JP2014233611A - Treatment planning support apparatus and treatment planning support system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment planning support apparatus and a treatment planning support system which provide support for developing a treatment plan by understanding the progress of a disease from third persons' medical images, applying the understanding to a medical image of a patient for whom treatment is being planned, and representing a prediction of the progress of the patient's disease on the medical image.SOLUTION: A treatment planning support apparatus comprises: a medication and treatment information extraction unit 14 which obtains information about at least one of medication and treatment of a patient from a database 4 containing treatment-related information; a similar-case image extraction unit 15 which performs search with at least one of the medication information and the treatment information as a search condition to retrieve similar-case images showing similarity to the patient's case from among medical images of third persons different from the patient; a treatment target image generation unit 16 which determines the information of changes of the region of interest in the similar case images, and generates on the basis of the information a treatment target image showing prediction of changes of the region of interest in a medical image relating to the patient; and a display unit 17 which displays the treatment target image.

Description

  Embodiments described herein relate generally to a treatment plan formulation support apparatus and a treatment plan formulation support system.

  In recent years, with the development of devices capable of handling electronic data, a vast amount of electronic data has been accumulated. Therefore, various attempts to utilize these electronic data are made at various levels. This trend has also spread in the medical field, and for example, the construction of a large-scale medical database led by the government in each country is intended.

  In the medical field, a medical treatment plan such as a doctor or an engineer may use the electronic data to plan and formulate a patient. By setting up a treatment plan and performing treatment, treatment, etc. based on the plan, not only can the burden on the patient be reduced, but also the maximum effect can be efficiently obtained.

  Therefore, when a medical professional formulates a treatment plan, as in Patent Document 1 or Patent Document 2 shown below, for example, a case similar to a case in which a patient who is a target of a treatment plan is affected The invention which can refer to the information about is disclosed.

JP 2007-287018 A JP 2007-287027 A

  However, in the invention disclosed in Patent Document 1 or Patent Document 2, the following points are not considered.

  In other words, the health care worker formulates a treatment plan based on various information about the patient for whom a treatment plan is to be formulated. Therefore, the treatment plan is not formulated separately from the patient's condition, and how to understand the patient's condition is important.

  On the other hand, as described above, there are various types of electronic data in the medical field. For example, the amount of medical images captured at one time using a medical image capturing apparatus is often enormous. When these medical images are used to formulate a treatment plan, the healthcare professional should recognize the prediction of disease progression, such as “when to take which drug, when and how to improve” by changes in the medical image. If it is possible, a more accurate treatment plan can be formulated.

  The invention described in Patent Document 1 or Patent Document 2 described above is limited to searching for cases similar to the current patient's disease. Therefore, even if it contributes to accurately diagnosing a patient's illness, it may not be easy to use when a treatment plan is formulated based on a general prediction of the future state.

  The present invention has been made to solve the above-described problems, and an object of the present invention is to grasp the progress of a disease from a medical image of a third party and use the medical progress of a patient whose treatment plan is to be determined. To provide a treatment plan development support device and a treatment plan development support system for applying a medical image to predict the progress of the disease of the patient on a medical image and assisting a medical worker in formulating a treatment plan It is in.

  According to a first aspect of the present invention, there is provided a medication / treatment information extracting unit for acquiring information on at least one of medication and treatment for a patient from a database storing information on treatment, A similar case in which a similar case image, which is a medical image similar to a patient's disease case, is extracted from medical images related to a third party different from the patient by performing a search including at least one of the treatment information in the search condition. Using the image extraction unit and the similar case image extracted by the similar case image extraction unit, information on the change in the region of interest in the similar case image is obtained, and based on the information on the change in the region of interest, the interest of the medical image related to the patient A treatment target image generation unit that generates a treatment target image indicating region change prediction and a display unit that displays the treatment target image are provided.

  According to a twelfth aspect of the present invention, in the treatment plan development support system, a medication / treatment information extraction unit for obtaining information on at least one of medication and treatment for a patient from a database storing information on treatment, and medication A similar case in which a similar case image, which is a medical image similar to a patient's disease case, is extracted from medical images related to a third party different from the patient by performing a search including at least one of the treatment information in the search condition. Using the image extraction unit and the similar case image extracted by the similar case image extraction unit, information on the change in the region of interest in the similar case image is obtained, and based on the information on the change in the region of interest, the interest of the medical image related to the patient A treatment plan formulation support apparatus comprising a treatment target image generation unit that generates a treatment target image indicating region change prediction and a display unit that displays the treatment target image A medical image capturing apparatus that captures a medical image relating to a patient for which a treatment plan is to be formulated, and a database that stores similar case images necessary for the formulation of a treatment plan, which are medical images acquired by the medical image capturing apparatus With.

It is a block diagram which shows the whole structure of the treatment plan formulation support system including the treatment plan formulation support device in the embodiment. It is a block diagram which shows the internal structure of the treatment plan formulation assistance apparatus in embodiment. It is a block diagram which shows the internal structure of the treatment plan formulation assistance part in embodiment. It is a flowchart which shows the flow of formulation of the treatment plan in embodiment. It is a flowchart which shows the flow of formulation of the treatment plan in embodiment. It is an example of a screen which shows an example of the display of the treatment plan formulated in embodiment. It is a flowchart which shows the flow of a treatment plan update in embodiment. It is a flowchart which shows the flow of a treatment plan update in embodiment.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

  FIG. 1 is a block diagram illustrating an overall configuration of a treatment plan formulation support system S including a treatment plan formulation support device 1 according to an embodiment. The treatment plan formulation support system S includes a treatment plan formulation support device 1, an information terminal 2, a medical image photographing device 3, a database 4, and a communication network N that connects them to each other.

  The treatment plan development support system S may be configured as an independent system, for example, a hospital information management system (HIS), a radiology information management system (RIS), a medical image, for example. The management system (PACS: Picture Archiving Communication System) may be configured to constitute all or a part of various management systems built in a medical institution.

  The treatment plan formulation support device 1 is a device used when a medical worker such as a doctor or an engineer formulates a treatment plan for a patient, and is a device that assists the medical worker in formulating a treatment plan. Various pieces of information related to a patient for which a treatment plan is formulated is acquired from, for example, the database 4 via the communication network N.

  In the embodiment of the present invention, the treatment plan formulation support device 1 is configured as an independent device for convenience of explanation. However, for example, the information terminal can be used as the treatment plan formulation support device 1 by starting a treatment plan formulation support application described later on an information terminal installed in the medical institution.

  The treatment plan formulation support device 1 may be, for example, an information terminal such as a personal computer used by a workstation or a medical worker, or a medical image diagnostic device (modality).

  The information terminal 2 is a workstation used when a medical worker uses a medical image to examine a patient or interprets a medical image. In the embodiment of the present invention, the treatment plan is described on the premise that the treatment plan is formulated in the above-described treatment plan formulation support apparatus 1. For example, by using an application that supports the formulation of a treatment plan, As described above, a treatment plan can be formulated in the information terminal 2.

  The medical image photographing apparatus 3 is an apparatus that photographs a subject as a patient and acquires internal information thereof. Examples of the medical imaging apparatus 3 include an X-ray CT apparatus (computed tomography) and a magnetic resonance imaging apparatus (MRI).

  The database 4 is a storage device that stores medical images of patients taken by the medical image photographing device 3. In addition, for example, electronic data such as information related to a patient, treatment performed on a patient, and information on an electronic medical record is stored.

  Here, it is assumed that all information (electronic data) handled in the medical institution is stored in the database 4, but a database may be provided in accordance with the stored information. Further, the database itself may be provided outside the medical institution separately from the various systems constructed in the medical institution. In this case, a necessary database is accessed via the communication network N constructed in the medical institution, for example, via the Internet network. Therefore, it is good also as a structure which the treatment plan formulation assistance apparatus 1 acquires the various information required in formulating a treatment plan using a cloud system.

  Further, as described above, the database 4 is assumed as a place for storing various kinds of information, and the following description will be made based on this assumption. However, as a method of storing various information, a file system may be used in addition to the method of storing in the database 4. Furthermore, for example, for medical images, the DICOM method may be used as the storage method, or the JPEG format may be used.

  In the treatment plan formulation support system S shown in FIG. 1, a state in which the treatment plan formulation support device 1, the information terminal 2, and the medical image photographing device 3 are connected to the communication network N one by one is shown. . However, the number of these devices connected to the communication network N may be singular or plural, and the number is arbitrary.

  The communication network N connects the treatment plan formulation support device 1, the information terminal 2, the medical image photographing device 3, and the database 4, and enables, for example, exchange of medical image information between them. Examples of the communication network N include a network such as a LAN (Local Area Network) and the Internet. The communication standard used in the communication network N may be any standard such as DICOM (Digital Imaging and Communication in Medicine).

  FIG. 2 is a block diagram showing an internal configuration of the treatment plan formulation support apparatus 1 according to the embodiment of the present invention.

  In the treatment plan formulation support apparatus 1, a central processing unit (CPU) 1a, a read only memory (ROM) 1b, a random access memory (RAM) 1c, and an input / output interface 1d are connected via a bus 1e. An input unit 1f, a display unit 1g, a communication control unit 1h, a storage unit 1i, and a removable disk 1j are connected to the input / output interface 1d.

  The CPU 1a reads out and executes a boot program for starting up the treatment plan formulation support apparatus 1 from the ROM 1b based on an input signal from the input unit 1f, and reads out various operating systems stored in the storage unit 1i. The CPU 1a controls various devices based on input signals from other external devices not shown in FIG. 2 via the input unit 1f and the input / output interface 1d.

  Further, the CPU 1a reads out the program and data stored in the RAM 1c, the storage unit 1i, etc., loads them into the RAM 1c, and performs processing and data processing for generating the treatment target image based on the command of the program read out from the RAM 1c. It is a processing device that implements a series of processing such as calculation and processing.

  The input unit 1f is composed of input devices such as a keyboard and a dial through which an operator (medical worker) of the treatment plan development support apparatus 1 inputs various operations, and creates an input signal based on the operation of the operator The data is transmitted to the CPU 1a via the bus 1e.

  The display unit 1g is a liquid crystal display, for example. The display unit 1g receives an output signal from the CPU 1a via the bus 1e, and displays, for example, a medical image of a patient necessary for formulating a treatment plan, a processing result of the CPU 1a, and the like. The number of monitors is not limited as the display unit 1g, and even if there are a single monitor or a plurality of monitors, it is handled as the display unit 1g.

  The communication control unit 1h is a means such as a LAN card or a modem, and is a means that enables the treatment plan formulation support apparatus 1 to be connected to a communication network N such as the Internet or a LAN. Data transmitted / received to / from the communication network N via the communication control unit 1h is transmitted / received to / from the CPU 1a via the input / output interface 1d and the bus 1e as input signals or output signals.

  The storage unit 1i is composed of a semiconductor or a magnetic disk, and stores programs and data executed by the CPU 1a.

  The removable disk 1j is an optical disk or a flexible disk, and signals read and written by the disk drive are transmitted to and received from the CPU 1a via the input / output interface 1d and the bus 1e.

  In the embodiment of the present invention, the treatment plan formulation support uses an application used when formulating a treatment plan stored in the removable disk 1j. The treatment plan formulation support application is used when formulating a treatment plan related to a patient, and presents various information necessary for formulating a treatment plan to a medical staff. By activating the treatment plan formulation support application, the treatment plan formulation support apparatus 1 is provided with a function for providing support necessary when formulating a treatment plan.

  The application itself may not be stored in the removable disk 1j but may be stored in the storage unit 1i, for example. Furthermore, it may be placed on a network outside the medical institution.

  In addition, without using a treatment plan formulation support application in this way, a treatment plan by a medical worker is installed in the treatment plan formulation support apparatus 1 by, for example, installing a device or a circuit as a treatment plan formulation support unit. It may be possible to support the formulation of

  FIG. 3 is a block diagram illustrating an internal configuration of the treatment plan formulation support unit 10 implemented in the treatment plan formulation support apparatus 1 as a result of the activation of the treatment plan formulation support application. The treatment plan formulation support unit 10 includes, for example, a transmission / reception unit 11 that exchanges information with the input unit 1f or the display unit 1g, a patient information acquisition unit 12, a medical information acquisition unit 13, and medication / treatment information. The extraction unit 14, the similar case image extraction unit 15, the treatment target image generation unit 16, the importance calculation unit 17, and the imaging condition acquisition unit 18 are configured.

  The function and function of each part constituting the inside of the treatment plan formulation support unit 10 will be described as appropriate in the treatment plan formulation flow described below.

  4 and 5 are flowcharts showing the flow of formulation of a treatment plan in the first embodiment. Here, first, explanation will be given on the assumption that a treatment plan is first formulated for a patient.

  A medical worker activates a treatment plan formulation support application in the treatment plan formulation support apparatus 1 when formulating a treatment plan. The treatment plan formulation support apparatus 1 detects that the treatment plan formulation support application has been activated (ST1). In the flowchart shown in FIG. 4, the application is indicated as “application”.

  When it is detected that the treatment plan formulation support application has been started up in the treatment plan formulation support apparatus 1, whether the medical staff intends to formulate a new treatment plan or update of a treatment plan that has already been formulated Figure out what is intended. Here, as described above, the case where a new treatment plan is formulated will be described as an example, so that the treatment plan formulation support apparatus 1 grasps a request for new formulation of a treatment plan by a healthcare worker (ST2).

  A treatment plan is a plan for treating a particular patient. Therefore, it is assumed that there is a patient to whom the treatment plan is applied. Of course, there are a lot of information that should be taken into consideration, such as the disease of the subject patient and the characteristics of the body. Therefore, the medical staff inputs information about the patient to whom the treatment plan is to be formulated through the input unit 1f. The treatment plan development support apparatus 1 grasps the input patient information (ST3).

  The patient information input here is, for example, basic information such as a patient ID or a name and sex. The treatment plan formulation support unit 10 of the treatment plan formulation support apparatus 1 obtains detailed information of the patient who is the target of the treatment plan from the various databases 4, but the information used here acquires various information from the database to the last. This is the information that triggers. Therefore, as described above, at this stage, it is only necessary to grasp only very simple information regarding patient information.

  First, the patient information acquisition unit 12 accesses the database 4 via the communication network N, and acquires information on a patient who is a target of a treatment plan (ST4). Specifically acquired information includes patient basic information and vital information. Here, “basic patient information” refers to information related to the patient, such as the patient's name, age, gender, address, customs, past hospitalization history, and the like. On the other hand, “vital information” refers to biological information such as a patient's height, weight, blood type, blood pressure, body temperature, and pulse.

  Next, the medical information acquisition unit 13 accesses the database 4 via the communication network N, and acquires the medical information of the patient who is the target of the treatment plan (ST5). Here, the “medical information” includes various information handled in the medical institution such as the name of the patient's disease, the treatment performed on the patient and the result, information on medication, information on medical records, medical images taken, etc. .

  As described above, various apparatuses are assumed as the medical image capturing apparatus 3 connected to the treatment plan formulation support system S. Accordingly, there are various types of medical images such as CT images, MR images, X-ray images, or ultrasonic images. Further, when stored in the database 4, not only the medical image itself but also information on the medical image and attached information accompanying the information are stored together. The attached information includes information (patient ID, vital information, etc.) for identifying a patient that is the basis of the medical image, an image ID for identifying a medical image, information about a photographed device (medical image photographing device 3), and the like. is there.

  Among the acquired medical information, the latest medical image of the patient who is the target of the treatment plan is once held in the medical information acquisition unit 13 and then displayed on the display unit 1g as will be described later, the medical information acquisition unit 13 Is transmitted to the display unit 1g and displayed. The latest medical image of the patient only needs to be able to be compared with the treatment target image when the treatment plan is finally formulated, and may be acquired at any stage.

  Further, the latest medical image of the patient that is the target of the treatment plan acquired by the medical information acquisition unit 13 is transmitted to the treatment target image generation unit 16 described later. Note that the latest medical image may be transmitted to the treatment target image generation unit 16 via the medication / treatment information acquisition unit 14 and the similar case image extraction unit 15.

  On the other hand, the medication / treatment information extraction unit 14 extracts medication or at least one medication information or treatment information from the medical information acquired by the medical information acquisition unit 13 (ST6). These extracted medication information and treatment information are used when searching and extracting similar case images described later. Here, “medicine information” is, for example, information such as a medicinal drug that is grasped by using medical record data and a drug master included in the medical information. The drug master may be stored in the database 4 or may be stored in the storage unit 1 i of the treatment plan formulation support apparatus 1. “Treatment information” is information relating to treatment performed on a patient for which a treatment plan is to be formulated. As for this treatment information, all the treatment information related to the patient may be extracted, or only information related to a predetermined treatment period may be extracted.

  The “basic patient information” acquired by the patient information acquisition unit 12 and the “medicine information” and “treatment information” extracted by the medication / treatment information extraction unit 14 are sent to the similar case image extraction unit 15. The similar case image extraction unit 15 searches and extracts medical images indicating similar cases stored in the database 4 using these pieces of information (ST7).

  Specifically, as described above, for the medical images stored in the database 4, since the auxiliary information is also stored, for example, the similar case image extraction unit 15 is the basic information of the patient. Search using the patient's age, sex, or vital information.

  The medical image searched and extracted here is a medical image of a third party different from the patient for which the treatment plan is to be formulated. This third party is a person who suffers from the same disease or has similar vital information. Therefore, it can be said that the patient is different from the patient, but is not a person who is not related at all to a disease or the like and has a similar item in some item.

  The similar case image is searched in consideration of the latest medical image of the patient who is the target of the treatment plan. This is because even a third party having an item similar to the patient in some item cannot be used by searching and extracting a completely different medical image (for example, a medical image having a different part).

  Here, the reason why such a third-party medical image is searched and extracted is that, as will be described in detail later, it is desired to grasp the temporal change of the disease (region of interest) in the third-party. In particular, if it is possible to search and extract a medical image of a third party for which treatment has been completed, it is very helpful in formulating a treatment plan for the patient. For this purpose, a medical image relating to a third party having items similar to a patient for which a treatment plan is to be formulated is extracted.

  When the similar case image extraction unit 15 searches for and extracts similar case images from the database 4, as described above, in addition to using basic patient information, for example, medication information and treatment information are also used. For example, even if the disease is the same, if similar drugs are used for treatment, similar case images relating to the respective drugs may be extracted. Or when the information regarding the medicine normally taken is included in the basic information of the patient, only a similar case image related to the medicine may be extracted.

  The similar case image extraction unit 15 searches and extracts medical images stored in the database 4 based on the basic information, vital information, and medication / treatment information of the patient. At this time, it may be narrowed down in order based on these conditions. Alternatively, it is possible to search in parallel based on all conditions, or to search and extract medical images corresponding to all these conditions from the beginning.

  Until the search and extraction of similar case images in the similar case image extraction unit 15 are completed, the search and extraction processes as described above are performed (ST8). A plurality of medical images are extracted here. This is because it is necessary to grasp the temporal change of the region of interest in the third party from the similar case images as described above.

  It should be noted that the range may be set in advance by a medical worker when performing similar case image search and extraction processing. Examples of the range to be set include a time range. For example, it is possible to narrow down the range of similar case images to be searched by performing settings such as weekly until one month after the start of medication.

  When the extraction is completed (YES in ST8), the extracted medical image (similar case image) is transmitted from the similar case image extraction unit 15 to the treatment target image generation unit 16. Here, the “treatment target image” is a medical image in which a temporal change in a region of interest that can be grasped from a similar case image is applied to a medical image of a patient for which a treatment plan is to be formulated.

  That is, the value target image generation unit 16 grasps the change based on the information on the change of the region of interest in the extracted similar case image and converts it into a function (ST9). For example, attached information is included in medical images retrieved and extracted as similar case images. In interpretation or medical examination using a medical image, for example, the size, volume, diameter, and the like of a region of interest are measured and digitized, and the change is grasped. Various measured numerical values (area, volume, diameter, etc.) are recorded as attached information of the medical image.

  The numerical value change thus grasped is extracted from a plurality of medical images (similar case images) and replaced with some function. This is shown here as “functionalization”. For example, when a certain medicine is administered to a third party, for example, when the area of the region of interest gradually decreases with time, a value indicating the area is functionalized. This functionalization process is performed for each series of extracted similar case images.

  The function calculated in the similar case image generation unit 16 is applied (applied) to the latest medical image of the patient ascertained in advance (ST10 in FIG. 5). As described above, information regarding the latest medical image of the patient acquired by the medical information acquisition unit 13 is held by the treatment target image generation unit 16. Therefore, a function is applied to the latest medical image of the patient, and how the medical image changes, and the changed medical image is held.

  Here, the similar case image extraction unit 15 searches and extracts medical images that match the conditions from among a large number of medical images stored in the database 4 using, for example, basic patient information. However, even if a medical image that matches the conditions indicated by the basic information of the patient is retrieved and extracted, there is a possibility that the amount (number of sheets) may be enormous in some cases. If all of these extracted medical images are functionalized and applied to the latest medical image of the patient, the number of treatment target images to be referred to when a medical worker formulates a treatment plan also increases. This can make it difficult for healthcare professionals to develop an appropriate treatment plan.

  Therefore, if the medical staff displays in advance which treatment target image matches the item to be displayed on the display unit 1g, or if the importance of the importance is determined and set, a huge amount of treatment target images can be displayed. Can be avoided.

  The importance level calculation unit 17 confirms whether or not the importance level is set by the medical staff (ST11), and if there is a setting, displays the treatment target image generated based on the setting on the display unit 1g ( ST12).

  Here, “importance” is the following concept. That is, when a huge amount of medical images are extracted as similar case images and functionalized, applying all of these functions to the latest medical image of the patient generates a huge amount of treatment target images. Become. In such a state, it can be said that from which image to be treated is displayed on the display unit 1g, a reference for determining the display order. Therefore, the treatment target image displayed differs depending on how importance is set by the medical staff.

  When selecting an importance level, for example, it is determined in combination with medication information. That is, when a certain drug is prescribed to multiple third parties, when the drug is taken, 25% of the patients have a ½ disease size, 30% have a 1/3 disease, Suppose there are 4% of people who became / 5. In such a case, when a drug for a certain disease is administered, many people are likely to have a disease size of 1/3 at this rate (30% rate).

  In other words, rather than generating and displaying a treatment target image based on a similar case image that can occur with a probability of 4% in relation to the similar case image and the drug, the treatment target is based on a similar case image that can occur with a probability of 30%. It can be said that it is appropriate and efficient to generate and display an image to support a medical worker in making a decision on a treatment plan. Therefore, the functionalization using the similar case image is performed using the image of the person who has become 1/3, and the treatment target image of the patient is generated using this function.

  In particular, when an image to be treated is generated by performing functionalization processing so that the disease is improved, a similar case image under the most effective condition among various similar case images By generating an image to be treated based on the above, a medical staff can formulate a more realistic treatment plan.

  On the other hand, depending on the conditions, there is also information necessary to make sure that the patient does not fall into that state when formulating a treatment plan such as the presence or absence of side effects, the presence or absence of sequelae, or the survival rate. When reflecting such information in the treatment plan, generate treatment target images based on similar case images that frequently cause side effects and sequelae, and display the importance as “high” in descending order of frequency. It is also possible. By selecting the importance in this way and displaying them in the order of importance, the medical staff can sufficiently avoid the danger.

  By determining the items that the medical staff considers important and displaying the treatment target image along the contents, it is possible to support the formulation of a treatment plan that is maximally in line with the medical staff's intention.

  Furthermore, in addition to the generated treatment target image, additional information accompanying a similar case image that is a basis for generating the treatment target image may be displayed together. For example, when an importance level related to medication is set and an image to be treated is generated and displayed based on medication information, additional information about medication (for example, what interval should be taken or what Etc.) can also be displayed together.

  Further, in the information attached to the similar case image that is the basis for generating the treatment target image, when there is information related to the complication, the information related to the complication can be displayed together. If information on complications is included in the extracted similar case images, there is a possibility that complications may develop even for the subject patient. Therefore, when formulating a treatment plan, it is possible to respond so that contraindicated drugs are not displayed and complications do not occur.

  The similar case image acquired by the similar case image acquisition unit 15 includes information regarding imaging conditions when the similar case image is captured as attached information. The imaging condition acquisition unit 18 acquires information related to the treatment target image to be displayed from the treatment target image generation unit 16, and sets the imaging conditions regarding the similar case image that is the basis for generating the treatment target image to the similar case image extraction unit. 15 from. Then, it is displayed on the display unit 1g together with the treatment target image (ST13).

  In the case where imaging conditions are not included as attached information, for example, the database 4 is accessed again via the medical information acquisition unit 13 using an ID for identifying the searched similar case image, and the imaging conditions are set. You may make it acquire.

  With the above, for the patients who are the target of the treatment plan, the latest medical images required at the time of formulating a new treatment plan, and the treatment that shows changes in the future disease when treatment is performed according to certain conditions The target image is displayed on the display unit 1g. Of course, as described above, additional information related to the treatment target image is also displayed. As a result, information necessary for the medical staff to formulate a treatment plan for the patient is displayed on the display unit 1g, and treatment plan formulation can be supported. The healthcare worker formulates a treatment plan based on the displayed various information (ST14).

  FIG. 6 is a screen example showing an example of a display of a treatment plan formulated in the embodiment.

  In FIG. 6, two monitors constituting the display unit 1g are shown. There is no particular limitation on the number of monitors, and it may be singular or plural. Here, the treatment target image is shown on the left monitor M1. Here, the right monitor M2 shows various information related to the treatment target image, for example, the type of medicine, the dosing period, the interval, the imaging condition, and the like in the form of an electronic medical record.

  For example, various conditions such as imaging conditions and information regarding the treatment target image may be displayed by any display method. In addition, what kind of conditions and information are to be displayed can be freely set by a medical worker using the treatment plan development support system S.

  A treatment target image is displayed on the left monitor M1. The displayed treatment target image is generated based on a function of temporal changes in similar case images. Accordingly, a plurality of treatment target images are generated every time. Therefore, in the monitor M1 shown in FIG. 6, radio buttons indicating the passage of time such as “after one week”, “after two weeks”, and “after three weeks” are provided at the top. For example, when a medical worker clicks a radio button of “2 weeks later”, a treatment target image that indicates a change in a disease that is expected to appear two weeks after the present time of formulating a treatment plan is displayed.

  In FIG. 5, the treatment target image is shown on the right side, and the latest medical image at the present time of the patient for comparison (when the treatment plan is formulated) is displayed on the left side. By displaying such two images side by side, it is possible to grasp and confirm the change in the disease of the patient at the time of, for example, two weeks from now with the medical image.

  Of course, there is no guarantee that the disease will change as indicated in the image to be treated after 2 weeks, and the image to be treated itself is an image for estimating the future change of the disease. However, in view of the fact that a treatment target image is generated based on a change in a third party's disease that is similar in some condition or item to a patient for whom a treatment plan is to be formulated, a medical staff will formulate a treatment plan It can be said that the image can be used as a reference sufficiently.

  As described above, the treatment target image is an image generated by taking into account the temporal change of the disease change in the future. In the screen example shown in FIG. 5, the time element can be specified with a radio button. However, for example, it may be specified by inserting a specific date such as “○ days later”. . Alternatively, it is also possible to continuously display disease changes by providing a scroll bar and operating the scroll bar. Furthermore, it is possible to clearly indicate a change in the region of interest by representing the region of interest with an arrow, for example.

  The treatment target image is displayed according to the importance based on the setting of the medical staff. When a medical professional formulates a treatment plan, the treatment image with the highest importance is first referenced, but the treatment image to be referenced may not necessarily be the treatment image with the highest importance. . Therefore, in the monitor M1 shown in FIG. 6, two treatment target images are displayed in advance in descending order of importance on the left side of the screen. If displayed in this way, the medical staff will be able to display three treatment target images in descending order of importance in addition to the latest medical image at the present time, which is considered to be very useful in formulating a treatment plan.

  The display layout on the monitor M1 can be arbitrarily set. In addition, here, the treatment object image having the second highest importance and the treatment object image having the third highest importance are respectively displayed. For example, among the treatment object images having different conditions (importances), It is good also as displaying the treatment object image which shows the highest importance in each importance. By displaying in this way, it is possible to examine a treatment plan taking into account a plurality of viewpoints simultaneously as well as one viewpoint when formulating a treatment plan.

  Up to this point, the flow when a health care worker newly formulates a treatment plan has been described. However, the formulation of a treatment plan is not always limited to the formulation of a new treatment plan, and it may be possible to review the treatment plan once established. In the following, updating of a treatment plan that has already been formulated will be described.

  The treatment plan is formulated such that treatment, medication, or surgery is performed using a method most suitable for the patient at the time of formulation. As a support method for this purpose, as described above, the treatment target image is supported by the medical staff by displaying the treatment target image and showing temporal changes in the region of interest.

  However, even if the treatment is performed based on the treatment plan once formulated, there may be a case where the effect assumed when the treatment plan is formulated does not appear. In addition, there may be new developments that were not known at the time of formulating a treatment plan, such as the development of a new procedure or the release of a new drug while treatment was being performed according to the treatment plan. is there. In such a case, the treatment plan is updated.

  FIG. 7 and FIG. 8 are flowcharts showing the flow of treatment plan update in the embodiment. In order for the medical staff to update the treatment plan, first, a treatment plan formulation application is activated (ST1). Up to this point, it is the same as the new formulation. There are several ways to ask a healthcare professional to ask whether a treatment plan is new or a treatment plan is updated. For example, a treatment plan formulation application is launched. After that, there may be a method in which an icon indicating a new treatment plan and an icon indicating an update are displayed on the display unit 1g and selected.

  When the treatment plan development support apparatus 1 grasps the selection of a medical worker, that is, an update request (ST21), the treatment plan to be updated is specified (ST22). In order to specify this treatment plan, for example, when there is an ID assigned to the treatment plan, it is possible to specify the treatment plan to be updated by directly inputting the treatment plan ID. It is. Furthermore, a method of specifying a treatment plan to be updated by specifying a patient to be a target of the treatment plan to be updated is also conceivable. Then, the specified treatment plan is retrieved from the database 4 and displayed (ST23).

  After the treatment plan to be updated is displayed, the update is performed in accordance with the procedure for redefining the treatment plan as described above. That is, an appropriate image is searched and extracted as a similar case image from medical images stored in the database 4 using the basic information, vital information, and medication / treatment information of the patient again. Then, the change of the region of interest of the extracted similar case image is grasped in time and converted into a function. The calculated function is applied to the latest medical image of the patient, and a change in the future disease of the patient for which a treatment plan is to be formulated is generated as a treatment target image. In addition to the display of these treatment target images, various conditions such as imaging conditions and items are also displayed (see ST4 to ST13 in FIGS. 7 and 8).

  The display unit 1g displays the latest medical image of the patient at the present time (here, the latest medical image in the middle of treatment according to the treatment plan) and a new treatment target image. . By displaying in this way, the medical staff can grasp the reason why the effect assumed in the current treatment plan (treatment plan before update) does not appear.

  In addition, a certain period has elapsed between the time when the current treatment plan is formulated and the time when the update process is being performed, during which a new medical image is stored in the database 4. The possibility is high. Therefore, even when a treatment plan is formulated for the same patient, different functions are used when generating a treatment target image. This difference also encourages healthcare professionals to adopt new treatment plans.

The medical staff confirms the newly displayed treatment target image and its conditions, updates the treatment plan, and confirms it (ST24).
As explained above, the progress of disease is grasped from a third-party medical image, and the progress is applied to the medical image of the patient for whom the treatment plan is formulated, thereby predicting the progress of the disease of the patient. It is possible to provide a treatment plan formulation support device and a treatment plan formulation support system that are shown on an image and that assist a medical worker in formulating a treatment plan.

  In addition, by providing treatment plan formulation support in the treatment plan formulation support apparatus 1, a medical worker can formulate an appropriate treatment plan after grasping the patient's condition. This has the advantage that if the treatment is performed according to the treatment plan, it is possible to avoid receiving a safer and useless treatment with less burden on the patient.

  Furthermore, when the treatment plan is appropriately formulated and updated, the treatment plan formulation support apparatus 1 may notify the proposal, the alternative, and the like. For example, the database also stores treatment plans that have been formulated so far, and also searches for and extracts treatment plans that were previously formulated using similar case images when searching and extracting similar case images. By displaying the information, it is possible to assist the medical staff in formulating a treatment plan.

  Although an embodiment of the present invention has been described, this embodiment is presented as an example and is not intended to limit the scope of the invention. This embodiment can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the spirit of the invention. This embodiment and its modifications are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

DESCRIPTION OF SYMBOLS 1 Treatment plan formulation assistance apparatus 2 Information terminal 3 Medical imaging device 4 Database 11 Transmission / reception part 12 Patient information acquisition part 13 Medical information acquisition part 14 Medication / treatment information acquisition part 15 Similar case image extraction part 16 Treatment object image generation part 17 Important Degree calculation unit 18 Shooting condition acquisition unit

Claims (12)

A medication / treatment information extraction unit for obtaining information on at least one of medication and treatment for a patient from a database storing information on treatment;
A similar case image which is a medical image similar to the patient's disease case among medical images relating to a third party different from the patient by performing a search including at least one of the medication / treatment information as a search condition A similar case image extraction unit for extracting
Using the similar case image extracted by the similar case image extraction unit, information on the change of the region of interest in the similar case image is obtained, and based on the information on the change of the region of interest, the interest of the medical image regarding the patient A treatment target image generation unit for generating a treatment target image indicating a change prediction of a region;
A display unit for displaying the treatment target image;
A treatment plan development support device characterized by comprising:   The treatment according to claim 1, wherein the treatment target image generation unit grasps the change in the region of interest in the similar case image as a function, and applies the function to the medical image related to the patient. Planning support device.   The treatment plan formulation support device according to claim 1 or 2, wherein the treatment target image generation unit grasps a change in the region of interest in the similar case image by a numerical value.   The treatment plan formulation according to any one of claims 1 to 3, further comprising an importance level calculation unit that calculates an importance level for each of the treatment target images when displaying the generated treatment target image. apparatus.   The said importance calculation part calculates importance along the item designated by the said medical worker who uses the said treatment plan preparation apparatus, The Claim 1 thru | or 4 characterized by the above-mentioned. Treatment plan development support device.   6. The treatment plan formulation support apparatus according to claim 1, wherein the display unit displays the treatment target image based on the importance calculated by the importance calculation unit. .   Information on at least one of medication and treatment for the patient acquired by the medication / treatment information extraction unit is information acquired in a medical information acquisition unit that acquires information on medical treatment and medical record information performed on the patient. The treatment plan formulation device according to claim 1, wherein the treatment plan formulation device is provided.   The said similar case image extraction part utilizes the information regarding the patient used as the object of formulation of the treatment plan acquired in a patient information acquisition part as said search conditions, The one of Claim 1 thru | or 7 characterized by the above-mentioned. Treatment planning device described in 1.   The treatment plan formulation according to any one of claims 1 to 8, wherein the treatment target image generation unit acquires information on complications included in the similar case image and displays the information on the display unit. Support device.   An imaging condition acquisition unit that grasps imaging conditions related to the similar case image based on generating the treatment target image, and displays the imaging conditions on the display unit. The treatment plan formulation support device according to claim 9.   When the patient information acquisition unit receives a request for updating an existing treatment plan by the medical staff, the treatment information is updated so that the treatment plan is updated by performing the same process as the new treatment plan. The treatment plan formulation support apparatus according to any one of claims 1 to 10, wherein the process is started. The treatment plan formulation support device according to any one of claims 1 to 11,
A medical image capturing device for capturing a medical image related to a patient for which a treatment plan is formulated;
A medical image acquired by the medical imaging apparatus, and a database storing similar case images necessary for the formulation of the treatment plan;
A treatment planning support system characterized by comprising:

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