 calculates a rectangular area from the CAD result (step S7). Specifically, the minimum and maximum values of the vertical and horizontal coordinates of the abnormal shadow candidate area are obtained by the control unit 41, and the minimum rectangular area surrounding the abnormal shadow candidate area is calculated.

  Next, the control unit 41 determines a position to which the identification information is to be added based on the calculated rectangular area (step S8). For example, the control unit 41 determines the upper right area of the rectangular area as the position to which the identification information is to be added.

  Next, the control unit 41 adds identification information “CAD” to the position determined in step S8 of the layer image of the CAD result (step S9). Then, the control unit 41 adds a layer image as a CAD result to the print image (step S10).

If the CAD result file D2 does not exist on the memory 47 in step S5 (step S5; NO), or after step S10, the control unit 41 sends the print image to the film output device 50 via the communication unit 44. It is transmitted (step S11).
Thus, the print image generation process ends.

  In the film output device 50, an image for printing is printed on the film. When the print image includes the annotation and the CAD result, the image is output on the film with the identification information “CAD” for identifying the annotation, the CAD result, and the CAD result added to the medical image.

  As described above, according to the medical image system 100, the client terminal 40 adds a plurality of types of additional information to the medical image, and at least one of the types of additional information added to the medical image. The identification information for identifying the type of additional information corresponding to the additional information is added to the medical image to generate the print image, so that the type of additional information added to the medical image can be identified. Can do.

  As in the present embodiment, when the identification information indicating the CAD result is added to the medical image in association with the additional information (CAD result) shown in FIG. Can be identified from the additional information (annotation). In this way, the CAD result can be used even when the doctor interprets the medical image output on the film.

  The description in the above embodiment is an example of the medical image system according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each device constituting the system can be changed as appropriate without departing from the spirit of the present invention.

  For example, in the above-described embodiment, the medical image system 100 includes the CAD device 20 as an independent device. However, the image server device 30 may include the CAD device 20.

  In the above-described embodiment, the case where a CAD image and an annotation are added to a medical image to generate a print image has been described. However, additional information illustrating a predetermined position on the medical image is a medical image. Measurement lines and measurement results illustrating the length and angle on the image, and GSPS (Grayscale Softcopy Presentation State) of DICOM standard can also be used. At this time, identification information may be added only to the CAD result, or corresponding identification information may be added to each of a plurality of types of additional information.

  In the above embodiment, characters are added as identification information. However, symbols, figures, and the like may be used as long as they are identification information for identifying the type of additional information. In the above embodiment, the case where identification information is added to the upper right area of the CAD result has been described. However, the position where the identification information is added is close to the additional information to the extent that the correspondence with the additional information can be recognized. However, it may be anywhere as long as it does not overlap with the additional information.

  Further, in the above-described embodiment, a case has been described in which additional information is added to a medical image, identification information is further added to generate a printing image, and the printing image is printed on a film. The recording medium for printing is not limited to a film, and paper or the like can also be used.

  In the above description, an example in which a ROM, a hard disk, or the like is used as a computer-readable medium storing a program for executing each process is disclosed, but the present invention is not limited to this example. As other computer-readable media, a non-volatile memory such as a flash memory and a portable recording medium such as a CD-ROM can be applied. A carrier wave may be applied as a medium for providing program data via a communication line.

10 modality 20 CAD device 21 control unit 22 operation unit 23 display unit 24 communication unit 25 ROM
26 storage unit 27 bus 30 image server device 31 control unit 32 operation unit 33 display unit 34 communication unit 35 ROM
36 storage unit 37 bus 40 client terminal 41 control unit 42 operation unit 43 display unit 44 communication unit 45 ROM
46 storage unit 47 memory 48 bus 100 medical image system 461 image viewer program 462 print image generation program D1 image file D2 CAD result file D3 annotation file N network

Claims (4)

A plurality of types of additional information illustrating a predetermined position on the medical image is added to the medical image, and corresponds to at least one type of additional information among the plurality of types of additional information added to the medical image. Control means for adding the identification information for identifying the type of the additional information to the medical image to generate a print image;
Printing means for printing the generated image for printing on a recording medium;
A medical image system comprising: The additional information corresponding to the identification information illustrates the position of the abnormal shadow candidate detected from the medical image.
The medical image system according to claim 1. Computer
A plurality of types of additional information illustrating a predetermined position on the medical image is added to the medical image, and corresponds to at least one type of additional information among the plurality of types of additional information added to the medical image. Control means for adding identification information for identifying the type of the additional information to the medical image to generate a printing image;
Output means for outputting the generated printing image to a printing apparatus;
Program to function as. The additional information corresponding to the identification information illustrates the position of the abnormal shadow candidate detected from the medical image.
The program according to claim 3.

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