JP2011250842A - Mammography apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To detect the existence of an image blur in a mammography apparatus.SOLUTION: The mammography apparatus 1 includes: a radiography control unit 52 for controlling the irradiation of mammogram with an x-ray for radiography; a detection value acquisition unit 51 for acquiring at least one detection value of an oppression force on the mammogram by an oppression plate 24 and thickness of the mammogram oppressed by the oppression plate 24 as an abnormal detection item; an failure detection unit 54 for detecting variation failure of the mammogram oppressed by the oppression plate 24 based on the detection value acquire during the radiography; and an alarm lamp 29 for alarming the variation failure to an external apparatus when the failure detection unit 54 detects the variation failure.

Description

  The present embodiment as one aspect of the present invention relates to a mammography apparatus that images a breast.

  Mammography, which provides a two-dimensional image of breast tissue and performs a breast examination, is widely used to diagnose cancer and other abnormalities. Since the breast has a three-dimensional and delicate structure, imaging is performed with a dedicated X-ray apparatus (mammography apparatus).

  The mammography apparatus is capable of imaging by irradiating X-rays with a breast placed on an imaging table and with a compression plate provided above the imaging table so that the thickness of the breast is thin and uniform. (For example, refer to Patent Document 1).

  Further, there is a mammography apparatus that acquires a compression force and a breast thickness when compression by a compression plate is started (see, for example, Patent Document 2). The mammography apparatus employs an interlock function such as not irradiating X-rays when the compression force and the breast thickness are outside a predetermined range based on the acquired compression force and breast thickness.

Japanese Patent No. 2500955 JP 2009-136390 A

  A mammography apparatus generally has a longer imaging period than other X-ray imaging apparatuses. However, an acquired image may be blurred (blurred) due to body movement of a subject during imaging. is there. A photographer such as an engineer judges a shake by looking at the displayed image. However, it is necessary to observe carefully in the operation of taking a picture in a short time, and the shake of the image may be missed.

  In addition, tomosynthesis imaging may be performed using a mammography apparatus in order to improve lesion detection capability. In tomosynthesis imaging, since the imaging is performed from a plurality of angles while rotating the arm portion holding the X-ray tube while the breast is compressed, the breast compression period is long. Therefore, in tomosynthesis imaging, the influence of the body movement of the subject within the breast compression period is a more important problem than general imaging.

  In order to solve the above-described problems, the mammography apparatus according to the present embodiment includes an X-ray generation unit that generates X-rays and a position that faces the X-ray generation unit across a breast as a subject. X-ray detection means, compression means capable of compressing the breast, imaging control means for controlling the X-ray generation means, and the X-ray detection means so as to perform imaging by irradiating the breast with the X-rays A detection value acquisition unit that acquires at least one detection value of a compression force applied to the breast by the compression unit and a thickness of the breast compressed by the compression unit, as an abnormality determination item; Based on the detected value obtained in step S3, an abnormality determination unit that determines abnormality of the breast compressed by the compression unit, and the abnormality determination unit determines that the abnormality of variation is determined as the variation abnormality. Having an abnormality informing means for knowledge, the.

  In order to solve the above-described problems, the mammography apparatus according to the present embodiment includes an X-ray generation unit that generates X-rays and a position that faces the X-ray generation unit across a breast as a subject. X-ray detection means, compression means capable of compressing the breast, period setting means for presetting a scheduled imaging period, and causing the breast to irradiate the X-ray from the start of imaging to the end of imaging based on the scheduled irradiation period The X-ray generation means and the X-ray detection means for controlling the X-ray detection means so as to perform imaging, the compression force applied to the breast by the compression means as an abnormality determination item, and the compression means Detection value acquisition means for acquiring at least one detection value of the breast thickness, and fluctuation abnormality of the breast compressed by the compression means based on the detection value acquired during the imaging An abnormality determination unit to be disconnected, and when the abnormality determination unit determines that the fluctuation abnormality is present at a predetermined acquisition time point, a ratio of an actual shooting period up to the predetermined acquisition time point to the scheduled shooting period is a predetermined value When determining that the above is true, when the photographing end control means forcibly ends the photographing by controlling the photographing control means, and the photographing end control means forcibly terminates the fluctuation abnormality And an abnormality notifying means for notifying forced termination of the photographing.

1 is a perspective view showing an overall appearance configuration of a mammography apparatus of the present embodiment. FIG. 2 is a perspective view showing an external configuration of a part of the mammography apparatus of the present embodiment shown in FIG. 1. FIG. 2 is a side view showing an external configuration of a part of the mammography apparatus of the present embodiment shown in FIG. 1 is a block diagram showing the configuration of an imaging control / image processing apparatus provided in a mammography apparatus according to an embodiment. FIG. 2 is a block diagram illustrating functions of an imaging control / image processing apparatus provided in the mammography apparatus according to the first embodiment. The time chart which shows the relationship of the compression pressure in the mammography apparatus of 1st Embodiment, breast thickness, and imaging | photography. The figure which shows an example of the display screen of a picked-up image. 6 is a flowchart showing the operation of the mammography apparatus of the first embodiment. The block diagram which shows the function of the imaging | photography control / image processing apparatus with which the mammography apparatus of 2nd Embodiment is equipped. The time chart which shows the relationship between the compression pressure and imaging | photography in the mammography apparatus of 2nd Embodiment. The time chart which shows the relationship between the breast thickness and imaging | photography in the mammography apparatus of 2nd Embodiment. The flowchart which shows operation | movement of the mammography apparatus of 2nd Embodiment. The block diagram which shows the function of the imaging | photography control / image processing apparatus with which the mammography apparatus of 3rd Embodiment is provided. The schematic diagram for demonstrating tomosynthesis imaging | photography. The time chart which shows the relationship between the compression pressure in the mammography apparatus of 3rd Embodiment, a breast thickness, X-ray irradiation of an arm part, and rotational motion. The flowchart which shows operation | movement of the mammography apparatus of 3rd Embodiment.

  The mammography apparatus of this embodiment will be described with reference to the accompanying drawings.

(First embodiment)
FIG. 1 is a perspective view showing an overall appearance configuration of the mammography apparatus according to the first embodiment. FIG. 2 is a perspective view showing an external configuration of a part of the mammography apparatus of the first embodiment shown in FIG. FIG. 3 is a side view showing an external configuration of a part of the mammography apparatus of the first embodiment shown in FIG.

  FIG. 1 shows a mammography apparatus 1 according to a first embodiment that images a breast (subject) of a patient O. The mammogram apparatus 1 includes an imaging table apparatus 11 and an imaging control / image processing apparatus 12.

  The imaging table device 11 includes an arm unit 15, a stand unit 16, a connection unit 17, and an operation unit 18. The arm portion 15 is supported by the stand portion 16 so as to be rotatable via the connection portion 17.

  The arm unit 15 includes an X-ray tube 21, a radiation quality adjustment filter / irradiation field limiting mask 22, a face guard 23, a compression plate 24, a grid 25, an imaging table 26, a compression foot pedal 27, and a C arm up / down / rotation fine adjustment switch 28. And a notification lamp 29 are provided. The stand unit 16 includes an information display panel 30 and a side panel 31. The operation unit 18 includes an imaging condition setting panel 32 and a high voltage supply device 33.

  The X-ray tube 21 of the arm unit 15 receives supply of high voltage power from the high voltage supply device 33 of the operation unit 18, and passes to the imaging table 26 via the breast of the patient O according to the condition of this high voltage power. It is a vacuum tube for irradiating X-rays.

  The radiation quality adjusting filter / irradiation field limiting mask 22 is an adjustment tool for adjusting the quality of X-rays generated by the X-ray tube 21 or limiting the irradiation field.

  The face guard 23 is a protective device for protecting the head of the patient O from X-ray exposure during imaging.

  The compression plate 24 is a compression device provided above the imaging table 26 in order to compress the patient's O breast with the imaging table 26. The compression plate 24 is formed of a transparent resin, and is supported so as to be able to contact and separate from the imaging table 26. Then, the breast of the patient O can be compressed by moving the compression plate 24 toward the imaging table 26, and the thickness of the breast can be made thin and substantially uniform. When the compression foot pedal 27 is operated by a photographer such as a technician, the compression plate 24 is driven in the vertical direction by driving a drive mechanism (not shown) including a motor for moving the compression plate 24 in the vertical direction. Moving.

  The grid 25 is an instrument for removing the scattered radiation and improving the contrast of the captured image.

  The imaging table 26 is a table in which an FPD (flat panel detector) for detecting X-rays transmitted through the breast of the patient O is provided. A plurality of detection elements are two-dimensionally arranged in the FPD, and scanning lines and signal lines are arranged between the detection elements so as to be orthogonal to each other. The projection data of the time-series analog signal (video signal) output from the FPD is converted into a digital signal and output to the photographing control / image processing device 12.

  The compression foot pedal 27 is a pedal for an operator to step on to adjust the position of the compression plate 24 in the vertical direction.

  The C-arm vertical / rotation fine adjustment switch 28 is a switch for vertically moving or rotating the C-arm constituted by the X-ray tube 21, the imaging table 26, and the like.

  Examples of the notification lamp 29 include an LED (light emitting diode), an LCD (liquid crystal display), and the like. The notification lamp 29 is lit or blinked under the control of the photographing control / image processing device 12.

  The information display panel 30 of the stand unit 16 is a panel for displaying various information such as compression information.

  The side panel 31 is an operation panel for controlling each part of the mammography apparatus 1.

  The imaging condition setting panel 32 of the operation unit 18 is a panel for setting X-ray imaging conditions.

  The high voltage supply device 33 is a device that supplies a voltage to the X-ray tube 21 of the arm unit 15.

  When X-rays are generated by the X-ray tube 21 of the imaging table apparatus 11, the X-ray is narrowed by an X-ray quality adjusting filter / irradiation field limiting mask 22, and then the compression plate 24 and the imaging table 26. It is irradiated to the breast compressed between. Then, the X-rays that have passed through the breast are detected by the FPD of the imaging table 26, converted into projection data, and output to the imaging control / image processing device 12.

  The imaging control / image processing apparatus 12 is an apparatus that performs operation control of the entire mammography apparatus 1, image processing relating to a captured image acquired by the imaging platform apparatus 11, and the like. The imaging control / image processing apparatus 12 includes an input device 42, a display device 43, a speaker 44, and the like.

  FIG. 4 is a block diagram illustrating the configuration of the imaging control / image processing apparatus 12 provided in the mammography apparatus 1 of the first embodiment.

  FIG. 4 shows an imaging control / image processing apparatus 12 provided in the mammography apparatus 1. The imaging control / image processing device 12 includes an allowable width storage device 41, an input device 42, a display device 43, a speaker 44, a system control unit 45, an image data generation unit 46, an image data storage unit 47, an image processing unit 48, and a display. A processing unit 49 is provided.

  The permissible width storage device 41 stores in advance a permissible width of the detection value of the abnormality determination item that is an index for determining that there is a variation abnormality (abnormal body movement) in the breast of the patient O compressed by the compression plate 24. It is a storage device. The abnormality determination items include the compression force applied to the breast of the patient O compressed by the compression plate 24, and the breast thickness of the breast of the patient O compressed by the compression plate 24, and the allowable width storage device 41. Stores at least one of an allowable width p of the detection value P of the compression force and an allowable width h of the detection value H of the breast thickness.

  The input device 42 is a keyboard and a mouse that can be operated by an operator, and an input signal according to the operation is sent to the system control unit 45.

  The display device 43 is configured by a liquid crystal display, a CRT (cathode ray tube), or the like. The display device 43 displays the display image output from the display processing unit 49 together with character information and scales of detection values of various abnormality determination items.

  The speaker 44 generates sound under the control of the system control unit 45.

  The system control unit 45 includes a CPU (central processing unit) and a memory. When a command is input by the operator operating the input device 42 or the like, the CPU controls the operation of the imaging platform device 11 and the overall imaging control / image processing device 12.

  Under the control of the system control unit 45, the image data generation unit 46 performs logarithmic conversion processing (LOG processing) on the projection data transmitted from the imaging platform device 11 and performs addition processing as necessary to obtain captured image data. The captured image is stored in the image data storage unit 47.

  The image processing unit 48 performs enlargement / gradation / space filter processing or time-series stored captured images on the captured image data stored in the image data storage unit 47 under the control of the system control unit 45. Minimum value / maximum value trace processing and addition processing for removing noise are performed. Data of the captured image after the image processing by the image processing unit 48 is stored in the image data storage unit 47. Further, when performing tomosynthesis imaging, the image processing unit 48 synthesizes captured images in a plurality of directions to reconstruct an image of an arbitrary cross section.

  The display processing unit 49 synthesizes the photographed image output from the image processing unit 48 together with character information and scales of detection values of various abnormality determination items, and outputs the resultant as a video signal to the display device 43.

  In addition, although the mammography apparatus 1 demonstrates the case where the patient's O breast is image | photographed in a sitting position, it is not limited to that case. For example, the mammography apparatus 1 may be a case where the breast of the patient O is imaged in the supine position or the like.

  FIG. 5 is a block diagram illustrating functions of the imaging control / image processing apparatus 12 provided in the mammography apparatus 1 according to the first embodiment.

  When the system control unit 45 of the imaging control / image processing apparatus 12 executes the program, the system control unit 45 includes a detection value acquisition unit 51, an imaging control unit 52, a threshold setting unit 53, an abnormality, as shown in FIG. It functions as a determination unit 54, an abnormality notification control unit 55, and an abnormal incidental control unit 56. Note that all or part of the components 51 to 56 of the system control unit 45 may be included in the system control unit 45 as hardware.

  The detection value acquisition unit 51 has a function of acquiring a detection value of an abnormality determination item that is an index for determining that there is a variation abnormality (abnormal body movement) in the breast of the patient O compressed by the compression plate 24. The detection value acquisition unit 51 detects a detection value P of the compression force applied to the breast of the patient O compressed by the compression plate 24 and a detection value H of the breast thickness that is the thickness of the breast of the patient O compressed by the compression plate 24. And at least one of them. The detection value acquisition unit 51 includes a compression force acquisition unit 51a that acquires the detection value P of the compression force, and a breast thickness acquisition unit 51b that acquires the detection value H of the breast thickness.

  The compression force acquisition unit 51a acquires the detection value P of the compression force applied to the breast of the patient O compressed by the compression plate 24. For example, when the torque of the motor that moves the compression plate 24 is detected, the compression force acquisition unit 51a acquires the force that the compression plate 24 applies to the breast from the torque as the detection value P of the compression force.

  The breast thickness acquisition unit 51b acquires a detection value H of the breast thickness of the breast of the patient O compressed by the compression plate 24. For example, when the rotation amount of the motor that moves the compression plate 24 is detected, the breast thickness acquisition unit 51b calculates the movement distance of the compression plate 24 from the rotation amount, and uses the movement distance as the detection value H of the breast thickness. Get as. However, the detection value H of the breast thickness obtained when the compression plate 24 compresses the breast with the photographer's hand attached is obtained by adding the thickness of the photographer's hand and the breast thickness. It becomes.

  The imaging control unit 52 controls the imaging table device 11 to perform imaging by irradiating the breast of the patient O with X-rays while the arm unit 15 is fixed to the stand unit 16 (non-rotating). It has a function to make. Here, the start of imaging is determined by an abnormality determination item, for example, reaching a predetermined value of the detection value H of the breast thickness, or by an instruction from the photographer via the input device 42. The end of shooting is determined by the elapse of a scheduled shooting period from the start of shooting or by an instruction from the photographer via the input device 42.

  In the mammography apparatus 1, the initial acquisition time point of the detection value (the time point when the imaging is started or the time point immediately after the start of the imaging) is expressed as T 0, and the first detection value from the time point T 1 after the initial acquisition time T 0 is expressed as T 0. The n acquisition time point is expressed as Tn (Tn = T1, T2,...). Also, in the mammography apparatus 1, the detection value of the compression force acquired at the initial acquisition time T0 among the detection values P of the compression force acquired by the compression force acquisition unit 51a is expressed as P0, and the nth acquisition. The detection value of the compression pressure acquired at time Tn is expressed as Pn (Pn = P1, P2,...). Further, in the mammography apparatus 1, among the detection values H of the breast thickness acquired by the breast thickness acquisition unit 51b, the detection value of the breast thickness acquired at the initial acquisition time T0 is expressed as H0, and the nth acquisition The detection value of the breast thickness acquired at time Tn is expressed as Hn (Hn = H1, H2,...).

  The threshold value setting unit 53 has a threshold value P0 ± p having an allowable width p acquired from the allowable width storage device 41 on both sides around the detection value P0 of the compression pressure acquired at the initial acquisition time point T0 by the compression force acquisition unit 51a. Has the function of setting. The threshold setting unit 53 also has a threshold value H0 having an allowable width h acquired from the allowable width storage device 41 on both sides around the breast thickness detection value H0 acquired at the initial acquisition time T0 by the breast thickness acquisition unit 51b. Has a function to set ± h.

  The abnormality determination unit 54 compares the threshold value P0 ± p set by the threshold value setting unit 53 with the detection value Pn of the compression pressure acquired at the nth acquisition time Tn by the compression force acquisition unit 51a, and obtains the nth acquisition. When the detection value Pi of the compression pressure at a certain i-th acquisition time among the time points exceeds the threshold value P0 ± p, it has a function of determining that there is a variation abnormality in the breast of the patient O at the i-th acquisition time. In addition, the abnormality determination unit 54 compares the threshold value H0 ± h set by the threshold setting unit 53 with the detection value Hn of the breast thickness acquired at the nth acquisition time Tn by the breast thickness acquisition unit 51b. When the detection value Hi of the breast thickness at an i-th acquisition time among the n acquisition time points exceeds the threshold value H0 ± h, it has a function of determining that there is a variation abnormality in the breast of the patient O at the i-th acquisition time point. If the detection value acquisition unit 51 includes both the compression force acquisition unit 51a and the breast thickness acquisition unit 51b, the abnormality determination unit 54 may detect if either the detection value Pn of the compression pressure or the detection value Hn of the breast thickness exceeds the threshold value. It may be determined that there is a variation abnormality in the breast of the patient O, or it may be determined that there is a variation abnormality in the breast of the patient O only when both of them exceed the threshold value.

  FIG. 6 is a time chart showing the relationship between compression pressure, breast thickness, and imaging in the mammography apparatus 1 of the first embodiment.

  As shown in FIG. 6, when the compression of the breast of the patient O is started, the detection value P of the compression force acquired by the compression force acquisition unit 51a gradually increases from zero. Further, when the compression of the breast of the patient O is started, the detection value H of the breast thickness acquired by the breast thickness acquisition unit 51b gradually decreases.

  The initial acquisition time T0 and the compression pressure P0 at the initial acquisition time T0 are determined by an abnormality determination item, for example, reaching the predetermined value of the detection value H of the breast thickness or by an instruction from the photographer via the input device 42. Is decided. When the compression pressure P0 is determined, a threshold value P0 ± p having an allowable width p on both sides centering on the detection value P0 of the compression pressure is determined. Comparison with the threshold value P0 ± p is started. When the initial acquisition time T0 is determined, the breast thickness detection value H0 at the initial acquisition time T0 is determined. When the detection value H0 of the breast thickness is determined, a threshold value H0 ± h having an allowable width h on both sides with respect to the detection value H0 of the breast thickness is determined. Comparison between the value Hn and the threshold value H0 ± h is started.

  In FIG. 6, the detection value Pi of the compression pressure at a certain i-th acquisition time Ti (Ti on the right side in FIG. 6) among the n-th acquisition time points Tn exceeds the threshold value P0 + p for the first time. It is determined that there is a variation abnormality in the breast of patient O at time Ti. Further, in FIG. 6, since the detection value Hi of the breast thickness at an i-th acquisition time Ti (left Ti in FIG. 6) among the n-th acquisition time points Tn exceeds the threshold value H0 + h for the first time, the abnormality determination unit 54 i It is determined that there is a variation abnormality in the breast of the patient O at the acquisition time Ti.

  The abnormality notification control unit 55 shown in FIG. 5 has a function of notifying the outside of the apparatus of a variation abnormality when the abnormality determination unit 54 determines that there is a variation abnormality at the i-th acquisition time Ti. For example, when the abnormality determining unit 54 determines that the variation is abnormal, the abnormality notification control unit 55 controls the notification lamp 29 of the imaging base device 11 to turn on or blink the notification lamp 29, thereby detecting the variation abnormality in the breast X. Notify the outside of the X-ray imaging apparatus 1, that is, the photographer and the patient O. Further, when the abnormality determination unit 54 determines that the fluctuation is abnormal, the abnormality notification control unit 55 notifies the photographer or the patient O of the fluctuation abnormality by controlling the speaker 44 to emit sound from the speaker 44. Further, the abnormality notification control unit 55 controls the display processing unit 49 to turn on or blink a part of the captured image display screen (shown in FIG. 7) when the abnormality determination unit 54 determines that the fluctuation is abnormal. The change abnormality is notified to the photographer and the patient O.

  The abnormality accompanying control unit 56 has a function of attaching fluctuation abnormality information to image data acquired by photographing by the photographing control unit 52 when the abnormality judging unit 54 determines that there is variation abnormality. By attaching the information of fluctuation abnormality to the image data, when the operator performs an image display based on the image data later, it can be shown to the operator that the display image is blurred.

  Next, the operation of the mammography apparatus 1 of the first embodiment will be described using the flowchart shown in FIG.

  The mammography apparatus 1 stores in advance the permissible width of the detection value of the abnormality determination item (step ST1). Here, the mammography apparatus 1 accepts the permissible width of the detection value H of the breast thickness as the permissible width. A case where only h is stored and only the detection value H of the breast thickness as an abnormality determination item is acquired will be described below as an example.

  When the compression foot pedal 27 is operated by the photographer after the breast of the patient O is extended on the imaging table 26 of the mammography apparatus 1 by the hands of a photographer such as a technician, the mammography apparatus 1 is Then, the motor is driven to start the compression of the breast by the compression plate 24 (step ST2). When breast compression is started in step ST2, the mammography apparatus 1 acquires a detection value H of the breast thickness (step ST3), and enters a standby state for an imaging instruction from the photographer.

  Next, the mammography apparatus 1 can perform imaging by reaching the predetermined value of the detection value H of the breast thickness acquired in step ST3 or by an instruction from the photographer via the input device 42. It is determined whether or not (step ST4). When the determination in step ST4 is YES, that is, when it is determined that imaging is possible, the mammography apparatus 1 starts imaging the breast of the patient O compressed by the compression plate 24, that is, X-ray irradiation. (Step ST5) The detection value H0 of the breast thickness at the initial acquisition time T0 is acquired (step ST6).

  On the other hand, if the determination in step ST4 is NO, that is, if it is determined that imaging is not possible, the mammography apparatus 1 acquires the detection value H of the breast thickness again (step ST3).

  Next, the mammography apparatus 1 sets a threshold value H0 ± h having the allowable width h stored in step ST1 on both sides around the detection value H0 of the breast thickness acquired in step ST5 (step ST7). .

  Next, the mammography apparatus 1 acquires the detection value H1 of the breast thickness at the first acquisition time point T1 (step ST8). The mammography apparatus 1 compares the threshold value H0 ± h set in step ST7 with the detected breast thickness value H1 acquired in step ST8. The mammography apparatus 1 determines whether the detection value H1 of the breast thickness does not exceed the threshold value H0 ± h as a result of the comparison in step ST8 (step ST9). When the determination in step ST9 is YES, that is, when it is determined that the detection value H1 of the breast thickness does not exceed the threshold value P0 ± p, the mammography apparatus 1 determines whether the scheduled imaging period has elapsed from the start of imaging, or Then, it is determined whether or not the photographing is completed based on the presence or absence of an instruction from the photographer via the input device 42 (step ST10). When the determination in step ST10 is NO, that is, when it is determined that the X-ray imaging is not completed, the mammography apparatus 1 obtains the detection value H2 of the breast thickness at the second acquisition time T2 next to the first acquisition time T1. Obtain (step ST8).

  Further, when the determination in step ST9 is NO, that is, when it is determined that the detection value Hi of the breast thickness at an i-th acquisition time Ti among the n-th acquisition time points Tn exceeds the threshold value H0 ± h, the mammography apparatus 1 notifies that there was a variation abnormality in the breast at the i-th acquisition time Ti (step ST11). Further, the mammography apparatus 1 determines whether or not the imaging has been completed based on whether the scheduled imaging period has elapsed from the start of imaging or the presence or absence of an instruction from the photographer via the input device 42 ( Step ST12). If the determination in step ST12 is NO, that is, if it is determined that shooting is not completed, the determination in step ST12 is repeated until it is determined that shooting is completed.

  On the other hand, if the determination in steps ST10 and ST12 is YES, that is, if it is determined that the imaging has ended, the mammography apparatus 1 ends imaging of the breast of the patient O (step ST13), and the breast compression of the patient O Is released (step ST14).

  As described above, by repeating the operations in steps ST8 to ST10 until the abnormality in the breast of the patient O is detected, the mammography apparatus 1 acquires the detection value Hn of the breast thickness and the detection value of the breast thickness. The comparison between Hn and the threshold value H0 ± h1 is continued.

  In the threshold value setting unit 53 and step ST7 of the mammography apparatus 1, the threshold value P0 ± p (the breast at the initial acquisition time point T0) having an allowable width p on both sides centering on the detection value P0 of the compression pressure at the initial acquisition time point T0. The threshold value H0 ± h) having an allowable width h on both sides with the thickness detection value H0 as the center has been described. However, the present invention is not limited to this case. For example, by storing the plus-side tolerance width p1 and the minus-side tolerance width p2 in the tolerance-width storage device 41 of the mammography apparatus 1, the threshold setting unit 53 and step ST7 compress the initial acquisition time T0. Threshold values P0 + p1 and P0−p2 having an allowable width p1 on the positive side and an allowable width p2 on the negative side around the detected pressure value P0 are set.

  Further, the permissible width storage device 41 of the mammography apparatus 1 may store a table in which a plurality of sizes of the detection values P0 of the compression pressure at the initial acquisition time T0 are associated with a plurality of permissible widths. In that case, the threshold value setting unit 53 and the step ST7 of the mammography apparatus 1 select an allowable width p corresponding to the detection value P0 of the compression pressure at the initial acquisition time T0 from a plurality of allowable widths, and the detection value of the compression pressure A threshold value P0 ± p having the selected allowable width p is set on both sides centering on P0.

(Second Embodiment)
FIG. 1 is a perspective view showing an overall appearance configuration of a mammography apparatus according to the second embodiment. FIG. 2 is a perspective view showing an external configuration of a part of the mammography apparatus according to the second embodiment shown in FIG. FIG. 3 is a side view showing an external configuration of a part of the mammography apparatus of the second embodiment shown in FIG.

  FIG. 1 shows a mammography apparatus 1A of a second embodiment for imaging a breast of a patient O. The mammogram apparatus 1A includes an imaging table apparatus 11 and an imaging control / image processing apparatus 12A.

  FIG. 4 is a block diagram showing a configuration of an imaging control / image processing apparatus 12A provided in the mammography apparatus 1A of the second embodiment.

  FIG. 4 shows an imaging control / image processing apparatus 12A provided in the mammography apparatus 1A. The imaging control / image processing device 12A includes an allowable width storage device 41, an input device 42, a display device 43, a speaker 44, a system control unit 45A, an image data generation unit 46, an image data storage unit 47, an image processing unit 48, and a display. A processing unit 49 is provided.

  FIG. 9 is a block diagram illustrating functions of the imaging control / image processing apparatus 12A provided in the mammography apparatus 1A of the second embodiment.

  When the system control unit 45A of the imaging control / image processing apparatus 12A executes the program, as shown in FIG. 9, the system control unit 45A has a detection value acquisition unit 51, an imaging control unit 52A, a threshold setting unit 53, an abnormality. It functions as a determination unit 54, an abnormality notification control unit 55A, an abnormal incidental control unit 56A, a shooting period setting unit 57, and a shooting end control unit 58. Note that all or part of the components 51 to 58 of the system control unit 45A may be provided as hardware in the system control unit 45A.

  In the mammography apparatus 1A shown in FIG. 9, the same components as those in the mammography apparatus 1 shown in FIG.

  The imaging period setting unit 57 has a function of setting an imaging period scheduled to image the breast of the patient O.

  The imaging control unit 52A controls the imaging platform device 11 and keeps the arm unit 15 fixed to the stand unit 16 from the start of imaging until the end of imaging based on the scheduled imaging period set by the imaging period setting unit 57 ( (Non-rotation) The patient O has a function of performing imaging by irradiating the breast of the patient O with X-rays. Here, the start of imaging is determined by an abnormality determination item, for example, reaching a predetermined value of the detection value H of the breast thickness, or by an instruction from the photographer via the input device 42. The end of shooting is determined by the elapse of a scheduled shooting period from the start of shooting.

  In the mammography apparatus 1A, the initial acquisition time point of the detection value (the time point when the imaging starts or the time point immediately after the imaging start) is expressed as T0, and the final Nth acquisition from the time point T1 after the initial acquisition time point T0. Tn (Tn = T1, T2,..., TN) is the nth acquisition time point of the detected value up to the time point (time point at which shooting is finished based on the scheduled shooting period or time point just before shooting based on the scheduled shooting period). It expresses. Also, in the mammography apparatus 1A, among the detection values P of the compression force acquired by the compression force acquisition unit 51a, the detection value of the compression force acquired at the initial acquisition time T0 is expressed as P0, and the nth acquisition The detection value of the compression pressure acquired at time Tn is expressed as Pn (Pn = P1, P2,..., PN). Further, in the mammography apparatus 1A, among the detection values H of the breast thickness acquired by the breast thickness acquisition unit 51b, the detection value of the breast thickness acquired at the initial acquisition time T0 is expressed as H0, and the nth acquisition The detection value of the breast thickness acquired at time Tn is expressed as Hn (Hn = H1, H2,..., HN).

  When the abnormality determination unit 54 determines that there is a fluctuation abnormality at the i-th acquisition time point Ti (Ti <TN), the imaging end control unit 58 determines the actual shooting period (from T0 to Ti) until the i-th acquisition time point Ti. When it is determined that the ratio of the (period) to the scheduled imaging period is equal to or greater than a predetermined value (for example, 80%), the imaging control unit 52A is controlled to end the X-ray irradiation and to forcibly terminate imaging. On the other hand, when the abnormality determination unit 54 determines that there is a variation abnormality at the i-th acquisition time Ti, the shooting end control unit 58 has a predetermined ratio of the actual shooting period up to the i-th acquisition time Ti to the scheduled shooting period. When the value is less than the value, the shooting control unit 52A is controlled to forcibly end shooting at the j-th acquisition time Tj (Ti <Tj <TN) when the ratio of the actual shooting period to the scheduled shooting period reaches a predetermined value.

  For example, it is assumed that the imaging period setting unit 57 sets the scheduled imaging period to 1 second and the imaging is started, but an abnormality in the breast is detected when 0.1 second has elapsed since the imaging was started. If the imaging is forcibly terminated, an X-ray irradiation is performed for only 1/10 of the scheduled imaging period, and an image with a poor S / N (signal to noise) is acquired. Since this image cannot be used for diagnosis, unnecessary exposure for 0.1 second is given to the patient O. Therefore, the photographing end control unit 58 forcibly terminates photographing only when the ratio of the actual photographing period to the scheduled photographing period is equal to or greater than a predetermined value. By forcibly terminating the shooting, the S / N of the image can be secured and the minimum image that can be used for diagnosis can be acquired.

  FIG. 10 is a time chart showing the relationship between compression pressure and imaging in the mammography apparatus 1A of the second embodiment.

  As shown in FIG. 10, when the compression of the breast of the patient O is started, the detection value P of the compression force acquired by the compression force acquisition unit 51a gradually increases from zero.

  Then, the initial acquisition time T0 and the initial acquisition time T0 according to the arrival of the detection value H of the breast thickness acquired by the breast thickness acquisition unit 51b to a predetermined value or an instruction from the photographer via the input device 42. The detection value P0 of the compression pressure is determined. When the initial acquisition time T0 is determined, the final Nth acquisition time TN based on the scheduled shooting period is determined. On the other hand, when the detection value P0 of the compression pressure is determined, a threshold value P0 ± p having an allowable width p on both sides around the detection value P0 of the compression pressure is determined, and the compression pressure at the n-th acquisition time Tn together with the imaging of the breast of the patient P. The comparison between the detected value Pn and the threshold value P0 ± p is started.

  In FIG. 10, since the detection value Pi of the compression pressure at an i-th acquisition time Ti before the final N-th acquisition time TN exceeds the threshold value P0 + p for the first time, the abnormality determination unit 54 Judge that there is an abnormality in the breast. If it is determined that there is a variation abnormality in the breast, the imaging end control unit 58 determines that the ratio of the actual imaging period up to the i-th acquisition time Ti to the scheduled imaging period is greater than or equal to a predetermined value. X-ray irradiation is terminated without waiting for the end of imaging based on the imaging period (Nth acquisition time TN), and imaging is forcibly terminated.

  FIG. 11 is a time chart showing the relationship between breast thickness and imaging in the mammography apparatus 1A of the second embodiment.

  As shown in FIG. 11, when the compression of the breast of the patient O is started, the detection value H of the breast thickness acquired by the breast thickness acquisition unit 51b gradually decreases.

  When the initial acquisition time T0 is determined, the detection value H0 of the breast thickness at the initial acquisition time T0 is determined. When the detection value H0 of the breast thickness is determined, a threshold value H0 ± h having an allowable width h on both sides with respect to the detection value H0 of the breast thickness is determined, and the breast thickness at the nth acquisition time Tn is detected together with the imaging of the breast of the patient P. Comparison between the value Hn and the threshold value H0 ± h is started.

  In FIG. 11, since the detection value Hi of the breast thickness at a certain time Ti before the time TN of the final Nth acquisition end exceeds the threshold value H0 + h, the abnormality determination unit 54 changes to the breast of the patient O at the ith time Ti. Judge that there is an abnormality. If it is determined that there is a variation abnormality in the breast, the imaging end control unit 58 determines that the imaging is forcibly terminated when the ratio of the actual imaging period up to the i-th acquisition time Ti to the scheduled imaging period is less than a predetermined value. At the time Tj when the ratio of the actual imaging period to the scheduled imaging period reaches a predetermined value, the X-ray irradiation is terminated without waiting for the imaging end based on the scheduled imaging period (Nth acquisition time TN). , Forcibly end shooting.

  The abnormality notification control unit 55A illustrated in FIG. 9 has a function of informing the outside of the apparatus of a variation abnormality and forced termination of photographing when photographing is forcibly terminated by the photographing end control unit 58. For example, when the photographing end control unit 58 forcibly terminates the photographing, the abnormality notification control unit 55A controls the notification lamp 29 of the photographing stand device 11 to turn on or blink the notification lamp 29, thereby causing fluctuation abnormality and photographing. Is notified to the outside of the mammography apparatus 1A, that is, to the radiographer and the patient O. In addition, the abnormality notification control unit 55A controls the speaker 44 to emit a sound from the speaker 44 when the photographing end control unit 58 forcibly terminates the photographing. Inform patient O. Furthermore, when the photographing end control unit 58 forcibly terminates the photographing, the abnormality notification control unit 55A controls the display processing unit 49 so that a part of the display screen of the photographed image is turned on or blinked. Is notified to the photographer and the patient O.

  The abnormal incidental control unit 56A is a function for attaching information of fluctuation abnormality and information about forced termination of photographing to image data acquired by photographing by the photographing control unit 52A when photographing is forcibly terminated by the photographing end control unit 58. Have By attaching the information of fluctuation abnormality to the image data, when the operator performs an image display based on the image data later, it can be shown to the operator that the display image is blurred. In addition, by adding information about forced termination of shooting to the image data, when the operator later displays an image based on the image data, the operator can confirm that shooting was performed with a shooting time shorter than the scheduled shooting period. Can be presented.

  Next, the operation of the mammography apparatus 1A of the second embodiment will be described using the flowchart shown in FIG.

  In the operation of the mammography apparatus 1A shown in FIG. 12, the same steps as those of the mammography apparatus 1 shown in FIG.

  Prior to the start of breast compression by the compression plate 24 (step ST2), an imaging period for which the breast of the patient O is to be imaged is set (step ST21).

  When the determination in step ST9 is NO, that is, when it is determined that the detection value Hi of the breast thickness at a certain i-th acquisition time Ti exceeds the threshold value H0 ± h, the mammography apparatus 1A determines that at the i-th acquisition time Ti, It is determined whether the ratio of the actual shooting period up to the i-th acquisition time Ti with respect to the scheduled shooting period is a predetermined value or more (step ST22). If YES in step ST22, that is, if it is determined that the ratio of the actual imaging period up to the i-th acquisition time Ti with respect to the scheduled imaging period is equal to or greater than a predetermined value, the mammography apparatus 1A performs X-ray irradiation. Is terminated forcibly (step ST23). Further, the mammography apparatus 1A notifies that there is a variation abnormality in the breast and the forced termination of imaging at the i-th acquisition time Ti (step ST24).

  On the other hand, when the determination in step ST22 is NO, that is, when it is determined that the ratio of the actual imaging period up to the i-th acquisition time Ti to the scheduled imaging period is less than a predetermined value, the mammography apparatus 1A performs imaging. It is determined whether or not it has reached a time point Tj at which the ratio of the actual shooting period to the scheduled shooting period is equal to or greater than a predetermined value (step ST25). If YES in step ST25, that is, if it is determined that the time Tj at which the ratio of the actual imaging period to the scheduled imaging period is equal to or greater than a predetermined value has been reached, the mammography apparatus 1A ends the X-ray irradiation. Thus, the photographing is forcibly terminated (step ST23).

  On the other hand, when the determination in step ST25 is NO, that is, when it is determined that the time Tj at which the ratio of the actual imaging period to the scheduled imaging period is not less than a predetermined value has been reached, the mammography apparatus 1A does not actually The determination in step ST25 is repeated until the time point Tj at which the ratio of the shooting period to the scheduled shooting period reaches a predetermined value or more is reached.

  Further, when imaging of the breast of the patient O is completed in step ST13 or ST23, the mammography apparatus 1A releases the breast compression of the patient O (step ST26).

  As described above, by repeating the operations of steps ST8 to ST10 until the abnormality in the breast of the patient O is detected, the mammography apparatus 1A acquires the detection value Hn of the breast thickness and the detection value of the breast thickness. The comparison between Hn and the threshold value H0 ± h1 is continued.

(Third embodiment)
FIG. 1 is a perspective view showing an overall appearance configuration of a mammography apparatus according to a third embodiment. FIG. 2 is a perspective view showing an external configuration of a part of the mammography apparatus of the third embodiment shown in FIG. FIG. 3 is a side view showing an external configuration of a part of the mammography apparatus of the third embodiment shown in FIG.

  FIG. 1 shows a mammography apparatus 1B of a third embodiment for imaging a patient's O breast. The mammography apparatus 1B includes an imaging table apparatus 11 and an imaging control / image processing apparatus 12B.

  FIG. 4 is a block diagram showing a configuration of an imaging control / image processing apparatus 12B provided in the mammography apparatus 1B of the third embodiment.

  FIG. 4 shows an imaging control / image processing apparatus 12B provided in the mammography apparatus 1B. The photographing control / image processing device 12B includes an allowable width storage device 41, an input device 42, a display device 43, a speaker 44, a system control unit 45B, an image data generation unit 46, an image data storage unit 47, an image processing unit 48, and a display. A processing unit 49 is provided.

  FIG. 13 is a block diagram illustrating functions of an imaging control / image processing apparatus 12B provided in the mammography apparatus 1B of the third embodiment.

  When the system control unit 45B of the imaging control / image processing apparatus 12B executes the program, the system control unit 45B includes a detection value acquisition unit 51, an imaging control unit 52B, a threshold setting unit 53, an abnormality, as shown in FIG. It functions as a determination unit 54, an abnormality notification control unit 55, and an abnormal incidental control unit 56. Note that all or part of the components 51 to 56 of the system control unit 45B may be provided as hardware in the system control unit 45B.

  In the mammography apparatus 1B shown in FIG. 13, the same components as those in the mammography apparatus 1 shown in FIG.

  The imaging control unit 52B controls the imaging table device 11 and irradiates the breast of the patient O with X-rays while rotating the arm unit 15 relative to the stand unit 16 to perform tomosynthesis imaging. Have. Here, the start of rotation of the arm unit 15 is determined by an abnormality determination item, for example, reaching a predetermined value of the detection value H of the breast thickness or an instruction from the photographer via the input device 42. Further, the end of the rotation of the arm unit 15 is determined by an instruction from the photographer via the input device 42.

  In the mammography apparatus 1B, the initial acquisition time point of detection values (the time point when the rotation of the arm unit 15 starts or the time point immediately after the start of the rotation of the arm unit 15) is expressed as T0, and after the initial acquisition time point T0. The nth acquisition time point of the detected value from time point T1 is expressed as Tn (Tn = T1, T2,...). Further, in the mammography apparatus 1B, among the detection values P of the compression force acquired by the compression force acquisition unit 51a, the detection value of the compression force acquired at the initial acquisition time T0 is expressed as P0, and the nth acquisition The detection value of the compression pressure acquired at time Tn is expressed as Pn (Pn = P1, P2,...). Furthermore, in the mammography apparatus 1B, among the breast thickness detection values H acquired by the breast thickness acquisition unit 51b, the detection value of the breast thickness acquired at the initial acquisition time T0 is expressed as H0, and the nth acquisition. The detection value of the breast thickness acquired at time Tn is expressed as Hn (Hn = H1, H2,...).

  FIG. 14 is a schematic diagram for explaining tomosynthesis imaging.

  FIG. 14 shows a case where tomosynthesis imaging is performed by irradiating the breast of the patient O with X-rays from five directions while rotating the arm unit 15 with respect to the stand unit 16. When tomosynthesis imaging is performed, the image processing unit 48 of the mammography apparatus 1B combines the captured images in a plurality of directions to reconstruct an image of an arbitrary cross section.

  FIG. 15 is a time chart showing the relationship among compression pressure, breast thickness, X-ray irradiation of the arm unit 15, and rotational movement in the mammography apparatus 1B of the third embodiment.

  As shown in FIG. 15, when the compression of the breast of the patient O is started, the detection value P of the compression force acquired by the compression force acquisition unit 51a gradually increases from zero. Further, when the compression of the breast of the patient O is started, the detection value H of the breast thickness acquired by the breast thickness acquisition unit 51b gradually decreases.

  Then, the initial acquisition time T0 and the detection value P0 of the compression pressure at the initial acquisition time T0 are determined by the rotation start instruction of the arm unit 15 from the photographer via the input device 42. When the detection value P0 of the compression pressure is determined, a threshold value P0 ± p having an allowable width p on both sides with the detection value P0 of the compression pressure as a center is determined, and the detection value of the compression pressure at the nth acquisition time Tn as the arm portion 15 rotates. Comparison between Pn and the threshold value P0 ± p is started. When the initial acquisition time T0 is determined, the breast thickness detection value H0 at the initial acquisition time T0 is determined. When the detection value H0 of the breast thickness is determined, a threshold value H0 ± h having an allowable width h on both sides with respect to the detection value H0 of the breast thickness is determined, and the detection value of the breast thickness at the nth acquisition time Tn as the arm unit 15 rotates. Comparison between Hn and the threshold value H0 ± h is started.

  After the rotation of the arm unit 15 starts, X-ray irradiation to the breast of the patient O is started, and tomosynthesis imaging is started.

  In FIG. 15, the detected pressure Pi exceeds the threshold value P0 + p for the first time at an i-th acquisition time Ti (Ti on the right side in FIG. 15) among the n-th acquisition time points Tn. It is determined that there is a variation abnormality in the breast of patient O at time Ti. Further, in the transition example of the detection value Hn of the breast thickness shown in FIG. 15, the detection value Hi of the breast thickness has a threshold value H0 + h at an i-th acquisition time point Ti (Ti on the left side in FIG. 15) among the n-th acquisition time points Tn. Since this is exceeded for the first time, the abnormality determination unit 54 determines that there is a variation abnormality in the breast of the patient O at the i-th acquisition time Ti.

  Next, the operation of the mammography apparatus 1B of the third embodiment will be described using the flowchart shown in FIG.

  In the operation of the mammography apparatus 1B shown in FIG. 16, the same steps as those of the mammography apparatus 1 shown in FIG.

  If YES in step ST4, that is, if it is determined that imaging is possible, the mammography apparatus 1B starts rotating the arm unit 15 with respect to the stand unit 16 (step ST31) and is compressed by the compression plate 24. X-ray irradiation to the breast of the patient O is started (step ST32). By steps ST31 and ST32, tomosynthesis imaging of the breast of the patient O is performed.

  When YES is determined in the determinations of steps ST10 and ST12, that is, when it is determined that the imaging is completed, the mammography apparatus 1B ends the X-ray irradiation to the breast of the patient O (step ST33). The rotation with respect to the stand unit 16 is terminated (step ST34). By steps ST33 and ST34, tomosynthesis imaging of the breast of patient O is completed. Next, the mammography apparatus 1B releases the breast compression of the patient O (step ST14).

  According to the mammography apparatus 1, 1 </ b> A, 1 </ b> B of the present embodiment, it is possible to identify the presence / absence of image blur due to body movement by analyzing the body movement during X-ray irradiation.

  In particular, according to the mammography apparatus 1A of the present embodiment, it is possible to avoid obtaining an unnecessary image blurred due to body movement during X-ray irradiation, and to reduce unnecessary exposure to the patient O. .

1, 1A, 1B Mammography apparatus 11 Imaging table apparatus 12, 12A, 12B Imaging control / image processing apparatus 15 Arm unit 21 X-ray tube 24 Compression plate 26 Imaging table 29 Notification lamp 41 Allowable width storage device 42 Input device 43 Display device 44 Speaker 45, 45A, 45B System control unit 51 Detection value acquisition unit 51a Compression force acquisition unit 51b Breast thickness acquisition unit 52, 52A, 52B Imaging control unit 53 Threshold setting unit 54 Abnormality determination unit 55, 55A Abnormality notification control unit 56, 56A Abnormal incident control unit 57 Shooting period setting unit 58 Shooting end control unit

Claims (10)

X-ray generation means for generating X-rays;
X-ray detection means provided at a position facing the X-ray generation means across a breast as a subject;
Compression means capable of compressing the breast;
Imaging control means for controlling the X-ray generation means and the X-ray detection means so as to perform imaging by irradiating the breast with the X-ray;
Detection value acquisition means for acquiring a detection value of at least one of the compression force applied to the breast by the compression means and the thickness of the breast compressed by the compression means as an abnormality determination item;
An abnormality determining means for determining an abnormality in fluctuation of the breast compressed by the compression means based on the detection value acquired during the imaging;
An abnormality notifying means for notifying the fluctuation abnormality when the abnormality determining means determines that the fluctuation abnormality;
A mammography apparatus characterized by comprising: The abnormality notification means is provided as a notification lamp in an imaging table apparatus including the X-ray generation means, the X-ray detection means, and the compression means, and is turned on when the abnormality determination means determines that the fluctuation abnormality is present. The mammography apparatus according to claim 1, wherein the apparatus is blinking. The abnormality abnormality unit displays the variation abnormality on a display device of an imaging control device including the imaging control unit when the abnormality determining unit determines that the variation abnormality is present. Mammography equipment. The breast X-ray according to any one of claims 1 to 3, further comprising incidental control means for attaching the information of the fluctuation abnormality to image data acquired by imaging by the imaging control means. Shooting device. The imaging control means performs tomosynthesis imaging as the imaging by irradiating the X-ray while rotating the X-ray generation means and the X-ray detection means around the breast. The mammography apparatus as described in thru | or 4. X-ray generation means for generating X-rays;
X-ray detection means provided at a position facing the X-ray generation means across a breast as a subject;
Compression means capable of compressing the breast;
Period setting means for presetting the scheduled shooting period;
From the start of imaging to the end of imaging based on the scheduled irradiation period, the X-ray generation means and the imaging control means for controlling the X-ray detection means so as to perform imaging by irradiating the breast with the X-ray,
Detection value acquisition means for acquiring a detection value of at least one of the compression force applied to the breast by the compression means and the thickness of the breast compressed by the compression means as an abnormality determination item;
An abnormality determining means for determining an abnormality in fluctuation of the breast compressed by the compression means based on the detection value acquired during the imaging;
When it is determined by the abnormality determining means that the fluctuation abnormality is present at a predetermined acquisition time, it is determined that the ratio of the actual shooting period up to the predetermined acquisition time with respect to the scheduled shooting period is a predetermined value or more. Photographing end control means for controlling the photographing control means to forcibly end the photographing;
When the photographing is forcibly terminated by the photographing end control means, the abnormality notifying means for notifying the fluctuation abnormality and the forced termination of the photographing;
A mammography apparatus characterized by comprising: The abnormality notifying unit is provided as a notification lamp in an imaging table apparatus including the X-ray generating unit, the X-ray detecting unit, and the compression unit, and the imaging is forcibly ended by the imaging end control unit The mammography apparatus according to claim 6, wherein the mammography apparatus is turned on or blinking. The abnormality notifying unit displays the fluctuation abnormality and the forced termination of photographing on a display device of a photographing control apparatus including the photographing control unit when the photographing is forcibly terminated by the photographing end control unit. The mammography apparatus according to claim 6, wherein the apparatus is a mammogram. 9. The image processing apparatus according to claim 6, further comprising incidental control means for adding information about the fluctuation abnormality and the forced termination of photographing to image data acquired by photographing by the photographing control means. The mammography apparatus described in 1. A storage means for storing a different threshold value in association with each abnormality determination item is further provided,
The abnormality determination unit obtains a threshold value associated with the abnormality determination item before the imaging from the storage unit, and when a detection value of the abnormality determination item exceeds the threshold value, the abnormality determination unit determines whether the breast is compressed by the compression unit. The mammography apparatus according to any one of claims 1 to 9, wherein it is determined that the fluctuation is abnormal.