JP2013172782A - Dynamic analyzing system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a dynamic analyzing system capable of responding to the preservation and obligation of data related to future dynamic analysis while suppressing the remodeling of existing equipment.SOLUTION: In a dynamic analyzing system, a plurality of frame image data acquired by the dynamic analyzing system are discriminated into an image data to be used in analysis by an analysis server 8 and an image data to be unused in analysis, to perform analysis using the image data to be used. Then, an image data used in analysis is preserved in the first preservation means (PACS 10 or HDD) in medical facilities and the image data to be unused in analysis is preserved in a second preservation means (external preservation server 60).

Description

  The present invention relates to a dynamic analysis system.

  Conventional chest diagnosis is performed mainly on a still image obtained by photographing a deep breathing state (maximum inspiratory position). Regardless of the digital or analog imaging method, the obligation to save the image as a material used as a basis for diagnosis is determined by the Medical Doctor Law, and a storage system is established for each medical facility according to the scale of medical treatment.

  In addition, a plurality of frame image groups generated and displayed in fluoroscopy with a general fluoroscopy device are used for confirmation of a loading position of a catheter or the like (whether it has reached the ROI (region of interest)) or an area to be photographed as a still image. In many cases, these fluoroscopic frame image groups are not required to store all data in the JIS standard.

  In recent years, for example, X-ray imaging of the respiratory state of the chest is continuously performed using an FPD (Flat Panel Detector), and a plurality of frame image groups are analyzed to examine the ventilation function and blood flow function of the chest. Technology for generating diagnosis support information related to a person's dynamic function is being developed (see, for example, Patent Documents 1 and 2).

  With the introduction of dynamic analysis technology, conventional X-ray imaging systems can be replaced with CT (Computed Tomography) and scintigraphy, which contributes to reducing medical costs and reservations like CT and scintigraphy. It is possible to start imaging immediately without using it, which can contribute to early diagnosis and early treatment.

JP 2009-153678 A International Publication No. 2007/0778012

On the other hand, as a weak point of dynamic analysis, there is a large amount of data involved (including a series of frame images (RAW data), intermediate generation data, and final analysis result data).
In the technique described in Patent Document 1, if the RAW data generated by one imaging is 15 frames, 15 frames of display data are additionally generated by the analysis process. That is, about 30 times the amount of data is involved as compared with the conventional diagnosis using a single still image, and the data storage capacity installed in the existing medical facility remains uneasy.

  In the technique described in Patent Document 2, the display data is replaced with a single still image. Therefore, compared with the technique described in Patent Document 1, the amount of data involved can be reduced by half. It is the same that considerable data is involved in comparison with still image diagnosis.

Further, in the diagnosis, a diagnosis style is assumed in which diagnosis is performed based on the feature amount of the analysis result, and a series of frame images are displayed for explanation to the patient.
In addition, when shooting at a higher frame rate than necessary, among the frame image groups obtained by performing dynamic shooting, for example, it is sufficient to use only odd frames for diagnosis (thus, even frames are unused). is assumed.

  Given the fact that the laws and regulations relating to the storage of these data are still fluid when patients are diagnosed using dynamic imaging, a technique that enables early diagnosis by dynamic imaging is widely disseminated. In addition, it is desirable to have a system that can cope with future legislation and has few modifications to existing facilities.

  In addition, dynamic imaging itself can be performed in any medical facility as long as there is an FPD and X-ray irradiation source compatible with dynamic imaging, but it is an analysis technique that does not place much restrictions on the upstream image data generation system. This is preferable from the viewpoint of dissemination of dynamic analysis and early diagnosis. For example, it is preferable that a fluoroscopic frame image group for position confirmation of an existing fluoroscopic device can be used for dynamic analysis.

  In addition, if an FPD capable of dynamic imaging is generally expensive, and only a large hospital can introduce the FPD for dynamic imaging, the patient listens to analysis results such as imaging and COPD (doctor) You have to go to a large hospital each time, and you will be detained all day long. However, it is preferable that a disease having a lifestyle-related illness such as COPD can be diagnosed by a local doctor (a practitioner). For this purpose, it is also necessary to provide teaching data to a doctor who is not accustomed to the diagnosis of dynamic images.

  The subject of this invention is providing the dynamic analysis system which can respond to the obligation of the preservation | save of the data concerning future dynamic diagnosis, suppressing the modification of existing facilities.

In order to solve the above-mentioned problem, the invention described in claim 1
A radiation source capable of continuously irradiating the subject with radiation, and a plurality of detection elements arranged in a two-dimensional manner, each of the plurality of detection elements being continuously irradiated by the radiation source and transmitted through the subject A radiation detector that sequentially detects radiation, and imaging means for imaging a subject's dynamics over one period using the radiation source and the radiation detector to generate a plurality of frame image data;
Analyzing means for analyzing dynamics of the subject based on a plurality of frame image data generated by the photographing means;
A dynamic analysis system comprising:
Discriminating means for discriminating the plurality of frame image data into image data used for analysis by the analyzing means and image data not used for analysis;
A first storage means for storing the image data used for the analysis after the analysis is performed using the image data used for the analysis by the analysis means;
Second storage means for storing unused image data that has not been used for analysis by the analysis means;
Is provided.

The invention according to claim 2 is the invention according to claim 1,
The first storage means further stores the analysis result data generated by the analysis means and the intermediate generation data generated in the analysis process by the analysis means in association with the image data used for the analysis. To do.

The invention according to claim 3 is the invention according to claim 2,
An input means for specifying a feature amount as a search condition;
A search unit that searches the first storage unit for analysis result data satisfying a search condition specified by the input unit and use image data corresponding thereto;
Is provided.

The invention according to claim 4
A radiation source capable of continuously irradiating the subject with radiation, and a plurality of detection elements arranged in a two-dimensional manner, each of the plurality of detection elements being continuously irradiated by the radiation source and transmitted through the subject A radiation detector for sequentially detecting radiation, and imaging means for imaging the dynamics of the subject over one period using the radiation source and the radiation detector to generate a plurality of frame image data; A medical department system comprising:
An analysis department system comprising: analysis means for analyzing dynamics of the subject based on a plurality of frame image data generated in the medical department system; and a second storage means;
Is a dynamic analysis system connected via a communication network,
The analysis department system transmits the analysis result data generated by the analysis means to the medical department system, and stores data accompanying the analysis in the analysis means in the second storage means,
The medical department system stores the analysis result data in the first storage unit.

The invention according to claim 5 is the invention according to claim 4,
The second storage unit is disposed at a location different from the analysis unit, and is connected to the analysis unit via a communication network.

  ADVANTAGE OF THE INVENTION According to this invention, the dynamics analysis system which can respond to the obligation of the preservation | save of the data concerning future dynamics diagnosis can be provided, suppressing the existing equipment remodeling.

It is a figure showing the whole dynamics analysis system composition concerning this embodiment. It is a figure which shows the structural example of the system in a facility of FIG. 1A. It is a block diagram which shows the functional structure of a bucky apparatus. It is a block diagram which shows the functional structure of a console. It is a figure which shows the example of data storage of an imaging | photography management table. It is a block diagram which shows the functional structure of an analysis server. It is a block diagram which shows the functional structure of FPD. It is a flowchart which shows operation | movement of a dynamic analysis system. It is a flowchart which shows the imaging | photography control process performed in FIG.7A step S4. It is a figure which shows the time change of the chest side. It is a figure which shows the time change of the chest front. It is a figure which shows the analysis result of the typical item of the analysis process when changing the block size of a small area | region, and the evaluation result of processing time. It is a figure which shows the analysis result of the maximum flow rate ratio when it is set as block size 2mm square. It is a figure which shows the analysis result of the maximum flow rate ratio when it is set as block size 5mm square. It is a figure which shows the analysis result of the maximum flow rate ratio when it is set as block size 10mm square. It is a figure which shows the analysis result of the typical item of an analysis process, process time, and the evaluation result of a patient exposure when changing the frame rate by making irradiation dose of each frame image constant. It is a figure which shows the analysis result of the typical item of an analysis process, process time, and the evaluation result of S / N when changing a frame rate by making the total irradiation dose constant. It is a figure which shows an example of the analysis result of the maximum flow rate ratio when the block size is 2 mm square, the frame rate is 2 frames / second, and the total irradiation dose is constant. It is a figure which shows an example of the analysis result of the maximum flow rate ratio when the block size is 2 mm square, the frame rate is 3.75 sheets / second, and the total irradiation dose is constant. It is a figure which shows an example of the analysis result of the maximum flow rate ratio when the block size is 2 mm square, the frame rate is 7.5 frames / second, and the total irradiation dose is constant. It is a figure which shows an example of the analysis result of the maximum flow rate ratio when the block size is 2 mm square, the frame rate is 15 frames / second, and the total irradiation dose is constant. It is a figure which shows an example of the analysis result of the maximum flow rate ratio when the block size is 2 mm square, the frame rate is 30 sheets / second, and the total irradiation dose is constant. It is a figure which shows an example of the inter-frame difference image of a blood-flow pulsation timing when the block size is 2 mm square, the frame rate is 3.75 sheets / second, and the total irradiation dose is constant. It is a figure which shows an example of the difference image between frames of a blood-flow pulsation timing when making block size 2mm square, frame rate 7.5 sheets / second, and total irradiation dose constant. It is a figure which shows an example of the difference image between frames of a blood-flow pulsation timing when making block size 2mm square, a frame rate 15 sheets / second, and a total irradiation dose constant. It is a figure which shows an example of the difference image between frames of a blood-flow pulsation timing when making block size 2mm square, a frame rate 30 sheets / second, and a total irradiation dose constant. The upper figure shows an example of the analysis result of the maximum flow rate ratio when binning is performed with a block size of 2 mm square, a frame rate of 3.75 frames / second, and a constant total irradiation dose, and the lower figure shows a block size of 2 mm. It is a figure which shows an example of the analysis result of the maximum flow rate ratio when a corner and a frame rate are 3.75 sheets / second, and the total irradiation dose is constant and thinning processing is performed. The upper figure shows an example when binning processing is performed on a difference image between ventilation frames with a block size of 2 mm square, and the lower figure shows an example of the analysis result of the maximum flow rate ratio when thinning processing is performed with a block size of 2 mm square FIG. The upper figure shows an example when the binning process is performed with a block size of 2 mm square on the blood flow inter-frame difference image, and the lower part is the analysis result of the maximum flow rate ratio when the thinning process is performed with a block size of 2 mm square. It is a figure which shows an example. It is a figure which shows the structural example of the dynamic analysis system for large-scale facilities which do not have an analysis server in a system in a facility. It is a figure which shows the structural example of the dynamic analysis system for small scale facilities which have a dynamic imaging system in the system in a facility. It is a figure which shows the structural example of the dynamic analysis system for small scale facilities which do not have a dynamic imaging system in an in-facility system. It is a figure which shows the structural example of the dynamic analysis system comprised by the medical department system and the analysis department system.

  Hereinafter, embodiments of a dynamic analysis system according to the present invention will be described with reference to the drawings. However, the present invention is not limited to the following illustrated examples.

  FIG. 1A is a diagram showing an example of the overall configuration of a dynamic analysis system 100 according to the present embodiment. The dynamic analysis system 100 is a system for a large-scale facility A including the dynamic imaging system 40, the analysis server 8, and the PACS 10. Examples of large-scale facilities include general hospitals and large hospitals. The dynamic analysis system 100 is configured by connecting an in-facility system 30 of a large-scale facility A and an external storage server 60 so as to be able to transmit and receive data via the Internet PN.

FIG. 1B shows a detailed configuration example of the in-facility system 30. Imaging rooms R1 to R3 shown in FIG. 1B are rooms for performing dynamic imaging or still image imaging of a subject by irradiating a subject (that is, a patient's imaging region) that is a part of the patient's body.
Dynamic imaging refers to acquiring a plurality of images (ie, continuous imaging) by continuously irradiating a subject with radiation such as X-rays in a pulsed manner. In dynamic imaging, for example, the dynamics of a subject having a periodicity (cycle), such as changes in the shape of lung expansion and contraction associated with respiratory motion, heart pulsation, and the like are captured. A series of images obtained by this continuous shooting is called a dynamic image. Each of the plurality of images constituting the dynamic image is called a frame image.
Still image photography is used for diagnosis based on the density resolution of the imaged part in the same way as in the conventional film method and CR method. A single piece of still image is irradiated by irradiating the subject with radiation such as X-rays once. It means acquiring an image.

The imaging room R1 is a room for performing dynamic imaging or still image imaging of a subject provided with a radiation source 3a capable of single shot and continuous shot. A dynamic imaging system 40 is configured by each device provided in the imaging room R1.
In the radiographing room R1, for example, a bucky device 1 for standing photography, a bucky device 2 for standing photography, a radiation source 3a, a cradle 4, a console 5, a console 6, and an access point AP are provided. , Is provided.

The imaging room R2 is a room for taking a still image of a subject, provided with a radiation source 3b capable of only a single shot and a radiation source 3c for portable imaging.
In the photographing room R2, for example, a bucky device 1 for standing photographing, a bucky device 2 for standing photographing, radiation sources 3b and 3c, a cradle 4, a console 5, a console 6, and an access point are provided. AP is provided.

The imaging room R3 is a room in which a radiation source 3b is provided for taking a still image of a subject.
In the photographing room R3, for example, a bucky device 1 for standing position photographing, a bucky device 2 for standing position photographing, a radiation source 3b, a cradle 4, a console 5, a console 6, and an access point AP are provided. , Is provided.

  Each of the photographing rooms R1 to R3 is provided with a front room Ra and a photographing room Rb, and the front room Ra is provided with a console 5 and a console 6 so as to prevent exposure of an operator such as a photographing engineer. It has become.

The bucky device 1 is a device for holding the FPD 9a or 9b when shooting in a standing position.
FIG. 2 shows a functional configuration example of the bucky device 1. As shown in FIG. 2, the bucky device 1 includes a control unit 11, a detector mounting unit 12, a communication I / F 13, and a drive unit 14.

The control unit 11 includes a CPU (Central Processing Unit), a ROM (Read Only Memory), and a RAM (Random Access Memory). The ROM of the control unit 11 stores various processing programs for controlling each unit of the bucky device 1, data necessary for the processing, a bucky ID that is identification information of the bucky device 1, and the like. The CPU comprehensively controls the operation of each part of the bucky device 1 in cooperation with a program stored in the ROM.
For example, when the FPD 9a or 9b is mounted on the detector mounting unit 12, the control unit 11 sends an FPDID (FPD identification information) transmission request to the mounted FPD via the connector 12b, and the FPDID is received. Then, the Bucky ID which is its own identification number is associated with the FPDID and transmitted to the console 5 via the communication I / F 13. Also, the received FPDID is temporarily stored in the RAM.
Further, for example, when the FPD is extracted from the detector mounting unit 12, the control unit 11 transmits the FPDID to the console 5 via the communication I / F 13, and issues a request for deleting the FPDID (from the imaging management table 521). Do.

  The detector mounting unit 12 includes a holding unit 12a for holding the FPD (FPD 9a or FPD 9b) and a connector 12b for connecting the FPD connector 94 mounted on the holding unit 12a. The connector 12b transmits / receives data to / from the FPD attached to the holding unit 12a and supplies power to the FPD.

  The communication I / F 13 is an interface for performing data transmission / reception via an access point AP and an external device such as the console 5 via a communication cable.

  The drive unit 14 moves the detector mounting unit 12 in the vertical direction or the horizontal direction in accordance with an operation of a foot switch or the like (not shown).

The bucky device 2 is a device for holding the FPD 9a or 9b during shooting in the supine position.
The bucky device 2 includes a control unit 21, a detector mounting unit 22, a communication I / F 23, and a drive unit 24. The control unit 21, the detector mounting unit 22, the communication I / F 23, and the driving unit 24 have the same configurations as the control unit 11, the detector mounting unit 12, the communication I / F 13, and the driving unit 14, respectively. Incorporate. Further, the bucky device 2 includes a subject table 26 for placing a subject.

  The radiation source 3a is a radiation generator capable of single shot and continuous shot (pulse irradiation). The radiation source 3a is suspended from the ceilings of the imaging rooms R1 and R3, for example, and is activated based on an instruction from the console 5 at the time of imaging, and is adjusted to a predetermined position and orientation by a driving mechanism (not shown). It has become. Then, by changing the irradiation direction of the radiation, the FPD 9a or 9b mounted on the standing-side bucky device 1 or the recumbent bucky device 2 can be irradiated with the radiation. The radiation source 3a irradiates the radiation once or continuously in accordance with an instruction from the console 5 to perform still image capturing or dynamic image capturing.

  The radiation source 3b is a radiation generating device capable of only a single shot. For example, the radiation source 3b is suspended from the ceiling of the imaging room R2, and is activated based on an instruction from the console 5 at the time of imaging, and is adjusted to a predetermined position and orientation by a drive mechanism (not shown). ing. Then, by changing the irradiation direction of the radiation, the FPD 9a or 9b mounted on the standing-side bucky device 1 or the recumbent bucky device 2 can be irradiated with the radiation. The radiation source 3b emits radiation once in accordance with an instruction from the console 5 and performs still image shooting.

  The radiation source 3c is a movable portable radiation source. The radiation source 3c can only be a single shot.

The cradle 4 has a connector (not shown) for connecting to the mounted FPD. When the FPD is mounted, the cradle 4 acquires the FPDID from the FPD mounted via the connector and notifies the console 5 of the FPDID.
After acquiring the FPDID, the console 5 thereafter puts the FPD under its own control, and controls activation, sleep transition, and the like.
In the present embodiment, the FPD can be detected by the console 5 via the cradle 4 by attaching the FPD to the cradle 4 when the FPD is brought into or taken out of the photographic room. It has become. In addition, the FPD can be entered and taken out of the photographic room other than the above cradle method, and for example, the RFID method disclosed in WO2008 / 111355 can be used.

  The console 5 is a device for controlling imaging by controlling the radiation sources 3a and 3b and the FPDs 9a and 9b. The console 5 is connected to a HIS / RIS (Hospital Information System / Radiology Information System) 7, an analysis server 8, a PACS (Picture Archiving and Communication System) 10, etc. via a communication network N such as a LAN (Local Area Network). Based on the photographing order information transmitted from the HIS / RIS 7, it is determined whether or not the order can be photographed in the photographing room to which the console 5 is associated (installed). Is displayed. If imaging is possible, the console 5 controls the radiation source and FPD used for imaging to perform imaging.

  In FIG. 3, the example of a principal part structure of the console 5 is shown. As shown in FIG. 3, the console 5 includes a control unit 51, a storage unit 52, an input unit 53, a display unit 54, a communication I / F 55, a network communication unit 56, and the like. It is connected.

The control unit 51 includes a CPU, a RAM, and the like. The CPU of the control unit 51 reads out various programs such as system programs and processing programs stored in the storage unit 52, expands them in the RAM, and executes various processes according to the expanded programs.
For example, when the FPDID and the Bucky ID are received via the communication I / F 55, the control unit 51 assigns the FPDID to an area corresponding to the received Bucky ID in the shooting management table 521 (see FIG. 4) of the storage unit 52. Write. In addition, when the FPDID is received from the cradle 4 via the communication I / F 55, the control unit 51 writes the FPDID in an area in the imaging management table 521 of the storage unit 52 that is not associated with a bucky ID. Further, when the image data is received via the bucky device 1 or 2, the control unit 51 stores the image reception time in an area corresponding to the bucky ID of the source bucky device in the photographing management table 521.

For example, the control unit 51 makes an inquiry to the HIS / RIS 7 via the network communication unit 56 every predetermined time, and acquires the imaging order information newly registered in the HIS / RIS 7.
In addition, for example, the control unit 51 performs imaging / analysis processing described later, and based on the imaging order information acquired from the HIS / RIS 7, the imaging of the order can be performed in the imaging room in which the console 5 is installed. It is determined whether or not there is, and the determination result is displayed. And when imaging | photography is possible, the console 5 controls the radiation source used for imaging | photography, and FPD used for imaging | photography, and performs imaging | photography.

  The storage unit 52 includes, for example, an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like.

The storage unit 52 stores various programs and data.
For example, the storage unit 52 stores a shooting management table 521 for managing shooting in each shooting room.
FIG. 4 shows a data storage example of the imaging management table 521. As shown in FIG. 4, the shooting management table 521 includes items such as “Bucky ID”, “tube type”, “FPDID”, and “image reception time”. In the “Bucky ID” and “tube type” areas, information on the type of the Bucky device and the radiation source provided in the radiographing room in which the console 5 is installed is set in advance. The “FPDID” area associated with the Bucky ID is an area for managing the FPD attached to the Bucky ID, and is received when the FPDID and the Bucky ID are received from the Bucky device. The FPDID is stored in association with the Bucky ID. The “FPDID” area not associated with the Bucky ID is an area for managing the FPD existing in the photographing room, and when the FPDID is received from the cradle 4, the received FPDID is stored. The When an FPDID is deleted from the Bucky device and an FPDID deletion request is received, the FPDID stored in correspondence with the Bucky ID among the FPDIDs requested to be deleted by the control unit 51 is deleted. When an FPDID stored in the “FPDID” area not associated with a Bucky ID is received from the cradle 4, the FPDID of the FPDID is taken out of the shooting room by the control unit 51 (that is, the shooting room). The FPDID is deleted from the imaging management table 521. The “image reception time” stores the time when image data is received from the communication I / F 55.

  In addition, the storage unit 52 stores various programs such as a program for performing image processing such as gradation processing and frequency processing based on automatic part recognition for detecting an affected part from image data. Stores image processing parameters (look-up table defining tone curve used for tone processing, enhancement degree of frequency processing, etc.) for adjusting image data of image to image quality suitable for diagnosis for each part .

  The storage unit 52 stores radiation irradiation conditions and image reading conditions in association with combinations of imaging types (dynamics or still images) and imaging regions. The radiation irradiation conditions are, for example, pulse rate, pulse width, pulse interval during continuous irradiation, the number of imaging frames per imaging, X-ray tube current value, X-ray tube voltage value, filter type, and the like. The pulse rate is the number of times of radiation irradiation per second, and matches the frame rate described later. The pulse width is a radiation irradiation time per one irradiation. The pulse interval is the time from the start of one radiation irradiation to the start of the next radiation irradiation in continuous imaging, and coincides with a frame interval described later. The image reading conditions are, for example, a frame rate, a frame interval, a pixel size, an image size (matrix size), and the like. The frame rate is the number of frame images acquired per second and matches the pulse rate. The frame interval is the time from the start of one frame image acquisition operation to the start of the next frame image acquisition operation in continuous shooting, and coincides with the pulse interval.

The storage unit 52 also stores the FPDID of each of the FPDs 9a and 9b registered in the dynamic analysis system 100, the type of shooting (dynamic and still image) that can be shot with the FPD, and the pixel size information of each FPD ( In the present embodiment, both moving images and still images are stored in association with 200 μm (microns). In addition, the storage unit 52 stores the bucky ID of each of the bucky devices 1 and 2 registered in the dynamic analysis system 100 in association with the posture (standing or standing) that can be photographed with the bucky device. ing.
The pixel size information is used at the time of block processing (binning) described later.

  Further, the storage unit 52 stores imaging order information transmitted from the HIS / RIS 7 every predetermined time.

  The input unit 53 includes a keyboard having character input keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key pressing signal pressed by the keyboard and an operation signal by the mouse. Are output to the control unit 51 as an input signal.

The display unit 54 includes a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), for example, and displays various screens according to instructions of a display signal input from the control unit 51.
A pressure-sensitive (resistive film pressure type) touch panel (not shown) in which transparent electrodes are arranged in a grid pattern is formed on the screen of the display unit 54, and the display unit 54 and the input unit 53 are configured integrally. It may be a touch screen. In this case, the touch panel is configured to detect the XY coordinates of the power point pressed by a finger, a touch pen, or the like as a voltage value, and output the detected position signal to the control unit 51 as an operation signal. The display unit 54 may have a higher definition than a monitor used in a general PC (Personal Computer).

  The communication I / F 55 is an interface for connecting to the Bucky device 1, the Bucky device 2, the radiation sources 3a to 3c, the FPD 9a or 9b via the access point AP, and performing data transmission / reception wirelessly or by wire. In the present embodiment, the communication I / F 55 transmits a polling signal to the FPDs 9a and 9b as necessary via the access point AP.

  The network communication unit 56 includes a network interface or the like, and transmits / receives data to / from an external device connected to the communication network N or the Internet PN via a switching hub.

  The console 6 is an input device that is connected to a radiation source in the imaging room and inputs a radiation irradiation instruction.

  The HIS / RIS 7 generates imaging order information in response to a registration operation by an operator based on an inquiry result or the like. The imaging order information includes, for example, patient information such as the name of a patient who is a subject, imaging ID that is imaging identification information, imaging date, imaging site, imaging direction, body position (standing position, standing position), imaging method, analysis required It contains information about shooting reservations such as NO and analysis items. Note that the shooting order information is not limited to the information exemplified here, but may include other information, or may be a part of the information exemplified above.

  As shown in FIG. 5, the analysis server 8 includes a control unit 81 configured by a CPU, a RAM, a storage unit 82 that stores an analysis program, an input unit 83, a display unit 84, and a communication network N or The workstation includes a communication unit 85 for transmitting and receiving data to and from an external device via the Internet PN. The analysis server 8 performs analysis processing based on a series of frame images transmitted from the console 5 in cooperation with the control program and the analysis program stored in the storage unit, and transmits the analysis result to the console 5. . The analysis server 8 functions as discrimination means and analysis means.

The FPD 9a is a radiation detector compatible with dynamic imaging and still image imaging capable of pulse irradiation imaging.
FIG. 6 shows a functional configuration example of the FPD 9a. As shown in FIG. 6, the FPD 9 a includes a control unit 91, a detection unit 92, a storage unit 93, a connector 94, a battery 95, a wireless communication unit 96, and the like, and each unit is connected by a bus 97.

The control unit 91 is configured by a CPU, a RAM, and the like. The CPU of the control unit 91 reads out various programs such as system programs and processing programs stored in the storage unit 93, expands them in the RAM, and executes various processes according to the expanded programs.
For example, in response to a request from the bucky device 1 or 2 connected via the connector 94, the control unit 91 reads FPDID, which is identification information of the FPD 9a, from the storage unit 93 and transmits it to the requesting bucky device.
Further, for example, the control unit 91 controls the switching unit of the detection unit 92 based on the image reading condition input from the console 5 to read the electrical signal accumulated in each radiation detection element (hereinafter, detection element). The image data (still image or frame image) is generated by reading the electrical signal stored in the detection unit 92. Then, the control unit 91 sequentially outputs the generated image data to the console 5 via the connector 94 and the bucky device 1 or 2. Each frame image acquired by shooting may be temporarily stored in the storage unit 93 of the FPD 9a, and may be output from the FPD 9a to the console 5 after completion of all shooting.
Note that the FPD 9a is configured to be battery-driven and wirelessly communicated when used alone without being attached to the bucky, but in the case of dynamic shooting, as disclosed in the registration No. 4,561,730, It is preferable to change to a configuration for external power supply and wired communication. This is because data transfer capacity and transfer time are overwhelmingly increased compared to still image shooting, so that no noise is given to the shooting (reading) of another frame image during transfer of one frame image and transfer. This is to shorten the time itself, and to prevent the battery from running out during a series of shootings.

The detection unit 92 includes, for example, a glass substrate, and detects radiation that has been irradiated from any of the radiation sources 3a to 3c and transmitted through at least the subject at a predetermined position on the substrate according to the intensity thereof. A plurality of detection elements that convert detected radiation into electrical signals and store them are two-dimensionally arranged. The detection element is configured by a semiconductor image sensor such as a photodiode. Each detection element is connected to a switching unit such as a TFT (Thin Film Transistor), for example, and the switching unit controls the accumulation and reading of electric signals.
Each pixel constituting the generated still image or frame image indicates a signal value (referred to herein as a density value) output from each detection element of the detection unit 92.

  The storage unit 93 is configured by, for example, a semiconductor nonvolatile memory. The storage unit 93 stores various programs for controlling the detection unit 92, FPDID that is identification information of itself, and the like. The storage unit 93 temporarily stores the image data output from the detection unit 92.

  The connector 94 is connected to the connectors on the Bucky devices 1 and 2 side, and performs data transmission / reception with the Bucky device 1 or 2. The connector 94 supplies power supplied from the connector of the bucky device 1 or 2 to each functional unit. Note that the battery 95 may be charged.

  The battery 95 supplies power to each unit of the FPD 9a based on the control of the control unit 91. As the battery 95, for example, a rechargeable battery such as a nickel cadmium battery, a nickel metal hydride battery, or a lithium ion battery can be used.

Like the FPD 9a, the FPD 9b includes a control unit 91, a detection unit 92, a storage unit 93, a connector 94, and a battery 95, but the frame rate cannot be set. That is, the FPD 9b can only take still images.
In addition, it can be used as a single unit, or can be used even when loaded into a Bucky device, and when loaded into the Bucky device, it can be switched from a battery / wireless system to a wired / power supply system by connecting a connector. Accordingly, even when a plurality of patients are continuously photographed, it is not necessary to worry about running out of the battery.

The PACS 10 includes a server device that stores image data and the like, and an interpretation terminal that acquires and displays a diagnostic image from the server device.
The server device of the PACS 10 stores used image data and analysis result data used for analysis in association with shooting order information as a first storage unit.
Specifically, the server device of the PACS 10 stores analysis result data (generated as an image), used image data used for analysis, and an area for storing intermediate generation data generated in the course of analysis, and stored It has an information management table for managing data, an analysis result table for each analysis item, and the like.
The information management table is a table for managing image data stored in the server device, and includes “imaging ID”, “imaging date”, “patient information”, “imaging site”, “ In addition to “Direction”, “Position (Standing, Standing)”, “Shooting Method”, “Analysis Item”, “Image Data Storage Path” (Use Image Data Storage Path, Intermediate Data Storage It includes storage areas for items such as a destination path, a storage destination path of analysis result data (generated as an image), “identification ID”, “analysis ID”, and the like. The analysis ID is a unique ID given at the time of storage.
The analysis result table is a table that stores values of dynamic image analysis results (calculated feature amounts or the like) for each analysis item. For example, “analysis ID”, “analysis date”, “result value 1” to “result value 1” to “result value 1” It has a storage area for the item “result value n”. “Result value 1” to “Result value n” represent feature amounts calculated for each analysis item, and are different for each analysis item. For example, when the analysis item is “(3) Ventilation−Airflow velocity” which will be described later, the items related to the result value of the analysis result table are “average value”, “standard deviation”, “lower 5%”, “higher 5”. % ". As a result, RAW data, intermediate generation data, and image data of analysis results can be searched through the analysis ID using the result value of the analysis result (calculated feature value) as a key. Data concerning cases can be read out and used by doctors for diagnosis. For example, when the feature type and the value range are specified as search conditions from the interpretation terminal (input means) of the PACS 10, the server device of the PACS 10 performs a search with the specified search conditions, and an analysis result that satisfies the search conditions. It functions as a search means for outputting data to the interpretation terminal.

The external storage server 60 is a server that has a large capacity storage device and provides a data storage service via the Internet PN. In the present embodiment, the external storage server 60 stores unused image data that has not been used for analysis transmitted from the analysis server 8 as a second storage unit for a predetermined period. Then, unused image data is deleted after the elapse of a predetermined period.
For example, if the cycle until the reexamination of the subject is two months, the data generated in two months has a capacity to store the data, and when the data is full, the old data is deleted sequentially and new data is deleted. Save over.

Next, a photographing operation in the dynamic analysis system 100 will be described.
FIG. 7A shows a flow of imaging / analysis processing executed in the dynamic analysis system 100. The processing on the console 5 side in FIG. 7A is executed in cooperation with the control unit 51 of the console 5 and the program stored in the storage unit 52. The processing on the analysis server 8 side is executed in cooperation with the control unit of the analysis server 8 and the analysis program stored in the storage unit.

  First, an operator such as a photographing engineer causes the display unit 54 to display a photographing order list screen for displaying a list of photographing order information by operating the input unit 53 of the console 5 in any photographing room. Then, by operating the input unit 53, the shooting order information of the shooting target is designated from the shooting order list screen.

  In the console 5, when shooting order information to be shot is specified by the input unit 53 (step S1), the shooting management table 521 of the storage unit 52 is referred to and selected in the shooting room in which the console 5 is installed. It is determined whether or not shooting based on the shooting order information is possible (step S2). For example, when dynamic imaging is instructed by the imaging order information, the imaging management table 521 is referred to, and a tube-type radiation source capable of continuous shooting and an FPD corresponding to dynamic imaging exist in the imaging room, and When the FPD is not in use (when a predetermined time has elapsed from the image reception time), it is determined that dynamic imaging is possible.

  If it is determined that shooting based on the selected shooting order information is possible in the shooting room in which the console 5 is installed (step S2; YES), the process proceeds to step S4.

If it is determined in the photographing room that photographing based on the selected photographing order information is impossible (step S2: NO), a warning is displayed on the display unit 54 (step S3). For example, when dynamic shooting is instructed by the shooting order information, it is determined that there is no continuous tube in the shooting room (in the case of the shooting room R2 in FIG. 1B), “ A warning such as “Cannot shoot in this room” is displayed. Further, for example, if it is determined that the FPD 9a corresponding to dynamic imaging is not attached to the Bucky device for performing dynamic imaging of the body position specified by the imaging order information, the FPD 9a Please put on "warning. Then, the photographing / analysis process ends. If the FPD 9a corresponding to dynamic imaging is not attached to the Bucky device for dynamic imaging of the posture specified by the imaging order information, the imaging management table 521 can be provided by attaching the FPD corresponding to dynamic imaging to the corresponding Bucky device. The contents of are updated. Therefore, it is determined that photographing is possible, and the process proceeds to step S4.
In this case, the FPD replacement operation is once performed in the photographing room, and the process returns to the console again.

In step S4, shooting control processing is executed (step S4).
FIG. 7B shows a flowchart of the imaging control process executed in step S4. The imaging control process illustrated in FIG. 7B is executed in cooperation with the control unit 51 and a program stored in the storage unit 52.
First, a radiation source and an FPD that are capable of imaging the specified imaging order information are activated, and the orientation and position of the radiation source are adjusted according to the used Bucky device. When the position of the FPD or the bucky device is adjusted according to the subject by the imaging engineer, the direction and position of the radiation source are adjusted accordingly (step S101). In addition, the radiation irradiation condition and the image reading condition corresponding to the part to be imaged, dynamic imaging or still image imaging are read out from the storage unit 52, the radiation irradiation condition is set in the radiation source, and via the Bucky device Image reading conditions are set in the FPD (step S102). When analysis is performed using the result of dynamic imaging, the frame rate is set to 3.75 frames / second or more in order to ensure analysis accuracy that can be used for diagnosis. Here, in the case of dynamic imaging of the lung field, the operator instructs the subject to make it easier to capture the dynamics of resting breathing, and urges the patient to continue resting breathing. When preparation for imaging is completed, the technician moves to the front room and operates the console 6 to input a radiation irradiation instruction.

When a radiation irradiation instruction is input from the console 6 (step S103; YES), the radiation source and FPD used for imaging are controlled and imaging is performed (step S104).
In the case of dynamic imaging, radiation is emitted from the radiation source 3a at the pulse interval set in step S102, and a frame image is acquired by the FPD 9a at the frame rate set in step S102. When photographing of a predetermined number of frame images is completed, the control unit 51 outputs a photographing end instruction to the radiation source 3a and the FPD 9a, and the photographing operation is stopped. The number of frame images to be photographed is the number that can be photographed in at least one dynamic cycle. Frame images obtained by photographing are sequentially input from the FPD 9a to the console 5 via the bucky device. Each frame image that is sequentially transmitted is subjected to simple thinning processing so that it can be displayed on the display unit 54 of the console 5 without performing correction processing (offset, gain, defect correction, etc.) or image processing (gradation processing), and sequentially switching display. Even an operator such as an engineer can visually check in real time whether the subject's posture has been lost (body motion has occurred) and whether the subject is moving for more than one cycle. preferable. Based on the result of this visual recognition, re-photographing can be started immediately.
When analysis is not instructed by the shooting order information, a dark image for offset correction may be read and input to the console 5.
In the case of still image shooting, one still image of the subject and one or several dark images for offset correction are shot under the conditions set in step S102. The still image and the dark image acquired by photographing are input to the console 5 from the FPD via the bucky device.

  Next, it is determined whether or not the analysis server 8 performs analysis (step S105). Here, the determination as to whether or not to perform analysis in the analysis server 8 is made based on, for example, the shooting order information specified in step S1 of FIG. 7A. If still image shooting is ordered according to the shooting order information, it is determined that analysis is not performed. When dynamic imaging is ordered, it is determined that analysis is necessary when the imaging order information includes information indicating that analysis is necessary.

If it is determined that the analysis server 8 does not perform analysis (step S105; NO), a correction process is performed on the image obtained by photographing (step S106), and the process proceeds to step S107. In the correction process in step S106, correction processes such as the offset correction process using the dark image, the gain correction process, the defective pixel correction process, and the lag (afterimage) correction process are performed as necessary. In the case of performing analysis, these correction processes may be omitted in order to give priority to shortening the processing time, and the process proceeds to step S107.
In the dynamic analysis, the inventors of the present invention are not so important in the absolute output value of each pixel such as a still image, and the feature amount based on the relative output value (variation component) between frames in each pixel. Since the calculation is fundamental, it has been found that even if a part or all of the correction process is omitted, an analysis result substantially equivalent to that obtained when the correction process is performed can be obtained. Accordingly, some or all of the correction processing can be omitted in order to shorten the time until the analysis result is obtained.

  In step S107, a frame image or a still image obtained by shooting is stored in the storage unit 52 in association with shooting order information (step S107). It should be noted that the frame image obtained for shooting is given a number indicating the shooting order and stored in the header information of each image.

  Next, the sequentially input images are thinned (step S108). The thinning-out processing here refers to processing for reducing the number of pixels of each frame image or still image. For example, a process of creating a thinned image composed of pixels at predetermined pixel intervals (referred to as simple thinning process), and a frame image in units of pixel blocks of a predetermined size, for example, 0.2 mm × 0.2 mm to 2 mm × Divide into small areas of 2 mm square unit, and calculate the representative value of the signal values of the pixels in each small area (here, the average signal value of the output signal values of 1 to 100 pixels). Binning processing for replacing the signal value of each pixel with the calculated representative value is included. In the binning process, the number of pixels to be processed can be reduced by treating each small area unit as one pixel. In the binning process, in the case of a dynamic image, division is performed so that each corresponding small region between each frame image is composed of a pixel group indicating an output at the same position of the detection element. For example, the division is performed at a square of 0.2 mm × 0.2 mm to 2 mm × 2 mm with the same pixel position (0, 0) on the frame image as a base point. In addition, it is preferable that the size of each pixel block in the binning process is a size corresponding to an imaging region that is a diagnosis target (that is, an analysis target). Moreover, when performing an analysis process in the latter stage, it is preferable to set the size according to the feature amount calculated by the analysis.

  Next, the thinned frame image is displayed on the display unit 54 (step S109). The imaging engineer confirms the positioning and the like based on the displayed dynamic image, and determines whether an image suitable for diagnosis is acquired by imaging (imaging OK) or re-imaging is necessary (imaging NG). Then, the input unit 53 is operated to input the determination result. Each frame image acquired by photographing may be temporarily stored in the storage unit 93 of the FPD 9a, and may be output from the FPD 9a to the console 5 after completion of all photographing.

When a determination result indicating shooting NG is input by a predetermined operation of the input unit 53 (step S110; NO), a series of frame images stored in the storage unit 52 is deleted (step S111), and the shooting / shown in FIG. The analysis process ends. In this case, re-photographing is performed.
When a determination result indicating photographing OK is input by a predetermined operation of the input unit 53 (step S110; YES), the process proceeds to step S5 in FIG. 7A.

  In step S5 of FIG. 7A, it is determined whether or not to perform analysis (step S5). The determination as to whether or not to perform the analysis is performed based on the same determination as described in step S8, for example. If it is determined not to perform analysis (step S5; NO), the captured still image or frame image is subjected to image processing as necessary, and transmitted to the server device of the PACS 10 via the network communication unit 56 (step S5). S6). In the server device of PACS 10, the received still image or frame image is stored in association with the shooting order information (step S12).

  On the other hand, if it is determined that the analysis is to be performed (step S5; YES), a series of frame images (RAW data) of the dynamic image is transmitted to the analysis server 8 via the network communication unit 56 in association with the shooting order information. (Step S7). For example, an identification ID for identifying a dynamic image, an imaging order ID, patient information, an imaging part, an irradiation condition, an image reading condition (frame interval, etc.), and an imaging order are set for each of a series of frame image thinning data. Information such as a number, a frame rate, a resolution, and a shooting date / time are attached (for example, written in the header area of the image data in a DICOM (Digital Imaging and Communications in Medicine) multi-format file format), via the network communication unit 56 And transmitted to the analysis server 8. The analysis item is also notified to the analysis server 8. The RAW data is a series of frame images acquired by the FPD. However, the RAW data is not limited to the read image data itself of the FPD, and may be data that has been subjected to thinning processing or correction processing (here, after thinning processing). Frame image).

In the analysis server 8, when a series of frame image groups (RAW data) is received by the communication unit, the received frame image groups are discriminated into used image data used for analysis and unused image data not used for analysis. (Step S8).
The discrimination between the used image data and the unused image data is performed based on, for example, the frame rate and resolution (number of pixels) of the received frame image group. For example, if a series of frame image groups is image data obtained by shooting at 15 fps for one dynamic cycle (here, the dynamic cycle is 3 seconds), 15 × 3 = 45 frames. However, about 20 frames taken at equal time intervals per cycle are sufficient for analysis of the ventilation function of breathing. For example, only even (odd) frames are used, and odd (even) frames are not. Discriminated to use. In addition, when the image is taken at 23 fps, 23 × 3 = 69 frames. In this case, use image data is extracted (discriminated) every three frames, such as first, fourth, seventh,. The remaining frame images are discriminated into unused image data.

Next, an analysis process is performed based on the frame image group discriminated into use image data (step S19).
The contents of the analysis process are different for each part to be imaged. Here, a case where lung field analysis is performed will be described as an example.

  The lung field analysis includes an analysis for calculating a feature value indicating local movement of the lung field and an analysis for calculating a feature value indicating the movement of the entire lung field. Further, there are an analysis for the ventilation function and an analysis for the blood flow function.

  For example, the following items (1) to (6) are listed as the analysis for calculating the feature quantity indicating the local signal change due to the ventilation function of the lung field. Hereinafter, the procedure of the calculation method for each feature amount will be briefly described. In the following, in order to clarify the processing necessary for the analysis, the processing content for calculating the feature amount from the raw data of the captured frame image will be described, but in the present embodiment, the processing to the analysis server 8 is described. From the viewpoint of reducing the amount of data during frame image transmission and shortening the processing time, each frame image has already been subjected to binning processing, which is one type of thinning processing (ie, divided into small areas of a predetermined size). The signal values are averaged for each small area).

  In the analysis process of the analysis server 8, the warping process is not performed and the feature amount is calculated by associating the pixels between the frame images as in the related art. The feature amount is calculated by associating pixels indicating outputs with each other, and the processing time is significantly shortened while maintaining the accuracy of the feature amount.

(1) Ventilation-interframe difference image An interframe difference image is calculated by performing the following processing on a series of frame images.
Binning process → Low-pass filter process in the time axis direction → Inter-frame difference process → Noise removal process As described above, the binning process divides the image area into small areas in units of pixel blocks of a predetermined size in each frame image. This is a process of calculating (averaging) a representative value, for example, an average value, of signal values of pixels in the area for each area. The representative value is not limited to the average value, and may be a median value, an average value, or a mode value. The size of the pixel block is preferably in accordance with the part to be analyzed and / or the feature amount calculated by the analysis from the viewpoint of improving the analysis accuracy.
The low-pass filter process in the time axis direction is a process for extracting a time change of a signal value due to ventilation, and for example, filtering with a cutoff frequency of 0.5 Hz.
The inter-frame difference processing associates small regions at the same pixel position (regions output from detection elements at the same position of the FPD) of a series of frame images with each other, and signal values between adjacent frame images for each small region. The difference value is calculated, and an inter-frame difference image is created.
When creating a still image of the inter-frame difference image, the inspiratory period and expiratory period in a series of frame images are calculated by analyzing the change in the concentration of the entire lung field or the change in the position of the diaphragm. For the inhalation period, an absolute value of the positive inter-frame difference value is integrated, and for the expiration period, an image of the absolute value of the negative inter-frame difference value is integrated.

(2) Ventilation-waveform drawing Ventilation-waveform drawing is calculated by performing the following processing on a series of frame images.
Binning process → low-pass filter process in time axis direction → waveform drawing The binning process and the low-pass filter process in time axis direction are as described above (hereinafter the same).
The waveform drawing process associates small regions at the same pixel position (regions of pixel blocks output from detection elements at the same position of the FPD) of a series of frame images with each other, and the horizontal axis for each small region starts from the start of imaging. By creating a coordinate plane with the vertical axis representing the average signal value of the pixel and plotting the points where the elapsed time from the start of capturing each frame image and the average signal value calculated for that small region intersect This is a process of drawing a waveform indicating a time change of a signal value indicating a ventilation amount.

(3) Ventilation-Airflow velocity The airflow velocity is a feature amount indicating the softness of the lungs (lung compliance) in each small area. The air velocity is calculated by performing the following processing on a series of frame images.
Binning processing → Low-pass filter processing in the time axis direction → Difference processing between frames → Calculate the representative value (maximum value or average value) of difference values between frames

When the maximum value is a representative value, for each small region, as an index representing the maximum value of the airflow velocity in each of the expiration period and the inspiration period, signal changes in the expiration period and the inspiration period (
The maximum value of the difference value between frames) is calculated, and a histogram showing the distribution of the ratio (maximum flow rate ratio) is created. An image indicated by color may be created, and both may be arranged and provided as an analysis result. This analysis is called histogram analysis of the maximum flow rate ratio.
In the histogram analysis of the maximum flow rate ratio, as shown in FIGS. 11A to 11C, the value of the ratio between the maximum value (absolute value) of the inspiratory airflow velocity and the maximum value (absolute value) of the expiratory airflow velocity in each small region is In addition to the histogram display, an image is generated in which the average value and standard deviation of the entire lung field, which is an indicator of whether or not the image is COPD, are displayed. In addition, by displaying each small region on the still image with luminance or color according to the ratio value, diagnostic information is provided so that the doctor can easily understand the distribution of abnormal parts.

(4) Ventilation Amplitude The ventilation volume amplitude is calculated by performing the following processing on a series of frame images.
Binning processing → Low-pass filter processing in the time axis direction → Small regions at the same pixel position (regions of pixel blocks output from detection elements at the same position in the FPD) of a series of frame images are associated with each other, Calculation of maximum signal value (maximum value)-minimum signal value (minimum value) during one breath cycle

(5) Intake delay time The intake delay time is calculated by performing the following processing on a series of frame images.
Binning processing → Low-pass filter processing in the time axis direction → Small regions at the same pixel position (regions of pixel blocks output from detection elements at the same position in the FPD) in a series of frame images are associated with each other, and density changes in the entire lung field Alternatively, a frame image of a resting expiratory position is extracted by analyzing a change in the diaphragm position, and a difference between the signal value of the resting expiratory position at the time of inspiration from a frame image of the resting expiratory position for each small region is a predetermined threshold value. Calculation of time until

(6) Inspiration time and expiration time The inspiration time and expiration time are calculated by performing the following processing on a series of frame images.
Binning processing → Low-pass filter processing in the time axis direction → Small regions at the same pixel position (regions of pixel blocks output from detection elements at the same position in the FPD) of a series of frame images are associated with each other, Calculation of maximum signal value (maximum value) and minimum signal value (minimum value) during one breath cycle → time from maximum signal value to minimum signal value is expiration time, time from minimum signal value to maximum signal value is expiration time Calculated as

  For example, the following (7) to (10) may be mentioned as the analysis for calculating the feature amount indicating the local signal change due to the blood flow in the lung field. Hereinafter, the procedure of the calculation method for each feature amount will be briefly described. In the following, the processing content for calculating the feature amount from the raw data of the captured frame image will be described. However, in the present embodiment, the reduction and processing of the data amount when transmitting the frame image to the analysis server 8 are described. From the viewpoint of time reduction, each frame image has already been subjected to a binning process which is a kind of thinning process (that is, divided into small areas of a predetermined size, and signal values are averaged for each small area. Is done).

(7) Blood flow-interframe difference image The interframe difference image is calculated by performing the following processing on a series of frame images.
Binning process → High-pass filter process in the time axis direction → Difference process between frames → Noise removal The high-pass filter process in the time axis direction is a process for extracting a temporal change in the signal value due to blood flow. Filter at 7 Hz. Others are the same as the processing described in the above (1) Ventilation-frame difference image.

(8) Blood flow-waveform drawing Blood flow-waveform drawing is calculated by performing the following processing on a series of frame images.
Binning process → High-pass filter process in the time axis direction → Waveform drawing for each small region The binning process and the high-pass filter process in the time axis direction are as described above (the same applies hereinafter).
The waveform drawing process is the same as the process described in (2) Ventilation-waveform drawing described above.

(9) Blood Flow Amplitude The blood flow amplitude is calculated by performing the following processing on a series of frame images.
Binning process → High-pass filter process in time axis direction → Small area at the same pixel position (area of the pixel block output from the detection element at the same position of the FPD) of a series of frame images is associated with each other, Calculation of maximum signal value (maximum value)-minimum signal value (minimum value) during one heartbeat cycle

(10) Ventricular contraction delay time The inspiration delay time is calculated by performing the following processing on a series of frame images.
Binning processing → High-pass filter processing in the time axis direction → Small regions at the same pixel position (regions of pixel blocks output from detection elements at the same position in the FPD) of a series of frame images are associated with each other, A frame image corresponding to the end of the ventricular diastole is extracted by analyzing the change in the ventricular wall position, and for each subregion, the frame image corresponding to the end of the ventricular diastole is extracted from the frame image corresponding to the end of the ventricular diastole. Calculating the time until the difference from the end signal value exceeds a predetermined threshold

  For example, the following (11) to (15) may be mentioned as the analysis for calculating the feature amount indicating the movement of the entire lung field. Hereinafter, the procedure of the calculation method for each feature amount will be briefly described. Analysis server In this embodiment, each frame image is subjected to binning processing from the viewpoint of reducing the amount of data when transmitting the frame image to the analysis server 8 and shortening the processing time. The following feature quantities can be calculated whether or not.

(11) Diaphragm movement amount analysis The diaphragm movement amount is calculated by performing the following processing on each captured frame image.
Extract the position of the diaphragm from each frame image by image analysis → track the position of the diaphragm in each frame image and calculate the movement amount (12) Thoracic movement amount analysis The thoracic movement amount is Calculated by performing processing.
Extract the positions of the upper rib cage (upper ribs (2nd to 6th ribs)) and the lower rib cage (lower ribs (7th to 10th ribs)) from each frame image by image analysis → upper and lower rib cages of each frame image Is tracked and the amount of movement is calculated.
(13) Respiration rate and respiration cycle The respiration rate and respiration cycle are calculated by performing the following processing on each captured frame image.
Changes in the diaphragm position (distance from the apex to the diaphragm) determined by image analysis from each frame image, or the signal change (signal value (average signal value)) from the local maximum to the next local minimum after low-pass filtering The respiratory cycle is obtained from the time interval until the respiratory rate is obtained, and the respiratory rate per unit time is calculated from the reciprocal of the respiratory cycle.
(14) Heart rate and cardiac cycle The heart rate and cardiac cycle are calculated by performing the following processing on each captured frame image.
Cardiac cycle based on changes in heart wall position obtained by image analysis from each frame image or signal changes in the entire lung field after high-pass filter processing (time interval from the maximum value of the signal value (average signal value) to the next minimum value) And the respiration rate per unit time is calculated from the reciprocal of the cardiac cycle.
(15) Calculation of a value corresponding to a spiro test A time change waveform of the diaphragm position is calculated, and a value corresponding to FEV 1.0% (one second rate) is calculated.
A change in lung field area is calculated from changes in the rib cage and diaphragm positions, and a value corresponding to VC (pulmonary vital capacity) is calculated by multiplying the change in chest thickness measured separately.

When the analysis process ends, the analysis server 8 transmits the analysis result data, the image data used for the analysis (referred to as used image data), and the intermediate generation data to the console 5 via the communication network N (step S10). . Here, the intermediate generation data is image data or the like (for example, a difference value between adjacent frames) generated in the process of obtaining an analysis result by analysis processing.
In the console 5, when analysis result data, use image data, and intermediate generation data are received by the network communication unit 56, the received analysis result data, use image data, and intermediate generation data are associated with shooting order information. Is transmitted to the PACS 10 (step S11).

  In the PACS 10, the received analysis result data, used image data, and intermediate generation data are stored in the HDD or the like of the server device in association with the shooting order information (step S12).

In the analysis server 8, unused image data is transmitted to the external storage server 60 via the Internet PN (step S13). In the external storage server 60, the received unused image data is stored (step S14), and this process ends.
Then, the photographing / analysis process ends. Note that each frame image data used for feature amount analysis cannot be used for density gradation-based lesion interpretation as in the case of conventional still images. It is preferable to store only the calculated feature amount data. In addition, even in the use image data to be stored internally, providing an arbitrary one frame image for observation similar to a conventional still image may cause misdiagnosis, and from the viewpoint of preventing misdiagnosis, for example, The use of single-shot frames is prohibited except for relative comparison of multiple frame images, such as comparing the maximum lung field area frame image (rest inspiratory position image) with the minimum lung field area frame image (resting expiratory position image). It is preferable to do.
Further, the analysis server 8 may associate the analysis result data, the used image data, and the intermediate generation data with the photographing order information received from the console 5 and transmit these data from the analysis server 8 to the PACS 10. .

Here, conventionally, in a system that calculates feature values related to dynamics based on a series of frame images obtained by dynamic imaging and provides them as diagnosis support information, in order to improve diagnosis accuracy, It has been thought that it is necessary to perform a so-called warping process in which areas where the same part is drawn are associated with each other (for example, Patent Documents 1 and 2).
In order to perform this warping process, one frame image is divided into a plurality of small areas, and a small area in which the same part of the structure drawn in each small area of the one frame image is rendered as each frame. It must be extracted for each image. In the warping process, alignment is generally performed based on spatial density changes caused by structures in the lung field, so the density of the structure must be faithfully (uniformly) reproduced over each frame image. Therefore, it is necessary to suppress the output variation of each pixel of the detector as much as possible (accordingly, various correction processes such as an offset correction process, a gain correction process, a defective pixel correction process, and a lag correction process are performed to correct the variation. Correction process takes time, and in order to perform high-accuracy warping, an image with a fine resolution is required accordingly, so a detector with a small pixel size is required. The total data capacity to be processed is greatly increased. For this reason, hardware such as a large-capacity memory and a high-speed processing CPU is required, and processing time is also required.

  However, as a result of intensive studies by the inventors of the present application, even without performing warping processing, between FPD individual detection element units or a series of frame images related to dynamic imaging in a pixel block unit including a plurality of pixels as a group. It was found that equivalent analysis results can be obtained by comparing the differences.

Hereinafter, the reason why an equivalent analysis result can be obtained without performing the warping process will be described using the lung field as an example.
First, changes in the signal value in the body thickness direction (z direction; side surface) will be described.
FIG. 8 is a diagram schematically showing the body thickness direction (z direction) of the lung field at time T1 in the resting expiratory position, and the lung field at time T2 at which the inspiratory position is reached by inhaling from time T1. It is a figure which shows a body thickness direction typically, and a figure which shows the detection element position (body-axis direction (y direction)) of FPD typically. In FIG. 8, the positions of alveoli a and b in the y direction move downward by inhaling, and the position of alveoli b in the y direction at time T1 and the position of alveolar a in the y direction at time T2. Shows an example of matching.

  The position of the alveoli in the lung field is moved by inspiration. Therefore, when the same alveoli between the frame images is aligned and the difference between the signal values is taken after warping, the X-ray attenuation amount in the z-direction in the portion outside the lung field is in the y-direction of the lung field. As the alveoli are aligned, the difference in X-ray attenuation in the lung field is added as an error factor to the signal increase due to the change in alveolar density due to respiration. It will be.

  For example, in FIG. 8, when the difference between the signal values is obtained after aligning and warping the alveoli b between the frame image at the time T1 and the frame image at the time T2, the difference value includes the difference at the time T1. This also includes the difference between the X-ray attenuation outside the lung field indicated by the solid arrow and the X-ray attenuation outside the lung field indicated by the dotted arrow at time T2, and the X-ray attenuation outside the lung field is also included. The difference is added as an error to the change in the signal value due to the density change due to respiration between the same alveoli. Thereby, the calculation accuracy of the signal change amount due to the change in alveolar density is lowered.

  Here, without performing alignment and warping of the alveoli, pixels (pixel blocks) in which the alveoli b of the frame image at time T1 and the alveoli a of the frame image at time T2 are drawn, that is, at the same position of the FPD. The difference between the signal values output from the detection elements (detection element group) is calculated. At this time, alveoli drawn in this pixel (pixel block) are different, but since the difference value is calculated for the same y-direction position of the lung field, as shown in FIG. The amount of X-ray attenuation does not change. Therefore, when the difference value of the signal value between different alveoli is calculated, the signal change due to the difference in density between different alveoli (Fig. 8) (difference in density between a and b at the same timing) is added as an error.

  “Signal change due to difference in density between alveoli having different y-direction positions in the lung field” is equal to or less than “signal change due to difference in X-ray attenuation in the outside of the lung field having different y-direction positions”. For this reason, the alveolar alignment and the warping process between frame images are not performed, and it is possible to save the processing effort by taking the difference for each pixel of the FPD as it is, and the signal change due to the alveolar density change with the same level of error. The amount can be calculated.

  In particular, the error component inherent in each pixel or small area is added and canceled when calculating the ventilation information of the entire lung field, and the characteristic quantity related to ventilation and blood flow of the entire lung field is calculated. In the case of calculation, if the warping process is performed, only a negative effect of extending the processing time by the warping process can be obtained.

Next, the xy direction will be considered. FIG. 9 shows a view of the lung field viewed from the front (xy direction). The solid line in FIG. 9 shows a view of the frame image at time T1 in FIG. 8 viewed from the xy direction (front), and the dotted line in FIG. 9 shows the frame image at time T2 in FIG. The figure is shown.
As shown in FIG. 9, normally, in inspiration, the alveoli move in the lower left direction in the case of the left lung field and in the lower right direction in the case of the right lung field. This is broken down into movement in the vertical direction (y direction) and movement in the horizontal direction (x direction). The warping process for the movement of the alveoli in the y direction is as described above. Hereinafter, the movement of the alveoli in the x direction during rest ventilation will be described.

  In the case of rest ventilation, the change width of the rib cage is about 10 mm at the maximum. At this time, when considering the change from the resting expiratory position to the resting inspiratory position, the amount of movement in the x direction is the largest in the alveoli located just inside the rib cage and is about 5 mm. Considering the case where dynamic images are acquired at a frame rate of 3.75 frames / second and the difference value between frames is calculated, the amount of movement of the alveoli between adjacent frame images is further reduced and can be ignored. During rest ventilation, the amount of movement in the x direction is small, and the amount of change in signal value when the warping process is performed and when the warping process is not performed is substantially the same. Accordingly, no warping process is required in the x-Y direction.

  According to the above knowledge, since the warping process is not performed, it is only necessary to perform calculation in units of pixels indicating the outputs of the individual detection elements of the FPD, or in units of small regions. Therefore, it is possible to process a frame image generated by the FPD 9a corresponding to dynamic photographing of each company, for example, a frame image subjected to binning processing, which enables an open system.

  By the way, dynamic imaging has a problem that the number of frame images used for analysis increases dramatically compared to still images, and the processing time increases dramatically. The inventors of the present application have also made extensive studies from this viewpoint.

In the conventional system (CAD) that detects abnormal shadow candidates of the breast and breast and provides them to the doctor as diagnosis support information, the detection algorithm is applied to the original image data, so the density resolution of the image itself to which the algorithm is applied And that the pixel size matches the detection algorithm (the pixel size and density resolution are high-definition) have been emphasized.
Also, in the conventional system, a thinned image is created from the original image. This is done by confirming that the region of interest of the subject is within the analyzable range, and detecting the target image within the density range that matches the detection algorithm. It is only used in the preparatory stage of detection processing, such as calculation of gradation processing conditions for keeping the density range, and is not used in the detection processing by CAD, but is discarded.

  On the other hand, as described above, the feature value analysis of dynamic images is mainly based on the difference value processing between adjacent frames. Therefore, in the dynamic image feature quantity analysis, the absolute output value of each pixel itself is compared with a threshold value, or a strict analysis of each pixel is performed as in analysis processing in a conventional CAD in which a fine structure is extracted. The present inventors have found that no output value is required and the pixel size of each image is not affected.

  In addition, as a result of further intensive studies, the inventors of the present application have calculated from a calculation (analysis) in units of pixels to a calculation in units of small areas of a specific pixel block size (block size) (one pixel value in each small area) It has been found that the same result can be obtained even if the calculation is performed by using the above-described method, and the calculation using a representative value (average value or the like) of pixel values in a small region. As a result, the present inventors have found that the amount of data required for the calculation of the analysis processing can be greatly reduced, and the processing time can be greatly shortened.

FIG. 10 is a diagram illustrating analysis results of typical items of the above analysis processing and evaluation results of processing time when the pixel block size of the small region is changed between 0.5 mm square to 10 mm square.
Here, an example is shown in which a ventilation amount inter-frame difference image, a maximum flow rate ratio histogram analysis, and a blood flow amount inter-frame difference image are set as target items. Note that each frame image uses an image taken with radiation irradiation conditions such as an irradiation dose and a frame rate, and image reading conditions constant. In FIG. 10, the incident surface dose at a frame rate of 7.5 frames / second and 10 seconds is 0.2 mGy, and the pixel size of the FPD 9a is 200 μm. In FIG. 10 (and FIGS. 11A and 11B described later), the evaluation result Δ or higher indicates that the feature quantity can be calculated with accuracy that can be used for diagnosis, and the analysis accuracy is low in the order of Δ → ○ → ◎. → Indicates that the price is high. Further, the processing time x indicates that the processing time is long and is not suitable for practical use, and Δ or more indicates that the processing time is within a practically allowable range. In the case of this processing time, even at the X level, the processing time can be considerably reduced as compared with the case where all pixel data is used.

  As shown in FIG. 10, when the block size is 0.5 mm square to 1 mm square, the analysis results are obtained for all items of calculation of the difference value of the ventilation volume between frames, histogram analysis of the maximum flow velocity ratio, and difference value of the blood flow volume between frames. Could be obtained with high accuracy. With a block size of 2 mm square, the analysis accuracy was slightly lower than the block size of 0.5 mm square to 1 mm square, but sufficient results were obtained for diagnosis. When the block size was 5 mm square, the analysis accuracy decreased for each item. However, analysis accuracy that can be used for diagnosis is ensured. When the block size was 10 mm square, it was not possible to obtain feature quantities with accuracy that could be used for diagnosis. On the other hand, as shown in FIG. 10, the processing time is longer as the block size is smaller.

Here, an example of the analysis result evaluation will be described.
11A to 11C show examples of analysis results of histogram analysis of the maximum flow rate ratio when the block sizes are 2 mm square, 5 mm square, and 10 mm square, respectively.
When the block size was 0.5 mm square and 1 mm square, there was almost no change from the histogram shown in FIG. 11A.
When the analysis result of the block size of 2 mm square shown in FIG. 11A is compared with the analysis result of the block size of 5 mm square shown in FIG. 11B, the shape of the histogram is slightly changed. Comparing the analysis result of the block size of 2 mm square shown in FIG. 11A and the analysis result of the block size of 10 mm square shown in FIG. 11C, it can be seen that a significant change is seen in the shape of the histogram and the analysis accuracy is greatly reduced. Therefore, in terms of analysis accuracy, the block size needs to be 5 mm square or less, particularly 2 mm square or less. On the other hand, from the viewpoint of processing time, as shown in FIG. 10 described above, the processing time increases as the block size decreases.
Therefore, from the viewpoint of maintaining the analysis accuracy and shortening the processing time, the block size is preferably about 2 mm square to 5 mm square in the analysis of lung field ventilation.

Furthermore, the block size is preferably about 2 mm from the viewpoint of removing signal changes due to movement of the ribs. For example, when the block size is expanded to include a plurality of ribs in order to remove the influence of signal changes due to the movement of the ribs, the thickness of the ribs is 10 mm to 20 mm, so the block size including the plurality of ribs is 50 mm square to 100 mm square. This is too low resolution and is not suitable for local analysis. When the block size is expanded to include one rib + the amount of rib movement at rest breathing, the rib thickness is 10 mm to 20 mm as described above, and the amount of rib movement at rest breathing is several mm, The block size is 15 mm square to 20 mm square. Even so, the resolution is too low to be suitable for local analysis. In addition, it is difficult to divide the small area so that other ribs are not included. Therefore, the influence of the ribs is removed by detecting a region where the signal change due to the rib is larger than the surroundings by reducing the block size to some extent and omitting that portion from the analysis or replacing it with a signal value of the period. In this case, the block size is preferably about 2 mm square to 5 mm square.
Also from the above viewpoint, the block size in the case of performing the analysis processing related to the ventilation of the lung field is preferably about 2 mm square to 5 mm square.
It should be noted that so-called group screening, which has a flow of primary screening by conventional indirect imaging (diagnosis based on reduced images) and secondary scrutiny by direct imaging (diagnosis based on life size images) for suspected abnormalities. When diverting the chest dynamics analysis, the analysis results for each block size can be substituted for the primary screening by making the left and right lung field regions into a relatively large block size that is divided into upper, middle, and lower. For suspected subjects, the analysis block size can be reorganized into smaller blocks, and each small block can be used as a substitute for secondary scrutiny by performing local, in other words, precise analysis. It is. The feature of this flow is that, unlike the conventional flow, re-imaging is unnecessary, and the burden on the subject can be reduced and it can be connected to early diagnosis.

In addition, the inventors of the present application also examined the influence on the analysis by the frame rate of the FPD 9a.
12A to 12B show the analysis results of typical items of the above analysis processing, the processing time, the influence of thinning, and the degree of patient exposure when the frame rate of the FPD 9a is changed from 2 frames / second to 20 frames / second. It is a figure which shows the evaluation result of. FIG. 12A shows an evaluation result when the irradiation dose in each frame image is constant. FIG. 12B shows an evaluation result when the total irradiation dose of one dynamic imaging is constant (equivalent to an incident irradiation dose of 0.2 mGy in 10 seconds of imaging). 12A and 12B, the pixel size is 200 μm, and the block size is 2 mm square.

  Assuming that the irradiation dose of each frame image is constant, as shown in FIG. 12A, for the histogram analysis of the ventilation volume and the maximum flow rate ratio, a feature of accuracy that can be used for diagnosis if the frame rate is 3.75 frames / second or more. I was able to get the amount. In addition, about the ventilation delay time, in order to obtain the feature quantity of the precision which can be used for a diagnosis, 10 sheets / second or more was required, and the blood flow delay time required 30 frames or more. On the other hand, the processing time was longer as the frame rate was higher, and the processing time of 15 sheets / second or more was not practical. When the pixel interval was thinned down to 1/8, the processing time was good at all frame rates. The patient exposure dose increases as the frame rate increases, and when it exceeds 30 frames / second, it is more than twice the normal incident surface dose at the time of taking a chest X-ray image of a still image, exceeding the allowable range. It was.

  In addition, when the total irradiation dose is constant in dynamic imaging and the irradiation dose per frame image decreases as the frame rate increases, as shown in FIG. / Second or more, the evaluation is lower than the evaluation result of FIG. 12A. This is because as the frame rate increases, the S / N ratio of each frame image deteriorates and the image deteriorates.

Here, an example of the evaluation of the analysis result in FIG. 12B will be described.
FIGS. 13A to 13E show examples of analysis results of histogram analysis of the maximum flow rate ratio when the total irradiation dose is constant in dynamic imaging and the frame rate is changed from 2 frames / second to 30 frames / second.
As shown in FIG. 13A, when the frame rate is 2 frames / second, the average value is 1.15 → 1.32 (15% increase) and the dispersion value is compared with the case where the frame rate is 3.75 frames / second. There is a difference in analysis results from 0.38 to 0.52 (37% increase). In addition, small areas that become abnormal values are increasing (areas in which the luminance corresponding to the maximum flow rate ratio is not superimposed on the still image in the lung field areas of FIGS. 13A to 13E), and the analysis accuracy decreases. Yes. Here, when calculating the maximum value of the inter-frame difference value in each of inspiration and expiration, if the maximum value of the inter-frame difference value is smaller than a predetermined threshold for the purpose of suppressing the influence of noise, the small area is set as an abnormal value. Are excluded from the analysis. More specifically, since the signal value increases during inspiration, the maximum value of the interframe difference value is equal to or greater than a predetermined positive threshold value, and the signal value decreases when exhalation. When the maximum value is equal to or less than a predetermined negative threshold value, it is determined as a normal value, and other values are determined as abnormal values.

  When the frame rate is 3.75 frames / second or more, as shown in FIG. 13B to FIG. 13E, the average respiratory rate (15 to 20 times / minute at rest. If it is the analysis result of an adult in seconds.), Almost the same analysis result is obtained. However, in consideration of rare cases of tachypnea patients (patients with high respiratory rate per unit time. 24 to 40 times / minute. If 40 times / minute, the respiratory cycle is 1.5 seconds), 7.5 sheets / Second or more is more preferable. At high frame rates, even if the dose per frame image decreases, the number of frame images increases, so by increasing the number of taps (number of integrations) used for the low-pass filter in the time axis direction, noise is reduced and analysis is performed. The deterioration of the result can be suppressed.

However, in order to realize a high frame rate, it is necessary to increase the data reading and transfer time of the FPD 9a and to make the X-ray generator complicated for outputting a short pulse, which increases the cost of hardware. Therefore, when the total dose is constant, there is not much merit in setting a high frame rate in the analysis of the ventilation function.
For example, as an example of imaging conditions for chest dynamic imaging at SID = 200 cm (assuming that the subject thickness is 20 cm) and a frame rate of 7.5 frames / second, tube voltage 100 kV, tube current 50 mA, pulse width 2 ms, additional filter Al0. 5mm + Cu0.1mm is mentioned. At this time, the irradiation dose of the X-ray pulse per frame image is 0.1 mAs (= 50 mA × 0.002 s), and the irradiation dose per frame image is set according to the frame rate so that the total dose is constant. When changed, the irradiation dose of X-ray pulses per frame image at a frame rate of 15 frames / second is 0.05 mAs, and the irradiation dose of X-ray pulses per frame image at a frame rate of 30 frames / second is 0.025 mAs. Become. However, it is difficult to control the X-ray pulse width to 1 ms, and when trying to lower the tube current, the time constant for discharging the charge stored in the capacitor between the anode and cathode of the X-ray tube becomes longer. As a result, the decrease in the tube voltage becomes gentle, so that a circuit for sharply discharging the electric charge is required, which increases the device cost. Therefore, a low frame rate is more advantageous from the viewpoint of X-ray pulse control.
In general, the afterimage (lag) in the FPD decreases exponentially with respect to time (imaging interval), so that the irradiation dose per frame image according to the frame rate so that the total dose is constant. Even when the value is changed, that is, when the dose is decreased in inverse proportion to the frame rate, the smaller frame rate is advantageous from the viewpoint of the afterimage visibility.
Therefore, in the ventilation analysis, the frame rate is preferably 3.75 frames / second to 7.5 frames / second.

14A to 14D show inter-frame difference images (blood pumping timings) when the total irradiation dose is constant in dynamic imaging and the frame rate is changed from 3.75 frames / second to 30 frames / second. An example of an analysis result is shown.
When the frame rate is 3.75 frames / second, the frame image interval is too far away, and in some cases, the timing of pulsing from the heart may not be captured. When the frame rate is 7.5 frames / second and 15 frames / second, as shown in FIGS. 14B and 14C, the average pulse rate (resting 50 to 100 times / minute. If it is an adult image with a period of 1.0 second, the blood ejection timing can be captured. However, in rare case tachycardia patients (patients with high pulse rate per unit time. 100 to 120 times / minute. If 120 times / minute, heart rate cycle is 0.5 seconds), 15 / second or more Is preferred. When the frame rate is 30 frames / second, the dose per frame image is small, so there is a lot of noise and the image quality of the inter-frame difference image is degraded.
Therefore, in the analysis of blood flow, it is preferable to set the frame rate to 7.5 / 15 to 15 / second.

  Next, the effect of binning and simple decimation on the analysis will be examined. Here, the histogram analysis of the maximum flow rate ratio when the binning process and the simple decimation process are performed, the difference image between ventilation frames, and the difference image between blood flow frames are compared, and the effects of both are examined.

  FIGS. 15A to 15C show examples of histogram analysis results of the maximum flow velocity ratio, ventilation frame difference image, and blood flow frame difference image when binning processing and simple thinning processing are performed. The analysis shown in FIG. 15A uses a dynamic image corresponding to a frame rate of 7.5 seconds / frame and a total dose (incident surface dose in 10 seconds of imaging) equivalent to 0.2 mGy. The upper part of FIG. 15A shows a case where binning processing is performed at 2 mm square, and the lower part of FIG. 15A shows a case where simple thinning processing is performed at intervals of 2 mm. The upper part of FIG. 15B shows a case where binning processing is performed at 2 mm square, and the lower part of FIG. 15B shows a case where simple thinning processing is performed at intervals of 2 mm. The upper part of FIG. 15C shows the case where binning processing is performed at 2 mm square, and the lower part of FIG. 15C shows the case where simple thinning processing is performed at intervals of 2 mm.

  As shown in FIGS. 15A and 15B, in the histogram analysis of the maximum flow rate ratio and the difference image between ventilation frames, the binning process and the simple thinning process for the analysis result are not significantly different. That is, in the analysis of ventilation, the influence of the binning process and the simple thinning process is not much different. On the other hand, as shown in FIG. 15C, in the difference image between blood flow frames, the simple thinning process has a larger noise on the image than the binning process, and blood flow information cannot be detected (the lung field area in FIG. 15C). In this case, there are many areas in which no inter-frame difference value is added on a still image. Therefore, in the case of analysis of the ventilation function, either binning processing or simple thinning may be performed (in each item of the above analysis processing, either binning processing or simple thinning may be performed). In the case of this analysis, it is preferable to perform a binning process.

Also, if binning processing is performed, the influence of individual pixel variations is mitigated by averaging signal values within a small region, so that correction processing such as offset correction processing, gain correction processing, and defective pixel correction processing can be omitted. And the processing time can be greatly shortened.
Further, since the image subjected to binning processing and simple thinning processing for positioning confirmation can be reused for analysis, processing time can be greatly shortened.
For example, in the case of existing video shooting support, for example, FPD for fluoroscopy, the FPD itself outputs data subjected to binning processing such as 2 × 2 pixels to a display device for real-time display, Some types are used for confirming the position of surgical tools, etc., but this type of output signal can be used as it is for analysis of features, and even if the output signal of an existing imaging device is used It is shown that the feature amount related to can be analyzed.

By the way, as a weak point of dynamic imaging and analysis, there is a large amount of data involved (RAW data, intermediate generation data, analysis result data).
For example, when 15 frame images are generated by one dynamic shooting, and the above-described still image of the inter-frame difference image is created based on these images, 15 frames are generated by shooting, and intermediate generation data is 14 frames by analysis. One still image (analysis result output display image) is generated as a target product. That is, about 30 times as much image data as a still image is generated. In order to store all of these inside the facility, a large amount of storage equipment is required. On the other hand, the images used for diagnosis are clearly obliged to be preserved by the Doctoral Law, but the object of preservation of the image group generated with the new method of dynamic analysis is undecided, and future legal regulations are fluid. is there. Therefore, in the above-described embodiment, analysis result data that is evidence of diagnosis that is expected to be required to be stored in the future, use image data related to generation of analysis result data that may be required to be stored, and intermediate generation The data is stored in the PACS 10 inside the facility, and unused image data that is not used for generating an analysis result with a low possibility of storage obligation is stored in the external storage server 60.

  In the above embodiment, an example of a storage mode for a large-scale facility A having equipment capable of dynamic imaging in the facility and an analysis server 8 has been described. Hereinafter, the scale of a medical facility, presence or absence of dynamic imaging equipment, Examples of various storage formats according to the presence or absence of an analysis server will be described.

[Example of a large-scale facility]
First, an example of a large-scale facility will be described. Here, a large-scale facility is assumed in which diagnosis is performed using the analysis result data (a series of dynamic images are not displayed in the diagnosis (paragraph display of each frame image)).

(A) Dynamic Analysis Performed Internally In a large-scale facility A that performs dynamic analysis internally as in the dynamic analysis system 100 shown in FIG. 1A, in addition to the storage form in the above embodiment, the following (a-1 ) To (a-7). Note that the analysis server 8 discriminates between used image data and unused image data.
(A-1) The analysis result data, the use image data, and the intermediate generation data are internally stored in the PACS 10 in the facility. Unused image data is stored in the external storage server 60 using an external data storage service.
(A-2) The analysis result data, the used image data, and the intermediate generation data are internally stored in the PACS 10 in the facility. Unused image data is deleted. This is an operation method similar to that at the time of re-shooting in the conventional still image shooting system.
In particular, the following preservation forms (a-3) and (a-4) are also conceivable in chest dynamic imaging. These are storage forms that internally store only the maximum lung field area frame image and the minimum lung field area frame image, which is the most important image data related to the dynamics of the lung field among the use image data, together with the analysis result data, The amount of data stored in the internal PACS 10 can be further suppressed. This storage method has the highest affinity with the image storage method related to the PACS 10 already operated in the facility.
(A-3) The maximum lung field area frame image and the minimum lung field area frame image among the analysis result data and the used image data are internally stored in the PACS 10 in the facility. Other used image data, unused image data, and intermediate generation data are stored in the external storage server 60.
This saving method is effective when the block size is changed and analysis processing or the like is to be performed again.
(A-4) The maximum lung field area frame image and the minimum lung field area frame image among the analysis result data and the use image data are internally stored in the PACS 10 in the facility. Other used image data, unused image data, and intermediate generation data are deleted.
Furthermore, in order to further reduce the amount of data stored in the internal PACS 10, the following storage forms (a-5) and (a-6) are conceivable.
(A-5) Only the analysis result data is internally stored in the PACS 10 in the facility. Use image data and intermediate generation data are stored in the external storage server 60. Unused image data is deleted.
(A-6) Only analysis result data is stored internally in the PACS 10 in the facility. The used image data and the intermediate generation data are stored in the external storage server 60 with a reduced resolution (either simple thinning or binning processing may be used). Delete unused data.
(A-7) Only analysis result data is stored internally in the PACS 10 in the facility. Use image data and intermediate generation data by reducing the number of bits per pixel (for example, by applying a non-linear LUT to each pixel to convert a pixel value of 12 bits per pixel to 8 bits), an external storage server Save to 60. Delete unused data.
(A-8) Only the analysis result data is stored internally in the PACS 10 in the facility. Everything else is left as it is, or the resolution is lowered (either simple thinning or binning can be used), or the number of bits per pixel is reduced, or both the resolution and the number of bits per pixel are reduced. And stored in the external storage server 60.
Here, in the conventional still image-based diagnosis based on density contrast, each element output of the FPD generally has a 12-bit resolution (0 to 4095 tone).
On the other hand, in the dynamic analysis process according to the present embodiment, since the analysis is based on the difference value between adjacent frames, the output range of each element in the inter-frame difference value falls within a considerably smaller range than 12 bits. . Therefore, when saving a series of image data used for analysis, only one image is saved as RAW data, and the other is replaced with a difference value between frames based on the image to save the data storage capacity. can do. In the case of the chest, the maximum lung field area frame image and / or the minimum lung field area frame image may be stored as RAW data, and the other frame images may be stored as inter-frame difference values based on the image group. . With either method, a series of image data used for analysis can be reproduced.

(B) Performing dynamic analysis outside (analysis center) FIG. 16 is intended for a large-scale facility B that has a dynamic imaging device (for example, an existing fluoroscopic device) in the facility but does not have an analysis server 8 The whole structure of the dynamic analysis system 101 is shown. As shown in FIG. 16, the dynamic analysis system 101 includes a dynamic imaging system 40, an in-facility system 31 having a PACS 10, an external storage server 61, an analysis center analysis server 8, and an external storage server 60. The in-facility system 31 and the analysis server 8 of the analysis center can transmit and receive data via the Internet PN. The external storage server 61 is an external storage server of a company that has concluded a contract for an external storage service with the large-scale facility B, and can exchange data with the in-facility system of the large-scale facility B via the Internet PN. The external storage server 62 is an external storage server of a company that has concluded an external storage service contract with the analysis center, and can send and receive data to and from the analysis server 8 of the analysis center via the Internet PN. In FIG. 16, the devices constituting the dynamic analysis system 100 shown in FIG. 1A to FIG. 1B, the devices and systems having the same configuration and functions as the system, are denoted by the same reference numerals (FIG. 17A, FIG. 17B, The same applies to FIG. 18).

In the dynamic analysis system 101 illustrated in FIG. 16, the following embodiments (b-1) to (b-4) are included.
(B-1) After the dynamic imaging, all the RAW data is transmitted from the in-facility system 31 to the analysis server 8 (a copy of the transmitted RAW data is temporarily stored), and the analysis server 8 uses the image data as unused. The image data is discriminated and used image data information (for example, a number indicating the shooting order of the used frame images) is returned together with the analysis result data. The in-facility system 31 stores the analysis result data and the frame image used in the series of frame images in the PACS 10. In addition, the intermediate generation data and unused image data are transmitted to the external storage server 62 by the analysis server 8 and stored.
(B-2) All RAW data is transmitted from the in-facility system 31 to the analysis server 8, the used image data and the unused image data are discriminated by the analysis server 8, and the used image data and the intermediate generation data are analyzed together with the analysis result data. Send back. In the facility system 31, the analysis result data, the used image data, and the intermediate generation data are stored in the PACS 10. Unused image data is stored in the external storage server 62 by the analysis server 8.
(B-3) The in-facility system 31 inquires the analysis server 8 about the number of frames per cycle to be used for analysis, and extracts only the frame images to be used for analysis according to the answer from the analysis server 8 to the analysis server 8 Send. Frame images that are not used are stored in the external storage server 61 from the in-facility system 31. The analysis server 8 returns only the analysis result data to the facility system 31, and the in-facility system 31 stores the analysis result data in the PACS 10. The use image data and the intermediate generation data are stored in the external storage server 62 by the analysis server 8.
(B-4) An inquiry is made from the in-facility system 31 to the analysis server 8 about the number of frames per cycle to be used for analysis, and only the frame image used for analysis is extracted according to the answer from the analysis server 8 to the analysis server 8 Send. Unused image data that has not been used is stored in the external storage server 61 from the in-facility system 31. The analysis server 8 returns analysis result data, use image data, and intermediate generation data to the facility system 31, and the in-facility system 31 stores the analysis result data, use image data, and intermediate generation data in the PACS 10.
The external storage server 62 has an information management table, an analysis result table, and the like, like the server device of the PACS 10 described above, and the use image transmitted from the analysis server 8 using the feature value, patient information, and the like as keys. Data and analysis result data are stored so as to be searchable, and data requested from the analysis server 8 can be searched and read out and transmitted to the analysis server 8. In response to a request from the in-facility system 31, the analysis server 8 can read out use image data stored in the external storage server 62, calculate an additional feature amount, and transmit it to the in-facility system 31. It is. This is effective when a data group (including analysis results) related to past dynamic analysis is used as a reference image.

[Example of small-scale facilities]
Small-scale facilities are small-scale medical facilities such as practitioners and clinics. The data storage capacity installed in the facility is generally small and, of course, no analysis server is provided. Therefore, there is a high possibility that basically only analysis result data can be stored in the facility. There is a need to provide a data flow that fits these situations.

(C) Case of having dynamic imaging equipment FIG. 17A shows an overall configuration of a dynamic analysis system 200 for a small-scale facility C having a dynamic imaging system 40 in the facility. As shown in FIG. 17A, the dynamic analysis system 200 includes a dynamic imaging system 40, an in-facility system 32 having an HDD 70, an analysis server 8 of an analysis center, and an external storage server 62. The in-facility system 32 and the analysis server 8 of the analysis center can transmit and receive data via the Internet PN. The analysis server 8 and the external storage server 62 can transmit and receive data via the Internet PN.
In the dynamic analysis system 200 shown in FIG. 17A, when dynamic imaging is completed in the in-facility system 32, a series of RAW data is transmitted to the analysis server 8. The analysis server 8 returns only the analysis result data to the in-facility system 32, and the in-facility system 32 stores only the analysis result data in the HDD 70. In the case of analyzing the dynamics of the chest, the analysis server 8 together with the analysis result data, the maximum lung field area frame image and the minimum lung field area which are the most important image data related to the dynamics of the lung field among the used image data. The frame image may be returned to the in-facility system 32 and the HDD 70 of the in-facility system 32 may store the maximum lung field area frame image and the minimum lung field area frame image together with the analysis result data.
The analysis server 8 processes the used image data, the intermediate generation data, and the unused image data according to any of the following.
Use image data and intermediate generation data are stored in the external storage server 62, and unused image data are deleted.
・ Use image data and intermediate generation data with a lower resolution than at the time of analysis, or reduce the number of bits per pixel, or reduce both the resolution and the number of bits per pixel, or use image data Are stored in the external storage server 62 in a combination of a predetermined frame image (maximum lung field area frame image and / or minimum lung field area frame image) and inter-frame difference value data, and unused image data is deleted. . Here, if each pixel of each frame image used for analysis has data corresponding to a 12-bit gradation range, the value indicated by the difference value between these adjacent frame images is 12-bit gradation. Since it falls within a narrow (small) gradation range compared to the range, the capacity for storage can be reduced.
Save everything in the external storage server 62.
In the case of analysis of chest dynamics, among the use image data, the maximum lung field area frame image and the minimum lung field area frame image are stored in the external storage server 62, and others are deleted.
In addition, according to the request from the facility, the analysis server 8 transmits a dynamic image for patient explanation (RAW data or image data processed for easy viewing) and / or a dynamic image for teaching together to the facility. It is good as well. A dynamic image for teaching is a dynamic image for a doctor who is not proficient in interpretation of a dynamic image to improve the interpretation of the dynamic image. For example, a dynamic image of a typical case (RAW data or processed for easy viewing) Image data).

(D) Case of not having dynamic imaging equipment FIG. 17B shows the overall configuration of a dynamic analysis system 201 for a small-scale facility D that does not have a dynamic imaging system in the facility. As shown in FIG. 17B, the dynamic analysis system 201 includes an in-facility system 33, an imaging system 41 that is installed in an imaging center and performs dynamic imaging, an analysis server 8 in the analysis center, and an external storage server 62. The in-facility system 33 and the analysis server 8 of the analysis center can transmit and receive data via the Internet PN. The imaging system 41 and the analysis server 8 can transmit and receive data via the Internet PN. The analysis server 8 and the external storage server 62 can transmit and receive data via the Internet PN. The imaging system 41 has substantially the same configuration as the dynamic imaging system 40 described above.
In the dynamic analysis system 101 shown in FIG. 17B, after a doctor interviews a subject, dynamic imaging is performed by the imaging system 41 of an external imaging center visited by the subject instructed by the doctor, and a series of RAW data. Is sent to the analysis server 8 of the analysis center for analysis. The analysis result data is transmitted to the in-facility system 33. A series of raw data, analysis result data, and intermediate generation data are stored in the external storage server 62.
In the analysis center, it cooperates with the external storage server 62 and can respond to various requests from the facility side. For example, when a dynamic image for patient explanation or a dynamic image for teaching is requested from the in-facility system 33, the analysis server 8 reads out the corresponding RAW data stored in the external storage server 62 and reads out the RAW data. Alternatively, the image data processed for easy viewing is transmitted to the in-facility system 33. When an additional feature amount analysis is requested, the analysis server 8 reads the raw data of the corresponding patient stored in the external storage server 62 and analyzes the additional feature amount, and the analysis result data is transmitted to the in-facility system. To 33. Further, for example, when the analysis server 8 is requested to transmit analysis result data and RAW data to another facility (such as a large hospital) with an introduction letter from the facility, the analysis server 8 receives the analysis result data and RAW data from the external storage server 62. And the analysis result data and the RAW data are transmitted to the designated address. Note that only RAW data may be transmitted if analysis can be performed at the introduction destination.
The storage period of the data in the external storage server 62 may be designated from the facility side, or may be deleted if there is no request for a certain period. The base point of preservation is when analysis result data is transmitted to the facility.

  In addition, with advances in network technology, collaboration between medical facilities is also progressing. Therefore, as shown in FIG. 18, the diagnosis department system (the above-mentioned in-facility system) 31 and 32 that does not include the analysis server 8, the analysis server 8 of the linked medical facility, and the analysis server 8 via the Internet PN The dynamic analysis system 300 may be configured by connecting the analysis department system 36 including the external storage server 63 capable of transmitting and receiving data via the Internet PN. Here, the external storage server 63 is an external storage server of a company that has concluded a contract for providing a data storage service with a partner medical facility, and is arranged at a location different from the analysis server 8. It is connected to be able to send and receive data via the Internet PN.

  In the dynamic analysis system 300, for example, RAW data that is a series of frame images generated in the medical department systems 31 and 32 is transmitted to the analysis server 8. The analysis server 8 performs an analysis process and transmits analysis result data to the medical department systems 31 and 32. In the medical department system 31, the received analysis result data is stored in the PACS 10 as the first storage unit. In the medical department system 32, the received analysis result data is stored in the HDD 70 as a first storage unit. Further, the analysis server 8 transmits the data accompanying the analysis, that is, the use image data and the intermediate generation data to the external storage server 63 as the second storage unit and stores it.

  As described above, according to the dynamic analysis systems 100 and 101, the image data group including a plurality of frame images acquired by the dynamic imaging system is not used for the analysis by the analysis server 8 and used image data. Discrimination into unused image data and analysis using the used image data. Then, the used image data used for the analysis is stored in the first storage means (PACS 10 or HDD 70) inside the medical facility, and the unused image data not used for the analysis is stored in the second storage means (external storage server 60). 62).

  Therefore, among the image data of frame images generated by dynamic shooting, use image data that may be required to be stored in the future and unused image data that is unlikely to be stored in the future are stored separately. It is possible to cope with the legalization of future preservation obligations while restraining facility modifications. In particular, the first storage means is the storage equipment inside the existing medical facility, and the second storage means is the external storage server, so that the existing storage equipment of the medical facility is used and the equipment is almost remodeled. It becomes possible to respond to the obligatory storage of data related to dynamic diagnosis assumed in the future.

  Further, in the first storage means, the analysis result data and the intermediate generation data are stored in association with the used image data used for the analysis, so that a series related to diagnosis that may cause future storage obligation may occur. Can be stored in association with each other.

  In addition, by providing a configuration that includes an input unit for designating a feature amount serving as a search condition and a search unit that searches the first storage unit for analysis result data that satisfies the search condition specified by the input unit, for example, When a doctor wants to refer to analysis result data or image data of a case having the same feature amount as a certain patient, it can be easily obtained.

  Further, according to the dynamic analysis system 300, the analysis server 8 of the analysis department system 34 transmits the analysis result data to the medical department systems 31 and 32, and the data associated with the analysis is an external storage server that is a second storage means. The medical department systems 31 and 32 store the analysis result data in the PACS 10 or the HDD 70 that is the first storage unit. Therefore, only the analysis result data necessary for diagnosis is stored in the existing storage facility of the medical facility of the medical department, and the other is stored in the analysis system department side, so there is almost no equipment modification in the medical facility of the medical department. It will be possible to cope with the mandatory storage of data related to the dynamic diagnosis assumed in the future.

  In addition, the second storage means is an external storage server 63 that is arranged at a location different from the analysis server 8 and connected to the analysis server 8 via a communication network, so that the equipment can be modified even in the medical facility of the analysis department. This makes it possible to respond to the obligatory preservation of data related to dynamic diagnosis that is assumed in the future without having to do so.

In addition, the said embodiment is a suitable example of this invention, and is not limited to this.
For example, in the above-described embodiment, it has been described that the thinning process is performed in the console 5, but for example, as in Japanese Patent No. 4,546,174, the imaging device side that captures dynamic images (this embodiment) Then, binning processing or simple thinning processing may be performed by the FPD 9 a), and the processed frame image may be transmitted to the console 5. This is more preferable because the transfer time of the image data between the FPD and the console can be shortened.

  In the dynamic analysis system 100 of the above embodiment, the analysis server 8 is provided separately from the console 5, but the console 5 may include an analysis program and perform analysis processing. In this way, it is possible to save time for transmitting image data from the console 5 to the analysis server 8 and to prevent a situation in which processing is delayed due to analysis by another console 5.

  In the dynamic analysis system 100 according to the first embodiment, the console 5 is arranged in each photographing room and the photographing in the photographing room is controlled by the console 5 in each photographing room. One or a plurality of consoles 5 may be installed so as to be connectable to the console 6 and the access point AP in each photographing room, and each console 5 may control any photographing in the photographing rooms R1 to R3. .

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

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

100 Dynamic Analysis System 1 Bucky Device 11 Control Unit 12 Detector Mounting Unit 13 Communication I / F
14 Drive unit 15 Bus 2 Bucky device 21 Control unit 22 Detector mounting unit 23 Communication I / F
24 Drive unit 25 Bus 3a Radiation source 3b Radiation source 3c Radiation source 4 Cradle 5 Console 51 Control unit 52 Storage unit 521 Imaging management table 53 Input unit 54 Display unit 55 Communication I / F
56 network communication unit 57 bus 8 analysis server 81 control unit 82 storage unit 83 input unit 84 display unit 85 communication unit 86 bus 9a FPD
9b FPD
91 control unit 92 detection unit 93 storage unit 94 connector 95 battery 96 wireless communication unit 97 bus 6 console 7 HIS / RIS
10 PACS
70 HDD
101, 200, 201, 300 Dynamic analysis system 60, 61, 62, 63 External storage server

Claims (5)

A radiation source capable of continuously irradiating the subject with radiation, and a plurality of detection elements arranged in a two-dimensional manner, each of the plurality of detection elements being continuously irradiated by the radiation source and transmitted through the subject A radiation detector that sequentially detects radiation, and imaging means for imaging a subject's dynamics over one period using the radiation source and the radiation detector to generate a plurality of frame image data;
Analyzing means for analyzing dynamics of the subject based on a plurality of frame image data generated by the photographing means;
A dynamic analysis system comprising:
Discriminating means for discriminating the plurality of frame image data into image data used for analysis by the analyzing means and image data not used for analysis;
A first storage means for storing the image data used for the analysis after the analysis is performed using the image data used for the analysis by the analysis means;
Second storage means for storing unused image data that has not been used for analysis by the analysis means;
Dynamic analysis system with   The first storage means further stores the analysis result data generated by the analysis means and the intermediate generation data generated in the analysis process by the analysis means in association with the image data used for the analysis. The dynamic analysis system according to claim 1. An input means for specifying a feature amount as a search condition;
A search unit that searches the first storage unit for analysis result data satisfying a search condition specified by the input unit and use image data corresponding thereto;
The dynamic analysis system according to claim 2, comprising: A radiation source capable of continuously irradiating the subject with radiation, and a plurality of detection elements arranged in a two-dimensional manner, each of the plurality of detection elements being continuously irradiated by the radiation source and transmitted through the subject A radiation detector for sequentially detecting radiation, and imaging means for imaging the dynamics of the subject over one period using the radiation source and the radiation detector to generate a plurality of frame image data; A medical department system comprising:
An analysis department system comprising: analysis means for analyzing dynamics of the subject based on a plurality of frame image data generated in the medical department system; and a second storage means;
Is a dynamic analysis system connected via a communication network,
The analysis department system transmits the analysis result data generated by the analysis means to the medical department system, and stores data accompanying the analysis in the analysis means in the second storage means,
The medical department system is a dynamic analysis system that stores the analysis result data in the first storage unit.   The dynamic analysis system according to claim 4, wherein the second storage unit is arranged at a location different from the analysis unit and is connected to the analysis unit via a communication network.